Common Conditions

Question 1

Hypertension (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 1

Description: A chronic condition characterized by consistently elevated blood pressure (≥140/90 mmHg). Often asymptomatic but can lead to serious cardiovascular complications.
Risk Factors: Obesity, high sodium intake, physical inactivity, excessive alcohol consumption, stress, family history.
Clinical Presentation: Often asymptomatic; may present with headaches, dizziness, or blurred vision in severe cases.
Complications: Stroke, myocardial infarction, heart failure, chronic kidney disease.
Differential Diagnoses: White coat hypertension, secondary hypertension (e.g., due to renal artery stenosis), pheochromocytoma.
Diagnostic Tests: Blood pressure measurement, urinalysis, serum electrolytes, renal function tests, ECG.
First-Line Treatment: Lifestyle modifications (diet, exercise), ACE inhibitors, calcium channel blockers, or thiazide diuretics.

Question 2

Type 2 Diabetes Mellitus (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 2

Description: A metabolic disorder characterized by insulin resistance and relative insulin deficiency, leading to hyperglycemia.
Risk Factors: Obesity, sedentary lifestyle, family history, age >45, history of gestational diabetes, hypertension.
Clinical Presentation: Polyuria, polydipsia, polyphagia, fatigue, blurred vision, slow-healing wounds.
Complications: Cardiovascular disease, nephropathy, retinopathy, neuropathy.
Differential Diagnoses: Type 1 diabetes, metabolic syndrome, Cushing’s syndrome, MODY (Maturity-Onset Diabetes of the Young).
Diagnostic Tests: Fasting plasma glucose, HbA1c, oral glucose tolerance test.
First-Line Treatment: Lifestyle modifications, metformin, sulfonylureas if metformin is contraindicated or not tolerated.

Question 3

Chronic Obstructive Pulmonary Disease (COPD) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 3

Description: A progressive lung disease characterized by airflow limitation, primarily caused by smoking, leading to chronic bronchitis and emphysema.
Risk Factors: Smoking, exposure to air pollutants, occupational dust and chemicals, genetic factors (e.g., alpha-1 antitrypsin deficiency).
Clinical Presentation: Chronic cough, sputum production, dyspnea, wheezing, recurrent respiratory infections.
Complications: Respiratory failure, pulmonary hypertension, cor pulmonale.
Differential Diagnoses: Asthma, bronchiectasis, congestive heart failure, pulmonary fibrosis.
Diagnostic Tests: Spirometry, chest X-ray, arterial blood gases (ABG), CT scan of the chest.
First-Line Treatment: Smoking cessation, bronchodilators (e.g., short-acting beta-agonists), inhaled corticosteroids in moderate to severe cases.

Question 4

Asthma (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 4

Description: A chronic inflammatory disorder of the airways characterized by reversible airflow obstruction and bronchospasm.
Risk Factors: Family history of asthma or allergies, exposure to allergens, respiratory infections in early childhood, smoking, occupational exposures.
Clinical Presentation: Episodic wheezing, shortness of breath, chest tightness, and cough, often worse at night or early morning.
Complications: Status asthmaticus, respiratory failure, chronic airflow limitation.
Differential Diagnoses: COPD, vocal cord dysfunction, bronchiectasis, congestive heart failure.
Diagnostic Tests: Spirometry with bronchodilator response, peak expiratory flow rate, methacholine challenge test, allergy testing.
First-Line Treatment: Inhaled corticosteroids, short-acting beta-agonists for acute symptoms, leukotriene receptor antagonists.

Question 5

Acute Coronary Syndrome (ACS) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 5

Description: A spectrum of conditions resulting from myocardial ischemia, including unstable angina, NSTEMI, and STEMI.
Risk Factors: Hypertension, hyperlipidemia, smoking, diabetes, family history of coronary artery disease, sedentary lifestyle.
Clinical Presentation: Chest pain (often radiating to the jaw or left arm), shortness of breath, diaphoresis, nausea, dizziness.
Complications: Arrhythmias, heart failure, cardiogenic shock, sudden cardiac death.
Differential Diagnoses: Gastroesophageal reflux disease, aortic dissection, pulmonary embolism, pericarditis.
Diagnostic Tests: ECG, cardiac biomarkers (e.g., troponin), coronary angiography, echocardiography.
First-Line Treatment: Aspirin, nitroglycerin, beta-blockers, reperfusion therapy (PCI or thrombolysis for STEMI).

