Sarcoidosis, D Linger, DSA Flashcards Preview

Year 2 Resp Exam 2 > Sarcoidosis, D Linger, DSA > Flashcards

Flashcards in Sarcoidosis, D Linger, DSA Deck (32):
1

What is sarcoidosis

systemic granulomatous disease characterized by non-caseating granulomas

2

90% patients with sarcoidosis present with what

mediastinal hilar lymph node involvement or parenchymal lung disease

3

When is the peak incidence of sarcoidosis

between ages 20 and 39

4

demographic distribution of sarcoidosis

3.5x more common in black americans
women >men

5

What is Lofgrens syndrome

acute manifestation of the disease consisting of erythema nodosum, arthritis, and b/l hilar lymphadenopathy

6

prognosis of lofgrens syndrome

favorable

7

chronic sarcoidosis can lead to what

progressive pulmonary fibrosis and increased morbidity

8

What are the general Sx of sarcoidosis

fatigue, fever, night sweats and weight loss

9

what are Sx and signs of pulmonary involvement in sarcoidosis

cough, dyspnea with exertion, wheeze, chest discomfort
rales, expiratory wheezing

10

What are signs and Sx of skin involvement in sarcoidosis

rash, macules, papules, nodules, hyperpigmentation or hypopigmentation, erythema nodosum
infiltration of old scars and tattoos, maculopapular lesions of face, neck, upper back and extremities
lupus pernio of nose, cheeks, ears and lips. erythema nodosum

11

what are signs and Sx of ocular involvement in sarcoidosis

gritty or dry eyes, pain, redness and or blurred vision
uveitis, iritis, scleral plaques, enlarged lacrimal glands

12

what are signs and Sx of cardiac involvement in sarcoidosis

arrhythmia, palpitations, near-syncope, lower extremity edema
usually normal

13

what are signs and Sx of nervous system involvement in sarcoidosis

HA, blurred vision, numbness, weakness, instability, seizures
cranial nerves II VII VIII, neuropathies, gait instability, weakness

14

what are signs and Sx of GI involvement in sarcoidosis

epigastric pain, early satiety, RUQ pain, jaundice
HSM, jaundice

15

What are signs and Sx of MSK involvement in sarcoidosis

swelling and joint stiffness, joint pain, muscle pain
arthralgias, arthritis

16

What are Signs of lymphatic involvement in sarcoidosis

common sites of palpable adenopathy: cervical, supraclavicular, axillae, inguinal regions

17

how can you Dx sarcoidosis based of signs found around eye

yellow nodules of conjunctival involvement that can be biopsied to make Dx

18

what are the cardiac manifestations that are rare in sarcoidosis

AV block, ventricular arrhythmias, L ventricular dysfunction and sudden death

19

Most common CN involved in sarcoidosis

VII II and VIII

20

most common joints affected by sarcoidosis

ankles and knees

21

What occurs with Ca metabolism in sarcoidosis

disorders of vitamin D that may result in nephrolithiasis, nephrocalcinosis and hypercalcuria
sometimes symptomatic renal stone

22

How do you Dx sarcoidosis

clinical, radiographic and histologic evidence of non-caseating granulomas in one or more organs

23

what is pathoneumonic of sarcoidosis

lofgrens syndrome

24

what is show up on a bronchoalveolar lavage in sarcoidosis

lymphocytosis and elevated CD4/8 ratio

25

What enzyme will be elevated in sarcoid granulomas

ACE

26

What is on DDx for sarcoidosis

mycobacteria, fungi, spirochetes, bacteria, parasites
lymphoma, carcinoma
extrinsic allergic alveolitis (bird fanciers lung and farmers lung)
chemical:silica and beryllium
Immuno: crohns disease, primary biliary cirrhosis, vasculitis

27

What are the CXR staging for sarcoidosis

stage 0: normal
stage 1: b/l hilar adenopathy
stage 2: b/l hilar adenopathy and parenchymal infiltrates
stage 3: parenchymal infiltrates w/o lymphadenopathy
stage 4: advanced parenchymal disease with fibrosis

28

how will sarcoidosis present on a PFT

restrictive ventilatory defect, concurrent obstruction and decreased DLCO

29

What labs should you order if you suspect sarcoidosis

CXR
PFT
opthalmic exam
EKG
CBC
CMP
24 urine
serum ACE
consider cardiac monitoring

30

When do you initiate Tx for sarcoidosis

symptomatic patients only

31

what is Tx for sarcoidosis

prednisone 20-40 mg daily for 3 mo
monitor for improvement in FVC and if improved wean 10-15mg daily for 6-9 mo then taper off
cytotoxic and immunosuppressives are used for those not responding to prednisone

32

Prognosis of sarcoidosis

spontaneous remission in 50% patients at 3 yrs
less than 5% die from sarcoidosis