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Meningism Recognition — MFDS Part 1 MCQ

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EasyHuman DiseaseMeningism RecognitionMFDS Part 1

During dental treatment, an adult develops an unexplained, extremely severe headache that reaches maximum intensity within 1 minute. They also have neck stiffness and photophobia. What is the most appropriate interpretation and immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Suspected subarachnoid haemorrhage; stop treatment and call 999

The correct answer is B. An extremely severe headache reaching maximum intensity within 1 minute is a thunderclap headache, a red flag for subarachnoid haemorrhage. Neck stiffness and photophobia further support this possibility. Dental treatment must be stopped and emergency help obtained by calling 999; definitive diagnosis requires urgent hospital assessment. Migraine can cause severe headache and photophobia, but a new thunderclap presentation must not be managed initially as migraine. Tension-type headache is not typically sudden, extremely severe or associated with meningism. A dental infection would require relevant local signs, while temporomandibular disorder causes musculoskeletal facial or jaw symptoms rather than thunderclap headache.

Reference: NHS, Subarachnoid haemorrhage, symptoms and immediate action sections, reviewed 2025. https://www.nhs.uk/conditions/subarachnoid-haemorrhage/