Headaches quiz - ch 149

Question 1

what is temporal arteritis (giant cell arteritis)

Answer 1

a systemic vasculitis that can cause a painless ischemic optic neuropathy.

Question 2

what is the typical demographic for temporal arteritis (GCA)

Answer 2

women older than 50 with hx of polymyalgia rheumatica

Question 3

what are associated symptoms for temporal arteritis (GCA)

Answer 3

• vision changes
• headache
• jaw claudication
• scalp/temporal artery tenderness
• fatigue
• fever
• sore throat
• URI symptoms
• anorexia

symptoms are usually UNILATERAL but can be bilateral

Question 4

1/3 of cases of temporal arteritis are assocaited with what

Answer 4

neurologic events such as TIA or stroke

Question 5

what are possible PE findings in temporal arteritis (GCA)

Answer 5

• auditory processing disorder (APD)
• flame hemorrhages on fundoscopy

Question 6

what laboratory studies should be ordered in temporal arteritis (GCA)

Answer 6

• CRP (elevated, more sensitive)
• ESR (elevated)

Question 7

what can occur in untreated temporal arteritis

Answer 7

permanent visual loss

Question 8

what is the plan of treatment for a person with strong suspicion of temporal arteritis or vision loss

Answer 8

• admission
• methlyprednisolone 250mg IV Q6 hrs

Question 9

what is the plan of treatment for a person with mild suspicion of temporal arteritis and no vision loss

Answer 9

• send home
• prednisone 80-100mg PO QD
• close follow up

Question 10

should you wait for biopsy results to start steroids in pts suspicious for temporal arteritis

Answer 10

NOOOO