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KATHMANDU UNIVERSITY

SCHOOL OF MEDICAL SCIENCES

BACHELOR OF MEDICINE & BACHELOR OF SURGERY
(MBBS) CURRICULUM
Revised Version 2011

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CURRICULUM
FOR
BACHELOR OF MEDICINE & BACHELOR OF SURGERY
(MBBS)

KATHMANDU UNIVERSITY
DHULIKHEL, KAVREPLANCHOWK
NEPAL
2011
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FOREWORD

Kathmandu University was established in November 1991 by an act of Parliament. Kathmandu University
started functioning from December 11, 1991. The University operates through the School of Sciences,
Engineering, Management, Arts, Education and Medical Sciences.

The University first granted affiliation to a private medical college, Manipal Colleges of Medical Sciences,
at Pokhara to start MBBS program since December 1994. Since then six other medical colleges have been
granted affiliation college of Medical Sciences, Bharatpur, Chitwan, in August 1996; Nepalgunj Medical
College, Chisapani, Banke, in December 1997; Kathmandu Medical College, Kathmandu, in December
1997; Nepal Medical College, Kathmandu, in December 1997; Nobel Medical College, Biratnagar, in
February 2007 and Lumbini Medical College, Palpa, in February 2009.

Kathmandu University School of Medical Sciences started its own Medical College in collaboration
between Kathmandu University and Dhulikhel Hospital. KUSMS launched its own constituent MBBS
program in August 2001.

The first MBBS curriculum in now called Pre-Clinical Science was developed in association with the
Manipal Academy of Higher Education, Manipal, India. In Keeping with developments in modern medical
education, the first review of the Pre-Clinical Science curriculum was carried out in 1996 along with the
participation of the Institute of Medicine, Tribhuvan University and Manipal Academy of Education,
Manipal, India. The outcome was the second version of Pre-Clinical Science curricumum in December
1996.

The University is in touch with the changing scenario in Medical education. The emphasis is now on
problem-based learning. With this concept in mind, another review of the Pre-Clinical Sciences curriculum
was carried out in March 2001. The new version emphasizes teaching Pre-Clinical Science subjects
system-wise and in an integrated way. Appropriate common clinical problems related to each organ system
was revised in consonance with the existing health situation; and practical activities were identified in each
subject. A chapter on medical ethics was added. Also during that phase the student were introduced to
clinical knowledge and skills utilizing a problem solving approach. Medical informatics was added in
newly to enhance computer literacy relevant to medical education. These changes fostered in students the
ability to learn through self-directed and independent study.The Third Version was introduced in august
2001 academic session; there was rearrangement of the Community Medicine curriculum.

The present edition of the Fourth version which begins from August 2011 academic session contains
rearrangement of semesters (instead of Unit) and evaluation scheme. Extensile information gathering from
all concerned was done. Workshops were conducted inviting all representatives from all affiliated colleges
of KU; TU-IOM and Nepal Medical Council necessary changes in the curriculum were done. Common
curriculum and evaluation scheme for both constituent and affiliated colleges is adapted. PBL (Problem
Based Learning) teaching methodology and Introduction to Clinical Medicine (ICM) are introduced in
both constituent as well as affiliated colleges. The University is aware of the fact that there is “no best
way” but always “a better way” and is always commited to improve the curriculum, as necessity demands.

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.................................................................... 2 General Description of the Curriculum ........................................... 3 Features of the Curriculum .............................................. Table of Contents Pre-Clinical Sciences Contents Page Kathmandu University Mission ......................................................................................... 12-40  Basic Concepts .......................... 10 First Year Semesters I & II Objectives & Contents…………………………………………………….................................................................................................................................................................................................................................. 59 4 ............................11 Semester ................................................................................................................................................................................................................................ 55  Introduction to Clinical Medicine (ICM) ............................................. (41-59)  Haemopoetic System……………………………………………………………………39  Respiratory System ................................................................................................................................. 12  Genetics .......................................................................................................36  Community Medicine……………………………………………………………………................................................................................................. 5 Objectives of the MBBS Program ........ 25  Autonomic Nervous system ..................................... 48  Community Medicine ................ 1 Overall Goals of the School of Medical Sciences ........................................................................................................................................40  Introduction to Clinical Medicine (ICM) ........................................................................... 40 Semester ............................................................................................................................................................................... 35  Musculo-Skeletal System……………………………………………………………….................II .........I .................................. 39  Medical Informatics................... 41  Cardiovascular System .......................................................................................................................................... 32  Integumentary System ...... 6 Guidelines to Medical College and Faculty .......................... 22  Immune system and immunology ................................ 4 The Curriculum Outline ..........................................................................................

Second Year
Semesters III & IV Objectives & Contents……………………………………………………..11
Semester - III ................................................................................................................... (60-98)
 Gastrointestinal System ................................................................................................. 61
 Hepatobiliary System .................................................................................................... 69
 Renal-Electrolyte System .............................................................................................. 73
 Metabolism and Endocrine System ................................................................................ 79
 Community Medicine .................................................................................................... 95
 Introduction to Clinical Medicine (ICM) ....................................................................... 98

Semester - IV ................................................................................................................. (99-121)
 Reproductive System ..................................................................................................... 99
 Central Nervous System and Special Senses ................................................................ 105
 Community Medicine .................................................................................................. 118
 Introduction to Clinical Medicine (ICM) ..................................................................... 121

List of Practical Classes.......................................................................................................... 122

List of Formate of ICM………………………………………………………………………..222

ANNEXES:
 Annex – I Subject wise break down of Semester hours: Semesters I- IV ..................... 217-218
 Annex – II Calendar of Operation for an Academic Year……………………………...219
 Annex – III Scheme for Semester Examinations ...................................................... ….220
 Annex – IV Flow Chart of Modules in Community Medicine..…………………………….221
 Annex – VIII List of Reference Books ....................................................................... ...234
 Annex – IX List of Participants .................................................................................... 238

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KATHMANDU UNIVERSITY MISSION

The Kathmandu University has the mission to:

a) promote all-round development of students’ abilities and personalities.

b) develop an awareness of the role of sciences and its application in the understanding of problems of
contemporary society.

c) extend and disseminate knowledge and encourage its application.

d) develop a community of scholars, students and staff in which understanding and wisdom can grow
and flourish.

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OVERALL GOALS OF THE SCHOOL OF MEDICAL SCIENCES

The School of Medical Sciences of Kathmandu University is headed by the Dean and has the following
overall goals:

1. conduct and give permission to conduct academic programs of certificate, bachelor, masters and
doctoral levels in medical sciences including other branches of health sciences.

2. collaborate and coordinate with medical schools of other universities for the growth and
development of academic programs, research undertakings and health care services.

3. promote and conduct research for the growth of new scientific knowledge.

4. participate and provide health care to the people.

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8 . ♦ proficiency to function in diverse health care settings. ♦ competency to determine and resolve health problems of the community. GENERAL DESCRIPTION OF THE CURRICULUM This curriculum. ♦ clinical skills to diagnose and manage disease. the basic medical doctor must possess. provides for acquisition of ♦ a core knowledge. ♦ desirable characteristics and attitudes ingrained in the profession. which has been designed embracing modern Educational Science Technology – as applied to Medical Education. ♦ interest in continuing medical education.

FEATURES OF THE CURRICULUM The curriculum is Student centered (rather than teacher centered) Problem based (rather than subject based) Integrated (rather than discipline based) Community oriented (rather than hospital centered) Electives embodied (rather than standard program oriented) Systematic (rather than apprentice based) 9 .

The accent of the curricular approach is community orientation. promotive and curative functions expected of a basic doctor. 10 . The curriculum synthesized initially (in 1994) consulting the curricula of medical institutions in Nepal is aptly revised and presented here. The next five semesters are devoted to Clinical Sciences. Pharmacology and Physiology. Also. Pre-Clinical Sciences include Anatomy. These subjects will be taught in an integrated manner and would be threaded into Community Medicine and Introduction to Clinical Medicine. who as a result of the five and half years of undergraduate education program in medical sciences will be competent to carry out preventive. The MBBS curriculum is divided into two Parts. Pre-Clinical sciences include the curriculum of the first and the second year. the Clinical Sciences include the curriculum of the remaining two and a half years. Medical Informatics will provide computer literacy relevant to medical education. Biochemistry. integrated teaching-learning and problem-based learning. Pre-Clinical Sciences (first year and second year): The First year and the Second year instruction cover Integrated Pre-Clinical Sciences. The first four semesters are devoted to the Pre-Clinical Sciences. Whilst. and having passed the final MBBS examination. each of six months duration. during this phase the student will be introduced to clinical knowledge and skills utilizing a problem solving approach. Microbiology. the student will have to complete one year of compulsory Rotating Residential Internship to become eligible for being conferred with the degree of MBBS of the Kathmandu University. Community Medicine and Introduction to Clinical Medicine. Pathology. as appropriate. The four-and-half year span of the MBBS course of study is divided into nine semesters. THE CURRICULUM OUTLINE The aim of this curriculum for the MBBS degree is to produce a well-rounded medical graduate. After successful completion of the course of study of four-and-half years.

elder citizens and women. k) Communicate well with patient and patient’s relatives by explaining matters known and refer them to appropriate persons when matters are not clear to self. p) Provide health care by becoming aware of the ethos of medical ethics. g) Provide immediate management care to life threatening situations by self. e) Possess qualities of a compassionate and socially accountable human being. n) Develop a health care team-approach and give respect to all the other members of the team. j) Participate in immunization programs and in health camps. l) Provide all information on matters of management of patients to the patient and the relatives. d) Demonstrate an understanding of contemporary knowledge and skills. b) Develop a holistic approach to the practice of modern medicine. c) Advance ones own knowledge and skills through higher education via continuing medical education programs and research. ask opinion from seniors or refer to appropriate health institutions when required. i) Provide education to people on health and health related matters. o) Give due care to children. 11 . manage them initially. m) Identify medico legal cases and function as required. h) Identify common health problems. f) Discharge job responsibilities with concern and care. OBJECTIVES OF THE MBBS PROGRAM On completion of the five and a half year of MBBS program. the Medical Graduate should be able to: a) Demonstrate the understanding of principles and practice of modern medicine with an in-depth knowledge of structure and functions of human body.

Electrolyte System Metabolism and Endocrine System Community Medicine Introduction to Clinical Medicine (ICM) SEMESTER – IV Reproductive System (including breast) Central Nervous System and Special Senses Community Medicine Introduction to Clinical Medicine (ICM) 12 .CLINICAL SCIENCES 11st year SEMESTER – I Basic concepts Genetics Immune System and Immunology Autonomic Nervous System Integumentary System Musculo-skeletal System Community Medicine Introduction to Clinical Medicine (ICM) Medical Informatics SEMESTER – II Haemopoietic System Respiratory System Cardiovascular System Community Medicine Introduction to Clinical Medicine (ICM) 2nd year SEMESTER – III Gastrointestinal System Hepatobiliary System Renal . CURRICULUM FLOWCHART PRE .

6. Average of these marks should constitute 50% of an individual’s internal assessment for theory component. Biology. The mandatory minimum mark for passing the practical examination in any subject likewise is 50% of the maximum marks in the practical segment (i. COURSE REGULATIONS (Eligibility. General Recommendations • Each semester consists of 20 weeks of 6 working days per week. Attendance. In order to derive maximum benefit from integrated teaching the student is expected to have 100% attendance in all the subjects.II MBBS Examination within four and half years from the date of admission. including not less than 50% of the maximum marks in the written component. or equivalent) with the subjects English. practical plus internal assessment). Physics.e. viva-voce and internal assessment components put together). however to meet unavoidable contingencies the student should have not less than 80% of the attendance separately in theory and practical / clinical to be eligible for the university examination. The evaluation scheme for Kathmandu University School of Medical Sciences will be according to the KUSMS Evaluation Scheme. A student should clear all the subjects of Pre-Clinical Sciences. Biology.Sc. 10. 5. Similarly. Internal assessment: At the end of every system. 2. The candidate should have completed 17 years of age on or before the date of admission. formative evaluation may be conducted to enable the students to learn and to get a feed back of the progress in all subjects. To qualify for the University examination a student is required to obtain a minimum of 50% internal assessment in both theory and practical separately in each subject. The mandatory minimum mark for passing the theory examination in any subject is 50% of the marks in the theory segment (i. The candidate must complete Intermediate Science or 10+2 years of education or equivalent with English.e. A student must complete the different subjects of the Pre-Clinical Sciences . before he/she is allowed into Semester V. Physics and Chemistry. • Curriculum should be approached in a manner so that not more than one third of the time allotted for each subject is spent as didactic teaching. or completed B. a student must complete the different subjects of the Pre-Clinical Sciences . The average of the sessional marks in practical shall constitute the internal assessment for practical.I MBBS Examination within three years from the date of admission. Physics and Chemistry as main subjects and having secured not less than 50% of marks in the subjects mentioned above put together and an aggregate of 50% overall. 7 hours/ day. Examinations) 1. Chemistry or Biology and at least one other prescribed science subject of study up to the ancillary level and should have scored not less than aggregate of 50% marks and provided that such candidate shall have passed the earlier qualifying examination (I. The time frame may not be relevant for hospital postings. Degree recognized by the university with one of the following subjects viz. written. Both written and viva- voce are compulsory components of university theory examination. 9. 7. The average of marks obtained in the semester examinations (two in a year) in that subject should account for the remaining 50%. Sc. 13 .

• The University will conduct workshops for faculty development (teaching-learning and student evaluation) as necessary. consisting of different types of questions.• The examinations in theory and practical will be as objective and structured as possible. • The University will maintain Question Bank for every system subject wise. 14 .

around which discipline-wise subject is threaded coherently. common clinical problems should form the prologue to establish relevance of basic sciences to clinical medicine. the concerned academic departments should get together and identify in an integrated manner. the student should be guided to address common problems / common clinical problems serving as themes. referring to Pre-Clinical sciences. GUIDELINES TO MEDICAL COLLEGE AND THE FACULTY • The Medical College should follow the curriculum guidelines in imparting knowledge to the undergraduate student. • As a rule. • Clinical symptoms and clinical signs must be emphasised upon and should be explained. 15 . • Emphasis should be laid to ensure that the undergraduate student grasps the basic concepts throughout the course. • When time-tabling the semester schedules. • In correlation seminars. • In instruction. the instructional objectives to be covered. wherever possible. the departments concerned should ensure integration of related subject matter of a particular System / Topic by carrying out teaching synchronously. • Pre-Clinical sciences should be revisited as a rule whilst implementing Clinical Sciences of the curriculum of clinical disciplines.

CLINICAL SCIENCES 16 .PRE .

PRE .CLINICAL SCIENCES 11st year SEMESTER – I Basic concepts Genetics Immune System and Immunology Autonomic Nervous System Integumentary System Musculo-skeletal System Community Medicine Introduction to Clinical Medicine (ICM) Medical Informatics SEMESTER – II Haemopoietic System Respiratory System Cardiovascular System Community Medicine Introduction to Clinical Medicine (ICM) 2nd year SEMESTER – III Gastrointestinal System Hepatobiliary System Renal .Electrolyte System Metabolism and Endocrine System Community Medicine Introduction to Clinical Medicine (ICM) SEMESTER – IV Reproductive System (including breast) Central Nervous System and Special Senses Community Medicine Introduction to Clinical Medicine (ICM) 17 .

 Provides learning inputs in structural-functional aspects on the immune system and immunology. function-dysfunction with a basis for understanding. affecting respiratory and cardiovascular systems. FIRST YEAR SEMESTERS – I & II OBJECTIVES: SEMESTER – I  Facilitates acquisition of fundamental knowledge in pre-clinical sciences. integumentary and musculo-skeletal to understand diseases process affecting these systems. CONTENTS: Basic Concepts Genetics Immune System and immunology Autonomic Nervous System Integumentary System Musculo-skeletal System Haemopoietic System Respiratory System Cardiovascular System Community Medicine Introduction to Clinical Medicine (ICM) Medical Informatics 18 . cardiovascular. required to understand the human body systems to follow. SEMESTER – II  Provides learning inputs in respiratory. common clinical disorders.

Disinfections.Introduction Viruses . Introduction. classification and nomenclature of microbes. PATHOLOGY Cellular adaptations.Introduction Antimicrobial Agents Microbial genectics Laboratory diagnosis of Viral. Hospitalacquired infection and HICC. cell injury and cell death Inflammation and Repair Hemodynamic disorders Neoplasia PHARMACOLOGY Introduction 19 . SEMESTER . Differences between Prokaryotic and Eukaryotic cells. Bacterail.Introduction Anaerobiosis Sterilization.Introduction Parasites . Bacteria . Fungi. Viruses and Parasites. fungal and parasitic infections.I BASIC CONCEPTS COMMON CLINICAL PROBLEMS: Understanding the Human Body and Its Functions Maintaining Normal Health Understanding Disease Human Values and Value-Systems Medical Profession and Professional Ethics ANATOMY General Anatomy General Histology General Embryology BIOCHEMISTRY Importance of Biochemistry in Medicine Introduction to cells Carbohydrates Amino acids Proteins Lipids Nucleic acids-Gene Expression Enzymes Metabolism Vitamins MICROBIOLOGY Historical perspectives and contributions of Microbiology to medical sciences. Biomedical waste management.Introduction Fungi . Bacteria. Decontamination: Normal Flora Infection Bacteria .

Long bones .introduction. 20 . growth.classification.Sources and Routes of Drug Administration Pharmacokinetics Pharmacodynamics Adverse Drug Reactions Essential Drugs Concept and Rational Drug Therapy P-drug concept PHYSIOLOGY Introduction Homeostasis Bioelectricity COMMUNITY MEDICINE Human and Medicine Concepts of Health Nutrition Environmental Sciences Biostatistics INTRODUCTION TO CLINICAL MEDICINE Medical Ethics Art of History Taking Clinical Examination MEDICAL INFORMATICS Fundamentals of Computer Windows 98/2000 Applications Word Processing (Microsoft Word) Working With Worksheets (Microsoft Excel) Graphic Presentation (MS-Power Point and Multimedia) Statistical Treatment of Data (Using Epi Info WHO Epidemiological Software) Retrieving Information (Internet WEB) CONTENTS ANATOMY General Anatomy: Introduction to anatomy . Locomotor system.classification. development.parts and blood supply. Bones . planes and terms.anatomical positions. Cell divisions Skin and fasciae . nutrition and growth. functions. Cartilage . sites of occurrence.

Microanatomy of adrenal medulla General Embryology: Menstrual cycle Gametogenesis Graafian follicle. Nervous tissue.structure Corpus luteum – formation. Muscles . mitochondrion.Joints . sympathetic ganglia. spermatozoon . Structure and function of nucleus. implantation Morula and blastocyst formation Bilaminar embryonic disc Neurulation Formation and fate of notochord Intraembryonic mesoderm and its subdivisions (somites) Ectoderm. Skin & Fascia.structure Exocrine glands – classification with examples.TS & LS Blood vessels: artery – large & medium size and vein.definition.nerve. Epithelial tissues . Connective tissues – classification. Golgi Apparatus. fate Ovulation. endoderm – derivatives 21 . synapses General Histology: Cell and sub-cellular organelles .types. Nervous tissue. functions. structure. neurons. mesoderm. examples of each type. fertilisation. endoplasmic reticulum. nerve fibres.classification.classification. classification. neurons & neuroglia. spinal ganglia. lysosome.electron microscopic structure. functions structural components.introduction to nervous system. Muscles – types with example. Bone. examples of each variety. subdivisions and their functions.

functions Lipids: Classifications. Enzymes: Definition. inhibition of activity. proteoglycans and glycoproteins Amino acids: Classification. poly unsatuarated fatty acids.pyrimidine bases. special structural features. glycogen. cell structure. decidua. concept of exons.biochemical functions. prostaglandins. regulation of activity. acid-base properties and characteristics of peptide bond Proteins: Classification and structural organisation. polysaccharides: starch. purine – pyrimidine derivatives. introns. regulation. International Union of Biochemistry (IUB).structure and properties. classification. umbilical cord amnion. gene expression. formation. enzyme kinetics. optical activity. function and twinning Foetal membranes: chorion. disaccharides. Metabolism: Essentials of metabolism. functions. classification. functions. isomerism Monosaccharides. yolk sac and allantois – brief account Foetal period Teratogens and teratology BIOCHEMISTRY Importance of Biochemistry in Medicine: Molecular basis of disease. biochemical functions of organelles Carbohydrates: Biomedical importance. DNA and RNA – structure and functions. factors affecting activity. glycosaminoglycans. cellulose . deficiency symptoms MICROBIOLOGY` 22 . integration Vitamins: Definition. Fatty acids and its classifications. metabolic pathways. vitamin cofactors . enzymology in medicine. types. steroids and lipoproteins Nucleic acids .Gene Expression: Purine . role of biochemistry in diagnosis Introduction to cells: Prokaryotic and Eukaryotic cells. classification. phospholipids.Folding of embryo Embryonic period Placenta: Structure. measurement of enzyme activity isoenzymes. triacylglycerols. iso-electric pH.

Fungi. fungal and parasitic infections: Principles. Decontamination: Definitions. Bacterial.Historical perspectives and contributions of Microbiology to medical sciences Differences between Prokaryotic and Eukaryotic cells. c. Principles.Introduction: a. source of infections (including Zoonotic diseases). Anaerobiosis: Definition. bacterial growth curve and its relationship with infection and disease. Viruses and Parasites Introduction. general characteristics and classification of fungal infections Viruses – Introduction: a. Bacterial growth requirements. pathogenesis of viral diseases Parasites – Introduction: Classifications of parasites (by morphology. methods and their applications Normal flora: Preliminary concepts. Bacteria. Replication. classification and method of anaerobiosis and anaerobic culture.definitions. anatomical distributions. role of normal flora in nosocomial infections and opportunistic infections Fungi: Introduction. Disinfections. infection sites/disease) Host parasite relationship Infections: Types of infections (local and systemic). hypertrophy. Infectious waste management Hospital acquired infection and HICC PATHOLOGY Cellular Adaptations: Atrophy. factors influencing normal flora. examples and mechanism Cell Injury: 23 . Introduction. reliability of tests. Mode of transmission of microorganisms. growth media and types of culture. specimen collection. storage and transport. fungi and parasites Complement system: Role of complement. general characteristics and classification of viruses and bacteriophage b. metaplasia . factors influencing susceptibility tests. methods of diagnosis Antimicrobial agents: Antibiotic susceptibility test. classification and nomenclature of microbes Bacteria . viruses. Sterilization. Morphology of bacteria and Bacterial spore b. hyperplasia. different pathways Laboratory diagnosis of Viral. bacteriocin. Virulence factors and Mechanism of pathogenesis Host parasite relationship of medically important bacteria.

sites. morphological changes in target organs and aetiopathogenesis. types. consequences.disadvantages.dysplasia. Embolism. oncogenesis and clinical presentation of tumors . Necrosis . mesenchymal. Granuloma . types..g. natural (plant. description. diseases. new drug delivery systems Pharmacokinetics: Absorption and bioavailability of a drug Methods of absorption. chemotherapy.Reversible and irreversible . pharmacodynamics. orphan drug Terminology of allied branches. drug. morphology. totipotent Aetiopathogenesis. therapeutics.brief discussion Laboratory diagnosis PHARMACOLOGY Introduction to General Pharmacology: Explanation of terms Pharmacology. fate of thrombus. glycoside. Thrombosis . placental barrier 24 . Infarction . Embolism .morphological types. Chronic venous congestion . factors affecting drug absorption and bioavailability Bioavailability.differences Mode of spread of malignant tumours with suitable examples Histogenetic classification . spleen. drug nomenclature Definition of terms: Alkaloid. types.mechanisms. carcinoma in situ and allied definitions Benign . chemical mediators and their role in inflammation. mechanism.malignant neoplasia .definition. oil. Bioequivalence: definition . pharmacokinetics.significance Distribution of drugs: concept of apparent volume of distribution. Clinical pharmacology. examples and morphology. factors affecting healing.mechanism and changes produced in different types of degeneration including fatty change in liver and heart.pathogenesis. Differences between necrosis and apoptosis Mechanism of apoptosis Pathologic Calcification: Definition.definition. animal) & synthetic Routes of drug administration: common routes. liver.benign-malignant Paraneoplastic syndromes .definition.epithelial. pharmacy. Shock. sources of information. acute and chronic inflammation . Thrombosis.protein-binding of drugs and its clinical importance Blood brain barrier. sequelae. Infarction and Chronic Venous Congestion: Shock -definition. tannin Sources and Routes of Drug Administration: Sources and nature of drugs: common sources e. Neoplasia: Definitions of neoplasia . vascular and cellular response. Oedema .gross and microscopic changes in lungs. examples Inflammation and Repair: Definition. Wound healing .types. Oedema. pathogenesis. advantages .tumour . types.

hypersensitivity. Drug Tolerance.Drug antagonism. Osmosis Cell membrane transport. different regulatory systems in homeostasis. d-Penicillamine. Kinetics: first order.definition.Functions of electrolytes: Dehydration and over hydration. biological half-life. Cutaneous receptors . LD50. clinical significance. Principles of control systems – general characteristics and components of biological control systems. types. Excretion: routes. Cell to cell and local commutation. control of internal environment. sex. examples: p-drug concept PHYSIOLOGY Introduction General functional organization of human body. Adverse Drug Reactions: Adverse drug reactions . factors affecting.receptor interactions. drug . maintenance dose and steady state plasma concentration. error. carcinogenicity. concept of negative and positive feedback correction. Dose response relationships. Therapeutic index. importance. EDTA. hypotonic fluids Osmotic pressure – crystalloid and oncotic. role of hormones in homeostasis. Rational drug therapy: concept.organ toxicity. Bioelectricity: Terminology – Excitable cells. clinical significance. generator potential. chelators . maintenance. gain. Optimization of dosage regimen: loading dose. Heavy metals . Action potential . Functional anatomy of neurons. Drug toxicity .dimercaprol. Resting membrane potential. Factors affecting drug response: Drug factor . body weight.Biotransformation: definition. Pharmacogenetics. properties and transduction.classification and function. hypertonic. types of reactions. zero order. cumulation. Drug Dependence. 25 . neurons and muscles and their excitable properties. Methods of prolonging the duration of action of a drug Pharmacodynamics: Principles of drug action. Nernst equation. receptors and target cell. dependence. Hormonal control mechanisms – definition of hormones. Neural control mechanism – role in homeostasis. Essential Drug Concept and Rational Drug Therapy: Essential drug concept: principles. Define and explain terminology: Isotonic. Therapeutic drug monitoring: importance. consequences. types of DRC different components like ED50.antagonists (brief). factors affecting biotransformation. model list preparation. synergism. Factors related to patient: age. Body fluid compartments. Intracellular mechanism of signal transduction Homeostasis: Definition.ionic basis of its genesis and propagation Its refractory period Receptor – Classification and functions. teratogenicity.

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Chromosomal Aberrations Sex Determination and Hermaphrodites BIOCHEMISTRY Nucleic acids and Genetics Biochemistry of Tumor Metabolism Trace Element Metabolism MICROBILOGY Microbial genectics PHARMACOLOGY Pharmacogenetics PHYSIOLOGY Growth and Development Disorders of Normal Growth Physiology of Aging CONTENTS ANATOMY Genetic Terms. Symbols Used in Pedigree Chart Mendelian inheritance (single gene and multifactorial patterns) Chromatin and Chromosomes (morphology and classification) Karyotyping Chromosomal aberrations (numerical and structural) Autosomal disorders of chromosomes (Patau’s.I GENETICS COMMON CLINICAL PROBLEMS: Cerebral Palsy Down’s Syndrome Intra-Uterine Growth Retardation Lactose Intolerance Prematurity ANATOMY Genetic Terms. Symbols Used in Pedigree Chart Mendelian Inheritance Structure of Chromosomes. metafemales) 27 . and fragile-X syndromes. and Down’s syndromes) Sex-chromosomal disorders (Turner’s. Klinefelter’s. SEMESTER . Edward’s.

MICROBIOLOGY Microbial genetics: Introduction. Structure of DNA. proto onco gene. purine and pyrimidine. semi-conservative replication. restriction enzyme. Replication: Cell cycle. base sequence determination. seen in the local hospital. mechanism Protein Synthesis: Transcription. antibiotic resistant and toxogenic gene. blot techniques application in medicine. vector. genetic materials. mutagens. Regulation of gene expression: Control of gene expression in prokaryotes (Lac operon) and eukaryotes Recombinant DNA Technology: Knowledge of: Recombinant DNA. fundamental differences between prokaryote-eukaryote protein synthesis. tumor suppressor gene. Chromium. lipid. tumor markers. Genetic Disorders: Mutation and repair. Molybdenum. Trace Element Metabolism: Zinc. loss of metabolic regulation. Fluoride. translation. amino. Enzyme Deficiency Disorders Cytogenetic Disorders Biochemistry of Tumor Metabolism: Biochemical basis of cancer. Selenium. types of RNAs.Crick Model of DNA Genes: Definition. Copper. types of mutation. uric acid. gene transfer. cobalt & manganese . gout. Iodine. genetic basis of pathogenicity. molecular diagnostic techniques PHARMACOLOGY Pharmacogenetics: general concept PHYSIOLOGY 28 . Watson .BIOCHEMISTRY Nucleic Acids – DNA and RNA: Chemistry. biochemical disorders of carbohydrate. mutation and repair mechanism. Purine and Pyrimidine Metabolism: Synthesis and degradation salvage pathway. Iron.comparison with normal cell metabolism. cloning.