Question 6

Stroke (Cerebrovascular Accident) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 6

Description: A condition where poor blood flow to the brain results in cell death, leading to neurological deficits. Can be ischemic or hemorrhagic.
Risk Factors: Hypertension, atrial fibrillation, diabetes, hyperlipidemia, smoking, history of TIA.
Clinical Presentation: Sudden onset of weakness, numbness (often unilateral), difficulty speaking or understanding speech, vision changes, severe headache (more common in hemorrhagic stroke).
Complications: Long-term disability, recurrent stroke, aspiration pneumonia, deep vein thrombosis (DVT).
Differential Diagnoses: Seizures, migraine with aura, hypoglycemia, brain tumor.
Diagnostic Tests: CT scan or MRI of the brain, carotid ultrasound, ECG, blood tests (e.g., glucose, electrolytes).
First-Line Treatment: Thrombolytics (for ischemic stroke within the therapeutic window), antiplatelet agents, antihypertensive therapy, surgical intervention for hemorrhagic stroke.

Question 7

Osteoarthritis (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 7

Description: A degenerative joint disease characterized by the breakdown of cartilage and subsequent joint pain and stiffness.
Risk Factors: Age, obesity, joint injury, repetitive joint use, genetic predisposition.
Clinical Presentation: Joint pain (often in the knees, hips, hands), stiffness, reduced range of motion, crepitus on movement.
Complications: Joint deformity, reduced mobility, chronic pain, disability.
Differential Diagnoses: Rheumatoid arthritis, gout, psoriatic arthritis, bursitis.
Diagnostic Tests: X-ray of affected joints, MRI (in complex cases), synovial fluid analysis (if joint effusion is present).
First-Line Treatment: Weight loss, physical therapy, NSAIDs, acetaminophen.

Question 8

Peptic Ulcer Disease (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 8

Description: A condition where sores develop on the lining of the stomach, small intestine, or esophagus, often due to H. pylori infection or NSAID use.
Risk Factors: H. pylori infection, chronic NSAID use, smoking, excessive alcohol consumption, stress.
Clinical Presentation: Epigastric pain (often relieved by eating or antacids), bloating, nausea, vomiting, hematemesis or melena in severe cases.
Complications: Gastrointestinal bleeding, perforation, gastric outlet obstruction.
Differential Diagnoses: Gastritis, gastroesophageal reflux disease (GERD), gastric cancer, pancreatitis.
Diagnostic Tests: Upper endoscopy, H. pylori testing (urea breath test, stool antigen, or biopsy), barium swallow.
First-Line Treatment: Proton pump inhibitors (PPIs), H. pylori eradication therapy (antibiotics and PPIs), lifestyle modifications.

Question 9

Heart Failure (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 9

Description: A chronic condition where the heart is unable to pump sufficiently to maintain blood flow to meet the body’s needs.
Risk Factors: Coronary artery disease, hypertension, diabetes, obesity, previous myocardial infarction.
Clinical Presentation: Dyspnea, fatigue, peripheral edema, orthopnea, paroxysmal nocturnal dyspnea, jugular venous distension.
Complications: Acute decompensated heart failure, arrhythmias, renal dysfunction, thromboembolism.
Differential Diagnoses: COPD, chronic kidney disease, anemia, hypothyroidism.
Diagnostic Tests: BNP or NT-proBNP levels, echocardiogram, chest X-ray, ECG.
First-Line Treatment: ACE inhibitors or ARBs, beta-blockers, diuretics for fluid overload, lifestyle modifications.

Question 10

Deep Vein Thrombosis (DVT) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 10

Description: The formation of a blood clot in a deep vein, usually in the legs, which can lead to complications like pulmonary embolism.
Risk Factors: Prolonged immobility, recent surgery, cancer, pregnancy, oral contraceptive use, thrombophilia.
Clinical Presentation: Swelling, pain, and tenderness in the affected leg, warmth, redness, or discoloration of the skin over the thrombosis.
Complications: Pulmonary embolism, post-thrombotic syndrome, recurrent DVT.
Differential Diagnoses: Cellulitis, superficial thrombophlebitis, ruptured Baker’s cyst, lymphedema.
Diagnostic Tests: Doppler ultrasound, D-dimer test, venography (rarely used).
First-Line Treatment: Anticoagulation (e.g., low molecular weight heparin, direct oral anticoagulants), compression stockings, lifestyle modifications.

