Internal Medicine and Allied Specialties
What you must understand
Internal medicine questions test diagnosis and first-line management across systems: cardiovascular (hypertension, ischaemic heart disease, heart failure), respiratory (asthma, COPD, pneumonia, tuberculosis), endocrine (diabetes, thyroid disease), renal, gastrointestinal, haematological and neurological disorders. For each, know the diagnostic criterion, the first-line investigation, and the initial treatment. Understand the difference between acute vs chronic presentations and how comorbidities change management.
Traps that appear in questions
- Confusing type 1 vs type 2 diabetes (autoimmune vs insulin resistance) and their initial therapy.
- Mixing up asthma vs COPD (reversible vs largely fixed obstruction; inhaled corticosteroids are central in asthma).
- Forgetting that tuberculosis requires multidrug therapy and that adherence is critical.
- Overlooking red-flag features (e.g., weight loss, night sweats) that change the differential.
Worked example (rule of thumb)
A patient with polyuria, polydipsia and random plasma glucose ≥11.1 mmol/L (200 mg/dL) has diabetes mellitus. Confirm with fasting glucose ≥7.0 mmol/L (126 mg/dL) or HbA1c ≥6.5%. First-line therapy in type 2 diabetes is metformin plus lifestyle modification. Rule of thumb: symptoms plus one abnormal confirmatory test = diagnosis.
Exam strategy
For every stem, identify the syndrome, the confirmatory test and the first-line treatment. Exclude red flags before committing to a benign diagnosis.