Skeletal age and physical maturity Organ growth: differential growth of specific organs and tissues i. brain. reproductive organs at various ages. late puberty. Growth spurts in human life: infancy.Growth and Development: Definition Physical growth: prenatal period. hormonal Disorders of Normal Growth: Abnormalities of foetal and postnatal growth Hereditary short stature Physiology of Aging: Changes in various systems and mechanisms involved. visceral. Factors affecting aging 29 . mental growth and IQ. Factors influencing growth: genetic. pubertal growth. lymphoid tissue. Growth rates in boys and girls. nutritional. head.e. birth to puberty.

I IMMUNE SYSTEM AND IMMUNOLOGY ANATOMY Lymphoid organs MICROBIOLOGY Immunity Antigens Antibody Immune response Complement system Hypersensitivity Autoimmune diseases Primary and secondary immune deficiency diseases AIDS Immuno-prophylaxis PATHOLOGY Amyloidosis Organ transplant rejection PHARMACOLOGY Immunosuppresant and Immunostimulants PHYSIOLOGY Spleen and Lymph Nodes Lymph and Tissue Fluids Immunology.Plasma Cells and Immune Scenario Immunoglobulins Innate and acquired immunity Plasma Cells and Immune Scenario CONTENTS ANATOMY Gross features and development of Spleen. active. Spleen. acquired. Tonsil and Thymus MICROBIOLOGY Immunity: Introduction. heterophilic antigens Antibody: Classes. basic concepts role of immunity in health and diseases Mechanism of innate. structure and functions of immunoglobulins Immune response: 30 . carrier. passive immunity Antigens: Hapten. SEMESTER . Tonsil and Thymus Microanatomy of Lymph node. epitope.

classification. plasma concentration. Role of B & T lymphocytes and macrophages in immunity Concepts of function of interleukins and complement system Immunoglobulins: Types. functions. mechanism. morphology. functions. active and passive. antibody production 31 . basic concepts.I. vaccines monovalent. different pathways Common immunological and serological tests used for diagnosis Hypersensitivity: Types and mechanisms Immunological disorders: Primary. synthetic and KBMA vaccines (killed but metabolically active) Common immunological and serological tests used for diagnosis PATHOLOGY Amyloidosis . Organ transplant rejection Types.definition.S. and morphology PHARMACOLOGY Immunosuppresant and Immunostimulants List the drugs and therapeutic uses PHYSIOLOGY Spleen and Lymph Nodes: Functions of reticuloendothelial system Lymph and Tissue Fluids: Formation and functions Immunology: Introduction.D. special stains. live. Auto immune disorders Immuno-prophylaxis: Introduction. killed. morphology. subunit.Humoral and cellular immunity Complement system: Role of complement. Secondary immune deficiency diseases A. special features Plasma Cells and Immune Scenario: Development. polyvalent.

SEMESTER . nor-epinephrine. Neuropsyciatric disorders 32 . Neuro transmitter receptors Acetylcholine. GABA. Nitric oxide Biosynthesis and metabolism of Polyamines and their medical importance Biochemical basis of Myasthenia gravis Parkinsons disease. epinephrine.I AUTONOMIC NERVOUS SYSTEM COMMON CLINICAL PROBLEMS: Shock Colic Organophosphorous Poisoning Mushroom Poisoning Myasthenia Gravis ANATOMY Autonomic Nervous System Adrenal Medulla BIOCHEMISTRY Neurotransmitters PHARMACOLOGY Introduction Cholinergic Receptor Agonists Muscarinic Receptor Antagonists Adrenergic Receptor Agonists Adrenergic Receptor Antagonists Antimicrobials PHYSIOLOGY Organisation of Nervous System Physiological Role of Autonomic Nervous System CONTENTS ANATOMY Autonomic Nervous System: Sympathetic nervous system Parasympathetic nervous system Adrenal Medulla Gross anatomy. organophospherous poisoning. Serotonin. dopamine. Nuromuscular transmission. microanatomy BIOCHEMISTRY Neurotransmitters: Definition Synaptic transmission.

Mechanism of action. Outline of actions. Define the terms – cholinergic receptors. uses and adverse effects Adrenergic Receptor Antagonists: Definition. Therapeutic Uses and Drug interactions . uses. types.PHARMACOLOGY Introduction to Autonomic Pharmacology: Review briefly physiology of autonomic nervous system. advantages. 33 . Cholinergic Receptor Antagonists: Definition List the drugs – belladonna alkaloids and atropine substitutes Discussion – atropine (prototype) Advantages and disadvantages of clinically used atropine substitutes Adrenergic Receptor Agonists/ Sympathomimetic agents: Adrenergic Receptor: types. Anti cholinesterases – neostigmine. distribution and function Endogenous catecholamines – epinephrine. Contraindications. Adverse effects. Therapeutic Uses and Drug interaction. dopamine Review biosynthesis. Mechanism of action. Contraindications.Blockers Classification (selective and non-selective). physostigmine etc Explain the principles of management of glaucoma. Contraindications. Bethanechol etc. α. nor-epinephrine. Propanolol (prototype) Antimicrobials: Introduction General principles Classification. uses and adverse effects α-adrenergic receptor agonists List the drugs. Cholinergic Receptor Agonists / cholinomimetics: Definition. Mechanism of action. Mechanism of action. enumerate the actions. Classification. β-blockers Classification (selective and non-selective). Adverse effects. organophosphorous poisoning. adverse effects and contraindications of : Esters of choline – acetylcholine . Alkaloids – pilocarpine. adverse effects. storage and release Adrenergic drugs classification Discussion – epinephrine (prototype) β-adrenergic receptor agonists – selective and non-selective List the drugs. sulphonamides Fluoroquinolons. Mucarine. pharmacological actions. myasthenia gravis. adrenergic receptors. Therapeutic Uses & Drug interactions of Cotrimoxazole.

mechanisms.β-lactam antibiotics: penicillins. Contraindications. Macrolides:Erythromycin: prototype. Adverse effects. Miscellaneous groups of antibiotics: very brief discussion.g. clindamycin. Mechanism of action. Aminoglycosides: list of important drugs . netilmicin. cephalosporins etc. polymyxin-B. Site and mechanism of generation of an action potential in a neuron Functional organisation of Autonomic Nervous System: divisions. neomycin: general features. e. Antifungal Agents: Introduction General principles. tobramicin. Inter neuronal communication – synapse structure. Rationale of combining with β-lactams.Streptomycin. bacitracin. Tetracyclines. adverse effects. distribution. amikacin.Classification. β-lactamase inhibitors: examples. gentamicin. comparison of clinically most useful preparations. chloramphenicol. Transmitters and receptors in ANS Higher control of autonomic nervous system Physiological role of autonomic nervous system in the control of various body functions 34 . Therapeutic Uses and Drug interactions PHYSIOLOGY Organisation of the Nervous System Functional organisation of nervous system – review. vancomycin. synaptic transmission. neurotransmitters and modulators. kinetics. . spectinomycin.

thick. SEMESTER . and pigmented skin) Appendages of Skin (hair. nail. pilosebaceous unit) BIOCHEMISTRY 35 .I INTEGUMENTARY SYSTEM COMMON CLINICAL PROBLEMS: Burn Scabies Dermatitis Leprosy Malignancies ANATOMY Skin Thick and Thin with Appendages BIOCHEMISTRY Melanin Synthesis MICROBIOLOGY Introduction to skin infections Bacillus anthracis Mycobacterium Leprae Atypical Mycobacteria Gas gangrene Superficial mycosis Dermatophytosis Subcutaneous Mycoses Viral infections Parasite infection PATHOLOGY Tumours Leprosy PHARMACOLOGY Antileprotic Drugs PHYSIOLOGY Skin – Functions Sweat Glands Thermoregulation CONTENTS ANATOMY Skin (microscopic structure of thin.

viral exanthematic diseases. Staph aureus.Melanin: Synthesis . laboratory diagnosis.cells involved. Nevus: definition. Tumours: Squamous papilloma. nigra etc. common etiological agents. Discussion of individual drugs. mode of spread of squamous cell carcinoma. clinical features and laboratory diagnosis. Larva migrans PATHOLOGY Leprosy: Classification. Malignant melanoma. MICROBIOLOGY Introduction to skin infections: Types of infections. Tuberculoid and Lepromatous leprosy: Pathogenesis. types of infection. Viral infection: Varicella zoster – clinical features. Strept pyogenes and its complication (PSGN= post streptococcal glomerular nephritis). microscopic features and diagnosis. laboratory diagnosis. Subcutaneous Mycoses: Mycetoma. clinical classifications. abbreviated pathway. implications. morphology. Gas gangrene: Cl perfringens etc Superficial mycosis: P. Bacillus anthracis: Morphology. laboratory diagnosis. chromomycosis. Dermatophytosis: classification. clinical features and laboratory diagnosis. Mycobacterium leprae: Morphology. Aetiology. laboratory diagnosis. Sporothrix schenkii. Albinism: The molecular defect. multiple drug therapy.Sources. PHYSIOLOGY Skin: 36 . aetiopathogenesis Classification of antileprosy drugs. clinical features. Buruli ulcer. pathogenicity. versicolor. complications. Atypical Mycobacteria: Swimming pool granuloma. types (intradermal Junctional and compound). T. Parasite infection: T spiralis. lepromin test. morphology. culture. PHARMACOLOGY Antileprosy Drugs: Introduction. pathogenicity. immunology.

Physiological responses on acute exposure to hot and cold environment. disorders of thermoregulation .hypothermia. 37 . Thermoregulation: Mechanism. receptors.Functions. fever. Sweat Glands: Types. functions. Acclimatisation. hypothalamic thermostat. control of secretion. hyperthermia.

ankle joint Gluteal region.I MUSCULO-SKELETAL SYSTEM COMMON CLINICAL PROBLEMS: Tetanus Hemiplegia Osteomyelitis Varicose Veins Arthritis Injuries ANATOMY Upper Limb – Gross Anatomy Bones. humerus. dorsum of foot Arches of foot Lymph nodes Muscles Nerves Arteries Veins Surface anatomy Radiological anatomy BIOCHEMISTRY Muscle Metabolism Creatine – Creatine Phosphate Markers of Muscle Damage Calcium homeostasis MICROBIOLOGY Infectious Arthritis Osteomyelitis PATHOLOGY Congenital disorders Fracture Osteomyelitis Osteoporosis 38 . sole. ulna and carpals bones Joints Axillary Lymph nodes Flexor – extensor compartments Muscles Nerves Brachial plexus Arteries Veins Surface anatomy Radiological anatomy Lower Limb – Gross Anatomy Bones: Hip bones. patella and bones of foot Thigh and leg Hip joint.clavicle. fibula. radius. scapula. femur. SEMESTER . knee joint. tibia.

Actions and nerve supply of interossei and lumbricals. carpo-metacarpal joint. Osteoarthritis Soft Tissue Tumors Muscular Dystrophies PHARMACOLOGY NSAIDS Drugs for RA and Gout Skeletal muscle relaxant PHYSIOLOGY Functional organization of striated muscles Neuromuscular transmission Excitation contraction coupling (ECC) Mechanical events during muscle contraction Denervated muscle Types of muscle fibers Physiology of smooth muscle CONTENTS Upper Limb: (cross section at the level of insertion of deltoid and middle of forearm) Boundaries. insertion. Identification of bones in an articulated hand. Axillary lymph nodes: Subgroups. adductor pollicis. ulnar nerves. Muscles: Origin. biceps brachii.Osteomalacia and rickets Paget disease of bone Bone Tumors Rheumatoid Arthritis. distribution and applied anatomy of – axillary. relations. immediate relations. radio-ulnar joints. supinator. pronator teres. radius. applied aspects. Joints: Types. acromio-clavicular joints. ligaments. radial. capsular attachments and blood supply of bones. applied aspects of: axilla. pectoralis minor. Flexor – extensor compartments: Contents of arm and forearm. Bones: clavicle. Type and subtypes: capsular attachments. Latissimus dorsi. deltoid. course. movements of sterno-clavicular. nerve supply and applied aspects of : shoulder joint. median. humerus. muscles involved. first carpo- metacarpal joint. pectoralis major. Gout. Nerves: Origin. root value. anatomical snuff box. carpal tunnel. contents. elbow joint. Palm: fascial spaces in the palm and Palmer aponeroses and their applied aspects. wrist joint. nerve supply and actions of Trapezius. carpals and metacarpals Side determination: parts. Brachial plexus: 39 . ulna. scapula. blood supply. cubital fossa. movements. branches. subtypes. ligaments.

Brachial. femur. biceps femoris. immediate relations. movements-muscles involved. termination and branches of – axillary. adductor canal. triceps surae. ulnar arteries. tibia. course. popliteus. parts. tarsals and metatarsals Side determination. Thigh and leg: Compartments and contents. Veins: Formation. nerve supply. radial. sole. median cubital veins. blood supply and applied aspects. Inversion – Eversion Lymph nodes: Inguinal group. and superficial and deep palmar arches Cephalic. olecranon process of ulna. popliteal groups – subgroups. insertion. subtype. branches and applied aspects. adductor magnus.Formation. cephalic. efferents and applied aspects. and styloid processes of radius and ulna bones. ligaments. dorsum of foot. Arches of foot: Formation. afferents. tributaries. head of radius bone. Nerves: 40 . Hip joint. termination. parts. nerve supply. position. palmar arches. semimembranosus. medial and lateral humeral epicondyles. elbow. Arteries: Origin. Radiological Anatomy X-rays of shoulder. Identification of structures in gluteal region. applied anatomy. and wrist Surface Anatomy Acromion process of scapula. supports. and median cubital vein Development of the limb bud Lower Limb – Gross Anatomy: (cross section at the level of apex of femoral triangle and middle one-third of the leg) Bones: Hip bone. actions of: gluteus maximus. popliteal fossa. capsular attachments. knee joint. ankle joint: Type. brachial. tibialis anterior and tibialis posterior. gluteus medius. Muscles: Origin. and ulnar arteries. radial. basilic. applied aspects of: femoral triangle. capsular attachments. blood supply. Contents. and peroneus longus. fibula.basilic. Boundaries. Identification of bones in an articulated foot. applied anatomy of . patella. rectus femoris.

Energy metabolism switch over in conditions: from resting to contracting. factors delaying the healing. course. Osteopetrosis Fracture: Types. pubic tubercle. PATHOLOGY Congenital Disorders: Achondroplasia. femoral. laboratory diagnosis. Creatine and Creatine Phosphate: Synthesis from precursors. calcitonin in regulation of Plasma calcium level. tetany and rigor mortis. Veins: Origin. anterial and posterior tibial. Markers of Muscle Damage: Myoglobin. Calcium homeostasis: Role of parathyroid hormone (PTH). and dorsalis pedis arteries. 41 . MICROBIOLOGY Infectious Arthritis: Causative organisms. knee. termination. adequate O2 to hypoxic. Osteomyelitis: Acute and chronic.Origin. popliteal. morphology of healing. Pathogenesis. and femoral veins. Osteogenesis imperfecta. common peroneal. Radiological Anatomy X-rays of hip. and ankle Surface Anatomy Anterior superior iliac spine. tibial. catabolism. branches of: femoral. pathogenesis. root value. greater trochanter of femur. anterior and posterior tibial. tributaries. role of calcium. Arteries: Origin. patella. peroneal. applied aspects of : sciatic. femoral and obturator. femoral. adductor tubercle. laboratory diagnosis. Development of limb bud and axis artery BIOCHEMISTRY Muscle Metabolism: Glycogen metabolism. creatine phosphate function. agents. enzymes. troponins. long and short saphenous. course. arteria dorsalis pedis. powre stroke of contraction. popliteal. applied aspects: long and short saphenous veins. medial and lateral malleoli. branches. plantar arch. popliteal. Cori Cycle. fed to fasting. calcitriol.

PHYSIOLOGY Functional organization of striated muscles: Muscle cell. sarcomere and organization of contractile proteins and sarcoplasmic reticulum Neuromuscular transmission: 42 . fibrosarcoma. Prostaglandins. clinical features and X-ray findings of: Ewing’s Sarcoma. Soft Tissue Tumors: Gross and microscopic features of lipoma . pathogenesis. Mode of inheritance. Muscular Dystrophies: Definition. Comparison of salient features of various groups. gross and microscopic features. morphology. Skeletal Muscle Relaxants Classification. Rheumatoid Arthritis. clinical features and complications. morphology. adverse effects. rhabdomyosarcoma. investigations of Duchenne’s muscular dystrophy. Polymyositis.Osteomyelitis: Aetiology. Gout: Aetiopathogenesis. Becker’s muscular dystrophy. clinical features Osteomalacia. salient features of various groups. uses and cautions. Drug therapy for gout Acute and chronic – drug treatment and prophylaxis. kinins and mediators of inflammation. Osteoporosis: Classification. chondrio sarcoma. clinical features Paget disease of bone Bone Tumours: Classification. pathogenesis. actions. rikets: Classification. Giant cell tumor (Osteoclastoma). Drug therapy for Rheumatoid Arthritis Drugs. morphology. mechanisms of action. Myasthenia gravis: Investigations. Osteosarcoma. PHARMACOLOGY Nonsteroidal Antiinflammatory Drugs (NSAID) (Analgesic – antipyretic and antiinflammatory drugs) Classification. limitations. clinical features. morphological features and complications. pathogenesis. Osteoarthritis.

rigor mortis Mechanical events during muscle contraction: Isotonic and isometric contraction. humoral and local factors on it. Physiology of smooth muscle: Structure.Structure. Physiological basis of fatigue. effect of length on tension developed. 43 . cross innervations. cross bridge cycle. reinnervation. mechanism of contraction and relaxation. mechanism of generation of end plate potential (EPP) and muscle action potential. preload and after load. myasthenia gravis Excitation contraction coupling (ECC): Role of T tubules and SR in the release of calcium. effect of load on velocity of contraction. mechanism of transmission. properties of smooth muscle and effect of neural. chronaxie and rheobase Types of muscle fibers: Structural and functional differences between slow and fast twitch muscle fibers Effect of exercise and training on skeletal muscle structure and function. Denervated muscle: Neurotropic factor/s and their role in maintenance of structure and function of the striated muscle (fibrillation and paralysis). types. EMG and streangth duration curve. effect of two or more stimuli on muscle contrction.titanic contraction. mechanism of contraction and relaxation.

• Describe the principles of Primary Health Care and other related concepts. • Orientation to the concept of epidemiological triad and theories of disease occurrence. Chinese Medicine. • Describe the levels of prevention and modes of intervention. SEMESTER – I COMMUNITY MEDICINE HUMAN AND MEDICINE Themes and Topics: Medicine in antiquity (Primitive Medicine. Greek Medicine. Egyptian Medicine. Indian Medicine. Roman Medicine) Dawn of Scientific Medicine Modern Medicine Medical Revolution Health Care Revolution Socio-Cultural aspects of Health in Nepal Eugenics Alternative medicine Medical Ethics Objectives: Appreciate that knowledge of past prevents repetition. Principal Teaching Learning Methods to be used: Group discussion Seminar presentation CONCEPTS OF HEALTH & DISEASE Themes and Topics: Definition of health and well-being Dimensions and determinants of health Indicators of health Epidemiological triad Theories of disease causation Natural history of disease Risk factor concept Concept of control of disease Levels of prevention Modes of intervention Primary Health Care Goals / targets set to achieve “Health for All” Critical review of HFA 2000 Revitalizing Primary Health Care MDGs in the context of Nepal Objectives: • Orientation to the basic concepts of health and its determinants. place and person. 44 . Describe medical and health in various time. Acquaintance of past health and medical practice in Nepal.

lactating woman and analyze and present the data. Follow up intervention by the students regarding nutritional education.g. • Assess the nutritional status of a community. • Describe the nutritional deficiency disorders especially protein energy malnutrition (PEM). NUTRITION -II Themes and Topics: Iodine Deficiency Disorders (IDD) Magnitude of the Problem in Nepal 45 . • Identify the environmental problems. pregnant / lactating / postpartum woman. • Describe the socio-cultural structure of the community. Nutritional problems in Nepal. Practical exercise: Nutritional status assessment in a community and presentation of data collected. Principal teaching-learning methods to be used: Lecture discussion Demonstration Small group discussion Simulated practical exercises in class room Student action: problem based learning (malnutrition): group activity . under-five child. PEM.• List the goals / targets set to achieve “Health for All”. • Prescribe a balanced diet within the socio-economic-cultural milieu for normal adult male / female. Objectives: • Describe the determinates of nutritional status of individual / community. Principal teaching-learning methods to be used: Lecture discussion Small group discussion Practical exercises NUTRITION -I Themes and Topics: Common problems: Protein-energy malnutrition Iron deficiency Vitamin A deficiency Determinants of nutritional status of individual / community Nutritional sources and requirements Balanced diet Nutritional deficiency disorders e. • Describe the existing health facilities. • Describe and prioritise the nutritional problems in Nepal. pregnant. vitamin A deficiency. • Suggest and conduct a simple intervention for an identified problem • State the National Health Policy and planning. iron deficiency anaemia. Vitamin A deficiency. • Make a simple presentation regarding the above.students as a group will conduct a nutritional survey in 10 houses each to collect information about nutrition for an under 5 year child. Iron deficiency. • Describe the nutritional sources and requirements at different ages and for males and females.

• Describe the family environment and principles of good housing. • Understand the methods of waste and excreta disposal. hand-pump. • Define and analyze the importance of water and sanitation in human health. • Describe appropriate methods for making water safe at the household level. ENVIRONMENTAL SCIENCES Themes and Topics: Environment: physical environment inside and outside the home Water: safe water. presentation with other departments. • Suggest feasible methods of environmental control.necessity of waste disposal General principles of waste disposal Excreta disposal . purification of water at the household and community levels Waste disposal . Problem based learning: integrated seminar. Small group discussion. • Describe the steps in the community assessment of IDD. level of Iodine in salt at the household level and analyze and present the data. Follow up intervention by the students regarding nutrition education. Student action: The students as a group will conduct a survey in 10 houses to collect information about IDD. Potable water. • Describe the importance of salt fortification (iodisation). • Define safe water obtained from tap. well.during the family health exercise students will identify environmental problems and suggest feasible and appropriate remedial measures BIOSTATISTICS Themes and Topics: 46 . Demonstration: use of field testing kits for iodine levels in salt.Community Assessment of IDD Zinc deficiency Salt Fortification Objectives: • State the magnitude of the problems on IDD in Nepal. Principal teaching-learning methods to be used: Lecture discussion Demonstration Small group discussion Practical exercises Student action .necessity of excreta disposal General principles of excreta disposal Family environment and principles of good housing (In all of the above topics the general principles are to be taught avoiding engineering details) Objectives: • Describe the physical environment: both inside and outside the home. Principal teaching-learning methods to be used: Lecture discussion.

pie-chart. Principal Teaching-Learning Methods To Be Used: Lecture discussion Small group discussion Simulated practical exercises in the classroom: calculate various statistical values using data from hospital or community 47 . • Select and use appropriate diagrammatic representation of statistical data. pictogram Objectives: • Define. line diagram. calculate and interpret commonly used statistical treatment. frequency polygon. histogram.Need of biostatistics in medicine Statistical methods Frequency distribution Measure of central tendency Proportions Presentation of statistical data Tables: simple and frequency distribution tables Charts and diagrams: bar.

list steps of testing patients clinically in relation to motor. familiarise with the societal expectations of medical profession. correlate anatomical structures and Pathophysiology involved in giving rise to different clinical signs in relation to Musculo-Skeletal System. 48 . 10. 4. gait and coordination. perceive medical ethics as an essential of medical profession and. acting in the best interest of the patient. recognise the geographical variations in the prevalence of different types of diseases. 4. appraise the common problems related to Musculo-skeletal System. practical demonstrations. Musculo-skeletal System 1. 5. 4.3 uphold confidentiality of patient related information. take relevant history on Musculo-Skeletal System. practice on peers and on patients.I INTRODUCTION TO CLINICAL MEDICINE Themes and Topics: Medical Ethics Art of History Taking Clinical Examination At the end of Semester-I the learner should be able to: 1. 4. state the importance and the need for history taking. SEMESTER .exhibit the behavior expected of a doctor.2 develop preparedness and readiness to provide medical care with dedication. 4. 6. supplementary video. reflexes. injection procedures. 3. 9. demonstrate on peers the techniques of systematic general physical examination procedures. 5.4 be truthful and honest with colleagues and others in the medical profession. dressings. . identify laboratory and radiological investigations required in making diagnosis.5 refrain from causing any form of harm to the patient. make observation of: first aid. comprehend the socio-cultural habits of ethnic groups. 2. 7. Instructional Method: Lectures in class-room.6 be well aware of the Law of the Land and strive to uphold the Law of the Land. 4. 11. 2.7 know the professional norms and imbibe .1 cultivate and exhibit an attitude of compassion and respect to patient as a fellow-human being. venesection. appraise with the components of communications skills. blood transfusion in emergency room / hospital wards. 4. 3. 4. sensory. realise the roles and responsibilities of a basic medical doctor. develop skill of taking history 8. 4. understand the functions of Nepal Medical Council.

4. Instructional Method: Demonstration. write reports using word and excel software. 2. download subject matter from the Internet and Websites of other medical schools and journal publications. practice under supervision. Objectives: On completion of the course in Medical Informatics. presenting correlation seminars and project findings. obtain subject matter from CD ROMs. 5.I MEDICAL INFORMATICS Fundamentals of Computer Windows 98/2000 Applications Word Processing (Microsoft Word) Working with Worksheets (Microsoft Excel) Graphic presentation (MS-PowerPoint and Multimedia) Statistical Treatment of Data (Epi Info WHO Epidemiological software) Retrieving Information (Internet Web) Aim : To provide hand-on-practice in order to increase and improve student’s ability to use computers to an extent that he / she will utilise computers effectively to improve learning. the student will be able to 1. SEMESTER . carry out statistical analysis using Epi Info package. computerised patient-records and from patient simulations. independent practice to achieve mastery. computerised tutorials. use MS-Powerpoint with multimedia facility when presenting to audiences. 49 . 3.

SEMESTER .II HAEMOPOIETIC SYSTEM COMMON CLINICAL PROBLEMS: Haemorrhage Anaemia Leishmaniasis Filariasis Malaria BIOCHEMISTRY Haemoglobin Iron Metabolism Vitamin B12 Metabolism Folic Acid Metabolism Blood pH Regulation Glycolysis HMP Shunt Glutathione (Redox) System Plasma Proteins MICROBIOLOGY Introduction to blood borne infections Blood borne parasites PATHOLOGY Anaemias Haemorrhagic Diathesis Idiopathic Thrombocytopenic Purpura Disseminated Intravascular Coagulation Blood Groups Blood Banking – Blood Transfusion Lymphadenitis Leukaemia Lymphomas Hodgkin’s Lymphoma and Non-Hodgkin’s Lymphoma Splenomegaly PHARMACOLOGY Haemostatics Therapy of Thromboembolic Disorders Therapy of Iron Deficiency Anaemia Therapy of Megaloblastic Anaemia. Pernicious Anaemia Therapy of Parasitic Infections Anti cancer agents PHYSIOLOGY Blood as a Body Fluid Plasma Blood Cells Blood Groups Haemostasis 50 .

irreversible steps. Blood pH Regulation: Blood hydrogen ion concentration. ribose generating step. biochemical functions. Abnormal haemoglobin: HbS as an example . definition. NADPH generating steps.haemolysis. biochemical impairments in deficiency.genetic basis. elimination. Vitamin B12 Metabolism: General metabolism. regulated steps. hepatocyte. molecular disease concept. classification. HMP Shunt: Importance. committed step. role of 2. in adipocyte. structure-function relation. acquired .one example. RDA. entry of fructose / galactose into glycolysis. G6PD deficiency . arterial blood gas analysis. Thalassaemias: Molecular basis of α-thalassaemia. overview of pathway. clinical intervention in respiratory acidosis / alkalosis. biochemical mode of action. functions. functions. hormonal regulation in fed / fasted conditions. key intermediates. laboratory diagnosis. laboratory identification of HbS. genetic basis. CONTENTS BIOCHEMISTRY Haemoglobin: Structure. Iron deficiency anaemia: Biochemical indicators. biochemical functions as 1-C carriage. transport. biochemical impairments in deficiency.[H+] buffering.one example. Glutathione (redox) System: Composition. glutathione-reductase. intermediates at metabolic junctions. significance of fetal Hb Haemoglobinopathy: Definition. congenital . Folic acid Metabolism: General metabolism. GSH-peroxidase. mechanisms of regulation. general overview of pathway. transketolase. buffers . diagnostic importance. Iron Metabolism: Functions. Porphyrias: Definition. MICROBIOLOGY Introduction to blood borne infections: 51 . chronology of gene expression. clinical relevance of [H+] measurement. Plasma Proteins: Introduction. glycolysis in RBC. release. Fe-cost per pregnancy. utilisation. interconnection with glycolytic pathway. menstrual losses. absorption. reaction at commencement/ termination. requirement for haemopoiesis. net energy yield. comparison with myoglobin. selenium. Glycolysis: Importance. respiratory acidosis/ alkalosis. β-thalassaemia. storage.3-BPG Biosynthesis: Chromosomes globin genes. Haem Biosynthesis: Building materials.

