🧠 IMBR Disease Overview

Problem-Based × Specialty Cross-Reference | Practical Pearls & Problem-Based in Internal Medicine

📋 Problem-Based Organization

จัดกลุ่มตาม chief complaint / clinical presentation — เหมาะสำหรับ approach ผู้ป่วยจากอาการนำ

🌬️ COUGH / ไอ

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Asthma / COPD
ไอเรื้อรัง, ไอมีเสมหะ, หอบเหนื่อย, wheezing
Pulmonology Cardiology cough
Gastroesophageal Reflux Disease (GERD)
ไอเรื้อรัง, เสียงแหบ, เนื้อใน горло, กลืนลำบาก
Gastroenterology cough
Tuberculosis
ไอเรื้อรัง >3 สัปดาห์, ไอเป็นเลือด, เสมหะ, น้ำหนักลด, ไข้กลางคืน
Infectious Disease Pulmonology cough
Lung Cancer / Pleural Effusion
ไอเรื้อรัง, เจ็บหน้าอก, ไอเป็นเลือด, dyspnea
Oncology Pulmonology cough
Interstitial Lung Disease (ILD)
ไอแห้งเรื้อรัง, หอบเหนื่อยเพิ่มขึ้นเรื่อยๆ, dry crackles
Pulmonology Rheumatology cough
Bronchiectasis
ไอมีเสมหะมาก, ไอเป็นเลือด, ลืมหายใจ
Pulmonology Infectious Disease cough
Pertussis / Chronic Bronchitis
ไอรุนแรงเป็นชุด, หายใจลำบาก, อาเจียนหลังไอ
Infectious Disease Pulmonology cough

😮‍💨 DYSPNEA / หอบเหนื่อย

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Congestive Heart Failure (CHF)
หอบเหนื่อยขณะพัก/ออกแรง, PND, orthopnea, ขาบวม, เสียงcrackles
Cardiology Nephrology dyspnea
Acute Coronary Syndrome (ACS)
เจ็บหน้าอกเฉียบพลัน, หอบเหนื่อย, เหนื่อยนิ่ง, เยื่อกบางหัวใจ
Cardiology dyspnea
Pulmonary Embolism (PE)
หอบเฉียบพลัน, เจ็บหน้าอก pleuritic, ไอเป็นเลือด, ขาบวม
Pulmonology Hematology Cardiology dyspnea
Chronic Kidney Disease / Uremia
หอบเหนื่อย, น้ำหนักขึ้นจาก edema, คลื่นไส้, คันทั่วตัว
Nephrology Cardiology dyspnea
Anemia (Severe)
หอบเหนื่อยเมื่อออกแรง, อ่อนเพลีย, ซีด, หัวใจเต้นเร็ว
Hematology Gastroenterology dyspnea
Sepsis / Septic Shock
หอบเหนื่อย, ไข้สูง, ชีพจรเร็ว, ความดันตก, mental change
Infectious Disease Cardiology dyspnea

🦵 EDEMA / บวม

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Nephrotic Syndrome
บวมทั่วตัว (pitting edema), โปรตีนในปัสสาวะมาก, คอเลสเตอรอลสูง, อัลบูมินต่ำ
Nephrology Oncology edema
Liver Cirrhosis / Portal Hypertension
ascites, ขาบวม, spider angioma, palmar erythema, jaundice, hematemesis
Gastroenterology Nephrology edema
Deep Vein Thrombosis (DVT)
ขาบวมข้างเดียว, เจ็บ, ผิวหนังอักเสบ, Homan's sign
Hematology Cardiology edema
Heart Failure (Right-sided)
ขาบวมทั้งสองข้าง, JVD, hepatomegaly, ascites
Cardiology Nephrology edema
Hypothyroidism / Myxedema
บวมทั่วตัว (non-pitting), ผิวหยาบ, เฉื่อยชา, ความดันสูง
Endocrinology Cardiology edema
Chronic Kidney Disease (Nephritic Syndrome)
บวมรอบตา, ขาบวม, ปัสสาวะน้อย, ปัสสาวะฟอง, ความดันโลหิตสูง
Nephrology Cardiology edema

💔 CHEST PAIN / เจ็บหน้าอก

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Acute Myocardial Infarction (AMI)
เจ็บหน้าอกเฉียบพลัน, กดทับหัวใจ, เหนื่อย, เหงื่อออก, คลื่นไส้
Cardiology chest pain
Aortic Dissection
เจ็บหน้าอกรุนแรงแผ่นหลัง, ความดันต่างกันข้าง, pulse deficit
Cardiology chest pain
Pulmonary Embolism (PE)
เจ็บหน้าอก pleuritic, หอบเหนื่อยเฉียบพลัน, ไอเป็นเลือด
Pulmonology Hematology chest pain
Pneumothorax
เจ็บหน้าอกเฉียบพลัน, หอบเหนื่อย, ลมหายใจสั้น, ดูซีด
Pulmonology chest pain
Pericarditis / Cardiac Tamponade
เจ็บหน้าอก pleuritic, นั่ง้องบน, friction rub, JVD, hypotension
Cardiology Infectious Disease chest pain
GERD / Esophageal Spasm
เจ็บหน้าอกแสบ, แย่ลงหลังอาหาร, กลืนลำบาก, เรอเป็นกรด
Gastroenterology chest pain
Pneumonia / Pleural Effusion
เจ็บหน้าอก pleuritic, ไข้, ไอ, เสมหะ, หายใจลำบาก
Pulmonology Infectious Disease chest pain

