Internal Medicine (Therapy)
Core content
Therapy questions span cardiology, pulmonology, gastroenterology, nephrology, endocrinology, rheumatology, and hematology. Focus on diagnostic criteria and first-line management of high-yield conditions: arterial hypertension and hypertensive crisis, acute coronary syndrome, heart failure, atrial fibrillation, community-acquired pneumonia, COPD and asthma exacerbation, peptic ulcer and GI bleeding, chronic kidney disease, diabetes with acute complications, and anemia.
Diagnostic reasoning
Know the defining criteria (e.g., blood pressure thresholds, ECG changes in ACS, spirometric criteria for obstruction, criteria for diabetes) and the recommended first-line drug classes. Understand when to escalate from outpatient to inpatient, and which red flags mandate emergency care.
Traps
- Confusing hypertensive emergency (organ damage) with urgency (no organ damage).
- Mixing up the first-line therapy for a given condition (e.g., which class is preferred in a patient with specific comorbidity).
- Forgetting contraindications that change the "correct" drug choice.
Rule of thumb
Before choosing treatment, ask two questions: (1) Is there a life-threatening feature requiring emergency care? (2) Is there a comorbidity or contraindication that changes the first-line choice? The answer usually narrows to one option.
Worked example
A patient with chest pain, ST elevation on ECG, and diaphoresis: this is an emergency - activate reperfusion pathway, give antiplatelet therapy, and arrange urgent transfer. The trap answer offering outpatient follow-up is wrong because the red flag (ST elevation) overrides routine management.