Leptospirosis. Megaloblastic anaemia: Aetiology. peripheral blood smear. Lymphomas: Classification with special reference to ‘Working International Formulation for Non Hodgkin’s lymphoma’. clinical presentations in AML. Sarcoidosis. laboratory diagnosis. septicemia. pyaemia. Hereditary spherocytosis: Aetiopathogenesis. Christmas disease. Lymphadenitis: Definition and causes. Blood Transfusion: Blood Grouping and cross matching Blood transfusion reactions. laboratory diagnosis. Leukaemias: FAB classification of acute leukaemias. bone marrow findings. complications. aetiopathogenesis. differences between myeloblast and lymphoblast. Blood Banking. laboratory diagnosis. Disseminated Intravascular Coagulation: Definition. viremia. Borreliosis Blood borne parasites: Leishmanisis. laboratory diagnosis. Malaria. morphology. pathogenesis. parasitemia: Definitions. Brucellosis. CML and CLL. differentiations. laboratory diagnosis. Thalassaemia: Aetiopathogenesis. Aplastic anaemia: Aetiology.Bacteraemia. laboratory diagnosis. Sickle cell anaemia: Aetiopathogenesis. Coagulation disorders: Haemophilia. Idiopathic Thrombocytopenic Purpura: Aetiopathogenesis. Toxoplasmosis. classification based on aetiology and morphology. 52 . laboratory diagnosis. Iron deficiency anaemia: Aetiology. Blood Groups: ABO blood group and Rh blood group. laboratory diagnosis. laboratory diagnosis. Filariasis: Morphology. reactive and tuberculous – gross and microscopic features. clinical features. significance of the tests. ALL. fungemia. Multiple Myeloma: Clinical manifestations. Hodgkin’s Lymphoma and Non-Hodgkin’s Lymphoma: Gross and microscopic features. Haemorrhagic Diathesis: Basic screening tests. life cycles. list of common organisms and diseases caused by them. aetiopathogenesis. PATHOLOGY Anaemias: Definition.

indications. uses of diethylcarbamazine citrate and Ivermectin. uses of Stibogluconate and pentamidine. Adverse effects. Hyperspleenism. inter-relationship between folic acid and vitamin B12 . Contraindications. Antiplatelet agents: Classification. Contraindications.Classification. Therapy of Thromboembolic Disorders: Anticoagulants : Introduction General principles. Anticancer Drugs: Introduction General principles. uses. Therapy of Iron Deficiency Anaemia: Introduction Iron Preparations. actions. Pernicious Anaemia: Folic acid and vitamin B12: Preparations. Adverse effects.Splenomegaly: Causes. Adverse effects. Adverse effects. Therapeutic Uses and Drug interactions. Therapeutic Uses and Drug interactions Drug therapy for Leishmaniasis: classification of drugs. Mechanism of action.Classification. Mechanism of action. Mechanism of action. PHARMACOLOGY Haemostatics Agents: Classification. Thrombolytics: preparations. treatment of overdose. Therapy of Megaloblastic Anaemia With / Without Neurological Involvement. Morphology. adverse effects. pharmacological basis for their actions and related usefulness. Contraindications. Contraindications. Mechanism of action. Drug therapy for Filariasis: classification of drugs. Therapeutic Uses and Drug interactions General adverse effects of anti-cancer drugs. PHYSIOLOGY 53 .Classification. Therapy of Parasitic Infections: Anti Malarial Drugs:- Introduction General principles. Therapeutic Uses. their actions and uses.

functions. Rh group. development. Red Blood Cells: Types. haemolysis. MCH. indications. regulating factors. Landsteiner’s law. Inheritance.Blood as a Body Fluid: Composition. Erythropoiesis: definition. Plasma: Normal constituents. erythroblastosis foetalis. Plasma proteins: types. Natural and other anticoagulants. normal count. MCV. overview of haematopoiesis. clot retraction. physical characteristics and functions of blood. ESR. 54 . Erythrocytes: morphology. concentrations. functions. properties. PCV. stages. morphology. Hemostasis: Physiology of coagulation – intrinsic and extrinsic mechanism. Anaemia : Physiological basis of causes and treatment White Blood Cells: classification. RBC indices and clinical usefulness. agglutinins. MCHC. fate. Platelets: morphology. hemolytic disease of the new-born. ABO group. fibrinolysis. tests for clotting.. Blood transfusion: relation to blood groups. Blood Groups: Agglutinogens. hazards. distribution. functions. normal counts and functions. fragility.

Antitubercular Drugs 55 .Bronchodilators Therapy of Allergic Rhinitis . Trachea Bronchial Tree.Antihistaminics Therapy of Cough .Antitussives and Mucolytics Therapy of Tuberculosis . Pleura and Lung Applied anatomy Surface anatomy Radiological anatomy BIOCHEMISTRY Cellular Respiration Biological Oxidation Oxidative Stress – Antioxidant Systems Vitamin E MICROBIOLOGY Introduction to respiratory system infections Approach to diagnosis of respiratory pathogens Bacteria as respiratory pathogens Fungi as respiratory pathogens Viruses as respiratory pathogens Parasites as respiratory pathogens PATHOLOGY Lesions of Upper Respiratory Tract Bronchial Asthma Bronchiectasis Atelectasis Hyaline Membrane Disease and Adult Respiratory Distress Syndrome Chronic Obstructive Pulmonary Disease and Cor-Pulmonale Pneumonia Lung Abscess Tuberculosis Pneumoconiosis Bronchogenic Carcinoma Pleural Lesions PHARMACOLOGY Therapy of Bronchial Asthma . SEMESTER .II RESPIRATORY SYSTEM COMMON CLINICAL PROBLEMS Acute Respiratory Infections Tuberculosis Bronchial Asthma Chronic Obstructive Pulmonary Disease Bronchogenic Carcinoma ANATOMY Nasal Cavity Paranasal Air Sinuses Larynx.

lungs. nerve supply lymphatic drainage. lymphatic drainage. applied anatomy. Trachea: Names of cartilages. and sternum). ribs or costae. Lung: Names of parts of bronchial tree. lung and bronchial tree. trachea. Pleura and lung: parts. sites of opening of various air sinuses and functions. contents and applied aspects Intercostal muscles – Nerve-supply and actions Intercostal nerves Superior thoracic aperture ( thoracic inlet) 56 . Thoracic Cage Skeletal framework – Components (thoracic vertebrae. Microanatomy of epiglottis. Parts and features of cavity of larynx with blood supply. Root and hilum of lung. lymphatic drainage. Bronchial Tree. relations. Rima glottidis. nerve supply. nerve supply. blood supply. innervations. and congenital and acquired anomalies Intercostals space: boundaries. Paranasal Air Sinuses: Names. applied anatomy. Relations and lymphatic drainage of lungs. blood supply. applied anatomy. nerve supply. Development of pleura. actions. applied anatomy. nerve supply. blood supply. Bronchial tree and bronchopulmonary segments and their applied anatomy. Nasal septum : formation. blood supply. Bronchi: right & left. applied anatomy.PHYSIOLOGY Functional Anatomy Mechanics of Breathing Spirometry Pulmonary Circulation Pulmonary Gas Exchange Gas Transport Regulation of Respiration Respiration in Unusual Environments Abnormal Breathing Respiratory Failure and Principles of Artificial Respiration Lung Function Tests Cyanosis and Asphyxia CONTENTS ANATOMY Nasal Cavity: Lateral wall of nasal cavity: boundaries. Pleural recesses. Maxillary air sinus: Boundaries. Pleura. blood supply. gross features. relation. Names of intrinsic muscles. nerve supply. Trachea: gross features. applied anatomy. Larynx.

ventilator associated pneumonia etc. course. thermogenin. transport. examples. amphibolism and clinical application. Oxidative phosphorylation: chemiosmotic theory. Vitamin E: Dietary sources. community acquired pneumonia. Atypical 57 . MICROBIOLOGY Introduction to respiratory system infections: Normal flora. nerve-supply. course. Brown adipose tissue energy metabolism.g. sources of free radicals. X-rays of skull showing paranasal air sinuses BIOCHEMISTRY Cellular Respiration / Biological Oxidation: Biological oxido-reduction: mechanism. antioxidant systems. Approach to diagnosis of respiratory pathogens: procedure of sample collection. processing and laboratory diagnosis of common respiratory pathogen. hospital acquired pneumonia. and structures passing through its major openings. laryngitis. metabolism and antioxidant function.List common pathogens Causative organisms of various respiratory diseases (Rhinitis. sinusitis. termination & tributaries Thoracic duct.list the normal flora. pathways leading from. xiphoid process.Inferior thoracic aperture (thoracic outlet) Diaphragm: Development. applied aspects. other biological anti-oxidants. clinical application of inhibitors / uncouplers. Citric acid cycle: feeder pathways. failure of antioxidant systems – clinical implications. channeling of reducing equivalents. Organisms causing Hospital Associated Pneumonia including Ventilator Associated Pneumonia (e. Oxidative Stress and Antioxidant Systems: Free radicals.origin. pharyngitis. Pseudomonas etc). Streptococcus pneumoniae and other Streptococci.A & lateral views. Staphylococcus.P. P. relations. overview of reactions. Haemophilus influenzae. Bordetella pertusis. attachments. counting of ribs Pleura and lungs Radiological Anatomy Chest X-rays A. storage. Pathogen of RTI .formation. termination. regulation. tributaries & area of drainage Surface Anatomy Sternal angle. Electron transport chain: cellular location. Respiratory movements Azygous vein. mechanism of ATP synthesis. Klebsiella. classification of respiratory diseases. Corynebacterium diphtheria. blood-supply. energetics of citric acid cycle. Bacteria as respiratory pathogens: Streptococcus pyogenes (Streptococcal sore throat and consequences).

Candida albicans. types.pneumonia (Legionella. Anthracosis. silicosis. life cycle. Parasites as respiratory pathogens: Pneumocystis jerovicii. morphology pathogenesis and complications. gross and microscopic features. primary complex . Tuberculosis: Aetiopathogenesis. Pneumoconiosis: Definition. Mycobacterium tuberculosis and MOTT Fungi as respiratory pathogens: Histopalsma capsulatum. Uearaplasma). pathogenesis. Rhinovirus. morphology. Morphology. pathogenesis and diagnosis. Gross and microscopic features. Bronchial Asthma: Mechanism and pathogenesis. aetiopathogenesis. stages. gross and microscopic features. Lung Abscess: Aetiopathogenesis. Pneumonia: Types. Bronchiectasis: Pathogenesis. Atelectasis: Definition. Hyaline Membrane Disease and Adult Respiratory Distress Syndrome: Definition.definition. pathogenesis. Cryptococcus neoformans -morphology. Paragonimus westermani. complications. complications.types of lesion. cavitary and miliary tuberculosis. Chronic Obstructive Pulmonary Disease and Cor Pulmonale: Chronic Bronchitis: Aetiology. laboratory diagnosis. Mycoplasma. Fibrocaseous. pathogenesis. asbestosis. gross and microscopic features of: 58 . Adenovirus. types. Ghon’s focus – morphology. SARS. complications. Emphysema: Definition. PATHOLOGY Lesions of Upper Respiratory Tract: Tumours of larynx. pathogenesis. Viruses as respiratory pathogens: Orthomyxo and paramyxo viruses. Bronchogenic Carcinoma: Aetiology. Chlamydia. Secondary tuberculosis . Aspergilus fumigatus.

pleural effusion. surfactant. therapeutic uses and adverse effects. mechanism of action/pharmacological basis for the use. contraindications and special features.Bronchodilators: Types of bronchial asthma – acute. List drugs for resistant tuberculosis. Muscles involved and their nerve supply. Therapy of Cough: Antitussives and mucolytic agents . Intrapleural. Therapy of Tuberculosis: Classification according to antibacterial effect. Lung compliance. significance. 59 . mechanism of action. Therapy of COPD. Sex hormones: preparation and antagonists. PHARMACOLOGY Therapy of Bronchial Asthma . chronic. Antihistaminics: Classification. adenocarcinoma.Squamous cell carcinoma. Pleural Lesions: Mesothelioma. Regimens and prophylaxis. adverse effects.examples for each group. usefulness and limitations. Comparison between primary and secondary antitubercular drugs. PHYSIOLOGY Functional Anatomy of Respiratory System. Severe acute asthma (status asthmaticus) Classification of drugs. advantages and disadvantages of each group. Investigations: examination of sputum and pleural fluid. small and large cell carcinomas. bronchioloalveolar carcinoma. composition of air in atmosphere and alveoli. Mechanism of action. Functional anatomy. comparison of various groups. airway resistance. adverse effects. pneumothorax. their limitations. Discussion of individuals drugs under mechanism of actions. gas laws Mechanism and Mechanics of Breathing: Movements of thoracic cage during respiration. intrapulmonary pressures and volume changes during inspiration & expiration. Pressure-volume inter-relationships. normal values. drugs interactions. Spirometry: Lung volumes – capacities: definitions. Adverse reactions and cautions. contraindications and drug interaction. Work of breathing.

advantage and disadvantages. features. features. Carbon dioxide transport: tissue production. indications. dysponea: definition. factors influencing diffusion of gases. Haldane effect. types. Role of red blood cell. Bohr effect. vagus. integrated responses. tachypnoea. Applied physiology – shunt and alveolocapillary block. Deep sea diving – nitrogen narcosis. central. distribution. respiratory failure. Measurement of diffusion capacity using carbon monoxide. non-chemical. Principles of Lung Function Tests and non respiratory functions of the respiratory system Applied respiratory physiology Cyanosis and Asphyxia. Carbon monoxide transport and its effects Regulation of Respiration: Neural control: medulla. Hyperbaric oxygen and oxygen toxicity. physiolological basis. carriage in blood and release at the lungs. partial pressure gradients. hyperpnoea. Oxygen dissociation curve: plot. chloride shift. Respiration in Unusual Environments: Ttypes of hypoxia High altitude hypoxia. chemical. factors affecting the shift of curve. Principles of Artificial Respiration: Definition. Pulmonary Gas Exchange: Alveolocapillary membranes. Abnormal Breathing: Apnoea. space flight. Chemo-receptors: peripheral. Restrictive and Obstructive Pulmonary Diseases 60 . role in acid-base balance. Ventilation – perfusion ratio and its importance in respiratory diseases. physiological advantage of its shape. Gas Transport: Oxygen transport: factors influencing the combination of haemoglobin with oxygen. diffusion capacities. Influences on respiration. Oxygen therapy. Emphysema. principles. Pneumothorax. special features & factors influencing. pons.Pulmonary Circulation: Functional anatomy.

SEMESTER - II

CARDIOVASCULAR SYSTEM

COMMON CLINICAL PROBLEMS:
Hypertension
Ischaemic Heart Diseases
Rheumatic Fever
Rheumatic Heart Diseases

ANATOMY
Mediastinum
Heart and Blood Vessels
Applied anatomy
Surface anatomy
Radiological anatomy

BIOCHEMISTRY
Cholesterol –TAG Metabolism
Fatty Acid Metabolism
Ketone Body Metabolism
Lipoprotein Metabolism
Eicosanoids
Cardiac Muscle Metabolism

MICROBIOLOGY
Acute Rheumatic Fever
Rheumatic Heart Disease
Infective Endocarditis

PATHOLOGY
Atherosclerosis
Hypertension
Inflammatory Disease of Blood Vessels
Rheumatic Heart Disease
Infective Endocarditis
Myocardial Infarction
Cardiomyopathies
Myocarditis
Congestive Cardiac Failure
Congenital Heart Disease
Diseases of the Pericardium

PHARMACOLOGY
Therapy of Myocardial Ischaemia and angina
Therapy of Hypertension
Therapy of Congestive heart failure
Therapy of Arrhythmia - Antiarrythmic Drugs
Therapy of Hyperlipoproteinaemias

PHYSIOLOGY
Heart – a Mechanical Pump
Properties of Myocardiac Cells
Cardiac Cycle
61

Electrocardiography
Cardiac Output
Haemodynamics of Circulation
Arterial Blood Pressure and Its Regulation
Microcirculation, formation & absorption of tissue fluid & lymph
Regional Circulation
Cardiovascular Changes During Exercise
Heart Sounds and murmurs
Arterial Pulse
Hypovolemic Shock

CONTENTS

ANATOMY

Divisions of Mediastinum and Their Contents:

Pericardium:
Parts, sinuses, blood supply, nerve supply, lymphatic drainage, development, applied anatomy.

Heart
Surfaces, borders, positions, relations.

Internal structures: right atrium, right ventricle, left atrium, left ventricle, interatrial septum -
development and anomalies, interventricular septum - development and anomalies.
Conducting system of heart.

Arch of aorta; superior vena cava.

Microscopic structure of heart and blood vessels.

Development of various chambers of the heart.

Development of major arteries and veins.

Congenital anomalies of heart and major vessels.

Foetal circulation and changes at birth.

Blood supply of heart.

Surface Anatomy
Heart, arch of aorta, pulmonary trunk, superior and inferior vena cavae, innominate veins

Radiological Anatomy
X-ray chest A.P. view, coronary angiogram

BIOCHEMISTRY

Cholesterol Metabolism:
Absorption, transport, functions.

62

Synthesis, regulation of synthesis - factors - mechanism, conversion to bile acids and excretion- blood
plasma cholesterol lowering agents – biochemical basis of action, hypercholesterolaemia-implications.

Fatty acid - TAG Metabolism:
Aspects on fatty acid synthesis – tissues, precursors, overview of conversion of Acetylcoenzyme-A ⇒
fatty acid (e.g. palmitic acid), regulatory step – mechanism.
Mechanism of conversion of e.g. palmitic acid to the next higher saturated / unsaturated fatty acid,
biochemical basis of ‘nutritionally essential fatty acid’.
Triacylglycerol formation and storage.
Aspects on oxidation (β) of a fatty acid - e.g. palmitic acid ⇒ Acetylcoenzyme-A, tissues, energy
yield.
The feed - fast cycle and hormonal intervention in reciprocal regulation of lipogenesis-lipolysis.

Ketone Body Metabolism:
Formation - degradation: tissues, overview of mechanism of formation - degradation,
Conditions favoring synthesis – physiological – pathological, oxidation, advantages,
Ketonaemia – undesirable aspects.

Lipoprotein Metabolism:
Chylomicron, VLDL, LDL, HDL: aspects on formation - maturation - discharge of cargo, lipoprotein
disorders
Lipid profile - Interpretation of - normal - marginally high - undesirable profiles, variations
predisposing to common clinical disorders, biochemical basis of clinical intervention to normalise the
profile.

Eicosanoids:
Formation, biochemical functions of selected eicosanoids, mechanisms inclined to pharmacological
intervention.

Metabolism in the Cardiac Muscle:
Fuel molecules, energy metabolism, metabolic alterations if tissue is made anoxic, biochemical aspects
of MI, cardiac markers. Reperfusion-injury due to free radicals.

MICROBIOLOGY

Acute Rheumatic fever/ RHD: Aetiopathogenesis, clinical features, laboratory diagnosis.
Infective endocarditis: types of endocarditis, predisposing factors, Causative agents (Streptococcus
viridians, Staphylococci, Gram Negative bacilli, HACEK group ( heamophilus, actinobacillus,
cardiobacterium, eikenella, kingella). Collection of appropriate specimen, Laboratory diagnosis.
.

PATHOLOGY

Atherosclerosis:
Risk factors, aetiopathogenesis.
Gross and microscopic features of atheromatous plaques, complications, aneurysms.

Hypertension:
Definition, classification, aetiopathogenesis, morphological changes, complications.

Inflammatory Diseases of Blood Vessels:
63

pathology. indications. therapeutic uses and drug interactions. pathology. Myocarditis: Aetiology. PHARMACOLOGY (Mechanism of action. mechanism of action. gross and microscopic features. Mechanism of action. Drugs: Classification. Therapy of arrythmics: Antiarrythmic drugs: Classification. types of vasculitis. Congenital Heart Disease: Examples. Contraindications. Mechanism of action. pathogenesis. Indications. Management principles: non-pharmacological. Adverse effects. Therapeutic Uses and Drug interactions Therapy of hyperlipoproteinaemias: Classification. mechanism of action. Adverse effects. complications. review.Thromboangitis obliterans. Diseases of Pericardium: Acute pericarditis – aetiology. Myocardial Infarction: Aetiopathogenesis. complications. Rheumatic Heart Disease: Aetiopathogenesis. Cardiomyopathies: Types. complications. rationale for use. Contraindications. adverse effects. pharmacological. Fallot’s tetralogy. Therapeutic Uses and Drug interactions 64 . Adverse Effects and Contraindication of following therapeutic agents) Therapy of Myocardial Ischaemia and Angina: Antianginal drugs: Classification. Infective Endocarditis: Aetiopathogenesis. Antihypertensive drugs: Classification. Mechanism of action. Therapy of Congestive heart failure: Types. Contraindications. Adverse effects. Therapeutic Uses and Drug interactions Therapy of Hypertension: Introduction and grading. gross and microscopic features. adverse effects. combination therapy. contraindication and drug interaction. gross and microscopic features. Congestive Cardiac Failure: Pathophysiology.

Cardiac Cycle: Mechanical and electrical events. velocity. variations. principle. ECG recording techniques. cutaneous. Reynold’s number. electrical properties of working myocardial cells. its importance. normal values and variations. All . contraction coupling. length-tension relationships. Edema. neural influences. turbulent flow. Origin of lymphatics. Frank-Stralings Law.Regulation of blood volume and pressure- Role of kidneys . Microcirculation Functional anatomy. Reabsorption of tissue fluid .or . humoral and autoregulation. splanchnic. Local regulation of blood flow to tissues . Regulation of heart rate and stroke volume. flow. factors affecting blood flow and resistance.baroreceptors. determinants.PHYSIOLOGY Heart . its limitations. 65 . (role of vasoconstrictors and vasodilators). critical closing pressure. mean arterial pressure. ANP ADH. normal value. Types of blood vessels. resistance. pressure-volume relationship.a Mechanical Pump: Design of systemic and pulmonary circulation. flow. Cardio-vasomotor centers. mechanisms of spontaneous generation of impulses. Mechanism of reflex control. specialized conducting system. Fick’s principle and its application. resistance.none phenomenon. Arterial Blood Pressure and Its Regulation: Definition. special features. foetal. molecular basis of contraction and excitation. CNS ischemic response Long term control . their functions. regulation. Introduction of the terms: pressure. Poiseuille law. Formation. Properties of Myocardiac Cells: Site of generation of cardiac impulse: pacemaker tissue. Cardiac Output: Definition. Role of chemoreceptors.Neural. mechanism of formation and absorption of tissue fluid (Starling’s forces) mechanism and routes of absorption of tissue fluid. Electrocardiography: Definition. cerebral. measurement. waves and their genesis. RAAS. uses. major determinants of cardiac output and regulation. Haemodynamics of Circulation: Definition of terms – pressure. Regional Circulation: Coronary. Laminar flow. effect of Ca2+ ions and chemicals on myocardial contractility. circulation and functions of lymph. . Normal values. their significance. higher influences Regulation of BP Short term reflex control .

Decompensation in shock 66 . Beneficial effect of tracing an HR. types.Cardiovascular Changes During Exercise: Cardiovascular changes during exercise. characteristics.origin of systolic and diastolic murmurs in relation to cardiac cycle and their hemodynamic effects Arterial Pulse: Normal. Murmurs . Effect of ‘G’ on cardiovascular functions. compensatory mechanisms – short term and long term. BP and blood flow in muscle. Hypovolemic Shock . SV.Pathophysiology Definition and causes. abnormal. Heart Sounds: Normal.

Morbidity: concept of incidence and prevalence of disease. Preventive dentistry. The skills of communication. ratio and proportion. The art of communication. advantages and disadvantages of the methods. Domestic environment. Significance of time.g. posters. place and person distribution in Epidemiology. • Plan and conduct health education sessions for an individual and community using different health educational aids. specific and standardized death rates. Uses of Epidemiology in hospital. Planning a health education programme Information Education Communication strategies Evaluation of health education activities. Mortality: concepts of crude. community and health planning. • Design different health education aids e. Objectives: • Understand and describe the basic epidemiological measures.g. • List and describe sources of epidemiological data. Objectives: • Describe health education methods. rate. • Communicate effectively with the individual. family and community. Practical exercise: Preparing and conducting a health education session on an issue like: Personal hygiene. Methods of overcoming resistance in the individual. • Evaluate a health education programme. scripts for role play etc. SEMESTER – II COMMUNITY MEDICINE EPIDEMIOLOGY-I Themes and Topics: Definition of Epidemiology. Principal Teaching-Learning Methods to Be Used: Small group discussion Simulated practical exercises in class room Practical exercises in field situations: to calculate the various indices using data from hospital or community Lecture discussion INFORMATION EDUCATION COMMUNICATION (IEC) Themes and Topics: Health educational methods including A-V aids for individual. Clean water. Sources of epidemiological data. group and mass: significance. • Use basic epidemiological tools to make rational decisions relevant at the individual and community level. Basic measures in Epidemiology e. 67 .

effects and control Ventilation Lighting Radiation Hazards Hospital Waste Management Urban Health Global warming Meteorology of Medical Relevance Mosquito Housefly Lice Ticks Fleas Sandfly Reduviid Bugs Rodents and Their Control (General principles only to be covered. ozone layer. talking to a couple about family planning. • Describe and identify the arthropods of medical importance. Use of Video films to demonstrate simple methods of health education and uses of simple A-V aids: films covering the following topics may be used. ENVIRONMENTAL HEALTH II (including Entomology) Themes and Topics: Air Pollution : source. green house effect. • Describe the long-term effects of smoke inhaled by the housewife while preparing meals for the family. effects. Principal Teaching-Learning Methods To Be Used: Lecture discussion Demonstration Small group discussion 68 . have it discussed with preceptor. cause of air pollution and describe appropriate measure Prevention. asking a woman about nutritional habits and beliefs etc. control. • Principles and importance of rodent control. • Describe measures to control and mitigate effects of such pollution.) Objectives: • Define air pollution. and deliver using simple A-V aids. • Describe the sources of environmental pollution and its impact on health. Students action: Each student will prepare a health education session plan. • List the hazards of smoking. avoiding engineering details. • Describe and apply measures to control such arthropods.Steps in communication: Overcoming difficulties and resistance to communication in the individual Wrong methods of communication / interviewing. Energy Conservation: alternate sources of energy Noise Pollution: source.Principal Teaching-Learning Methods To Be Used: Lecture discussion Demonstration Small group discussion Simulated practical exercises in class room: Role-play-students to be encouraged to role-play based on different themes provided by the preceptors e.g. debriefing at the end of the session.

life expectancy.determinants of fertility: biological and behavioral determinants Fertility related statistics. (Family welfare programme. Transmigration. Principal Teaching-Learning Methods To Be Used: Lecture discussion Small group discussion Simulated practical exercises in class room 69 . DEMOGRAPHY Themes and Topics: Importance of Demography Demography Cycle World population trends: regional differences. population surveys. sex ratio.Practical exercises Student action: During the family health exercise students will identify environmental Problems and suggest appropriate remedial measures. Effect on population of changes in birth. Vital statistics and methods of collection: census. literacy. age pyramids. family size. registration of vital events. population policy will be covered in the 6th semester) Objectives: • Describe the basic demographic pattern of the country. birth and death rates. • Define vital statistics. urbanisation. Demographic trends of the country: age and sex composition. Fertility . Growth Rates. density of population. describe their methods of collection. Hospital records. death and growth rates.

identify normal structures in diagrams. 3. 8. angiograms. integrate basic sciences with clinical problems related to respiratory system and cardiovascular system. blood and other investigations in relation to respiratory system and cardiovascular system. SEMESTER . 6.II INTRODUCTION TO CLINICAL MEDICINE THEMES AND TOPICS Examination of Respiratory System Examination of Cardiovascular System At the end of Semester II. 4. correlate anatomical locations of organs and describe steps of clinical examinations. and on patients and supplementary video. Instructional Methods: Lectures in class room. demonstrate locations of important structures related to respiratory and cardiovascular over the chest. echocardiograms. 70 . neck and limbs. as appropriate. familiarise with X-ray chest. practice on peers the method of clinical examination of respiratory system and cardiovascular system. take good history related to respiratory and cardiovascular system. the undergraduate medical students should be able to: 1. ECG. practical demonstrations. 7. recall the structures of respiratory and cardiovascular systems. practice on Peers. 2. 9. mention the steps followed in performing cardiopulmonary resuscitation. sputum. 5.

special senses and reproductive system to understand diseases process affecting these systems. metabolic and homeostatic functions and their functional impairments encountered in common clinical conditions. CONTENTS: Gastrointestinal System Hepatobiliary System Renal-Electrolyte System Metabolism and Endocrine System Reproductive System Central Nervous System and Special Senses Community Medicine Introduction to Clinical Medicine (ICM) 71 . SEMESTER – IV  provides learning inputs in structural-functional aspects on the nervous system. SECOND YEAR SEMESTERS .III & IV OBJECTIVES: SEMESTER – III  provides learning inputs in digestive-absorptive. excretory.

