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Year 6 Respiratory > Sarcoidosis > Flashcards

Sarcoidosis Flashcards

1
Q

What is sarcoidosis?

A

Sarcoidosis is a multisystem disorder of unknown aetiology characterised by non-caseating granulomas. It is more common in young adults and in people of African descent.

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2
Q

What are the acute features of sarcoidosis?

A

Acute features include erythema nodosum, bilateral hilar lymphadenopathy, swinging fever, and polyarthralgia.

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3
Q

What are the insidious features of sarcoidosis?

A

Insidious features include dyspnoea, non-productive cough, malaise, and weight loss.

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4
Q

What ocular condition is associated with sarcoidosis?

A

Uveitis.

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5
Q

What skin condition is associated with sarcoidosis?

A

Lupus pernio.

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6
Q

What causes hypercalcaemia in sarcoidosis?

A

Macrophages inside the granulomas cause an increased conversion of vitamin D to its active form (1,25-dihydroxycholecalciferol).

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7
Q

What is Lofgren’s syndrome?

A

Lofgren’s syndrome is an acute form of sarcoidosis characterised by bilateral hilar lymphadenopathy, erythema nodosum, fever, and polyarthralgia. It usually carries an excellent prognosis.

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8
Q

What is Mikulicz syndrome?

A

Mikulicz syndrome involves enlargement of the parotid and lacrimal glands due to sarcoidosis, tuberculosis, or lymphoma.

This term is now considered outdated and unhelpful by many as there is a confusing overlap with Sjogren’s syndrome.

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9
Q

What is Heerfordt’s syndrome?

A

Heerfordt’s syndrome (uveoparotid fever) involves parotid enlargement, fever, and uveitis secondary to sarcoidosis.

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10
Q

What is the diagnostic approach for sarcoidosis?

A

Diagnosis is largely clinical as there is no one diagnostic test for sarcoidosis.

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11
Q

What are the sensitivity and specificity of ACE levels in diagnosing sarcoidosis?

A

ACE levels have a sensitivity of 60% and specificity of 70%.

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12
Q

What role do ACE levels play in sarcoidosis?

A

ACE levels are not reliable for diagnosis but may help in monitoring disease activity.

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13
Q

What routine blood findings may be present in sarcoidosis?

A

Routine bloods may show hypercalcaemia in 10% of patients and a raised ESR.

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14
Q

What does a chest x-ray show in stage 0 of sarcoidosis?

A

Stage 0 = normal.

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15
Q

What does a chest x-ray show in stage 1 of sarcoidosis?

A

Stage 1 = bilateral hilar lymphadenopathy (BHL).

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16
Q

What does a chest x-ray show in stage 2 of sarcoidosis?

A

Stage 2 = BHL + interstitial infiltrates.

17
Q

What does a chest x-ray show in stage 3 of sarcoidosis?

A

Stage 3 = diffuse interstitial infiltrates only.

18
Q

What does a chest x-ray show in stage 4 of sarcoidosis?

A

Stage 4 = diffuse fibrosis.

19
Q

What might spirometry show in sarcoidosis?

A

Spirometry may show a restrictive defect.

20
Q

What does a tissue biopsy reveal in sarcoidosis?

A

Tissue biopsy shows non-caseating granulomas.

21
Q

Is the gallium-67 scan used routinely in sarcoidosis?

A

No, the gallium-67 scan is not used routinely.

22
Q

What is the Kveim test and its current status?

A

The Kveim test involves injecting part of the spleen from a patient with known sarcoidosis under the skin, but it is no longer performed due to concerns about cross-infection.

23
Q

What is sarcoidosis?

A

Sarcoidosis is a multisystem disorder of unknown aetiology characterised by non-caseating granulomas.

24
Q

Who is more commonly affected by sarcoidosis?

A

It is more common in young adults and in people of African descent.

25
Q

When are steroids indicated in sarcoidosis management?

A

Steroids are indicated for patients with chest x-ray stage 2 or 3 disease who are symptomatic.

26
Q

Do asymptomatic patients with stable stage 2 or 3 sarcoidosis require treatment?

A

No, asymptomatic and stable stage 2 or 3 disease patients with only mildly abnormal lung function do not require treatment.

27
Q

What are other indications for steroids in sarcoidosis?

A

Indications include hypercalcaemia and eye, heart, or neuro involvement.

28
Q

What is sarcoidosis?

A

Sarcoidosis is a multisystem disorder of unknown aetiology characterised by non-caseating granulomas.

29
Q

Who is more commonly affected by sarcoidosis?

A

It is more common in young adults and in people of African descent.

30
Q

What is the typical prognosis for sarcoidosis without treatment?

A

Sarcoidosis remits without treatment in approximately two-thirds of people.

31
Q

What factors are associated with poor prognosis in sarcoidosis?

A
  1. Insidious onset, symptoms > 6 months
  2. Absence of erythema nodosum
  3. Extrapulmonary manifestations: e.g. lupus pernio, splenomegaly
  4. CXR: stage III-IV features
  5. Black African or African-Caribbean ethnicity

Year 6 Respiratory (23 decks)

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