Vasculitis Syndromes MCQ — NEET PG Practice Question | NEETPGAI
Vasculitis Syndromes
medium
microscope Pathology
A 68-year-old man presents with sudden onset of severe headache, jaw claudication, and visual disturbances. Temporal artery biopsy shows granulomatous inflammation with giant cells. Which is the most common site of vascular involvement in this condition?
A. Coronary arteries
B. Aortic arch and descending thoracic aorta
C. Mesenteric arteries
D. Temporal and other extracranial branches of carotid artery
Giant cell arteritis (GCA) is a large-vessel vasculitis that predominantly affects the extracranial branches of the carotid artery, particularly the temporal artery, though it can involve other branches including occipital, ophthalmic, and posterior ciliary arteries.
Pathological Features
The disease is characterized by:
Granulomatous inflammation of the media and intima
Giant cells and epithelioid histiocytes
Fragmentation of the internal elastic lamina
Predominantly affects arteries of medium to large caliber
Distribution of Vascular Involvement
Table
Vessel Site
Frequency
Clinical Significance
Temporal artery
>90%
Diagnostic biopsy site; presents with headache, scalp tenderness
Occipital artery
Common
Occipital headache
Ophthalmic/posterior ciliary
Common
Amaurosis fugax, vision loss
Coronary arteries
~10%
Rare; can cause MI
Aorta/aortic arch
~15%
Late complication; aortic regurgitation, aneurysm
Mesenteric arteries
<5%
Uncommon; mesenteric ischemia rare
High-YieldNEET PG
The temporal artery is the diagnostic gold standard — biopsy showing granulomatous inflammation confirms GCA. However, the disease affects a spectrum of extracranial carotid branches, not just the temporal artery alone.
Clinical Correlation
Jaw claudication = involvement of facial/maxillary arteries (branches of external carotid)
Vision loss = involvement of ophthalmic and posterior ciliary arteries (branches of internal carotid)
Headache = temporal and occipital artery involvement
Clinical Pearl
Aortic involvement (aortic arch syndrome) occurs in ~15% of GCA patients, typically as a late complication, and can present with aortic regurgitation or thoracic aortic aneurysm. This is why long-term follow-up imaging is important.
Warning
Do not confuse GCA with Takayasu arteritis (which affects the aorta and its proximal branches in young women) or polyarteritis nodosa (which spares the temporal arteries and typically affects medium-sized muscular arteries).
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