General Medicine

General Medicine — 30-Min Notes

Hypertension: Primary (essential) → most common; Secondary → renal, endocrine causes.
Heart failure: Left → pulmonary edema; Right → peripheral edema, hepatomegaly.
Arrhythmias: Atrial fibrillation → irregularly irregular; Ventricular tachycardia → emergency.
High-yield: MI: ST elevation in STEMI; Troponin I elevated
Tip: ACE inhibitors → reduce mortality in heart failure; Beta-blockers for rate control in AF.

Asthma: reversible airway obstruction, eosinophilic inflammation; treated with inhaled corticosteroids and bronchodilators.
COPD: irreversible airway obstruction, smoking most common cause; manage with bronchodilators, oxygen therapy.
Pneumonia: community-acquired → Streptococcus pneumoniae most common.
High-yield: Tuberculosis: upper lobe cavitation, positive Mantoux test
Tip: Oxygen saturation monitoring important in chronic lung disease.

Peptic ulcer: H. pylori most common cause; presents with epigastric pain, relieved by food.
GERD: reflux of gastric acid → heartburn, regurgitation; managed with PPIs.
Hepatitis: viral causes → A, B, C; B and C can lead to chronic liver disease.
High-yield: Cirrhosis: portal hypertension → ascites, varices, splenomegaly
Tip: Liver function tests → AST:ALT ratio >2 → alcoholic liver disease

Diabetes mellitus: Type 1 → autoimmune; Type 2 → insulin resistance, obesity.
Thyroid disorders: Hypothyroidism → fatigue, bradycardia; Hyperthyroidism → weight loss, tachycardia, exophthalmos in Graves.
High-yield: Diabetic ketoacidosis: ketone bodies, hyperglycemia, metabolic acidosis
Tip: HbA1c reflects 2–3 months glycemic control; used for diagnosis and monitoring.
Adrenal disorders: Addison → hypotension, hyperpigmentation; Cushing → moon face, central obesity

Stroke: Ischemic → thrombotic/embolic; Hemorrhagic → hypertension-related.
Seizures: Epilepsy → recurrent unprovoked seizures; status epilepticus → emergency.
High-yield: Bell’s palsy → LMN facial nerve palsy, unilateral, idiopathic
Tip: FAST → Face droop, Arm weakness, Speech difficulty, Time to call emergency
Meningitis: bacterial → CSF neutrophilic, low glucose; viral → lymphocytic, normal glucose

Acute kidney injury: prerenal → hypovolemia; intrinsic → ATN; postrenal → obstruction.
Chronic kidney disease: progressive loss of nephrons, causes anemia, secondary hyperparathyroidism.
High-yield: Nephrotic syndrome: proteinuria >3.5 g/day, hypoalbuminemia, edema
Tip: Monitor electrolytes → hyperkalemia dangerous in AKI

Anemias: Microcytic → iron deficiency; Macrocytic → B12/folate deficiency; Normocytic → hemolysis or chronic disease.
Coagulopathies: Hemophilia A → factor VIII deficiency; Hemophilia B → factor IX deficiency.
High-yield: Leukemia: ALL common in children, AML in adults; pancytopenia, blast cells in peripheral smear
Tip: INR monitoring needed for warfarin therapy; target 2–3 in most indications

Sepsis: SIRS + confirmed/suspected infection; manage with fluids and broad-spectrum antibiotics.
High-yield: HIV: CD4 count <200 → AIDS defining illnesses; ART therapy crucial
Malaria: Plasmodium falciparum → severe → cerebral malaria, hemolysis.
Tip: Blood culture before starting antibiotics if possible
Common viruses: Dengue → thrombocytopenia; Influenza → respiratory symptoms

Hypertension → ACE inhibitors, lifestyle modification
MI → STEMI: ST elevation, Troponin I elevation
Heart failure → Left vs Right features, diuretics and ACE inhibitors for treatment
Diabetes → Type 1 vs 2, DKA emergency, HbA1c monitoring
Stroke → FAST assessment, differentiate ischemic vs hemorrhagic
Nephrotic syndrome → proteinuria >3.5 g/day, edema
Sepsis → early antibiotics and fluid resuscitation
HIV → ART, monitor CD4 count
Hepatitis → B and C can lead to chronic liver disease, cirrhosis signs

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