Question 11

Atrial Fibrillation (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 11

Description: A common arrhythmia characterized by an irregular and often rapid heart rate that can lead to blood clots, stroke, and heart failure.
Risk Factors: Hypertension, heart disease, hyperthyroidism, alcohol use, obesity, age >65.
Clinical Presentation: Palpitations, fatigue, dyspnea, dizziness, chest pain, or may be asymptomatic.
Complications: Stroke, heart failure, thromboembolism, cardiomyopathy.
Differential Diagnoses: Atrial flutter, supraventricular tachycardia, ventricular tachycardia, anxiety/panic disorder.
Diagnostic Tests: ECG, Holter monitoring, echocardiography, thyroid function tests.
First-Line Treatment: Rate control (e.g., beta-blockers, calcium channel blockers), anticoagulation, rhythm control (e.g., antiarrhythmic drugs, cardioversion).

Question 12

Chronic Kidney Disease (CKD) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 12

Description: A progressive loss of kidney function over months or years, often leading to end-stage renal disease (ESRD).
Risk Factors: Diabetes, hypertension, recurrent urinary tract infections, family history of kidney disease, age >60.
Clinical Presentation: Often asymptomatic in early stages; later stages may present with fatigue, edema, anorexia, pruritus, hypertension.
Complications: Cardiovascular disease, anemia, electrolyte imbalances, bone mineral disorder, ESRD.
Differential Diagnoses: Acute kidney injury, nephrotic syndrome, glomerulonephritis, obstructive uropathy.
Diagnostic Tests: Serum creatinine and eGFR, urine albumin-to-creatinine ratio, renal ultrasound.
First-Line Treatment: Blood pressure control (ACE inhibitors or ARBs), glycemic control in diabetes, dietary modifications, treatment of underlying cause.

Question 13

Gout (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 13

Description: A form of inflammatory arthritis caused by deposition of urate crystals in joints, leading to acute pain and inflammation.
Risk Factors: Hyperuricemia, obesity, high-purine diet, alcohol consumption, chronic kidney disease, male gender.
Clinical Presentation: Sudden onset of severe joint pain (often the big toe), redness, swelling, warmth, and tenderness.
Complications: Recurrent gout attacks, tophi formation, joint damage, kidney stones.
Differential Diagnoses: Septic arthritis, pseudogout (calcium pyrophosphate deposition disease), rheumatoid arthritis, cellulitis.
Diagnostic Tests: Joint aspiration and synovial fluid analysis, serum uric acid levels, X-ray (for chronic gout).
First-Line Treatment: NSAIDs, colchicine, corticosteroids, lifestyle modifications to reduce uric acid levels.

Question 14

Pneumonia (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 14

Description: An infection that inflames the air sacs in one or both lungs, which may fill with fluid or pus, caused by bacteria, viruses, or fungi.
Risk Factors: Age extremes (infants and elderly), smoking, chronic lung disease, immunosuppression, recent respiratory infection.
Clinical Presentation: Cough with sputum, fever, chills, dyspnea, pleuritic chest pain, fatigue, confusion (especially in older adults).
Complications: Respiratory failure, sepsis, lung abscess, pleural effusion.
Differential Diagnoses: Acute bronchitis, pulmonary embolism, congestive heart failure, lung cancer.
Diagnostic Tests: Chest X-ray, sputum culture, blood cultures, pulse oximetry, complete blood count (CBC).
First-Line Treatment: Empiric antibiotics (e.g., amoxicillin, doxycycline, macrolides), supportive care (e.g., oxygen therapy, fluids).

Question 15

Urinary Tract Infection (UTI) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 15

Description: An infection in any part of the urinary system, most commonly the bladder and urethra, often caused by E. coli.
Risk Factors: Female gender, sexual activity, history of UTIs, urinary tract abnormalities, diabetes, catheter use.
Clinical Presentation: Dysuria, frequency, urgency, suprapubic pain, cloudy or strong-smelling urine, hematuria.
Complications: Pyelonephritis, urosepsis, recurrent infections, renal scarring.
Differential Diagnoses: Vaginitis, interstitial cystitis, sexually transmitted infections, prostatitis (in men).
Diagnostic Tests: Urinalysis, urine culture, imaging (e.g., ultrasound or CT in complicated cases).
First-Line Treatment: Oral antibiotics (e.g., trimethoprim-sulfamethoxazole, nitrofurantoin), increased fluid intake.

Question 16

Hyperthyroidism (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 16

Description: A condition where the thyroid gland produces excessive thyroid hormones, leading to hypermetabolism.
Risk Factors: Female gender, family history of thyroid disease, autoimmune conditions, smoking, iodine intake.
Clinical Presentation: Weight loss, heat intolerance, palpitations, tremors, anxiety, hyperdefecation, goiter.
Complications: Atrial fibrillation, osteoporosis, thyrotoxic crisis (thyroid storm).
Differential Diagnoses: Anxiety disorders, pheochromocytoma, primary hyperparathyroidism, drug-induced hyperthyroidism.
Diagnostic Tests: Serum TSH, free T4, and T3 levels, thyroid ultrasound, radioactive iodine uptake test.
First-Line Treatment: Antithyroid drugs (e.g., methimazole), beta-blockers, radioactive iodine therapy, surgery in refractory cases.

