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Sarcoidosis — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)SarcoidosisUSMLE Step 3

A 36-year-old woman has dry cough, fatigue, and tender erythematous nodules on the shins. Chest radiograph shows bilateral hilar lymphadenopathy. Serum calcium is mildly elevated. Biopsy of a lymph node shows noncaseating granulomas and stains are negative. Which of the following is the most likely diagnosis?

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Correct answer: A — Sarcoidosis

Noncaseating granulomas with bilateral hilar lymphadenopathy, erythema nodosum, and hypercalcemia support sarcoidosis after infection is excluded.

Reference: ATS Sarcoidosis Diagnosis Guideline