6. MTB Step 3 - Sarcoidosis

Question 1

PRESENTATION

What are (5) Common Presenting characteristics/manifestations of Sarcoidosis?

Answer 1

1. African-American Woman
2. Age < 40
3. Cough
4. Shortness of Breath (SOB)
5. Fatigue

Question 2

PRESENTATION

What is the Most Common Physical Exam finding for Sarcoidosis?

Answer 2

Rales

on Pulmonary exam

Question 3

PRESENTATION

Even though Sarcoidosis can involve many organs, which organs findings make up the vast majority of cases?

Answer 3

LUNG

the ONLY finding in the vast majority of cases.

Question 4

PRESENTATION

What is (1) Rare Physical Exam finding of the EYE in Sarcoidosis?

Answer 4

1. Uveitis that can be sight threatening

Question 5

PRESENTATION

What is (1) Rare NEURAL Physical Exam finding in Sarcoidosis?

Answer 5

1. Seventh CN involvement (most common, yet still rare)

Question 6

PRESENTATION

What are (2) Rare Physical Exam finding of the SKIN in Sarcoidosis?

Answer 6

1. Lupus Pernio - purplish lesion of the skin of the face
2. Erythema Nodosum

Question 7

PRESENTATION

What are (2) Rare CARDIAC Physical Exam findings in Sarcoidosis?

Answer 7

1. Restrictive Cardiomyopathy
2. Cardiac Conduction Defects

Question 8

PRESENTATION

Which (2) Organs are normal on Physical Exam in Sarcoidosis?

Answer 8

1. Renal
2. Hepatic

Question 9

DIAGNOSIS

What Electrolyte Disturbance occurs in a small number of patients with Sarcoidosis, and why?

Answer 9

HYPOCALCEMIA

secondary to vitamin D production by the granulomas of sarcoidosis.

Question 10

DIAGNOSIS

1. What is the Best INITIAL Diagnostic Test for Sarcoidosis?
2. What is the Most ACCURATE Diagnostic Test for Sarcoidosis?

Answer 10

1. CXR - always shows Enlarged Lymph Nodes.
2. Lung or Lymph Node Biopsy - shows Noncaseating Granulomas

Question 11

DIAGNOSIS

What does Bronchoalveolar Lavage (BAL) show?

Answer 11

Increased CD4 Cells

Question 12

TREATMENT

What is the Absolute BEST Treatment for Sarcoidosis?

Answer 12

STEROIDS!!!