Neurology - temporal arteritis

Question 1

what size of vessels are affected?

Answer 1

medium and large

Question 2

which condition has a strong association with GCA?

Answer 2

polymyalgia rheumatica

Question 3

people most at risk

Answer 3

caucasian women >50yrs

Question 4

key complication

Answer 4

vision loss

Question 5

describe the headache

Answer 5

severe unilateral - temple and forehead
scalp tenderness
jaw claudication
blurred or double vision

Question 6

associated systemic symptoms

Answer 6

fever
muscle aches 
weight loss 
peripheral oedema 
fatigue

Question 7

3 parts of making a definitive diagnosis

Answer 7

clinical presentation
raised ESR 50mm/hr
temporal artery biopsy

Question 8

what is found on temporal artery biopsy?

Answer 8

multinucleated giant cells

Question 9

additional investigations

Answer 9

FBC - normocytic anaemia and thrombocytosis
LFT
CRP
duplex USS

Question 10

findings duplex USS

Answer 10

hypoechoic halo sign

Question 11

initial management

Answer 11

40-60mg prednisolone

Question 12

when to review steroid response?

Answer 12

48 hours

Question 13

why is it important to commence steroids quickly?

Answer 13

prevent visual loss

Question 14

other medications

Answer 14

75mg aspirin

PPI

Question 15

referrals

Answer 15

vascular surgeons - temporal artery biopsy
rheumatology
ophthalmology

Question 16

DONT STOP steroid rules

Answer 16

dont stop taking abruptly
sick day rules
treatment card 
osteoporosis - bisphosphonates, calcium, vit D
PPI

Question 17

early neuro-ophthalmic complications

Answer 17

vision loss

CVA - stroke

Question 18

late neuro-ophthalmic complications

Answer 18

relapses
steroid side effects
CVA - stroke
aortitis - aortic aneurysm and dissection