Family Nurse Practitioner Exam

What is expected of the erythrocyte sedimentation rate (ESR) when diagnosing temporal arteritis?

1. Normal

2. Lower than normal

3. Elevated

4. Indeterminate result

The correct answer is: Elevated

Temporal arteritis, also known as giant cell arteritis, is associated with systemic inflammation, particularly affecting the arteries of the head. The erythrocyte sedimentation rate (ESR) is a non-specific marker that reflects the level of inflammation in the body. In the context of temporal arteritis, a significantly elevated ESR is expected because it indicates the presence of inflammation, which is a hallmark of this condition. High levels of ESR can help support the diagnosis when evaluating a patient presenting with symptoms such as new-onset headaches, visual disturbances, or jaw claudication, which are common in temporal arteritis. The elevation of ESR occurs due to the production of acute-phase reactants, such as fibrinogen, in response to inflammatory stimuli. In cases of temporal arteritis, this inflammatory process leads to vascular changes and symptoms that require prompt recognition and management, often with corticosteroids. A normal ESR might suggest the absence of significant inflammation, whereas a lower-than-normal ESR would be inconsistent with the typical inflammatory response seen in this condition. An indeterminate result might reflect technical issues or factors outside the expected range, but elevated ESR is a critical piece of the diagnostic puzzle.