Internal medicine review

Internal medicine review for medical students and postgraduate doctor to provide simplified knowledge :

17/04/2026

Which one of the following is not caused by cortisol in the stress response?

1-Anti-inflammatory effects

2-Hypoglycaemia

3-Skeletal muscle protein breakdown

4-Stimulation of lipolysis

5-Mineralocorticoid effect

17/04/2026

36-year-old man is brought to the emergency department with new-onset confusion and lethargy. An arterial blood gas reveals findings consistent with an increased anion gap metabolic acidosis. An underlying cause is established, and appropriate treatment is instituted. Within several hours, the patient's mental status improves significantly.

Repeat laboratory studies show an increase in serum bicarbonate and sodium level, a decrease in serum osmolarity, and a drop in serum potassium level.

What treatment was most likely given to this patient?

1-Insulin and normal saline
2-Loop diuretics
3-Mineralocorticoid injection
4-Naloxone
5-Thyroxin therapy

17/04/2026

A 65-year-old man with a history of atrial fibrillation has been experiencing irregular heartbeats and his doctor is concerned about the risk of stroke. After discussing various treatment options, they decide to start him on dabigatran to help prevent thromboembolic events.

What is the mechanism of action?

1-Activation of antithrombin
2-Antagonism of vitamin K
3-Direct inhibition of thrombin
4-Inhibition of factor Xa
5-Inhibition of platelet aggregation

17/04/2026

An 82-year-old woman presents to your GP surgery complaining of a hoarse voice for the past 2 months. She can't remember if she had a viral infection to begin with and she has tried over the counter remedies with no effect. What would your management be?

1-Tell her it is probably viral and to come back in 3 weeks

2-Red flag referral to ENT

3-Routine referral to ENT

4-Explain that as this has been going on for 8 weeks her voice is unlikely to come back

5-Prescribe some antibiotics and ask her to come back in 3 weeks

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