🌡️ FEVER / ไข้

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Sepsis / Severe Infection
ไข้สูง, หนาวสั่น, ชีพจรเร็ว, ความดันตก, confusion
Infectious Disease Cardiology fever
Tuberculosis (Pulmonary / Extrapulmonary)
ไข้ต่ำๆ เรื้อรัง, เหงื่อตกนอน, น้ำหนักลด, ไอเรื้อรัง
Infectious Disease Pulmonology Nephrology fever
Malaria
ไข้เป็นรอย, หนาวสั่น, เหงื่อออก, ปวดศีรษะ, มีประวัติเดินทาง
Infectious Disease Hematology fever
Dengue Fever / Dengue Hemorrhagic Fever
ไข้สูง, ปวดกล้ามเนื้อ, ผื่น, petechiae, ความดันตก
Infectious Disease Hematology fever
Typhoid Fever
ไข้สูงเรื้อรัง, ปวดท้อง, ท้องเสีย/ท้องผูก, rose spots
Infectious Disease Gastroenterology fever
Connective Tissue Diseases (SLE, RA, Vasculitis)
ไข้ต่ำเรื้อรัง, ปวดข้อ, ผื่น, อ่อนเพลีย
Rheumatology Infectious Disease Nephrology fever
Leptospirosis
ไข้, ปวดกล้ามเนื้อ, ตาแดง, คลื่นไส้, ตัว/ตาเหลือง
Infectious Disease Nephrology Gastroenterology fever

🧠 ALTERED MENTAL STATUS / สับสน

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Stroke (Ischemic / Hemorrhagic)
ชาตะกระบวน, พูดไม่ชัด, อ่อนแรงข้าง, มองเห็นบกพร่อง, สับสน
Neurology Cardiology AMS
Uremic Encephalopathy
สับสน, ชัก, coma, กลิ่นปัสสาวะในลมหายใจ, เกาทับ
Nephrology Neurology AMS
Hepatic Encephalopathy
สับสน, ซึม, asterixis, hyperreflexia, ตัวเหลือง
Gastroenterology Neurology AMS
Hyponatremia / Hypernatremia
สับสน, ชัก, คลื่นไส้, ปวดศีรษะ, ซึม
Nephrology Endocrinology Neurology AMS
Hypoglycemia / Hyperglycemia (DKA)
สับสน, เหงื่อออก, ชัก, coma, กลิ่นผลไม้, Kussmaul breathing
Endocrinology Neurology AMS
Meningitis / Encephalitis
ไข้, ปวดศีรษะ, ตึงคอ, สับสน, ชัก, ผื่น
Infectious Disease Neurology AMS
Septic Encephalopathy
ซึม, สับสน, agitation, มีไข้/ไม่มีไข้, ชีพจรเร็ว
Infectious Disease Neurology Cardiology AMS

🔴 SKIN MANIFESTATIONS / ผิวหนัง

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Systemic Lupus Erythematosus (SLE)
ผื่น butterfly rash, photosensitivity, oral ulcer, arthritis, alopecia
Rheumatology Nephrology Neurology Hematology skin
Systemic Sclerosis (SSc) — Scleroderma
ผิวหนังตึงแข็ง, Raynaud's phenomenon, digital ulcers, telangiectasia
Rheumatology Pulmonology Nephrology Gastroenterology skin
Dermatomyositis / Polymyositis
heliotrope rash, Gottron's papules, proximal muscle weakness
Rheumatology Pulmonology Oncology skin
Psoriasis / Psoriatic Arthritis
ผื่นหนาวเป็นสะเก็ด, nail pitting, dactylitis, enthesitis
Rheumatology skin
Vasculitis (ANCA-associated, Polyarteritis)
purpura, livedo reticularis, skin ulcer, mononeuritis multiplex
Rheumatology Nephrology Neurology skin
Endocarditis (Infective)
Janeway lesions, Osler nodes, splinter hemorrhages, Roth spots, fever
Infectious Disease Cardiology skin
Atherosclerosis / Peripheral Vascular Disease
ผิวหนังบาง, hair loss, ulcer, gangrene, intermittent claudication
Cardiology skin

🩸 HEMATURIA / URINARY PROBLEMS / เลือดปัสสาวะ

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Glomerulonephritis (Acute / Chronic)
hematuria, proteinuria, edema, hypertension, oliguria
Nephrology Cardiology hematuria
Urinary Tract Infection (Pyelonephritis)
ปัสสาวะแสบขัด, fever, flank pain, ปัสสาวะขุ่น
Infectious Disease Nephrology hematuria
Nephrolithiasis (Kidney Stones)
flank pain severe, hematuria, ปัสสาวะลำบาก, nausea
Nephrology Gastroenterology hematuria
Bladder Cancer / Renal Cell Carcinoma
painless hematuria, weight loss, fever
Oncology Nephrology hematuria
Benign Prostatic Hyperplasia (BPH)
ปัสสาวะลำบาก, frequency, nocturia, weak stream, hesitancy
Nephrology Oncology hematuria

😣 ABDOMINAL PAIN / ปวดท้อง

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Peptic Ulcer Disease (PUD)
ปวด epigastric, ดีขึ้นหลังอาหาร (gastric), แย่ลงหลังอาหาร (duodenal)
Gastroenterology Infectious Disease abdominal pain
Acute Cholecystitis / Cholangitis
ปวด RUQ, Murphy's sign, fever, jaundice, ปัสสาวะเข้ม
Gastroenterology Infectious Disease abdominal pain
Acute Pancreatitis
ปวดท้อง severe epigastric, ลามหลัง, อาเจียน, ไม่ทนเสียงดัง, Cullen sign
Gastroenterology Endocrinology abdominal pain
Acute Appendicitis
ปวดท้องนัด RLQ, fever, anorexia, nausea, McBurney's point tenderness
Gastroenterology Infectious Disease abdominal pain
Inflammatory Bowel Disease (IBD)
ปวดท้องเรื้อรัง, ท้องเสียเป็นเลือด, weight loss, fatigue
Gastroenterology Oncology abdominal pain
Peritonitis / Secondary Peritonitis
ปวดท้อง diffuse, guarding, rebound tenderness, rigid abdomen
Gastroenterology Infectious Disease abdominal pain
Mesenteric Ischemia
ปวดท้องไม่ตรงกับ physical exam, กินข้าวแล้วปวด, weight loss
Gastroenterology Cardiology abdominal pain

