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Non infectious granulomas Flashcards

1
Q

Causes/risk factors of sarcoidosis

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2
Q

Name the clinical subtypes of sarcoidosis

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3
Q

Discuss NB points about sarcoidosis

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4
Q

Write a summary of the findings of cutaneous sarcoidosis

A

1) 20% skin lesions develop before systemic findings, 50% with systemic findings, 30% after systemic findings
2) lesions are astmptomatic (or mild itching)
3) Multiple, firm, elastic lesions - red, brown, purple, yellow
4) involve whole thickness of dermis
Clinical appearances: papular, plaques, annular, ulcerative, subcutaneous (Darier Roussy) - arms, skin may look normal, morpheiform, scars, icthyosiform, erythrodermic, alopecia, mucosal, hypopigmented

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5
Q

Name sarcoidosis syndromes

A

1) Lupus pernio
2) Lofgren’s sarcoidosis (acute sarcoidosis)
3) Heerfordt
4) Mikulicz syndrome
5) Unthoff phenomenon

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6
Q

Write short notes on lupus pernio

A

1) asymptomatic, red, brown papules on the nose, ears and cheeks - may ulcerate and leave telangiectatic scars. Nasal lesions may involve the septum and cause nosebleeding
2) increased association with chronic pulmonary fibrosis
3) Upper respiratory tract sarcoidosis (50%)
4) Granulomas/cysts bones (distal phalanges) -40%
5) clinically diascopy - apple jelly appearance
6) recalcitrant to rx - Topical and IL c/s, topical calcineurin inhibitors, systemic steroids if rapidly progressing skin lesions. other: Hydrochloroquine, minocycline

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7
Q

Write short notes on lofgren’s (acute) sarcoidosis

A

Acute sarcoidosis with triad: bilateral hilar LAD, erythema nodosum, acute arthritis (esp ankles)
Fever+malaise, female predominance, strong association with HLA-DRB1 allele
other: Respiratory symptoms: ( mild shortness of breath),
acute uveitis or iridocyclitis (inflammation of the eye), parotitis. Treatment : NSAIDs, colchicine, systemic c/s

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8
Q

Write short notes on Heerfordt syndrome

A

Subacute variant of sarcoidosis
(neurosarcoidosis)
Anterior uveitis, parotid/lacrimal gland enlargement, Cranial nerve palsy, low grade fever.

Heerfordt’s syndrome is classified into complete type, in which all four main symptoms are presented, and incomplete type, in which two out of the three symptoms of facial nerve palsy, parotid gland enlargement, and anterior uveitis are detected.

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9
Q

Write short notes on Mikulicz syndrome

A

Associations: IgG4-related diseases, Sjögren syndrome, gland involvement with sarcoidosis, gland involvement with lymphoma
Clinically - painless bilateral symmetric swelling of the lacrimal and salivary glands
-xerostomia
-xerophthalmia

Mikulicz syndrome is a non-specific inflammatory enlargement of at least two or more of the salivary and lacrimal glands with xerostomia.

Markers
IgG4 titres (80% sensitivity)
ANA

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10
Q

Write short notes on Unthoff phenomenon

A

Unthoff syndrome - transient, worsening of neurological function lasting less than 24 hours that usually occur in multiple sclerosis patients due to increases in core body temperature
Can also occur in atypical form of sarcoidosis

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11
Q

Name the systemic symptoms of sarcoidosis

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12
Q

Write notes on diagnosis/tests with re to sarcoidosis

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13
Q

Write notes on activity monitoring in sarcoidosis

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14
Q

Write short notes on the treatment of sarcoidosis

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15
Q

Write short notes on the outcome and prognosis of sarcoidosis

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16
Q

Write short notes on granuloma annulare with regards to granuloma annulare

A

Epidemiology
-children and young adults (2/3rds before 30)
- F>M

Pathogenesis
-unknown
-Th1 delayed type hypersensitivity reaction to a variety of triggers (trauma/isomorphic koenner repo se, insect bites, TBST, mycobacterial/viral infection or UV radiation)
Trigger-> Th1 reaction -> monocyte accumulation jn dermis -> release of lysosomal enzymes -> degredation of elastic fibres

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17
Q

Name the 2 main categories of granuloma annulare

A

1) localized
2) generalized

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18
Q

Name the associations which occur more commonly in generalized GA

A

1) hyperlipidemia
2) type I DM
3) HIV
4) Thyroid disease
5) Malignancy

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19
Q

Write key notes on Granuloma annulare
-clinical features
-variants

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20
Q

Write key notes on histopathology of Granuloma annulare

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21
Q

Write key notes on the treatment and prognosis of granuloma annulare

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22
Q

Write short notes on annular elastolytic giant cell granuloma

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23
Q

Write short note on interstisial granulomatous dermatititis and arthritis (IGDA) and Neutrophilic granulomatous dermatitis (PNGD)

24
Q

Tabulate and compare IGDA and PNGD

25
Write short notes on interstitial granulomatous drug eruption
26
Write notes on necrobiosis lepoidica 1) epidemiology 2) pathogenesis 3) clinical features 4) histopathology
27
Write notes on necrobiosis lepoidica - treatment -prognosis
28
Write short notes on necrobiotic xanthogranuloma
29
Picture of necrobiotic xanthogranuloma
30
Write notes on cutanoeus chrons disease -epidemiology -pathogenesis
31
Write notes on cutaneous chrons -clinical features -histopathology -treatment/prognosis
32
picture of cutaneous chrons
33
picture of sarcoidosis
34
Write notes on sarcoidosis -epidemiology -pathogenesis
35
Write short notes on sarcoidosis -clinical features -histopathology
36
Write notes on laboratory testing and treatment of sarcoidosis
37
picture of lupus pernio
38
Name and write notes on different variants of sarcoidosis
39
Algorithm for histologic diagnosis of non-infectious granulomas
40
Clinical features of the major granulomatous dermatitis
41
Histological features of major granulomatous dermatitis
42
Treatment ladder of cutaneous sarcoidosis
43
Spectrum of cutaneous manifestations of sarcoidosis
44
Systemic manifestations of sarcoidosis
45
Picture of cutaneous chrons
46
picture id sarcoidosis
47
Pictures of granuloma (non infectious) d/o
48
Causes of interstisial granulomatous drug reactions
49
Spectrum of granulomatous, neutrophilic and vasculitic dermatoses in patients with rheumatologic disorders
50
Picture of non infectious granulomatous d/o
51
Pictures of non infectious granulomas
52
picture of necrobiosis lepoidica
53
Pictures of cutaneous chrons
54
Pictures of GA variants
55
Picture of annular elastolytic giant cell granuloma
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Pictures of non infectious granulomas
57
Pictures of non infectious granulomas

Test 2 (14 decks)

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