Sarcoidosis Flashcards Preview

Gen Med Unit 6 > Sarcoidosis > Flashcards

Flashcards in Sarcoidosis Deck (19):
1

Define sarcoidosis

1. Abnormal collections of inflammatory cells (granulomas) that can form as nodules in multiple organs
2. Intrathoracic lymphadenopathy

2

Where does sarcoidosis form?

Most often located in the lungs (90%) or its associated lymph nodes, but any organ can be affected (MSK, liver, eye, skin, CNS, kidneys, spleen, heart)

3

What is sarcoidosis characterized by?

non-caseating granulomas

4

What demographics are at the highest risk for sarcoidosis?

1. Incidence highest in North American blacks and Northern European whites
2. Among blacks, women > men
3. Onset of disease 30-40 years
4. Genetic predisposition
A. Risk 5x > if + FH

5

What is the pathophys of sarcoidosis?

1. Unknown antigen triggers a cell-mediated immune response
A. Accumulation of T cells and macrophages
B. Release of cytokines
C. Inflammatory process leads to formation of noncaseating granulomas
-Hallmark of sarcoidosis
-Most commonly in the lungs and lymph nodes

6

What are the clinical presentation sxs for sarcoidosis?

1. Asymptomatic
2. Fatigue
3. Fevers
4. Arthralgias
-Wrists, ankles, elbows
5. DOE
6. Cough
7. Mild CP

7

What other sxs may be present in sarcoidosis?

1. Skin involvement
2. Rash
3. Erythema nodosum
4. Iritis
5. Peripheral neuropathy
6. Cardiomyopathy
7. Seizures
8. Headache

8

What is Löfgren Syndrome? How is it treated? Who gets it?

1. Most common in Scandinavian & Irish females
2. Often self-limiting
3. NSAIDs help
4. Triad
-Acute polyarthritis
-Erythema nodosum
-Hilar adenopathy

9

What is Blau syndrome? How is it treated? Who gets it?

1. Inherited autosomal dominant type in children
2. Presents before the age of 4 yr
3. Self-limited
4. NSAIDs help
5. Triad
-Arthritis
-Rash
-Uveitis

10

Is sarcoidosis most similar to a restrictive or obstructive lung disease?

PFTs demonstrate restrictive pattern
↓ TLC
Normal FEV1/FVC

11

What happens to ACE levels in sarcoidosis?

Angiotensin converting enzyme (ACE) levels increased in 40-80% of time

12

What test is performed in sarcoidosis?

↑ Erythrocyte Sedimentation Rate (ESR)

13

What are the cxr results in sarcoidosis?

1. Bilateral hilar adenopathy
2. Diffuse reticular infiltrates

14

Why is a biopsy performed in sarcoidosis? What are the results?

1. Biopsy of lymph nodes, skin lesions, lung biopsy
A. Provides histologic diagnosis
B. Transbronchial or fine needle lung Bx confirms Dx of noncaseating granulomas

15

What is the treatment for sarcoidosis?

Oral corticosteroids
0.5-1.0 mg/kg/d
Taper slowly over 6 mo

16

What happens to ACE levels with treatment?

Serum ACE levels should fall with clinical treatment

17

What annual tests are recommended for sarcoidosis pts?

CPX
PFT’s
CMP
Eye exam
CXR
EKG

18

What are the complications of sarcoidosis?

1. Progressive pulmonary fibrosis
2. Pneumothorax: due to granulomas
3. Death
A. Resp. hemorrhage due to aspergilloma
B. Respiratory failure
C. Cardiomyopathy causing arrhythmias and heart failure (Japan)

19

What is the prognosis for sarcoidosis?

1. Fatal in 1-5% of cases
2. Spontaneous remission is common
3. Chronic in up to 30% of cases