Giant cell arteritis Flashcards
1
Q
Risk factors
A
- Age >50
- F:M = 2:1
2
Q
Presentation
A
- NEW headache usually temporal
- Rapid onset
- Fever and fatigue
- Scalp tenderness
- Jaw claudication
- Temporal arteries may be thickened and/or tender - pulsate
- May have polymylagia rheumatica (PMR) symptoms
- Visual disturbances
3
Q
Visual disturbances
A
- 10% of GCA cases
- repeated episodes of amaurosis fugax
- sudden, painless, permanent loss
4
Q
Ix for GCA
A
Bloods - if no visual disturbances as indication of severe
- CRP
USS and temporal artery biopsy
5
Q
Temporal artery biopsy
A
Panarteritis
Giant cell granulomas
- ve biopsy does not exclude GCA due to skip lesions
6
Q
Mx
A
Early treatment prevents blindness - don’t defer treatment to await biopsy
Start prednisolone daily
- Dramatic response to headache/stiffness < 7 days
Titrate prednisolone dose against clinical response and ESR
Treat for at least 2 years
PPI and alendronate cover
7
Q
Bloods
A
↑↑ESR and CRP
↑ALP
↓Hb normocytic
↑Plats
8
Q
When to do temporal artery biopsy
A
w/i 3days
