Migraine with aura — MCCQE Part 1 MCQ

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ModerateHeadacheMigraine with auraMCCQE Part 1

A 28-year-old woman has recurrent unilateral throbbing headaches with photophobia and nausea, preceded by shimmering zig-zag lines for 20 minutes. Which of the following is the most likely diagnosis?

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Reveal the answer and explanation

Correct answer: E — Migraine with aura

Migraine with aura is the single best answer because the age, timing, examination findings and investigations in the vignette fit Migraine with aura better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Headache Society guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Headache Society guidance