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Takayasu arteritis — SCE Rheumatology MCQ

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ModerateVasculitisTakayasu arteritisSCE Rheumatology

A 28-year-old woman has limb claudication, dizziness, unequal arm blood pressures, absent radial pulse and MR angiographic aortic branch wall thickening. What is the most appropriate management?

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Correct answer: C — Start high-dose glucocorticoids with steroid-sparing immunosuppression

Start high-dose glucocorticoids with steroid-sparing immunosuppression is the single best answer because young age, pulse deficits and aortic branch involvement indicate Takayasu arteritis. The stem is testing management choice, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Migraine is less suitable because it fits a different clinical pattern or a different treatment threshold; Sarcoidosis, Aspirin monotherapy and Etanercept do not address the key discriminator in this vignette. Clinical pearl: in SCE-style rheumatology questions, autoantibodies, imaging and synovial fluid findings should be interpreted with the whole phenotype.

Reference: BSR/EULAR vasculitis recommendations; NICE technology appraisals; BNF