Aerial biopsy of elderly male shows fragmentation of elastic lamina, lymphocyte infiltration and giant cells ?

Ans. is 'a' i.e., Temporal aeritisGiant cell aeritis or temporal aeritisIt is the most common form of systemic vasculitis in adults.It is an acute and chronic, often granulomatous inflammation of aeries of large to small size.Giant cell aeritis affects principally the aeries in the head, especially the temporal aeries which is the extracranial branch of carotid aery.Veebral and ophthalamic aeries may also be involved.Segment of affected aery develops nodular thickening with narrowing of lumen.There is granulomatous inflammation in the vessel wall with foreign body and Langhans type multinulated giant cells and fragmentation of internal elastic lamina.Presentation of Giant cell aeritisConstitutional symptomsMost common nonspecific symptomsInclude malaise, fatigue, anorexia and weight loss.These symptoms are due to generalized involvement of the body and are not related to any organ involvement. o HeadacheIt is most common vasculitis related symptom.Most commonly over temporal region.Jaw claudicationIt is most specific symptom of GCA. It is manifestated as pain in masseter when eating food that require vigrous chewing because oxygen demand of the masseter exceeds the supply provided by narrowed and inflamed aeries.Visual symptomsDiplopia and visual loss.Ophthalmic aery involvement can lead to sudden blindness which is the most feared complication of GCA.Polymylagia rheumaticaAching and stiffness of the shoulder, neck and lip girdle area.AhritisRaised ESRNormocytic - Normochromic anemia