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OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is sarcoidosis. While this may seem a odd practice, it is useful to see multiple examples of how sarcoidosis will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
KEY CHARACTERISTICS OF THIS CONDITION (ON EXAMS)
When it comes to standardized exams, each condition has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for sarcoidosis.
- African american female: is the classic race/sex combination for this condition.
- Hilar adenopathy: very important buzzword for this condition. Can be seen on imaging.
- Elevated calcium can be observed intros condition.
- Granulomatous tissue: can be seen on histology. Multiple noncaseating granulomas with many giant cells is classic.
QUESTION EXAMPLES
Question # 1
A 35 year old man comes to the clinic because he has had an intermittent fever and cough for the past 4 months. He also explains that he has had a 30-lb weight loss for during this period of time. His past medical history is notable for a recent episode of anterior uveitis that was treated. A physical exam is unremarkable and his vitals are within reference range. Lab studies show a leukocyte count that is normal, an AST of 106 U/L, and alkaline phosphatase of 205 U/L. A chest X-ray reveals hilar adenopathy but is otherwise unremarkable. Diffusion capacity for carbon monoxide is 65% of predicated, and a PPD skin test is negative. What is the likely diagnosis in this patient?
Explanation # 1
Hiliar adenopathy = sarcoidosis
Question # 2
Explanation # 2
TESTABLE FACTS ABOUT THIS CONDITION (BEYOND ITS IDENTIFICATION)
Many questions on standardized exams go beyond simply recognizing the underlying condition. Often there are specific testable facts regarding some aspect of the disease’s pathophysiology/management/clinical implications that are commonly asked. Some of these are listed below:
- Mechanism of hypercalcemia: Activated macrophages in sarcoidosis and other granulomatous diseases produce excess 1,25-dihydroxyvitamin D, which can cause hypercaicemia by increasing intestinal absorption of calcium and phosphate.
Page Updated: 01.22.2017