year mbbs curriculum 2020 - Multan Medical & Dental College

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Multan Medical & Dental College

5th YEAR MBBS CURRICULUM 2020- 2021

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PATRON:

Mr. Imran Rasool Chief Operating Officer

Multan Medical and Dental College

CURRICULUM COMMIITTEE:

Dr. Tanveer Jahan

(Professor Gynae & Obs) Chairman

Dr. M. Awais Khan

(Assistant Professor DME) Secretary

MEMBERS:

Dr. Kamran Ameer (Associate Professor)

Dr. Sakina Joiya (Demonstrator)

EDITED AND COMPILED BY:

Dr. Sakina Muhammad Joiya

ASSISTANCE:

Dr. Mirza M. Hassan

Dr. Aman Fatima

Dr. Asad Ali

Multan Medical & Dental College

MBBS CURRICULUM 2020 - 2021

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Prof. Dr. Shabbir Ahmad Nasir

Chief Executive & Principal Multan Medical

& Dental College

Avicenna once said ―The extraordinary faith put in oneself &

in one‘s creator, as one takes the very first step for a new

journey, shall mark itself as a milestone to one‘s eternal

glory‖. This was my vision and that of my team to provide

quality medical education to the students at Multan Medical

& Dental College, when we laid the foundation stone of this

nascent Alma Mata, seven years ago. This college has come

of a small age in terms of years but we feel a genuine pride

to see that it is fledgling with powerful wings to embark towards its destination of eternal glory in the

field of quality medical education. A journey, which apparently seemed to be less promising at the

beginning, has now turned into a story of achievements at every front. It is indeed a matter of immense

pleasure to welcome applications for the Seven batch at Multan Medical & Dental College with a mission

to impart profound quality medical education.

In consonance with the vision of the Government to extend healthcare to all segments of society and

groom the best quality medical professionals, Multan Medical & Dental College has responded positively

well to this national cause. We have taken the pledge to keep serving this noble mission and prove our

credentials as a beacon so that our nation reposes its full confidence in our commitment to excellence.

Besides providing quality education, based on modern teaching techniques, I am sure the college shall

also develop a strong spectrum of research-oriented activities. Owing to a top-class faculty, supported by

a 600-bedded modern hospital, Ibn-e-Siena Hospital & Research Institute, I am confident that its

graduates shall emerge as doctors upholding the highest intellectual, professional & social values.

Institutions are developed through professional acumen and commitment to the cause. My advice to the

students & faculty alike is to leave no stone unturned to keep on bringing laurels to themselves and this

institution as they have done it in their initial trials. In their endeavors, they shall always find me at their

back to provide them a genuine direction and elan to help channel their energies into a glorious outcome.

I wish the best of luck to all those who are associated with this project for the fulfillment of this already

being realized dream.

MESSAGE FROM PRINCIPAL

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MULTAN MEDICAL & DENTAL COLLEGE

MISSION STATEMENT

To Produce Professionally Competent, Research Oriented Health Care Providers, Through

Modern Medical Education, Meeting the Local And Global Needs And Committed To Serve

Humanity

VISION

Working in Consonance with the vision of UHS, the Federal and provincial Health Authorities to

groom best quality Medical Professionals by providing the best quality Education based on

Modern Teaching Techniques. Also, committed to develop a strong spectrum of research-

oriented activities.

Envisaging an example in eliminating Health disparities faced by the different strata of the

society by finding their solution through research and execution of Public Health Programs.

OUTCOMES

By the end of (MBBS/BDS) program the graduates of MM&DC will be able to:

1. Perform various basic Medical/Surgical and Dental procedures independently.

2. Demonstrate Knowledge and comprehension of common Medical/Surgical and Dental

procedures.

3. Assist in management of Critically ill patient.

4. Manage common non critical conditions Independently.

5. Demonstrate professional, ethical and culturally appropriate behavior.

6. Advocate health promotion and disease prevention.

7. Involve in research programs.

8. Quality Outcomes:

Develop a habit of reflection, critical thinking and applying the knowledge to reach the level of

Creativity.

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Multan Medical and Dental College is grateful to its faculty

for their contribution in the

preparation of the Curriculum.

&

The College is also thankful to

faculty and students for their

feedback and suggestions.

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Contents MESSAGE FROM PRINCIPAL .......................................................................................................................... 3

CURRICULUM COMMIITTEE .......................................................................................................................... 7

DEFINITIONS AND ABBREVIATIONS .............................................................................................................. 9

ASSESSMENT POLICIES ................................................................................................................................ 10

PROMOTION POLICIES ................................................................................................................................ 13

YEARLY DISTRIBUTION OF SUBJECTS .......................................................................................................... 14

SUBJECT ....................................................................................................................................................... 15

ORGANOGRAM ........................................................................................................................................... 16

INTRODUCTION .................................................................................................................................. 17

TEACHING STRATAGIES ............................................................................................................................... 18

TEACHING ENVIRONMENT .......................................................................................................................... 18

SUBJECT OUTCOMES ................................................................................................................................... 18

SYLLABUS .................................................................................................................................................... 18

SCHEME OF STUDIES ................................................................................................................................... 18

TABLE OF SPECIFICATIONS .......................................................................................................................... 18

TIMETABLE .................................................................................................................................................. 18

BATCHES ALLOCATIONS .............................................................................................................................. 18

WARD PRE-REQUISITES ............................................................................................................................... 18

LEARNING RESOURCES ................................................................................................................................ 18

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The Curriculum Committee for session 2020--2021 is hereby notified as under:

Curriculum Committee

Sr. # Name Designation Department

1. Dr. Tanveer Jahan

(Professor Gynae & Obs) Chairman Clinical Sciences

2. Dr. M. Awais Khan

(Assistant Professor) Secretary Medical Education

3. Dr. Sakina Joiya Member Medical Education

4. Dr. Kamran Ameer

(Associate Professor of Anatomy) Member Basic Sciences

5. Dr. Khalid

(Professor) Member Community Medicine

6. Dr. Asif Mughal

(Assistant Professor) Member Behavioral Sciences

7. Waleed Ahmad Member Student Representative

8. Muhammad Bilal Member Student Representative

9. Hasnat Sahu Member Student Representative

10. Hassan Masood Member Student Representative

CURRICULUM COMMIITTEE

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The following faculty members were involved

in the process of documentation of curriculum

at various stages

1. Prof. Dr. Siraj Munir

2. Prof. Dr. Naveed Aslam

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DEFINITIONS Definitions of the following terms used in the Curriculum Document have been

taken from HEC Guidelines.

CREDIT HOURS:

1. A credit hour means teaching a theory course of 50 minutes each week throughout the year

(1 lecture of 50 minutes = 1 credit hour).

2. One credit hour in laboratory or practical work / project would require lab contact of two

hours per week throughout the year

Credit Hours:

15 MIN OF INFORMATION TRANSFER/ LEARNING=0.25 HRS

30 MIN OF INFORMATION TRANSFER/ LEARNING =0.5 HRS

45 MIN OF INFORMATION TRANSFER/ LEARNING =0.75 HRS

60 MIN OF INFORMATION TRANSFER/ LEARNING =1 HR

ABBREVIATIONS

KEY: SEQ:

SAQ:

MCQ:

SGD:

PBL:

CBL:

SBL:

OSPE:

OSCE:

HEC:

PMC:

DME:

SC:

Short Essay Questions

Short Answer Questions

Multiple Choice Questions

Small Group Discussion

Problem Based Learning

Case Based Learning

Scenario Based Learning

Objective structured Practical Evaluation

Objective structured Clinical Evaluation

Higher Education Commission

Pakistan Medical Commission

Department Of Medical Education

Short Cases

DEFINITIONS AND ABBREVIATIONS

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Examinations are of two kinds:

I) Internal Examinations

II) University Examinations

I) Internal Examinations

Send Up examinations shall be compulsory for students of all classes. Students who do not

appear or fail in the examination will be regarded as students whose courses of instructions

are incomplete and unsatisfactory and will not be allowed to appear in the university

professional examination for promotion to the next higher class and may also loose the

scholarship, if any, granted to them.

Pass percentage for Send up examinations is 50%.

i) First Year M.B.B.S. There will be send up examination in the subjects of Anatomy,

Physiology and Biochemistry. Students will not be allowed to sit in the University

Examination if they fail in any of the subjects in the send up examination.

ii) Second Year M.B.B.S. There will be send up examination in the subjects of Anatomy,

Physiology and Biochemistry. Failed Students will not be allowed to sit in the University

Examination if they fail in any of the subjects in the send up examination.

iii) Third Year M.B.B.S. There will be one send up examination. The subjects will be: -

1. Pharmacology and Therapeutics

2. Forensic Medicine and Toxicology

3. General Pathology

4. Behavioural Sciences

5. Clinical Methods in Surgery

6. Clinical Methods in Medicine

All subjects will be compulsory for the purpose of examination but only those students will

be detained from appearing in the University Examination who fail in any of the first four

subjects.

iv) Fourth Year M.B.B.S. There will be send up examination in the following subjects: -

1. Special Pathology

2. Community Medicine

3. Ophthalmology

4. Otorhinolaryngology

5. Medicine

6. Surgery

7. Obstetrics &Gynecology

The students will be allowed to sit the University Examination only if they clear at least the

first four subjects.

ASSESSMENT POLICIES

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v) Final Year M.B.B.S. The send up examination will be conducted in the following

subjects:

1. Medicine & Allied Specialties including Psychiatry and Dermatology

2. Surgery & Allied Specialties including Orthopedics and Anesthesia etc.

3. Obstetrics &Gynecology

4. Pediatrics

The students will be allowed to appear in the University Examination only if they pass in all

subjects.

NOTE:

1. During the clinical years, the progress of the students will be judged from the remarks of

the respective Professor on the Clinical Record Cards. Those students, whose cards show

unsatisfactory work during any of their clinical assignments, will be detained from appearing

in the final professional examination of the university.

2. A duplicate record of Clinical Card of each student will be kept in the office of the

concerned Professor.

3. Ten percent (10%) of marks of university examinations are based on internal assessment.

4. Remanded students will not be detained from the University examination if they have

fulfilled the required percentage of attendance and have satisfactory report from the

respective professor for their work during the terms, in question.

5. Certificate of Honor is awarded by the college to the student who obtains 75% or more

marks in a subject of Send Up examination of the year provided he/she does not get less than

50 percent marks in other subjects of the same examination.

Regulations for Internal Assessment

(i) The weightage of internal assessment shall be 10% in all subjects. 5% internal assessment

marks shall be added to the aggregate score of Theory and 5% internal assessment marks to

aggregate score of Oral and Practical Examination and not to an individual component like

MCQs, SEQs Paper or Oral /

Practical / Clinical Examination.

(ii) Continuous internal assessment shall consist of evaluation at the end of each assignment,

e.g. stages/sub-stages, class tests etc., attitudinal assessment from educational and or clinical

supervisors, clinical skill assessment from clinical supervisors, and Year‘s work books.

(iii) Assessment of Knowledge, Skills and Attitude shall contribute towards internal

assessment. Methods used to assess these domains shall include Multiple Choice Questions,

Short essay questions, Oral/Viva, and Practical Clinical examinations.

(iv) The score of internal assessment shall contribute 10% to final examination and final

university examination of each subject shall contribute 90% to total score, and the candidate

shall pass in aggregate.

