Question

question 86
1 pts
a 65 - year - old patient presents with new - onset headache, scalp tenderness, and blurred vision in the right eye. esr is elevated. what is the most appropriate initial management?
begin high - dose corticosteroids and refer to ophthalmology
prescribe nsaids and recheck in 48 hours
order head ct and monitor symptoms
recommend acetaminophen and hydration
previous

Explanation:

The patient's symptoms (new - onset headache, scalp tenderness, blurred vision) and elevated ESR are highly suggestive of giant cell arteritis (temporal arteritis). High - dose corticosteroids are the standard initial treatment to prevent vision loss, and referral to ophthalmology is appropriate for further evaluation of the visual symptoms. NSAIDs (non - steroidal anti - inflammatory drugs) are not sufficient for the treatment of giant cell arteritis. Ordering a head CT is not the first - line management as the diagnosis is more likely related to vasculitis (giant cell arteritis) rather than a structural brain lesion. Recommending acetaminophen and hydration is too conservative and does not address the underlying potentially sight - threatening condition.

Answer:

Begin high - dose corticosteroids and refer to ophthalmology.