Sarcoidosis

Question 1

Definition of sarcoidosis

Answer 1

Multi-system disease characterised by granulomas formation, resulting in widespread inflammatory changes and complications

Question 2

Acute symptoms of sarcoidosis

Answer 2

Fever, polyarthralgia, erythema nodusum, bilateral hilar lymphadenopathy

Question 3

Most common chronic manifestations of sarcoidosis

Answer 3

Pulmonary - dry cough, dysopnoea, reduced exercise tolerance, crepitations

Question 4

Constitutional features of sarcoidosis

Answer 4

Fatigue, weight loss, low-grade fever, lymphadenopathy, enlarged parotids

Question 5

Neurological / ocular features of sarcoidosis

Answer 5

Meningitis, peripheral neuropathy, bilateral Bell’s palsy, uveitis, keratoconjunctivitis sicca

Question 6

Other chronic features of sarcoidosis including the heart and abdomen

Answer 6

Arrhythmias, restricted cardiomyopathy, hepatomegaly, splenomegaly, renal stones, lupus permo

Question 7

Skin feature in sarcoidosis

Answer 7

Erythema nodusum

Question 8

Diagnostic test of sarcoidosis

Answer 8

Tissue biopsy of lung, lymph nodes finding non-caseating granulomas

Question 9

Blood findings in sarcoidosis

Answer 9

Raised ESR, ACE and Ca2+, reduced lymphocytes

Question 10

Stage 1 on CXR

Answer 10

Bilateral hilar lymphadenopathy

Question 11

Stage 2 on CXR

Answer 11

BHL with peripheral infiltrates

Question 12

Stage 3 on CXR

Answer 12

Peripheral infiltrates alone

Question 13

Stage 4 on CXR

Answer 13

Pulmonary fibrosis

Question 14

Management of BHL

Answer 14

Usually self-limiting

Question 15

Management of acute symptoms

Answer 15

Bed rest and NSAIDs

Question 16

When are immunosuppressants used

Answer 16

In severe disease

Question 17

Other options for moderate disease

Answer 17

Steroids IV or oral depending on severity