💪 WEAKNESS / MYOPATHY / อ่อนแรง

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Guillain-Barré Syndrome (GBS)
ascending paralysis, areflexia, facial weakness, respiratory failure
Neurology Infectious Disease weakness
Myasthenia Gravis
fatigable weakness, ptosis, diplopia, dysphagia, อ่อนลงเมื่อใช้มาก
Neurology Thymoma weakness
Thyrotoxic Myopathy / Hypothyroid Myopathy
proximal muscle weakness, มือสั่น, ใจสั่น, น้ำหนักลด (hyper), อ่อนเพลีย (hypo)
Endocrinology Neurology weakness
Cushing's Syndrome / Steroid Myopathy
proximal muscle weakness, moon face, central obesity, striae
Endocrinology weakness
Periodic Paralysis (Hypokalemic / Hyperkalemic)
อัมพาตเป็นช่วง, กล้ามเนื้ออ่อนแรง severe, ระดับ K+ ผิดปกติ
Endocrinology Nephrology Neurology weakness
Dermatomyositis / Polymyositis
proximal muscle weakness, heliotrope rash, Gottron's papules, elevated CK
Rheumatology Oncology weakness

🩸 HEMATOLOGIC ABNORMALITIES / เลือด

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Iron Deficiency Anemia
ซีด, อ่อนเพลีย, Koilonychia, pica, ลิ้นเลีย
Hematology Gastroenterology anemia
Megaloblastic Anemia (B12 / Folate Deficiency)
ซีด, อ่อนเพลีย, ชาปลายมือ-เท้า, loss of proprioception, glossitis
Hematology Gastroenterology Neurology anemia
Aplastic Anemia
ซีด, ติดเชื้อราบ, เลือดออกง่าย, pancytopenia
Hematology Oncology Infectious Disease anemia
Hemolytic Anemia (Sickle Cell, Thalassemia, AIHA)
ซีด, ตัวเหลือง, ปัสสาวะเข้ม, splenomegaly, elevated LDH
Hematology Gastroenterology anemia
Thrombocytopenia (ITP, TTP, DIC)
เลือดออกง่าย, petechiae, purpura, ตัวอักเสบ
Hematology Infectious Disease Oncology thrombocytopenia
Leukemia / Lymphoma
ซีด, ติดเชื้อ, เลือดออก, lymphadenopathy, splenomegaly, weight loss
Oncology Hematology Infectious Disease leukemia

⚕️ Specialty Organization

จัดกลุ่มตาม organ system / specialty — เหมาะสำหรับ consult และ differential diagnosis แบบ系统性

❤️ CARDIOLOGY / หัวใจ

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Coronary Artery Disease

  • ACS (UA, STEMI, NSTEMI)
  • Stable Angina
  • Silent MI

Heart Failure

  • HFpEF
  • HFrEF (Systolic HF)
  • Right-sided HF
  • Diastolic Dysfunction

Valvular Disease

  • Mitral Stenosis/Regurg
  • Aortic Stenosis/Regurg
  • Tricuspid Regurg
  • Infective Endocarditis

Arrhythmias

  • Atrial Fibrillation
  • SVT / AVNRT
  • Ventricular Tachycardia
  • Heart Block (AVB)
  • Long QT Syndrome

Myocardial Disease

  • Dilated Cardiomyopathy
  • Hypertrophic CM
  • Restrictive CM
  • Myocarditis
  • Takotsubo Cardiomyopathy

Pericardial Disease

  • Pericarditis
  • Cardiac Tamponade
  • Constrictive Pericarditis

Vascular Disease

  • Aortic Dissection
  • Aortic Aneurysm
  • Peripheral Artery Disease
  • Renal Artery Stenosis

Hypertension

  • Essential Hypertension
  • Resistant HTN
  • Hypertensive Emergency
  • Renovascular HTN
Cross-specialty manifestations:
Neurology → Stroke, Syncope Nephrology → CKD, Cardiorenal GI → Mesenteric ischemia Pulmonology → Pulmonary edema, PE Endocrinology → Thyroid heart disease

🧠 NEUROLOGY / ไข้สมอง

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Cerebrovascular

  • Ischemic Stroke (LVO, Lacunar)
  • Hemorrhagic Stroke
  • Transient Ischemic Attack (TIA)
  • Cerebral Venous Thrombosis

Movement Disorders

  • Parkinson's Disease
  • Multiple System Atrophy
  • Progressive Supranuclear Palsy
  • Dystonia, Chorea, Tic

Neuromuscular

  • Guillain-Barré Syndrome
  • Myasthenia Gravis
  • CIDP
  • ALS (Motor Neuron Disease)
  • Peripheral Neuropathy (DM, B12)

Seizure / Epilepsy

  • Focal (Partial) Seizure
  • Generalized Seizure
  • Status Epilepticus
  • PNES (Psychogenic Seizures)

Dementia / Cognitive

  • Alzheimer's Disease
  • Vascular Dementia
  • Normal Pressure Hydrocephalus
  • Frontotemporal Dementia
  • Delirium (acute confusional state)

Demyelinating

  • Multiple Sclerosis
  • Neuromyelitis Optica (NMO)
  • ADEM

Headache

  • Migraine (with/without aura)
  • Cluster Headache
  • Tension-type Headache
  • Secondary (SAH, Tumor, IIH)

Neuro-infection

  • Meningitis (Bacterial, TB, Viral)
  • Encephalitis (HSV, Japanese, Autoimmune)
  • Brain Abscess
  • Neurocysticercosis
Cross-specialty manifestations:
Rheumatology → CNS vasculitis, SLE Cardiology → Cardioembolic stroke, syncope Endocrinology → DKA encephalopathy, thyroid Nephrology → Uremic encephalopathy, dialysis Oncology → Paraneoplastic, brain tumor Infectious Disease → Meningitis, encephalitis

🦴 RHEUMATOLOGY / รูมาติก

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Connective Tissue Diseases

  • Systemic Lupus Erythematosus (SLE)
  • Systemic Sclerosis (SSc)
  • Dermatomyositis / Polymyositis
  • Mixed Connective Tissue Disease
  • Sjögren's Syndrome

