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Migraine without aura — USMLE Step 2 CK MCQ

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HardInternal MedicineMigraine without auraUSMLE Step 2 CK

A 55-year-old Native American woman comes to the urgent care clinic because of neurologic symptoms. History and focused examination are notable for recurrent unilateral throbbing headache with photophobia and nausea. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most likely diagnosis?

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Correct answer: B — Migraine without aura

The vignette describes Migraine without aura, supported by recurrent unilateral throbbing headache with photophobia and nausea. Migraine without aura is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: https://www.ncbi.nlm.nih.gov/books/#stage-9-order-17