QuestionSBA
QuestionChoice
Hepatic monitoring is not routinely performed for patients taking prednisolone.
50362
d
He will need regular hepatic function monitoring whilst taking prednisolone
QuestionChoice
Height and weight are monitored in paediatric patients taking prednisolone not adult patients. Weight may be monitored in adult patients as weight gain is a common side effect of steroid use.
50361
c
His height and weight should be monitored whilst taking prednisolone
QuestionChoice
Hyperhydrosis is a uncommon side effect of corticosteroid use therefore it is not likely that this patient will experience this.
50360
b
He is likely to experience excess sweating
QuestionChoice
Vertigo is a uncommon side effect of corticosteroid use therefore it is not likely that this patient will experience this.
50363
e
He is likely to experience vertigo when taking prednisolone
QuestionChoice
Prednisolone treatment for GCA occurs at high doses and can last a very long time, in some cases as long as two years. With prolonged use there is likely to be adrenal suppression, if there is abrupt withdrawal this can lead to acute adrenal insufficiency, hypotension and even death. A tapering regime in which the corticosteroid dose is slowly reduced over time is preferred due to this.
50359
a
He should not abruptly stop taking his prednisolone
Concept
Chapter
Osteoporosis, otherwise known as thin bones, is a condition associated with high risk of low trauma fractures due to reduced bone mineral density. Osteoclast activity exceeds osteoblast activity, meaning that bone resorption is occurring at a greater rate than bone formation.

**Symptoms and Signs**

- Generally asymptomatic until a fragility fracture occurs
- Back pain
- Kyphosis (stooped posture)
- Fragility fractures

**Risk factors**

- Female sex
- Increasing age
- Smoking
- Corticosteroid use
- Low BMI (< 20-25kg/m<sup>2</sup>)
- Low body weight (<58kg)
- Vitamin D deficiency

**Protective factors**

- Higher BMI
- Exercise - mechanical loading stimulates bone formation

**Diagnosis**
Osteoporosis can be detected on dual-energy x-ray absorptiometry (DEXA) scan.
A T score of < -2.5 indicates osteoporosis

**Management**

- Fall prevention
- Vitamin D and calcium supplementation
- Hormone replacement therapy (postmenopausal women)
- Oral bisphosphonates
2657
3655
The need for a tapering regime when a patient has been taking high dose corticosteroids for giant cell arteritis
Topic
9
Internal Medicine
10126
Case presentation: A 68-year-old man attends the emergency  with jaw pain. He mentions that he has found it difficult to chew and the side of his head is sore to touch.



**PH** Hypertension, hypercholesterolaemia

**DH** Ramipril 10mg PO OD, amlodipine 10mg PO OD, atorvastatin 20mg PO OD

**Investigations** ESR 42 mm/hr (1-13 mm/hr)

It is decided that this gentleman likely has giant cell arteritis and he is promptly started on 40mg prednisolone PO OD.

Question: Select the most important information that should be provided for this patient.
a