Pulmonology

Question 1

Name the adverse prognostic indicators associated with sarcoidosis. ( 8 )

Answer 1

1. Age of onset > 40 years
2. Afro-Caribbean or Afro-American race
3. Cardiac involvement
4. Chronic hypercalcemia
5. Lupus pernio
6. Nasal mucosal involvement
7. Neurosarcoidosis
8. Progressive pulmonary sarcoidosis

Question 2

Describe the 5 stages of pulmonary involvement of sarcoidosis based on chest radiograph findings

Answer 2

Stage 0: Normal chest radiograph
Stage 1: bilateral hilar lymphadenopathy ( BHL )
Stage 2: BHL with pulmonary infiltrates
Stage 3: parenchymal infiltrates without hilar lymphadenopathy
Stage 4: pulmonary fibrosis ( volume loss ) +/- cavitations, calcifications, bullae

Question 3

Name the differential diagnoses of bilateral hilar lymphadenopathy. ( 6 )

Answer 3

1. Sarcoidosis
2. Lymphoma
3. Tuberculosis
4. Berylliosis
5. Pneumoconiosis
6. Fungal diseases ( eg histoplasmosis )