Question 17

Hypothyroidism (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 17

Description: A condition where the thyroid gland fails to produce enough thyroid hormones, leading to a slowed metabolism.
Risk Factors: Female gender, age >60, autoimmune disease (e.g., Hashimoto’s thyroiditis), iodine deficiency, previous thyroid surgery.
Clinical Presentation: Fatigue, weight gain, cold intolerance, constipation, dry skin, depression, bradycardia.
Complications: Myxedema coma, hyperlipidemia, cardiovascular disease, infertility.
Differential Diagnoses: Depression, chronic fatigue syndrome, anemia, obstructive sleep apnea.
Diagnostic Tests: Serum TSH, free T4, thyroid antibodies (e.g., anti-TPO).
First-Line Treatment: Levothyroxine (synthetic thyroid hormone) replacement therapy.

Question 18

Hyperlipidemia (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 18

Description: A condition characterized by high levels of lipids in the blood, increasing the risk of cardiovascular disease.
Risk Factors: Obesity, sedentary lifestyle, poor diet (high in saturated fats), smoking, family history of hyperlipidemia, diabetes.
Clinical Presentation: Often asymptomatic; may present with xanthomas, xanthelasma, or signs of atherosclerosis in severe cases.
Complications: Atherosclerosis, coronary artery disease, stroke, pancreatitis (with severe hypertriglyceridemia).
Differential Diagnoses: Familial hypercholesterolemia, hypothyroidism, nephrotic syndrome, chronic kidney disease.
Diagnostic Tests: Fasting lipid profile (total cholesterol, LDL, HDL, triglycerides), liver function tests.
First-Line Treatment: Lifestyle modifications (diet, exercise), statins, fibrates for hypertriglyceridemia.

Question 19

Rheumatoid Arthritis (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 19

Description: A chronic autoimmune disorder that primarily affects joints, leading to inflammation, pain, and eventual joint damage.
Risk Factors: Female gender, family history, smoking, environmental factors, age 40-60.
Clinical Presentation: Symmetrical joint pain and swelling (commonly in hands, wrists, feet), morning stiffness lasting >1 hour, fatigue, fever.
Complications: Joint deformities, osteoporosis, cardiovascular disease, pulmonary fibrosis.
Differential Diagnoses: Osteoarthritis, systemic lupus erythematosus (SLE), psoriatic arthritis, gout.
Diagnostic Tests: Rheumatoid factor (RF), anti-CCP antibodies, ESR, CRP, joint X-rays.
First-Line Treatment: Disease-modifying antirheumatic drugs (DMARDs), NSAIDs, corticosteroids for flare-ups.

Question 20

Anemia (Iron Deficiency) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 20

Description: A condition characterized by a deficiency of red blood cells or hemoglobin, commonly due to iron deficiency.
Risk Factors: Poor dietary intake, chronic blood loss (e.g., menstruation, gastrointestinal bleeding), malabsorption (e.g., celiac disease), pregnancy.
Clinical Presentation: Fatigue, pallor, dyspnea on exertion, dizziness, palpitations, cold intolerance.
Complications: Heart failure, immune dysfunction, pregnancy complications (e.g., preterm delivery, low birth weight).
Differential Diagnoses: Anemia of chronic disease, thalassemia, vitamin B12 deficiency, folate deficiency.
Diagnostic Tests: Complete blood count (CBC), serum ferritin, serum iron, total iron-binding capacity (TIBC).
First-Line Treatment: Oral iron supplementation, dietary changes to increase iron intake, treatment of underlying cause.

Question 21

Chronic Obstructive Pulmonary Disease (COPD) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 21

Description: A progressive lung disease characterized by airflow limitation that is not fully reversible, typically due to chronic bronchitis or emphysema.
Risk Factors: Smoking, occupational exposure to dust and chemicals, air pollution, genetic factors (e.g., alpha-1 antitrypsin deficiency), age >40.
Clinical Presentation: Chronic cough, sputum production, dyspnea, wheezing, frequent respiratory infections.
Complications: Respiratory failure, pulmonary hypertension, cor pulmonale, frequent exacerbations.
Differential Diagnoses: Asthma, bronchiectasis, heart failure, lung cancer.
Diagnostic Tests: Spirometry (FEV1/FVC ratio <0.7), chest X-ray, CT scan, arterial blood gases (ABGs).
First-Line Treatment: Smoking cessation, bronchodilators (e.g., beta-agonists, anticholinergics), inhaled corticosteroids, pulmonary rehabilitation.