(v) Awards of internal assessment in all the subjects of all the candidates shall be submitted

to the Controller of Examinations along with Admission Forms for the annual examination.

Internal assessment received after commencement of the final examination shall not be

accepted.

(vi) The marks of internal assessment shall be submitted only once a year prior to annual

examination and the same shall be counted both for annual and supplementary examinations.

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It is further emphasized that fresh assessment or a revision of assessment for supplementary

examination shall not be permissible.

(vii) Proper record of continuous internal assessment shall be maintained by respective

departments of the medical/dental colleges.

(viii) Internal assessment awarded in particular year may not be decreased subsequently

detrimental to the candidate.

II) University Examinations

University Examinations are strictly governed by the statutes and regulations of the

University

A) MBBS

i) First Professional M.B.B.S Examination will be held at the end of first academic year.

NOTE: Any student who fails to clear the 1st Professional M.B.B.S. examination in four

chances, availed or un-availed, after becoming eligible for each examination and has been

expelled on that account shall not be eligible for continuation of medical and dental studies

of MBBS and BDS in subsequent professional examinations.

ii) Second Professional M.B.B.S Examination held at the end of second academic year.

iii) Third Professional M.B.B.S Examination will be held at the end of third academic year.

iv) Fourth Professional M.B.B.S Examination will be held at the end of fourth academic year.

v) Final Professional M.B.B.S. Examination will be held at the end of fifth academic year.

NOTE: Any student who fails to clear the 1st Professional M.B.B.S. examination in four

chances, availed or un-availed, after becoming eligible for each examination and has

been expelled on that account shall not be eligible for continuation of medical and

dental studies of MBBS and BDS in subsequent professional examinations.

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1. Minimum attendance and satisfactory completion of the log book is required for a

student to be eligible for Certifying Examination(s).

2. Formative and Summative Assessment: The same tools may be used for formative or

summative assessment. Formative Assessments will be used only for feedback to

develop the learners, while Summative Assessments will be used to make pass/fail or

progress decisions). Any assessment where the results contribute to a final score,

which leads to a decision of

the progress of the student, must be considered summative.

3. Summative Assessment consists of the sum of the Continuous Assessment score

(Internal assessment based on assessment of student performance during the module

or clerkship) and end of year University Examination.

4. University Examinations will be held at the end of each

academic year

PROMOTION POLICIES

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YEAR WISE DISTRIBUTION OF SUBJECTS:

1ST YEAR 2ND YEAR 3RD YEAR 4TH YEAR 5TH

YEAR

General

Anatomy

Histology and

Embryology

General

Anatomy

Histology and

Embryology

Pharmacology

and therapeutics

ENT Gynaecology and

Obstetrics

Physiology Physiology Forensic

Medicine and

Toxicology

Ophthalmology Pediatrics

Bio-Chemistry Bio-Chemistry Pathology Pathology Surgery

Pak Studies and

Islamiyat /

Ethics

Behavioural

Sciences

Community

Medicine

Medicine

YEARLY DISTRIBUTION OF SUBJECTS

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General Medicine

SUBJECT

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Head of Department Prof. Dr Siraj Munir Ahmed Tarin

Professor Prof. Dr. Innayat Ullah Dr. M. Naveed Aslam Dr. Umar Farooq Dr. M. Nadeem Ansari

Assistant Professor Dr. Akram

Malik

Dr.

Azhar

Saeed

Dr. Kashif

Sardar

Dr. Nighat

Kashif

Dr. Sufyan

Saleem

Safdar

Dr. Tariq

Tarin

Dr. Ubaid

Ullah Ansar

Senior Registrar Dr. Shahzad Khan

Admin Registrar Dr. Roha Fiaz

ORGANOGRAM

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INTRODUCTION

Medicine is a broad-based specialty dedicated to providing primary and specialized care to

adults. Therefore, it forms a key component of the undergraduate curriculum and is taught

throughout the five years with increased emphasis in last three years. Its primary focus is on

building knowledge, skills and attitudes of the students for the practice of medicine not only at

the primary care level but to advance to postgraduate studies for clinical practice, medical

education and research. Allocation of hours is as per latest PMC regulations and fulfills the

minimum requirement.

Mission:

To develop medical students, in accordance with the best practices; to prepare future doctors

who can provide patient centered medical care with highest standards of professionalism. To

identify and answer fundamental questions in the mechanisms, prevention and treatment of

diseases, in the field of medicine

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The educational strategies in this curriculum are multiple and aligned with domain of learning

and according to the desired outcome

Interactive lectures

One-third of the curriculum will be delivered in a traditional didactic format including

PowerPoint presentations and case discussions. Didactic education is considered to be a one-way

transmission of material from teacher to learner, we cannot overlook the possibility of

meaningful interaction between experts and learners during live lectures. This type of interaction,

which allows for immediate clarification of concepts and extension of knowledge, may be

particularly important for novice learners who have relatively little exposure to the subject

matter, such as our study population.

Small Group Discussions

Small group discussion provides a unique environment to achieve high standards in medical

education. Activation of prior knowledge, exchange of ideas, and engagement at a higher

cognitive level are assumed to result in deeper learning and better academic achievements by

students.

Self- directed Learning

Students' take responsibilities of their own learning through individual study, sharing and

discussing with peers, seeking information from Learning Resource Center, teachers and

resource persons within and outside the college. Students can utilize the time within the college

scheduled hours or afterwards for self-study.

Power Point Presentations

Power point Presentations on various topics are assigned to the students which will increase their

knowledge and build their confidence.

CBL

Using a case-based approach engages students in discussion of specific scenarios that resemble

or typically are real-world examples. This method is learner-centered with intense interaction

between participants as they build their knowledge and work together as a group to examine the

case.

Assignments

TEACHING STRATAGIES

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Students are given written formative assignments on designated topics. Revision of the topics

already covered by anatomy and physiology departments are given to students as oral

presentations.

Tutorials/Demonstrations

A tutorial, in education, is a method of transferring knowledge and may be used as a part of a

learning process. More interactive and specific than a book or a lecture, a tutorial seeks to teach

by example and supply the information to complete a certain task.

Bedside Teaching

Bedside teaching is a specialized form of small group teaching that takes place in the presence of

the patient. Although it is known to enhance a student‘s learning experience and improve patient

care, the use of this type of teaching is unfortunately in steady decline. As well as in the hospital

setting, bedside teaching skills can be used elsewhere, such as long-term care facilities and in the

office.

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Lecture Hall

OPD

Ward

TEACHING ENVIRONMENT

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Goals Students should be able to understand the basic principles of Surgery. Concepts of

sterilization and disinfection. How to manage Surgical emergencies , and the

management protocols of surgical infections, trauma, and various pathologies.

•The Medical students are able to address the main Surgical problems of their

community.

•They should be able to manage Surgicals emergencies. For example Trauma,

emergency Tracheotomy, ATLS protocols

Outcomes At the end of this curriculum the student should be able to:

KNOWLEDGE:

Identify health status, knowledge about systemic illnesses and their impacts

on oral surgical procedures with pre-operative managements. Emergency

managements on chair side.

Outline the pre requisites and basic principles of surgery

Outline the indications and contraindications of surgery.

Interpret the trauma and outline immediate treatment plan

Recall embryology anatomy pathophysiology, clinical and radiographic

examination of management of different surgical conditions.

Enlist indictment, medicament, complications and procedure of general

anesthesia& sedation

SKILLS:

1. Evaluate & Manage medical emergencies

2. Perform infiltration of local Anesthesia

3. Plan trauma pt management

4. Evaluate & plan Head & Spine, Torso, injuries

5. Assess and plan trauma patient

6. Design flap surgery and manage its complications

7. Construct treatment plan for infected patients.

ATTITUDE:

1. Demonstrate compassion and care for patients while performing the medico-

legal examination

2. Demonstrate the team work while working in the hospital environment.

3. Demonstrate good communication skills while history taking or breaking

bad news and examining the patients.

4. Respect the patient and be professional when it comes to consent

SUBJECT OUTCOMES

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MEDICINE Distribution of subjects Paper-I All except Paper-II

Paper-II will include:

1. Infectious Diseases 7.Endocrinology including Diabetes

2. Metabolic Diseases 8.Genitourinary System

3. Immunology 9. Genetics

4. Oncology 10.Water and Electrolyte Balance

5. Acid and Base Balance 11.Psychiatry

6. Dermatology

1. CARDIOLOGY

The course outline is as follows :

• Rheumatic fever and infective endocarditis.

• Valvular heart diseases.

• Mitral valve

• Aortic valve

• Ischaemic heart disease.

• Angina

• Myocardial infarction

• Cardiac arrhythmias

• Atrial fibrillation

• Ventricular tachycardia

• Premature atrial and ventricular beats.

• Heart failure.

• Left ventricular failure.

• Congestive cardiac failure.

• Cor pulmonale.

• Congenital heart diseases (brief).

• Cyanotic/acyanotic heart diseases.

• Fallot‘s tetralogy

• Atrial septal defect

• Ventricular septal defect

• Patent ductus arteriosus

• Cardiomyopathies

SYLLABUS

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• Pericardial diseases.

• Constrictive pericarditis

• Pericardial diseases

• Pericardial effusion

• Atherosclerosis/arteriosclerosis.

• Hypertension.

• Peripheral vascular disease.

• Symptoms and signs

• Arteriosclerosis

• Acute & chronic ischaemia of the leg

• Aneurysms

• Buerger's disease

• Raynaud's disease

• variocose veins

• Venous thrombosis

• Investigations.

• Electrocardiography, Xray chest, Echocardiography, Thallium

Scan, Stress Testing, Holter And Angiography Etc.

CLINICAL TRAINING:

Important Topics To Be Discussed:

Case discussion for diagnosis and management of common cardiovascular diseases.

• Systemic hypertension

• Ischaemic heart diseases

• Congestive cardiac failure

• Valvular diseases and infective endocarditis

Understand the Symptomatology to reach the Differential Diagnosis:

Palpitation, breathlessness, chest pain, raised JVP, jaundice etc.

Skills to Be Learnt:

• History taking in CVS.

• GPE in CVS – clubbing, koilonychia, osler‘s nodes, splinter haemorrhages, cyanosis.

• Pulse, JVP, blood pressure.

• Inspection, palpation of precordium.

• Percussion, auscultation of precordium – mitral, tricuspid, aortic, pulmonary areas.

• Interpretation of related radiological and laboratory investigations

• General medication and prescription writing in CVS diseases.

Procedures (Observe/ Assist):

• ECG taking and basic reading i.e. Normal, Acute MI, Ischemia, complete heart block, APC,

VPC, SVT, VT etc.

• X-ray chest interpretation – (Cardiology).

• Should observe, learn and even may assist electroversion therapy (DC shock) with indications,

complications etc.

• Observe Echo and should recognize chambers and valves on echo print.

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• Observe pericardial effusion aspiration.

• Should learn thrombolytic therapy, heparinisation/anticoagulation therapy and control,

antiplatelet therapy, nitrates infusion, digitalization, treatment of acute pulmonary edema, o2

therapy.

• Cardiac monitoring.

• Basics of ETT.

1. PULMONOLOGY

COURSE OUTLINES:

• Asthma.

• Environmental lung diseases/occupational.

• Asbestosis

• Silicosis

• Bagassosis

• Pneumoconiosis

• Byssinosis

• Farmer‘s lung

• Pneumonia

• Community acquired

• Nosocomial

• Lobar and bronchopneumonia

• Adult respiratory distress syndrome

• Acute respiratory failure

• Mechanical ventilation.

