Internal medicine questions with solutions
Save Groups
-Shortness of breath
-Fatigue and weakness
-Swelling in the legs (ankles and feet)
-Nocturia
-Tachycardia
-Irregular heart beat
What are the symptoms of -Reduced ability to exercise
heart failure: -Persistent cough or wheezing
-Possible pink blood stained sputum
-Ascites
-Hepatosplenomegaly
-Rapid weight gain from fluid build up
-Nausea and lack of appetite
-Chest pain in case HF was caused by AMI
-Left or right
-Acute or chronic
Classification of heart -Forward or backward
failure: -Systolic or diastolic
-High output or low output
-Low EF or preserved EF
-We can evaluate the pumping function of the heart
What kind of heart failure
-We can calculate the EF
can you see during ECHO:
-We can evalaute wall motility, valve functions
, 55-70%. HFrEF: heart failure with reduced
ejection fraction meaning the EF ‹ 40%,
HFpEF: heart failure with preserved ejection fraction
Different types of heart
meaning that the EF is still normal.
failure according to EF
HFmrEF: Heart failure with mid range ejection fraction
meaning
the EF is between 40-50%.
More than 2 times/night urination and volume is
Definition of nocturia:
higher at night than during the day
-Heart failure is the most common cause
-Infection (UTI)
-BPH
Main causes of nocturia:
-Diabetes insipidus
-Osmotic diuresis in DM
-Compensatory polyuria
Treatments used in heart
failure:
- Coronary bypass surgery
- Heart valve replacement
- Implantable cardioverter defibrillator: monitors the
Surgical treatments used heart rhythm and is able to induce shock to
in heart failure: convert to normal rhythm.
- Cardiac resynchronisation therapy
- Ventricular assist devices
- Heart transplant
, - Exophthalmos
- Diplopia
- Weight loss despite the increased appetite (Ddx
DM1)
- Diarrhoea
- Heat intolerance
Symptoms of
- Tachycardia
hyperthyroidism:
- Supraventricular tachycardia, atrial fibrillation
- High output heart failure
- Anxiety
- Sleep disturbances
- Amenorrhea
- Pretibial myxoedema
-Subclinical: normal T3/t4, decreased TSH
-Clinical: elevated T3/T4. decreased TSH
-US: nodular lesions
How can you diagnose
-FNAB
hyperthyroidism:
-99Tc isotope scan: hot vs cold nodule
-Autoantibody detection: anti-TPO, antithyroglobulin
-Iodine uptake studies
- ß-blockers to decrease sympathetic activity
- Antithyroid drugs: thionamides {methimazole,
carbimazole}, impairing hormone synthesis
What are the treatment
- Thyrostatic drugs: tiamazol, propylthiouracil (in
options in
pregnant), lithium carbonate.
hyperthyroidism:
- Radioactive iodine ablation
- Surgical resection: near-total thyroidectomy
Save Groups
-Shortness of breath
-Fatigue and weakness
-Swelling in the legs (ankles and feet)
-Nocturia
-Tachycardia
-Irregular heart beat
What are the symptoms of -Reduced ability to exercise
heart failure: -Persistent cough or wheezing
-Possible pink blood stained sputum
-Ascites
-Hepatosplenomegaly
-Rapid weight gain from fluid build up
-Nausea and lack of appetite
-Chest pain in case HF was caused by AMI
-Left or right
-Acute or chronic
Classification of heart -Forward or backward
failure: -Systolic or diastolic
-High output or low output
-Low EF or preserved EF
-We can evaluate the pumping function of the heart
What kind of heart failure
-We can calculate the EF
can you see during ECHO:
-We can evalaute wall motility, valve functions
, 55-70%. HFrEF: heart failure with reduced
ejection fraction meaning the EF ‹ 40%,
HFpEF: heart failure with preserved ejection fraction
Different types of heart
meaning that the EF is still normal.
failure according to EF
HFmrEF: Heart failure with mid range ejection fraction
meaning
the EF is between 40-50%.
More than 2 times/night urination and volume is
Definition of nocturia:
higher at night than during the day
-Heart failure is the most common cause
-Infection (UTI)
-BPH
Main causes of nocturia:
-Diabetes insipidus
-Osmotic diuresis in DM
-Compensatory polyuria
Treatments used in heart
failure:
- Coronary bypass surgery
- Heart valve replacement
- Implantable cardioverter defibrillator: monitors the
Surgical treatments used heart rhythm and is able to induce shock to
in heart failure: convert to normal rhythm.
- Cardiac resynchronisation therapy
- Ventricular assist devices
- Heart transplant
, - Exophthalmos
- Diplopia
- Weight loss despite the increased appetite (Ddx
DM1)
- Diarrhoea
- Heat intolerance
Symptoms of
- Tachycardia
hyperthyroidism:
- Supraventricular tachycardia, atrial fibrillation
- High output heart failure
- Anxiety
- Sleep disturbances
- Amenorrhea
- Pretibial myxoedema
-Subclinical: normal T3/t4, decreased TSH
-Clinical: elevated T3/T4. decreased TSH
-US: nodular lesions
How can you diagnose
-FNAB
hyperthyroidism:
-99Tc isotope scan: hot vs cold nodule
-Autoantibody detection: anti-TPO, antithyroglobulin
-Iodine uptake studies
- ß-blockers to decrease sympathetic activity
- Antithyroid drugs: thionamides {methimazole,
carbimazole}, impairing hormone synthesis
What are the treatment
- Thyrostatic drugs: tiamazol, propylthiouracil (in
options in
pregnant), lithium carbonate.
hyperthyroidism:
- Radioactive iodine ablation
- Surgical resection: near-total thyroidectomy