Inflammatory Arthritis

  • Rheumatoid Arthritis
  • Psoriatic Arthritis
  • Ankylosing Spondylitis
  • Reactive Arthritis
  • Enteropathic Arthritis (IBD)

Vasculitis

  • ANCA-associated (GPA, MPA, EGPA)
  • Polyarteritis Nodosa
  • Giant Cell Arteritis (Temporal)
  • Takayasu's Arteritis
  • IgA Vasculitis (HSP)

Crystal Arthropathy

  • Gout (Uric Acid)
  • Pseudogout (CPPD)
  • Basic Calcium Phosphate

Degenerative / Non-inflammatory

  • Osteoarthritis
  • Osteoporosis / Fracture
  • Fibromyalgia

Autoimmune Disease + Key Extrarenal

  • SSc → ILD, SRC, PPH
  • SLE → NPSLE, LSE, serositis
  • DM/PM → ILD, malignancy
  • RA → ILD, vasculitis,icarditis
  • APS → DVT, stroke, pregnancy loss
Cross-specialty manifestations:
Pulmonology → ILD, PE, pulmonary hypertension Nephrology → Lupus nephritis, SSc renal crisis, vasculitic nephritis Neurology → CNS vasculitis, peripheral neuropathy Cardiology → Pericarditis, myocarditis, coronary vasculitis GI → SSc esophageal dysmotility, mesenteric vasculitis Hematology → Antiphospholipid syndrome, anemia of chronic disease Oncology → Paraneoplastic arthritis, cancer screening

🫁 PULMONOLOGY / ปอด

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Obstructive

  • Asthma (Allergic, Non-allergic)
  • COPD / Emphysema
  • Bronchiectasis
  • Bronchiolitis Obliterans

Restrictive / Interstitial

  • Idiopathic Pulmonary Fibrosis
  • SSc-ILD, RA-ILD, DM-ILD
  • Sarcoidosis
  • Hypersensitivity Pneumonitis
  • Pneumoconiosis

Infection

  • Community-Acquired Pneumonia
  • Ventilator-Associated Pneumonia
  • Tuberculosis
  • Opportunistic (HIV/AIDS, Immuno)
  • Fungal (Aspergillosis, Histoplasmosis)

Vascular

  • Pulmonary Embolism
  • Chronic Thromboembolic PH
  • Pulmonary Hypertension (Group 1-5)

Pleural

  • Pleural Effusion (Transudative, Exudative)
  • Pneumothorax (Primary, Secondary, Tension)
  • Empyema / Parapneumonic Effusion

Mass / Tumor

  • NSCLC / SCLC (Lung Cancer)
  • Mesothelioma
  • Solitary Pulmonary Nodule
  • Mediastinal mass (Lymphoma, Thymoma)

Critical Care

  • ARDS (all causes)
  • Acute Respiratory Failure
  • Sepsis-associated ARDS

Sleep / Breathing Control

  • Obstructive Sleep Apnea
  • Obesity Hypoventilation Syndrome
  • Neuromuscular respiratory failure

🫘 NEPHROLOGY / ไต

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Glomerular Disease

  • Nephrotic Syndrome (MCD, FSGS, MGN, MPGN)
  • Nephritic Syndrome (IgA, Post-strep, Lupus nephritis)
  • Rapidly Progressive GN (Crescentic)

Tubulointerstitial

  • Acute Interstitial Nephritis (Drug-induced)
  • Chronic Tubulointerstitial Nephritis
  • Analgesic Nephropathy
  • Reflux Nephropathy

Vascular Nephropathy

  • Renal Artery Stenosis (ARAS)
  • Ischemic Nephropathy
  • Cholesterol Emboli

Cystic Disease

  • Autosomal Dominant Polycystic Kidney Disease (ADPKD)
  • Simple Renal Cysts

AKI

  • Prerenal Azotemia
  • Intrinsic (ATN, AIN, AGN)
  • Postrenal (obstruction)

CKD Progression & Complications

  • CKD-MBD (Ca, P, PTH)
  • CKD Anemia (ESA deficiency)
  • Uremic Encephalopathy
  • Cardiorenal Syndrome
  • Volume overload / Pulmonary edema

Acid-Base / Electrolyte

  • Metabolic Acidosis (Anion gap, Non-AG)
  • Hyponatremia / Hypernatremia
  • Hypokalemia / Hyperkalemia
  • SIADH, Diabetes Insipidus

Renal Replacement

  • Hemodialysis Access (AVF, AVG, Catheter)
  • Peritoneal Dialysis complications
  • Transplant rejection workup
Cross-specialty manifestations:
Cardiology → Volume overload, HTN, arrhythmias (K+), uremic pericarditis Neurology → Uremic encephalopathy, neuropathy, seizures GI → Uremic gastritis, nausea, GI bleeding Hematology → Anemia, bleeding diathesis Rheumatology → Lupus nephritis, ANCA vasculitis, SSc renal crisis Endocrinology → CKD-MBD, adrenal insufficiency, diabetes

🟤 GASTROENTEROLOGY / ทางเดินอาหาร

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Upper GI

  • GERD / Barrett's Esophagus
  • Peptic Ulcer Disease (H. pylori)
  • Gastric Cancer / GIST
  • Esophageal Cancer

Liver

  • Viral Hepatitis (A, B, C, D, E)
  • Alcoholic Liver Disease
  • NAFLD / NASH
  • Autoimmune Hepatitis
  • Cirrhosis & Portal Hypertension
  • Hepatocellular Carcinoma (HCC)
  • Liver Failure (Acute, Acute-on-Chronic)

Gallbladder / Biliary

  • Cholelithiasis / Cholecystitis
  • Choledocholithiasis / Cholangitis
  • Primary Sclerosing Cholangitis
  • Cholangiocarcinoma

Pancreas

  • Acute Pancreatitis (Gallstone, Alcohol, HyperTG)
  • Chronic Pancreatitis
  • Pancreatic Cancer
  • IPMN / Cystic Neoplasms

