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Migraine prevention — USMLE Step 3 MCQ

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HardAmbulatory Medicine / Primary CareMigraine preventionUSMLE Step 3

A 36-year-old woman has unilateral throbbing headaches with photophobia and nausea 8 days monthly. Neurologic examination is normal. Sumatriptan gives partial relief, but she misses work twice monthly. She is not pregnant and has no kidney stones or asthma. Which of the following would you recommend at the follow-up visit?

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

Reveal the answer and explanation

Correct answer: B — Start a preventive migraine medication

Frequent disabling migraines warrant preventive therapy when neurologic examination is normal and no red flags are present.

Reference: Current US clinical practice standards and USMLE Step 3 content outline, https://www.usmle.org/exam-resources/step-3-materials