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Respiratory Y1 > Sarcoidosis > Flashcards

Sarcoidosis Flashcards

1
Q

what is sarcoidosis

A
  • granulomatous inflammatory condition usually assc. w/ chest symptoms
  • also has multiple extra-pulmonary manifestations e.g. erythema nodosum and lymphadenopathy
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2
Q

what are granulomas

A

nodules of inflammation full of macrophages

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3
Q

when are the two spikes of incidence of sarcoidosis

A
  • young adulthood

- appx age 60

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4
Q

what people are more often affected by sarcoidosis

A
  • women

- black people

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5
Q

where on the body may nodules appear to suggest erythema nodosum

A

shins

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6
Q

what organs are affected in sarcoidosis

A
  • lungs (affecting >90%)
  • liver
  • eyes
  • skin
  • heart
  • kidneys
  • CNS
  • PNS
  • Bones
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7
Q

what lung pathology might be seen as a result of sarcoidosis

A
  • mediastinal lymphadenopathy
  • pulmonary fibrosis
  • pulmonary nodules
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8
Q

give some systemic symptoms of sarcoidosis

A
  • fever
  • fatigue
  • weight loss
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9
Q

what liver pathology might be seen as a result of sarcoidosis

A
  • liver nodules
  • cirrhosis
  • cholestasis
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10
Q

what eye pathology might be seen as a result of sarcoidosis

A
  • uveitis
  • conjunctivitis
  • optic neuritis
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11
Q

what skin pathology might be seen as a result of sarcoidosis

A
  • erythema nodosum
  • lupus pernio
  • granulomas develop in scar tissue
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12
Q

what heart pathology might be seen as a result of sarcoidosis

A
  • bundle branch block
  • heart block
  • myocardial muscle involvement
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13
Q

what kidney pathology might be seen as a result of sarcoidosis

A
  • kidney stones (due to hypercalcaemia)
  • nephrocalcinosis
  • interstitial nephritis
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14
Q

what CNS pathology might be seen as a result of sarcoidosis

A
  • nodules
  • pituitary involvement (diabetes insipidus)
  • encephalopathy
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15
Q

what PNS pathology might be seen as a result of sarcoidosis

A
  • facial nerve palsy

- mononeuritis multiplex

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16
Q

what bone pathology might be seen as a result of sarcoidosis

A
  • arthralgia
  • arthritis
  • myopathy
17
Q

what’s is Lofgren’s syndrome

A

specific presentation of sarcoidosis…

triad of:

  • erythema nodosum
  • bilateral hilar lymphadenopathy
  • polyarthralgia
18
Q

give some differential diagnoses of sarcoidosis

A
  • tuberculosis
  • lymphoma
  • hypersensitivity pneumonitis
  • HIV
  • toxoplasmosis
  • histoplasmosis
19
Q

what results might be seen in blood tests in suspected sarcoidosis

A
  • ^ serum ACE
  • hypercalcaemia
  • ^ serum soluble interleukin-2 receptor
  • ^ CRP
  • ^ immunoglobulins
20
Q

what blood test result is often used as a screening test for sarcoidosis

A

^ serum ACE

21
Q

what imaging results would be seen in sarcoidosis

A
  • CXR –> hilar lymphadenopathy
  • high resolution CT thorax –> hilar lymphadenopathy and pulmonary nodules
  • MRI –> CNS involvement
  • PET scan –> active inflammation in affected areas
22
Q

what is the gold standard for confirming diagnosis of sarcoidosis

A

histology from biopsy

23
Q

how is a biopsy obtained for sarcoidosis

A

bronchoscopy w/ ultrasound guided biopsy of mediastinal lymph nodes

24
Q

what would be seen histologically to suggest sarcoidosis

A

non-caseating granulomas w/ epitheliod cells

25
Q

what tests could be done to show other organ involvement

A
  • U&Es –> kidney
  • urine dipstick or urine albumin-creatinine ratio to look for proteinuria –> nephritis
  • LFTs –> liver
  • opthalmology –> eye
  • ECG and echo –> heart
  • ultrasound abdomen –> liver and kidney
26
Q

what is the treatment of sarcoidosis

A
  • no treatment considered as first line in Px w/ no or mild symptoms as condition often resolves spontaneously
  • oral steroids usually first line where treatment req. given for between 6-24 months
  • 2nd line options –> methotrexate or azathioprine
  • lung transplant in severe pulmonary disease
27
Q

what should Px be given while taking long term oral steroids and why

A

Px given bisphosphonates to protect against osteoporosis

28
Q

what is the prognosis of sarcoidosis

A
  • spontaneously resolves within 6 months in around 60% of px
  • can progress w/ pulmonary fibrosis and pulmonary hypertension in small number of px
  • death in sarcoidosis is usually when it affects the heart or CNS

Respiratory Y1 (14 decks)

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