Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3M - Respiratory > Sarcoidosis > Flashcards

Sarcoidosis Flashcards

1
Q

Epidemiology of sarcoidosis.

A

Highest in northern europe.

Usually affects adults aged 20-40 years more common in women.

Associated with HLA-DRB1 alleles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is sarcoidosis often detected?

A

Incidentally on route CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Explain the immunopathology in sarcoidosis.

A

Typical sarcoid granulomas consisting of focal accumulations of epitheloid cells, macrophages and lymphocytes, mainly T cells.

There is a depressed cell mediated reactivity to tuberculin.

Overall lymphopenia but B cells can be raised.

Bronchoalveolar lavage shows a great increase in the overall number of cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define sarcoidosis.

A

A multisystemic disorder with chronic inflammation and granuloma formation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Symptoms of sarcoidosis.

A

The typical MCQ exam patient is a 20-40 year old black woman presenting with a dry cough and shortness of breath. They may have nodules on their shins suggesting erythema nodosum.

Asymptomatic

Fatigue

Weight loss

Aches and pains

Arteritis

Dyspnoea

Dry eyes

Cough

Extertional dyspnoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Signs of sarcoidosis.

A

Erythema nodosum

Lymphadenopathy

Rashes

Hepatomegaly

Arrhytmia

Anaemia

Nerve palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Common general findings in sarcoidosis.

A

Bilateral lymph node enlargement

Erythema nodosum in forms of a maculopapular rash

Nodularity of the trachea

Bluish discoloration of nose

Pulmonary infiltration

Uveitis in eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Organs involved in sarcoidosis.

A

Lungs, bronchi and trachea (90%)

Liver (50-80%)

Lymph nodes (70%)

Eyes

Skin (25%)

Heart (30%)

Spleen (18%)

Brain (5%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do people with acute sarcoidosis generally present with?

A

Fever

Erythema nodosum

Polyarthralgia and bilateral hilar lymphadenopathy

This is also called Löfgren syndrome and usually resolves spontaneously.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Non-pulmonary signs of sarcoidosis.

A

Lymphadenopathy

Hepatomegaly

Splenomegaly

Uveitis

Conjunctivitis

Bell’s palsy

Neuropathy and meningitis

Erythema nodosum

Arrhythmias

Hypercalcaemia

Hypercalciuria

Renal stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Most common cause of erythema nodosum

A

Sarcoidosis

Can also be idiopathic or due to bacterial infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain erythema nodosum.

A

Usually found in young adult women.

Commonly found on shins and face.

There are bilateral deep tender nodules that are pre-tibial.

The overlying skin is shiny red.

It is called a maculopapular rash.

There can be onset of acute arthralgia, malaise and oedema.

After 2-3 days the lesions flatten and will show up as a bruised appearance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Diagnostic criteria of sarcoidosis.

A

Clinical findings

Exclude differentials

Evidence of non-caseating granulomas on lymph node biopsy of bilateral lymph node enlargement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Differentials of bilateral hilar lymphadenopathy.

A

Sarcoidosis

TB

Lymphoma

Lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Investigations of sarcoidosis.

A

Bloods - ESR, lymphopenia, LFTs, serum ACE, Ca2+, immunoglobulins

24h urine for Ca2+

CXR

HRCT

ECG

PFTs

Tissue biopsy

Bronchoalveolar lavage

USS of kidneys and liver/spleen

Bone x-ray

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Blood findings in sarcoidosis.

A

Raised serum ACE. This is often used as a screening test.

Raised LFTs

Hypercalcaemia is a key finding.

Raised serum soluble interleukin-2 receptor

Raised CRP

Raised immunoglobulins

17
Q

24h urine findings in sarcoidosis.

A

Ca2+ raised

18
Q

Differentials of raised serum ACE.

A

Lymphoma

Pulmonary TB

Asbestosis

Silicosis

This makes raised serum ACE supportive but not diagnostic.

19
Q

ECG findings in sarcoidosis.

A

May show arrhythmias or bundle branch block.

20
Q

Radiological stages of sarcoidosis.

A

Stage 0 - Normal

Stage 1 - BHL

Stage 2 - BHL + peripheral pulmonary infiltrates

Stage 3 - Peripheral pulmonary infiltration alone

4 - Lung fibrosis, bulla formation (honeycomb) and pleural involvement.

21
Q

Findings on PFTs in sarcoidosis.

A

May be normal or show redcued lung volumes, restrictive pattern and reduced transfer factors.

22
Q

What is the diagnostic test of sarcoidosis?

A

The gold standard for confirming the diagnosis of sarcoidosis is by histology from a biopsy. This is usually done by doing bronchoscopy with ultrasound guided biopsy of mediastinal lymph nodes.

The histology shows characteristic non-caseating granulomas with epithelioid cells.

23
Q

Eye involvement in sarcoidosis.

A

Anterior uveitis

Keratoconjunctivitis sicca

24
Q

Neurological involvement in sarcoidosis.

A

Cognitive dysfunction

Nodules

Central diabetes insipidus

Headache

Cranial nerve palsies

Mononeuritis multiplex

Peripheral neruopathy

Seizures

25
Q

Cardiac involvement in sarcoidosis.

A

Arrhythmias

Heart block

Cardiomyopathy

Sudden death

26
Q

Kidney involvement in sarcoidosis.

A

Hypercalciuria

Nephrocalcinosis

Calculi

Tubulointerstitial nephritis

It can be secondary to hypercalcaemia or due to granulomas in kidneys.

27
Q

Hepatic involvement in sarcoidosis.

A

Deranged LFTs

Hepatomegaly

Liver nodules

Cirrhosis

Cholestasis

28
Q

Explain the indication of treatment in sarcoidosis.

A

Not all need treatment -> continous follow-up should be done -> acute sarcoidosis should be treated with bed rest and NSAIDs -> spontaneous remission is common.

However if there is progressive pulmonary disease, disfiguring skin disease, hypersplenism, uveitis, persistent hypercalcaemia or other organ involvement treatment should be considered.

29
Q

Give indications for corticosteroids.

A

Parenchymal lung disease that is symptomatic, static progressive.

Uveitis

Hypercalcaemia

Neurological or cardiac involvement

30
Q

Treatment of sarcoidosis indicating management.

A

Prednisolone 40mg OD PO for 4-6 weeks then decrease the dose over 1 year.

Patients should be given bisphosphonates to protect against osteoporosis whilst on such long term steroids.

31
Q

Treatment of severe sarcoidosis.

A

IV methylprednisolone or

Methotrexate, hydroxychloroquine, ciclosporin or cyclophosphamide or azathioprine.

Anti-TNFalpha treatment can be tried in refractory cases.

Lung transplant

32
Q

Complications of sarcoidosis.

A

Pulmonary fibrosis

Pulmonary respiratory failure

Cor pulmonale

Resp failure

Y3M - Respiratory (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions