A 74-year-old woman presents to her primary
care physician with a 1-month history of temporal headaches, fevers, and general malaise.
The headaches are described as a throbbing
pain, especially localized to her temporal regions bilaterally. She denies any recent trauma or exposure to infectious agents. Her temperature is 38.0°C (100.4°F), heart rate is 82/min,
and blood pressure is 119/96 mm Hg. On
physical examination, the patient is extremely
tender over her temples, and abnormally thickened temporal arteries are palpable bilaterally.
Laboratory tests demonstrate an erythrocyte
sedimentation rate of 31 mm/h. What is the
most appropriate initial step in treatment for
this patient?