Intestinal

  • Celiac Disease
  • IBD (Crohn's, Ulcerative Colitis)
  • Small Intestinal Bacterial Overgrowth
  • Malabsorption Syndrome
  • Colon Cancer / Polyps
  • Ischemic Colitis

Functional / Motility

  • Irritable Bowel Syndrome (IBS)
  • Gastroparesis
  • Small Bowel Dysmotility

🔵 ENDOCRINOLOGY / ต่อมไร้ท่อ

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Diabetes

  • Type 1 DM (DKA)
  • Type 2 DM (HHS, CKD)
  • Diabetic Retinopathy / Nephropathy
  • Diabetic Foot / Neuropathy

Thyroid

  • Hyperthyroidism (Graves', Toxic MNG)
  • Hypothyroidism (Hashimoto's)
  • Subacute Thyroiditis (De Quervain)
  • Thyroid Cancer (Papillary, Follicular, Medullary)
  • Thyroid Storm

Adrenal

  • Primary Adrenal Insufficiency (Addison's)
  • Secondary Adrenal Insufficiency
  • Cushing's Syndrome (Exogenous, Endogenous)
  • Primary Hyperaldosteronism (Conn's)
  • Pheochromocytoma

Pituitary

  • Acromegaly / Gigantism
  • Prolactinoma
  • Non-functioning Pituitary Adenoma
  • Diabetes Insipidus (Central)
  • SIADH (from lung cancer, infection)

Metabolic Bone

  • Primary Hyperparathyroidism
  • Secondary Hyperparathyroidism (CKD)
  • Vitamin D Deficiency / Osteomalacia
  • Osteoporosis
  • Paget's Disease

Gonadal / Reproductive

  • Polycystic Ovary Syndrome (PCOS)
  • Primary Ovarian Insufficiency
  • Male Hypogonadism
  • Turner / Klinefelter Syndrome

🔴 HEMATOLOGY / เลือด

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Anemia

  • Iron Deficiency Anemia
  • Megaloblastic (B12, Folate)
  • Aplastic Anemia (Bone Marrow Failure)
  • Hemolytic Anemia (Sickle Cell, Thalassemia, AIHA)
  • Anemia of Chronic Disease (ACD)

Myeloid Disorders

  • Acute Myeloid Leukemia (AML)
  • Chronic Myeloid Leukemia (CML)
  • Myelodysplastic Syndrome (MDS)
  • Myelofibrosis
  • Polycythemia Vera, Essential Thrombocythemia

Lymphoid Disorders

  • Acute Lymphoblastic Leukemia (ALL)
  • Chronic Lymphocytic Leukemia (CLL)
  • Non-Hodgkin Lymphoma
  • Hodgkin Lymphoma
  • Multiple Myeloma

Bleeding Disorders

  • Thrombocytopenia (ITP, TTP, DIC)
  • Hemophilia A/B
  • von Willebrand Disease
  • Coagulopathy (Liver disease, Vit K def)

Thrombotic Disorders

  • Venous Thromboembolism (DVT, PE)
  • Antiphospholipid Syndrome
  • Inherited Thrombophilia (Factor V, Prothrombin)
  • Heparin-Induced Thrombocytopenia (HIT)

Transfusion Medicine

  • Transfusion Reactions (Hemolytic, Allergic, TRALI)
  • Blood Product Replacement

🦠 INFECTIOUS DISEASE / โรคติดเชื้อ

▼

Respiratory Infections

  • CAP, VAP, HAP
  • Influenza
  • Tuberculosis
  • COVID-19

GI Infections

  • Acute Diarrhea (Salmonella, Shigella, Campylobacter)
  • Cholera
  • Viral Hepatitis (A, B, C, E)
  • Amebic Liver Abscess
  • Helicobacter pylori

Systemic Infections

  • Sepsis / Septic Shock
  • Dengue (DHF/DSS)
  • Malaria
  • Leptospirosis
  • Typhoid Fever
  • Rickettsial Infections

Neuro-infections

  • Meningitis (Bacterial, TB, Viral, Fungal)
  • Encephalitis (HSV, Japanese B, Autoimmune)
  • Brain Abscess
  • Neurocysticercosis

UTI / Genital

  • Uncomplicated UTI / Pyelonephritis
  • Prostatitis (Acute / Chronic)
  • STIs (Syphilis, Gonorrhea, Chlamydia)
  • HIV / AIDS

Opportunistic (Immunocompromised)

  • PJP (Pneumocystis jirovecii)
  • CMV Disease
  • Cryptococcal Meningitis
  • Aspergillosis
  • Candida Infection

🎀 ONCOLOGY / มะเร็งวิทยา

▼

Thoracic

  • NSCLC (Adeno, Squamous, Large Cell)
  • Small Cell Lung Cancer (SCLC)
  • Mesothelioma
  • Thymoma / Thymic Carcinoma

GI

  • Esophageal Cancer
  • Gastric Cancer
  • Colorectal Cancer
  • Pancreatic Cancer
  • Hepatocellular Carcinoma (HCC)
  • Cholangiocarcinoma

Breast / Gynecologic

  • Breast Cancer ( subtypes: HR+, HER2+, TNBC)
  • Cervical Cancer
  • Ovarian Cancer (Epithelial, Germ Cell)
  • Endometrial Cancer

Genitourinary

  • Prostate Cancer
  • Renal Cell Carcinoma
  • Bladder Cancer (NMIBC, MIBC)
  • Testicular Cancer (Germ Cell)

Hematologic

  • Leukemia (AML, ALL, CML, CLL)
  • Non-Hodgkin Lymphoma
  • Hodgkin Lymphoma
  • Multiple Myeloma

Paraneoplastic Syndromes

  • SIADH (SCLC)
  • Lambert-Eaton Myasthenic Syndrome (SCLC)
  • Hypercalcemia of Malignancy
  • POEMS Syndrome
  • Paraneoplastic Cerebellar Degeneration