Lipids-Digestion & Absorption. Obesity MICROBIOLOGY Normal Flora Gastrointestinal Infections Pathogens: Bacteria. Starvation.III GASTROINTESTINAL SYSTEM COMMON CLINICAL PROBLEMS: Worm infestation Acid-peptic disease Diarrhoea Dysentery Constipation Colitis ANATOMY Oral Cavity Pharynx Oesophagus Stomach Intestines Appendix Pancreas Rectum Anal Canal Pancreas Anterior Abdominal Wall Posterior abdominal wall Lumbar vertebrae Surface anatomy Radiological anatomy Applied anatomy BIOCHEMISTRY Biochemical Principles to Nutrition Digestion and absorption Carbohydrates-Digestion & Absorption. Virus. Parasites Food Poisoning PATHOLOGY Oral pathology – Premalignant Lesions Squamous Cell Carcinoma Pleomorphic Adenoma Barret’s Oesophagus Carcinoma of the Oesophagus Peptic Ulcer (acid-peptic disease) Carcinoma of the Stomach Tuberculosis of Intestine Typhoid-Intestine 72 . SEMESTER . Proteins-Digestion & Absorption.

microscopic structures Stomach: 73 .Appendicitis Amoebic Colitis Necrotising Enterocolitis Ulcerative Colitis and Crohn’s Disease Polyps of Large Intestine Carcinoma of the Colon Acute Pancreatitis Carcinoma of the Pancreas PHARMACOLOGY Drug therapy for peptic ulcer Emetics and Anti-emetic agents Drugs for diarrhea and constipation Anthelminthics Antiprotozoals Hepatotoxic drugs PHYSIOLOGY Introduction Oral cavity Deglutition Secretions Motility of Gut Functions of Colon Gastrointestinal Hormones Vomiting Defecation CONTENTS ANATOMY Gross Anatomy: Regions and quadrants of abdomen Umbilicus: normal position. parts. microscopic structure Salivary glands: development. relations. gross features. Gastrointestinal tract: development and congenital anomalies Peritoneum and Subdiaphragmatic spaces Oesophagus: Extent. innervation. microscopic structure Pharynx: Gross features. blood-supply. sacrum and coccyx. blood supply. nerve supply. umbilical hernia Lumbar vertebrae. lymphatic drainage. normal constrictions. XII rib. and hip bone Oral cavity: Teeth: dental formulae. gross features. microscopic structure of adult tooth Palate: development and gross features Tongue: development.

position. microscopic structure Large Intestine: Parts. pancreas. microscopic structure. nerve-supply. Rectus abdominis Inguinal canal: boundaries. cardinal features Differences between small and large intestines Blood supply and nerve supply Caecum and Appendix: position. relations. duodenum. blood supply. boundaries and contents. nerve supply. inguinal hernias Posterior abdominal wall: Muscles and fasciae. regional differences between jejunum and ileum. and lymphatic drainage Rectum and anal canal: parts. gross features. applied aspects Jejunum and Ileum: gross features. ileo-caecal junction. blood supply. lymphatic drainage. relations of different parts.Thoracolumbar fascia Abdominal aorta: Extent and branches Infereior vena cava: formation and tributaries Lumbar plexus: Formation and branches Abdominal parts of the sympathetic and parasympathetic subdivisions of the autonomic nervous system Cisterna chyli Surface anatomy Anterior superior iliac spine. gross features. gross features. Anterior abdominal wall: Flat muscles. blood-supply. lymphatic drainage. nerve supply.microscopic structures. applied aspect. blood supply. nerve-supply. relations. applied anatomy. development. and posterior superior iliac spine Stomach. Rectus sheath: Formation. blood-supply. iliac crest. contents in males and females. and lymphatic drainage Pancreas: Parts. and McBurney’s point 74 . lymphatic drainage. microscopic structure.gross features. blood-supply. microscopic structure of appendix Colon: parts. applied aspects Small Intestine: Duodenum: gross features. caecum Base of appendix.

pancreatic. malabsorption. cystic fibrosis. Intestinal absorption of lipids. energy expenditure related to BMR. Caloric value (Atwater Factors) of carbohydrate. Clostridium difficile b. Digestion and absorption: Digestive enzymes. dysentery. Energy requirement: with age. pancreatic. intestinal enzymes. Dietary fiber: types. Protein intolerance. pancreatic . barium meal and barium enema BIOCHEMISTRY Biochemical Principles to Nutrition: BMR: factors affecting. Lipids Digestion: Dietary lipids. diarrheoea. Acquisition and transmission of infections. Proximate principles of diet. disadvantages. RDA. NaHCO3 secretion by pancreas. b. Intestinal absorption of monosaccharides: glucose. MICROBIOLOGY Normal flora. protein energy under-nutrition. requirement. pseudomembraneous colitis (enterocolitis). Proteins Digestion: Enzymatic digestion of proteins . composition of pancreatic . protein requirement. Nutritional importance of protein. Maldigestion. intestinal enzymes. H pylori. Virus: Viral diarrhea (Rotavirus. role of bile. specific dynamic action and respiratory quotient. Enzymatic digestion of lipids :. adenovirus etc).NaCl absorption and secretion.carrier systems for absorption of amino acids.gastric. Starvation and Obesity: Biochemistry of starvation and obesity. steatorrhoea. secretagogues. Intestinal absorption of amino acids . Salmonella typhi and paratyphi. galactose. Mechanism of absorption of glucose. gastric and bile secretion Carbohydrate Digestion: Dietary carbohydrates. for physical activity. Shigella. fat. c. laboratory diagnosis. diarrhoea. protein. Bacteria: E coli. advantages. fructose. ethanol. host defenses. Vibrio cholera. Norwalk virus. causative agents of gastroenterititis. Pathogens: a. Lactose intolerance. GI Infections: Terminology. Parasite 75 .Radiological anatomy Plain X-ray of abdomen Contrast X-rays of barium swallow. Enzymatic digestion of carbohydrates: salivary.

Giardia lamblia. Tenia saginata. complications. gross and microscopic features. Peptic Ulcer: Definition and sites of occurrences. Trichuris trichiura Food poisoning: Bacterial and mycotic poisoning PATHOLOGY Oral Pathology – Premalignant Lesions: List. Comparison of morphology of tubular and villous adenomas. Polyps of Large Intestine: Classification. gross and microscopic features. Entameba histolytica. gross and microscopic features. Balanitidium coli. Morphology. Carcinoma of the Colon: 76 . Classification. Typhoid of Intestine: Pathogenesis. Ulcerative Colitis and Crohn’s Disease: Aetiology. Pleomorphic Adenoma: Classification. Amoebic Colitis: Aetiology. complications.Protozoa . gross and microscopic features and complications. gross and microscopic features. Barret’s Oesophagus: Carcinoma of the Oesophagus: Aetiopathogenesis. Diphylobothrum latum. morphology. Strongyloides stercoralis. Ancylostoma duodenale. Necator americans. Appendicitis: Pathogenesis. Squamous Cell Carcinoma: Aetiopathology. life cycle. pathogenesis. pathogenicity. complication of Entameba histolytica infection Worms – Ascaris lumbricoides. morphology. complications. gross and morphology of pleomorphic adenoma. Tuberculosis of Intestine: Pathogenesis. complications. complications. gross and microscopic features. Carcinoma of the Stomach: Benign and malignant. Tenia solium. gross and microscopic features. aetiopathogenesis. Enterobias vermicularis. gross and microscopic features. Necrotising Enterocolitis: Pathogenesis and morphology. laboratory diagnosis.

gross and microscopic features. Stomach: 77 . its mechanism of action. Non. morphology and complications. PHARMACOLOGY Therapy of peptic ulcer Introduction. stages. Physiology of Deglutition: Definition. mechanism of action. uses.list. adverse effects and drug interactions. Therapy of nausea and vomitimg Classification. uses. adverse effects.Classification.constituents. innervation of the gut. Carcinoma of the Pancreas: Morphology and complications. digestion in the mouth. Therapy of diarrohea Oral rehydration solution . regulation of GI function. adverse effects and drug interactions. Non-drug treatment. indications. mechanism of action.Pathogenesis. drug interactions and contraindications Therapy of amoebiasis and giardiasis Antiprotozoals Classification. general overview. Non-drug treatment. mastication. Acute Pancreatitis: Aetiopathogenesis. mechanism of action. enteric nervous system. Therapy of worm infestation Anthelminthics List the drugs. Hepatoxicity of drugs Brief discussion PHYSIOLOGY Introduction to Gastrointestinal Physiology: Functions of gastrointestinal system.specific antidiarrhoeals and antispasmodics . adverse effects and drug interactions non-drug measures. adverse actions. uses. pathogenesis list of durgs .regulation. composition. functions. Therapy of constipation Commonly used drugs in constipation. uses. Oral Cavity: Salivary secretion – mechanism of formation. clinical importance. individual parts. neural control.

Pancreatic Secretions (exocrine) Composition. functions and their control. Gastric mucosal barrier Digestion & absorption in stomach. Gastric motility .characteristics. control. functions. Physiology of gastric secretion . movements. control. Large Intestine: Movements. their regulation and functions.mechanism. functions and control Gastrointestinal Hormones: Role in secretomotor functions of the gut. Functions. Physiology of Vomiting: Reflex mechanism involved Defecation: Mechanism. control. gastric emptying. 78 .Overview of functions. Experimental procedures to elucidate phases of gastric secretion. control. composition. Small Intestine: Exocrine and endocrine secretions. antral pump mechanism.

Hepato-portal System Hepatobiliary Apparatus. Applied anatomy Surface anatomy Radiological anatomy BIOCHEMISTRY Carbohydrate Metabolism Bile Acids Bilirubin Metabolism Jaundice Liver Functions and tests Urea Cycle and blood urea Vitamin K MICROBIOLOGY Hepatobiliary Parasitism Hepatitis – A. C. B. SEMESTER . Amoebic Liver Abscess Cirrhosis of Liver ANATOMY Liver. Bile Duct. D. E PATHOLOGY Jaundice Cirrhosis of Liver Viral Hepatitis Portal Hypertension Hepatocellular Failure Liver Abscess – Amoebic and Pyogenic Tumours of Liver Chronic Cholecystitis Cholelithiasis Carcinoma of the Gall Bladder PHYSIOLOGY Liver Functions Mechanism of Formation of Bile Regulation of Bile Synthesis and Secretion Gall Bladder Liver Function Tests CONTENTS ANATOMY 79 .III HEPATOBILIARY SYSTEM COMMON CLINICAL PROBLEMS: Infective Hepatitis Jaundice Amoebic Hepatitis. Gall Bladder.

plasma enzyme elevations. Urea cycle disorders and ammonia toxicity. metabolic. organ / tissues. applied anatomy. fundus of gall bladder Radiological anatomy: cholangiogram BIOCHEMISTRY Carbohydrate Metabolism: Gluconeogenesis: importance.liver and gall bladder. 80 . excretory. reciprocal regulation of glycogenesis and glycogenolysis. hepatocyte involvement. congenital anomalies of hepatobiliary system.Liver. Gall bladder. regulated enzymes. Bile Acids: Synthesis and role in digestion of lipids. metabolic functions. secretory. glycogenolysis. Hepatobiliary Apparatus Parts. detoxication. precursors. regulation. Surface anatomy: Inferior border of liver. organ / tissues. gross anatomy. Physical-chemical properties of urea. secretory. Vitamin K: Metabolism. glycogenesis. excretory. Blood and urine levels. Bilirubin Metabolism: Tissue cells involved. hormonal influence – hormonal mechanism of action. overview of pathways. biochemical differentiation. Development. Urea cycle and blood urea: Tissue location Generation of ammonia Flow of nitrogen into ‘ornithine-urea cycle’. intracellular site/s. Microscopic structure . effect of hormones. Liver Function tests: Tests based on: synthetic. pathway overview. Glycogen metabolism: purpose. detoxication. Liver Functions: Functions from a biochemical angle: synthetic. physiological-pathological conditions causing alterations. enterohepatic circulation of urobilinogen. Jaundice: Types. Bile duct and Hepato-portal System: Gross features. genetic disorder of bilirubin metabolism. enzymes and intermediates relation of urea cycle and TCA cycle. Uronic acid pathway: purpose. further metabolism of bilirubin diglucuronide in the gut. properties of the end product. organ.

Mechanism of Formation of Bile. E. Liver abscess – Amoebic and Pyogenic: Gross and microscopic features.Mechanism of activation of clotting factors II. types. hepatoblastoma: gross and microscopic features. laboratory diagnosis. formation of urea. storage. Portal Hypertension: Definition. interpretation of immunomarkers PATHOLOGY Jaundice: Types and pathogenesis. IX. D.B. aetiologic and morphologic types. complications. Carcinoma of Gall Bladder: Gross and microscopic features. C. complications. hepatic macrophage. pathogenesis. hemolysis of R. A. Cholelithiasis: Pathogenesis. MICROBIOLOGY Hepatobilliary parasitism: C sinensis. morphology. VII. synthesis of proteins.. sequelae of acute viral hepatitis. properties. Hepatocellular Failure: Pathophysiology.defense mechanism. Viral Hepatitis: Aetiology. X. major clinical consequences.C. Fasciola hepatica. clinical picture. Infective hepatitis. Morphology with special reference to alcoholic cirrhosis. PHYSIOLOGY Liver Functions: Carbohydrate. Cirrhosis of the Liver: Definition. G: virus structure. laboratory diagnosis. Tumors of Liver: Classification. gross and microscopic features. immunomarkers. gross and microscopic features. complications. Chronic Cholecystitis: Aetiology. fat & protein metablosim. Echinococcus granulosus.morphology. and clotting factors. life cycle. hepatocellular carcinoma. endocrine (release of Erythropoietin & thrombopoietin). modes of transmission. B. 81 . Detoxification of drugs.

Regulation of gall bladder contraction . secretion. regulation & enterohepatic circulation.mechanism. 82 .Bile formation. Gall Bladder: Functions. Liver Function Tests: Physiological basis.

treatment of Diabetes insipidus Nephrotoxic drugs Drugs in urinary tract infection 83 .III RENAL AND ELECTROLYTE SYSTEM COMMON CLINICAL PROBLEMS: Urinary Tract Infection Glomerulonephritis Nephrotic Syndrome Urinary Calculi Haematuria Albuminuria Renal Failure ANATOMY Kidney Ureter Urinary Bladder Urethra Applied anatomy Surface anatomy Radiological anatomy BIOCHEMISTRY Role of Kidney in Acid-Base Regulation Metabolic Acidosis . SEMESTER . Calculi. Tumors Systemic Lupus Erythematosus Examination of Urine PHARMACOLOGY Diuretics Antidiuretics.Alkalosis Water and electrolyte balance Renal Function Tests Amino acid Metabolism MICROBIOLOGY Urinary Tract Infection Renal Tuberculosis PATHOLOGY Polycystic Kidney Glomerular Diseases Glomerulonephritis Nephrotic Syndrome Acute Tubular Necrosis Renal Failure Pyelonephritis Nephrosclerosis Hydronephrosis Renal Calculi Tumours of Kidney Urinary Bladder – Cystitis.

vascular segments. ‘essential–non-essential amino acid’ concept. methionine. homocystinuria. protein–amino acid turnover. applied aspects. and microscopic structure Urethra: development. course in males and females. phenylketonuria.PHYSIOLOGY Over view of functions of the kidney Functional Unit of Kidney Glomerular Filtration Tubular Functions Micturition Renal Function Tests Cystometrogram CONTENTS ANATOMY Kidneys: development. principle. nerve supply. tryptophan. alkaptonuria. asparatic acid. extent. mapple syrup disease. Amino Acid Metabolism: Amino acid pool. methylmalonic aciduria. blood supply. development. cystinuria. and microscopic structure Urinary bladder: retropubic space (of Retzius). gross features. Commonly clinically encountered aminoacidopathies (viz.. Tyrosinosis. water balance. Key steps of metabolism of: phenyl alanine. gross features. gross features and relations (in males and females). Renal Function Tests: Tests. kidneys and ureters Radiological anatomy: plain X-rays of KUB region. relations (in males and females). lymphatic drainage.) 84 .Metabolic Alkalosis and compensation: Water and electrolyte balance: Sodium and Potassium homeostasis. contrast X-rays of Intravenous urography BIOCHEMISTRY Role of Kidney in Acid-Base Regulation: Metabolic Acidosis . and microscopic structure Ureters: development. general overview. Hartnup disease. method. glutamic acid. tyrosine. ‘glucogenic amino acid’ concept. interpretation of findings. Metabolism of individual amino acids: alanine. anterior and posterior relations of right and left kidneys. disorders. and microscopic structure Surface anatomy: Parallelogram.

pathophysiology. Renal Failure: Concept. Chronic pyelonephritis: aetiopathogenesis. types. morphology. aetiopathogenesis. stages. morphology. aetiophathogenesis. Glomerular Diseases (in general): Clinical presentation. Hydronephrosis: Definition. morphology. morphology. Modern techniques of diagnosis PATHOLOGY Polycystic Kidney: Adult and childhood . Chronic glomerulonephritis. complications. Nephrotic Syndrome: Definition. morphology. 85 .aetiopathogenesis. Glomerulonephritis: Classification. pathogenesis. Acute pyelonephritis: aetiopathogenesis. morphology. renal cell carcinoma. Acute post-streptococcal glomerulonephritis . Rapidly progressive glomerulonephritis: type. laboratory diagnosis Renal tuberculosis and Schistosomiasis: Pathogenesis.morphology. morphology. sequelae. Acute Tubular Necrosis: Definition. Diabetic nephropathy. morphology. causes. Nephrosclerosis: Benign and malignant: definition. Differences between Nephritic syndrome and Nephrotic syndrome. laboratory diagnosis. causes – minimal change disease (lipoid nephrosis). Pyelonephritis: Definition. organisms. aetiopathogenesis. membranoproliferative glomerulonephritis and focal segmental glomerulosclerosis. morphology. causes.MICROBIOLOGY UTI: types of Urinary Tract Infection. Renal Calculi: Aetiopathogenesis. Membranous glomerulonephritis. Tumours of Kidney: Wilm’s tumour.

Renal circulation: pressure profile. Glomerular Filtration: Structure of glomerulus and filtering membranes. Calculi: types. dilution. Role of hormones in their absorption & secretion. Adverse Effects and Contraindications Antidiuretics: Vasopressin analogues. morphology. water diuresis. functional significance. mechanism of formation and composition of glomerular filtrate. Water excretion – mechanisms of concentration. generation of medullary osmotic gradient. functions. Countercurrent mechanism. Tumour: transitional cell carcinoma. aetiopathogenesis. Mechanism of Action. . peculiarities. Micturition: Definition. Mechanism of formation of acidic & alkaline urine. Examination of Urine: Urine Examination in UTI. variations. analgesics. Define and list urinary antiseptics. Indications. methods of measurement. PHARMACOLOGY Diuretics: Classification. 86 . Adverse Effects and Contraindications Treatment of Diabetes insipidus Vasopressin antagonists Nephrotoxic Drugs: Drugs. Review antimicrobials of choice for common infections PHYSIOLOGY Overview of functional anatomy of kidney: Nephron – divisions of nephron. Role of kidney in homeostasis. precautions. its physiological importance. Systemic Lupus Erythematosus: Lesions in kidney. gross and microscopic features. complications. Indications. Tubular Functions: Mechanisms of reabsorption.Urinary Bladder: Cystitis: types. secretion of electrolytes and other substances in various segments of nephrons. morphology. factors influencing and regulation of GFR. Processes involved in urine formation. Mechanism of Action. Urinary Tract Infection: Common organisms.

Micturition reflex and its higher neural control Renal Function Tests: Physiological basis. Cystometrogram: Principle. 87 .Nerve supply of urinary bladder and its control.

SEMESTER .III METABOLISM AND ENDOCRINE SYSTEM COMMON CLINICAL PROBLEMS: Diabetes Mellitus Goiter Thyrotoxicosis Osteoporosis ANATOMY Pituitary Gland Pineal Gland Thyroid Gland Parathyroid Gland Adrenal Gland BIOCHEMISTRY Hormones Pituitary Thyroid Calcium Homeostasis Regulation Endocrine Pancreas Adrenal Cortex PATHOLOGY Pituitary Gland Thyroid Gland Parathyroid Gland Metabolic Bone Diseases Adrenal Gland Endocrine Pancreas PHARMACOLOGY Anterior pituitary Hormones & Analogues. Thyroid and Antithyroid Drugs Drugs affecting calcium balance and bone turnover Adrenocorticosteroids and Synthetic Analogues Drug therapy for Diabetes Mellitus PHYSIOLOGY Introduction to Endocrinology Hypothalamus Pituitary Gland Thyroid Gland Calcium and Phosphorus Metabolism Adrenal Cortex Adrenal Medulla Stress Endocrine Pancreas Pineal Gland 88 .

regulation of. steroid. and microscopic structure of adrenal cortex Applied anatomy BIOCHEMISTRY Classification of Hormones: Polypeptide. blood supply. relations. Pituitary Hormones: Classification of anterior Pituitary. gross features. calcitonin. venous drainage. Adrenal Cortex: Hormones of adrenal cortex. transport. blood supply. Parathyroid hormone: physiological effects and mechanism of action. Endocrine Pancreas: Insulin: synthesis. location. functions. Iodine metabolism and thyroid function tests. Calcitonin – source. Ca2+ as an intracellular messenger. deficiency symptoms. and microscopic structure Pineal gland: development. vitamin-D. transport. biochemical pathways in operation. blood supply. biochemical effects Glucagon: biochemical effects. consequences of hypo and hyper parathyroidism. Mechanism of Hormone Action: Polypeptide. physiologic and biochemical action. second messenger. Vitamin D: source. Calcium Homeostasis Regulation: Integrated role of parathormone. Homeostasis of blood glucose: Normoglycaemia maintenance in fed – fasted conditions. blood supply. regulation of release. 89 . renal glycosuria. Conns disease. Hypoglycemia. metabolic syndrome. location. regulation. diagnostic and prognostic tests. transport. and microscopic structure Parathyroid glands: development. biosynthesis. mechanism of action. lymphatic drainage. CONTENTS ANATOMY Pituitary gland: development. hormonal play. pathophysiology Thyroid Hormones: Chemistry. metabolism. Diabetes mellitus: definition. biochemical basis of clinical complications. biochemical investigations. physiologic and biochemical action. location. metabolism. location. gross features. classification. Addisons disease. Cushing syndrome. functions. chemistry. surface marking. and microscopic structure Adrenal gland: development. degredation and metabolic effects. and microscopic structure Thyroid gland: development. steroid. biosynthesis. blood supply. location. pathophysiology Classification of posterior Pituitary. physiological effects.

Diabetes Mellitus: Aetiopathogenesis of IDDM and NIDDM. morphology. Parathyroid Gland: Primary and secondary hyperparathyroidism. Zollinger– Ellison syndrome. Tumours – classification. clinical features. Prolactinoma. thyrotoxicosis. Morphological changes. Goiter – types. morphology. Thyroiditis – Hashimoto’s. follicular carcinoma. morphology. Grave’s disease – aetiology. papillary carcinoma.somatotropic adenoma.PATHOLOGY Pituitary Gland: Hypopituitarism: causes and brief discussion on Sheehan’s syndrome. Granulomatous – aetiology. adverse effects Thyroid and Antithyroid Drugs: 90 . Pheochromocytoma. uses and adverse effects Growth hormone inhibitors Prolactin analogues and inhibitors – uses. myxoedema. gross and microscopic features of – Thyroid adenoma. aetiopathgenesis.Causes. aetiology. Neuroblastoma. Tumours – adrenal adenoma. Tumours : Parathyroid adenoma – causes. pathogenesis. pathogenesis. Craniopharyngioma. anaplastic carcinoma. adverse effects GnRH agonist and antagonist preparations. gross and microscopic features. uses. medullary carcinoma. Hyperpituitarism: causes and brief discussion of pituitary adenoma . Adrenal Gland: Cushing’s syndrome. Adrenogenital syndrome. adverse effects Gonadotropin preparations. uses. morphology. corticotropic adenoma. cortical carcinoma . Brown tumour of Hyperparathyroidism Hypoparathyroidism.gross and microscopic features. complications. Metabolic Bone Diseases: Rickets and osteomalacia – clinical features. Empty SellaTurcica’s syndrome. Hypothyroidism – cretinism. morphology. PHARMACOLOGY Anterior pitutary hormone GH and its analogues. Diabetes insipidus. Thyroid Gland: Hyperthyroidism – causes. pathogenesis. Addison’s disease. Multiple endocrine neoplasia.

Concept of hypothalamo-hypophyseal portal sysetm. therapeutic implications of parathormone. Contraindications. Posterior pituitary: Hormones. Drugs affecting calcium balance and Bone Turnover : Integrated physiological role.clinical symptoms. Enumerate other drugs that may alter the blood sugar level. Oxytocin. mechanism of action. general mechanisms of action. oral hypoglycaemics. mechanism of action.names of hormones. functions and regulation of secretion and disorders.Review biosynthesis and physiology of thyroid hormones. 91 . regulation and physiological actions. Growth hormone – release. regulation of release. Adverse effects. Consequences of excess and deficiency of thyroid hormones. mechanism of action hyperactivity. Adverse effects. calcitonin and vitamin-D. Principles of management.explain the uses and the rationale. concept of second messenger. Adrenal Cortex: Glucocorticoids . Contraindications. uses and adverse effects Adrenocorticosteroids and Synthetic Analogues: Review the synthesis. enumerate the preparations and compare the salient features. Drugs for treating hypo and hyperthyroidism. Bisphosphonates – classification. role of insulin. PHYSIOLOGY Introduction to Endocrinology: Definition of hormones. Mechanism of action. mechanism of action. pathogenesis. regulation of secretion. Hypothalamus: Role of hypothalamus in the regulation of secretion of hormones of anterior and posterior pituitary. regulation of release. Anterior Pituitary: List the hormones. Thyroid Gland: Review biosynthesis of T3 and T4. Physiological effects. (discuss the common drugs as per format) List drugs that can cause hyper or hypothyroidism. classification.review. hyperthyroidism. consequences of hypothyroidism. Glucagon . physiological effects. Parathyroid Gland: Calcium and phosphorus metabolism. Drug therapy for Diabetes Mellitus: Diabetes . Vasopressin -. physiological actions. consequences of hyper and hypo secretion. Indications. Discuss the commonly used preparations under Mechanism of action. Indications. hypoactivity . List the various preparations and compare the salient features.

92 . secretion. physiological effects. consequences of deficiency and excess. regulation of secretion. physiological effects. transport. effects of excessive secretion.names of hormones. Stress: Definition. Endocrine Pancreas: Hormones. Adrenal Medulla: Review the physiological actions of epinephrine. metabolism. clinical importance. Insulin: sites of synthesis. consequences of hyper and hypo secretion. physiological effects. Insulin-glucagon molar ratio and implications in alternation. Physiological mechanisms (hormonal and neural) for coping up with stress. Glucagon . transport.names of hormones.review secretion. regulation of secretion. actions. physiological effects. mechanism of action. Sex corticoids . Beneficial and harmful effects of stress. mechanism of action. metablolism. Summary of the effects of adrenocortical hyper and hypo functions. Glucose homeostasis Pineal Gland: Hormone secreted.Mineralocorticoids . regulation of release. mechanism of action.

93 .

