Cardiovascular: giant cell arteritis: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Cardiovascular: giant cell arteritis

Sample item

A 72-year-old woman has a new temporal headache, scalp tenderness, jaw pain on chewing and an ESR of 95 mm in the first hour. She reports a transient episode of visual loss in the right eye this morning. What is the most appropriate next step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Start high-dose glucocorticoids immediately and then arrange temporal artery biopsy

Giant cell arteritis is a granulomatous vasculitis of large and medium arteries, mainly the temporal artery, and threatens permanent blindness through ophthalmic artery involvement. Treatment is started immediately on clinical suspicion because the biopsy remains diagnostic for some days after steroids begin. Biopsy shows granulomatous inflammation with giant cells and fragmentation of the internal elastic lamina, though skip lesions can give false negatives.

Option by option

  • A. Start high-dose glucocorticoids immediately and then arrange temporal artery biopsy (correct)

    Correct. Immediate steroids protect vision, and biopsy can follow within days.

  • B. Wait for the temporal artery biopsy result before giving any treatment

    Delaying treatment for the biopsy risks irreversible blindness in the second eye.

  • C. Arrange an elective ophthalmology review without treatment

    Elective review ignores a sight-threatening emergency that needs same-day treatment.

  • D. Start aspirin alone and review in two weeks

    Aspirin alone does not suppress the vasculitis and offers inadequate protection from visual loss.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, Start high-dose glucocorticoids immediately and then arrange temporal artery biopsy. Giant cell arteritis is a granulomatous vasculitis of large and medium arteries, mainly the temporal artery, and threatens permanent blindness through ophthalmic artery involvement.

Why is "Wait for the temporal artery biopsy result before giving any treatment" not the answer?

Delaying treatment for the biopsy risks irreversible blindness in the second eye.

Why is "Arrange an elective ophthalmology review without treatment" not the answer?

Elective review ignores a sight-threatening emergency that needs same-day treatment.

Why is "Start aspirin alone and review in two weeks" not the answer?

Aspirin alone does not suppress the vasculitis and offers inadequate protection from visual loss.

What concept does this question test?

It tests Cardiovascular: giant cell arteritis in Pathology. Treatment is started immediately on clinical suspicion because the biopsy remains diagnostic for some days after steroids begin. Biopsy shows granulomatous inflammation with giant cells and fragmentation of the internal elastic lamina, though skip lesions can give false negatives.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiovascular: giant cell arteritis?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.