Sarcoidosis, D Linger, DSA Flashcards

(32 cards)

1
Q

What is sarcoidosis

A

systemic granulomatous disease characterized by non-caseating granulomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

90% patients with sarcoidosis present with what

A

mediastinal hilar lymph node involvement or parenchymal lung disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When is the peak incidence of sarcoidosis

A

between ages 20 and 39

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

demographic distribution of sarcoidosis

A

3.5x more common in black americans

women >men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Lofgrens syndrome

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

prognosis of lofgrens syndrome

A

favorable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

chronic sarcoidosis can lead to what

A

progressive pulmonary fibrosis and increased morbidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the general Sx of sarcoidosis

A

fatigue, fever, night sweats and weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are Sx and signs of pulmonary involvement in sarcoidosis

A

cough, dyspnea with exertion, wheeze, chest discomfort

rales, expiratory wheezing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are signs and Sx of skin involvement in sarcoidosis

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are signs and Sx of ocular involvement in sarcoidosis

A

gritty or dry eyes, pain, redness and or blurred vision

uveitis, iritis, scleral plaques, enlarged lacrimal glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are signs and Sx of cardiac involvement in sarcoidosis

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are signs and Sx of nervous system involvement in sarcoidosis

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are signs and Sx of GI involvement in sarcoidosis

A

epigastric pain, early satiety, RUQ pain, jaundice

HSM, jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are signs and Sx of MSK involvement in sarcoidosis

A

swelling and joint stiffness, joint pain, muscle pain

arthralgias, arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are Signs of lymphatic involvement in sarcoidosis

A

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

17
Q

how can you Dx sarcoidosis based of signs found around eye

A

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

18
Q

what are the cardiac manifestations that are rare in sarcoidosis

A

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

19
Q

Most common CN involved in sarcoidosis

A

VII II and VIII

20
Q

most common joints affected by sarcoidosis

A

ankles and knees

21
Q

What occurs with Ca metabolism in sarcoidosis

A

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

22
Q

How do you Dx sarcoidosis

A

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

23
Q

what is pathoneumonic of sarcoidosis

A

lofgrens syndrome

24
Q

what is show up on a bronchoalveolar lavage in sarcoidosis

A

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