Under Five-Year Child to Record Growth and Development. SEMESTER . A Neonate. 94 . Principal teaching-learning methods to be used: Lecture discussion Small group discussion Simulated practical exercises in class room e. role play Field exercises COMMUNITY DIAGNOSIS ORIENTATION Themes and Topics Collect demographic data and study: The Community Environment Family Environment Family Support System Water Collection / Storage Refuse / Waste Disposal Customs / Beliefs During Pregnancy.III COMMUNITY MEDICINE SOCIOLOGY Medical Sociology. • Acquire the necessary skills for making a community diagnosis.g. Lactation. • determine the socio-economic status of a family and describe its importance in health maintenance and disease prevention. Psychology and Social Anthropology Themes and Topics Types of family Functions of family Role of family in health and disease Cultural factors influencing health and disease Social organisation and community participation Measurement of the socio-economic status of a family and its importance in health and disease Objectives • describe the role of family / community in health maintenance and disease prevention. Diet Pattern of a Pregnant. Lactating and Postpartum Woman Follow Up an Adolescent Follow Up Elderly / Disabled Persons Follow Up Eligible Couples and Provide Family Planning Advice Objectives • Describe the principles and importance of making a community diagnosis. Postpartum Customs / Practices Towards Elderly / Disabled Illness Behavior Food Practices / Customs / Beliefs Beliefs About Family Size / Son (Male) Preference Child Rearing Practices Acute Morbidity in the Family Follow Up A Pregnant Woman.

Pertusis. • Plan. Measles Diarrhea Fever HIVand AIDS Bronchial asthma / COPD Objectives • Function as a family physician. Acute respiratory infections. Principal Teaching-Learning Methods To Be Used: Lecture discussion Demonstration Small group discussion Student action: feasible community intervention involvement at regular intervals. Each student should present the allotted case individually. 95 . Student action: feasible community intervention to be done at regular intervals. • Plan. This will be followed by a visit to the patient family to determine the psycho-social aspects of the disease and the effects on the patient and family. conduct. conduct and evaluate an intervention programme with community participation. Principal Teaching-Learning Methods To Be Used: Lecture discussion. Tuberculosis. analyze. • Learn to manage the patient / family within the available health resources. Rubella. Problem-based learning. socio-cultural milieu and economic resources of the family / community. • Plan and conduct an immunization camp. Mumps . Chickenpox. • Describe the role of health services in the National Health Programs. Students will follow up and record the results of community intervention Problem based learning: Clinico-psycho-social case review---each student will be allotted a case from the hospital to take history and do a complete physical examination and reach a diagnosis. Pneumonia. Student will follow up and record the results of community intervention. FAMILY MEDICINE Themes and Topics Identify and diagnose illness in the family Follow up and study response(s) of the individual / family / community to the specific illness Identify and diagnose and manage illness in the family as a family physician to acquire familiarity with the common illnesses: e. interpret and present an epidemiological field exercise.• Diagnose and manage the common morbidity in an individual / family / community within the resources available.g. Demonstration. Diptheria. Small group discussion.

96 .

familiarise with routine blood. supplementary video. demonstrate Heimlich maneuver. SEMESTER . stool examination and with upper and lower endoscopic examination and other examinations in relation to Gastrointestinal. Metabolism and Endocrine Systems. 2. practice on peers and on patients. Hepatobiliary. 4.III INTRODUCTION TO CLINICAL MEDICINE THEMES AND TOPICS Gastrointestinal System Hepatobiliary System Renal System Metabolism and Endocrine System At the end of the Semester. perform on peers clinical examination procedures related to Gastrointestinal. 1. correlate anatomical structures of different systems while performing clinical examinations on peers. 3. Renal and Endocrine Systems. Hepatobiliary and Renal System. Instructional Methods: Lectures in class-room. the undergraduate medical students should be able to. list common problems related to Gastrointestinal.III. Renal. 97 . practical demonstrations. urine. Hepatobiliary. 5.

Biochemical test for infertility MICROBIOLOGY Introduction to STD& STI Syphillis Gonorrohoea & Non gonococcal urethritis LGV & GI Herpes simplex HIV/ AIDS Genital warts Vaginitis and vaginosis Vertically transmitted infections PATHOLOGY Male Genital Tract Benign Prostatic Hyperplasia Carcinoma Prostate Tumours of Testes Premalignant and Malignant Lesions of Penis Female Genital Tract Including Breast Cervicitis Carcinoma Cervix Endometrium Carcinoma Endometrium Leiomyoma Tumours of Ovary Trophoblastic Tumours Breast Abscess Fibrocystic Disease of Breast Tumours of Breast Paget’s Disease of Breast 98 . SEMESTER .IV REPRODUCTIVE SYSTEM COMMON CLINICAL PROBLEMS: Pregnancy – normal and abnormal Sexually Transmitted Diseases (STD) Acquired Immune Deficiency Syndrome (AIDS) Cancer cervix Pelvic inflammatory diseases ANATOMY Male Reproductive System Female Reproductive System Including Breast Pelvis Pelvic Diaphragm Radiological anatomy Applied anatomy BIOCHEMISTRY Sex hormones Synthesis and Regulation.

epididymis. Parts. broad ligament. Gross features . developmental anomalies. sexual dimorphism. congenital anomalies. seminal vesicle. penis. Gross and microscopic features of testes. breast. vas deferens. uterus. micturition and pregnancy. Female Reproductive System: Uterus. Anabolic Steroids Hormonal Contraceptives Oxytocics and Tocolytics Medication during pregnancy and lactation Sexually Transmitted Diseases Antiviral agents Drugs. development and age changes.morphology. cervix.ovary. Development .female genital system. prostate. Male genital system :. supports of uterus and other features. various diameters. PHYSIOLOGY Male Reproductive System Female Reproductive System Physiology of Fertilisation and Implantation Physiology of Pregnancy Physiology of Parturition Physiology of Lactation Physiological Basis of Contraceptive Methods CONTENTS ANATOMY Male Reproductive System: Blood supply and lymphatic drainage of: Scrotum. Breast . vagina.Gynaecomastia Acquired Immune Deficiency Syndrome PHARMACOLOGY Gonadal hormones and antagonists. Skeletal Plevis: Types. features. lymphatic drainage. Perineum: 99 .development. difference in sexes. blood supply. oviduct. structure.ovary. spermatic cord. Pelvic Diaphragm: Levator ani and connection with defecation. Microscopic structure . fallopian tube. external genitalia.

pathogenicity. etc PATHOLOGY Male Genital Tract Benign prostatic hyperplasia Carcinoma prostate Tumours of testes Premalignant and malignant lesions of penis Female Genital Tract Including Breast Cervicitis Carcinoma cervix Endometrium Carcinoma endometrium 100 . anatomy. laboratory diagnosis. pathogenicity. LH. laboratory diagnosis. contents. Rubella. Progesterone and Androgens: Synthesis. HSV. pathogenicity. laboratory diagnosis. pathogenicity.Spaces. clinical presentations. pathogenicity. Candidiasis. pathogenicity. clinical presentations. Biochemical test for infertility MICROBIOLOGY Introduction to STD & STI Syphillis: agents. CMV. complications Gonorrohoea & Non gonococcal urethritis: agents. metabolism and functions. pathogenicity. complications HIV/ AIDS: agents. clinical presentations. complications. applied.agents. Estrogen. laboratory diagnosis. laboratory diagnosis. Vertically transmitted infections: TORCH. laboratory diagnosis.agents. opportunistic infections Genital warts: papiloma virus and Molluscum contagiosum. clinical presentations. clinical presentations. clinical presentations. complications Herpes simplex: agents. complications. Applied Anatomy Radiological anatomy Salphingograph BIOCHEMISTRY FSH. bacterial vaginosis. clinical presentations. complications LGV & GI: agents. laboratory diagnosis. Vaginitis and vaginosis: Trichomonas vaginalis. Toxoplasma. Perineal Body and urogenital diaphragm. complications.

Leiomyoma Tumours of ovary Trophoblastic tumours Breast abscess Fibrocystic disease of breast Tumours of breast Paget’s disease of breast Gynaecomastia Male Genital Tract Prostatic Benign Hyperplasia: aetiology. Cervical intra-epithelial neoplasia. Aetiopathogenesis. Fibrocystic Disease of Breast: Pathogenesis. gross and microscopic features – mucinous cystadenoma. Tumours of Ovary: Classification with examples. pathogenesis. Endometrium: Simple and complex (cytoglandular and adenomatous) hyperplasia – aetiology and morphology. Embryonal carcinoma.gross and microscopic features. 101 . Gross and microscopic features of Seminoma. gross and microscopic features. risk factors and pathogenesis. serous cystadenoma. gross and microscopic features. Carcinoma Endometrium: Aetiopathogenesis. gross and microscopic features. Tumours of Testes: Classification. gross and microscopic features. gross and microscopic features. Trophoblastic Tumours: Hydatidiform mole and choriocarcinoma . “Chocolate Cyst”. Carcinoma Cervix: Aetiology. dysgerminoma. Premalignant and Malignant Lesions of Penis: Carcinoma penis. Endometriosis: Definition. Leiomyoma: Aetiology. Teratoma. Female Genital Tract Including Breast Cervicitis: Aetiology and morphology. aetiology. gross and microscopic features. pathogenesis. Adenomyosis and its complications. Squamous cell carcinoma – gross and microscopic features and staging. gross and microscopic features. examples. Carcinoma: aetiology. sites and pathogenesis. teratoma. Breast Abscess: Aetiology. complications.

Mechanism of action Indications. pharmacological actions. Contraindications. their functions. Hormonal Contraceptives: Types. Adverse effects. mechanism of action. Spermatogenesis. development of sex organs Physiology of puberty. its regulation. Gynaecomastia: Definition and causes. Gross and microscopic features of fibroadenoma. contraindications. basis for use.Classification. uses. Role of Sertoli cells Testosterone: transport. 102 . adverse effects. physiological actions.Tumours of Breast: Classification. Differential diagnosis of lump in the breast. Antiviral Agents: Introduction General principles. gross and microscopic features of ductal (invasive) carcinoma. Paget’s Disease of Breast: Definition. Carcinoma breast – pathogenesis. mechanism. choice of preparation. Medication during pregnancy and lactation Examples of safe drugs Drugs causing teratogencity and its categories Types of damage to foetus and its prevention Sexually Transmitted Diseases: Preparations of choice. uses. misuse. PHARMACOLOGY Gonadal hormones and antagonists: Anabolic Steroids: Preparations. Therapeutic Uses and Drug interactions PHYSIOLOGY Introduction: Sexual differentiation. gross and microscopic features. Male Reproductive System: Primary and accessory organs. Oxytocics and Tocolytics: Mechanism of actions. medullary carcinoma. metabolism. adverse effects.

mechanism of action. Physiology of Parturition: Factors which determine onset of parturition. Physiology of Lactation: Hormones involved in growth and development of breast during pregnancy and their actions. species specificity. 103 . and factors involved in its maintenance.feedback mechanism. Day of implantation. prevention of polyspermia.Control of testicular function . tests for pregnancy. Onset of lactation. physiological actions. vaginal. Female Reproductive System: Physiology of menstrual cycle: ovarian cycle. Mechanism of uterine contractions . Ovarian hormones: estrogen and progesterone. uterine cycle. Transport of sperms in female genital tract. cervical cycle. Role of oxytocin. Physiology of Fertilization and Implantation. abnormalities. capacitation. fertilization. changes in mother during pregnancy. functions of placenta. prolactin. menopause.Role of oxytocin. formation and functions of fetoplacental unit Physiology of Pregnancy: Endocrine changes. Mechanism of lactation amenorrhorea Physiological Basis of Contraceptive Methods: Physiological basis of various methods of contraceptives and emergency ‘pill’. Transport of fertilized ovum-zygote-blastocyst. acrosomal reaction. Control of ovarian function – feedback mechanism. abnormalities. Role of hormones Physiology of ovulation and its detection.

IV CENTRAL NERVOUS SYSTEM AND SPECIAL SENSES COMMON CLINICAL PROBLEMS: Sinusitis Meningitis Epilepsy Cerebrovascular Accidents Encephalitis Poliomyelitis Cataract Deafness Migraine ANATOMY HEAD AND NECK Development Cranial bones Triangles of neck Joints Infratemporal fossa Pterygopalatine fossa Parotid and submandibular regions Scalp Orbit Ear Nose Surface anatomy Radiological anatomy Applied anatomy CENTRAL NERVOUS SYSTEM AND SPECIAL SENSES Brain Cranial Nerves Spinal Cord Meninges Eye Ear Nose Surface anatomy Radiological anatomy Applied anatomy BIOCHEMISTRY Cell Membrane Neurotransmitters Vitamin A MICROBIOLOGY Meningitis Tetanus 104 . SEMESTER .

frontal. temporal. zygomatic bone Cranial bones. sphenoid Foetal skull 105 .Botulism Encephalitis Trachoma Conjunctivitis Acute/Chronic Suppurative Otitis Media PATHOLOGY Meningitis Brain Abscess Hydrocephalus Viral Encephalitis Cerebrovascular Accident Degenerative Diseases Demyelinating Diseases Tumours Retinoblastoma PHARMACOLOGY Indroduction Aliphatic Alcohols General Anaesthetics Local Anaesthetics Therapy of Epilepsies Therapy of Parkinsonism Opioid Analgesics and Antagonists Sedatives and Hypnotics CNS Stimulants Drug Abuse Psychopharmacology Antipsychotic and antianxiety drugs Antidepressants and antimanic drugs PHYSIOLOGY Nervous System Visual System Auditory System Vestibular System Olfactory System Gustatory System CONTENTS ANATOMY HEAD AND NECK: Pharyngeal arches Development of: face & eye Bones: Gross and Special Features of Bones Maxilla. parietal.

Names of skull bones in adult
Cranial fossae with structures passing through major foramina
Cervical vertebrae: general and special features
Mandible: attachments of muscles and ligaments, differences in mandible at different ages

Face: muscles of facial expression, nerves & vessels

Scalp: layers, blood-supply, and nerve-supply

Joints:
Atlanto-occipital & Atlanto-axial
type, subtype, ligaments, movements, applied aspects
Temporomandibular –type, movements and applied aspects, including the muscles involved in
producing movements

Deep fascia of neck- distribution & clinical important

Triangles of neck: Boundaries, contents and applied aspects

Infratemporal fossa: boundaries, contents and applied aspects

Pterygopalatine fossa: boundaries, contents and applied aspects

Parotid and submandibular regions

Muscles:
Names and nerve-supply of muscles of facial expressions
Attachments, nerve-supply, and actions of following muscles:
Sternocleidomastoid
Muscles of mastication
Orbicularis oculi
Buccinator
Scalenus anterior (including Scalenus anterior syndrome)

Blood vessels:
origin, course, termination, and branches/tributaries of:
Common carotid artery
External carotid artery
Internal carotid artery
Subclavian arteries (right and left)
Maxillary artery
Internal jugular vein

Cervical lymph nodes:
subgroups, drainage areas, applied aspects

Radiological anatomy:
X-rays of skull A.P & lateral views
Angiogram of external & internal carotid arteries.

Surface anatomy:
External carotid artery,Internal carotid artery,Subclavian arteries (right and left) & Internal jugular vein

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CENTRAL NERVOUS SYSTEM

Development of nervous system

Brain and its meninges
Parts of Brain

Cerebral Hemispheres- Sulci and Gyri, Functional areas, Fibres (white matter), Blood supply,
Microscopic structure of cerebral cortex,

Iinternal capsule: parts, fibres, blood supply and applied aspects

Diencephalon:
Thalamus and Hypothalamus- Parts, Connections, Blood supply,
Epithalamus and Metathalamus- Parts and their functions

Basal Nuclei- Parts, Blood supply
Major connections of corpus striatum

Limbic system: parts, connections & functions

Dural venous sinuses
Base of brain: surface attachment of cranial nerves, arterial circle (of Willis)

Ventricular System and Cerebrospinal Fluid (CSF)
Ventricles and the boundaries of their parts
Circulation of CSF

Cerebellum- Gross Features, Connections, Blood supply, Microscopic structure of cerebellar cortex

Brainstem (Midbrain, Pons, and Medulla oblongata)- External features, Blood supply,
Cross-sections at different labels of each brainstem
Red nucleus – position, connections and applied aspects
Olivary nucleus – position, connections and applied aspects
Clinical conditions associated with vascular/neurological deficits

Cranial nerves: origins, course, distributions & applied aspects

Spinal Cord
Vertebral canal
Extent, gross features, meninges, and blood supply
Transverse sections at cervical, thoracic, lumbar & sacral regions showing positions of major tracts
Origin, course termination, modalities, and applied aspects of the following tracts:
Corticospinal
Spinothalamic
Spinocerebellar, and
Posterior column tracts

SPECIAL SENSES

Vision
Eye ball (Development, and associated anomalies)
Tunics of eyeball and their blood supply

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Microscopic structure of cornea and retina
Chambers of the eyeball, and circulation of aqueous humor

Extraocular muscles (attachments, nerve supply and actions)

Hearing
Ear and its parts
External ear (gross features, blood supply, and nerve supply)
Middle ear (tympanic cavity): parts, boundaries, and contents; pharyngo-tympanic (Eustachian) tube
Internal ear: names of its parts only

Smell
External nose, parts of the nasal cavity with particular reference to olfactory epithelium

Taste
Taste buds: location and microscopic structure

Surface anatomy:
Middle meningeal aertery

Radiological anatomy:
Angiogram of cerebral arteries

BIOCHEMISTRY

Cell Membrane:
Components, transport systems, impulse propagation.

Vitamin A:
Sources, Synthesis, transport, functions, deficiency symptoms.

Biochemical analysis of CSF:
Content of CSF, Biochemical aspect of normal and abnormal CSF (Pyogenic , tubercular and viral
menengitis)

MICROBIOLOGY

Introduction to CNS infections: Definitions, etiological agents, principles of laboratory diagnosis

Meningitis: Pyogenic, Aseptic, and Chronic: agents, pathogenicity, clinical presentations, laboratory
diagnosis, complications.

Tetanus: agents, pathogenicity, clinical presentations, laboratory diagnosis, complications, vaccines.

Botulism: agents, pathogenicity, clinical presentations, laboratory diagnosis, complications.

Encephalitis: Rabies, Arbovirus, Poliomyelitis: agents, pathogenicity, clinical presentations,
laboratory diagnosis, complications.

Trachoma: agents, pathogenicity, clinical presentations, laboratory diagnosis, complications

Conjunctivitis: agents, pathogenicity, clinical presentations, laboratory diagnosis, complications

108

Acute/ Chronic Suppurative Otitis Media: agents, pathogenicity, clinical presentations, laboratory
diagnosis, complications.

Slow Viruses, Prion diseases etc (introductory).

PATHOLOGY

Meningitis:
Aetiopathogenesis, gross and microscopic features of: Bacterial meningitis, viral meningitis, tubercular
meningitis.
CSF examination as a tool in its differential diagnosis.

Brain Abscess:
Aetiopathogenesis, morphology, diagnosis.

Hydrocephalus:
Definition, types, morphology, clinical features, complications.

Viral encephalitis:
Aetiology, pathogenesis, morphology.

Cerebrovascular Accidents:
Intracranial haemorrhage.

Degenerative Diseases:
Classification with examples, aetiopathogenesis, gross and microscopic features of – Alzheimer's
disease, Parkinson’s disease.

Demyelinating diseases:
Classification with examples.
Gross and microscopic features of multiple sclerosis.

Tumours:
Classification.
Gross and microscopic features of: astrocytoma, meningioma, basal cell carcinoma.

Retinoblastoma:
Gross and microscopic features.

PHARMACOLOGY

Introduction

Aliphatic Alcohols:
Ethanol and methanol - effects on different organ systems, acute and chronic alcoholism, methyl
alcohol poisoning - management

General Anaesthetics:
Principles, classification.
Commonly used general anaesthetics.
Dissociative anesthesia, neuroleptanalgesia.
109

adverse effects and the rationale of therapy. causes. drug interactions and contraindication. Ionic basis for electrical. Therapy of Parkinsonism: Types. Sedative and Hypnotics Classification. Resting membrane potential – ionic basis. Drug Abuse: Types and management. Opioid Analgesics and Antagonists: Classification. mechanism. pharmacological actions. indications. uses and adverse effects. adverse effects and drug interactions. Response of neurons and nerve fibers to injury: Types of injuries. morphology. Signal transmission : Review. acute poisoning. adverse effects. uses. 110 . The structural and functional unit of nervous system. Graded potential: definition. morphology. drug dependence . functional components. adverse effects. functions. regeneration.management. Neurons: types. types. uses. mechanism. classification. management. mechanism of action.management. mechanism of action. mechanism. Types of changes: Wallerian degeneration. drug dependence . Classification. factors influencing. classification of nerves. characteristic. chemical. adverse effects.rationale and examples. Classification of antiparkinsonian drugs. Local Anaesthetics: Types of local anesthesia. excitability changes. uses. Antiepileptic drugs: Classification. management. pharmacological actions. pharmacological actions. factors influencing regeneration. antidepressants and mood stabilizers. physiological significance. Action potential – definition. Propagation: mechanism. acute poisoning.Preanaesthetic medication. mechanism. Types of epilepsies and drugs for each. Antianxiety drugs: brief discussion PHYSIOLOGY Introduction to Nervous System: Organization of the nervous system. Therapy of insomnia. Psychopharmacology: Anti-psychotics.

Microenvironment of the neuron: Blood brain barrier. importance. Control of posture and movement: General principles of organisation of motor control. connections. functions. Intraocular pressure. speech. neurotransmitters and mode of transmission. drainage. reticulospinal.cerebellum and vestibular apparatus in control of -motor movements. overview of functions. Prefrontal lobe: Components. Pupil. Hypothalamus: Components. their clinical significance. Effects of lesions. types. Properties of reflexes. connections. 111 . its functions. Visual System: Structure of eye. Neurotransmitters and neuromodulators and their properties. Sensory receptors: Definition. classification. Definition. Physiological basis of consciousness and sleep. language. circulation. Descending pathways involved in motor control. basal ganglia. Motor cortical areas. Sensory pathways and regulation at the higher level. functions. Pyramidal (corticospinal) and extrapyramidal system (vestibulospinal. functions. classificationReflex arc and stretch reflex. connections. connections. and their disorders. functions. functions. . properties. Reflexes: Definition. Structure and function of cornea. EEG: Evoked potentials. Higher cortical functions: Learning. Thalamus: Components. properties. Somato-sensory system: Classification and characteristics of different sensations. judgement. structure and mechanism of transmission. synaptic plasticity. Limbic system: Components. memory. connections. functions. Reticular formation: Definition. Physiology of pain including endogenous pain relief system and referred pain. Aqueous humor: formation. Synapses – Ultra structure. tectospinal and rubrospinal). Thalamic syndrome. Optics of vision-image forming mechanism. their clinical significance. Effects of complete transection and hemisection of spinal cord.

squint. Physiology of colour vision. Colour blindness: classification. mechanism of sound transmission. its clinical applications. nerve pathway from the cochlea to the auditory cortex. Audiometry. impedance matching. visual pigments mechanism of excitation and their functions.Light reflex. Internal ear: structure and function of cochlea. tests. pitch and intensity discrimination. photopic and scotopic vision.distribution. accommodation. Clinical tests for vestibular integrity. 112 . binaural interactions. mechanism of stimulation and pathways.response to rotational and linear acceleration. Neurophysiological basis of fixation of gaze and conjugate movements. Eye movements. Vestibulo-ocular reflex. Effects of transection of visual pathway at various levels. External ear: functions. Visual pathway-transduction. Tests to diagnose deafness. Deafness: Types. sound localisation. Auditory pathway: receptive fields and tonotopic maps. Vestibular transduction . its clinical importance. Light and dark adaptation. Visual acuity and visual fields-clinical importance. Disorders of olfactory sensation. Vestibular System: Structure of labyrinth. function of eustachian tube. disorders of labyrinth Olfactory System: Location of receptors. Photo receptors . and perimetry. Auditory Systems: Functional anatomy of ear and general properties of sound. Common errors of refraction. . Organisation of auditory cortex. mechanism of stimulation and pathways. functions. Ophthalmoscopy. Gustatory System: Location of receptors. Middle ear: functions of tympanic membrane and ossicles.Disorders of gustatory sensation. Synaptic modulation and visual cortex. Central vestibular pathway.theories and electrophysiological aspects. Binocular and monocular vision. transmission.

• Describe and illustrate with suitable examples the natural history of a disease (communicable and non-communicable). development Cognitive development Puberty and adolescence 113 . analyze (using a computer to encouraged). their applications. SEMESTER – IV COMMUNITY MEDICINE EPIDEMIOLOGY II Themes and Topics Epidemiological studies: descriptive. interpret and present. nature. positive predictive value etc. • Advise relevant (psycho-social. biases involved and relative merits and demerits. cultural and economic context) promotive. • Describe the various types of epidemiological study designs. They will collect the data. They will plan the investigation under the guidance of preceptor (Community Medicine and Clinician if needed). execute and evaluate it. psycho-social information from a patient and family. for screening tests Collect and interpret clinical. • Define the terms used in measurement. • Differentiate between screening and diagnostic tests. A final presentation will be made. • Describe the need and uses of screening tests. • Collect relevant clinical. specificity and positive predictive value of tests from the given data. they will plan an intervention programme. • Describe Bradford Hill’s criteria for causation of disease. Based on their findings. BEHAVIOURAL SCIENCES (Integrated teaching with Psychology) Themes and topics Factors affecting behavior attitude Attitudes. analyse and present the same to illustrate natural history of a common disorder. curative and rehabilitative measures. preventive. analytical and experimental Basic concepts about transmission of infectious agents Principles of control of communicable diseases Principles of control of non-communicable diseases Investigation and control of an epidemic Epidemiological principles underlying screening Distinction between screening and diagnostic test Calculate: sensitivity. Principal Teaching-Learning Methods to Be Used: Small group discussion Simulated practical exercises in class room Practical exercises in field situations: Students will be encouraged to select an area that they would like to investigate. psycho-social information from patient / family to understand natural history of a disease Objectives • Apply epidemiological methods to different health problems. specificity. • Calculate the sensitivity. Lecture discussion.

• Small group discussion.Behavior problems Sexual behavior Normal and abnormal behaviors Implications of behavior in illness Methods to change attitude. Presentations will be made. • Acquire basic skill in individual and group counseling. pre-test and validate a questionnaire / interview schedule to test attitudes of individual / community. students will construct an interview schedule on any topic of their choice. They will interview about 20 people and analyse the results to validate the questionnaire. 114 . • Describe the process of attitudinal development and methods to change attitudes. Principal Teaching-Learning Methods to Be Used: Lecture discussion Demonstration Small group discussion Simulated practical exercises in class room e.g. b. Problem-based learning COMMUNITY BASED INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESSES (CB-IMCI) Topics a. Use of computers is encouraged. role play Student action: In groups of 2-3. Importance of IMCI in family medicine.g. • Construct. HIV / AIDS affected person) Proper approach and attitude of counselor Communication skills required of a counselor Objectives • Define attitudes. behavior Measurement of attitudes Questionnaire / pre-testing and validation of a questionnaire / interview schedule The need for counseling in various situations (e. Practicals: • Video cassette show. Introduction to IMCI and orientation to the Global program.

take relevant history on Reproductive system.IV INTRODUCTION TO CLINICAL MEDICINE THEMES AND TOPICS Reproductive system Central Nervous System and Special Senses At the end of the semester IV the undergraduate medical students should be able to: 1. supplementary video displays. Central Nervous System and Special Senses. list steps of testing patients clinically in relation to higher functions. SEMESTER . correlate anatomical structures and Pathophysiology involved in giving rise to different clinical signs in relation to Reproductive system.. appraise the common problems related to Reproductive system. practical demonstrations. cranial nerves. Central Nervous System and Special Senses. 115 . Instructional Method: Lectures in classroom. sensory. 4. 2. 5. motor. identify laboratory and radiological investigations required in making diagnosis. Central Nervous System and Special Senses. 3. reflexes. gait and coordination. practice on peers and on patients.

Dissection & Demonstration of shoulder joint. spermatogenesis. early development of embryo. carpal tunnel. blastocyst. Dissection & Demonstration of cubital fossa. umbilical cord. deltoid. Dissection & Demonstration of elbow joint. Study of models of spermatozoa. 2 Dissection & Demonstration of muscles of anterior and medial compartments of thigh and obturator nerve. 6. 5 Dissection & Demonstration of muscles of back of thigh and sciatic nerve. Study of body parts and regions. thymus. Study of parts of nervous system . 8 Dissection & Demonstration of anterior and lateral compartments of leg. Integumentary System: 1. Dissection & Demonstration of mammary gland. 9 Dissection & Demonstration of posterior compartment of leg and ankle joint. Radiological anatomy of upper limb. 3. oogenesis. 8. implantation. axillary artery. 2. 11. hip joint. front of forearm. Gross anatomy of tonsil. acromio-clavicular joint. 5. Dissection & Demonstration of upper arm – front and back. radio-carpal joint. sterno-clavicular joint.I Gross Anatomy Practicals Basic concepts and Autonomic Nervous System: 1. 3 Dissection & Demonstration of adductor canal. 2. spinal cord and nerves and autonomic system. movements of scapula. 12. 2 Dissection & Demonstration of axilla. Musculo-skeletal System: Upper Limbs: 1. 116 . 9. brachial plexus. Dissection & Demonstration of pectoral region. Dissection & Demonstration of shoulder region. front of thigh. Study of models of fertilisation. axillary artery. lymph nodes. back of hand. 7 Dissection & Demonstration of knee joint. Gross anatomy of spleen. Surface anatomy of upper limb Lower Limbs: 1 Dissection & Demonstration of femoral triangle. PRACTICAL CLASSES ANATOMY SEMESTER . femoral vessels and nerve. Study of different parts of skin. Lymphoid organs: 1. 4 Dissection & Demonstration of gluteal region. 4. 7. breast. Study of models of placenta. ova. Dissection & Demonstration of scapular muscles. Dissection & Demonstration of palm.brain. 10. 5. 3. 2. Dissection & Demonstration of back of forearm. muscles of back. 6 Dissection & Demonstration of popliteal fossa. 4. gluteus maximus.