🔗 Disease-Specialty Manifestation Matrix

แผนที่ความสัมพันธ์ระหว่าง Disease → Manifestations → Involved Specialties ตารางนี้ช่วยเห็นว่าโรคเดียวกระทบกี่ specialty และมี manifestation อะไรบ้าง

Cardiology
Neurology
Rheumatology
Pulmonology
Nephrology
Gastroenterology
Endocrinology
Hematology
Infectious Disease
Oncology

🩺 SSc (Systemic Sclerosis)

  • Skin: Raynaud's, sclerodactyly, digital ulcers
  • ILD: Non-specific interstitial pneumonia
  • SRC: Malignant HTN, acute kidney injury
  • GI: GERD, esophageal dysmotility, gastroparesis
  • Cardiac: Myocardial fibrosis, arrhythmias
  • Risk: Lung cancer, scleroderma renal crisis

🦋 SLE (Systemic Lupus Erythematosus)

  • MSK: Arthritis, myositis
  • Renal: Lupus nephritis (Class I-VI)
  • NPSLE: Seizure, psychosis, stroke, cranial neuropathy
  • Heme: Hemolytic anemia, leukopenia, thrombocytopenia
  • Cardiac: Libman-Sacks endocarditis, pericarditis
  • Infection: Opportunistic infections (immunosuppressed)

💪 Dermatomyositis / Polymyositis

  • Skin: Heliotrope rash, Gottron's papules
  • Muscle: Proximal weakness, elevated CK
  • ILD: Antisynthetase syndrome (anti-Jo-1)
  • Ca: Ovarian, lung, GI malignancy screening
  • Cardiac: Myocarditis, conduction defects

🫁 Rheumatoid Arthritis

  • Joint: Symmetric erosive polyarthritis
  • ILD: RA-associated interstitial lung disease
  • Cardiac: Accelerated atherosclerosis, pericarditis
  • Neuro: Mononeuritis multiplex, cervical myelopathy
  • Heme: Felty syndrome (RA + splenomegaly + neutropenia)

🩸 ANCA-Associated Vasculitis

  • Renal: Pauci-immune crescentic GN
  • Lung: Pulmonary hemorrhage, nodules
  • ENT: Sinusitis, saddle nose (GPA)
  • Neuro: Mononeuritis multiplex, cranial neuropathy
  • Systemic: Fever, weight loss, purpura

🫘 IgA Nephropathy

  • Renal: Hematuria, proteinuria, ESRD
  • GI: Associated with celiac disease, liver cirrhosis
  • Pulmo: Pulmonary hemorrhage (rare, with liver disease)
  • Skin: Henoch-Schönlein purpura (IgA vasculitis)

🍺 Alcoholic Liver Disease

  • Liver: Fatty liver → Cirrhosis → HCC
  • Neuro: Hepatic encephalopathy, Wernicke-Korsakoff
  • GI: Esophageal varices, ascites, spontaneous bacterial peritonitis
  • Heme: Coagulopathy, thrombocytopenia (splenomegaly)
  • Endo: Cushing's features, feminization

🧊 Amyloidosis

  • Renal: Nephrotic syndrome, renal failure
  • Cardiac: Restrictive cardiomyopathy, arrhythmias
  • GI: Diarrhea, malabsorption, hepatomegaly
  • Neuro: Peripheral neuropathy (AL amyloidosis)
  • Heme: Factor X deficiency, bleeding

🩸 Multiple Myeloma

  • Plasma: Clonal plasma cell proliferation
  • Renal: Myeloma kidney (cast nephropathy), amyloidosis
  • Heme: Anemia, hypercalcemia, infections
  • Bone: Lytic lesions, pathologic fractures, pain
  • Neuro: Spinal cord compression, carpal tunnel

🍬 Diabetes Mellitus (Type 2) — Complications

  • Renal: Diabetic nephropathy → ESRD
  • Cardiac: Coronary artery disease, CHF
  • Neuro: DPN (stocking-glove), autonomic neuropathy
  • Ophth: Diabetic retinopathy, cataract
  • Vascular: PAD, diabetic foot, ulcer
  • Infection: UTI, skin infection, osteomyelitis

🫀 Hyperthyroidism (Graves' Disease)

  • Cardiac: AF, tachycardiomyopathy, high-output HF
  • Neuro: Tremor, anxiety, periodic paralysis (Asian males)
  • Endo: Weight loss, heat intolerance, DTR ↑
  • Ophth: Graves' ophthalmopathy (proptosis, diplopia)
  • GI: Diarrhea, increased appetite
  • Heme: Leukopenia, splenomegaly

🩸 Antiphospholipid Syndrome (APS)

  • Heme: Venous/arterial thrombosis, DVT, PE
  • Neuro: Stroke, TIA, cognitive impairment
  • OB: Recurrent pregnancy loss, preeclampsia
  • Cardiac: Libman-Sacks endocarditis
  • Renal: APS nephropathy (vascular lesions)
  • Skin: Livedo reticularis

🫁 Sarcoidosis

  • Lung: Bilateral hilar lymphadenopathy, pulmonary fibrosis
  • Neuro: Cranial neuropathy (CN VII), peripheral neuropathy
  • Cardiac: Cardiac sarcoidosis (arrhythmias, HF)
  • Eyes: Uveitis, glaucoma
  • Endo: Hypercalcemia (1α-hydroxylase in granulomas)
  • Skin: Lupus pernio, erythema nodosum

🩸 Sickle Cell Disease

  • Heme: Chronic hemolytic anemia, vaso-occlusive crisis
  • Pulmo: Acute chest syndrome, pulmonary hypertension
  • Neuro: Stroke (ischemic, hemorrhagic) — especially children
  • Renal: Hyposthenuria, papillary necrosis, CKD
  • Cardiac: LVH, high-output heart failure
  • Infection: Encapsulated organism infections (S. pneumoniae)

🔄 Multi-System Diseases — Cross-Specialty Summary

โรคที่กระทบหลาย organ systems — สรุปว่าโรคเดียวมี manifestation กี่ระบบ และต้อง collaborate กับ specialty ใดบ้าง

