Chapter 1: Cardiovascular Disease
* SBA: A patient with a history of hypertension and angina presents with sudden onset of severe chest pain radiating to the left arm. An ECG shows ST elevation in the anterior leads. What is the most likely diagnosis?
* Answer: Acute anterior myocardial infarction
* EMQ: Describe the risk factors for atherosclerosis and explain how they contribute to the development of the disease.
* Example: Risk factors include hyperlipidemia, hypertension, smoking, and diabetes. Hyperlipidemia leads to the accumulation of cholesterol in the arteries, which forms plaques. Hypertension increases the pressure on the artery walls, making them more susceptible to plaque formation. Smoking damages the endothelium (the lining of the arteries) and increases inflammation, which promotes atherosclerosis. Diabetes impairs the body's ability to regulate blood sugar levels, which can damage blood vessels and contribute to plaque formation.
Chapter 2: Respiratory Disease
* SBA: A patient with a 20-pack-year history of smoking presents with a chronic cough and shortness of breath. A chest X-ray shows hyperinflation and bullae. What is the most likely diagnosis?
* Answer: Chronic obstructive pulmonary disease (COPD)
* EMQ: Explain the pathophysiology of asthma and discuss the different types of triggers that can lead to an asthma attack.
* Example: Asthma is a chronic inflammatory condition of the airways. Triggers that can cause an asthma attack include allergens (e.g., pollen, dust mites), irritants (e.g., smoke, pollution), exercise, and cold air. These triggers stimulate the release of inflammatory mediators, which lead to airway constriction, mucus production, and edema.
Chapter 3: Gastrointestinal Disease
* SBA: A patient with a history of gastroesophageal reflux disease (GERD) presents with abdominal pain and vomiting. An endoscopy shows a large hiatal hernia. What is the most likely cause of the patient's symptoms?
* Answer: The hiatal hernia allows stomach contents to reflux into the esophagus, causing GERD symptoms.
* EMQ: Describe the different types of liver disease and discuss the potential causes and consequences of each type.
* Example: Types of liver disease include viral hepatitis, autoimmune hepatitis, alcoholic liver disease, and cirrhosis. Viral hepatitis is caused by infection with viruses such as hepatitis A, B, and C. Autoimmune hepatitis is an autoimmune disorder where the body attacks its own liver cells. Alcoholic liver disease is caused by chronic excessive alcohol consumption. Cirrhosis is the end-stage of liver disease, where the liver is damaged and replaced by scar tissue. Consequences of liver disease can include jaundice, ascites, encephalopathy, and hepatic failure.
Chapter 4: Endocrine Disease
* SBA: A patient with a history of type 1 diabetes mellitus presents with polyuria, polydipsia, and polyphagia. A blood test shows a high blood sugar level and low insulin levels. What is the most likely diagnosis?
* Answer: Diabetic ketoacidosis
* EMQ: Explain the pathophysiology of type 2 diabetes mellitus and discuss the different factors that can contribute to its development.
* Example: Type 2 diabetes is a metabolic disorder characterized by insulin resistance and impaired insulin secretion. Factors that can contribute to its development include obesity, physical inactivity, genetics, and aging. Obesity leads to increased insulin resistance, while physical inactivity impairs insulin sensitivity. Genetics plays a role in the risk of developing type 2 diabetes, and the risk increases with age.
Chapter 5: Musculoskeletal Disease
* SBA: A patient with a history of gout presents with sudden onset of severe pain, swelling, and redness in the right big toe. What is the most likely diagnosis?
* Answer: Gouty arthritis
* EMQ: Describe the different types of arthritis and discuss the potential causes and manifestations of each type.
* Example: Types of arthritis include osteoarthritis, rheumatoid arthritis, gout, and ankylosing spondylitis. Osteoarthritis is a degenerative joint disease that occurs with aging and wear and tear. Rheumatoid arthritis is an autoimmune disorder that causes inflammation of the joints. Gout is a metabolic disorder that causes sudden attacks of pain and swelling in the joints. Ankylosing spondylitis is an inflammatory disorder that affects the spine and other joints. Manifestations of arthritis can include pain, swelling, stiffness, and joint damage.