10.arch of aorta.10 Dissection & Demonstration of sole and arches of foot. Gross anatomy of left lung. 3. 2. Histological structure of smooth muscle. thymus. Dissection & Demonstration of structures of root of lung – right and left. 12.S. 7. Histological structure of skin – thick and thin skin. relations of mediastinal surface. Lymphoid organs: 1 Histological structure of lymph node. Histological structure of nerve.spinal and sympathetic.II Gross Anatomy Practicals: Respiratory System: 1. 12 Surface anatomy of lower limb.S & L. Radiological anatomy of respiratory system. Dissection & Demonstration of outlet of thorax. 8. 4. 14. Dissection & Demonstration of structures in superior mediastinum. spleen. Histological structure of ganglion . 8. superior vena cava. Histological structure of bone (T. Study of microscope. thoracic diaphragm. ANATOMY SEMESTER . 6. Histology Practicals Basic Concepts: 1. 13. cardiac muscle. Dissection & Demonstration of thoracic wall. oesophagus brachiocephalic veins. 10. Dissection & Demonstration of structures of inlet of thorax. Histological structure of fibrous tissue. 9. Histological structure of compound epithelium. Gross anatomy of right lung. 2. different parts of pleura. 4. 7. 2 Histological structure of tonsil. Dissection & Demonstration of structures in posterior mediastinum – descending aorta. internal thoracic vessels. thoracic duct azygos and hemiazygos veins. vessels. adipose tissue. 9. Surface anatomy of respiratory system Cardio-Vascular System: 117 . 11. 6. Histological structure of mammary gland – active and resting phase. relations of mediastinal surface.oesophagus.). Histological structure of different types of cartilages. 2.inter costal nerves. 3. 11 Radiological anatomy of lower limb. pleural recesses & para-nasal sinuses. histological techniques. Dissection & Demonstration of thoracic wall – inter costal muscles. 5. histological structure of an animal cell. Histological structure of skeletal muscle. Dissection & Demonstration of structures in posterior mediastinum. Histological structure of simple epithelium. Dissection & Demonstration of structures in superior mediastinum – trachea. Integumentary System: 1. 5. Dissection & Demonstration of pleura.

14 Surface anatomy of cardiovascular system. Dissection & Demonstration of portal vein 11.ascending. Histological structure of bronchi and bronchioles. 12. caecum. 8 Dissection & Demonstration of left ventricle features in the interior. 3. 8. sigmoid. Histological structure of epiglottis. marginal artery. Dissection & Demonstration of anterior abdominal wall – rectus sheath. 5. mesentery. Surface anatomy. Histological structure of lung. neuromyocardium. ileum. 2 Histological structure of aorto-elastic artery. Radiological anatomy. 10 Dissection & Demonstration of ascending aorta. pancreas. 7. 3 Histological structure of inferior vena cava – large vein. 2 Study of external features of heart and its surface markings. Dissection & Demonstration of coelic axis artery. 9. Dissection & Demonstration of anterior abdominal wall – inguinal canal. 13 Radiological anatomy of cardiovascular system. ANATOMY SEMESTER . Hepatobiliary System: 118 . Dissection & Demonstration of stomach. 5 Dissection & Demonstration of right atrium – features in the interior. Dissection & Demonstration of duodenum. 4. 10. 4 Dissection & Demonstration of veins draining venous blood from heart. Dissection & Demonstration of inferior mesenteric artery. Histology Practicals: Respiratory System: 1. 9 Dissection & Demonstration and study of interatrial and interventricular septa. Dissection & Demonstration of superior mesenteric artery jejenum. Histological structure of trachea. 3. descending. 7 Dissection & Demonstration of left atrium – features in the interior. Dissection & Demonstration of colon. 3 Dissection & Demonstration of arteries supplying heart.1 Dissection & Demonstration of pericardium – fibrous and serous pericardium. 12 Dissection & Demonstration of superior vena cava and inferior vena cava. 11 Dissection & Demonstration of pulmonary trunk and pulmonary veins. cardiac plexuses. Dissection & Demonstration of omental bursa. 4. 6 Dissection & Demonstration of right ventricle – features in the interior. appendix. 6. subdiaphragmatic space. 2. transverse.III Gross Anatomy Practicals: Gastro-intestinal System: 1. Cardio-Vascular System: 1 Histological structure of cardiac muscle and neuromyocardium. 2. sinuses of pericardium. 4 Histological structure of medium size artery and vein.

relations.IV Gross Anatomy Practicals Reproductive System: Male: 119 . Gross anatomy of thyroid gland and parathyroid gland. relations. Histological Structure of thyroid gland and parathyroid gland. Gross anatomy of kidneys – surfaces. Gross anatomy of common bile duct. fundic and pyloric parts. stomach. 5. parts of nephron. 2. Histological Structure of kidney. cystic duct. Gross anatomy of lesser omentum. Histology Practicals: Gastro-intestinal System: 1. Gross anatomy of hepatic ducts. Histological Structure of liver. Histological Structure of pancreas. blood supply. Gross anatomy of ureter. Histological Structure of pituitary gland. Histological Structure of urinary bladder. ileum. Histological Structure of ureter. 4. termination of bile duct. Histological Structure of duodenum. 2. 3. 5.1. juxta-medullary apparatus. Gross anatomy of liver – borders. Endocrine system: 1. hilum. peritoneal ligaments of liver. 4. Radiological anatomy 6. 5. 3. ANATOMY SEMESTER . Histological Structure of suprarenal gland. gall bladder. Histological Structure of jejunum. 4. Surface anatomy Endocrine System: 1. 2. 4. 2. blood vessels. Gross anatomy of urinary bladder. Histological Structure of kidney cortex and medulla. 3. 2. surfaces. 2. Histological Structure of oesophagus. Histological Structure of gall bladder. Hepatobiliary System: 1. 3. Surface anatomy Renal and Electrolyte System: 1. vermiform appendix. Renal Electrolyte System: 1. Dissection and gross structure of kidney. 2. 3. Gross anatomy of suprarenal gland – relations. Histological Structure of large intestine.

and atlanto-axial joint. 7. Dissection & Demonstration of anterior triangle of neck. Dissection & Demonstration of nasal cavity – septum of nose. Radiological anatomy Central nervous system and special senses Head and neck: 1. middle and internal ear. 4.external. 4. 3. Dissection & Demonstration of temporomandibular joint. Dissection & Demonstration of arteries of brain. scrotum and spermatic cord. 5. Gross anatomy of vas deferens and seminal vesicle.opening in lateral wall of nose. 4. Gross anatomy of fallopian tube. Dissection & Demonstration of eyeball – its internal structure. 8. Radiological anatomy 10. Dissection & Demonstration and study of external features of medulla oblongata. Gross anatomy of prostate gland. Dissection & Demonstration of veins of brain and venous sinuses of skull. 2. Dissection & Demonstration of muscles of neck. Gross anatomy of testis. broad ligament. relations. Gross anatomy of vagina and levator ani. Gross anatomy of uterus. their nerve supply. 2. 9. 7. 6. 3. 11. Dissection & Demonstration of ear. Gross anatomy of penis. Study of external features of cerebrum – sulci. Surface anatomy Central Nervous System: 1. Radiological anatomy Special Senses: 1. 4. gyri and lobes. supports of uterus. Dissection & Demonstration and study of attachment of cranial nerves on base of brain. Dissection & Demonstration of fourth ventricle of brain. Dissection & Demonstration of arteries and veins of eyeball. Dissection & Demonstration of scalp. circle of Willis. cortical areas. 6. Dissection & Demonstration of face. 10. 5. 5. Dissection & Demonstration of tongue and study of papillae of tongue. 4. Female: 1. 2. 3. lateral wall of nose. Dissection & Demonstration of posterior triangle of neck. Dissection & Demonstration of common carotid. Dissection & Demonstration of extraocular muscles of eyeball. blood supply. 3. Dissection & Demonstration of parts of diencephalon and structures the floor of third ventricle. 5. Dissection & Demonstration of internal jugular vein and cranial nerves in neck. Dissection & Demonstration of meninges of brain and folds of duramater. 2. 8. 9. external carotid and internal carotid arteries. Dissection & Demonstration and study of external features of pons and mid-brain. 3. Dissection & Demonstration of cerebellum – its parts and important fissures. 6.1. Histology Practicals: Reproductive System: Male: 120 . 2. Gross anatomy of ovary.

Histological Structure of uterus. Horizontal section of brain – study of internal capsule and basal nuclei. 3. 3. Histological Structure of epididymis. Female: 1. Transverse Section of midbrain – at the level of superior colliculus . Transverse Section of pons. Histological structure of cerebrum. 3. Transverse Section of spinal cord in cervical region. Histological structure of internal ear – Organ of Corti.at the level of inferior colliculus. Histological structure of cerebellum. Histological Structure of prostate gland. 4. 5.1. Histological Structure of ovary.Sensory decussation. 121 . Special Senses: 1. Transverse Section of medulla oblongata . Histological Structure of uterine tube. 3. Histological structure of retina and interior of eyeball. 4. . vagina. 2. 2. Central Nervous System: 1. 4. 8. Histological Structure of vas deferens and seminal vesicle. 6. Histological structure of papillae of tongue-taste buds. Histological Structure of mammary gland – active phase. Histological structure of cornea. 2. resting phase. Histological Structure of testis. 4. 2. 7. Median section of brain – third ventricle and thalamus.Motor decussation.

creatinine.III & IV Practicals: 1. 5. Interpretation of cerebrospinal fluid (CSF) finding. Instruments: spectrophotometer. 10. 7. Qualitative analysis of gastric juice estimation of free and total acidity. Estimation of blood glucose. uric acid and calcium and phosphate. Protein and lipoprotein electrophoretic pattern in normal and abnormal condition. SEMESTERS . 3. 8. Estimation of blood glucose: glucose oxidase method/ O-Toluidine method). calculation of BUN.urea. 6. 4. 2. colorimeter. interpretation of result. Students should be able to interpret the liver function test findings. Salivary amylase action on starch. Knowledge of NPN. Alkaline phosphatase. paper/ thin layer chromatography. BIOCHEMISTRY SEMESTERS . 5. AST and ALT. electrophoresis apparatus. Estimation of serum. Oral glucose tolerance test. importance of GFR-its calculation. 2. 122 . Introduction and uses of Laboratory Instruments.I & II Practicals: 1. flame-photometer. Urine analysis-normal and pathological. 3. (b) serum cholesterol. Estimation of: (a) serum protein and A/G ratio. DNA extractions 4. bilirubin (conjugated and un-conjugated) 9. Estimation of serum. 11. Student should be able to interpret OGTT findings and know the criteria for diagnosing diabetes mellitus.

Motility by Hanging Drop Preparation and agar inoculation 8. Introduction to Microbiology laboratory and Biosafety 2. 6. Study of colony characteristics of bacteria on NA. Growth on BA. Blood culture for bacterial isolation. Str. MacConkey’s agar. 11. Growth of fungi on SDA 16.I Practicals: 1. Chocolate Agar. Visit to Clinical Microbiology Laboratory at Hospital 6. pyogens. Study of antibiotic sensitivity tests by Stokes’ method and Kirbey Baur Method. containers etc. 5. Quellung reaction. Application of different disinfection methods 5. Diagnosis of pulmonary TB: Staining for Acid-fast bacilli (Ziehl-Neelsen stain). sputum) 2. CLED. Study of morphology and classification of microorganisms by Gram’s stain. Approach to laboratory diagnosis (specimen collection. Visit to Leprosy hospital 13. Microscopy 3. Application of different sterilization methods 4. Laboratory Diagnosis of Gram Positive bcteria: Staph. Clinical cases – Cellulitis: Staph and Strept 14. Leishmania. BA. Demonstration of capsule by India ink. 7. Smear preparation and Gram staining 7. Medical Mycology: Lab diagnosis of fungal infection: Skin scraping: KOH mount. Collection and processing of clinical specimen for respiratory tract infections (throat swab. SDA 17. Visit to CSSD. Niacinproduction etc) 4. Demonstration of blood parasites: Malaria. biochemical reactions (catalase. serum eosin preparation. handling) 9. Filaria and their laboratory diagnosis. 10. Pneumonia. demonstration of LJ media. 15. Coryne diphtheriae 3. Spotters MICROBIOLOGY SEMESTER . S. Candia: Germ tube tests. Hosp Waste management. MICROBIOLOGY SEMESTER . Study of biochemical tests and identification of Gram positive and Gram negative bacteria. transport. LPCB mount. Spotters 123 .II Practicals: 1. Demonstration of lepra bacilli 12.

IV Practicals: 6. Diagnosis of enteric fever. HBsAg. Microbiological examination of vaginal swab 8. MICROBIOLOGY SEMESTER . TSI. 11. Urea. biochemical reactions. and other tests.Laboratory Diagnosis of UTI: Sample collection significant bacteriurea (1) (Clinical case of UTI with E coli. Western Blot Demonstration 10. Specimen collection. Laboratory diagnosis of Sexually Transmitted Diseases (Gram staining for GNC. Spotters 124 . HCV) 9. Lab diagnosis of enteric pathogenic bacteria: IMViC. Laboratory diagnosis of HIV: Serological tests HIV1 & 2. Demonstration of Ova/cyst/adult parasites of gastrointestinal system 5. Kleb. Demonstration of Salmonella on selective media. 2. TPHA. Spotters MICROBIOLOGY SEMESTER . enrichment media. ELISA. Widal test 3.III Practicals: 1. Laboratory diagnosis of meningitis: CSF Gram staining and ZN staining 12. Spore staining using malachite green staining 7. Demonstration of RPR test. oxidase. Presumptive coliform count of drinking water 4. RPR. Proteus etc) 6.

Indications of different laboratory tests and interpretations of reports. platelet count. photographs): Acute appendicitis Adenoma of Pleomorphic adenoma thyroid Chronic gastritis Papillary Gastric ulcer carcinoma thyroid Intestinal tuberculosis Lepromatous Acute appendicitis leprosy Juvenile polyp Tuberculoid Adenocarcinoma of colon leprosy Fatty liver Squamous cell Cirrhosis of liver papilloma 125 . 3. Study of morphology of RBC. haemoglobin. Identification of cells in Leishman-stain stained blood film. chemical. preparation – staining of peripheral blood smears. 3. 2. knowing equipment and instruments. Orientation to the Pathology Laboratories. Differential leukocyte count (DLC) determination.I & II 1. anticoagulants. PATHOLOGY SEMESTERS . Demonstration of peripheral blood smears and bone marrow smear in different diseases. CT. microscopic. 2. ESR determinations and absolute values. Gross and microscopic changes in diseases (on materials available. Cross-matching. Gross and microscopic changes in diseases. RBC. specimens. BT. Total leukocyte count (TLC) determination. Blood grouping – ABO and Rh. (On materials available. Tuberculous lymph node Squamous papilloma Squamous cell carcinoma Basal cell carcinoma Chronic venous congestion . Haematology: Collection of blood. slides and photographs). PCV.spleen Infarction of spleen Hodgkin’s lymphoma Amyloidosis of spleen Myocardial infarction Medial calcification of artery Thromboangitis obliterans Haemangioma Lobar pneumonia Bronchopneumonia Bronchiectasis of lung Chronic venous congestion – lung Fibrocasseous tuberculosis lung Bronchogenic carcinoma PATHOLOGY SEMESTER .III & IV 1. specimens. Urine examination: physical.

Chronic venous Squamous cell congestion .Liver carcinoma Infective hepatitis Basal cell Heaptocellular carcinoma carcinoma Chronic cholecystitis Melanoma Adenocarcinoma of Meningitis gallbladder Meningioma Chronic pyelonephritis Astrocytoma Renal cell carcinoma Glioblastoma Wilm’s tumour multiforme Amyloidosis of kidney Osteogenic Benign prostatic sarcoma hyperplasia Osteoclastoma Carcinoma of prostate Lipoma Carcinoma of penis Fibroma Endometrium – Neurofibroma proliferative phase Fibrosarcoma Endometrium secretory Liposarcoma phase Rhabdomyosarcoma Adenocarcinoma of endometrium Leiomyoma Mucinous cystadenoma – ovary Dysgerminoma Teratoma Fibroadenoma breast Adenocarcinoma breast Paget’s disease of breast Primary hyperplasia thyroid 126 .

Local anesthetics 11. Dissolution time of Aspirin. OBSERVATIONS: TABLE 1 DRUG: Disintegration Time Dissolution Time Aspirin Soluble Aspirin Enteric coated aspirin _____________________________________________________________ REMARKS: _____________________________________________________________ TABLE 2 Enteric coated aspirin Double distilled water OBSERVATIONS 1. Effect of autonomic drugs on eye 10. __________________________________________________________ CONCLUSIONS: 127 . soluble Aspirin and enteric coated Aspirin. Prescription writings and clinical problems for each system OBJECTIVE: To compare Disintegration time. Note the time of its complete disintegration. Commonly used abbreviations in prescriptions 3. Note the time of disintegration of each tablet. To study Drug Use Indicators (Prescription audit) 8. Introduction 2. HCl (Dil) 2. In first beaker place Soluble Aspirin one tablet and start the stopwatch simultaneously. Study of different drug delivery devices 5. Dissolution time of Aspirin. To compare Disintegration time. PHARMACOLOGY GENERAL PHARMACOLOGY 1. Rational drug therapy 7. Prescription writing 9. Soda bicarb. Occasionally stir the contents with stirrer. soluble Aspirin and enteric coated Aspirin. Study of different dosage forms 4. METHOD: Take One Beaker and fill it with 50 ml of distilled water. Repeat the same procedure with Enteric coated Aspirin and Aspirin similarly. 6.

• to select a drug on the basis of comparative efficacy. whether or not a prescriber has prescribed the drugs keeping in mind the concept of rational use of drugs and essential drug. by the number of encounters surveyed. Essential Drugs are the drugs that satisfy the health care needs of majority of the population. These behaviors include the processes of making a dispensing. (i) Average number of drugs per encounter: Calculated by dividing the total number of different drug products prescribed. Here lies the concept of rational use of drugs. they should therefore be available at all times in adequate amounts and in appropriate dosage form. • to write a correct prescription. For achieving this objective. students will be given scenario that should focus on therapy but not the diagnosis. by the total number of encounters surveyed × 100. drugs are prescribed to treat the illness of patients.RATIONAL PRESCRIBING Process of Rational Prescribing: The practical sessions in Pharmacology to provide systematic approach to prescribing are designed with an objective that students will be able to write an appropriate and correct prescription for a patient. The different aspects of drug use can be assessed by some of the indicators. (iv) Percentage of encounters with an injection prescribed. • to make appropriate arrangements for follow-up. and use of drugs by patient. The guide to Good Prescribing (WHO) should serve as source of clinical scenarios and discussions. in doses that meet their own requirements for an adequate period of time. safety. put forth by WHO namely. Drug Use Indicators Study (Prescription Audit) In all the health care delivery systems. • to counsel the patient. cost and suitability. the interaction between the prescriber (provider) and the patient. (v) Percentage of drugs prescribed from essential drug list or formulary. • to choose between drug and / or non-drug. “Drug Use” involves not only the actual prescribing of drugs but also wide range of behaviors that occur during the drug use encounter. At the end of the session. (ii) Percentage of drugs prescribed by generic name: Calculated by dividing the number of drugs prescribed by generic name by the total number of drugs prescribed. (iii)Percentage of encounters with an antibiotic prescribed: Calculated by dividing the number of patient encounters during which an antibiotic is prescribed. It entails: (i) Average number of drugs per encounter. called drug use indicators. patient care indicators and facility indicators. and the lowest cost to them and their community. the student should be able : • to specify the therapeutic objective. (iii)Percentage of encounters with an antibiotic prescribed. Prescribing indicators assess the drug prescribing behavior of a prescriber. multiplied by hundred. (iv) Percentage of encounters with an injection prescribed: 128 . (ii) Percentage of drugs prescribed by generic name. prescribing indicators. Rational Use of Drugs requires that patients receive medications appropriate to their clinical needs.

by the total of number of encounters surveyed. . . 129 . multiplied by hundred. INDICATORS ENCOUNTER FORM TEACHING HOSPITAL Enumerator: ……………………. (v) Percentage of drugs prescribed from essential drug list: Calculated by dividing the number of products prescribed which are listed on essential drug list. by the total number of products prescribed.Calculated by dividing the number of patient encounters during which an injection is prescribed. Date: ………………… # A I # D n n D A D # a t j # r g r G t i e u e u e e b c o g DEPAR g n . n D TMEN ( e o i T y P r f ( ( E s r r i 0 0 D p s e c R / / L e ) s s x 1 1 n c ) ) . multiplied by hundred.

Encounters (#) Sum Average o o f o f f t t t O O o o o f f t t t a a a Percentage e e l l l n n d d c c r d r e e u r u g u g s g s s 130 .

to sensitize about existence of misleading information. to achieve the objectives. 5. students are divided into small groups and each group is asked to review the printed material against “WHO Ethical Criteria for Drug Marketing and Promotion”. After completing the form. 3. to be completed as required. Total: ………. 4. COMMUNICATIONS SKILL OSCE Score list Examinee: ……………………………………. the data is analyzed and submitted for scrutiny to the concerned teacher. 6.Objectives: To make the student analyse the prescription on the basis of prescribing indicators independently. Each prescription is to be thoroughly scrutinized by the students and the proforma. Procedure: 1. Par W N tial el o ly l Define the problem 0 1 2 Check the suitability of your P- drug for this patient • 0 1 2 ontra – indications • 0 1 2 nteractions • 0 1 2 onvenience Non-drug measures • 0 1 2 escribes rationale • 0 1 2 ives instructions • 0 1 2 ives warnings 131 .. Conclusion: Assessing Promotional Materials The Practical sessions on promotional materials has been developed with following objectives: to critically analyze the promotional materials against “WHO Ethical Criteria for Drug Marketing and Promotion”. to keep up to date with appropriate objective information. National list of essential drugs (alphabetical order) is provided to the student. Ten simulated prescriptions are given to each student. The groups are asked to present their findings and is followed by discussions. 2. Indicator Encounter form is also provided to the student. /38 Scorer ………………………………………….

Instructions. name and address of patient • eneric name. form administered. patient to ask questions • nsure patient understands. dosage. asks to 0 1 2 repeat instructions 132 . points of care) • arnings (maximum dose. understandable. onset and 0 1 2 duration of action) • 0 1 2 ide-effect (describes. stop the drug) Monitoring • 0 1 2 ext appointment • 0 1 2 hen earlier Communication style • lear. 0 1 2 signature. duration of therapy.Write the full prescription (if necessary) • ame and address of prescriber. what to do) • nstructions (when to take. dosage. warnings Information. 0 1 2 interactions. total amount • 0 1 2 nstructions. warnings • rug effect (effect. date. 0 1 2 dosage interval. logical 0 1 2 structure • 0 1 2 llow. concentration / 0 1 2 strength.

and stimulator. Estimation of hemoglobin percentage. Vitalograph.I & II Growth & development practicals: 1. 3. Methods of artificial respiration. Reticulocytes and platelets Respiratory System Practicals: 1. 4. 3. 5. Demonstrations: 1. 4. WBC). PHYSIOLOGY SEMESTERS . 2. Effect of exercise on respiration and CVS. Total Count (RBC.: Simple muscle curve. 4. i. Electrocardiogram. Peak flow meter. Clinical Examination of CVS. Stethograph for respiratory movements and breatholding time. Demonstrations: 1.. 3. Spirometry. 133 . 6. 2. Study of the compound microscope.: kymograph. 7. Blood film drawing. figures to explain applied aspects of growth and development. Bleeding time. 5. 2. Musculo-skeletal system practicals: 1. 3. Osmotic fragility test. Differential leukocyte count. Clotting Time. 2. Clinical examination of respiratory system. ESR. Cardiovascular System Practicals: 1. 2. Cardiopulmonary resuscitation. PCV (Haemogram). i. To show important recorded graphs of nerve-muscle preparation. 2. Blood practicals: 1. staining and identification of cells.e. myograph. Blood groups.e. Determination of work done and fatigue by ergograph. Measurement of blood pressure. To show the prepared charts and diagrams. 5. Study of apparatus used in experimental physiology. 3. 4. Haemin crystal. fatigue curve.

Tests for hearing: Rinne’s test. Examination of cranial nerves. To show the prepared charts and diagrams. colour vision.III & IV Renal and electrolyte system/ endocrine. 2. Tests for taste and smell. & reproductive system practicals: 2. 6. Physiological examination of reflexes. 7. 4. PHYSIOLOGY SEMESTERS . field of vision. Visual activity. Weber’s test. 8. 3. Examination of cerebellar functions 134 . figures to explain applied aspects of renal and electrolyte system/ endocrine and reproduction. Physiological examination of motor system. 5. Physiological examination of sensory system. CNS & special senses practicals: 1.

. physical exercise. alcohol/tobacco/others Level of self-dependence in case of elderly 135 . housing. 3………………………………. INTRODUCTION TO CLINICAL MEDICINE HISTORY TAKING: SKILL DEVELOPMENT FORMAT Name: Age: Gender: Marital status: Religion: Address: Occupation: Date of admission: Date of examination: Source of history (patient/relative): History of cheif complaint/s and duration of each in chronological order: 1……………………………….. status of health. family /school/workplace relationships Habits – recreation. cause of death (if relevant) Social and personal history: Details of occupation.. 2………………………………. Present illness: Onset and progress in chronological order Previous health: Illness/operation/accidents Travel abroad Prophylactic medications Immunizations History of birth in case of infants and children: Family history: Parents/siblings/spouse – age.

nutrition.physique. gait. history taking and physical examination should also match the same. endophthalmos Thyroid swelling Scoliosis. asymmetry Facies Exophthalmos. personality and mental state: Record height and weight: Regional examination: Skull deformity. kyphosis. Posture. INTRODUCTION TO CLINICAL MEDICINE PHYSICAL EXAMINATION FORMAT General assessment: Demeanour and general conditions.oral Jaundice Peripheral pulse Respiration Blood pressure Lymph nodes Skin: Abnormal pigmentation/texture/swelling/rashes Nails: Roughness/pitting/brittleness/spooning/ridging As the Pre-clinical Sciences progress to organ systems. state of hydration. lordosis Abdominal swelling Abdominal asymmetry Abnormal posture of limbs Deformity of limbs Scrotal swelling Cardinal signs: Anaemia Clubbing Venous engorgement Cyanosis Oedema legs/sacrum Temperature . 136 . Eliciting additional information according to system.

ask for prostatic symptoms such as difficulty in initiating micturition. blood Male – If. Breathlessness when lying flat (orthopnoea). presence or absence of vaginal discharge. ITRODUCTION TO CLINICAL MEDICINE SUGGESTED STANDRAD QUESTIONS Locomotor system: Joint pain or stiffness Muscle pain or weakness Cardiovascular system: Ankle swelling. stress and/or urge incontinence. Pain during intercourse (dyspareunia). pale. poor stream. waking up with breathlessness (paroxysmal nocturnal dyspnoea) Respiratory system: Shortness of breath – exercise tolerance. palpitations. Type of contraception. duration of the menstrual cycle. wheezing. colour of stool – normal.e. indigestion. miscarriage or induced abortions. dark.6/30 etc. bleeding gums Difficulty with swallowing (dysphagia). spontaneous. of appropriate age. Post-menopausal bleeding. Weight loss. ability to maintain erections. complications during pregnancy. coughing Sputum – colour. presence of blood (haemoptysis) Chest pain in relation to respiration or coughing Gastrointestinal system: Condition of mouth – oral and dental hygiene. Vomiting : Character and Quantity. Frequency of intercourse. ask for mental attitude to sex (libido). heartburn. ulcers. Change in bowel habits. ejaculations.g. terminal dribbling If. of appropriate age. labor or the puerperium children born and year of each Endocrine system : Heat/cold intolerance Prominence of eyes Swelling in neck Obesity Tremor of fingers 137 . amount. The relation between duration of menstrual flow and cycle can be conveniently recorded as 5/28. if relevant. Urethral discharge. the date of last menstruation. black. chest pain or pain in legs on exertion. number of sexual partners Female – age at menarche. and the number of sexual partners if relevant Obstetric history: The number of pregnancies and the outcome i. Genito-urinary system: Pain on passing urine (dysuria) Frequency of passing urine during day and night Abnormal color of urine e. duration and severity of menstruation. abdominal Pain. fresh blood. dysmenorrhoea.

deafness.g.g. double vision.Nervous system: Headache. visual symptoms e. sleep patterns. tinnitus Excessive thirst 138 . Tingling. numbness. Loss of acquity or visual field. fits or faints. muscle weakness Hearing symptoms e.

hernial orifices and inguinal lymph nodes percussion: fluid. gait and coordination. vas deferens Female – Breast examination Inspection of external genitalia Pelvic examination by speculum and then digitally as bimanual vagino-abdominal examination Rectal examination in certain instances. tonsils. sensory. Respiration – rate and depth. epididymis. signs of inflammation Arterial pulse and pressure. general and local changes. hepatic dullness Auscultation – breath sounds. vocal resonance and added sounds Gastrointestinal: Mouth: lips. tongue. jugular venous pulse and pressure Heart: Inspection – pulsations and deformities of anterior chest wall Palpation – apex beat Auscultation – first and second heart sounds Respiratory system: Upper respiratory tract – nose. teeth gums and other mucosae Abdomen: Inspection: scars. Nervous System: Higher functions (place. pharynx Chest – inspection – shape and lesions of chest wall. palpation: tenderness. guarding. gas and individual organs auscultation: frequency and character of bowel sounds Genito-urinary system Genitalia: Male – Inspection: swellings and skin changes Palpation: penis. carnial nerves. individual organs and abnormal masses. time) motors. person. testis.. INTRODUCTION TO CLINICAL MEDICINE SYSTEMIC EXAMINATION FORMAT Cardiovascular system: Skin temperature and colour Venous – abnormal vessels. chest expansion and mode of breathing Palpation – position of trachea and range of movement Percussion – anterior lateral and posterior chest wall. abdominal wall – shape ± dilated veins. 139 . reflexes.

