**Start LD CT screening in smokers at age '''50'''.
**Start LD CT screening in smokers at age '''50'''.
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=Sarcoidosis=
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*H&P: Usually presents in young adults. Fever, cough, malaise, fatigue, weight loss, dyspnea, knee/ankle arthritis, '''hepatomegaly, Bells palsy'''
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*Dx: '''GRUELING mnemonic''' (Granulomas, Rheumatoid arthritis, Uveitis, Erythema nodosum, Lymphadenitis, Interstitial fibrosis, Negative PPD, Gammaglobulinemia). CXR is best screening test, 90% have bilateral hilar or mediastinal adenopathy. CBC can show decreases in any of the cell lines. LFTs show elevated Alk phos. Ddx includes TB, lymphoma, fungal infection, idiopathic pulmonary fibrosis, HIV, berylliosis.
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*Tx: Steroids for flares. Methotrexate for maintenance.