Internal medicine is rarely linear. A good guide provides flowcharts.

Thyroid ultrasound – assess for microcalcifications, irregular margins, taller-than-wide shape, or extrathyroidal extension (TI-RADS score).

CURB-65 (Confusion, Uremia, RR, low BP, age≥65).

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Internal medicine is the specialty of differential diagnosis. The same symptom (e.g., fatigue) can stem from a dozen different etiologies. Without a systematic approach, you risk missing "zebras" or, worse, treating the wrong "horse."