STEPPIN

G TO
CLINICS
EASY manual for
House Officers
Medical and
Nursing Students
Author:
DR.SHAHID ILYAS
FRCS
BAQAI UNIVERSITY
HOSPITAL
Co-Authors;
Dr.Syed Arsalan Ahmed
[KMDC]
Dr.Hafiz Abdul Wase
BAQAI University HOSPITAL

STEP 1
(Yellow)

STEP
2(Green)

History & Exam
Electrolytes
balance

Instrument Sizes
I/V Fluids
management
General Surgery

Blood Transfusion

Orthopedic
Pediatrics &
Neonatology

Basic Life Support
Emergency Cases
ECG
ICU management

Gynae & Obs

STEP 3 (Orange)





Diabetes &
Insulin
Nursing
Management
Drug Doses
Important
Formulae
Antidotes
Vaccines
Doses

Preface
It’s a pleasure for me to write preface of this book. This
novel idea was adopted by me after the completion of my
1st book “ROENTGEN ORTHOPEDICA” which contains 100
different orthopedic x rays related to my own clinical work.
In “Stepping to Clinics” surgical/orthopedic section is
tabulated from my own experience in medical field and
another section was helped by co-authors.
It has been observed since many years that students need
pocket review book for clinical rotation. It was a small effort
from my side that is respectfully presented to the students
of all medical and nursing colleges. It confidently covers all
the necessary topics that are required for examination
point of view. This book is for rapid review of high yields
points which are difficult to memorize. I would not
recommend this book to any student to use alone or
entirely depend on it. It’s better to read any text book
along with this book.

Prof Dr. Shahid Ilyas
M.B.B.S, F.R.C.S
Baqai Medical University
Karachi.

Foreword
This book ‘Stepping to Clinics’ is an
excellent collection of clinical facts and
approach towards the optimum management
of patients in clinical settings. I have gone
through it in detail and I found it very
beneficial for students of medical science
therefore, I would recommend it to all my
students who are willing to sharpen their
clinical knowledge and decision making skills.
I wish all the authors best for this book and
their future endeavors as well. Any mistake or
error in this book if found will be highly
appreciated and will be duly corrected in next
edition by the author.
Regards

Prof Dr.Saleemullah
MBBS, MRCP
Incharge Med-II
KMDC &Abbasi Shaheed Hospital

REVIEWERS
Dr.Qaisar
Jamal

Dr.Aneela

Professor of Medicine

Associate Professor

Unit III Abbasi
Shaheed
Hospital (ASH)

Unit II Medicine ASH

Dr.Waseem
Professor of Neurology

DR.Muhammad
Irfan

Abbasi Shaheed
Hospital (ASH)

MBBS, FCPS, FRCP

Dr.Bushra
Rabbani
Baqai University
Hospital

Associate Professor
Aga khan Hospital

Dr.Jamal Ara
Assistant Professor
Unit II Medicine ASH

Dr.Muhammad
Adil Ramzan
Assistant Professor
Unit II Medicine ASH

DR.Mariam,DR
Saira Mughal
Karachi Medical &
Dental
College

Miss Nargis Mairaj
Senior Registered
Nurse (Principal)
Baqai University
Hospital

Dr.Imran
Ansari

Dr.Jamaluddin

MBBS, FCPS (IM)

Unit II Surgery ASH

Aga Khan Hospital

Dr.Abdul Basit
MBBS, FCPS (IM)
Aga Khan Hospital

Dr.Taha Nafees
KMDC

Dr.Faisal Zahid
KMDC
Dr.Hassan Tahir
KMDC

DR.Isra Ahmed
KMDC

Associate Professor

MBBS, FCPS
Dr.Mustaqeem
Rehman
Baqai Medical
College
Mr.Abdul Wadood
Agakhan University
BSCN
Miss Tazeen
Zaheer
Agakhan University
Miss Tooba
Zaheer
Sir Syed College
Dr.Hafiz Aashir

KMDC

A

cknowledgements:

We are particularly grateful to Dr.Abdul Qadir ,
,Prof.Dr.Ashraf Hassan, Prof.Dr.Tariq Aftab,
Assc.Prof.Dr.Jamaluddin , Prof.Dr.Tahir Hussain
Prof.Mehmood Haider,Dr.,Prof Dr.Abbas
Hussain,Prof.Dr.Tazeen Abbas,Prof Dr.Raheel
Rehman,Dr.Sina Aziz,Dr.Arshad,Prof.Dr.Sultan
Mustafa,Dr.Zahid,Dr.sufyan,Dr.Masood Zakai,Dr.Aqeel
Sheikh,Dr.Ashraf Ayub,Dr.Nasir,Prof
Dr,Rubina,Dr.Sumbul,Dr.Aisha,Dr.Tanver ,Dr. Anwar
Alam,Dr.Alamgir,Dr.Asfar,Dr.Salequain,Dr.Atiya
Sabeen,Dr.Shaista,Dr.Baqir,Dr.Emmad,Dr.Mohsin,Dr.Ab
dul Basit (AKU),Dr.Tanveer,Dr.Sajjad,Dr.Hina,
Dr.Nadeem,Dr.Fareeda islam,Prof.Dr.Nargis
Anjum(Principal KMDC), ,Dr.Nasir,Dr.Hussain Kath ,Dr.
Imran
Ansari,Dr.Anwar,Dr.Murtaza,Dr.Ali,DR.Ghazanfar ,Dr.
Osama Shakeel,Dr.Shahraiz ,Dr Makki
Mehmod,Rizvi,Dr.,Dr.Aneela,Dr.Akbar,Dr.Sehrish
Munir,Dr.Kulssom,Dr.Anum Sohail Dr.Maira
Ahsan,Dr.Arooj Shariq,Dr.Anum Mustafa,Dr.Anum
Mumtaz,Dr.Faiza Shabbir,Dr.Madiha Aziz,Dr.Anum
KamranDr.Humaira Amin,Dr.Hajra Rehman,Dr.Wardah
Jabeen,Dr.Arsalan Mughal,Dr.Khizar,Dr.Rameez
Ali,Dr.Ali Hussain,Dr.Fahad Abd Mallick,Dr.Asjad
Arif,Dr.Usman Rehman,Dr.Saad Jamal,Dr.Ahmad
Nawaz,Dr.Nabeel,Dr.Tariq
Aftab,Dr.Hina,Dr.Erum,Dr.Urooj Rana,Dr.Sharay
islaam,Dr.Pinki Parkash,Dr.Saira Liaqat,Dr.Khadija and
Dr Sanam Khan who always encourage us in every
step of making this book.

Special
Thanks:

We are very thankful to

our respectful brothers Dr.Danish Ashraf,Dr.Saad
Hussain,Dr.Shahbaz, Dr.Hasnain Abbas,Dr.Rohail
Rizvi,Dr.Hussain Kath,Dr.Shaz Dr.Haris, Dr.Shohaib
Talib,Dr.Faizan
Arfin,Dr.Sameer,Dr.Mubashir,Dr.Rabi,Dr.Saleh,Dr.Ali
Hussain, Dr.Shahraiz,Staff Zeeshan Anwar, Staff
Aqeel,Staff Yousuf Randhawa,Staff Hamza Khan,Staff
Nadeem Sardar,Staff Nadeem Nawaz,Staff
Arsalan,Staff joshuwa,Staff Sultan,Staff Tahir, ,Staff
Sarfaraz,Staff Samson,Staff Arnold,Mr.Abdul
Wahab,Mr.Abdul Haseeb and our Sisters Miss
Saleha,Miss Namra,Miss Sana, Senior Staff Miss Rahat,
Staff Shabana ,Senior Matran Parveen Amdad, Staff
Sehrish,Staff Fakhra Latif, Staff Sarah Shahjahan, Staff
Zarnab pervaiz,Staff Saabia Aslam,Staff Aarzoo Qasim
Ali, Staff Sundus Paul, Staff Farwa,Staff Arooj,Staff
Saman,Staff Sonia,Staff Zebah,Staff Naila,Staff
Natasha, Staff Farzana,Staff Tehmina,Staff Sana,Staff
Rukhsana INayat,Staff Amber,Staff Hina Maria, Staff
Maras Yousuf,Staff Verginia,Staff Sehwish,Staff
Taqdees,Staff Hina,Staff Veronica, Staff Sawera
Aslam,Staff Nazia,Staff Mehwish,Staff Sana
Jaras,Dr.Anum Sohail Khan,Dr.Javeria Khalid, Dr.Isra
Ahmad,for their moral support in every step of making
this edition.

INDEX
S.No Topics

Page

S.N
o

P.No

1

Acronyms and
Abbreviations

1

18-

Ward Notes

143

2

History & Physical
Exam

6

19

Surgery

145

3

Neurological Exam

10

20

Orthopedic Surgery

147

4

Glasgow Coma Scale

16

21

General Surgery

157

5

Things to Remember
( VIVA)

17

22

Gynae & OBS

168

6

Differential Diagnosis

41

23

Pediatrics

178

7

Important procedures

52

24

EPI schedule

184

8

Managing Electrolytes 61

25

Neonatal
Examination

190

9

Blood Transfusion

26

Diabetes Mellitus

206

72

Insulin Sliding scale

209

ALS ( Advance Life
Support)

211

10

Emergency Cases

75

11

Basic Life Support

97

28

Nursing Management

217

27

12

Arterial Blood
Gases(ABGs)

99

29

Important Formula

224

13

ECG

103

30

Drug Doses

231

14

ICU management

117

31

Lab Values Ranges

255

15

ICU drugs

119

32

Antidotes of
Poisoning

295

16

I/V Fluid types and
Management

137

33

296

Vaccination Schedule
17

Commonly Used
Instrument
141

MESSAGE FROM CO-AUTHORS
We are humbly grateful to you people for
choosing one of the best professions which
is so called “LIFE SAVING”. It’s the
compilation of various international
authorized manuals of Nursing as well as
Medical.
Furthermore we want to say that you may
find mistakes in this collection. We would be
commendable for you guys if you will mark
out our mistakes and acknowledge us
through email. It will be the great step to the
betterment of next edition. As we stated on
our title page that the amount which will be
raised by this book will be donated as
Charity.
KARACHI MEDICAL & DENTAL COLLEGE