Sarcoidosis, Pulmonary Tuberculosis, and Pneumothorax Flashcards
where is the incidence highest for sarcoidosis?
scandinavian countries and african american populations
what is the general idea of the pathophysiology of sarcoidosis?
there is a trigger (most likely bacterial like tuberculosis or an inhaled particle); interaction of trigger with other factors leads to a dysregulated immune response in genetically predisposed people
what is the pathological hallmark of sarcoidosis?
compact, epithelioid, non-necrotizing granulomas with varying degrees of lymphocytic inflammation
what is the clinical presentation of pulmonary sarcoidosis?
gradual onset (months), constitutional symptoms, respiratory symptoms, incidental finding on CXR
what are the different disease courses of pulmonary sarcoidosis?
self limited, chronic and stable, chronic and progressive
how do you make the diagnosis of sarcoidosis?
clinical findings + histological evidence of non-caseating granulomas, while excluding other diseases with similar picture (NEED BIOPSY)
what labs might you order when trying to diagnose sarcoidosis?
cbc, cmp, UA, HIV and TB testing, ACE (may be elevated in sarcoidosis)
besides labs what else might you order when trying to diagnose sarcoidosis?
CXR then high resolution CT, bronchoscopy with biopsy, EKG, and PFTs
what are the CT findings in a patient with sarcoidosis?
string of beads; galaxy appearance
what does a CXR show in a patient with sarcoidosis?
enlarged hilar lymph nodes
how do you manage sarcoidosis?
asymptomatic patients: need to see if their organ function is in danger. If it is not then you wait and watch. If it is then you give them anti-inflammatory medications like CSs. If the patient was symptomatic you need to determine if their symptoms were caused by inflammation, risk of permanent organ defect, and if there is high symptom burden. If there is, then treat them with anti-inflammatory therapy like CSs. If there isnt, wait and watch
what are some of the complications associated with sarcoidosis?
they are at increased risk of infection, CHF, stroke, VTE, and autoimmune disease; they are also at increased risk of cancer, and high rates of anxiety, depression, and sleep disorders
