Cluster headache — USMLE Step 3 MCQ

Instant feedback + full explanation. One question, done properly.

HardAmbulatory Medicine / Primary CareCluster headacheUSMLE Step 3

A 37-year-old has excruciating unilateral periorbital headaches lasting 45 minutes nightly for three weeks with ipsilateral tearing, nasal congestion, ptosis, and pacing. Which diagnosis is most likely?

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

Reveal the answer and explanation

Correct answer: A — Cluster headache

Short, recurrent severe orbital attacks with cranial autonomic features and agitation are cluster headache. Migraine lasts longer and patients often prefer stillness; neuralgia has much briefer shock-like pain.

Reference: International Classification of Headache Disorders: Cluster Headache: https://ichd-3.org/3-trigeminal-autonomic-cephalalgias/3-1-cluster-headache/