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I-HUMAN NEUROLOGICAL CASES LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
i-Human Neurological Cases: 70 Questions with Rationales
DOMAIN 1: HISTORY OF PRESENT ILLNESS & OLD CARTS FRAMEWORK (15
Questions)
1. The nurse is interviewing an i-Human patient with a headache. Which of the
following is the MOST appropriate question to assess the "Character" of the pain?
A) "When did your headache start?"
B) "Is your headache throbbing or pressing?"
C) "Does anything make your headache worse?"
D) "Where exactly is the pain located?"
Answer: B) "Is your headache throbbing or pressing?"
Rationale: The OLD CARTS framework includes Character as a key component of
symptom description. Character describes the quality or nature of the symptom—in this
case, whether the headache is throbbing (migraine) or pressing (tension-type). Onset
(A), Aggravating factors (C), and Location (D) are separate components of OLD CARTS .
2. A 35-year-old i-Human patient reports the "worst headache of my life" for the
past two days. Which of the following is the MOST important red flag question to
ask NEXT?
A) "Have you had any fever or chills?"
B) "Do you have any family history of migraines?"
C) "Have you ever had a headache this bad before?"
D) "How much caffeine do you consume daily?"
Answer: C) "Have you ever had a headache this bad before?"
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Rationale: In an i-Human headache case, the question "Have you ever had a headache
this bad before?" is a critical red flag. A patient who reports this as the "worst headache
of my life" requires urgent evaluation for subarachnoid hemorrhage, meningitis, or other
serious conditions. This is a "must-not-miss" diagnosis .
3. In the i-Human Amanda Wheaton case, the patient reports photophobia and asks
to turn off the overhead light. This symptom is MOST consistent with:
A) Tension-type headache
B) Migraine headache
C) Cluster headache
D) Sinus headache
Answer: B) Migraine headache
Rationale: Photophobia (sensitivity to light) is a classic associated symptom of migraine
headaches. In the Amanda Wheaton i-Human case, the patient's photophobia, nausea,
and throbbing headache are characteristic of migraine without aura .
4. A patient reports visual aura described as "flashing zigzag lights" and "scotomas"
lasting approximately 20-30 minutes before headache onset. This presentation is
MOST consistent with:
A) Migraine with aura
B) Tension-type headache
C) Cluster headache
D) Transient ischemic attack
Answer: A) Migraine with aura
Rationale: Migraine with aura is characterized by fully reversible visual, sensory, or
speech symptoms that typically develop over 5-20 minutes and last less than 60
minutes. Visual aura (flashing lights, zigzag lines, scotomas) is the most common type.
In i-Human cases, the 20-30 minute duration before headache onset is classic .
5. An i-Human patient reports headaches that are "worse around my menstrual
cycle." This trigger is MOST characteristic of:
A) Tension-type headache
B) Migraine headache
C) Cluster headache
D) Medication overuse headache
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Answer: B) Migraine headache
Rationale: Hormonal changes, particularly around menstruation, are a well-
documented trigger for migraine headaches. In i-Human case studies, asking about
hormonal triggers is an important part of the headache history .
6. An i-Human patient with suspected migraine reports associated symptoms
including nausea, vomiting, and fatigue after headache resolution. These are
characteristic of:
A) Tension-type headache
B) Migraine headache
C) Cluster headache
D) Sinus headache
Answer: B) Migraine headache
Rationale: Nausea, vomiting, and postdrome fatigue are classic associated symptoms
of migraine headaches. In i-Human case studies, these symptoms help differentiate
migraine from tension-type headache .
7. A 28-year-old i-Human patient reports headaches occurring "two to three times a
month" with throbbing pain on one side. The MOST likely diagnosis is:
A) Tension-type headache
B) Migraine without aura
C) Cluster headache
D) Medication overuse headache
Answer: B) Migraine without aura
Rationale: Migraine without aura is characterized by recurrent headaches lasting 4-72
hours with unilateral location, pulsating quality, moderate to severe intensity, and
associated symptoms (nausea, photophobia, phonophobia). The frequency of 2-3 times
per month is consistent with episodic migraine .
8. In the OLD CARTS framework, a patient reports that their headache is "usually on
the right side." This corresponds to which component?
