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Giant cell arteritis with amaurosis fugax — SCE Acute Medicine MCQ

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ModerateMusculoskeletal systemGiant cell arteritis with amaurosis fugaxSCE Acute Medicine

A 56-year-old man has sudden painless loss of vision in the left eye for 40 minutes, now resolved. He has jaw claudication, scalp tenderness and a new temporal headache. ESR is 92 mm/hour and CRP is 118 mg/L. Visual acuity is normal at assessment. What is the most appropriate next step in management?

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Correct answer: C — Start high-dose corticosteroids immediately and arrange urgent specialist assessment

Transient monocular visual loss with cranial symptoms and markedly raised inflammatory markers is highly suspicious for giant cell arteritis. High-dose corticosteroids should be started immediately to protect vision and should not wait for biopsy or imaging. Aspirin may be considered in selected patients but does not replace urgent steroid treatment.

Reference: BSR Giant Cell Arteritis Guideline; NICE CKS