Podcast
Questions and Answers
What are two common clinical features of giant cell arteritis, besides visual symptoms?
What are two common clinical features of giant cell arteritis, besides visual symptoms?
Severe headache and jaw claudication.
Why is it important to start steroid treatment for suspected giant cell arteritis quickly, without waiting for a biopsy?
Why is it important to start steroid treatment for suspected giant cell arteritis quickly, without waiting for a biopsy?
To prevent irreversible vision loss.
What is the most accurate diagnostic test for giant cell arteritis?
What is the most accurate diagnostic test for giant cell arteritis?
Temporal artery biopsy.
Besides giant cell arteritis and polymyalgia rheumatica (PMR), list two other conditions that can cause a markedly elevated erythrocyte sedimentation rate (ESR > 100 mm/hour)?
Besides giant cell arteritis and polymyalgia rheumatica (PMR), list two other conditions that can cause a markedly elevated erythrocyte sedimentation rate (ESR > 100 mm/hour)?
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Name two conditions associated with a markedly low erythrocyte sedimentation rate (ESR) of 0 mm/hour?
Name two conditions associated with a markedly low erythrocyte sedimentation rate (ESR) of 0 mm/hour?
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Study Notes
Giant Cell Arteritis (Temporal Arteritis)
- Giant cell arteritis (GCA) may be part of a spectrum of polymyalgia rheumatica (PMR).
- Key symptoms include severe headaches and scalp tenderness
- Jaw claudication (painful jaw movement) is a possible symptom
- Sudden, painless vision loss is a potential concern, potentially permanent or temporary
- Symptoms might also affect other arteries, like decreased arm pulse or aortic regurgitation
- Elevated erythrocyte sedimentation rate (ESR) is a diagnostic marker
- High C-reactive protein (CRP) levels are also indicative
- Temporal artery biopsy is the gold standard for diagnosis but can yield false negatives if performed after 36 hours of steroid treatment
Diagnosis and Treatment
- Optimal treatment involves high-dose steroids, administration without waiting for biopsy results
- Normal ESR values typically fall below (Age in years divided by 2) + 5 for females
- Elevated ESR (>100 mm/hour) may signal conditions like:
- Subacute bacterial endocarditis
- Tuberculosis
- Giant cell arteritis (GCA)
- Polymyalgia rheumatica (PMR)
- Systemic lupus erythematosus (SLE)
- Rheumatoid arthritis (RA)
- Leukemia and Lymphoma
- Multiple myeloma
- Extremely low ESR (0 mm/hour) may suggest conditions like:
- Afibrinogenemia
- Agammaglobulinemia
- Extreme polycythemia (hematocrit >65%)
- Increased plasma viscosity
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Description
This quiz covers the essentials of Giant Cell Arteritis (GCA), including its symptoms, diagnostic markers, and treatment protocols. Learn about the relationship between GCA and polymyalgia rheumatica, as well as the significance of ESR and CRP levels in diagnosis. Evaluate your understanding of this condition and improve your clinical knowledge.
