American Board of Internal Medicine (ABIM) Certification Practice Exam

What role does the ESR play in the management of GCA?

1. Establishing a definitive diagnosis

2. Monitoring the response to treatment

3. Determining the need for surgery

4. Assessing joint involvement

The correct answer is: Monitoring the response to treatment

The erythrocyte sedimentation rate (ESR) plays a significant role in managing giant cell arteritis (GCA) primarily by monitoring the response to treatment. In the context of GCA, an elevated ESR indicates the presence of inflammation, which is common in this condition. Once treatment, typically corticosteroids, is initiated, a decrease in the ESR is expected as the inflammatory process responds to therapy. Therefore, following ESR levels over time helps clinicians assess whether the treatment is effective in controlling the disease. While the ESR is useful in suggesting the presence of inflammation, it does not provide a definitive diagnosis of GCA on its own, nor does it determine the need for surgery or assess joint involvement specifically. These tasks typically involve clinical evaluation and imaging studies rather than solely relying on ESR levels. Thus, understanding the trend of ESR alongside clinical symptoms forms a crucial part of ongoing management and helps guide further treatment adjustments in patients with GCA.