• Bronchiectasis.

• Chronic obstructive airway diseases.

• Chronic bronchitis

• Emphysema

• Interstitial lung diseases.

• Pulmonary thromboembolism

• Acute corpulmonale.

• Type-I and type-II respiratory failure

• Pleural effusion.

• Pneumothorax.

• Tuberculosis

• Tumors of the lung • Disorders of chest wall and pleura

• Chest trauma

• Deformities of the rib cage

• Dry pleurisy, pleural effusion, empyema, and pneumothorax.

• Basics of pulmonary function tests.

• Imaging in pulmonary diseases/investigations

CLINICAL TRAINING:

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Important Topics to Be Discussed:

Case discussion for diagnosis and management of common pulmonary diseases.

• Bronchial asthma

• Pleural effusion

• Pneumonia

• Hemoptysis

• Pulmonary tuberculosis

• Chronic obstructive airway disease

• Type-I and type-II respiratory failure

• Bronchogenic carcinoma


• Breathlessness

• Wheezing

• Haemoptysis

• Orthopnoea

• Paroxysmal nocturnal dyspnoea (PND)

• Pain in calf on walking

• Undue coldness, redness or blueness of extremities

• Chest pain

• Cough/expectoration/sputum


• History taking in respiratory system – dyspnoea, cough, expectoration, haemoptysis.

• Chest pain, wheezing.

• Inspection, palpation, percussion, auscultation front of chest.

• Inspection, palpation, percussion, auscultation back of chest.

• Interpretation of related radiological and laboratory investigations.

• Interpretation of pulmonary function tests.

• General medication and prescription writing in pulmonology

• Any deficient program.


• How to start O2 therapy, indications, and complications.

• Learn pleural aspiration and assist

• Endotracheal suction, assist

• Pleural biopsy, observe

• FNA biopsy, observe

• Under water seas aspiration, observe/assist

• Management of respiratory failure

• Observe bronchoscopy

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2. DERMATOLOGY

COURSE OUTLINES:

• Anatomy, physiology of skin related to clinical dermatology

• Infestations: scabies, pediculosis.

• Bacterial and mycobacterial infections

• Fungal and viral diseases.

• Acne vulgaris

• Eczemas.

• Psoriasis

• Lichen planus

• Bullous disorders.

• Pigmentary disorders

• Disorders of nails.

• Disorders of hairs.

• Sexually transmitted diseases.

CLINICAL TRAINING:


Case discussion for diagnosis and management of common dermatological diseases.

Should recognize lesions of:

• Leprosy

• Syphilitic lesions (chancre, secondary syphilis, gumma)

• Tinea (corporis, capitis, inguinale, unguam)

• Candida (oral, skin)

• Scabies

• Lice

• Mosquito bite

• Acute & chronic eczema

• Lesions of small pox, chicken pox, herpes simplex, herpes zoster

• SLE.

• Psoriasis

• Lichen planus

• Impetigo contagiosum

• Moluscum contagiosum

• Acne vulgaris

• Seborhoea

• Exfoliative dermatitis

• Skin neoplasm like squamous cell cacinoma, basal cell carcinoma and melanoma

• Leukoderma

• Pityriasis versicolor

• Alopecia and hirsutism

• Sexually transmitted diseases

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• Furnculosis, cellulitis

• Drug eruption


• Alopecia

• Eruption and rashes

• Itching

• Pigmentation and depigmentation


• History taking in Dermatology

• Clinical examination of various skin lesions


• General medication and prescription writing in Dermatology


• Scraping for fungus

• Use of magnifying glass

• Observe skin biopsy

• Use of Wood‘s lamp

3. Neurology and Central Nervous System

COURSE OUTLINES:

o Infections and inflammatory lesions

� Meningitis

• Bacterial.

• Tuberculous.

• Viral etc.

� Brain abscess

� Encephalitis

� Hydrocephalus

o Epilepsy and other convulsive disorders

o Cerebrovascular diseases (stroke).

• Ischemic

• Embolism

• Infarction

• Haemorrhage

• Intra-cerebral

• Subarachnoid

o Dementia and Alzheimer‘s disease.

o Parkinson‘s disease and other movement disorders.

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o Motor neuron disease.

o Multiple sclerosis.

o Cranial nerve disorders.

• Transient mono-ocular blindness (amaurosis fugax).

• Trigeminal neuralgia.

• Facial palsy (Bell‘s).

• Vertigo, nystagmus

o Spinal cord disorders.

• Spinal cord compression

• Hemiplegia, paraplegia, quadriplegia

• Myelitis.

• Spondylosis.

• Syringomyelia and syringobulbia.

o Peripheral nerve disorders.

• Peripheral polyneuropathy

• Gullian Barry syndrome

• Mononeuritis multiplex.

o Space occupying lesions of brain and spinal cord.

o Muscular dystrophies

o Myopathies, myasthenia gravis

CLINICAL TRAINING:


Case discussion for diagnosis and management of common CNS disorders:

• Cerebrovascular accident

• Paraplegia

• Polyneuropathy

• Muscular dystrophies and Motor neuron disease

• Parkinsonism

• Meningitis

• Tetanus

• Hemiplegia

• Facial Palsy


• Behaviour

• I.Q

• Speech disturbances

• Memory

• Confusional states

• Dementia

• Tremor

• Fasciculations

• Athetosis

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• Chorea

• Gait abnormalities

• Convulsions/fits

• Coma

• Syncope/dizziness

• Vertigo

• Deafness

• Blindness

• Numbness, tingling, sensory loss

• Rigidity / paralysis.

• Movement disorders


• History taking in CNS.

• Higher mental functions – level of consciousness, behaviour, speech, memory.

• Examination of cranial nerves.

• Examination of motor system.

• Examination of sensory system – crude touch, pain, temperature.

• Fine touch, pressure, vibration, joint position.

• Cortical sensations

• Two point localization, two point discrimination.

• Reflexes

• Examination of cerebellar system

• Examination of nystagmus

• Examination of rigidity

• Assessment of movement disorders


• General medication and prescription writing in Neurology


� Observe and learn lumbar puncture

4. ALIMENTARY SYSTEM

COURSE OUTLINES:

o Oral cavity

� Infections and inflammatory disorders

� Benign and malignant diseases

o Esophagus.

� Dysphagia with special reference to

� Ca oesophagus

� GERD

� Achalasia

� Candiasis of oral cavity and oesophagus

o Stomach

30

� Gastritis.

� Peptic ulcer

o Intestines

o Malabsorption syndromes.

o Tropical sprue

o Coeliac disease

o Inflammatory bowel diseases.

• Ulcerative colitis

� Crohn‘s disease

o Irritable bowel syndrome (IBS).

o Liver

o Ascites.

o Jaundice.

o Congenital hyperbilirubinaemia

o Gilbert syndrome

o Dubin Johnson syndrome

o Rotor syndromes

o Haemolytic

o Obstructive

o Hepatitis

o Viral, acute and chronic

o Toxic

o Drugs

o Auto immune hepatitis.

o Cirrhosis of liver.

o Hepatic encephalopathy.

o Carcinoma liver and transplant.

o Acute and chronic pancreatitis.

o Upper GI bleeding, lower GI bleeding

o Drugs contraindicated in liver diseases

CLINICAL TRAINING:


Case discussion for diagnosis and management of common gastrointestinal and hepatobiliary

diseases.

• Acid peptic disease

• Tender hepatomegaly

• Hepatosplenomegaly

• Jaundice

• Chronic liver disease

• Acute and chronic diarrhoea

• Variceal bleeding and peptic ulcer bleeding.

• Abdominal Koch‘s infection

31


• Oral ulceration

• Dysphagia

• Heart burn

• Nausea/vomiting

• Indigestion/flatulence

• Diarrhoea and constipation

• Melena, hematemesis, bleeding per rectum

• Jaundice

• Hepatomegaly

• Abdominal distension/ascites


• History taking in GIT – vomiting, diarrhoea, pain abdomen, constipation, haematemesis,

melena, dyspepsia, distension.

• Examination of GIT –

• Inspection, palpation.

• Percussion, auscultation.


• General medication and prescription writing in GIT diseases.

• Any deficient programme.


• Learn N/G tube passing and feeding

• Learn and observe aspiration of peritoneal fluids

• Learn and observe endoscopies, upper and lower GIT

• Preparing a patient for GI endoscopies

5. KIDNEYS AND URINARY SYSTEM

COURSE OUTLINES:

• Acute renal failure.

• Chronic renal failure

• Nephrotic syndrome.

• Nephritic syndrome.

• Urinary tract infections

� Infections of the kidneys

� Infections of the lower urinary tract

• Inflammatory lesions of the kidneys • Introduction to dialysis & renal transplant

• Drugs causing renal disease (brief).

� Analgesic nephropathy.

32

� Lead, uric acid, hypercalcemia, radiation & hypersensitivity

� Nephropathy.

� Drugs contra indicated in renal insufficiency

� Drugs to be used with caution in renal disease.

• Polycystic kidneys.

• Renal vascular disorders

� Renal artery stenosis

� Renal vein thrombosis

� Tumours

• Hemolytic uremic syndrome.

• Prostatic diseases

CLINICAL TRAINING:


Case discussion for diagnosis and management of common Renal & Urinary system diseases

• Nephrotic syndrome

• Nephritic syndrome

• Acute renal failure

• Chronic renal failure


• Lumbar /pelvic pain

• Anuria, oliguria

• Hematuria

• Dysuria, pyuria

• Urgency / frequency of micturation

• Urinary retention

• Urinary incontinence

• Nocturia

Skills To Be Learnt:

• History taking – lumbar pain, anuria, oliguria, hematuria, dysuria, urgency/frequency of

micturition, pyuria, urinary retention, nocturia, urinary incontinence, pelvic pain.

• Examination of abdominopelvic and lumbar area

• Inspection, palpation, percussion, auscultation.


• General medication and prescription writing in upper & lower urinary tract diseases.


• Observe and assist insertion of Foley‘s catheter/Red rubber catheter • Learn and observe peritoneal and hemodialysis

• Indications and outcomes of renal transplant

33

• Observe I/V urograms

6. ENDOCRINOLOGY

COURSE OUTLINES:

o Anterior pituitary.

� Growth hormone disorders

o Acromegaly

o Gigantism.

o Short stature

� Infertility

o Diseases of hypothalamus and posterior pituitary.

� Empty sella syndrome

� Diabetes insipidus

� Syndrome of inappropriate ADH secretion (SIADH).

o Thyroid gland.

� Hyperthyroidism (thyrotoxicosis)

� Hypothyroidism (myxedema, cretinism)

� Inflammatory lesions

� Benign and malignant tumors

o Adrenal Gland.

� Cushing Syndrome

� Aldosteronism Primary/ Secondary.

� Hirsutism.

� Addison‘s disease

� Acute Addisonian crisis

� Inflammatory lesions

� Adrenocortical tumors including Pheochromocytoma

o Endocrine Pancreas

� Diabetes mellitus and hypoglycaemic states

� Other associated endocrine disorders

o Testes

� Sexual precocity

� Heterosexual precocity

� Gynaecomastia

� Inflammations

� Tumours

o Multiple endocrine neoplasia

� Type I

� Type II

CLINICAL TRAINING:


Case discussion for diagnosis and management of common endocrine disorders

34

• Diabetes mellitus

• Thyroid diseases

• Cushing‘s disease

• Infertility and common reproductive disorders


• History taking and correlate with a specific diagnosis.