🔴 SLE — 6+ Systems

  • 🟡 Joints → Rheumatology
  • 🫘 Kidney → Nephrology
  • 🧠 Brain → Neurology + Psychiatry
  • ❤️ Heart → Cardiology
  • 🩸 Blood → Hematology
  • 🫁 Lung → Pulmonology (serositis)
  • 🦠 Infection → Infectious Disease

🟤 SSc — 5+ Systems

  • 🔴 Skin → Rheumatology + Dermatology
  • 🫁 Lung → Pulmonology (ILD)
  • 🫘 Kidney → Nephrology (SCR)
  • 🟤 GI → Gastroenterology
  • ❤️ Heart → Cardiology

💪 DM/PM — 4+ Systems

  • 🦴 Muscle → Rheumatology + Neurology
  • 🔴 Skin → Rheumatology + Dermatology
  • 🫁 Lung → Pulmonology (ILD)
  • 🎀 Cancer → Oncology (screening!)
  • ❤️ Heart → Cardiology

🩸 Vasculitis (ANCA) — 4+ Systems

  • 🫘 Kidney → Nephrology (GN)
  • 🫁 Lung → Pulmonology (DAH)
  • 🦷 ENT → ENT
  • 🧠 Nerve → Neurology
  • 🔴 Skin → Rheumatology

🫁 Sarcoidosis — 5+ Systems

  • 🫁 Lung → Pulmonology
  • 👁️ Eye → Ophthalmology
  • ❤️ Heart → Cardiology
  • 🧠 Nerve → Neurology
  • 🦴 Bone → Orthopedics
  • 🟡 HyperCa → Endocrinology

🩸 Amyloidosis — 5+ Systems

  • 🫘 Kidney → Nephrology
  • ❤️ Heart → Cardiology
  • 🟤 GI → Gastroenterology
  • 🧠 Nerve → Neurology
  • 🩸 Blood → Hematology (bleeding)

🩸 Multiple Myeloma — 4+ Systems

  • 🦴 Bone → Orthopedics
  • 🫘 Kidney → Nephrology
  • 🩸 Blood → Hematology
  • 🧠 Nerve → Neurology (cord compression)
  • 🦠 Infection → Infectious Disease

🟤 Sjögren's Syndrome — 4+ Systems

  • 👁️ Eye → Ophthalmology (keratoconjunctivitis sicca)
  • 🟤 Mouth → Rheumatology (xerostomia)
  • 🫘 Kidney → Nephrology (interstitial nephritis, RTA)
  • 🩸 Blood → Hematology (lymphoma risk ↑)
  • 🫁 Lung → Pulmonology (ILD)

🦠 Tuberculosis — Multi-System

  • 🫁 Lung → Pulmonology
  • 🫘 Kidney → Nephrology (urogenital TB)
  • 🦴 Bone → Orthopedics (Pott's disease)
  • 🧠 Brain → Neurology (TB meningitis)
  • 🟤 GI → Gastroenterology (abdominal TB)
  • ❤️ Pericardium → Cardiology (TB pericarditis)

🍺 Alcoholic Liver Disease — Multi-System

  • 🟤 Liver → Gastroenterology + Hepatology
  • 🧠 Brain → Neurology (Wernicke, Korsakoff, HE)
  • 🫁 Lung → Pulmonology (HPS, hepatopulmonary syndrome)
  • 🩸 Blood → Hematology (coagulopathy)
  • ❤️ Kidney → Nephrology (HRS)

🫘 ADPKD — Multi-System

  • 🫘 Kidney → Nephrology (cysts, CKD)
  • ❤️ Heart → Cardiology (valve prolapse, berry aneurysm)
  • 🫁 Liver → Gastroenterology (hepatic cysts)
  • 🧠 Brain → Neurology (berry aneurysm → SAH)

🦋 HIV/AIDS — Multi-System

  • 🦠 Infection → Infectious Disease
  • 🩸 Blood → Hematology (cytopenias, KS)
  • 🧠 Brain → Neurology (PML, crypto meningitis)
  • 👁️ Eye → Ophthalmology (CMV retinitis)
  • 🫁 Lung → Pulmonology (PCP, fungal)
  • 🟤 GI → Gastroenterology (Oral candidiasis, KS)

📖 Quick Index — Disease Lookup

พิมพ์ชื่อโรค, อาการ, หรือ specialty ในช่องค้นหาด้านบนเพื่อ filter ทั้งหมด

A

  • Acute Cholecystitis → GI, ID
  • Acute Pancreatitis → GI, Endo
  • Acute Appendicitis → GI, ID
  • ACS / STEMI → Cardiology
  • Addison's Disease → Endocrinology
  • ADPKD → Nephrology, Cardiology, GI, Neuro
  • Aortic Dissection → Cardiology
  • Alcoholic Liver Disease → GI, Neuro, Heme
  • AL Amyloidosis → Nephrology, Cardiology, Neuro, Heme
  • ALS → Neurology
  • Ankylosing Spondylitis → Rheumatology
  • ANCA Vasculitis → Nephrology, Pulmo, Neuro, Rheum
  • Aplastic Anemia → Hematology, Oncology
  • ARDS → Pulmonology, ICU
  • Atrial Fibrillation → Cardiology, Neuro

B

  • Bladder Cancer → Oncology, Nephrology
  • Bronchiectasis → Pulmonology, ID
  • Biliary Cirrhosis (PBC) → GI, Rheumatology

C

  • Celiac Disease → GI, Heme
  • Cholangitis → GI, ID
  • Cirrhosis → GI, Nephrology, Neuro
  • CLL → Oncology, Hematology
  • CKD → Nephrology, Cardiology, Neurology, Endo
  • COPD → Pulmonology, Cardiology
  • Colorectal Cancer → Oncology, GI
  • Crohn's Disease → GI, Rheumatology, Oncology
  • Cushing's Syndrome → Endocrinology
  • Cystic Fibrosis → Pulmonology, GI

