Family Nurse Practitioner Exam

What symptom is a primary indicator of potential giant cell arteritis in PMR patients?

1. Joint swelling

2. Vision loss

3. Fever

4. Weight gain

The correct answer is: Vision loss

In patients with polymyalgia rheumatica (PMR), vision loss serves as a critical warning sign of potential giant cell arteritis (GCA), also known as temporal arteritis. GCA is a serious inflammatory condition that can lead to irreversible vision loss if not detected and treated promptly. This connection between PMR and GCA is pivotal; about 15-20% of patients with PMR may develop GCA. Vision loss in this context typically manifests as sudden onset blurriness, changes in vision, or even complete visual impairment due to the inflammation of the temporal arteries, which can compromise blood flow to the optical nerves. While joint swelling, fever, and weight gain are symptoms that could present in patients with PMR or other conditions, they do not specifically indicate the presence of GCA in the same way that vision loss does. Fever may suggest inflammation or an infection, joint swelling is characteristic of the arthralgias associated with PMR, and weight gain is not a common symptom in this scenario. Hence, vision loss is distinguished as the primary indicator that requires immediate further evaluation for GCA in PMR patients. This understanding highlights the importance of vigilance in monitoring patients with PMR for symptoms that might suggest a progression to giant