Respiratory Medicine · NEET PG Preparation Medicine
A 28-year-old woman presents with bilateral hilar lymphadenopathy and Erythema nodosum on her shins. Serum calcium is slightly elevated, and serum an…
Practice question from Respiratory Medicine (NEET PG Preparation Medicine), with the correct answer and a step-by-step solution.
medium · MCQ · Q-846EDE
A 28-year-old woman presents with bilateral hilar lymphadenopathy and Erythema nodosum on her shins. Serum calcium is slightly elevated, and serum angiotensin-converting enzyme (ACE) levels are high. Transbronchial biopsy reveals non-caseating granulomas. What is the most appropriate initial management for this asymptomatic or mildly symptomatic patient?
- A.Lifelong systemic corticosteroids
- B.Observation with serial clinical and pulmonary function evaluationsCorrect answer
- C.Immediate initiation of Methotrexate
- D.Incisional surgical biopsy of the mediastinal lymph nodes
Solution
This patient presents with Lofgren syndrome (a classic acute presentation of sarcoidosis consisting of erythema nodosum, bilateral hilar lymphadenopathy, and arthralgia), which carries an excellent prognosis with a high rate of spontaneous remission. Asymptomatic patients or those with mild symptoms (like Lofgren syndrome) do not require immediate systemic corticosteroids and can be managed conservatively with observation and serial follow-up.
More from Respiratory Medicine
- A 55-year-old chronic smoker presents with worsening dyspnea and cough with purulent sputum. Arterial blood gas analysis on room air reveal…
- A 65-year-old male with a 40 pack-year smoking history presents with a 3-month history of cough and hemoptysis. Chest X-ray reveals a cavit…
- A 45-year-old cement worker presents with progressive dyspnea and dry cough. Chest radiograph shows bilateral upper lobe calcified nodular…
- A 32-year-old man presents with recurrent episodes of wheezing, fleeting pulmonary infiltrates on chest radiography, and peripheral blood e…
Practise more Medicine
Sign up free for adaptive practice on this chapter, with instant feedback and hints on every question.
Start practising freeFree to start · No credit card needed