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A 45-year-old man is brought to the emergency department by his wife because he is confused. On examination he has ataxia and horizontal nystagmus. He reports drinking alcohol daily for many years. What is the most likely diagnosis? A. Wernicke's encephalopathy B. Ischaemic stroke C. Multiple sclerosis D. Acute alcohol withdrawal E. Hepatic encephalopathy Answer: A. Wernicke's encephalopathy Explanation: The triad of confusion, ataxia, and nystagmus/ophthalmoplegia in a chronic heavy drinker is the classic presentation of Wernicke's encephalopathy, caused by thiamine (vitamin B1) deficiency. It is a medical emergency requiring immediate IV thiamine before any glucose is given, to prevent precipitating or worsening the encephalopathy. Why the other options are wrong: B. A stroke would typically cause focal neurological signs of sudden onset rather than the classic triad described, and would not specifically explain nystagmus plus ataxia plus confusion together in this pattern. C. Multiple sclerosis usually presents with relapsing-remitting focal neurological deficits in a younger patient, not an acute confusional state tied to chronic alcohol use. D. Alcohol withdrawal typically causes tremor, agitation, autonomic hyperactivity, and possibly seizures/hallucinations, not the specific triad of ataxia, nystagmus, and confusion. E. Hepatic encephalopathy causes confusion and asterixis in the context of liver failure, not classically nystagmus and ataxia. Medical Pearl: Wernicke's triad = confusion + ataxia + ophthalmoplegia/nystagmus. Always give IV thiamine BEFORE glucose in any malnourished or alcohol-dependent patient to avoid precipitating Wernicke's encephalopathy. ⛔️ AMC recalls here reviewed and verified by real doctors, led by Dr. Moaaz not just confusing Ai answers "Stay active with us! React, comment, and answer our questions to unlock a discount on Medical Hub"

A 30-year-old woman presents with recurrent episodes of chest pain and shortness of breath. During episodes, ECG shows ST-segment elevation in leads II and aVF that resolves spontaneously between episodes. Coronary angiogram is normal. What is the most likely diagnosis? A. Viral myocarditis B. Prinzmetal (vasospastic) angina C. Takotsubo (stress) cardiomyopathy D. ST-elevation myocardial infarction E. Acute pericarditis Answer: B. Prinzmetal (vasospastic) angina Explanation: Recurrent, transient ST-segment elevation with chest pain that resolves spontaneously, in the setting of a structurally normal coronary angiogram, is characteristic of Prinzmetal (vasospastic) angina, caused by transient coronary artery spasm rather than fixed atherosclerotic obstruction. Why the other options are wrong: A. Myocarditis typically presents with signs and symptoms of heart failure or arrhythmia in the setting of a preceding viral illness, not recurrent transient ST elevation that fully resolves between episodes with a normal angiogram. C. Takotsubo cardiomyopathy is typically a single acute episode triggered by severe emotional or physical stress, with transient LV apical ballooning on imaging, rather than recurrent self-resolving ST elevation episodes. D. A true STEMI would show a fixed coronary occlusion on angiography and would not resolve spontaneously without intervention. E. Pericarditis causes diffuse (not focal, territorial) ST elevation with PR depression, and is typically positional/pleuritic rather than episodic with normal angiography. Medical Pearl: Recurrent transient ST elevation with pain, normal coronary arteries on angiogram = coronary vasospasm (Prinzmetal angina) - managed with calcium channel blockers and nitrates, avoiding non-selective beta-blockers which can worsen spasm. ⛔️ AMC recalls here reviewed and verified by real doctors, led by Dr. Moaaz not just confusing Ai answers "Stay active with us! React, comment, and answer our questions to unlock a discount on Medical Hub"

Welcome everyone ❤️ We'll be sharing lots of high-yield AMC notes, accurate recalls, and useful exam tips here that can genuinely save you a lot of time and make your preparation much easier. 1️⃣ AMC high-yield notes: are designed to give you a basic clinical background before solving MCQs and recalls. If you're weak in a topic, or just need a quick refresher, read the notes first, then start practicing questions. 2️⃣ AMC Recalls: our goal isn't just to collect them. We do our best to make them as accurate as possible. Since many AMC recalls are incomplete or have incorrect answers, we review them carefully and include the different possibilities you might actually be asked about, so you understand the concept instead of memorizing one answer. You'll find plenty of free content here and on the app that can make a real difference in your preparation. If you find it helpful, you can unlock the complete notes and recalls on the app for an affordable price. For any inquiries, feel free to contact us @AMCAccuracy ⛔️ AMC recalls here reviewed and verified by real doctors, led by Dr. Moaaz not just confusing Ai answers "Stay active with us! React, comment, and answer our questions to unlock a discount on Medical Hub"

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