140 .III Semester. tutorials and problem-based learning. Practicals include laboratory work. hands on skill development. etc. Note: Theory and Practical hours given in the table are approximate hours of instruction. ANNEXES ANNEX – Ia Subject-wise break down of Semester hours: Pre-Clinical Sciences: Semesters I – IV SUBJECTS Semester. seminars.Practical (PR) * Plus 1 week for field visits / practice.IV TOTAL TH PR TH PR TH PR TH PR Anatomy 49 71 25 57 48 88 65 69 472 Biochemistry 63 25 30 25 70 25 37 25 300 Microbiology 32 20 15 20 49 20 32 20 208 Pathology 60 26 32 20 83 20 39 20 300 Pharmacology 51 26 40 24 41 30 29 26 267 Physiology 31 30 37 30 56 30 62 30 306 Community Medicine 48 45 35 40 35 30* 24 30 287 Introduction to Clinical 20 20 20 20 80 Medicine Medical Informatics 30 30 Total Instructional Hours 627 446 653 524 2250 Self Study 326 196 522 Theory (TH) .II Semester.I Semester. Theory includes admixture of lectures.

Dasai and Tihar Vacations 18 days maximum 3. Medical college may also prepare its own holiday’s list. ANNEX – II CALENDAR OF OPERATION FOR AN ACADEMIC YEAR Medical college is required to prepare its own calendar of operations for an academic year at the beginning of an academic year which may be in the month of August or the month of February. Tentative allocated days for different purposes during a calendar year: 1. Medical college will make decisions on matters related to vacations and holidays as per its rules and practices. Other Holidays (local and national) 10 days maximum 4. by taking note of HMG. Kathmandu University and the local practices. Summer and Winter Vacations 45 days maximum 2. Annual University Examinations-Period for preparatory leave 30 days Total 133 141 . Days required for holding 2 Sessional Examinations (Theory + Practicals) 30 days 5.

3 hours health and specific age group -5 hrs 28. Health Delivery 30 hours/40 hours Health -10 hours Health Info Planning & System Program for .Communicable Diseases 18.Occupational Health 40 hours/45 hours .10 hours Communication .internatio Methodology hours – 5 Hours nal Health .10 hours .5 hours . Disaster 31.5 hours Management in Nepal reproductive .Community Diagnosis 13. Epidemiology 7.8 hours SEMESTER – VII Theory/ Practical 23. Demography 35 hours/40 hours I Education & . Non-Communicable 22. Inferential 29. Human & Medicine 2. 8. National plan for Non- 40 hours/40 hours + 3 weeks Diseases communicable .10 hours .10 hours SEMESTER – IV Theory/ Practical 14. Health 27. Psychology 12.10 hours .5 hours SEMESTER – III Theory/ Practical 11.4 hours SEMESTER – VI Theory/ Practical 17. National plan of communicable 19. Nutrition I 4.Information.5 hrs 21.20 hours diseases -10 hours .Mental health.2 hours .15 hours .Medical Sociology. Environmental Health II 9.10 hours SEMESTER – II Theory/ Practical 6. Reproductive 24.Concept of Health 3. Epidemiology II 15.12 hours diseases .10 hours Management of Childhood illnesses (IMCI) . Family Medicine 35 hours/30 hours & Social Anthropology Orientation .5 hours .6 hours . Community Based Integrated 24 hours/30 hours -10 hours .8 hours . ANNEX – IV FLOW CHART OF MODULES IN COMMUNITY MEDICINE SEMESTER – I THEORY Theory/ Practical 1.5 hours Theory/ Practical 20. Research Statistics-12 Management 30. EPI – 26.2 Hours 142 .National 25. Nutrition II 5 Environmental Science 48 hours/45 hours .Behivioral Science 16.

I. I. Dominiczak Medical Biochemistry. Lippincotts Biochemistry . J. 7. Granner. Melnick & Adelberg’s Medical microbiology. Hemang Dixit 7. 6th edition. Gray’s Anatomy by Drake 2. 2009. 2005. COMMUNITY MEDICINE 1. 2009. Bishop Clinical Chemistry: Principles. volume. David & Pauld 5. Elsevier. Text book of Neuroanatomy K garg M kaul I Bahl 4th edition 5. Procedures. 2nd edition. Lippincott Williams & Wilkins. Foundation of Epidemiology by Lilienfield. Burtis and Ashwood (Eds). M Kaul 4th edition 4. 3rd edition. Lippincott Williams & Wilkins. Editor: Krishna Garg 3. ANNEX – VIII LIST OF REFERENCE BOOKS PRE-CLINICAL SCIENCES ANATOMY 1. Harvey 3. Jawetz. Micheal L. Mayes & Rodwell 2. Text book of Histology K Garg. John W. Satyanayarana 4. Baynes. Clinical Neuroanatomy by Snell 14. Tietz Textbook Of Clinical Chemistry. 2009. Marek H. 5. Mosby.I & II 8. Appleton & Lenge 143 . Langman Medical Embryology by T W Sandler 9. Mcminns Atlas of Anatomy by Abrahams 16. Correlations. Wheaters Functional Histology by Young 11. Champ. Netter’s Atlas of Anatomy by Netter 15. Text Book of Histology by Inderbir Singh 12. Text book of Anatomy by AK Datta. II & III by BD chaurasia.Pamella C. 6. Fletcher MICROBIOLOGY 1. Clinical Anatomy by Keith and Moore 13. Richard A. Control of Communicable Diseases in Man by Benson 3. Methods in Biostatistics for Medical Students by Mahajan 4. DiFiore’s Atlas of Histology with Functional Correlation BIOCHEMISTRY 1. Text book of Biochemistry by Vasudevan M D et al. Park’s Textbook of Preventive and Social Medicine by Park 2. Human Embryology by Inderbir Singh 10. 6th edition Jaypee Brothers Medical Publishers (P) Ltd 2006. Harper’s Biochemistry by Murray. Romanes 7. BD Chaurasia Hand book of General Anatomy Editor Krishna Garg 4th edition 6. 8. 6th edition. A Method of Anatomy by Grant 17. Clinical Epidemiology “The essentials” by Robert H. II & III by G. The Quest for Health by Dr. Cunningham’s Manual of Practical Anatomy Vol. Text book of Biochemistry by U. I Bahl. Mark’s Basic Medical Biochemistry: A Clinical Approach. Essential Preventive Medicine Shai & Gupta 6. Human Anatomy Volume. 5th edition.

Essential of Medical Physiology by K. Mathew N. WHO How to investigate drug use in health facilities PHYSIOLOGY 1. Robert & pearsall. Janda. Levy. Hariet Rouses & Bruce D. Robbins Basic Pathology 2. Practical Physiology by Pinaki Chattopadhyay 144 .Hill by Warren Levison & Ernest Jawetz. Clinical Pharmacology by Laurence & Bennett. Pathology Practical Book for Undergraduates by Harsh Mohan PHARMACOLOGY 1. Berne. Nester. Sembulingam & Prema Sembulingam 8. Text book of Medical Physiology by Indu Khurana 7.Ashraf Mohammad 4. Physiology by Linda S. Textbook of Medical Physiology by Guyton & Hall 2. Diagnostic Microbilogy. Microbiology human prospective. Questions and answers in Pathology . Medical microbiology and immunology. Lippincott William & Wilkins 5. A Blakeley & Cecil Kidd 6. Winn. Lenge Medical books/ McGraw. Practical Examination Manual of Pathology . Review of Medical Physiology by W.2. BM Koeppen & BA Stanton 4. PATHOLOGY 1. Physiology by Robert M. Lippincort co. Robbins Pathologic Basis of Diseases 3. Pharmacology and Pharmacotherapeutics by Satoskar. Anderson. Human Physiology by Andrew Davies. Mc Graw Hill 3. Microbiology by Willian A. Concise Pathology by Chandrasoma & Taylor 5. by Koneman. WHO Guide to good prescribing 4. Fisher. Schreckenberger.Ashraf Mohammad 6. 3. Costanzo 5. Bhandarakar & Ainapure 2. 4. Allen. Janeway’s Immunobiology by Kenneth Murphy. F. Strohl. Ganong 3. Paul Trevers & Mark Walport 6.

P. Nepalganj Medical College. R. Kathmandu Medical College. Archana Saha Professor of Pharmacology. College of medical Sciences. Dr. N. Rana Dean. Adhikari Controller of Examinations. N. KUSMS –Member Attendees 1. Nepal Associate Dean. Malla Professor of Opthalmology. Veena Gupta Professor of Paediatrics. Ranjit Guha Associate of Anatomy. B. Heera Tuladhar Associate Professor of OBGY. Ashraf Mohammad Professor of Pathology. KUSMS –Member 9. B. Nepalgunj –Member 6. KUSMS 5. Dr. KU 2. Nepal Medical College. Prof. Dr. ANNEX – IX LIST OF PARTICIPANTS IN CURRICULUM REVIEW MBBS Subject Committee 1. Lakhey Assistant Controller of Examinations. Manipal College of Medical Sciences. Prof. Dr. O. Prof. Dr. Sashi L. Tuladhar Associate Dean. B. Arpana Neopane Associate Professor of Medicine. Bharatpur –Member 7. KUSMS 1. Rajendra Koju CAO. Dr. KUSMS 7. Ram Kantha Makaju Shrestha Professor of Surgery. R. Pokhara –Member 10. Dr. KUSMS 4. Dr. Dr. K. Anjana Singh Dongol Assistant Professor of OBGY. KUSMS 3. Mr. Dr. Kathmandu University School of Medical Sciences. Prof. P. Kathmanu Medical College. Nepal Medical College. Kathmandu –Member 5. Dr. KU 6. Dr. Dr. Dr. Dil Islam Mansur 145 . Malik Professor of Physiology. Kathmandu –Member 4. Dr. Kathmandu –Member 3. Dr. Kathmandu –Member 8. Shiva Kumar Rai Professor of Microbiology. Dhulikhel –Chairman 2. Dr.

Dr. Birendra Lakhe. Dr. K. Assistant Controller of Examinations List of Core Members Prof. S. Dr. Dr. D. KUSMS 8. S. Mishra Dr. Dr. Pandey Dr. Dr.B. D. Dr. P. N. Dutta Dr. Marcus Ritter. J. J. B. KUSMS Kathmandu University School of Medical Sciences Prof. Lecturer of Anatomy. Bharatpur Prof. Dr. Marcus Ritter Prof. Mr. B. Dr. Arpana Neupane Mr. Rajendra Koju Dr. Paracelsus Medical University Salzburg. Dr. M. P. Sinha Dr. Nepal Prof. N. Nagpal Prof. N. Dr. Kathmandu Prof. Kathmandu Prof. Chawla Prof. Shambhu Nath Dr. Dr. N. Dr. Controller of Examinations Mr. Dr. Joshi Kathmandu Medical College. A. Tribhuvan University. Associate Dean Prof. Nepalgunj Prof. D. Arti S. Reddy Prof. B. Anjana Dongol Singh Dr. K. M. Hemang Dixit Prof. Dr. Sharma 146 . Dil Islam Mansur Logistics Members Mr. N. Dipak Dahal Mr. Gokhale Prof. Austria Prof. P. R. S. N. Mishra Prof. Tuladhar Prof. Rana. Pashupati Adhikari Institute of Medicine. Agrawal Manipal College of Medical Sciences. Prakash Aryal Office assistant. R. Puspa Raj Adhikari. Pokhara Prof. Ram Kantha Makaju Shrestha. K. Dr. Dean Prof. Sinha Dr. Dr. Abhinav Vaidya Dr. Ranjit Guha Nepalgunj Medical College. C. Singh Prof. Dr. Archana Saha College of Medical Sciences. R. Dr. Dr.

Jyoti Tara Manandhar 147 . B. T. Biratnagar Dr.Nepal Medical College. Lumbini Dr. S. M. Kamal Parajuli Lumbini Medical College. R. Chawla Dr. Dr. P. N. Sinha Prof. B. Dr. Raj Kumar Chhetri Dr. Dr. Raj Kumar Karki Dr. Dr. Dr. Amatya Dr. Tuladhar Prof. Sita Pokhrel Dr. K. D. Kapoor Prof. C. R. Ashraf Mohammad Prof. Mansur Dr. Dr. Sushila Jain Kathmandu University School of Medical Sciences. G. Dr. R.B. P. Gynendra Ghimire Nobel Medical College. Nirajan Parajuli Dr. P. Singh Mr. S. M. K. Sangina Ranjitkar Dr. Mallik Prof. Shashi L. Ajit Agrawal Mr. Ramesh P. Bedi Prof. N. Puspa Raj Sharma Dr. I. Shrestha Dr. Dharmendra Karn Dr. Anjana Singh Dongol Dr. Jagdish Chataut Dr. Dr. Tambey Dr. Haque Dr. Rizyal Prof. C. B. Y. R. Nepal Prof. Chandan Upadhayay Dr. Dr. Dhulikhel Prof. Rajendra Koju Dr. D. Jorpati Prof. Dr.

Obstetrics & Gynecology. Obstetrics & Gynecology Dental. Forensic Medicine Psychiatry. Medicine Orthopedics Orthopedics Radiology. Oto-rhinolaryngology Surgery. Ophthalmology Dermatology. Pediatrics Anesthesia. CLINICAL SYLLABUS V SEMESTER VI SEMESTER Community Medicine Community Medicine Medicine Forensic Medicine Surgery Ophthalmology Obstetrics & Gynecology Oto-rhinolaryngology Pediatrics Medicine Surgery Obstetrics & Gynecology Pediatrics VII SEMESTER VIII SEMESTER Community Medicine Medicine. Pediatrics IX SEMESTER INTERNSHIP Medicine One year rotating Surgery Orthopedics Obstetrics & Gynecology Pediatrics .

IMCI.Info 2002 SEMESTER VII Theory Module 26 Health Planning and Management Module 27 Health delivery system in Nepal Module 28 Inferential Statistics Module 29 Disaster Management Module 30 International Health Module 31 Research Methodology . IMCI Module 24 National Health programs for Reproductive Health and specific age group Module 25 EPI.Community Medicine SEMESTER III Theory Module 11 Sociology Module 12 Community Medicine Module 13 Family Medicine SEMESTER IV Theory Module 14 Epidemiology II Module 15 Behavioral Sciences Module 16 Integrated Management of Childhood illnesses SEMESTER V Theory Module 17 Communicable Diseases. Neonatal Health Strategy Module 18 National Plans for Communicable Diseases Module 19 Occupational Health Module 20 Mental Health SEMESTER VI Theory Module 21 Non-communicable Diseases Module 22 National Plans for Non-communicable Diseases Module 23 Reproductive Health.

Community Medicine Course Content SEMESTER V Modules 17: COMMUNICABLE DISESASES.J.Rabies. Plague  Enteric Fever  Chicken pox. German measles  Re-emerging infectious measles  Hospital acquired infections  IMCI and Neonatal Health-Strategy  Introduction to IMCI and orientation to the global program.Yellow fever  Filaria  Zoonoses . B. E  Kala-azar  Arboviral diseases . IMCI AND NEONATAL HEALTH STRATERGY MODULE Themes and Topics:  Malaria  STD/AIDS  Pulmonary Tuberculosis  Leprosy  Vaccine preventable disease (VPDs) included in the Expanded Program on Immunization  Diarrhoeal diseases  Hepatitis .  Importance of IMCI in family medicine  Neonatal health strategy of Nepal Module 18: National Plans for Communicable Diseases Themes and Topics National plans for  Malaria  STD/AIDS  Pulmonary Tuberculosis  Leprosy  Vaccine preventable diseases (YPDs) included in the Expanded Program of Immunization: cold chain and surveillance of VPDs  Diarrhoeal diseases etc. health hazards & international safety limits  Principles of control of Occupational diseases  Legal aspects  Practical exercise: visit to a factory Module 20: MENTAL HEALTH Themes & Topics  Problems of mental health  Assessment of mental health  Causes of mental ill health ...A. Module 19: OCCUPATIONAL HEALTH MODULE Themes and Topics:  Working environment: health hazards of industrial and agricultural workers  Common occupational diseases  Industrial toxic substance. C. Dengue. E. D.

tubectomy / vasectomy.  Nutritional anemia  Night Blindness etc.IUD insertion.g.  Impairment / Disability / Handicap: Definitions and concepts  Assessment of Impairment / Disability / Handicap: e. . Post-Polio residual paralysis  Programs for rehabilitation at the individual and community levels  Community based rehabilitation Module 23: REPRODUCTIVE HEALTH & IMCI Themes and Topics:  Maternal and child health  Safe motherhood  Magnitude of the problem  Maternal morbidity and mortality  Under 5 year child morbidity and motility . Administer injectable contraceptives.  Types of mental illness  Mental development in children  Alcoholism & drug abuse/addiction  Suicide a deliberate self-harm  Problem of sexuality and gender disorders  Prevention of mental ill health  Mental health services in Nepal SEMESTER VI Module 21: Non-communicable diseases Themes and Topics:  Epidemiology of non-communicable diseases  Nutrition disorders  Rheumatic health diseases  Hypertension  Cancers  Blindness  Diabetes  Obesity  Accidents Module 22: National plans for non-communicable diseases Themes and Topics:  Program for control of Iodine Deficiency Disorders  Blindness Control Programs  Program for control of other Nutritional Disorders e.  Breast feeding and weaning  Family planning methods  Practical exercises  Insertion of IUD  Use of injectable contraceptives  Tubal ligation  Vasectomy  Perform .g.

 Cleaning of data set  Frequencies and other tables  Graphical output  Cross-tabulation SEMESTER VII Module 26: Health planning and management Themes and Topics:  Primary Health Care  Management of health resources  Planning and organization of health services in Nepal  Health team at district hospital.g. legal values etc.  "ANALYSIS" of data set.Module 24: NATIONAL HEALTH AND PROGRAMS For REPRODOCTIVE HEALTH and SPECIFICAGE GROUPS Themes and topics:  Mother and child health (MCH) program  School health program  Problems for the elderly  Social organizations to assist the elderly Module 25: EPI info 2002 Themes and Topics:  How to design a computer compatible questionnaire in "EPED"  How to "ENTER" data in the questionnaire  Simple forms of "CHECK" programes while entering date e. health post etc.  Concepts of cost benefit and cost effectiveness  Practical exercise: Game to demonstrate management Module 27: HEALTH DELIVERY SYSTEM IN NEPAL Themes & Topics:  Evolution of health services  Organization of health delivery system in Nepal from center (MOH) Jo sub Health Post functions of different category health personnel . range checks.  Voluntary agencies in health care  Evaluation of a health program: epidemiology and management principles  Need of health economics.

Poison distribution. line of command etc. what does it all mean?" ---------Discussion  Difference between meta-analysis and review  Research project protocol write up Community activity project proposal write-up . Binomial distribution  Estimation of standard error  Confidence interval  Tests of significance  Concepts of alpha and beta error  Bias and random error  Sample.  Relief measures: when and what to ask for?  Concept of Triage  Practical play in a disaster situation  Simulated exercise on patient triage Module 30: INTERNATIONAL HEALTH Themes and Topics:  Need of International Health Organization. cluster sampling (UIP)  Correlation and regression Module 29: DISASTER MANAGEMENT Themes and Topic:  Definitions of Calamity. Hill's question.  Structure and functions of WHO  Other UN agencies and their role in Health care. size calculation  Sampling  Practical exercise in: random sampling.Module 28: INFERENTIAL BIOSTATISTIC Themes and Topics:  Probability  Normal distribution. "Why did you begin?"-------------------Introduction/Objective (s) "What did you do?"----------------------Methods "What did you find?"--------------------Results / Analysis "So.B.  Bilateral Health Agencies  Non-government International Health Agencies Module 31: RESEARCH SKILLS Themes and Topics:  Research: Aptitude or Attitude?  Avenues of medical research: Clinical/Laboratory/Epidemiological  Critical analysis of a published paper:  A. Disaster .natural and man-made  Concepts of Hazard and Vulnerability  Disaster Cycle  Planning for Disaster management  Disaster management committee: constituents.

skeletal remains examination. poroscopy. exhumation. types. dactylographic. scars. hairs. aids and autopsy. time since death  Somatic and molecular death.  Organ transplantation act. types of death. Tattoo.  Basics of human experimentation and clinical trials in general practices. confidentiality in testing blood banks. Nepal Medical Council Act  Nepal Medical "Council-formation and functions  Registered Medical Practitioner . modes of death  Causes of death. identity . suspended animation. mummification. issuing death certificate  Postmortem changes-immediate. foot prints. late  Adipocere. confidentiality in testing. -  Malpractice.  Identity:  Definition. blood banks.race-.duties and privileges  Professional misconduct (Infamous Conduct). Punishments.  AIDS and its legal implication.Forensic Medicine COURSE CONTENT  Introduction  Definitions synonyms of Forensic Medicine  Text books recommended  Historical aspect-evolution and development  Modem forensic medicine-sub-divisions  Medical Law and Ethics:  Definitions.its medico legal importance  Other . manner of death. stature. negative and obscure autopsy. practices.age and its medico legal importance  Sex .  Medico-legal autopsy and artifacts:  Objectives and rules  Routing procedures of medico-legal autopsy examination in Nepal. signs and symptoms of asphyxia.  Brief introduction with medico legal aspect of genetic engineering and closing. Medical Indemnity Insurance  Consent-its relevance in medical practice '  Euthanasia  AIDS and its legal implication.  Brain death and organ transplantation. sudden death  Medico-legal importance of death. ' . corpus delecti  Factors establishing.  Thanatology  Definition.  Brief introduction with medico-legal aspect of genetic engineering and cloning. early. Appeal. pathophysiology.  Preservation of viscera in poisoning. superimposition etc. artifacts  AIDS and autopsy  Asphyxial deaths:  Classification. . moment of death.'  Legal Procedure: . COPRA.  Basics of human experimentation and clinical trials in general.

Examination and reporting of victim of torture  Sexual jurisprudence:  Virginity.  Mental health act. injury to scalp. corrosives. feigned insaniy. delivery . non-metallic  Organic vegetable and animal insecticides.abrasions. definitions. still birth. classification . stab wounds.  Epidemiology of poisoning in Nepal  Laws involving poisoning in Nepal  Deciding on management of poisoning cases . lacerations.  Complications and causes of death by trauma  Medico legal aspects of trauma-homicide.  Definitions. lesbianism. dellriant poison. types mechanisms. lightning. pregnancy. incised wounds. cardiac poisons. etc. burns. viability. bones. buccal coitus.head injuiy: mechanisms.  Trauma-mechanical injuries:  Definitions. spinal poisons.profiling. signs and medico-legal importance  Paternity.  Restraint of insane in Nepal. examining a case of infanticide. hurt. biological stains of medico-legal importance. medico-egal aspects. rifle fire arm & smooth bore fire arm wounds and their medico-legal aspects. sudden infant death syndrome. types autopsy findings and medico-legal aspects.  Strangulation. inebriant poisons. neck. wound certificate  Other types:  Thermal injuries due to heat. medical termination of pregnancy.definitions and medico-legal importance. skull and brain. criminal abortion and its complications  Sexual Offence:  Classification.  Toxicology:  General consideration. food poisoning. restraint of the insane in Nepal. dowry death.  Forensic Psychiatry:  Definition. abdomen.  Blood. types.  Traumatic asphyxia. radio-active substances. chest. irritants: metallic. contusion. suffocation. battered baby syndrome. and bone densitometry  Injury sustained in road traffic accidents.rape. Hanging . suicide. grievous hurt. dead birth.  Civil and criminal responsibilities of an insane person. x-rays. asphyxiants.  Drowning definitions.definitions. methods and consequences. plane crash. injury to spine.  Forensic Science:  FSL. sexual asphyxia. scals  Thermal injuries due to cold (hypothermia)  Injury due to electricity. railway accidents.  Fire arm wounds-basics. intra-cranial hemorrhages.  Regional injuries . drug dependence. live birth. explosion and mass disasters  Self-inflicted injuries and defense injuries  Torture: definition. ultrasonography. chop wounds & their medico legal significance. incest. sterility . DNA . impotency. MRI. saliva and semen.definitions. sodomy. autopsy findings and medico legal aspects. autopsy findings. somniferous poisons. CT-scans. joints etc.  Abortion. bestiality  Definition.

discharge on treatment.  Chemical and biological warfare agents: advantage. chemical poison. common. knee.  Occupational and environmental toxicology.  Study of Museum Specimens: Soft specimens. structure. hipbone etc. weapons. appliances & instruments of medico . histopathology slides. cases. selectivity. time since death. : ankle.  Taking students to courts to witness recording of evidence. poisonous animal & insects. disadvantages. dissemination and delivery. assault. vegetable poisons.legal significance ( Including autopsy instruments)  Drafting Certificates during Routine Medical Practice: a) Birth certificate b) Physical fitness certificate c) Leave certificate d) wound certificate e) Age certificate f) Drunkenness Certificate g) Death certificate h) Postmortem report  Drafting police intimation letters in medico. sex. femur. cause of death. elbow and wrist joints)  Forensic Odontology: Age determination by teeth examinatipn. etc. shoulder.  Witnessing and drafting report of medico. brought dead. . photographs.legal cases of accident. on examining the skeletal remains (skull. mandible.legal autopsy. etc.)  Forensic Radiology: Expert opinion on age by examining the radiographs (Pelvis. PRACTICALS  Forensic Osteology: Giving expert opinion on age.

leprosy. epistaxis. of the larynx-congenital. rhinospoddiosis.  Examination of the larynx and lower respiratory tract. vestibulitis.acute .stenosis of anterior nares. diagnosis: . acute and chronic retropharyngeal abscess. tuberculosis. acute diphtheritic pharyngitis.  Oral ulcers  Sub mucous fibrosis  Lesions of tongue .  New growths: Benign. paranasal sinuses and nasopharynx  Applied physiology of the nose. rhinoliths. para.  Endoscopy .  Complications of suppurative sinusitis . syphilis.  Diseases of the nose: congenital malformations . paranasal sinuses and Nasopharynx  Surgical anatomy of the nose. neoplasia  Fungal infection of the oral cavity Larynx. hypertrophic and atrophic rhinitis.method. .geographical tongue. Specific- tuberculosis. abscess. polyp of the nasopharynx.  Diseases of the nasopharynx . indications. ulceration. scleroma.  Diseases of the nasal cavity: foreign bodies. rhinoscleroma. sphenoiditis. nasal polypi. indications for tonsillectomy. nasal furunculosis.  Acute tonsillitis & chronic tonsillitis.pharyngeal-abscess.chronic simple. adenoids. lupus. syphilitic. secondary effects of sinusitis. trachea and bronchi:  Surgical Anatomy and applied physiology.haematoma. (Pharynx. injuries. paranasal sinuses.juvenile angiofibromas. Vincent's angina. Acute and chronic maxillary sinusitis.nonspecific common cold . posterior chaoanal atresia.non .g. nasopharyngitis-acute and chronic. ethmoditis. oro-antral fistula. acute rhinitis. deviation and spurs. malformations of larynx.  Abscesses of the pharynx: peritonsillar abscess.  Sinusitis: general considerations of acute and chronic sinusitis.perforation.specific . intracranial complications. carcinoma and sarcoma and simple cysts.Otorhinolaryngology COURSE CONTENT Nose.frontal sinusitis. lingual tonsil abscess. trauma.congenital dermoid.specific .  New growth-benign and malignant.  Diseases of nasal septum: . Osteomyelitis of maxilla-orbital complications. granuloma.frontal ostemyelitis. angioma.  Diseases.  New growths and cysts of the nose and sinuses: papilloma. Moniliasis.-. leprosy. malignant-carcinoma. dermoid cyst. Chronic . nasopharynx and. oropharynx)  Examination of the pharynx. Specific — diphtheria. Nasal allergy. inflammations . Foreign bodies in the air passages. Chronic non-specific pharyngitis.non-specific and specific. .  Rhomboid ulcers  Ulcers caused by other causes e.  Examination of nasal passages. Pharynx/ Oral cavity  Anatomy and applied physiology.nasal diphtheria. malignant. nasal allergy.  Foreign bodies.

