Internal Medicine

Diffuse small pulmonary nodules (2-3 mm)+alcohol abuse+ weight loss ? diagnosis

Miliary tb

What is the most common cause of sensorineural hearing loss in the elderly?

Presbycusis

multiple, hard, fixed, rounded swellings seen all over the patient's neck. Otoscopic examination revealed a fluid level behind the right tympanic—- DX AND TT

Nasopharyngeal Carcinoma—DO Endoscopic guided biopsy

one-year history of recurring abdominal pain associated with intermittent diarrhea dx? and treatment

Celiac— OR IT CAN BE IBD .. GIVE HER LOPERAMIDE ( ANTIDIARRHEAL )

HIV medications side effects

Lipodystrophy which refers to abnormal central fat accumulation (lipohypertrophy) and localized loss of fat tissue (lipoatrophy).

Ebstein anomaly effect on ecg

Delta wave -WPW

Transient ischemic attack next step

MRI of brain

Q: In suspected subacromial bursitis, what can an X-ray show, and can it confirm the diagnosis?

X-rays can reveal underlying causes such as calcifications or bony abnormalities, but cannot specifically diagnose bursitis. Ultrasound evaluates the bursa and rotator cuff; MRI may help in complex cases.

medication that will most likely reduce both preload and afterload.

nitroprusside, prazosin, ACE inhibitors (captopril) , and angiotensin II receptor blockers.

Orthopnea meaning

shortness of breath when lying flat that improves when sitting or standing up.

• Tall, thin body habitus

• Long fingers (arachnodactyly)

• Lens subluxation

• Mid-systolic click

DX

mARFAN SYNDROME + MITRAL VALVE PROPLAPSE ( MID D C)

What is the mechanism of action of disulfiram in alcohol use disorder?

Inhibits aldehyde dehydrogenase → acetaldehyde accumulation after drinking alcohol → flushing, nausea, vomiting, headache, palpitations. Memory: Disulfiram disables aldehyde dehydrogenase.

All patients with suspected irritable bowel syndrome constipation alternates with diarrhea should have which test?

CBC to check for anemia

anterior SPINAL cord INJURY means can't move- can't feel pain and temperature, but position sense stays.

READ

despite of chest tube placement, lung will not re-expand.

SO AIR KEEP COMING TO PLEURA THIS MIGHT BE FISTULA OR CRONCHIAL DAMAGE DO BRONCHOSCOPY

Digoxin Toxicity main symptom

yellow green vision

Organophosphate poisoning causes miosis, bradycardia, bronchorrhea and muscle weakness. After atropine, HR rises to 140 but secretions persist. Next step? Why? kILLER B

Continue atropine + add pralidoxime.

• Mechanism: Inhibits acetylcholinesterase → ↑ acetylcholine.

• Atropine: Blocks muscarinic receptors → dries secretions, treats bronchospasm and bradycardia.

• Pralidoxime: Reactivates acetylcholinesterase → improves muscle weakness.

• Exam trap: Tachycardia alone is NOT a reason to stop atropine if bronchorrhea persists.

• Memory: SLUDGE + Killer B's (bradycardia, bronchorrhea, bronchospasm).

Remember: Atropine saves the lungs; pralidoxime restores the enzyme.

Subdural vs epidural heamatoma

Subdural hematoma S = Sickle moon 🌙	Epidural hematoma = E = Egg 🥚 Lens-shaped (oval),
Crescent-shaped	Lens-shaped (biconvex)
Bridging vein injury	Usually middle meningeal artery
Can cross suture lines	Usually cannot cross suture lines
Often after trauma	Often associated with skull fracture

Patient taking aspirin presents with confusion, rapid breathing, and vomiting.

ABG: pH 7.30, HCO₃⁻ 15, PCO₂ 25.

What is the diagnosis, acid–base disorder, and treatment?

Salicylate (aspirin) toxicity

• Classic clues: Tinnitus (ringing ears), vomiting, sweating, confusion, hyperventilation.

• Acid–base: Mixed respiratory alkalosis + anion-gap metabolic acidosis.

• Why? Aspirin stimulates breathing (CO₂ ↓) and causes acid accumulation (HCO₃⁻ ↓).

• Treatment: IV sodium bicarbonate for alkalinization; hemodialysis for severe poisoning.

Memory trick: ASPIRIN = AIR + ACID

hEMORHAGIC SHOCK VS CARDIOGENIC

HEMO JVP WILL BE FLAT . CARDIO WILL BE LEVATED

Trigeminal vs Facial injusy

Facial motor movement. Trigeminal sensation

acetaminophen overdose plus alcoholism plus high AST/ALT and prolonged PT. What's depleted? What's the antidote?

glutathione is depleted. NAPQI builds up and injures the liver. Treat with N-acetylcysteine to replenish glutathione.

Abd injury negative fast she is still at risk of injury to which organ

Pancreas can be asymptomatic . Diaphgram has symptoms like orthopnea and happens months after

Methanol poisoning from washer fluid or alcohol how to treat?

Fomepizole

anti cholenorgic

pinpoint vs dilated pupil toxcity and tt

• Opioids = Pinpoint + Slow breathing → Naloxone

• Stimulants = Dilated + Sweaty

• Anticholinergics ( atropine ) Cocaine, amphetamines= Dilated + Dry

• Organophosphates = Pinpoint + Wet → Atropine + Pralidoxime

Burning household items (e.g., plastics, furniture, rubber) can release cyanide, which causes toxicity seconds after inhalation. Cyanide binds treatmen?