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photophobia

Practice targeted AMC-style multiple-choice questions on photophobia.

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A 32-year-old woman presents to the emergency department with sudden onset of severe headache, nausea, and photophobia. She has no significant past medical history and is not on any medications. On examination, she is alert but in distress due to the headache. Her vital signs are stable, and there is no neck stiffness. A CT scan of the head is performed and shows no abnormalities. What is the most appropriate next step in the management of this patient?

A. Consult neurology for further evaluation
B. Administer intravenous analgesics and observe
C. Order an MRI of the brain
D. Discharge with oral analgesics and follow-up
E. Perform a lumbar puncture
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A 45-year-old man presents to the emergency department with sudden onset of severe headache, described as the worst headache of his life. He also reports nausea and photophobia. On examination, he is alert but in distress, with a blood pressure of 160/100 mmHg, heart rate of 90 bpm, and no focal neurological deficits. A CT scan of the head is performed and shows no acute intracranial hemorrhage. What is the most appropriate next step in management?

A. MRI of the brain
B. Administer analgesics and observe
C. Start antihypertensive therapy
D. Lumbar puncture
E. Repeat CT scan with contrast
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A 45-year-old woman presents to the emergency department with sudden onset of severe headache, described as the worst headache of her life. She also reports nausea and photophobia. Her past medical history is significant for hypertension, which is poorly controlled. On examination, she is alert but in distress, with a blood pressure of 180/110 mmHg, heart rate of 90 bpm, and temperature of 37°C. Neurological examination reveals neck stiffness but no focal neurological deficits. A CT scan of the head is performed and shows no acute intracranial hemorrhage. What is the next best step in management?

A. Lumbar puncture
B. Start intravenous labetalol
C. MRI of the brain
D. Administer sumatriptan
E. Repeat CT scan with contrast
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