Chapter 97: Sarcoidosis Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

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

ANS: B a. Chest radiographs b. Erythrocyte sedimentation rate (ESR) c. Pulmonary function test (PFT) d. Radionucleotide scanning

Stage 1 sarcoidosis is classified based on bilateral hilar lymphadenopathy (BHL) only. Stage 2 presents with BHL and pulmonary infiltrates, stage 3 with pulmonary infiltrates without BHL, and stage 4 with pulmonary fibrosis.

2. Which diagnostic test is most useful when monitoring the progression of sarcoidosis over a long period of time?

ANS: C

Pulmonary function tests may be normal or may demonstrate a restrictive pattern and may be of most value in monitoring the course of the disease in individual cases. Chest radiographs may help with staging the disease initially. The ESR may be elevated with sarcoidosis but is a non-specific finding. Radionucleotide scanning is non-specific, although it can be used to locate the presence of pulmonary lesions.

NURSINGTB.COM a. A beta-adrenergic medication b. An antimalarial agent c. An immunosuppressant drug d. An oral corticosteroid

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?

ANS: D

Corticosteroids are begun when pulmonary symptoms develop. Beta-adrenergics are not used. Antimalarial agents are used to treat chronic skin lesions. Immunosuppressants are used when corticosteroids are no longer effective or when the disease progresses.