Question 22

Asthma (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 22

Description: A chronic inflammatory disorder of the airways, leading to variable airflow obstruction and bronchial hyperresponsiveness.
Risk Factors: Family history of asthma, atopy (e.g., allergic rhinitis, eczema), smoking, air pollution, occupational exposures.
Clinical Presentation: Recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing, often worse at night or early morning.
Complications: Acute exacerbations, respiratory failure, impaired quality of life, pneumonia.
Differential Diagnoses: COPD, vocal cord dysfunction, heart failure, foreign body aspiration.
Diagnostic Tests: Spirometry with bronchodilator response, peak expiratory flow (PEF) monitoring, methacholine challenge test.
First-Line Treatment: Inhaled corticosteroids, short-acting beta-agonists (SABA) for relief, long-acting beta-agonists (LABA), leukotriene receptor antagonists.

Question 23

Gastroesophageal Reflux Disease (GERD) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 23

Description: A chronic condition where stomach acid flows back into the esophagus, causing symptoms and potential damage to the esophageal lining.
Risk Factors: Obesity, smoking, alcohol use, pregnancy, hiatal hernia, certain medications (e.g., NSAIDs, calcium channel blockers).
Clinical Presentation: Heartburn, regurgitation, dysphagia, chest pain, chronic cough, hoarseness.
Complications: Esophagitis, Barrett’s esophagus, esophageal strictures, increased risk of esophageal adenocarcinoma.
Differential Diagnoses: Peptic ulcer disease, angina, esophageal motility disorders, eosinophilic esophagitis.
Diagnostic Tests: Endoscopy, esophageal pH monitoring, esophageal manometry, barium swallow.
First-Line Treatment: Lifestyle modifications (e.g., weight loss, dietary changes), proton pump inhibitors (PPIs), H2 receptor antagonists.

Question 24

Depression (Major Depressive Disorder) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 24

Description: A common mental health disorder characterized by persistent feelings of sadness, hopelessness, and a lack of interest in activities.
Risk Factors: Family history of depression, stressful life events, chronic illness, substance abuse, female gender, early childhood trauma.
Clinical Presentation: Depressed mood, anhedonia, fatigue, changes in appetite or weight, sleep disturbances, difficulty concentrating, suicidal thoughts.
Complications: Suicide, substance abuse, impaired functioning, cardiovascular disease.
Differential Diagnoses: Bipolar disorder, anxiety disorders, hypothyroidism, chronic fatigue syndrome.
Diagnostic Tests: Clinical evaluation, screening tools (e.g., PHQ-9), thyroid function tests to rule out medical causes.
First-Line Treatment: Antidepressants (e.g., SSRIs, SNRIs), psychotherapy (e.g., cognitive-behavioral therapy), lifestyle modifications.

Question 25

Osteoporosis (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 25

Description: A condition characterized by weakened bones and an increased risk of fractures, due to loss of bone density.
Risk Factors: Postmenopausal women, advanced age, family history of osteoporosis, low body weight, smoking, prolonged use of corticosteroids, low calcium/vitamin D intake.
Clinical Presentation: Often asymptomatic until a fracture occurs; may present with back pain, loss of height, kyphosis.
Complications: Fractures (especially hip, vertebral, wrist), chronic pain, disability, decreased quality of life.
Differential Diagnoses: Osteomalacia, multiple myeloma, metastatic bone disease, hyperparathyroidism.
Diagnostic Tests: Dual-energy X-ray absorptiometry (DEXA) scan, serum calcium, vitamin D levels, thyroid function tests.
First-Line Treatment: Bisphosphonates (e.g., alendronate), calcium and vitamin D supplementation, weight-bearing exercise, lifestyle modifications.

Question 26

Peptic Ulcer Disease (PUD) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 26

Description: A condition where open sores develop on the inner lining of the stomach or the upper part of the small intestine, often due to H. pylori infection or NSAID use.
Risk Factors: H. pylori infection, chronic NSAID use, smoking, excessive alcohol consumption, stress.
Clinical Presentation: Epigastric pain (often relieved by eating in duodenal ulcers, worsened by eating in gastric ulcers), nausea, vomiting, bloating.
Complications: Bleeding, perforation, gastric outlet obstruction, increased risk of gastric cancer (with H. pylori).
Differential Diagnoses: Gastroesophageal reflux disease (GERD), gastritis, pancreatitis, gastric cancer.
Diagnostic Tests: Endoscopy, H. pylori testing (urea breath test, stool antigen, biopsy), complete blood count (CBC) for anemia.
First-Line Treatment: Proton pump inhibitors (PPIs), H. pylori eradication therapy (if positive), lifestyle modifications (e.g., reducing NSAID use, alcohol, and smoking).

