UKMLA PLAB AMC USMLE Prometric MCQ

Question Number 0695

Question:
A 56 year old male presents with acute progressive headache and neck and back pain. He has a history of multiple cerebral infarcts assumed secondary to embolization of a left ventricular clot for which he is treated with coumadin to prevent further left ventricular thromboemboli. On examination he has mild nuchal rigidity, confusion and disorientation, slow incomprehensible speech, but no localizing neurologic deficit. His hemoglobin and electrolytes are normal but his INR is 6.0. A likely diagnosis is

a) migraine
b) cluster headache
c) trigeminal neuralgia
d) sub-arachnoid hemorrhage
e) tension headache