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Year One - Respiratory System > Sarcoidosis > Flashcards

Sarcoidosis Flashcards

1
Q

What is sarcoidosis?

A

It is defined as a multisystem disorder, characterised by non-caseating granulomatous inflammation

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2
Q

What are granulomas?

A

They are nodules of inflammation, containing macrophages

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3
Q

What is the aetiology of sarcoidosis?

A

Unknown

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4
Q

Why do respiratory specialists manage sarcoidosis, despite being a multisystem disorder?

A

In most cases, sarcoidosis affects the lungs

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5
Q

Is sarcoidosis an obstructive or restrictive lung disease?

A

Restrictive lung disease

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6
Q

What are the three risk factors of sarcoidosis?

A

Female Gender

Young Age, 20 – 40 Years Old

Black Ethnicity

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7
Q

What are the clinical features of sarcoidosis?

A

It is a multisystem disorder that affects almost any organ in the body, therefore the clinical features vary significantly

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8
Q

In exams, what form of sarcoidosis is usually presents?

A

Lofgren’s syndrome

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9
Q

What are the five clinical features associated with Lofgren’s syndrome?

A

Respiratory Features

Erythema Nodosum

Lupus Pernio

Bilateral Hilar Lymphadenopathy

Polyarthralgia

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10
Q

What is erythema nodosum?

A

It is defined as tender, red nodules on the shins

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11
Q

What is the cause of erythema nodosum?

A

It is caused by inflammation of the subcutaneous fat

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12
Q

What is lupus pernio?

A

It is defined as rash, consisting of a raised purple plaque

It affects the tip of the nose, checks, lips, ears and the skin around the right nostril

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13
Q

What is bilateral hilar lymphadenopathy?

A

It s defined as bilateral enlargement of the pulmonary hilla lymph nodes

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14
Q

What is polyarthralgia?

A

It is defined as joint pain, affecting multiple joint

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15
Q

Which joints are affected by sarcoidosis - small or large?

A

Large

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16
Q

What four investigations are used to diagnose sarcoidosis?

A

Blood Tests

Chest X-Ray (CXR)

CT Scan

Tissue Biopsy

17
Q

What five blood test results indicate sarcoidosis?

A

Increased Serum ACE Levels

Increased CRP/ESR Levels

Increased Serum Soluble Interleukin-2 Receptor Levels

Hypercalcaemia

Hyperglobulinaemia

18
Q

Describe why hypercalcaemia is associated with sarcoidosis

A

This is due to the fact that the macrophages in the granulomas cause an increased conversion of vitamin D to its active form

19
Q

What CXR feature indicates stage one sarcoidosis?

A

Bilateral Hilar Lymphadenopathy (BHL)

20
Q

What two CXR features indicate stage two sarcoidosis?

A

Bilateral Hilar Lymphadenopathy (BHL)

Interstitial Pulmonary Infiltrates

21
Q

What CXR feature indicates stage three sarcoidosis?

A

Diffuse Interstitial Infiltrates

22
Q

What CXR feature indicates stage four sarcoidosis?

A

Diffuse Fibrosis

23
Q

What fibrosis is associated with fibrosis - upper lung zone or lower lung zone?

A

Upper lung zone

24
Q

What are the two signs of sarcoidosis on CT scan?

A

Bilateral Hilar Lymphadenopathy

Pulmonary Nodules

25
Q

What is the gold standard investigation used to diagnose sarcoidosis?

A

Tissue biopsy

26
Q

What tissue is biopsied in pulmonary sarcoidosis? How is this biopsy conducted?

A

Mediastinal lymph nodes

It is conducted by bronchoscopy, under ultrasound guidance

27
Q

What histology results indicate sarcoidosis?

A

Non-caseating granulomas with epithelioid cells

28
Q

When is no treatment of sarcoidosis recommended? Why?

A

In individuals who present with mild clinical features

In 60% of cases, sarcoidosis spontaneously resolves

29
Q

How long does it usually take for sarcoidosis to spontaneously resolve?

A

6 months

30
Q

What are the two pharmacological management options for sarcoidosis?

A

Steroids

Immunosuppressants

31
Q

What is the first line pharmacological management option used to treat sarcoidosis?

A

Steroids

32
Q

What steroid is used to treat sarcoidosis? At what dose? How long is the course?

A

Oral prednisolone

40mg for 4 -6 weeks

This dose is then gradually reduced over a period of 6 - 24 months

33
Q

Due to the long term administration of steroids, what do we additionally prescribe patients? Why?

A

Bisphosphonates

To prevent the development of osteoporosis

34
Q

What is the second line pharmacological management option used to treat sarcoidosis?

A

Immunosuppressants

35
Q

What two immunosuppressants are used to treat sarcoidosis?

A

Methotrexate

Azathioprine

36
Q

What surgical management option is used to treat sarcoidosis?

A

Lung transplant

37
Q

When is a lung transplant recommended to treat sarcoidosis?

A

In severe cases of sarcoidosis, in which pulmonary fibrosis and pulmonary hypertension develop

Year One - Respiratory System (14 decks)

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