Question 27

Irritable Bowel Syndrome (IBS) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 27

Description: A functional gastrointestinal disorder characterized by a group of symptoms including abdominal pain and altered bowel habits without any detectable organic cause.
Risk Factors: Female gender, young age, family history of IBS, stress, anxiety, history of gastrointestinal infections.
Clinical Presentation: Recurrent abdominal pain, bloating, diarrhea, constipation, or alternating bowel habits, often relieved by defecation.
Complications: Impaired quality of life, psychological distress, chronic pain, food intolerances.
Differential Diagnoses: Inflammatory bowel disease (IBD), celiac disease, lactose intolerance, colon cancer.
Diagnostic Tests: Clinical diagnosis based on Rome IV criteria, exclusion of organic causes (e.g., celiac serology, stool studies).
First-Line Treatment: Dietary modifications (e.g., low FODMAP diet), antispasmodics (e.g., hyoscine), laxatives for constipation-predominant IBS, antidiarrheals for diarrhea-predominant IBS.

Question 28

Chronic Pain (Non-Malignant) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 28

Description: Pain that persists for more than 3 months, often without a clear cause, and can lead to significant impairment in quality of life.
Risk Factors: History of injury, chronic illness (e.g., arthritis), psychological factors (e.g., depression, anxiety), age >50, female gender.
Clinical Presentation: Persistent pain in one or more areas of the body, often described as aching, burning, or shooting; associated with fatigue, sleep disturbances, mood changes.
Complications: Depression, disability, opioid dependency, social isolation.
Differential Diagnoses: Fibromyalgia, neuropathic pain, myofascial pain syndrome, complex regional pain syndrome (CRPS).
Diagnostic Tests: Clinical assessment, imaging (e.g., MRI or X-ray if structural cause suspected), nerve conduction studies.
First-Line Treatment: Multimodal approach including physical therapy, cognitive-behavioral therapy (CBT), non-opioid analgesics (e.g., NSAIDs, acetaminophen), antidepressants or anticonvulsants for neuropathic pain.

Question 29

Dementia (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 29

Description: A progressive decline in cognitive function, affecting memory, thinking, language, and the ability to perform everyday activities.
Risk Factors: Age >65, family history, cardiovascular disease, diabetes, smoking, alcohol abuse, low education level.
Clinical Presentation: Memory loss, difficulty with problem-solving, disorientation, language difficulties, personality changes, decreased ability to perform daily activities.
Complications: Increased risk of falls, malnutrition, infections (e.g., pneumonia), depression, caregiver burden.
Differential Diagnoses: Mild cognitive impairment (MCI), delirium, depression, normal pressure hydrocephalus, vitamin B12 deficiency.
Diagnostic Tests: Cognitive assessments (e.g., MMSE, MoCA), brain imaging (MRI or CT scan), blood tests to rule out reversible causes, lumbar puncture in certain cases.
First-Line Treatment: Cholinesterase inhibitors (e.g., donepezil), NMDA receptor antagonists (e.g., memantine), supportive care, cognitive stimulation therapy.

Question 30

Ankylosing Spondylitis (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 30

Description: A chronic inflammatory disease primarily affecting the spine and sacroiliac joints, leading to pain and progressive stiffness.
Risk Factors: HLA-B27 positive status, family history of ankylosing spondylitis, male gender, young age (typically begins in late adolescence or early adulthood).
Clinical Presentation: Chronic back pain and stiffness, particularly in the morning or after periods of inactivity, improvement with exercise, reduced flexibility of the spine.
Complications: Spinal fusion, uveitis, cardiovascular disease, reduced lung capacity.
Differential Diagnoses: Mechanical back pain, rheumatoid arthritis, psoriatic arthritis, fibromyalgia.
Diagnostic Tests: X-rays or MRI of the spine and sacroiliac joints, HLA-B27 testing, inflammatory markers (e.g., ESR, CRP).
First-Line Treatment: NSAIDs, physical therapy, biologic agents (e.g., TNF inhibitors) for severe cases, regular exercise.

