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Internal Medicine Shelf Review
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Internal Medicine Shelf Review
Internal Medicine Shelf Review
Study
1
Question
According to GINA guidelines, what is the preferred reliever medication for asthma?
Answer
ICS-formoterol as reliever (SMART therapy) is the preferred reliever medication for asthma.
2
Question
Which biologic treatment is indicated for severe asthma management?
Answer
Anti-IL5 (Mepolizumab) is used as biologic treatment for severe asthma.
3
Question
What constitutes the standard treatment regimen for drug-resistant tuberculosis?
Answer
The BPaL regimen: Bedaquiline + Pretomanid + Linezolid is used for drug-resistant tuberculosis.
4
Question
What is the treatment regimen for latent tuberculosis infection?
Answer
3HP, which consists of Isoniazid + Rifapentine weekly for 12 weeks, is the treatment for latent TB.
5
Question
What is the KDIGO criterion for diagnosing Acute Kidney Injury (AKI)?
Answer
An increase in creatinine by ≥0.3 mg/dL within 48 hours or an increase to ≥1.5 times baseline indicates AKI according to KDIGO.
6
Question
What mnemonic helps remember the causes of AKI and what do the terms represent?
Answer
POST-RENAL (urinary tract obstruction), PRE-RENAL (hypovolemia), and INTRINSIC (like Acute Tubular Necrosis and Glomerulonephritis) summarize causes of AKI.
7
Question
How is Chronic Kidney Disease (CKD) staged?
Answer
CKD is staged from G1 to G5 based on estimated glomerular filtration rate (eGFR).
8
Question
What is the first-line treatment for patients with CKD and diabetes?
Answer
SGLT2 inhibitors are the first-line treatment for CKD in patients with diabetes.
9
Question
How is anemia in CKD typically managed and what is the target hemoglobin level?
Answer
Anemia in CKD is managed with erythropoietin and intravenous iron, aiming for hemoglobin levels of 10–11 g/dL.
10
Question
What are the treatments for spontaneous bacterial peritonitis (SBP) and variceal bleeding in cirrhosis?
Answer
SBP is treated with Albumin and Ceftriaxone; variceal bleeding is managed using Octreotide and TIPS (transjugular intrahepatic portosystemic shunt).
11
Question
How is hepatic encephalopathy treated?
Answer
Hepatic encephalopathy is treated with Lactulose and Rifaximin.
12
Question
What are the pathological differences between Crohn's disease and ulcerative colitis (UC)?
Answer
Crohn's disease features transmural inflammation and skip lesions, whereas UC has mucosal inflammation with continuous lesions.
13
Question
Which biologic agents are commonly used for inflammatory bowel disease (IBD)?
Answer
Anti-TNF agents like Infliximab and Anti-Integrin agents such as Vedolizumab are used in IBD treatment.
14
Question
What are the first-line drug classes for diabetes that offer cardiovascular and renal benefits?
Answer
GLP-1 agonists provide cardiovascular benefits, while SGLT2 inhibitors provide renal protection.
15
Question
What is the standard treatment sequence for diabetic ketoacidosis (DKA)?
Answer
The sequence is: fluid replacement, insulin administration, followed by potassium replacement.
16
Question
What is the preferred first-line treatment for Graves' disease, and which caution applies during pregnancy?
Answer
Methimazole is first-line treatment but should be avoided during the first trimester of pregnancy.
17
Question
How is myxedema coma managed?
Answer
Treatment involves intravenous levothyroxine along with glucocorticoids.
18
Question
According to SEPSIS-3 criteria, how is sepsis defined?
Answer
Sepsis is defined as suspected infection plus a Sequential Organ Failure Assessment (SOFA) score of 2 or greater.
19
Question
What are the components of the 1-hour bundle in sepsis management?
Answer
Blood cultures, administration of antibiotics, and fluid resuscitation are components of the 1-hour sepsis management bundle.
20
Question
What is the recommended initial antiretroviral therapy (ART) regimen for HIV patients regardless of CD4 count?
Answer
Integrase strand transfer inhibitor (INSTI)-based regimens, specifically BIC/TAF/FTC, are recommended regardless of CD4 count.
21
Question
When is prophylaxis for Pneumocystis jirovecii pneumonia (PJP) indicated in HIV patients?
Answer
Prophylaxis with TMP-SMX is indicated when the CD4 count falls below 200 cells/mm³.
22
Question
What are the key diagnostic criteria for rheumatoid arthritis (RA) per ACR/EULAR 2010 guidelines?
Answer
RA diagnosis involves serological markers and joint involvement criteria as per ACR/EULAR 2010.
23
Question
What is the first-line treatment for rheumatoid arthritis and what is used if there is inadequate response?
Answer
Methotrexate is first-line; TNF inhibitors are considered if the response to methotrexate is inadequate.
24
Question
How is systemic lupus erythematosus (SLE) diagnosed and how is disease activity assessed?
Answer
Diagnosis is based on ANA and dsDNA antibodies; the SLEDAI score is used to assess disease activity.
25
Question
What is the preferred treatment for Class III/IV lupus nephritis?
Answer
Mycophenolate is preferred over cyclophosphamide for Class III/IV lupus nephritis.
26
Question
What defines iron deficiency anemia based on ferritin levels?
Answer
Iron deficiency anemia is defined by ferritin levels below 30 ng/mL.
27
Question
How is megaloblastic anemia treated and how do treatments vary based on symptom presentation?
Answer
Vitamin B12 is used especially if neurological symptoms are present; folate is supplemented in folate deficiency.
28
Question
What is the standard induction chemotherapy regimen for acute myeloid leukemia (AML)?
Answer
The 7+3 regimen, which includes Cytarabine and Daunorubicin, is the standard for AML induction therapy.
29
Question
What is the first-line treatment for chronic myeloid leukemia (CML)?
Answer
Tyrosine kinase inhibitors, such as Imatinib, are the first-line treatment for CML.