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Thunderclap headache — DipIMC MCQ

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EasyMedical EmergenciesThunderclap headacheDipIMC

A woman develops an explosive occipital headache during exercise and vomits twice. She is photophobic but has no focal weakness. What is the most appropriate management?

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Correct answer: B — Transport to emergency care for possible subarachnoid haemorrhage

Option B is correct because Thunderclap headache with vomiting is subarachnoid haemorrhage until excluded. Option A is less appropriate because watchful waiting risks deterioration or delays definitive care; option D is less appropriate because the clinical risk exceeds that destination or timeframe. Option C is less appropriate because it is plausible in a different scenario but suboptimal for the features described; option E is less appropriate because analgesia is important but not sufficient as the primary intervention. Clinical pearl: in DipIMC-style questions, the best answer is the intervention that changes outcome earliest in the pre-hospital phase.

Reference: JRCALC Guidelines