A 72-year-old woman has a new temporal headache, jaw claudication, scalp tenderness and an ESR of 95 mm/hr. What is the most appropriate immediate treatment?
Answer and explanation
Correct answer: C. High-dose oral prednisolone started at once, before biopsy
- Step 1: This is suspected giant cell arteritis, which carries a risk of irreversible visual loss. Step 2. Treatment is started on clinical suspicion, as biopsy remains useful for some days after steroids begin. Answer: High-dose oral prednisolone started at once, before biopsy. Why not the others: Withholding steroids until biopsy risks blindness. The jaw claudication is not dental. Antibiotics do not treat arteritis.
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