Rheumatology - Giant Cell Arteritis

Question 1

What is GCA?

Answer 1

Systemic vasculitis affecting medium and large arteries

Question 2

What is the key complication of GCA?

Answer 2

Irreversible vision loss

Question 3

What are the presenting features of GCA?

Answer 3

Scalp tenderness
Jaw claudication
Blurred or double vision
Vision loss

Question 4

What are the associated features of GCA?

Answer 4

Strong association with PMR
Muscle tenderness
Carpal tunnel syndrome
Peripheral oedema

Question 5

How is GCA diagnosed?

Answer 5

Clinical presentation
Raised ESR
Temporal artery biopsy
Duplex USS

Question 6

What does temporal artery biopsy show in GCA?

Answer 6

Multinucleated giant cells

Question 7

What does duplex USS show in GCA?

Answer 7

Hypoechoic halo sign
Stenosis of the temporal artery

Question 8

How is GCA treated?

Answer 8

Steroids immediately before diagnosis confirmation to reduce risk of vision loss

Prednisolone if no visual symptoms or jaw claudication

Methylprednisolone with visual symptoms or jaw claudication

Question 9

What medications are given alongside steroids?

Answer 9

Aspirin- decreases vision loss and stokres

PPI- gastroprotection while on steroids

Bisphosphonates, vitamin D and calcium- bone protection while on steroids

Question 10

What are the complications of GCA?

Answer 10

Steroid-related complications (weight gain, diabetes, osteoporosis)
Visual loss
Stroke