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Neurological Disorders

A 21-year-old primigravida at 32 weeks’ gestation reports headaches occurring approximately every other day described as dull, located at the temporal and occipital region extending down into the neck and shoulders. Which of the below treatment strategies is least appropriate?

a. Massage

b. Ibuprofen as needed

c. Acetaminophen as needed

d. Local heat therapy and stress relief techniques

A 21-year-old primigravida at 26 weeks’ gestation reports bothersome headaches, occurring once or twice per week. She describes unilateral temporal throbbing headaches accompanied by nausea. She does endorse that prior to the onset of the headache she has noted seeing “sparkles” on occasion. She has experienced similar headaches in the past prior to pregnancy, but feels they are increasing in severity and frequency. What is the most appropriate diagnosis?

a. Chronic migraine

b. Tension headache

c. Migraine with aura

d. Migraine without aura

A 21-year-old primigravida at 26 weeks’ gestation reports bothersome headaches, occurring once or twice per week. She describes unilateral temporal throbbing headaches accompanied by nausea. She does endorse that prior to the onset of the headache she has noted seeing “sparkles” on occasion. She has experienced similar headaches in the past prior to pregnancy, but feels they are increasing in severity and frequency. Which drug would be the most appropriate therapy to be prescribed to be taken when necessary?

a. Propranolol

b. Amitriptyline

c. Magnesium oxide

d. Acetaminophen, isometheptene, dichloralphenazone (Midrin)

Which of the following seizure types is least likely to demonstrate a postictal state?

a. Focal

b. Absence

c. Eclamptic

d. Generalized

A 22-year-old woman presents for her annual well-woman exam. She reports a history of generalized seizure disorder which is well-controlled on levetiracetam. She desires pregnancy and you recommend initiation of folic acid supplementation. What is the most appropriate dose for this patient?

a. 1 mg

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