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Takayasu arteritis — SCE Rheumatology MCQ

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HardVasculitisTakayasu arteritisSCE Rheumatology

A 58-year-old woman has arm claudication, dizziness and constitutional symptoms. Examination shows blood pressure differs between arms and pulses are reduced. Investigations show CRP is raised and CT angiography shows aortic branch stenoses. The consultant wants the next test most likely to confirm the suspected process or guide treatment. The result will change diagnosis, staging or immediate treatment. What is the most appropriate investigation?

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Correct answer: D — CT angiography

CT angiography is the best answer because ct angiography is the investigation most likely to resolve the immediate diagnostic or monitoring question in takayasu arteritis. Hepatitis B serology is a plausible distractor, but it does not account for the key discriminator in the stem. Urinalysis and renal function and CRP and ESR would be more appropriate in a different clinical pattern or at another point in the pathway, while Chest CT is suboptimal for this presentation. Clinical pearl: autoantibodies are supportive tests and should be interpreted alongside phenotype, inflammatory markers, urinalysis and imaging.

Reference: BSR GCA guideline; EULAR ANCA-associated vasculitis recommendations; BNF