• Examination of thyroid gland, male and female genital organs etc.


• General medication and prescription writing in endocrinology

7. RHEUMATOLOGY

COURSE OUTLINES:

o Osteoarthritis

o Osteoporosis

o Rheumatoid arthiritis and related arthropathies

o Paget‘s disease of the bone.

o Osteopetrosis (marble bone disease).

o Multiple myeloma

Multi-System Immunological Diseases

o Systemic lupus erythematosis (SLE)

o Serum sickness

o Systemic sclerosis (scleroderma).

o Mixed connective tissue diseases (brief).

o Sjogren‘s syndrome (brief).

o Ankylosing spondylitis.

o Bechet‘s syndrome (brief).

o Vasculitis syndromes (brief).

o Anaphylactoid purpura

o Polyarteritis nodosa

o Hpersensitivity vasculitis

o Wegner‘s granulomatosis

o Temporal arteritis

o Takayasu‘s arteritis

o Thromboangitis obliterans (Burger‘s disease)

o Sarcoidosis (brief).

CLINICAL TRAINING:


35

Case discussion for diagnosis and management of common rheumatologic diseases.

• Rheumatoid arthritis

• Osteoarthritis

• Multiple Myeloma

• SLE etc.


• Joint pain and joint swelling

• Joint deformities

• Muscle cramps

• Muscle weakness

• Muscular wasting

• Other related systemic signs and symptoms



• Examination and assessment of the pattern of involvement of bones, joints, skin and other

organs


• General medication and prescription writing in rheumatology.


• Observe aspiration of fluids from joints (knee)

• Observe bone marrow aspiration/trephine

8. METABOLIC DISORDERS

COURSE OUTLINES:

� Hyperlipidemia

� Hemochromatosis

� Porphyrias

� Wilson‘s disease

� Gout and hypercalcemia

� Storage diseases.

� Lipid.

• Leukodystrophies

• Niemann pick disease.

• Gaucher‘s disease.

� Glycogen.

• Fabry‘s disease.

� Hereditary connective tissue disorders

� Osteogenesis imperfecta.

36

� Ehler‘s danlos syndrome.

� Chondrodysplasias.

� Marfan syndrome.

� Alport syndrome.

� Disorders of amino acid metabolism and storage

� Homocystinuria.

� Alkaptonuria.

� Hartnup disease.

� Renal glycosuria

9. INFECTIOUS DISEASES

COURSE OUTLINES:

o Clinical syndromes.

� Sepsis and septic shock, meningococcaemia

� Acute infectious diarrhoeal diseases and bacterial food poisoning.

� Hospital acquired infections.

o Common disease syndromes caused by the following bacteria and their drug therapy.

� Pneumococci

� Staphylococci.

� Streptococci.

� Hemophilis influenzae.

� Shigella.

� Gonococci.

� Pseudomonas.

o Following diseases in detail.

� Tetanus.

� Enteric fever/ salmonellosis.

� Cholera.

� Tuberculosis.

� Leprosy.

� Amoebiasis/giardiasis/ trichomoniasis.

� Malaria.

� AIDS.

� Rabies.

� Infectious mononucleosis.

o Helminthic infestations

� Ascariasis

� Hookworm

� Whipworm (trichuriasis)

� Threadworm (entrobiasis)

� Taenia (tapeworm)

� Hydatid diseases

CLINICAL TRAINING:

37


Case discussion for diagnosis and management of common infectious

diseases in Pakistan

• Malaria

• Typhoid fever

• Acute diarrhoeal diseases

• Acute / chronic respiratory tract infections

• Generalized septicemia etc.


o Fever

o Headache, pain

o Anorexia/ weight loss

o Haemoptysis/ chest pain/ epigastric

o Cough/expectoration/sputum

o Dysuria, pyuria

o Diarrhoea / vomiting

o Melena, hematemesis

o Jaundice/hepatomegaly

o Eruption and rashes

o Itching

o Joint pain and joint swelling etc.



• Examination and assessment of the pattern of fever, involvement of organ systems and any

positive findings.


• Symptomatic treatment and prescription writing in infectious diseases.

Procedures:

Perform:

• Injection I/V, I/M, S/C, intradermal

• Oxygen therapy

• Urinary catheterisation – collection of samples

• Collection of blood samples/ blood film preparation

Observe:

• Observe I/V lines/Fluids/Blood/Blood products, direct,

38

branula, cutdown, CVP

• N/G tube passing and feeding

• Foley‘s catheter/Red rubber catheter

• IOP record maintenance

• Aspiration of fluids (Pleural, Pericardial, Peritoneal, Knee)

• Lumbar Puncture

• O2 therapy

• Nebulisation etc.

10. HAEMATOLOGY

COURSE OUTLINES:

Anaemias.

• Classification

• Iron deficiency

• Megaloblastic

o B-12 deficiency

o Folic acid deficiency

• Anaemia of chronic disorder

• Haemolytic anaemia

o Hereditary

o Acquired

o Intra-corpuscular

o Extra-corpuscular

• Aplastic anemia

Haemoglobinopathies.

• Sickle cell syndromes

• Thalassaemias

Myeloproliferative diseases.

• Chronic myeloid leukemia (CML)

• Polycythemia vera

• Myelofibrosis

• Essential thrombocytosis

• Leukemias.

• Acute

• Chronic

• Lymphomos

• Non-Hodgkin‘s

• Hodgkin‘s

Blood groups and blood transfusion.

Bone marrow transplantation.

Disorders of haemostasis.

• Thrombocytopenia

• Idiopathic thrombocytopenic purpura (ITP)

• Von Willebrand‘s disease.

39

• Vessel wall disorders.

• Disorders of coagulation.

• Haemophilia

• Vitamin K deficiency.

• Disseminated intravascular coagulation (DIC).

Anticoagulants Therapy

• Heparin

• Oral (warfarin etc.)

• Vit. K infusion

• Antiplatelet drugs

CLINICAL TRAINING:


Case discussion for diagnosis and management of common haematological disorders

• Anaemias

• Bleeding disorders

• Myeloproliferative or lymphoproliferative diseases


• Lassitude

• Dyspnoea

• Infections

• Edema

• Gum hypertrophy

• Bleeding tendency

• Bruising purpura

• Lymph node enlargement

• Weight loss

• Facial swelling

• Bone pain

• Jaundice

• Hepatosplenomegaly

• Hypersensitivity/ allergic reactions etc.


• History taking in general

• General physical examination, pallor, cyanosis, jaundice, clubbing, koilonychia, lymph nodes,

edema, pulse, cyanosis, fever, headache, anorexia, weight loss, pain, facial swelling etc.

• Examination and assessment of the extent of the disease


• General medication and prescription writing in Haematology.

40



• Collection of samples of blood/blood film preparation

• Perform I/V lines/fluids/blood/blood products, direct branula, cutdown, CVP etc.

• Observe bone marrow aspiration/ trephine

11. PSYCHIATRY

COURSE OUTLINES:

• Mood disorders.

• Major depressive episodes

• Unipolar

• Bipolar

• Dysthymic

• Atypical

• Maniac episodes

• Anxiety disorders.

• Acute anxiety states

• Panic disorders

• Generalized anxiety disorders

• Psychic Traumatic disorders

• Obsessive-compulsive disorders

• Phobic disorders

• Schizophrenia.

• Alcoholism.

• Addiction.

• Psychosexual disorders in men and women.

CLINICAL TRAINING:


Case discussion for diagnosis and management of common Psychiatric disorders like-

• Anxiety

• Depression

• Schizophrenia

• Manic depressive psychosis

• Phobias

• Eating disorders



41

• History taking in psychiatry

• Clinical examination of patients

• Counseling and psychoanalysis especially in patients with suicidal and homicidal attitude.


• General medication and prescription writing in psychiatry

Procedures:

• Psychotherapy

• Electroconvulsive Therapy (ECT)

• Electroencephalogram (EEG)

12. MISCELLANEOUS AND

EMERGENCIES

• Heat stroke

• Snake bite

• Electric shock

• Poisoning etc.

Procedures To Be Performed/Observed/Assisted:

Perform:


• Oxygen therapy

• Urinary catheterisation – collection and samples of blood

Observe:

• Observe I/V lines/fluids/blood/blood products, direct, branula, cutdown, CVP

• N/G tube passing and feeding

• Foley‘s catheter/Red rubber catheter, IOP record maintenance

• Endotracheal tube placement

• Endotracheal suction/maintenance of airway/nursing on side etc.

• Aspiration of fluids (Pleural, Pericardial, Peritoneal, Knee)

• Lumbar puncture

• O2 therapy

• Nebulisation

• ECG taking/reading

• X-ray chest reading

• Barium series

• I/V urograms

• Bone and joint X-ray reading for medical problems

(Rheumatoid arthritis, osteoarthritis, collapse vertebra, caries spine, multiple myeloma, cervical

rib etc.)

• Preparing a patient for endoscopies, upper and lower GIT

42

THE LOG BOOK/CLINICAL CARD RECORD

The student is expected to make a record of his/her achievements in the log book. The log book

is a collection of evidence that learning has taken place, it is a reflective record of achievements.

The log book shall also contain a record of the procedures which student would have performed

in 3rd, 4th & 5th year.

RECOMMENDED BOOKS:

1. Practice of Medicine by Davidson.

2. Clinical Medicine by Parveen J Kumar & Michaell, Clark

3. Hutchison's Clinical Methods by Michael Swash. 21st edition

4. Basic psychiatry by Myre Sim, e. B. Gordon

5. Oxford Text Book of Psychiatry

6. ABC of Dermatology. Latest Edition.

7. Smith's General Urology by Emil A. Tanagho and Jack W. McAninch 15th edition. 2007

8. Online Journals and Reading Materials through HEC Digital Library Facility

43

Credit Hours of 5th

Year MBBS (Session 2020-2021)

Subj

ect

1st Year

MBBS

Total

Hour

s

Achie

ved

in

1st

Year

MBB

S

2nd Year

MBBS

Total

Hour

s

Achie

ved

in

2nd

Year

MBB

S

3rd Year

MBBS

Total

Hour

s

Achie

ved

in

3rd

Year

MBB

S

4th Year

MBBS

Total

Hour

s

Achie

ved

in

4th

Year

MBB

S

5th Year

MBBS

Total

Hour

s

Achie

ved

in

5th

Year

MBB

S

PM

C

Req

.

Total

Hour

s

Achi

eved

MM

DC

Surge

ry

Clinical

Lecture---

-27 H

27

Hour

s

Clinical

Session --

-27 H

27

Hour

s

Clinical

Lecture -----

-18 H

Skill Lab ---

-18 H

36

Hour

s

Lecture -----

-36 H

Clinical ----

75 H

111

Hour

s

Test---------

---36 H

Lecture -----

-216 H

SGD--------

---36 H

Symposium

--9 H

Clinical-----

-112 H

409

Hours

600

Hou

rs

610

Hour

s

Medi

cine

Clinical

Lecture ---

27 H

27

Hour

s

Clinical

Session --

-27 H

27

Hour

s

Clinical

Lecture -----

-18 H

Skill Lab ---

-18 H

36

Hour

s

Lecture -----

36 H

Clinical ----

75 H

111

Hour

s

Test---------

---36 H

Lecture -----

-180 H

SGD--------

---36 H

Symposium

---9 H

Clinical-----

-112 H

373

Hours

500

Hou

rs

565

Hour

s

Gyna

e &

Obs.

