MRCS Part B Revision · Surgical pathology
Temporal Arteritis — MRCS Part B Surgical pathology
By Dr Richard Miller, MBChB FRCS · Reviewed
Temporal Arteritis is a surgical pathology station. Two of the seventeen examined stations in the MRCS Part B OSCE are surgical pathology. The surgical pathology stations ask you to reason from a specimen, a slide, a report or a vignette to a diagnosis, and then to say what it means for the patient in front of you.
What you need to know for the Temporal Arteritis station
Temporal Arteritis
Giant-cell arteritis (GCA) is an inflammatory disease of blood vessels most commonly involving large and medium arteries of the head, predominantly the branches of the external carotid artery.
Temporal arteritis specifically involves the temporal artery. The most serious complication is occlusion of the ophthalmic artery, which is a branch of the internal carotid. It can create a medical emergency which can cause irreversible ischaemia and blindness if not treated promptly.
GCA is treated with glucocorticoids (steroids), which reduce the inflammation and prevent occlusion. No other drugs are effective or contribute to the effect of glucocorticoids.
Inflammation involves the arterial media and intima (layers within the blood vessel wall). Infiltration by mononuclear cells is typically associated with giant cells (immune and inflammatory cells).
Intimal damage leads to formation of thrombi (blood clots), which usually become organised and there may be severe damage to the internal elastic lamina, sometimes going on to complete destruction.
Healing is by fibrosis (scarring), particularly of the media, thickening of the intima, and partial re-canalisation of the thrombus (blood clot).
Images from this station
What are you asked at the Temporal Arteritis station?
The station runs to 14 questions over nine minutes. These are the questions as they are put to you; the model answers are in the question bank.
- What is temporal arteritis?
- What patient population is most at risk of developing temporal arteritis?
- How can temporal arteritis become a medical emergency?
- Why have the rheumatologists requested a biopsy?
- Why might the biopsy result not be entirely reliable?
- What blood test would you request if you were investigating this patient?
- What clinical signs and symptoms might this patient have presented with?
- What are the diagnostic criteria for giant cell arteritis?
- Temporal arteritis is confirmed on biopsy. How would you manage this patient?
- What is the underlying pathological process that causes temporal arteritis?
- What are giant cells?
- Describe how you would perform a temporal artery biopsy
And 2 more at this station.
How is the surgical pathology station marked in MRCS Part B?
Like the anatomy stations, a surgical pathology station is marked out of 20 with all 20 marks going to clinical knowledge and its application. The second of the two may be a microbiology station.
FAQ
What does the Temporal Arteritis station ask?
It opens with "What is temporal arteritis?" and runs to 14 questions over nine minutes. Like the anatomy stations, a surgical pathology station is marked out of 20 with all 20 marks going to clinical knowledge and its application. The second of the two may be a microbiology station.
How many pathology stations are in MRCS Part B?
Two of the seventeen examined stations. The intercollegiate blueprint titles the second one surgical pathology and/or microbiology, so infection and antimicrobial topics appear here rather than in a station of their own.
How is the pathology station marked?
Out of 20, with every mark awarded for clinical knowledge and its application. There are no communication or professionalism marks available in it.
What should I revise for surgical pathology?
The general processes the syllabus names, inflammation, healing, neoplasia and infection, applied to the specimens and reports a surgical trainee meets. Candidates most often report malignancies and their mutations, inherited cancer syndromes, and obstructive jaundice.
How many stations are in the MRCS Part B OSCE?
Seventeen examined stations of nine minutes each, with a minute to read the task before each one. Two preparation stations and at least one rest station bring the circuit to about twenty, and the exam takes about three and a half hours.
What is the pass mark for MRCS Part B?
There is no published pass mark. The cut score is set separately for Applied Knowledge and Applied Skills, for each circuit, by borderline regression. Published pass rates across the 2024/25 diets ranged from 51% to 66%.
Can I fail a station and still pass?
Yes. There is no rule about how many stations you may fail: the cut score applies to your total mark in each component, so a weak station costs the marks you lost on it and strong stations elsewhere can make them back. Applied Knowledge and Applied Skills are passed separately and must both be passed at the same sitting, so a strong anatomy performance cannot rescue a weak communication one.
Dr Richard Miller, MBChB FRCS
Station summaries are reviewed against the current intercollegiate MRCS syllabus and the published marking blueprint. Guidance changes between diets: check the royal colleges' own pages before relying on a date, a fee or a threshold.
Practise this station
The question bank carries the model answer to every question above, with the rest of the surgical pathology stations.
More surgical pathology stations