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step2ck_form6/Block 1/Question#14 (3.1 difficulty score)
A 72-year-old man comes to the emergency ...
Corticosteroid therapy🔍,📺

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submitted by sugaplum(376),

Giant cell arteritis. These people have inflammation of large and medium vessels, we think carotid arteries mostly, and their branches. The most immedieate concern for these patients is BLINDNESS which can be caused if the retinal artery gets blocked (branch of internal carotid). SO for these people you don't wait for a biopsy you start them on high dose steroids ASAP. mc in >50 white women. But sometimes they like to get interesting with the demographics.

submitted by atypicalgowda(3),

Threatened (eg, vision change) or confirmed vision loss in GCA requires high-dose intravenous glucocorticoids (eg, methylprednisolone 500-1,000 mg daily), followed by oral therapy with a slow taper over several months to prevent worsening or contralateral vision loss.  Temporal artery biopsy can confirm the diagnosis of GCA; however, therapy should be started immediately when the diagnosis is suspected and should not be withheld while awaiting confirmation. UWorld qid: 3164