------------

--

-------

-------

------------

--

-------

------- --------------

-------

-------

Lecture -----

36 H

Clinical ----

75 H

111

Hour

s

Test---------

---36 H

Lecture -----

--72 H

Symposium

----9 H

Clinical-----

-112 H

229

Hours

300

Hou

rs

340

Hour

s

Peads ------------

--

-------

-------

------------

--

-------

------- --------------

-------

-------

Lecture -----

36 H

Clinical ----

75 H

111

Hour

s

Test---------

---36 H

Lecture -----

--72 H

Symposium

----9 H

Clinical-----

-112 H

229

Hours

300

Hou

rs

340

Hour

s

SDL SDL-----

36 H

36

Hour

s

SDL-------

- 72 H

72

Hour

s

SDL---------

- 72 H

72

Hour

s

SDL---------

- 36 H

36

Hour

s

SDL---------

--36 H

36

Hour

s

125

Hou

rs

252

Hour

s

SCHEME OF STUDIES

44

Medicine -I

Sr. # Topic MCQs SEQs

1. Cardiovascular System 07 02

2. Pulmonology Medicine 07 01

3. central Nervous System 07 01

4. gastrointestinal System 07 02

5. Liver, Pancrease, Gallbladder 06 01

6. Blood 05 01

7. Rheumatology 06 01

Medicine –II

SEQs

Sr.# Topic Specification SEQs

1. Endocrines 02

2. Renal/ Kidneys, Water Acid Base / Electrolyte,

Metabolism 02

3. Infection / Tropical Disease 02

4. Neuro- Psychiatry 02

5. Dermatology 01

Total 09

MCQs

TABLE OF SPECIFICATIONS

45

Sr.# Topic Specification MCQs

1.

Endocrines :

a) Diabetes Mellitus

b) Thyroid

c) Adrenals Mise / other

05

01

01

01

02

2. Renal/ Kidneys, Water Acid Base / Electrolyte,

Metabolism 10

3. Infection / Tropical Disease 07

4.

Neuro- Psychiatry :

a) Signs and Symptoms in Psychiatric Patients

b) Patients presenting with dear and panic

c) Persistent complainer and somatization

d) The depressed patient

e) Patients brought with features of psychosis (odd,

excited aggressive )

f) Conversion states

g) Mental handicap

h) Confused and disoriented patients

i) Substance abuse disorder

j) Obsessional states

10

(Brackup of

Mcqs 10)

One Mcqs

form each

Topic

5.

Dermatology :

Eczema

Papulosquamous dermatoses

Drug Eruptions

Bullous dermatoses

Bacterial Infections of skin

Cutaneous infections

Sexually transmitted infections

Skin manifestations of systemic disorder

06

(06 Mcqs

form the

topies

given)

6. Nutrition data photo 02

46

TOPIC LEARNING OBJECTIVES In

teractive L

ecture

SG

D

SD

L

CB

L

Ward

Classes

Presen

tation

s

SE

Qs

MC

Qs

Viv

a/OS

PE

At the end of the session student will be able to:

Knowledge Skill/Attitude Teaching Strategies Assessment

1

History taking

1.Plan the components of

history taking

1.develop doctor-patient

relationship with patients

2. identify the chief

complaints of the patient,

prompting the patient to

seek medical advice

3. ask the medically

relevant questionnaire for

the patients so that they

are able to make the

foundation for differential

diagnosis

4. perform the systemic

query to the patient so

that no important clues to

his disease are missed

5. take the past medical

history of the patient

6. take drug history,

social history, family

history and personal

history of the patient and

their importance in the

overall diagnosis and

management of the

patients‘ illness/es

7.describe the history to

other medical

professionals and seniors

so that a comprehensive

intra- and inter-

departmental discussion

could be ensued after

history taking

* * * * * * * * *

2

General Physical

examination

1. enlist important general

physical signs associate with

various systemic and local

diseases like pallor, jaundice,

cyanosis, clubbing, oedema,

gynecomastia, tremors,

leukonychia, spider naevi etc

etc

1. identify Important

general physical signs

associate with various

systemic and local

diseases like pallor,

jaundice, cyanosis,

clubbing, oedema,

gynecomastia, tremors,

leukonychia, spider naevi

etc etc

* * * * * * * * *

LEARNING OBJECTIVES

TEACHING AND ASSESSMENT STRATAGIES

47

2. interpret different

physical signs and their

relation with medical

history

3.interpret different

physical signs and their

relation with medical

history

3

Examination of

abdomen

1.identify the steps in

examination of abdomen and

their importance

2. correlate various physical

findings in abdominal

examination and formulate a

clinical diagnosis of

underlying pathology through

interpretation of physical

findings

1. perform inspection of

abdomen with proper

techniques and identify

important physical

findings on inspection of

abdomen

2. perform general

palpation of abdomen and

to identify guarding,

rigidity and tenderness

3. detect and describe

abdominal mass

4. perform proper

technique for palpation of

liver

5. palpate liver for

hepatomegaly, its borders

and surface, its clinical

importance, its relation

with other points in

history and examination

6. palpate spleen with

proper technique

7. interpret splenomegaly,

its clinical importance, its

relation with other points

in history and

examination

8.. palpate other viscera

like kidneys, urinary

bladder, Murphy sign,

aorta and abdominal

lymph nodes

8. interpret the above

findings, their clinical

importance, their relation



9. perform percussion of

abdomen especially

shifting dullness,

percussion of spleen, liver

span etc

10. interpret above

findings especially

shifting dullness, its

clinical importance, its


* * * * * * * * *

48

in history and

examination and its

influence on overall

management of the

patient

11. auscultate bowel

sounds, renal bruit,

hepatic bruit

12. relate the examination

findings especially bowel

sounds, its clinical

importance, its relation



and its influence on

overall management of

the patient

4

Chest examination


examination of abdomen and

their importance

2.correlate various physical

findings in chest examination

and formulate a clinical

diagnosis of underlying

pathology through


findings

1. perform inspection of

chest with proper


important physical

findings on inspection of

chest and know their

clinical significance.

2. perform palpation of

chest to identify

tenderness and crepitus

and know its clinical

significance.

2. assess position of

trachea and apex beat.

3. palpate chest for chest

movements and vocal

fremitus anteriorly and

posteriorly on chest.

4. percuss the chest and

identify different notes of

percussion including

normal, impaired, dull,

stony dull and hyper-

resonant and know their

clinical significance.

5. percuss the chest to

find upper border of liver

and to compare both sides

of chest through

percussion on anterior,

lateral and posterior chest.

6. To make students able

to auscultate the chest and

identify differences in

intensity of breath sounds

and to differentiate

vesicular from bronchial

* * * * * * * * *

49

breath sounds and to

know their clinical

significance.

7. auscultate the chest

anteriorly, laterally and

posteriorly on chest and

identify added sounds

including rhonchi,

crepitations and pleural

rub.

8. perform vocal

resonance on front and

back of chest and identify

the clinical significance of

differences in vocal

resonance.

5

Cardiovascular system

examination


examination of CVS and their

importance


findings in CVS examination



pathology through


findings

1. perform pulse

examination with proper


abnormalities in rate,

rhythm, volume, character

etc and how to proceed

further from these

abnormalities

2. perform Blood pressure

measurement with proper

techniques and its

significance with

relevance to the history

and other examination

findings

2. detect and measure

jugular venous pulse and

what is its interpretation

with regard to the

differential diagnosis

3. palpate the apex beat,

its types and significance

4. summarize precordium

palpatory findings like

parasternal heave,

palpable p2, thrills etc

5. perform cardiac

auscultation, its normal

and abnormal findings, its

clinical importance, its


in history and

examination

6. correlate and evaluate

the above findings

especially S3, S4,

different common

murmurs, the various

techniques applied to

* * * * * * * * *

50

differentiate between

them, their clinical

importance, their

discerning place in the

differential diagnosis

7. palpate central and

peripheral pulses, and

restate their significance

6

Nervous system

examination

1 identify the steps in

examination of CNS and their

importance


findings in CNS examination



pathology through


findings

1. examine higher mental

functions which includes

conscious level,

orientations of patient in

time of place, memory,

speech, executive

function, abstract thinking

and their clinical

correlation.

2. check for

comprehension, fluency,

repetition, reading,

writing or naming objects

for motor / sensory

abnormalities and to

differentiate between

sensory and motor

aphasia.

3. perform memory

examinations and mini-

mental state examination.

4. examine all 12 cranial

nerve for any correlation

with history and other

clinical signs e.g different

b/w upper and lower

motor neuron facial palsy,

3rd cranial nerve lesion

causing squint, diplopia or

ptosis also check for

Dysphagia gag reflex for

9th an 10th cranial nerve

lesion or there clinical

correlation.

5. examine motor system

of both upper and lower

limbs which includes

inspection after proper

exposure of limbs and to

look for any deformity,

palpation to look for tone,

power, deep tendon

reflexes and Babinski

sign. Also to make to

students able to

differentiate b/w upper

and lower motor neuron

lesion then make the

* * * * * * * * *

51

students able to look for

coordination and gait

examinations.

6. examine sensory

system which includes

fine touch, pain

temperature, vibration and

proprioception. Also look

for any sensory level to

look spinal cord lesion if

any suspicion of cortical

lesion then look for

cortical sensation which

are two point

discrimination etc

7. perform clinical

methods for cerebellar

signs e.g nystagmus,

dysarthric speech, past

pointing, dysdia

dochokinesia, rebound

phenomenon, pendular

knee jerk, ataxic gait.

8. identify any sign of

meningeal imitation e.g

Neck stiffness Kernig's

sign, Brudzenski sign for

meningo-encephalitis o

7

Headache Syndromes

1. differentiate between

migraine, tension type

headache and intracranial

pathology 2.manage cases of

sudden severe headache

Perform relevant clinical

examination and correlate

with history points

* * * * * * * * *

8

Investigations CNS

Disorder

1. interpret and analyze CT

scan and MRI of central

nervous system.

2.differentiate different causes

of meningoencephalitis on

CSF biochemistry and

cytology.

perform relevant clinical


with history points

* * * * * * * * *

9

Dementia

1. analyze, investigate and

manage different causes of

dementia e.g Alzheimer‘s

disease, lewy body dementia,

Parkinson disease dementia

etc



with history points

* * * * * * * * *

10

Disorders of sleep

1. evaluate causes of sleep

disorders.

2. Differentiate between

narcolepsy and obstructive

sleep apnea and manage these

disorders.



with history points

* * * * * * * * *

11

Spinal Cord Disease

1. Localize the lesion in spinal

cord by clinical examination

and relevant investigations.

2. Differentiate between

Pott‘s disease and metastatic

spine disease and how to



with history points

* * * * * * * * *

52

manage these diseases.

12

Muscular Dystrophies/

Myositis

1. Localize the lesion at

muscular level and evaluate

duchenne and becker

muscular dystrophy with

management.

