The MKSAP Challenge
A 78-year-old woman is evaluated because she has had a headache for the past eight days and has noted the onset of blurring and double vision. The double vision lasted for approximately 15 minutes this morning but then resolved. She has lost 6.8 kg (15 lb) over the past two months. She had been taking lisinopril for mild hypertension for five years.
Which of the following is the best next step in this patient's management?
A. Refer her to an ophthalmologist or a neurologist.
B. Schedule a temporal artery biopsy as soon as possible.
C. Test her erythrocyte sedimentation rate and schedule a temporal artery biopsy if it is >50 mm/h.
D. Administer sumatriptan.
E. Administer prednisone, 60 mg, immediately and schedule a temporal artery biopsy.
Internist Archives Quick Links
Internal Medicine 2014 Advance Program Now Online
Details about Internal Medicine 2014's robust offerings are now available on our Website! Use the online Schedule Planner to build and save your own schedule.
New from ACP: Free High Value Care Cases
Free MOC and CME Credit with easy online submission
HVC Cases provide:
Get started now with your ACP user name and password!