Giant Cell Arteritis Flashcards
1
Q
What is giant cell arteritis?
A
Idiopathic vasculitis
*same clinical/ disease spectrum as PMR
*affects medium and large arteries in the head and neck
2
Q
What is the clinical presentation of GCA?
A
- Headache
- Scalp tenderness
- Thickened temporal arteries
- Jaw claudication (while talking, chewing, eating, there will be pain with that task)
- Acute visual change
*Acute amaurosis fugax (sudden loss of vision in one eye) or diplopia - Constitutional problems
3
Q
What are the ocular complications of GCA?
A
- Transient monocular visual loss
*due to central retinal artery occlusion (CRAO) OR
*anterior ischemic optic neuropathy (AION) - Visual field defects
4
Q
What are the hallmark signs of GCA?
A
- Headache
- Scalp tenderness
- Jaw claudication
- Fever
- Visual changes
Honorable mention - Temporal artery may be nodular, enlarged, tender, or pulse less
- Asymmetry of pulses in arms
- Murmurs and bruits
5
Q
What is the treatment of GCA?
A
- Start on high dose steroids (prednisone 60mg) immediately to prevent stroke or secondary eye involvement
- Temporal artery biopsy within a week of starting steroids (DO NOT delay starting treatment)
6
Q
What is one way to confirm GCA?
A
Temporal artery biopsy
7
Q
What would be found histological in GCA?
A
- Giant cells
- Occlusion off lumen
*giant cells are so inflamed there is a cut off of blood supply
8
Q
What is the treatment of GCA?
A
- Prednisone 60mg orally daily
*or IV is patient presents with visual disturbances - Maintain high dose for a month, then taper
9
Q
What is the prognosis of GCA?
A
- Blindness (usually permanent) is common if untreated
- Thoracic aortic aneurysm are 17 times more common in patients with GCA
*use CT, MRI, Auscultation