American Board of Internal Medicine (ABIM) Certification Practice Exam

What should patients with GCA be monitored for during treatment?

1. Kidney function

2. Allergic reactions

3. Signs of relapse

4. Cardiovascular events

The correct answer is: Signs of relapse

Monitoring for signs of relapse is critical when treating patients with Giant Cell Arteritis (GCA). GCA is a systemic vasculitis that primarily affects the large vessels, particularly the temporal arteries, and can lead to serious complications such as loss of vision if not adequately treated. Following initiation of therapy, typically with corticosteroids, it is essential to observe patients for any resurgence of symptoms, which may indicate a flare or relapse of the disease. These symptoms can include new onset of headaches, visual changes, jaw claudication, and other systemic symptoms. By closely monitoring for these signs, clinicians can make timely adjustments to therapy, including increasing corticosteroid dosage or considering additional immunosuppressive agents, thereby minimizing the risk of complications and ensuring adequate disease control. While it is important to monitor kidney function and watch for allergic reactions and cardiovascular events due to medication side effects or comorbidities, the specific focus during treatment of GCA remains on identifying any signs of a relapse, as this directly impacts the patient's long-term outcomes and quality of life.