sarcoidosis

Question 1

what type of condition is sarcoidosis

Answer 1

it is a granulomatous inflammatory condition

Question 2

what are granulomas

Answer 2

nodules of inflammation full of macrophages

Question 3

spikes in incedence

Answer 3

young adulthood

~60yrs

Question 4

who is more frequently effected

Answer 4

women

black people

Question 5

typical patient

Answer 5

20-40yo black woman presenting with dry cough and SOB

Question 6

most commonly affected organ

Answer 6

lungs

Question 7

effect on organs: lungs

Answer 7

mediastinal lymphadenopathy
pulmonary fibrosis
pulmonary nodules

Question 8

effect on organs: systemic symptoms

Answer 8

fever
fatigue
weight loss

Question 9

effect on organs: liver

Answer 9

liver nodules
cirrhosis
cholestasis

Question 10

effect on organs: eyes

Answer 10

uveitis
conjunctivitis
optic neuritus

Question 11

effect on organs: skin

Answer 11

erythema nodosum

lupus pernio

Question 12

effect on organs: heart

Answer 12

bundle branch block
heart block
myocardial muscle involvement

Question 13

effect on organs: kidney

Answer 13

kidney stones (hypercalcaemia) 
nephrocalcinosis 
interstitial nephritis

Question 14

effect on organs: CNS

Answer 14

nodules
pituitary involvement
encephalopathy

Question 15

effect on organs: peipheral nerve palsy

Answer 15

facial nerve palsy

mononeuritis multiplex

Question 16

effect on organs: bones

Answer 16

arthralgia
arthritis
myopathy

Question 17

Lofgren’s syndrome triad

Answer 17

erythema nodosum
bilateral hilar lymphadenopathy
polyarthralgia

Question 18

differential diagnoses

Answer 18

TB
lymphoma 
hypersensitivity pneuonitis
HIV
toxoplasmosis 
histoplasmosis

Question 19

blood test findings

Answer 19

raised serum ACE
hypercalcaemia 
raised serum soluble IL-2 receptor
raised CRP 
raised Ig

Question 20

imaging findings

Answer 20

hilar lymphadenopathy

pulmonary nodules

Question 21

gold standard for confirming diagnosis

Answer 21

histology from biopsy

Question 22

histological finding

Answer 22

non-caseating granulomas with epithelioid cells

Question 23

management

Answer 23

none - no/mild symptoms

oral steroids (+ bisphosphonates)

or methotrexate or azathioprine

Question 24

prognosis

Answer 24

60% resolve

can progress with pulmonary fibrosis + hypertension

Question 25

Indications for corticosteroid treatment for sarcoidosis are

Answer 25

parenchymal lung disease,
uveitis,
hypercalcaemia
neurological or cardiac involvement