A 72-year-old woman has a new temporal headache, scalp tenderness, and jaw fatigue while chewing. ESR is 102 mm/h. Visual acuity is normal. There is

Question

A 72-year-old woman has a new temporal headache, scalp tenderness, and jaw fatigue while chewing. ESR is 102 mm/h. Visual acuity is normal. There is no fever or meningismus, and biopsy can be arranged later in the week. Which of the following is the most appropriate next step in management?

Accepted Answer

Start high-dose glucocorticoids immediately

Answer

Wait for temporal artery biopsy before treatment

Answer

Start low-dose aspirin as sole therapy

Answer

Order sinus radiography first

Answer

Treat with sumatriptan and observe

Giant cell arteritis — USMLE Step 3 MCQ

A 72-year-old woman has a new temporal headache, scalp tenderness, and jaw fatigue while chewing. ESR is 102 mm/h. Visual acuity is normal. There is no fever or meningismus, and biopsy can be arranged later in the week. Which of the following is the most appropriate next step in management?