29th January 2024

A 74-year-old woman presents to the Acute Medical Unit with a 1-week history of blurred vision and generalised headache.

A 74-year-old woman presents to the Acute Medical Unit with a 1-week history of blurred vision and generalised headache. Her past medical history consists of hypertension, ischaemic heart disease and rheumatoid arthritis on methotrexate. She was not confused and did not have any focal neurological deficits on clinical examination. CT head showed age-related small vessel disease, and serum ESR is 68mmol/L.

Which of the following is the best initial treatment?