A) Location
B) Radiation
I-HUMAN NEUROLOGICAL CASES LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
i-Human Neurological Cases: 70 Questions with Rationales
DOMAIN 1: HISTORY OF PRESENT ILLNESS & OLD CARTS FRAMEWORK (15
Questions)
1. The nurse is interviewing an i-Human patient with a headache. Which of the
following is the MOST appropriate question to assess the "Character" of the pain?
A) "When did your headache start?"
B) "Is your headache throbbing or pressing?"
C) "Does anything make your headache worse?"
D) "Where exactly is the pain located?"
Answer: B) "Is your headache throbbing or pressing?"
Rationale: The OLD CARTS framework includes Character as a key component of
symptom description. Character describes the quality or nature of the symptom—in this
case, whether the headache is throbbing (migraine) or pressing (tension-type). Onset
(A), Aggravating factors (C), and Location (D) are separate components of OLD CARTS .
2. A 35-year-old i-Human patient reports the "worst headache of my life" for the
past two days. Which of the following is the MOST important red flag question to
ask NEXT?
A) "Have you had any fever or chills?"
B) "Do you have any family history of migraines?"
C) "Have you ever had a headache this bad before?"
D) "How much caffeine do you consume daily?"
Answer: C) "Have you ever had a headache this bad before?"
, Page 2 of 25
Rationale: In an i-Human headache case, the question "Have you ever had a headache
this bad before?" is a critical red flag. A patient who reports this as the "worst headache
of my life" requires urgent evaluation for subarachnoid hemorrhage, meningitis, or other
serious conditions. This is a "must-not-miss" diagnosis .
3. In the i-Human Amanda Wheaton case, the patient reports photophobia and asks
to turn off the overhead light. This symptom is MOST consistent with:
A) Tension-type headache
B) Migraine headache
C) Cluster headache
D) Sinus headache
Answer: B) Migraine headache
Rationale: Photophobia (sensitivity to light) is a classic associated symptom of migraine
headaches. In the Amanda Wheaton i-Human case, the patient's photophobia, nausea,
and throbbing headache are characteristic of migraine without aura .
4. A patient reports visual aura described as "flashing zigzag lights" and "scotomas"
lasting approximately 20-30 minutes before headache onset. This presentation is
MOST consistent with:
A) Migraine with aura
B) Tension-type headache
C) Cluster headache
D) Transient ischemic attack
Answer: A) Migraine with aura
Rationale: Migraine with aura is characterized by fully reversible visual, sensory, or
speech symptoms that typically develop over 5-20 minutes and last less than 60
minutes. Visual aura (flashing lights, zigzag lines, scotomas) is the most common type.
In i-Human cases, the 20-30 minute duration before headache onset is classic .
5. An i-Human patient reports headaches that are "worse around my menstrual
cycle." This trigger is MOST characteristic of:
A) Tension-type headache
B) Migraine headache
C) Cluster headache
D) Medication overuse headache
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Answer: B) Migraine headache
Rationale: Hormonal changes, particularly around menstruation, are a well-
documented trigger for migraine headaches. In i-Human case studies, asking about
hormonal triggers is an important part of the headache history .
6. An i-Human patient with suspected migraine reports associated symptoms
including nausea, vomiting, and fatigue after headache resolution. These are
characteristic of:
A) Tension-type headache
B) Migraine headache
C) Cluster headache
D) Sinus headache
Answer: B) Migraine headache
Rationale: Nausea, vomiting, and postdrome fatigue are classic associated symptoms
of migraine headaches. In i-Human case studies, these symptoms help differentiate
migraine from tension-type headache .
7. A 28-year-old i-Human patient reports headaches occurring "two to three times a
month" with throbbing pain on one side. The MOST likely diagnosis is:
A) Tension-type headache
B) Migraine without aura
C) Cluster headache
D) Medication overuse headache
Answer: B) Migraine without aura
Rationale: Migraine without aura is characterized by recurrent headaches lasting 4-72
hours with unilateral location, pulsating quality, moderate to severe intensity, and
associated symptoms (nausea, photophobia, phonophobia). The frequency of 2-3 times
per month is consistent with episodic migraine .
8. In the OLD CARTS framework, a patient reports that their headache is "usually on
the right side." This corresponds to which component?
A) Location
B) Radiation
