American Board of Internal Medicine (ABIM) Certification Practice Exam

What is a key feature of temporal artery tenderness associated with giant cell arteritis?

1. It is usually not present

2. It is often bilateral

3. It is accompanied by low blood pressure

4. It is most often unilateral

The correct answer is: It is most often unilateral

Temporal artery tenderness is a hallmark symptom of giant cell arteritis (GCA), a condition characterized by inflammation of the temporal arteries. The feature that it is most often unilateral is significant because it highlights how GCA can present differently in patients. While some patients may experience bilateral tenderness, the unilateral aspect is more commonly noted and is crucial in the clinical diagnosis of this condition. In GCA, the inflammation can lead to artery ischemia, and tenderness may be localized to one side. This asymmetrical tenderness is a key differentiator for clinicians assessing a patient suspected of having GCA, as it informs the decision for further evaluation, which may include imaging techniques like ultrasound or biopsies of the affected temporal artery. Other features, such as bilateral involvement, may occur but are not as prevalent as unilateral tenderness. The absence of tenderness or bilateral tenderness can lead to alternative diagnoses, while low blood pressure generally is not a feature associated with GCA, as it may indicate other underlying issues. Understanding these nuances is critical for identifying and managing giant cell arteritis effectively.