American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the typical initial dose of prednisone for treating polymyalgia rheumatica?

1. 5 to 10 mg/d

2. 10 to 20 mg/d

3. 20 to 30 mg/d

4. 30 to 50 mg/d

The correct answer is: 10 to 20 mg/d

The typical initial dose of prednisone for treating polymyalgia rheumatica is in the range of 10 to 20 mg per day. This dosage is generally effective in rapidly alleviating the symptoms associated with this condition, which often includes significant musculoskeletal pain and stiffness, particularly in the shoulders and hips. Starting at this dose provides a balance between efficacy and the risk of potential side effects associated with corticosteroid therapy. Polymyalgia rheumatica is an inflammatory disorder that responds well to corticosteroids, and the initial dose aims to achieve symptom control while minimizing long-term exposure to higher doses of prednisone, which can lead to unwanted complications such as osteoporosis, weight gain, and increased blood sugar levels. By initiating treatment within this recommended range, healthcare providers can closely monitor the patient’s response and adjust the dosage as necessary to ensure the best outcomes and manage any side effects effectively. Higher doses might initially seem appealing for symptom relief, but they tend to escalate the risk of adverse effects, often without significant additional benefit for most patients. Therefore, the approach is to start with 10 to 20 mg and then taper down as symptoms improve.