اکنون در دسترس! پژوهش تلگرام ۲۰۲۵ — مهمترین بینشهای سال 
Internal medicine hub
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52 history of a non-functioning pituitary macroadenoma presents with sudden severe headache, vomiting and ophthalmoplegia. O/E hypotensive & confused. most appropriate initial management?
🧠 Central vs Peripheral Hormonal Deficiencies
- Central adrenal insufficiency: Characterized by the absence of hyperpigmentation and hyperkalemia.
- Central hypothyroidism: Typically presents without goiter, and the diagnosis is established by measuring free T4 rather than TSH.
Patient presented with fever headache and myalgia after 1 week returning from umrah with maculopapular rash, neutropenia and thrombocytopenia with picture, what is the likely diagnosis?
patient presented with fever, bony back pain and tenderness by examination. Culture showed gram negative coccobacilli. What is the most likely diagnosis?
40-year-old female with chronic kidney disease comes for a follow-up with no active complaints. Investigations show
Ca 1.7 mmol/L and Phosphate at 1 mmol/L. Next step?
⛑️ Barrett’s esophagus surveillance:
- Without dysplasia: EGD every 3-5 years
- Low grade dysplasia: EGD every 12 months
- High grade dysplasia: Endoscopic eradication
patient is admitted with a diagnosis of lower lobe pneumonia. You are planning to obtain blood cultures. When is the best time to collect them?
patient with hepatitis C, cirrhosis, and upper gastrointestinal bleeding (UGIB)
presents to the ER with frothy secretions. What is the most appropriate initial management?
patient diagnosed with TB & started on anti-TB. He presented to the clinic for a follow-up with signs of gout. laboratory investigations showed increased uric acid level. What drug causing this?
Remember:
Normal/Elevated PaCO₂ with low pH in asthma exacerbation is a red flag, indicating respiratory muscle fatigue and impending respiratory failure 🫁.
adult with asthma exacerbation was given SABA and ICS but did not improve.
IV magnesium sulfate was administered.
Lab results: PCO2 normal, pH 7.29, P02 decreased. Next step?
What is the most common cause of death in chronic kidney disease?
43 year old male felt drowsy while awaiting in the clinic waiting room. His blood sugar was low. What is the best management?
