Question 1

A patient reporting dyspnea and chest pain along with occasional chills and night sweats has a chest radiograph that shows bilateral hilar lymphadenopathy (BHL) and pulmonary infiltrates. The provider suspects which classification of sarcoidosis?

A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4

B

Accepted Answer

The presence of BHL and pulmonary infiltrates indicates stage 2 sarcoidosis. Stage 1 sarcoidosis typically only presents with BHL and no pulmonary infiltrates, while stage 3 sarcoidosis presents with fibrosis and stage 4 with end-stage organ damage. The patient's symptoms of dyspnea, chest pain, chills, and night sweats are also consistent with the presentation of stage 2 sarcoidosis.

Question 2

Which diagnostic test is most useful when monitoring the progression of sarcoidosis over a long period of time?&#10;A) Chest radiographs&#10;B) Erythrocyte sedimentation rate (ESR)&#10;C) Pulmonary function test (PFT)&#10;D) Radionucleotide scanning

Accepted Answer

Pulmonary function tests (PFTs) are the most useful test for monitoring the progression of sarcoidosis over a long period of time. This is because sarcoidosis most commonly affects the lungs, and PFTs measure lung function, including the volume of air a person can exhale and the rate of airflow. Chest radiographs can show changes in the lungs, but may not be as sensitive as PFTs. Erythrocyte sedimentation rate (ESR) and radionucleotide scanning may be useful in diagnosing sarcoidosis, but are not as useful for monitoring its progression over time.

Question 3

A patient diagnosed with stage 1 sarcoidosis is prescribed a nonsteroidal anti-inflammatory medication to treat joint discomfort has now developed mild dyspnea and cough. Which medication will be added to assist in treating this new symptom?

A) A beta-adrenergic medication
B) An antimalarial agent
C) An immunosuppressant drug
D) An oral corticosteroid

D

Accepted Answer

The development of dyspnea and cough indicate possible pulmonary involvement in the sarcoidosis. Oral corticosteroids have been shown to improve lung function in sarcoidosis patients and are often used as first-line therapy for sarcoidosis involving the lungs. Immunosuppressants and antimalarial agents may also be used in the treatment of sarcoidosis, but are not typically the first choice for pulmonary involvement. Beta-adrenergic medications are not typically used in the treatment of sarcoidosis.

Deck 97: Sarcoidosis