Paramedic National Registry Practice

A patient had an argument with her husband and is now complaining of headache, nuchal tightness, and dizziness. What does this indicate?

1. Common cold

2. Adult meningitis

3. Stress-induced headache

4. Hyperventilation syndrome

The correct answer is: Adult meningitis

The symptoms presented by the patient—headache, nuchal tightness, and dizziness—warrant attention for a potential serious condition. Nuchal rigidity, or tightness in the neck, is a classic sign associated with meningitis, which is an inflammation of the protective membranes covering the brain and spinal cord. This inflammation can lead to increased intracranial pressure, resulting in severe headaches and any accompanying dizziness. In cases of meningitis, patients often describe their headaches as severe and debilitating, and the presence of nuchal rigidity is particularly notable. It indicates irritation of the meninges, which can occur in bacterial or viral meningitis scenarios. While stress-induced headaches can cause discomfort and tension, the specific combination of nuchal tightness and headache points towards a more serious condition that requires immediate medical attention. Furthermore, although hyperventilation syndrome can lead to dizziness and some headaches, it typically does not present with nuchal tightness. In considering all these factors, the combination of symptoms strongly supports the diagnosis of adult meningitis as the most plausible explanation for the patient’s condition.