Question

72 yo female - recent HAs pain generalized all over her head - persisting over past several months feels more achy and fatigued - dec appetite and unintentional weight loss (4 lbs in 2 months) acetaminophen - minimally helpful denies sinus congestion, N/V, N/T, weakness, or vision changes 100.2 F PE: normal CNs, fundo gucci, no tenderness on head palpation; mildly tender to palpation of shoulders/upper arms labs: ESR 88 mm/hr what should you get to confirm dx?

Answer 1

A temporal artery biopsy is the gold standard test to confirm a diagnosis of Giant Cell Arteritis (GCA), which is suspected in a 72-year-old female with systemic symptoms, elevated ESR, and headache.

Step-by-step explanation:

The presented case describes a 72-year-old female with symptoms such as generalized headaches, achiness, fatigue, decreased appetite, unintentional weight loss, mild fever, and notably elevated ESR levels. Given these clinical features, especially the high ESR and systemic symptoms, a condition called Giant Cell Arteritis (GCA) should be considered. GCA is an inflammation of the blood vessels (vasculitis) typically affecting the arteries of the head, which can present similarly to the symptoms described. To confirm the diagnosis of GCA, a temporal artery biopsy is usually performed, as it's the gold standard diagnostic test. If immediate treatment with corticosteroids is considered necessary due to the severity of symptoms, it can be initiated even before the biopsy results are obtained to prevent complications such as vision loss.