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Respiratory > Sarcoidosis > Flashcards

Sarcoidosis Flashcards

1
Q

What is sarcoidosis?

A

A chronic granulomatous disorder characterised by non-caseating granulomas

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2
Q

What is the epidemiology of sarcoidosis?

A

More common in:
- Aged 20-39 or around 60
- Women
- Black ethnic origin

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3
Q

What are the skin features of sarcoidosis?

A

Erythema nodosum
Lupus pernio - raised purple lesions often on the cheek and nose

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4
Q

What are the lung features of sarcoidosis?

A

Non-productive cough
Dyspnoea
Cervical and submandibular lymphadenopathy
Pulmonary fibrosis
Pulmonary nodules

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5
Q

What are the possible systemic symptoms of sarcoidosis?

A

Fever
Fatigue
Weight loss

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6
Q

What are the potential liver features of sarcoidosis?

A

Liver nodules
Cirrhosis
Cholestasis

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7
Q

What are the eye features of sarcoidosis?

A

Uveitis
Conjunctivitis
Optic neuritis

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8
Q

What are the MSK manifestations of sarcoidosis?

A

Arthralgia
Arthritis
Myopathy

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9
Q

What is Lofgren’s syndrome?

A

A specific presentation of sarcoidosis with a classic triad of symptoms:
- Erythema nodosum
- Bilateral hilar lymphadenopathy
- Polyarthralgia

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10
Q

What are the differentials of sarcoidosis?

A

TB
Lymphoma
Hypersensitivity pneumonitis
HIV
Toxoplasmosis
Histoplasmosis

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11
Q

What investigations are used in the diagnosis of sarcoidosis?

A

Blood tests:
- ACE - raised
- Serum calcium - raised

Imaging:
- CXR - hilar lymphadenopathy
- CT chest - hilar lymphadenopathy and pulmonary nodules

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12
Q

What other investigations may be considered in sarcoidosis?

A

Spirometry - restrictive lung disease
Lung tissue biopsy
ECG - sarcoidosis can cause heart block
LFTs for liver involvement
U&Es for kidney involvement

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13
Q

What is the staging of sarcoidosis on CXR?

A

Stage 0 - normal
Stage 1 - bilateral hilar lymphadenopathy
Stage 2 - bilateral hilar lymphadenopathy and interstitial infiltrates
Stage 3 - diffuse pulmonary infiltrates without hilar lymphadenopathy
Stage 3 - diffuse fibrosis

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14
Q

What are the indications for steroids in sarcoidosis?

A

Symptomatic and stage 2 or 3 on CXR
Extrapulmonary involvement
Hypercalcaemia

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15
Q

What is the treatment of symptomatic sarcoidosis or progressive disease?

A

First line - corticosteroids
Second line - immunosuppressants (methotrexate)
End stage - consider lung transplantation

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16
Q

What is the management of asymptomatic or non-progressive disease?

A

Conservative management

17
Q

What are the complications of sarcoidosis?

A

Pulmonary hypertension
Respiratory failure
Cor pulmonale
Heart block
Cranial nerve palsies
Meningeal disease
Uveitis

Respiratory (12 decks)

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