Giant Cell Arteritis Flashcards
1
Q
What is giant cell arteritis (temporal arteritis)?
A
- Systemic vasculitis of medium and large arteries
2
Q
What is GCS associated with?
A
- Polymyalgia Rheumatica
3
Q
What is the cx of GCA?
A
- irreversible vision loss
4
Q
What are the Sx for GCA?
A
- Headache
- temporal artery & scalp tenderness
- tongue and jaw claudication
- amaurosis fugax
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5
Q
What are the extracranial features of GCA?
A
- malaise
- dyspnoea
- weight loss
- morning stiffness
- weak pulses
6
Q
What disease to consider if pt present with GCA features but under 55?
A
- Takayasu’s
7
Q
How would you diagnose GCA?
A
- Clinical presentation
- Raised ESR: usually 50 mm/hour or more
- Temporal artery biopsy findings
8
Q
What cells are found on biopsy of temporal artery?
A
- multinucleated giant cells
9
Q
Which artery does GCA commonly affect?
A
- Temporal artery
- BUt can affect surrounding arteries as well
10
Q
What additional Ix would you order for GCA?
A
- High ESR/CRP
- High Plt - thrombocytosis
- LFT - High ALP
- Low Hb -normocytic anaemia
- DUS of temporal artery
- hypoechoic halo
11
Q
How would you Mx GCA?
A
- urgent referral for specialist evaluation
- Prednisolone 40mg/d PO
- 60mg/d if claudication sx present
- Aspirin 75mg/d
- PPI - gastric prophylaxis for steroids
12
Q
What are the Cx of GCA?
A
- Early
- Vision loss
- Stroke
- Late
- Relapse
- Steroid side effect
- Aortitis
13
Q
What are the SE of steroid use?
Use ABCDEHIMNOS
A
- Acne
- Blurred vision - galucoma
- Cataracts
- DIabetes, Difficulty sleeping
- Easy bruising
- HTN
- Increased appetite, increase body mass
- Muscle weakness
- Nervousness
- Osteoporosis
- Swelling
14
Q
A
15
Q
If biopsy is negative for GCA, how would you stop steroids?
A
- Reduce it from 60/40 to 20mg in 10mg steps each two weeks
- Then in 2.5mg steps
