Giant Cell Arteritis

Question 1

Aetiology?

Answer 1

50% have PMR

Question 2

Typical presentation

Answer 2

50y/o woman presents with new onset temporal headache and tenderness. She also complains of fleeting blindness “like a curtain being drawn”.

Question 3

What is GCA?

Answer 3

Granulomatous inflammation of medium sized vessels

Question 4

What is fleeting blindness in GCA?

Answer 4

Amaurosis fugax

Question 5

Branches of which artery are affected?

Answer 5

ECA

Question 6

What is a red flag symptom and what does it mean?

Answer 6

Blindness

CN2 ischaemia

Question 7

What is the diagnostic criteria?

Answer 7

Requires 3/5

1. > 50
2. New onset temporal headache
3. Temporal tenderness
4. ESR >50
5. Abnormal temporal artery biopsy

Question 8

Tests?

Answer 8

ESR

Temporal artery biopsy

US Temporal artery

Question 9

What is seen on temporal artery ultrasound?

Answer 9

Halo sign of granulomas

Question 10

Treatment?

Answer 10

Prednisolone
+
Aspirin

Question 11

What can be used if PMR +?

Answer 11

Methotrexate

Question 12

What follow up stuff must be done?

Answer 12

AAA screening = abdo USS

Yearly CxR for aortic dilatation

Question 13

What differential must be considered if <55?

Answer 13

Takayasu’s arteritis