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Respiratory > Sarcoidosis > Flashcards

Sarcoidosis Flashcards

1
Q

What is sarcoidosis?

A

Sarcoidosis is a chronic granulomatous disorder

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2
Q

What are granulomas?

A

Granulomas are inflammatory nodules full of macrophages

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3
Q

What are the main 2 extrapulmonary manifestations of sarcoidosis?

A

Erythema nodosum
Lymphadenopathy

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4
Q

What is the common patient in sarcoidosis? (3)

A

• Aged 20-39 or around 60
• Women
• Black ethnic origin

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5
Q

What are the systemic symptoms of sarcoidosis? (4)

A

• Fever
• Fatigue
• Weight loss
Painful nodule

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6
Q

What is the screening test for sarcoidosis?

A

Raised angiotensin converting enzyme

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7
Q

What are the 2 key blood test findings in sarcoidosis?

A

Raised angiotensin converting enzyme
Raised calcium (hyper calcium)

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8
Q

What is seen on cxr in sarcoidosis?

A

Hilar lymphadenopathy

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9
Q

What is seen on a high resolution ct in sarcoidosis? (2)

A

Hilar lymphadenopathy
Pulmonary nodules

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10
Q

What does an mri show in sarcoidosis?

A

Central nervous system involvement

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11
Q

What is seen on biopsy of mediastinal lymph nodes in sarcoidosis?

A

non-caseating granulomas with epithelioid cells.

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12
Q

What is the first line management of sarcoidosis? What drug is given in conjunction to prevent side effects?

A

Oral steroids (for 6-24 months) are usually first-line where treatment is required.
Bisphosphonates protect against osteoporosis whilst on long-term steroids.

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13
Q

What is the second line medical management in sarcoidosis?

A

Methotrexate

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14
Q

What is the prognosis of sarcoidosis?

A

Sarcoidosis spontaneously resolves in around half of patients, usually within two years. In some patients, it progresses to pulmonary fibrosis and pulmonary hypertension. Overall mortality is less than 10%.

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15
Q

What skin changes are seen in sarcoidosis? (2)

A

Erythema nodosum
Lupus Pernia

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16
Q

What is lupus pernio? When is it seen?

A

Raised purple lesions on cheeks and nose
Sarcoidosis

17
Q

What is erythema nodosum?

A

Inflamed subcutaneous fat on the shins
Raised red tender painful

18
Q

What is inflammation of fat called?

A

Panniculitis

19
Q

What is Panniculitis?

A

Inflammation of fat

20
Q

What are raised red tender painful subcutaneous nodules on both shins called?

A

Erythema nodosum

21
Q

What is seen on Spirometry in sarcoidosis?

A

Restrictive picture
>80%

22
Q

What does sarcoidosis cause in the lungs? (3)

A

• Mediastinal lymphadenopathy
• Pulmonary fibrosis
• Pulmonary nodules

23
Q

What does sarcoidosis cause in the liver? (3)

A

• Liver nodules
• Cirrhosis
• Cholestasis

24
Q

What does sarcoidosis cause in the eyes? (3)

A

• Uveitis
• Conjunctivitis
• Optic neuritis

25
Q

What does sarcoidosis cause in the heart? (3)

A

• Bundle branch block
• Heart block
• Myocardial muscle involvement

26
Q

What does sarcoidosis cause in the kidneys? (3)

A

• Kidney stones (due to hypercalcaemia)
• Nephrocalcinosis
• Interstitial nephritis

27
Q

What does sarcoidosis cause in the central nervous system? (3)

A

• Nodules
• Pituitary involvement (diabetes insipidus)
• Encephalopathy

28
Q

What does sarcoidosis cause in the peripheral nervous system? (2)

A

• Facial nerve palsy
• Mononeuritis multiplex

29
Q

What does sarcoidosis cause in the bones? (3)

A

• Arthralgia
• Arthritis
• Myopathy

30
Q

What is lofgrens syndrome? What symptoms are seen?

A

Lofgren’s syndrome refers to a specific presentation of sarcoidosis with a classic triad of symptoms:
• Erythema nodosum
• Bilateral hilar lymphadenopathy
• Polyarthralgia (joint pain in multiple joints)

31
Q

What are the top differentials of sarcoidosis? (6)

A

• Tuberculosis
• Lymphoma
• Hypersensitivity pneumonitis
• HIV
• Toxoplasmosis
• Histoplasmosis

Respiratory (18 decks)

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