USMLE Answer 44

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44. The correct answer is C. Sarcoidosis is a multisystem disease characterized by noncaseating granulomata in a variety of organs. The disease may be symptomatic (respiratory and constitutional symptoms) or may be discovered incidentally when chest x-ray or autopsy reveals bilateral hilar adenopathy. Definitive diagnosis is based on biopsy, which reveals noncaseating granulomata that are negative for fungi or acid-fast bacilli. Sarcoidosis is more common in individuals of African-American descent.

Caroli disease (choice A) is a congenital malformation of the bile duct system.

Raynaud disease (choice B) is a vasospasm of vessels that causes temporary ischemia in the hands.

Scleroderma (choice D), or progressive systemic sclerosis, is characterized by progressive fibrosis of skin and internal organs.

Systemic lupus erythematosus (choice E) is an autoimmune disease characterized by vasculitis (which may produce a variety of symptoms depending on the site of the lesion), rash, renal disease, hemolytic anemia, and neurologic disturbances.