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Giant cell arteritis with visual symptoms — SCE Acute Medicine MCQ

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EasyAcute Rheumatological and Dermatological EmergenciesGiant cell arteritis with visual symptomsSCE Acute Medicine

A 76-year-old woman is assessed on the acute medical unit. She has new temporal headache, jaw claudication and transient monocular visual loss. ESR is 88 mm/hour. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

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Correct answer: B — Start high-dose glucocorticoid therapy immediately

Start high-dose glucocorticoid therapy immediately is the best answer because suspected GCA with visual symptoms needs immediate steroids to prevent irreversible sight loss. Give vitamin K and prothrombin complex concentrate is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Temporal artery ultrasound or biopsy should not delay treatment.

Reference: BSR giant cell arteritis guideline