D

  • Dengue (DHF/DSS) → ID, Hematology, Cardiology
  • Depression → Psychiatry, Neurology
  • Dermatomyositis → Rheumatology, Pulmo, Oncology
  • Diabetes Mellitus (T1/T2) → Endocrinology, Nephrology, Cardiology, Neurology, ID
  • DKA → Endocrinology, Neurology
  • DVT → Hematology, Cardiology

E

  • Emphysema → Pulmonology
  • Endocarditis → ID, Cardiology, Neurology, Dermatology
  • Epilepsy → Neurology
  • ERCP Complications → GI, Hematology

G

  • GBS → Neurology, ID
  • GERD → GI, Pulmonology
  • Giant Cell Arteritis → Rheumatology, Neurology, Cardiology
  • Glomerulonephritis → Nephrology, Cardiology
  • Gout → Rheumatology, Nephrology
  • Graves' Disease → Endocrinology, Cardiology, Neurology, Ophthalmology
  • Guillain-Barré Syndrome → Neurology, ID

H

  • HCC → Oncology, GI
  • Hashimoto's → Endocrinology
  • Hemolytic Anemia → Hematology, GI
  • Hepatitis B/C → GI, ID, Oncology
  • Hepatopulmonary Syndrome → GI, Pulmonology
  • HIV/AIDS → ID, Heme, Neuro, Pulmo, GI
  • Hodgkin Lymphoma → Oncology, Heme, ID
  • HRS (Hepatorenal Syndrome) → GI, Nephrology
  • Hyperaldosteronism → Endocrinology, Cardiology
  • Hyperparathyroidism → Endocrinology, Nephrology, Orthopedics
  • Hypertension → Cardiology, Nephrology, Neurology

I

  • IBD (Crohn's, UC) → GI, Rheumatology, Oncology
  • IgA Nephropathy → Nephrology, GI, Dermatology
  • ILD → Pulmonology, Rheumatology
  • Infective Endocarditis → ID, Cardiology, Neuro, Derm
  • ITP → Hematology, ID, Rheumatology

L

  • Lung Cancer (NSCLC/SCLC) → Oncology, Pulmonology, Neurology, Endo
  • Lupus Nephritis → Nephrology, Rheumatology, Neurology
  • Lyme Disease → ID, Neurology, Cardiology

M

  • Malaria → ID, Hematology
  • Meningitis → ID, Neurology
  • Mesenteric Ischemia → GI, Cardiology
  • MG → Neurology, Thymoma/Oncology
  • Mixed Connective Tissue Disease → Rheumatology, Pulmo, Nephrology
  • MS → Neurology, Ophthalmology
  • Multiple Myeloma → Oncology, Nephrology, Heme, Orthopedics
  • Myasthenia Gravis → Neurology, Oncology (thymoma)

N

  • NAFLD/NASH → GI, Endocrinology
  • Nephrotic Syndrome → Nephrology, Cardiology, Oncology
  • NMO → Neurology, Ophthalmology
  • Non-Hodgkin Lymphoma → Oncology, Heme

P

  • Pancreatic Cancer → Oncology, GI, Endocrinology
  • Parkinson's Disease → Neurology
  • PCOS → Endocrinology, Gynecology
  • Peptic Ulcer Disease → GI, ID
  • Pericarditis → Cardiology, ID, Rheumatology
  • Pheochromocytoma → Endocrinology, Cardiology
  • Polyarteritis Nodosa → Rheumatology, Nephrology, Neuro
  • Polycystic Kidney Disease → Nephrology, Cardiology
  • Primary Sclerosing Cholangitis → GI, Oncology
  • Prostate Cancer → Oncology, Nephrology
  • Psoriatic Arthritis → Rheumatology, Dermatology
  • Pulmonary Embolism → Pulmonology, Hematology, Cardiology
  • Pulmonary Hypertension → Pulmonology, Cardiology, Rheumatology

R

  • RA → Rheumatology, Pulmonology, Cardiology, Neurology
  • RCC → Oncology, Nephrology
  • Renal Failure (CKD) → Nephrology, Cardiology, Neuro, GI, Heme
  • Rheumatic Fever → Rheumatology, Cardiology
  • Rheumatoid Arthritis → Rheumatology, Pulmo, Cardio, Neuro

S

  • SAH → Neurology, Neurosurgery, Cardiology
  • Sarcoidosis → Pulmonology, Cardiology, Neuro, Oph, Endo
  • Seizure Disorder → Neurology
  • Sepsis → ID, Cardiology, Pulmonology, Nephrology, Neurology
  • SIADH → Endocrinology, Oncology, Pulmonology
  • Sjögren's Syndrome → Rheumatology, Oph, Nephrology, Heme
  • SLE → Rheumatology, Nephrology, Neuro, Cardio, Heme, ID, Pulmo
  • SSc → Rheumatology, Pulmo, Nephrology, GI, Cardiology
  • Stroke (Ischemic/Hemorrhagic) → Neurology, Cardiology
  • Systemic Sclerosis → Rheumatology, Pulmo, Nephrology, GI, Cardiology

T

  • Takayasu's Arteritis → Rheumatology, Cardiology, Neurology
  • Thalassemia → Hematology, GI
  • Thyroid Cancer → Endocrinology, Oncology
  • Thyroid Storm → Endocrinology, Cardiology, Neurology
  • TTP → Hematology, Nephrology, Neurology
  • TB → ID, Pulmo, Nephrology, Ortho, Neuro, GI, Cardiology
  • Thyrotoxic Heart Disease → Endocrinology, Cardiology

U

  • Ulcerative Colitis → GI, Rheumatology, Oncology, Hepatology
  • Uremic Syndrome → Nephrology, Neurology, Cardiology, GI

V

  • Vasculitis → Rheumatology, Nephrology, Neuro, Dermatology
  • Viral Hepatitis → GI, ID, Oncology

🧠 IMBR Disease Overview | Practical Pearls & Problem-Based in Internal Medicine

Cross-reference summary — เหมาะสำหรับ clinical reasoning และการเตรียมสอบ