This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pathology
[{'content': 'A young lady presented with bilateral nodular lesions on shins. She was also found to have bilateral hilar lymphadenopathy on chest X-ray. Mantoux test reveals indurations of 5 mms. A skin biopsy would reveal - \nSelect and explain. \nA. Non caseating Granuloma, B. Vasculitis, C. Caseating Granuloma, D. Malignant cells', 'role': 'user'}, {'content': "Answer: A \nExplanation: Skin lesions in this patient is\xa0Erythema nodosum.\nErythema nodosum, bilateral hilar lymphadenopathy negative Mantoux test is strongly suggestive of sarcoidosis.\n\nSkin biopsy (or biopsy from hilar nodes, conjunctiva, lip, or spleen, intraabdominal nodes) would reveal non-caseating granulomas.\n\nSigns and symptoms of sarcoidosis\nAny organ system of the body can be involved. However, lungs with lymph nodes, skin and eye are the three most\xa0common sites involved in sarcoidosis.\nI.\xa0\xa0 Lungs with lymph nodes (95%)\n\nRespiratory complaints including a cough and dyspnea are the most common presenting symptoms.\nUsually, the infiltrate in sarcoidosis are predominantly an upper lobe process.\nThere is bilateral hilar lymphadenopathy.\n\nII.\xa0Skin (24%-43%)\n\nErythema nodosum\nMaculopapular lesions\nHyper-or hypopigmentation\nKeloid formation and subcutaneous nodules\nLupus pernio → Involvement of the bridge of the nose, the area beneath the eyes and cheek. It is diagnostic for a chronic form of sarcoidosis.\nLofgren's syndrome →\xa0Erythema nodosum with hilar adenopathy and uveitis.\n\nIII.\xa0Eye (12-29%)\n\nUveitis\xa0→ Cause Photophobia, blurred vision, increased tearing\nRetinitis\xa0→ Cause Photophobia, blurred vision, increased tearing\nPars plastic\xa0→ Cause Photophobia, blurred vision, increased tearing\n\nIV Non-specific constitutional symptoms are fatigue (most common), fever, night sweat and weight loss. Other organs/systems involved are\n\nLiver \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0\xa0\nSpleen \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0\nEndocrine → Granuloma can secret 1-25 (OH)2 Vit D which causes hypercalcemia.\nUveoparotid fever →\xa0Uveitis + parotitis + VII nerve palsy, it is associated with Heerfordt - waldenstrom syndrome.\nParotid glands \xa0 \xa0 \xa0 \xa0 \xa0\xa0\nHeart\nBrain (Neurosarcoidosis)", 'role': 'assistant'}]