Resp: Sarcoidosis: Free MSRA Podcast

🫁FREE MSRA PODCAST –SarcoidosisA high-yield,system-by-system revision guide to this puzzling multisystem inflammatorycondition. 🧠Key Learning Points📌Definition• Sarcoidosis = Multisystem granulomatousdisorder• Characterised by non-caseating granulomas (immune cell clusters)• Most commonlyaffects the lungs and lymph nodes, butmay involve skin, eyes, heart, nervous system, liver, and more 📌Aetiology• Unknown trigger: Possibly genetic,environmental, or infectious• Immune system overreacts, forming granulomaswhere they shouldn't• Common in adultsaged 20–40, more frequent in women, Blackand Scandinavian populations 📌Pathophysiology• CD4+ T-cell mediated inflammation• Granulomas cause tissue disruption and organ dysfunction• Persistentinflammation → fibrosis and scarring 📌Presentation (varies by organ system)🫁Respiratory (90%): Dry cough, dyspnoea, chest pain🧑‍⚕️Lymphadenopathy: Bilateral hilar nodes (classic CXR finding)🌡️ Constitutional: Fatigue, fever, weight loss, nightsweats🧴Skin: Erythema nodosum (shins), lupus pernio (face)👁️Eyes: Uveitis, dry eyes, glaucoma risk🧠Neurosarcoidosis: Bell’s palsy, meningitis, DI, seizures❤️Cardiac: Arrhythmias, cardiomyopathy, sudden death🦴Musculoskeletal: Arthritis, dactylitis ("sausagedigits")🧪Calcium derangement: Hypercalcaemia/hypercalciuria due to ↑ vitamin Dactivation by granulomas 📌Diagnosis🧪Bloods: ↑ ACE, ↑ calcium, ↑ ESR, ↓ lymphocytes📷Imaging: • CXR: Bilateralhilar lymphadenopathy • HRCT chest:Interstitial lung disease, scarring • PET scan: Activeinflammation🧫Biopsy: Non-caseating granulomas = diagnostic🫁BAL (bronchoalveolarlavage): ↑ CD4:CD8 ratio🫀ECG/Echo: Rule out cardiac involvement🔬Other: Eye exam, lung function tests, VQ scan if CTEPHsuspected 📌Management💊 First-line: Oral steroids(prednisolone)💊 Second-line: Immunosuppressants(e.g., methotrexate, azathioprine)💉 Third-line: Biologics (e.g.,infliximab for severe or refractory disease)🩺 Management is organ-basedand tailored to disease severity🦴 Consider bisphosphonatesfor bone protection if on long-term steroids🫁 Severe lung disease may require lung transplantation 📌Prognosis• Variable – some cases spontaneously remit• Löfgren’s syndrome = Good prognosis• ~20% develop chronic progressive disease with pulmonary fibrosis• Worse prognosiswith cardiac/CNS involvement• Leading cause ofdeath = respiratory failure 📌Complications• Pulmonary fibrosis• Pulmonaryhypertension• Aspergillomas →haemoptysis• Renal stones (dueto hypercalcaemia)• Arrhythmias,sudden death• Blindness(uveitis, glaucoma)• Chronic jointdamage, skin disfigurement• Lymphoma risk• Psychosocialeffects and fatigue 📎More Sarcoidosis MSRAResources:📝 Revision Notes: https://www.passthemsra.com/topic/sarcoidosis-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/sarcoidosis-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/sarcoidosis-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/sarcoidosis-rapid-quiz/🎓 Respiratory Course: https://www.passthemsra.com/courses/respiratory-for-the-msra/ Hashtags#MSRA #Sarcoidosis#MSRARevision #RespiratoryMSRA #MSRAFlashcards #Granulomas #MSRAExam#NICEGuidelines #MedicalEducation #MSRAOnlineRevision