skip to main content

Giant cell arteritis with visual symptoms — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardAcute Neurological PresentationsGiant cell arteritis with visual symptomsSCE Acute Medicine

A 51-year-old woman presents with acute neurological symptoms. Relevant history includes vascular, infectious or neuromuscular risk factors. On assessment, neurological examination shows focal or global dysfunction. Investigations show jaw claudication, scalp tenderness and transient monocular visual loss. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: AStart high-dose glucocorticoid immediately and arrange urgent specialist assessment

The key discriminator is that jaw claudication, scalp tenderness and transient monocular visual loss, which makes Start high-dose glucocorticoid immediately and arrange urgent specialist assessment the single best answer. Give targeted antidote or reversal therapy is less appropriate because it does not address the dominant acute risk in the vignette; Optimise chronic medication and discharge would fit a different presentation or later stage of care. Start broad-spectrum intravenous antibiotics and Start anticoagulation after assessing bleeding risk are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: BSR GCA guideline