2. Diagnose and treat

polymyositis and

dermatomyositis.



with history points

* * * * * * * * *

13

Myasthenia Gravis

1. Evaluate neuromuscular

junction disorders with

relavant examination and

investigations with

management.



with history points

* * * * * * * * *

14

Parkinson‘s Disease

1. diagnose clinically

idiopathic Parkinson disease

2. rule out other causes of

parkinsonism e.g progressive

supranuclear palsy, multiple

system atrophy, and lewy

body disease



with history points

* * * * * * * * *

15

CVA

1. Localize the lesion

according to arterial blood

supply of brain 2. manage the

patients on emergency basis.



with history points

* * * * * * * * *

16

Multiple Sclerosis

1. diagnose and manage

relapsing remitting multiple

sclerosis

2. Evaluate the different

treatment modalities

available.



with history points

* * * * * * * * *

17

Meningitis /

Encephalitis


meningitis and encephalitis

and the possible

microorganism causing the

disease 2

2. initiate empirical therapy as

soon as possible



with history points

* * * * * * * * *

18

Motor Neuron

Diseases

evaluate different causes of

motor neuron disease and

manage each cause with

relevant investigations and

treatment



with history points

* * * * * * * * *

19

Epilepsy----Diagnosis

and classification

1.differentiate between

seizure due to epilepsy and

other metabolic/structural

causes

2.classify epilepsy

3. determine the role of

EEG/brain imaging in the

diagnosis of epilepsy



with history points

* * * * * * * * *

20 Akinetic Rigid

Syndrome

evaluate different causes of

akinetic rigid syndrome and

management



with history points

* * * * * * * * *

21

GB Syndrome

1. diagnose patients with

ascending paralysis

2. Evaluate the treatment on

urgent basis in ICU settings.



with history points

* * * * * * * * *

22 Chronic

Polyneuropathies

1.determine different causes

of chronic neuropathies e.g

DM, drugs, endocrine



with history points

* * * * * * * * *

53

abnormalities etc

2. manage neuropathy cases

23

Vestibular disorders

Evaluate the patients

presenting with vertigo,

tinnitus and hearing

complaints and their

management.



with history points

* * * * * * * * *

24 Sphincter

Disturbances

Localize the lesions causing

sphintor disturbance and their

management.



with history points

* * * * * * * * *

25 Management of

Epilepsy and Status

Epilepticus

Diagnose the patients with

status epilepticus with proper

management.



with history points

* * * * * * * * *

26 Importance of

Cardiology & Basics

Of Investigation

make the students able to

have a basic concept of

clinical problems in

cardiology



with history points

* * * * * * * * *

27

Mitral Stenosis

evaluate clinical symptoms

and signs of mitral stenosis

2. analyze the mode and scope

of various investigations

3. review treatments available

and when and where to refer

the patient



with history points

* * * * * * * * *

28

Mitral Regurgitation

1. evaluate clinical symptoms

and signs of the lesion



3. review the modes of

treatment available and when

and where to refer the patient



with history points

* * * * * * * * *

29

Aortic Stenois

1 evaluate clinical symptoms




3. review modes of treatment

available and when and where

to refer the patient



with history points

* * * * * * * * *

30

Aortic Regurgitation

1. evaluate clinical

symptoms and signs of the

lesion








with history points

* * * * * * * * *

31

MitralValve

Proslapse,Trisupic

Regurgitation,Tricuspi

d Stenosis



lesions

2. analyze the mode and

scope of various

investigations






with history points

* * * * * * * * *

32

Pulmonary

Hypertenion

Pulmonary Stenosis



lesion






with history points

* * * * * * * * *

54

treatment available

and when and

where to refer the

patient

33

Pulmonary

Regurgitation



lesion








with history points

* * * * * * * * *

34

Stable Angina Pectoris

1. evaluate chest pain

syndromes, including cardiac

and non-cardiac chest pain

2. review concept of typical/

atypical chest pain



lesion








with history points

* * * * * * * * *

35

Acute Coronary

Syndrome

1.evaluate clinical symptoms

and signs of the Acute Chest

Pain Syndrome

2. differentiate and ‗triage‘

the patients with ACS



4. evaluate the emergency

modes of treatment available

5. valuate the urgency of

referral and where to refer the

patient



with history points

* * * * * * * * *

36

Angina with normal

coronaries




scope of various

investigations






with history points

* * * * * * * * *

37

Cyanotic Congenital

heart










with history points

* * * * * * * * *

38

Coarctation of Aorta/

Takayasu disease


and signs of the lesions








with history points

* * * * * * * * *

39

Aortic Dissection






* * * * * * * * *

55

scope of various

investigations




with history points

40

Disease of

pericardium










with history points

* * * * * * * * *

41

Heart Failure



lesion and their relation with

each other

2.evaluate the different causes

leading to heart failure

syndrome

3. differentiate mode and

scope of various

investigations

3. choose the modes of





with history points

* * * * * * * * *

42

Cardiomyoptahies


and signs of the lesions

2. classify the

cardiomyopathies based on

clinical presentation








with history points

* * * * * * * * *

43

Rheumatic Fever


and signs of the rheumatic

fever

2. differentiate from other

arthritis syndromes



according to Jone‘s Criteria


treatment available

5. plan prophylaxis of further

attacks



with history points

* * * * * * * * *

44

Infective Endocarditic



2. evaluate the differential

diagnosis

3.analyze the mode and scope

of various investigations,

based on Duke‘s Criteria

4. formulate the modes of





with history points

* * * * * * * * *

45

ECG

1. review the basic concepts

of electrocardiography

2. evaluate the rate and

rhythm

3. analyze electrical axis,



with history points

* * * * * * * * *

56

LVH, ST segment and T wave

changes

4. conclude ECG diagnosis

and

5.plan clinical action

accordingly

46

Heart Blocks










with history points

* * * * * * * * *

47

Ventricular

Tachycardia and

Fibrillation


and signs of the VT

2. analyze the central place of

Pulseless VT/VF in Cardio-

Pulmonary Resuscitation

3. review the place, mode and

scope of Defibrillation in CPR

4. manage a patient after

resuscitation



with history points

* * * * * * * * *

48

Hypertension

1. review the epidemiology of

the illness

2. identify the causes of

secondary hypertension

3. evaluate and investigate a

patient with secondary

hypertension

4. plan the hypertension

treatment based on clinical

guidelines



with history points

* * * * * * * * *

49

DVT & Pulmonary

Embolism










with history points

* * * * * * * * *

50

Anticoagulation and

its Principles

1. review the concept of

anticoagulation

2. analyze the risk of

bleeding with anticoagulation

3. review the place of

anticoagulation in different

lesions



with history points

* * * * * * * * *

51

1. Basic Concepts of

Nephrology and

kidney disease

1review normal structure of

kidney

2. review about GFR.

3. interpret normal sodium

and other solute and water

handling of kidney.

4.review vascular supply of

kidney



with history points

* * * * * * * * *

52

Nephrotic syndrome

1. evaluate proteinuria

2. investigate a patient with

proteinuria

3. manage proteinuria and

plan investigations

4. demonstrate about renal

biopsy



with history points

* * * * * * * * *

57

53

Nephritic syndrome

1. evaluate hypertension,

AKI and hematuria

2.investigate a patient with

hematuria

3. manage hematuria patients

and plan their investigations

4. discuss the role of renal

biopsy



with history points

* * * * * * * * *

54

Acute Renal Failure

1. define ARF.

2. investigate ARF

3 manage a case of ARF.



with history points

* * * * * * * * *

55

Chronic renal failure

1. review the definition of

CRF.

2. investigate CRF

3 manage a case of CRF.

4. demonstrate about central

vein catheterization.



with history points

* * * * * * * * *

56

Hereditary diseases of

kidneys

1. review hereditary diseases.

2. investigate ARF

3. how to council patient and

family.



with history points

* * * * * * * * *

57

Urinary tract infection

1. review the symptom of

UTI.

2. investigate UTI

3. manage a case of UTI.



with history points

* * * * * * * * *

58

Renal vascular

disorders

1. review about renal artery

stenosis and other vascular

disorders

2. investigate vascular

disorders

3 plan the management a case

of vascular disorder



with history points

* * * * * * * * *

59

Hemolytic uremic

syndrome

1. review hemolytic uremic

syndrome.

2. investigate and manage

Hemolytic uremic syndrome



with history points

* * * * * * * * *

60

Hemodialysis and

renal transplant

1. review Hemodialysis and

renal transplantation

2. acquire the basics of

hemodialysis and

transplantation



with history points

* * * * * * * * *

61

Approach to

Abdominal Pain

1. elucidate important points

in history of abdominal pain

2. differentiate the red flags

in abdominal pain

3. differentiate various causes

of abdominal pain

4.proceed with management

safely in patient with

abdominal pain



with history points

* * * * * * * * *

62

Approach to vomiting

1.differentiate various causes

of abdominal pain

2. proceed safely in a case of

persistent vomiting



with history points

* * * * * * * * *

63

Esophageal motility

disorders

1. differentiate various

varieties of esophageal

motilitily disorder

2. review the place of

esophageal motility disorders

in non-cardiac chest pain



with history points

* * * * * * * * *

64 Approach to 1. differentiate various causes perform relevant clinical * * * * * * * * *

58

Abdominal distension of abdominal distension

2. analyse the history and

physical signs in a patient

with ascites

3. analyze the concept of

SAAG and its place in the

differential diagnosis of

ascites


with history points

65

Approach to

Dysphagia

1. analyze the symptoms in

patient with Dysphagia

2. analyze and investigate a

patient with oropharyngeal

Dysphagia

3. analyze and investigate a

patient with esophageal

dysphagia



with history points

* * * * * * * * *

66

Approach to Diarrhea

1. classify various types of

diarrhea

2. investigate a case of

diarrhea based on clinical

calssification



with history points

* * * * * * * * *

67

Approach to

Hematemesis and

Melena


various causes of hematemsis

and Melena based on history

and examination

2. identify life-threatening

symptoms and signs

3. resuscitate in a patient with

UGI bleed

4. start pharmacological

treatment in the emergency

ward

5. review different treatment

options available



with history points

* * * * * * * * *

68

Abdominal TB

1- review Mode of spread

2-identify the presentation

(ascites, lymph node,

intestine)

