<prompt> 65-year-old lady underwent mastectomy for carcinoma breast. Later she developed frontai headache, pain in temple region and around eye. Her ESR is 55 mmhour. What is the most probable diagnosis?Cavernous sinus thrombosisMeningeal metastasisFrontal sinusitisGiant cell arteritis  <response>: Ans: D Giant cell arteritis Ref: Harrisons Principles of Internal Medicine, 18th ednExplanation:Giant Cell Arteritis taka Temporal ArteritisInflammation of large sized arteries.Commonly involves extracranial branches of external carotid artery.Most common involved artery - Temporal artery.Associated with polymyalgia rheum ail ca seen in 40-50 cases of GCA.Common in elderly patients 55 years.More common in women.Clinical Featureso Localized scalp tenderness over the temporal artery.o Thick and nodular on palpation,o Jaw claudication - Most specific symptom.o Visual symptoms: Diplopia or amaurosis fugax Anterior ischemic optic neuropathy,o Fever, Malaise, Fatigue,o Anorexia, Less of weight, Sweats,o Arthralgia.Investigationso Elevated ESR.o Anemia.o Temporal artery biopsy - showing giant cells - Investigation of choice.Treatment - Oral Prednisolone. 