Giant cell arteritis — MCCQE Part 1 MCQ

Correct answer: A — Start high-dose glucocorticoids immediately and arrange temporal artery imaging or biopsy

Start high-dose glucocorticoids immediately and arrange temporal artery imaging or biopsy is the single best answer because the age, timing, examination findings and investigations in the vignette fit Giant cell arteritis better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Rheumatology Association guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Rheumatology Association guidance