3- investigate a patient with

abdominal TB

4- select treatment options

5-predict side effects of ATT

and modified ATT options



with history points

* * * * * * * * *

69

Celiac Disease

1-review presenting

symptoms of celiac disease


features suggesting Celiac

disease

3- comprehend the

complications of untreated

celiac disease

perform relevant

clinical

examination and

correlate with

history points

* * * * * * * * *

70

Acute Pancreatitis

1.review scores regarding

severity

2- identify acute and chronic

complications and

management

3-manage a case of

pancreatitis

perform relevant

clinical examination

and correlate with

history points

* * * * * * * * *

71 Chronic Pancreatitis

1-review the various causes of

chronic pancreatitis perform relevant * * * * * * * * *

59

2 review-Complications of

chronic pancreatitis

3- plan pain management


and correlate with

history points

72

Approach to Mal-

absorption Syndromes

1- Sketch presentations of

malabsorption syndrome

2-Differentiate between

phases of malabsorption

3- investigate a patient

with malabsorption



with history points

* * * * * * * * *

73

Functional Dyspepsia

& Zollinger-Ellison

Syndrome

1-differentiate between

organic and functional

dyspepsia

2- identify the alarm features


with FD and ZES

perform relevant


and correlate with

history points

* * * * * * * * *

74

IBD and Ulcerative

colitis

1 . differentiate between

ulcerative colitis and Crohn,s

disease

2. review the features on

colonoscopy

3- review the treatment

options

4- comprehend the

complications of long

standing IBD/ulcerative

colitis



with history points

* * * * * * * * *

75

Irritable Bowel

Syndrome

1- differentiate b/w IBS and

IBD

2-A classify IBS


IBS

4- plan treatment options



with history points

* * * * * * * * *

76

Acute Liver Failure

1- define and classify acute

liver failure

2-review the indication of

liver transplant

3- manage a patient with

liver failure



with history points

* * * * * * * * *

77 Dyspepsia & Acid—

peptic disease

1- define dyspepsia

2-recognize alarm features

3- manage a patient with

helicobacter pylori



with history points

* * * * * * * * *

78

Chronic Hepatitis B &

C

1- identify the modes of

presentation

2- review the natural history

of hepatitis B and C

3- identify the complications

of hepatitis B and C

4-prevent the transmission

5- Treatment options



with history points

* * * * * * * * *

79

Alcoholic/Non-

Aloholic Fatty Liver

Disease

1-review the harmful drinking

2- identify Various risk

factors for NAFLD

3- identify complications


with fatty liver disease



with history points

* * * * * * * * *

80

Inherited Liver

Diseases

1- review various inherited

disease

2- comprehend the

different presenting

features



with history points

* * * * * * * * *

60

81

Auto-immune

Hepatitis

1-comprehend presenting

features of autoimmune

hepatitis

2- differentiate from other

causes of liver disease



with history points

* * * * * * * * *

82

Intra-hepatic Biliary

Disorders

1- classify various

intrahepatic Biliary disorders

2-differentiate b/w

various disorders on the

basis of history, clinical

examination and

investigations



with history points

* * * * * * * * *

83

Approach to Heart-

Burn/GERD

1-review and interpret

esophageal and extra-

esophageal symptoms of

GERD

2- evaluate Complications of

GERD

3- plan management



with history points

* * * * * * * * *

84

Approach to Jaundice

1- classify jaundice


jaundice

3- plan management of

different causes of

jaundice



with history points

* * * * * * * * *

85

Complications of

Liver Cirrhosis

1- identify various causes of

liver cirrhosis

2- differentiate b/w

compensated and

decompensated cirrhosis

3- plan management of

PSE, ascites and variceal

bleed



with history points

* * * * * * * * *

86

Approach to anemia

and classification

1. make students able to

evaluate clinical symptoms


2. review different

classification models of

anemia and their clinical

importance



4. identify the treatment

available and when and

where to refer the patient



with history points

* * * * * * * * *

87

Microcytic anemia



lesion




treatment available and

when and where to refer

the patient



with history points

* * * * * * * * *

88

Thalassemia



lesion



3. compare the modes of




with history points

* * * * * * * * *

61


4. plan the prophylactic

measures in the family to

prevent the spread of

illness

89

Megaloblastic anemia




scope of various

investigations

3. evaluate the modes of



the patient



with history points

* * * * * * * * *

90

Aplastic anemia



lesion


scope of various

investigations



their efficacy



with history points

* * * * * * * * *

91

Enzymopathies



RBC enzymopathies


of various investigations and

their place in clinical decision

making



with history points

* * * * * * * * *

92

Polycythemia Rubra

Vera




scope of various

investigations




the patient



with history points

* * * * * * * * *

93

Leukemias



different forms of leukemias


scope of various

investigations

3. review the prognosis

of various forms of

leukemias and proper

and urgent referral of the

patient



with history points

* * * * * * * * *

94

Leukemias


and signs of the different

forms of leukemias


scope of various

investigations

3. review the prognosis

of various forms of

leukemias and proper

and urgent referral of the

patient



with history points

* * * * * * * * *

62

95

Somatiform Disorders

1. identify the manifestations

of somatiform disorders

2 differentiate various

subtypes of somatiform

disorder

3. evaluate the

Importance of

psychotherapy in

management



with history points

* * * * * * * * *

96

Mania and Bipolar

Disorders


of bipolar disorders

2.evaluate treatment options

available and side-efffects of

various drugs

3. review the mportance

of psychotherapy in

management



with history points

* * * * * * * * *

97

Eating Disorders

1. identify manifestations of

eating disorders

2. discuss treatment options

available

3. review the

Importance of

psychotherapy in

management



with history points

* * * * * * * * *

98

Schitzophrenia


schitzophrenia


available and side-effects of

drugs

3. review Importance of

psychotherapy in

management



with history points

* * * * * * * * *

99

Personality Disorders


per sonality disorders

2. review the

Importance of

psychotherapy in

management



with history points

* * * * * * * * *

100

Stress-related Disorder


stress-related disorders


available

3. review the

Importance of

psychotherapy in

management



with history points

* * * * * * * * *

101

Substance Misuse

Disorder


of substance-misuse

disorders


available

3. review the

Importance of

psychotherapy in

management



with history points

* * * * * * * * *

102

Depression


of depressive disorders


available

3. review the

Importance of



with history points

* * * * * * * * *

63

psychotherapy in

management

103

Anxiety Disorders


of anxiety disorders


available

3. review the

Importance of

psychotherapy in

management



with history points

* * * * * * * * *

104

Delusional &

Factitious Disorders


delusional and factitious

disorders


available

3. review the importance

of psychotherapy in

management



with history points

* * * * * * * * *

105

Anatomy Physiology

of skin

1. review the layers of

skin and important

students in skin.

review basic functions of

skin.



with history points

* * * * * * * * *

106

infestation scabies

pediculosis

identify clinical

symptoms, diagnosis and

treatment of scabies and

pediculosis



with history points

* * * * * * * * *

107

Bacterial infections

identify the clinical

signs, diagnosis and

treatment of frunculosis,

carbuncle and cellulitis



with history points

* * * * * * * * *

108

Viral Infections

differentiate viral

infection like chicken

pox, measles, rubella



with history points

* * * * * * * * *

109

Fungal infections

diagnose tinea corporis, tinea,

pedis, candidiasis

2. a treat fungal infection



with history points

* * * * * * * * *

110

Acne vulgaris

identify stages of acne

development staging

2.plan treatment of acne



with history points

* * * * * * * * *

111

Eczema

diagnose and treat atopic

dermatitis seborrhoeic

dermatitis xerotic

eczema



with history points

* * * * * * * * *

112

Psoriasis

1.review the pathophysiology

of psoriasis,

2. interpret diagnosis and

treatment of psoriasis



with history points

* * * * * * * * *

113

Lichen plan

identify clinical signs of

lichen plan

2. Plan treatment of

options available



with history points

* * * * * * * * *

114

Bullous disorder

review differential

pemphigus vulgaris

bullous pemphigoid and

treatment of bullous

disease



with history points

* * * * * * * * *

115

Pigmentary disorders

recognize causes of

hypopigmentation and

hyperpigmentation



with history points

* * * * * * * * *

64

116

Disorders of hair

identify causes of hair

loss, patchy and diffuse perform relevant clinical


with history points

* * * * * * * * *

117

Disorders of Nail

identifycauses of nail

dystrophy perform relevant clinical


with history points

* * * * * * * * *

118

Bronchial Asthma

1. define bronchial

asthma

2. recall etiology and

pathophysiology of

bronchial asthma.

3. Identify symptoms

of bronchial asthma

and recognize

wheezing on

auscultation.

4. interpret flow

volume loop on

spirometry and

identify obstructive

pattern on flow

volume loop.

5. Plan investigations

of bronchial asthma

6. evaluate steps of

management of

stable asthma.

7. identify signs of

acute severe asthma

determine the drugs

used in management of

acute severe asthma



with history points

* * * * * * * * *

119

Chronic obstructive

pulmonary disease.

Chronic Bronchitis

Emphysema

1. define COPD,

chronic bronchitis

and emphysema

2. enlist etiology and

pathophysiology of

chronic bronchitis

and emphysema

3. identify key

symptoms and

recognize signs of

COPD on bedside.

4. interpret spirometry

and identify

obstructive pattern

on flow volume

loop.

5. Plan investigations

of COPD

6. plan management of

stable COPD.

7. recognize signs of

acute exacerbation

of COPD

evaluate the drugs used

in management of COPD



with history points

* * * * * * * * *

120

Bronchiectasis

1. define

bronchiectasis

2. identify the

etiology and



with history points

* * * * * * * * *

65

pathophysiology of

Bronchiectasis

3. identify the key

symptoms and

recognize signs of

Bronchiectasis on

bedside.

4. identify

Bronchiectasis on

CXR and HRCT

chest

5. plan investigations

of Bronchiectasis

6. evaluate the steps

of management of

Bronchiectasis

review the drugs used in

management of

Bronchiectasis

121

Environmental lung

diseases/occupational

Asbestosis

Silicosis

Bagassosis

Pneumoconiosis

Byssinosis

Farmer‘s lung

1. define

occupational lung

diseases

2. enlist various

occupations linked

with lung diseases

3. identify key

symptoms and

recognize signs of

occupational lung

diseases on bedside.

4. identify patterns of

various

occupational lung

diseases on CXR

and HRCT chest

5. enlist investigations

of occupational lung

diseases

enlist steps of

management of

occupational lung

diseases



with history points

* * * * * * * * *

122

Pneumonia

Community acquired

Nosocomial

Lobar and

bronchopneumonia

1. define community

acquired, hospital

acquired, lobar and

broncho-pneumonia

2. identify various

micro-organisms

responsible for

causation of

pneumonia in

community and

hospital setting

3. identify key

symptoms and

recognize signs of

pneumonia on

bedside.

4. identify

consolidation on

CXR and CT chest

5. plan investigations



with history points

* * * * * * * * *

66

of pneumonia

6. Classify

pneumonia

according to

severity using

CURB-65 score.

7. enlist steps of

management of

pneumonia in

community and

hospital setting

enlist and recognize

various complications of

pneumonia

123

Acute Respiratory

Failure

Type I

Type II

1. define acute

respiratory failure

2. enlist various

causes of acute

respiratory failure

3. identify key

symptoms and

recognize severity

of acute respiratory

failure

4. enable to enlist

investigations

needed in patients

with acute

respiratory failure

enlist steps of

management of acute

respiratory failure



with history points

* * * * * * * * *

124

Adult Respiratory

Distress Syndrome

1. To make students

enable to define

Adult Respiratory

Distress Syndrome

2. enlist various

causes and recall

pathogenesis of

Adult Respiratory

Distress Syndrome

3. identify key

symptoms and

recognize signs of

Adult Respiratory

Distress Syndrome

on bedside.

4. identify patterns of

Adult Respiratory

Distress Syndrome

on ABGs, CXR and

HRCT chest

5. enlist

investigations of

Adult Respiratory

Distress Syndrome

enlist steps of Adult

Respiratory Distress

Syndrome



with history points

* * * * * * * * *

125 Mechanical

Ventilation

1. Identify modes of

mechanical

ventilation



with history points

* * * * * * * * *

67

2. summarize settings

used in various

modes of

mechanical

ventilation

3. enlist various

indications of

mechanical

ventilation

4. enlist various

complications of

mechanical

ventilation

review methods of

weaning

126

Interstitial lung

disease

1. define interstitial

lung disease


pathophysiology of

interstitial lung

disease

3. recall key

symptoms and

recognize signs of

interstitial lung

disease on bedside.

