We are excited to see so many of you join our FMEP courses. Several of you have requested we continue to post more practice SAMPs, so here you go!

SAMP

A 27-year-old woman presents with headaches occurring 10 days per month. Unilateral throbbing with photophobia, worsened by movement. No neurological deficits. (8 points)

1. Most likely diagnosis? (1 point)
   1. Cluster headache
   2. Migraine without aura
   3. Tension-type headache
   4. Medication-overuse headache
   5. Temporal arteritis

   Answer: B

2. Best first-line acute treatment? (1 point)
   1. Opioids
   2. Triptans
   3. Amitriptyline
   4. Verapamil
   5. Acetazolamide

   Answer: B

3. Which is an indication for migraine prophylaxis? (1 point)
   1. 1 headache/month requiring bed rest
   2. 2 headaches/month relieved by NSAIDs
   3. ≥4 disabling headaches/month
   4. Patient request
   5. Headache triggered by chocolate

   Answer: C

4. Effective prophylactic options include: Select all that apply. (4 points)
   1. Propranolol
   2. Topiramate
   3. CGRP monoclonal antibodies
   4. Oxycodone
   5. Onabotulinum toxin A (if chronic)

   Answer: A, B, C, E

5. Which red-flag feature warrants urgent imaging? (1 point)
   1. Mild nausea
   2. Photophobia
   3. Thunderclap onset
   4. Family history of migraine
   5. Menstruation-related attacks

   Answer: C