اکنون در دسترس! پژوهش تلگرام ۲۰۲۵ — مهمترین بینشهای سال 
Internal medicine hub
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آرشیو پست ها
Indian male presents with weight loss and hemoptysis and has a right-sided pleural effusion, Based on the most likely diagnosis in such a case, most sensitive test from pleural fluid?
💊 Methotrexate & RA:
- First DMARD given for RA
- Maximum dose is 25 mg per week
- Hold for 1-2 after seasonal influenza vaccination
- Reported to have a protective effect in reducing the risk of DM in patients with inflammatory disease (RA)
- Folate supplementation may reduce GI side effects of methotrexate (1 mg/day or 5 mg/week)
- Hepatic toxicity usually resolves within 10 days
- Antidote: LEUCOVORIN
patient with rheumatoid arthritis (RA) who is on methotrexate and was previously in remission now has elevated LFTs. What is the next step in management?
🦠 Poststreptococcal GN may occur 1-6 weeks after resolution of infection:
• 1-2 weeks after pharyngitis
• 4-6 weeks after impetigo
• 3-6 weeks after a pyoderma
25-year-old presents with dark urine and confirmed blood in the urine test, 3 weeks after a throat infection. What is the most likely diagnosis?
🦴 Risk factors for avascular necrosis: “S”
- Steroids
- Sickle cell disease
- SLE
- Smoking/alcohol
- biSphosphonate
SLE patient on steroid, azathioprine hydroxychloroquine Present with 3 week history of right hip pain with walking. O/E pain with internal rotation of right leg. XR unremarkable. Likely diagnosis ?
💡 Remember:
ECG in uremic pericarditis does not show typical diffuse ST and T wave elevation
Elderly patients known case of CKD, presented with low grade fever and pleuritic chest pain. ECG and Troponin unremarkable. What is the best next step?
Post-kidney transplant patient with a history of severe allergic reaction to sulfonamides requires PCP prophylaxis. Which drug should be prescribed?
💡 Remember:
Do not give antiplatelet therapy in place of anticoagulation, or in addition to anticoagulation for the purpose of preventing ischemic stroke and thromboembolism in patients with AF
64-year-old man is diagnosed with persistent atrial fibrillation. His past medical history includes hypertension and type 2 diabetes. What is next?
soldier is being deployed to the southern region of Saudi Arabia. Which of the following is the most appropriate option for malaria prophylaxis?
CKD patient presents with knee swelling since 2 days. On examination, joint is swollen and painful. There is no
evidence of infection or trauma. Which of the following is the best initial treatment?
Elderly female known case of CKD stage-4 present with pruritus for 3 days. Patient is vitality, clinically and lab wise unremarkable. What is the best next action?
🫁 Cornerstone in asthma management:
- Acute exacerbation (ER setting): Salbutamol (SABA)
- Chronic management (at home): Budesonide (steroid inhaler)
