A 44-year-old woman comes to the physician because of a 6-month history of fatigue, intermittent fever, a 4.0-kg (9-lb) weight loss, and a progressive, nonproductive cough. She does not smoke. Physical examination shows mild wheezing over bilateral lung fields. Chest x-ray demonstrates enlarged hilar lymph nodes, and laboratory testing reveals an elevated ACE level. Purified protein derivative testing is negative. Appropriate pharmacotherapy is initiated. At follow-up a few days later, the symptoms have improved but blood glucose is elevated. Which of the following additional changes is most likely present in this patient due to her treatment?

Question

A 44-year-old woman comes to the physician because of a 6-month history of fatigue, intermittent fever, a 4.0-kg (9-lb) weight loss, and a progressive, nonproductive cough. She does not smoke. Physical examination shows mild wheezing over bilateral lung fields. Chest x-ray demonstrates enlarged hilar lymph nodes, and laboratory testing reveals an elevated ACE level.  Purified protein derivative testing is negative.  Appropriate pharmacotherapy is initiated.  At follow-up a few days later, the symptoms have improved but blood glucose is elevated.  Which of the following additional changes is most likely present in this patient due to her treatment?

Quizplus · Accepted Answer

Eductional Objective: Glucocorticoids have a variety of effects that can be useful in reducing inflammation and limiting end-organ damage in inflammatory diseases (eg, sarcoidosis).  These include decreased proinflammatory cytokine (IL-1, interferon-gamma) production, increased anti-inflammatory cytokine (eg, IL-10) production, and impaired migration of leukocytes (eg, neutrophils) to sites of inflammation.

A 44-Year-Old Woman Comes to the Physician Because of a 6-Month