Question 31

Diverticulitis (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 31

Description: Inflammation or infection of diverticula (small bulging pouches) in the colon, often causing abdominal pain and bowel habit changes.
Risk Factors: Age >50, low-fiber diet, obesity, sedentary lifestyle, smoking, chronic NSAID use.
Clinical Presentation: Left lower quadrant abdominal pain, fever, nausea, change in bowel habits (e.g., constipation or diarrhea), bloating.
Complications: Abscess formation, bowel perforation, fistula, intestinal obstruction.
Differential Diagnoses: Irritable bowel syndrome (IBS), colorectal cancer, ischemic colitis, inflammatory bowel disease (IBD).
Diagnostic Tests: Abdominal CT scan, complete blood count (CBC), colonoscopy (post-acute phase).
First-Line Treatment: Antibiotics (e.g., metronidazole with ciprofloxacin), bowel rest, high-fiber diet after recovery, surgical intervention in complicated cases.

Question 32

Chronic Liver Disease (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 32

Description: A long-term condition characterized by progressive damage to the liver, leading to cirrhosis and potential liver failure.
Risk Factors: Chronic hepatitis B or C infection, alcohol abuse, non-alcoholic fatty liver disease (NAFLD), obesity, type 2 diabetes.
Clinical Presentation: Fatigue, jaundice, pruritus, abdominal swelling (ascites), gastrointestinal bleeding, confusion (hepatic encephalopathy).
Complications: Cirrhosis, portal hypertension, hepatocellular carcinoma, liver failure.
Differential Diagnoses: Acute liver failure, alcoholic hepatitis, biliary obstruction, Wilson’s disease.
Diagnostic Tests: Liver function tests (LFTs), abdominal ultrasound, CT or MRI of the liver, liver biopsy.
First-Line Treatment: Address underlying cause (e.g., antiviral therapy for hepatitis, alcohol cessation), manage complications (e.g., diuretics for ascites), liver transplantation in severe cases.

Question 33

Ménière’s Disease (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 33

Description: A disorder of the inner ear causing episodes of vertigo, tinnitus, and hearing loss.
Risk Factors: Family history, middle age, autoimmune conditions, allergies.
Clinical Presentation: Episodic vertigo, fluctuating hearing loss, tinnitus, aural fullness, nausea.
Complications: Permanent hearing loss, increased risk of falls due to vertigo.
Differential Diagnoses: Benign paroxysmal positional vertigo (BPPV), vestibular neuritis, acoustic neuroma, otosclerosis.
Diagnostic Tests: Audiometry, electronystagmography (ENG), MRI to rule out other conditions, vestibular evoked myogenic potentials (VEMP).
First-Line Treatment: Low-sodium diet, diuretics, antiemetics for vertigo, intratympanic steroid injections, vestibular rehabilitation.

Question 34

Peripheral Arterial Disease (PAD) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 34

Description: A common circulatory problem where narrowed arteries reduce blood flow to the limbs, typically affecting the legs.
Risk Factors: Smoking, diabetes, hypertension, hyperlipidemia, age >65, obesity, sedentary lifestyle.
Clinical Presentation: Intermittent claudication, rest pain in advanced cases, weak or absent pulses, cool, pale extremities, ulcers or gangrene in severe cases.
Complications: Critical limb ischemia, amputation, cardiovascular events (e.g., heart attack, stroke).
Differential Diagnoses: Deep vein thrombosis (DVT), lumbar spinal stenosis, diabetic neuropathy, osteoarthritis.
Diagnostic Tests: Ankle-brachial index (ABI), Doppler ultrasound, angiography, CT or MR angiography.
First-Line Treatment: Smoking cessation, exercise therapy, antiplatelet agents (e.g., aspirin), statins, revascularization procedures in severe cases.

Question 35

Polycystic Ovarian Syndrome (PCOS) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 35

Description: A hormonal disorder common among women of reproductive age, characterized by enlarged ovaries containing multiple small cysts.
Risk Factors: Family history of PCOS, obesity, insulin resistance, diabetes.
Clinical Presentation: Irregular menstrual cycles, hirsutism, acne, obesity, infertility, acanthosis nigricans.
Complications: Type 2 diabetes, metabolic syndrome, infertility, endometrial cancer, depression, and anxiety.
Differential Diagnoses: Cushing’s syndrome, hyperprolactinemia, androgen-secreting tumors, thyroid dysfunction.
Diagnostic Tests: Serum androgen levels, pelvic ultrasound, glucose tolerance test, lipid profile, LH/FSH ratio.
First-Line Treatment: Lifestyle modifications (e.g., weight loss, exercise), combined oral contraceptives, metformin, anti-androgens (e.g., spironolactone) for hirsutism, fertility treatment if needed.

