ENT: Temporal Arteritis: Free MSRA Podcast

🎧 FREE MSRA PODCAST – Temporal Arteritis (Giant Cell Arteritis, GCA)Temporal arteritis (giant cell arteritis/GCA) is a true medical emergency! In this Deep Dive, we break down the notes you need to master for exams and practice: what it is, why it matters, who gets it, how to spot it, and how to treat it fast—before irreversible complications like blindness occur.📝 Key Learning Points🧠 Definition & Overview• Chronic granulomatous inflammation of large/medium arteries of the head—mainly the temporal arteries.• Also called giant cell arteritis (GCA) or cranial arteritis.👩‍⚕️ Who Gets It? (Risk Factors)• Almost always age >50 (average ~70 years)• Female:Male = 2.5:1• Caucasian ancestry, HLA-DRB1/BR-104 genetics• Strong association with polymyalgia rheumatica (PMR)⚙️ Pathophysiology• Immune-mediated granulomatous inflammation causes artery wall thickening & narrowing → reduced blood flow (ischaemia), especially to the optic nerve and brain.🚩 Red Flag Symptoms• Headache (temporal, sharp/burning)• Scalp tenderness (hurts to brush hair)• Jaw claudication (pain chewing, relieved by rest)• Sudden visual symptoms: blurred/double vision, vision loss (can be permanent!)• General: fever, fatigue, weight loss, muscle stiffness (esp. with PMR)• Vascular: tender/thick/nodular temporal artery, weak pulse• Neurological: TIA/stroke symptoms, cranial nerve involvement (rare but serious)🔍 Diagnosis• Inflammatory markers: ↑ ESR, ↑ CRP (usually very high)• Normocytic anaemia, ↑ platelets (thrombocytosis), normal autoantibodies• Definitive test: temporal artery biopsy (shows granulomatous inflammation with giant cells)• Ultrasound: “halo sign” (wall thickening); PET-CT for large vessel involvement🩺 Management• Immediate high-dose corticosteroids (prednisolone 40mg/day, or 60mg/day if jaw claudication/visual symptoms)• If visual symptoms: EMERGENCY admission, IV methylprednisolone• Start steroids BEFORE biopsy—do NOT delay• Long-term tapering over 1–2 years (often with bone protection: calcium, vit D, bisphosphonates)• Add immunosuppressants (methotrexate, tocilizumab) to reduce relapse and steroid side effects⚠️ Complications• Permanent vision loss (up to 15–20%) if untreated or late• Aortic aneurysm/dissection, stroke/TIA, relapse (50%), glucocorticoid toxicity (80%)• Lifelong risk of vascular complications—monitor for aortic disease🔗 Prognosis• Good if treated early—vision loss prevented, most symptoms respond to steroids• Frequent relapses; long-term follow-up needed📎 More GCA Revision Resources:📝 Revision Notes: https://www.passthemsra.com/topic/temporal-arteritis-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/temporal-arteritis-flashcards-2/💬 Accordion Q&A: https://www.passthemsra.com/topic/temporal-arteritis-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/temporal-arteritis-rapid-quiz-2/🎓 Full Course: https://www.passthemsra.com/courses/ent-for-the-msra/#MSRA #GiantCellArteritis #TemporalArteritis #ENT #MSRARevision #Headache #VisionLoss #PMR #Steroids #HighYield #ExamPearls #NICEGuidelines #MedicalRevision #PassTheMSRA