4. identify interstitial

lung disease on

CXR and HRCT

chest

5. enlist

investigations of

interstitial lung

disease

enlist steps of

management of

interstitial lung disease



with history points

* * * * * * * * *

127

Cor-pulmonale

1. define Cor-

pulmonale


pathophysiology of

Cor-pulmonale

3. recall key

symptoms and

recognize signs of

Cor-pulmonale on

bedside.

4. identify Cor-

pulmonale on CXR

5. enlist

investigations of

Cor-pulmonale

enlist steps of

management of Cor-

pulmonale



with history points

* * * * * * * * *

128

Pleural effusion

1. define Pleural

effusion


pathophysiology of

Pleural effusion

3. differentiate

transudative from



with history points

* * * * * * * * *

68

exudative effusion

using lights criteria

4. recall key

symptoms and

recognize signs of

Pleural effusion on

bedside.

5. identify Pleural

effusion on CXR

and CT chest

6. enlist

investigations done

in evaluation of

Pleural effusion

7. recognize upper

border of lower rib

for pleural

aspiration

enlist steps of

management in

transudative and

exudative pleural

effusions

129

Pneumothorax

1. define

Pneumothorax

2. To make students

enable to recall

etiology and

pathophysiology of

Pneumothorax

3. recall key

symptoms and

recognize signs of

Pneumothorax on

bedside.

4. identify

Pneumothorax on

CXR and CT chest

5. recognize triangle

of safety for chest

intubation

To make students enable

to enlist indications of

chest intubation in

management of

Pneumothorax



with history points

* * * * * * * * *

130

Tuberculosis

1. define pulmonary

and extra-

pulmonary TB, new

cases, relapse,

defaulter.


pathophysiology of

Tuberculosis

3.

recall key

symptoms and

recognize signs of

Tuberculosis on

bedside.

4. identify

Tuberculosis on



with history points

* * * * * * * * *

69

CXR and HRCT

chest

5. enlist

investigations used

in diagnosis of

tuberculosis

6. enlist various

drugs of

Tuberculosis and

recall their doses

and side effect

profiles.

7. define category I

and category II

treatment plans

define MDR-TB

131

Bronchogenic

carcinoma

1. define

Bronchogenic

carcinoma


pathophysiology of

Bronchogenic

carcinoma

3. recall key

symptoms and

recognize signs of

Bronchogenic

carcinoma on

bedside.

4. enlist various para-

neoplastic

syndromes

associated with

bronchogenic

carcinoma

5. identify

Bronchogenic

carcinoma on CXR

and HRCT chest

6. enlist

investigations used

in diagnosis and

staging of

Bronchogenic

carcinoma

7. describe various

stages of

Bronchogenic

carcinoma

enlist treatment options

used in management of

Bronchogenic carcinoma



with history points

* * * * * * * * *

132

Basics of pulmonary

function testing

1. explain basic

physiology of

pulmonary function

testing

2. identify various

patterns of flow

volume loops on

pulmonary function

testing

interpret various volumes



with history points

* * * * * * * * *

70

recorded in pulmonary

function testing

133

Oxygen therapy

Indications

Complications

1. describe various

modes of oxygen

therapy in type I

and II respiratory

failure and long

term oxygen

therapy

2. enlist various

indictions of oxygen

therapy

3. enlist complications

of oxygen toxicity

identify venture masks

used in controlled

oxygen therapy



with history points

* * * * * * * * *

134

Pleural Aspiration

1. indications of

pleural aspiration

2. To make students

enable to identify

site of aspiration

enable to perform pleural

aspiration under

supervision



with history points

* * * * * * * * *

135

Prolactinoma and

Pituitary Adenoma

1. impotant cuaese of

hyperprolactinemia

2. describe important

clinical features,

appropriate

investigations and

management plan for

patients with

prolactinoma



with history points

* * * * * * * * *

136

Long Term

Complications of

Diabetes Mellitus

1. long term complications of

diabetes mellitus

2. diagnose and manage micro

and macrovascular

compliations of DM

3. plan strategies prevent

complications of DM



with history points

* * * * * * * * *

137

Hypogonadism


primary and secondary

hypogonadism

2. describe clinical

features, relevent

investigations and

management plan for

patients with

hypogonadism



with history points

* * * * * * * * *

138

Adrenal Insufficiency

1. important causes of adrenal

insufficiency

2. describe clinical features,

appropriate investigations and

management plan for adrenal

insufficiency

3.To make students

enable to manage adrenal

crisis



with history points

* * * * * * * * *

139

SIADH

important causes,

describe clinical features,

request relevent



* * * * * * * * *

71

investigations and give

management plan for

patients with SIADH

with history points

140

Approach to Patient

with Diabetes Mellitus

1. Diabetes Mellitus and its

diagnostic criteria


different types of DM

Should be able to request for

relevent investigations in

patients with DM



with history points

* * * * * * * * *

141

Cushing‘s Syndrome


various causes of cushing‘s

syndrome

2. describe impotant clinical

features of cushing‘s

syndrome

3, request appropriate


management plan for patients

with cushing‘s syndrome



with history points

* * * * * * * * *

142

Hyperparathyroidism

and Hypercalacemia

1.Should be able to enlist

important causes of

hypercalcemia

Should be able to describe

symptoms of hypercalcemia

and hyperparathyroidism

Should be able to order and

interpret relevant

investigations in patients with

suspected

hyperparathyroidism

2.Should be able to

describe management of

hypercalcemia and

hyperparathyriodism



with history points

* * * * * * * * *

143

Diabetes Insipidus

enlist important causes,


request relevent


management plan for

patients with diabetes

inspidus



with history points

* * * * * * * * *

144

Thyrotoxicosis

1. impotant causes of

hyperthyroidism and to

describe clinical features of

hyperthyroidism

2. request appropriate

tests and give

management plan for

hperthyroid patients



with history points

* * * * * * * * *

145

Hirsutism and

Gynecomastia

1. important causes,


request relevent


management plan for

patients with hirsutism

and gynecomastia



with history points

* * * * * * * * *

146

Hypothyroidism

Should be able to describe

important causes, clinical

features of hypothyroidism



* * * * * * * * *

72

Should be able to request

appropriate


management plan for

hypothyroid patients

with history points

147

Hypopituitarism

describe clinical features

, request appropriate


treatment plan

forpatients with

hypopitutrism



with history points

* * * * * * * * *

148

Management of

Diabetes Mellitus

manage patients with diabetes

by dietery advice, life style

changes and medications

Should be able to advise

individualized treatment for

different types of DM patients

Should be able to demonstrate

insulin injection technique



with history points

* * * * * * * * *

149

Acromegaly

describe clinical features

, request appropriate


treatment plan for

patients with

acromegaly



with history points

* * * * * * * * *

150

Autoimmune Diseases

1. understand autoimmune

diseases like SLE etc

2. diagnose, investigate

and manage these

diseases



with history points

* * * * * * * * *

151

Monoarthritis

understand the

differential diagnosis and

management of

monoarthritis



with history points

* * * * * * * * *

152

Polyarthritis

understand the

differential diagnosis and

management of

polyarthritis



with history points

* * * * * * * * *

153

Bone Disease

1. understand different bone

diseases like osteoporosis,

osteomalacia, Paget‘s disease

etc.

2. diagnose, investigate

and manage these

diseases



with history points

* * * * * * * * *

73

w.e.f. 5th

April, 2021 to 18th

December, 2021

Day /

Time 8:30-09:20 09:20–10-10 10:10–11:00 11:00–11:50

11:50–

12:10

12:10–

02:40

Monday Test /

Discussion

Test /

Discussion

Lecture

Medicine

Lecture

Surgery Break Clinical

Tuesday Lecture

Surgery

Lecture

Gynae & Obs. Lecture Peads

SGD

Batch A—

Surgery

Batch B—

Medicine

Break Clinical

Wednesday Lecture

Medicine

Symposium

(Surgery /

Medicine /

Gynae /

Peads)

Research

Work

Community

Medicine

SDL Break Clinical

Thursday Test /

Discussion

Test /

Discussion

Lecture

Surgery

Lecture

Medicine Break Clinical

Friday

8:30-09:30 09:30–10-30 10:30–11:30 11:30–12:30 ---------- ----------

Lecture

Gynae &

Obs.

Lecture

Surgery

Lecture

Medicine

Lecture

Surgery ---------- ----------

Saturday Lecture

Medicine

Lecture

Surgery Lecture Peads

SGD

Batch B—

Surgery

Batch A—

Medicine

Break Clinical

*Note: Self Directed Learning (Every Wednesday) would be monitored by the

Department, that will be conducting test on Thursday.

TIMETABLE

74

Final Year MBBS (Session 2020-2021)

Batches

Sr.# Roll No. Batch

1 1-94 Batch-A

2 M8-217 Batch-B

SGD

Sr.# Days Surgery Medicine

1 Tuesday Batch-A Batch-B

2 Saturday Batch-B Batch-A

BATCHES ALLOCATIONS

75

CLINICAL GROUPS

Sr.# Roll No. Groups

1 1-48 Group-1

2 49- M8101 Group-2

3 M8102-169 Group-3

4 171-217 Group-4

CLINICAL ROTATION GROUPS

Sr.# Date Surgery Medicine Gynae &

Obs. Peadiatrics

1 5

th April, 2021 to 12

th June,

2021 Group-1 Group-2 Group-3 Group-4

2 14

th June, 2021 to 13

th

August, 2021 Group-2 Group-3 Group-4 Group-1

3 16

th August, 2021 to 16

th

October, 2021 Group-3 Group-4 Group-1 Group-2

4 18

th October, 2021 to 24

th

December, 2021 Group-4 Group-1 Group-2 Group-3

(May vary due to COVID-19 Outbreak)

76

Rules and Regulations of Clinic/Wards & Rotations:

Students must wear white overall in the clinical/ward rotation

Students must wear face masks in the clinical/ward

Students must wear gloves before starting the clinical procedure and remove them after

ending the procedure.

Students must be trained about the usage of any instrument or machine before using it on

a patient.

Students must have their quota books and log books at the start of session and they must

keep them safe and maintain the record timely.

Students must submit their log books and quota books at the end of the session to the

relevant Head of Department.

Student must inform the Demonstrator or the Supervisor before starting and ending any

clinical procedure.

Students should not use mobile phones in the clinical/ward.

Students should never perform any procedure alone. The Demonstrators and the assistant

must be there with the student.

Students must always remove or secure anything that might get caught in moving

machinery. Female students should never work with loose hair and jewelry etc.

Students should wear semi-formal shoes in the clinical/ward.

Always keep your hands at a safe distance from sharp instruments.

Unnecessary talking is not allowed in the wards.

No student is allowed to leave the clinical/ward rotation without the permission of

Supervisor.

No game of any sort is allowed to be played during the clinical/ward.

Any student breaking or damaging any property of the institution shall be required to pay

the cost of repair or replacement.

No Riots, strike and boycotts are prohibited in the clinical wards.

Students must demonstrate Professionalism and Medical Ethics.

WARD PRE-REQUISITES

77

Learning Recourses Books:

1. Current medical diagnosis and treatment of internal medicine

2. Davidson’s principle and practice of medicine

3. Kumar and clark’s clinical medicine

4. Harrison’s principles of internal medicine

5. Oxford textbook of medicine

6. Hutchison’s Clinical Methods

LEARNING RESOURCES

year mbbs curriculum 2020 - Multan Medical & Dental College

Documents

Transcript of year mbbs curriculum 2020 - Multan Medical & Dental College