Question 36

Addison’s Disease (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 36

Description: A rare disorder that occurs when the adrenal glands do not produce enough of the hormones cortisol and aldosterone.
Risk Factors: Autoimmune conditions, family history, infections (e.g., tuberculosis), cancer, chronic use of corticosteroids.
Clinical Presentation: Fatigue, weight loss, hyperpigmentation, hypotension, salt craving, abdominal pain, dizziness.
Complications: Adrenal crisis (life-threatening emergency), electrolyte imbalances, shock, hypoglycemia.
Differential Diagnoses: Hypothyroidism, chronic fatigue syndrome, depression, gastrointestinal disorders.
Diagnostic Tests: Serum cortisol, ACTH stimulation test, electrolytes (e.g., hyponatremia, hyperkalemia), abdominal CT scan.
First-Line Treatment: Corticosteroid replacement therapy (e.g., hydrocortisone), fludrocortisone for aldosterone deficiency, emergency management for adrenal crisis.

Question 37

Temporal Arteritis (Giant Cell Arteritis) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 37

Description: An inflammatory disease of the blood vessels, typically the large and medium arteries of the head, particularly the temporal arteries.
Risk Factors: Age >50, female gender, polymyalgia rheumatica, family history, Northern European descent.
Clinical Presentation: Temporal headache, scalp tenderness, jaw claudication, visual disturbances, fever, weight loss.
Complications: Vision loss, stroke, aortic aneurysm, myocardial infarction.
Differential Diagnoses: Migraine, tension headache, cluster headache, trigeminal neuralgia.
Diagnostic Tests: Elevated ESR and CRP, temporal artery biopsy, duplex ultrasonography of temporal arteries.
First-Line Treatment: High-dose corticosteroids (e.g., prednisone), tocilizumab in steroid-refractory cases, low-dose aspirin for stroke prevention.

Question 38

Primary Biliary Cholangitis (PBC) (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 38

Description: A chronic liver disease in which the bile ducts in the liver are slowly destroyed, leading to cholestasis and liver damage.
Risk Factors: Female gender, age 30-65, autoimmune conditions, family history, smoking.
Clinical Presentation: Fatigue, pruritus, jaundice, hepatomegaly, xanthelasma, steatorrhea.
Complications: Cirrhosis, portal hypertension, osteoporosis, fat-soluble vitamin deficiencies.
Differential Diagnoses: Primary sclerosing cholangitis (PSC), autoimmune hepatitis, drug-induced liver injury, cholangiocarcinoma.
Diagnostic Tests: Antimitochondrial antibodies (AMA), liver function tests (LFTs), liver biopsy, ultrasound elastography.
First-Line Treatment: Ursodeoxycholic acid (UDCA), obeticholic acid for non-responders, symptomatic treatment for pruritus, liver transplantation in advanced cases.

Question 39

Bell’s Palsy (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 39

Description: A sudden, temporary weakness or paralysis of the muscles on one side of the face, often thought to be due to viral infection.
Risk Factors: Recent viral infection (e.g., herpes simplex), diabetes, pregnancy, upper respiratory infection.
Clinical Presentation: Sudden onset of facial droop, inability to close the eye on the affected side, loss of taste sensation, hyperacusis.
Complications: Permanent facial weakness, synkinesis (involuntary movements), dry eye, corneal ulceration.
Differential Diagnoses: Stroke, Lyme disease, Ramsay Hunt syndrome, brain tumor.
Diagnostic Tests: Clinical evaluation, MRI or CT to rule out stroke or tumor, electromyography (EMG) in prolonged cases.
First-Line Treatment: Corticosteroids (e.g., prednisone), antiviral therapy in severe cases, eye protection (e.g., artificial tears, eye patch), physical therapy.

Question 40

Gilbert’s Syndrome (Description, RFs, Presentation, Complications, DDx, Tests, Tx)

Answer 40

Description: A common, mild liver disorder characterized by intermittent jaundice due to unconjugated hyperbilirubinemia.
Risk Factors: Male gender, family history of Gilbert’s syndrome, fasting, illness, stress.
Clinical Presentation: Mild jaundice (often triggered by stress, fasting, or illness), otherwise asymptomatic.
Complications: Generally benign with no serious complications; rare psychological impact due to jaundice.
Differential Diagnoses: Hemolytic anemia, Crigler-Najjar syndrome, viral hepatitis, liver cirrhosis.
Diagnostic Tests: Serum bilirubin levels (elevated unconjugated bilirubin), normal liver function tests, genetic testing for UGT1A1 mutation.
First-Line Treatment: Typically no treatment needed; patient education and reassurance.