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Temporal arteritis — USMLE Step 3 MCQ

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HardAmbulatory Medicine / Primary CareTemporal arteritisUSMLE Step 3

A 73-year-old woman has new unilateral temporal headache, scalp tenderness when brushing hair, jaw fatigue while chewing, and shoulder stiffness. ESR is 88 mm/h. Visual acuity is normal today. Temporal artery is tender and nodular. Which of the following is the most appropriate at this time?

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

Reveal the answer and explanation

Correct answer: B — Start high-dose glucocorticoids immediately and arrange temporal artery biopsy

Suspected giant cell arteritis requires immediate glucocorticoids to prevent vision loss; biopsy can follow after treatment begins.

Reference: ACR/Vasculitis Foundation Giant Cell Arteritis Guideline