 Otosclerosis: etiology. herpes.  Ototoxicity Head and Neck:  Mid line and lateral swellings of the neck and their management  Parotid swelling .. leukoplakia. Eustachian sampingitis.  Newgrowth: middle ear and mastoid: . mumps. glomus jugular tumor. leprosy. and prevention. Ear Surgical anatomy and applied physiology Examination of the ear: clinical examination of the ear. pachydermia.  Acute inflammations of middle car cleft. syphilis. otitis. new growth. Extracranial: . subdural abscess. -  Chronic non-specific . otomycosis. herpes Zoster. meningitis. catarrhal otitis media.meningitis.  Tracheostomy: indications. test for vestibular function. functional examinations tests for hearing.simple laryngitis. acute suppurative otitis media acute mastoiditis. wax. Internal: .carcinoma. lupus. petrositis.furuncles. Mastoid abscest.  Chronic suppurative otitis media.  Other types (non suppurative): . facial nerve paralysis. O. secretory otitis media. drug toxicity. otogenic labyrinthitis. . leprosy. organic laryngeal paralysis. dermatitis. specific-diphtheria.  Function: laryngeal paralysis.  Diseases of external ear: congenital malformations.  Complication of suppurative otitis media. scleroma. pathology. tuberculous otitis media. complications. otitis external. laryngismus stridulus  New-growths of the larynx. brain abscess. test for Eustachian tube function. myringitis bullosa.  Prevention of S. treatment.  Other types (non-suppurative): . traumatic disorders. Menier's disease.chronic. rubella.  Affection of the external auditory canal .simple and dangerous. perichondritis. syplilitic otitis media. after treatment. M. labyrinthitis. presbyacusis. foreign bodies.  Inflammations: acute non-specific . laryngo. Thrombosis.  Vocal nodules-tuberculosis. of complications of otitis media.tracheo-  Bronchitis.  Rehabilitation of deaf'and dumb. otitis barotraumas.  Chronic suppurative otitis media-sample and dangerous.Mastoiditis. extradural abscess.  Diseases of inner ear: congenital disorders. clinical features. secretory otitis media. syphilis.chronic catarrhal otitis media.  Noise trauma. technique. affections of the auricle. lupus. otitis media. acute catarrhal otitis medial acute suppurative otitis media acute mastoiditis. injuries of external ear and tympanic membrane. deafness. acute and chronic.simple laryngitis. . auditory nerve tumor.

Complications d.Ophthalmology A. Optics. stages development. b. Uveitis  Types  Causes  Clinical features  Investigations  Treatment c. Degenerative changes in the conjunctiva:  Pinguecula  Pterygium Cornea / Sclera a. conjunctiva and Cornea Optics Optics  Elementary Optics and Physiological Optics  Measurement of Visual acuity Refractive Errors a. Applied anatomy. allergic  Symptoms and signs  Treatment c. Cataract: Causes. Episcleritis / scleritis B. Diagnosis. and physiology. Applied anatomy. Classification of glaucoma:  Primary open angle glaucoma (POAG)  Clinical features  Diagnosis . Uvea and Liens Uvea a. Applied anatomy and physiology b. management and complications C. symptoms. b. Conjunctivitis  Types: infective. Refration. clinical features and treatment)  Myopia  Hypermetropia  Astigmatism b. Panophthalmitis Lens a. Applied anatomy b. Endophthalmitis e. Presbyopia & accommodation Conjunctiva a. Types of refractive errors (etiology. classification. Glaucoma. Applied anatomy and physiology implications b. Retina and Vitreous Glaucoma a.

Retinopathy of blood dyscrasia i. Applied anatomy and physiology b. Applied anatomy b. Diabetic retinopathy  Non-proliferative diabetic retinopathy  Proliferative diabetic retinopathy . Toxemia of pregnancy Vitreous a. Orbital cellulites: causes. Pupil. Visual pathway b. investigation and treatment . Vitreous degeneration (in general) c.  Management  Primary angle closure glaucoma (PACG)  Stages of ACG  Clinical features  Management  Congenital glaucoma  Etiology  Clinical features  Treatment  Secondary glaucoma  Causes Retina a. Optic atrophy: causes Orbit a. Retinal detachment  Clinical features and management g. Leukocoria  Causes / differential diagnosis j. Variations of pupil  Physiological: mydriasis and miosis  Pharmacological variations: mydriatiocs and miotics Optic Nerve a. optic nerve and orbit Pupil a. Papilledema: etiology and clinical features d. Retinal vein occlusion (CRVO/BRVO) e. Retinal artery occlusion (CRAO/BRAO) f. Vitreous hemporrhage  Causes D. Papillitis: etiology and clinical features c. . Pulillary pathways and reflexes b. Age related macular degeneration (ARMD) h.  Treatment c. Hypertensive retinopathy  Clinical features  Grading of hypertensive retinopathy d. Anatomy b.

Applied anatomy of extraocular muscles b. Inflammation of lids .  Trichiasis  Ectropion  Causes  Clinical features  Management  Entropion  Causes  Clinical features  Management  Ptosis/lagophthalmos o Causes o Clinical features o Management  Tumors of eye lids  basal cell Carcinoma  squamous cell carcinoma G. Clinical features e. Inflammation of the lacrimal passage (  Acute dacryocystitis  Etiology  Clinical features  Management  Chronic dacryocystitis  Clinical presentation  Investigation  Treatment c. Types b. Diagnosis c. Treatment Amblyopia a. Eye injuries and community Ophthalmology . Causes d. Applied anatomy / b. a. Dry eye: causes. Types c. blepharitis c. Eye. clinical features and treatment H. Lacrimal apparatus a. abnormalities in the position of eye lids. Applied anatomy b. Squint/Diploma Squint a. Management F. Inflammation of the glands of the lids  Stye  Chalazion d. c. Proptosis: causes and management E. lid margin and eye lashes.

thermal.Eye injuries: a. glaucoma)  Epidemiology: global and national perspectives blindness b. Primary management c. Referral criteria Community ophthalmology a. eye infections and Injuries. Ocular manifestations of tuberculosis leprosy . Types:  Mechanical (extraocular foreign bodies. Blindness:  Definition  Major causes (cataract. xerophthalmia. radiational) b. blunt injury) Penetrating /perforating injury. electrical. trachoma. sympathetic ophthalmitis  Non-mechamcal (chemical.

infective endocarditis.  Perform thorough physical examination of cardiovascular system. peptic ulcers. Aspiration). pericardial effusion. pleural effusion. chicken pox. chronic. gastritis. hepatic coma.  Diagnose and manage following emergencies: he'metemesls & malena. kalazar.e acute pulmonary edema. pancreatitis. pneumonia (broncho. . Thromboembolism. lung absecess. high altitude sickness.  Recognize and refer pneumothorax. shock. plague. due to toxic substances. disorders of cardiac rhythm. hemoptysis. obstructive airway disease (COAD) and emphysema. mumps. cardiac arrest.  Diagnose and learn the management of following common conditions: Congestive heart failure. esophageal varices. acute coronary syndromes. hydatid). filariasis and tropical eosinophilia. malabsorption syndrome.  Learning and performing the clinical examination of respiratory system. cirrhosis of liver. achlasia. carcinoma lung. gastroesphageal disease due to parasitic infestations (round worms. Diseases of Gastrointestinal System  Take detail history of patient suffering from gastrointestinal disease. Infectious and Tropical diseases  Learning and taking the history of patients suffering from infective and tropical diseases  Learning and performing the relevant physical examination  Diagnosis and treatment of common infective and Tropical diseases (amoebiasis. rabies.e bone marrow examination for parasitic fever and investigations of viral disorders). hook worm. peripheral vascular disease. empyema (including amoebic empyema). measles. tape worms. infarction. congenital heart disease. pulmonary embolism. myocarditis. acute and chronic respiratory failure. acute pancreatitis. brucellosis)  Learning appropriate investigations for diagnosis of infective and Tropical disorders (fr. pneumothorax. hepatitis jaundice.Medicine and Allied Subjects Diseases of Cardiovascular System  Take appropriate history pertaining to cardiovascular system. . Diseases of Respiratory System  Learning and taking the history of a patient suffering from respiratory diseases. bronchiectasis. pericarditis. dysentery. give initial treatment and refer: hiatus hernia.  Diagnose and manage the following cardiac emergencies i. lobar. myocardial. manage following emergencies: status asthmaticus. amoebiasis (hepatic and intestinal). Chrons disease. as a complication of peptic ulcer. enteric fever. bronchial asthma.  Recognizing normal X-ray chest and common abnormalities. carcinoma GI tract.  Diagnose and manage following problems: gastro esophageal reflux disease (GERD).  Learning of normal plain X-ray abdomen and recognition of significance of air under diaphragm and other findings. poliomyelitis. aortic aneurysm and coarctation of aorta. small pox. giardiasis. malaria. ulcerative colitis. giardiasis.  Diagnose.  Diagnose and manage the following respiratory illnesses: acute and chronic bronchitis.  Diagnose and. hypertension. sputum examination for AFB. leprosy.  Perform thorough physical examination of gastrointestinal system including rectal examination and examination of hernial orifices. irritable bowel syndrome. allergic alveolitis.  Learning the normal EGG and interpretation of abnormal findings. occupational lung disease. tropical sprue. pulmonary tuberculosis.

 Diagnosis and management of following emergencies: cerebral malaria and its complications.  Recognize give initial treatment and refer e. addisonian crisis.  Diagnosis and manage the following emergencies: diabetic coma. pheochro raocytoma. . hypogonadism.  Learning stool examination.  Recognise.  Recognize. osteomelacia. heat stroke and exhaustion.  Learn the principles of blood transfusion and indications.  Do a physical examination of lymphoreticular system. genitourinary tuberculosis. give initial treatment and refer: growth -disorders. hyperkalemia.  Performing physical examination relevant to dysfunctions of endocrine glands. infertility. rheumatoid arthritis. acute glomerulonephritis. goitre with stress on endemic goiter as one of the four major health problems in the hills and other thyroid disorders including hyperthyroidism and hypothyroidism.  Perform physical examination of musculoskeletal system and relevant physical examination  Diagnosis. Sheehan's syndrome. polycystic kidney disease chronic recurrent urinary tract infections.  Examination of disorders of urinary systems and relevant physical examination.  Learning the normal values of examination of blood CBC. pathogenesis and management of gout. thyrotoxic crisis.  Learning the diagnostic procedures i. recognition of hemoparasites (i. acidosis & alkalosis.  Learning the basics of immunosuppressive therapy. Disease of Blood and lymph reticular system  Outline the normal coagulation process and the abnormal coagulation. Diseases of Endocrinal systems and Disorders of Metabolism  Learning taking the appropriate history. rickets in adult.  Manage the emergency of acute blood loss.  Diagnose and manage following common conditions: urinary tract infection. reticulosis. bleeding time. and complication. hyperthyroidism. polycythemia.  Learning the normal radiology of joints and other bones and the recognition and interpretation of abnormal findings. hypoplastic anemia. renal & vesical calculus.e malarial parasites and LD bodies) and blood smear examination. Diseases of Urinary systems and electrolyte disorders  Taking of appropriate history related to renal diseases. megaloblastic. techniques. nephrotic syndrome.g. systemic lupus erythematosus.e Diabetes mellitus. Diseases of Bone and Joints and Immunological disorders  Take history pertaining to joints and immunological disorders. cholera. Take proper history pertaining to lymph reticular system and hematological disorders. platelet count blood and blood groups and their interpretation. hemolytic anemia bleeding disorders due to disorders of coagulation. hypoparathyroidism..  Diagnose and treat following common disease anemia (iron deficiency.  Diagnosis and management of following common endocrinal disorders i.  Diagnosis and management of renal emergencies: hematuria acute renal failure. agranulocytosis bleeding disorders.e. ankylosing spondylitis and scleroderma. hodgkins diseases and non- hodgkins lymphoma. give initial treatment and refer acute leukemia. hypokalemia. impotency.  Describe the pathogenesis of various hematological disorders. coagulation time. neoplastic diseases of kidney. joints aspiration. chronic renal failure.

e staphylococcal food poisoning. cerebrovascular accidents. food poisoning (i. epilepsy.  Diagnose and treat following poisoning: organophosphorous compounds. muscular differentiate the causes and manage an unconscious patient).  Diagnosis and treatment of snake bites. multiple sclerosis. brain tumor. Encephalitis. corrosive poisoning and Heavy metals (i . principles of CT scanning. poisoning).e lead. peripheral neuropathies. carnial nerve palsies. status epilepticus. arsenic) poisoning. neurosyphilis. mushroom poisoning. botulinism.  Learn to perform thorough neurological examination  Diagnose and treat following common conditions: meningitis. Diseases of Central Nervous System  Take appropriate history in relation to central nervous system. Poisoning and Toxicology  Learn to give first aid management in poisoning cases including gastric lavage.  Barbiturates. mercury. involuntary movement disorders (i. morphine and other sedatives poisoning. paracetamol.  Recognize. scorpion and spider bites. headaches including migraine. Motor neuron disease. ). give initial treatment and refer brain abscess.e. tremors etc. choreas.  Learn examination of urine:  Learn to recognize abnormal shadows in relation to ureter and bladder in x-ray. Parkinsonism.  Learn to do CSF examination and interpretation of abnormal ' findings interpret normal X-ray skull. sub arachnoid hemorrhage. Clinical pharmacology  Antibiotic therapy  Immunosuppressive therapy  Antihypertensive agents  Diuretics  Anti anginal drugs  Anticonvulsant drugs  Anticoagulant therapy Common Geriatric problems and their management .

Non organic sexual functions. Reaction on -severe stress and adjustment disorders.Psychiatry SPECIFIC OBJECTIVES  General psychiatry. contraindications and procedures of electro convulsive therapy. epidemiology. Describe non pharmacological methods of treatment in psychiatry  Forensic psychiatry. manage and outline the preventive measures against the most common infective skin diseases in the community. perform clinical examination. clinical manifestations and the principles of following psychiatric disorders. Plan. Neurasthenia and depersonalization. Refer for relevant investigations including psychological testing. Nutritional and Metabolic disorders  Diagnose. mental retardation and substance abuse.derealisation syndrome. and manage pellagra.  Community psychiatry. . panic & phobic disorders.rehabilitation for patients with chronic mental illness. perform psychiatric interview. Psycho-physiological disorders: in systemic organic disease. Infective disorders  Diagnose.  Elicit a complete clinical history from the patients. Apply counseling skills. Describe psychopathology. Dermatology BASIC CONCEPTS (INTRODUCTION)  Outline the role and importance of dermatology in modern medicine. Obsessive compulsive disorders. Psychiatric disorders in geriatrics.  Clinical Psychiatry. Psychiatric disorders in childhood and adolescences. classify psychiatric disorders  Clinical evaluation. Refer difficult cases to secondary or tertiary care centers. requisition of relevant investigation and outline the principles of management. Describe indications. Drug abuse. Basic concept of psychiatry. Diagnose and refer hyperlipidemia and acrodermatitis. Mood disorders. Organic mental disorders. Diagnose psychiatric disorders in a rationale and systemic manner.  Emergency psychiatry: Refer to emergency medicine  Management: Describe pharmacology of commonly psychotropic medicine. and phrynoderma. Schizophrenia and related disorders. . Differentiate between normal and abnormal behavior.  Consultation liaison psychiatry  Rehabilitation. personality' disorders.  Perform skin scrapings and do a KOH preparation for fungus infections.  Define terms commonly used in dermatological practice. Dissociative and somatoform disorders. Take detail psychiatric case history and conduct mental state examination. Diagnose and manage common psychiatric disorders in the community. Anxiety disorder: generalized anxiety. Describe legal and ethical issues in psychiatry. Psychiatric disorders: describe etiology.  Explain the structure and function of the skin as an organ.

Stevens-Johnson syndrome. pityriasis and lichen planus  Refer complicated cases of psoriasis Vesiculobulbous diseases  Diagnose pemphigus  Institute primary care with steroids  Refer complicated cases Drug reactions and eruptions  Diagnose and manage acute drug eruptions: erythema multiforme. leprosy.  Refer chronic recurrent cases of eczema.  Bacterial-skin tuberculosis. chancroid. and hypopigmentation.  Viral-herpes zoster. pyogenic infections. .dermatophytosis.  Endogenous atopic. Papulo-squamous diseases  Idenfity and treat psoriasis. syphilis.  Parasitic-scabies and pediculosis. miliaria and alopecia  Diagnose and outline principles of management of vitiligo. its prevention '  Refer cases of AIDS * Will be taught under medicine Sexually transmitted diseases  Diagnose and treat gonococcal urethritis. common warts  Fungal-superficial . albinism. Leprosy  Diagnose various types of leprosy Manage and treat patients of leprosy Recognize and treat leprosy reactions Refer cases requiring surgery  Describe preventive and rehabilitative aspects of leprosy Acquired Immuno-deficiency Syndrome  Describe dermatological manifestations of AIDS. pityrasis versicolor. fixed drug eruption.  Diagnose case of HIV and AIDS  Provide health education regarding. lympho granuloma venereum. herpes simplex. non-gonococcal urethritis.  Refer complicated cases Disorders of pigmentation  Diagnose and treat acne. PSS Dermatological manifestations of systemic diseases  List common causes  Outline principles of management Tumors of the skin  Describe diagnose and outline of the principles of management and refer common precancerous and cancerous conditions of the skin. candidiasis. granuloma inguinale. Dermatitis and Eczema  Identify and manage common eczemas. Immunological diseases  Identify and refer patients having SLE. seborrhoeic and nummular dermatitis simplex chronicus. genital herpes.

Vital Statistics  IMCI practice (orientation global program. present status) Clinicals  History taking in pediatrics  Anthropometric measurements  Developmental assessment  Physical examination of the child  Code of conduct during clinical examination  Normal development of child Integrated  School Health  National Health Program  Immunization  Nutritional assessment  Behavior pediatrics Semester VI Theory  Infectious diseases  Diseases of respiratory system  Neonatolosis  Tuberculosis  Fluid and electrolyte-therapy  Diarrhoeal disease and their management Clinical  History taking  Developmental assessment in a child  General physical examination  Systemic examination-CVS. Respiratory.Pediatrics Semester V Theory Introduction/overview/ of pediatrics  Normal child/ newborn nomenclature  Growth & development  Immunizations  Nutritional assessment  Nutritional deficiency  Behavior pediatrics  National Health programs related to children in Nepal  School Health  Breastfeeding  Infant feeding  Child Health situation. GI & CNS  Approach to IMCI in clinical practice  Examination of newborn Semester VII Theory .

medication.documentation. video show) Semester IX Theory  Pediatric surgical problems  Emergencies in pediatrics  Collagen vascular diseases  Inborn errors of metabolism-General aspect  AIDS in children  Rational drug therapy  Poisoning. danger sign. follow up & referral Clinical  Emergency room posting  Instruments  X-rays study  Immunization training  Procedure training  Diarrhea unit training .  IMCL training (documentation.self learning  Embryology. snake bite & drowning  IMCI. follow up.  Cardiovascular diseases  Renal disease  Hepatobiliary system diseases INTEGRATED . physiology of the above' Semester VIII Theory  Hematology  Oncology  CNS & neuromuscular disorders  Diseases of endocrines  Genetics & chromosomal disorders  Childhood disabilities  Congenital malformation Clinical  Examination of a newborn (Normal and abnormal)  Gestational assessment of newborn  Low birth weight babies  Resuscitation of newborn  Breast feeding & BFHI  Identification & management of common neonatal problems.

atelectasis. pericarditis.  Multiple Trauma. haemothorax. actively participate in treating such a patient. chylothorax.g crystalloids plasma. special methods of investigations. assess the blood loss in relation to the clinical condition of the patient. cardiopulmonary resuscitation.  Describe the complication and their treatment including skin grating Cardiothoracic Surgery:  This is a specialized branch of surgery and 'students are expected to have brief knowledge of the following common conditions.  List the causes the path physiology of shock. specially the fluid and electrolytes imbalance. antibiotic analgesics. and describe the natural compensatory mechanisms involved preventing shock. the indications for tracheotomy.  Initiate treatment of shock and correct fluid. electrolyte and pH imbalance. describe the role of drugs like steroids. penumothorax. secondary closure. blood transfusion. consolidation. flail chest. lung abscess. tumors. embolism infarction.  Describe the principles of blood transfusion. pyothoax. antibiotics. debridement wound excision and skin grafting  Describe the types. e. pericardial effusion.  Correlate the requirement of particular painted instruct treatment e. infected or contaminated. bronchoscopy and bronchography  Outline the surgery of chest injuries. Surgery of Genito-urinary system:  Describe the anatomy arid physiology of the related organs. cardiac tamponade.g. anticoagulants and analgesics. congenital and acquired heart diseases and their surgical management. degree and percentage of burns. details of its technique and post-operative care of a tracheotomised patient.  Outline the path physiology. and correlate the clinical features with the degree of shock. hydatid cyst.  Outline the principles of control of bleeding (bearing in mind condition such as haemorrhagic diathesis). tuberculosis.  Management of mass disaster. mechanism of respiration.  List tile causes of respiratory failure and describe the emergency management of. administer first aid treatment to a patient with active bleeding. nature of wound..disadvantages). including stove in chest.  Describe investigation. their investigations. cardiac catheterisation.Surgery and allied subjects Theoretical Knowledge: General Surgery  Describe the causes of bleeding the type and source. bronchiectasis. diagnosis and management. collapse. surgical emphysema. understand the importance of time elapsed since sustaining such wounds. chest X-ray. . ABC of trauma & resuscitation  Describe anatomy of respiratory passage and. bronchial adenoma. make reasonable judgment concerning' active surgical investigation in such patient.  Describe the mechanism of wound healing and list the indications for primary closure.  Describe the types of wound. angiocardiography.  Outline the surgery of heart. blood substitute.  Outline the surgery of diseases of lung. and their treatment. pulmonary Oedema. its indication and hazards. clean. bronchopneumonia. fracture ribs. hydrothorax. blood grouping cross matching. bronchogenic carcinomas. radiology. such cases including assisted respiration (its advantages the .

 Retention of urine (acute and chronic) and obstructive uropathy.of spleen and splenomegaly. seminoma. space occupying lesion of brain and spinal cord. carcinoma bladder.  Epidydimitis and orchitis. thrombocytopenic purpura. haenatocele. horseshoe kidney. hypospadius. testes pancreas and ovaries Lympho-reticular System:  Describe different conditions that are encountered in surgical practice of require surgical management including lymphomas.  Diagnose and manage the different types of head injuries. hydrocephalus. polycystic kidney. pyelitis. rupture. benign .g tropical. hydrocoele. cystitis and urethretis). Miscellaneous  Describe physiology and different condition involving breast abscess. Central Nervous System  Examine the central nervous system. acromegaly  Common conditions of thyroids. Renal cell carcinoma. stricture urethra. pin hole meaturs.  Know the anatomy and physiology of vessels. varicose veins.  Describe the following common diseases. paraphimosis.  Calculous obstructive diseases of Kidneys. bladder. e.enlargement of prostate.g. phimosis. haematuria). lymph oedema and their management. scrotum and penis. papilloma of bladder. diagnosis and treatment. . deep vein thrombosis. e. diabetic gangrene.  Describe the hypothyrodism. infertility and subfertility in man. tumors of adrenal  Hyperparathyrodism and tetany  Diseases of pituitary gland that are encountered in surgical practice. ectopia vesicae.  Prostatitis. teratoma. carcinoma penis.  Testes. posterior urethral valve. vas.  Genito-urinary tumours (Wilm's tumor. solitary cyst of the kidney. congenital spherocytosis. benign and malignant tumors and their management. urinary stones.  Rupture of kidney.  Describe the anatomy and physiology of the lymph node and lymph vessels. and prostate. nephritis. epispadius. their function and different condition such as lymphangitis. impotency. effects of occlusion of a vessel and tile common diseases. chyluria.  Surgical Oncology . prostatic carcinoma stricture urethra. pyonephrosis. lymph adenitis. goitre. post-caval ureter.  Congenital abnormalities. their clinical features. double ureter.  Obstructive nephropathy and calculus diseases (hydronephrosis. ureters urinary bladder urethra (stone urinary bladder. examination.  Vasectomy. maldescended testes. utethra and trauma to testes. crypto-orchidism. Hodgkin's and non-Hodgkins' lymphoma. crypto orchism. Musculoskeletal System: (To be covered in curriculum of orthopaedics) Endocrine System:  Describe the anatomy. carcinoma of ureter and urethra. epidydimitis. gigantism. idiopathic. phimosis. tumors  Hypo and hyper function of adrenal gland. physiology and the hormone secretion of the endocrine glands and its surgical aspect.

INTRODUCTION CLINICS General introduction to orthopedic examination . rejection and immune-suppression. .  Specific management of acutely injured. . Examination of the elbow .  Minimal invasive surgery  Principles of organ transplant. Examination of diseased bone . Examination of the fool.CDH  Neuromuscular I .  Upper & Lower Endoscopy Orthopedics SPECIAL OBJECTIVES VII Semester: THEORY Traumatology:  Introduction to Orthopaedics.  Tractions: Principles of skeletal traction  Plaster.Cerebral palsy . Examination of the spine . Types of casts and complications  Imaging in the acutely injured: Techniques and interpretation. classification of fractures and fracture  General management of acutely injured and polytrauma. Examination of the shoulder . Examination of a bone tumor CLINICAL ASSIGNMENT Case discussion and observation of surgical procedures VII Semester THEORY Cold Orthopaedics  Congenital anomalies I-CTEV  Congenital anomalies H.  Acute management of acutely injured  Splinting in Orthopaedics  V Tractions: Principle of skin traction. Examination of the wrist . Examination of the child with polio . Examination of the ankle . Examination of the knee . Examination of peripheral nerve lesion .techniques . Examination of the hip .principles of application. Examination of the hand . General format of examination of a paralyzed limb.

flat foot.  Infection II .  Neuromuscular H. Torsinal deformities.polio. ankylosing spondylitis.  Back ache.Malignant bone tumors. supraspinats. disc prolapse. tennis elbow.g Perthes disease  Metabolic bone disease: Rickets. DEMONSTRATION CLASSES Instrument used in Orthopaedic Surgery.  Deformities I .  Trethoyan's bone lever  Bristow's bone lever  Lane's bone lever  Sewestrectomy forceps  Osteotome  Bone gauge  Lanes bone holding forceps  Mallet  Periosteal elevator  Chisel  Curette  Bone hook Implants used in Orthopaedics  Austin Moore pin  Knowles pin  Austin Moore prosthesis  Thompson's prosthesis  Smith Petersen nail  Jewett nail  Dynamic hip screw  Kuntscher's nail  Kirchner's wire  Square nails for radius & ulna  Rush nail  Steinamnn's pin  Bone plates  Bone screws  Bone screws X-rays (Trauma) .  Infection I-Osteomyelitis acute/chronic. M CC.  Soft tissue lesions.Septic arthritis  Infection W -Tuberculosis of the spine  Arthritis III .  Tumors H . Dequervain's Dupuytren's. Haemophilia & Gout. spondylolisthesis. trigger finger. genuvaigum. plantar fascitis. carpal tunnel syndrome. tendinitis. genuvarum.Axial skeleton: Torticollis scoliosis.periathritis. spina bifida. Scurvy.  Deformities W-Lower limb: Coxa vara. Hansen's  Osteochondroses: e.Seronegative arthritis.Rheumatoid arthritis  Arthritis IB . Osteomalacia. valgus and wrist deformities and hand deformities. Kyphosis  Deformities H-Upper Limb: Cubitus Varus.

 Aust Shoulder dislocation  Fracture clavicle  Fracture humerus  Supracondylar fractures  Elbow dislocation  Monteggia fracture  Olecranon fracture  Radial head fracture  Galleazzi fracture  Fracture both bones of Forearm.cervical and thoracic  Nonunion of fracture  Tibia & fibula fracture X-rays (Cold orthopaedics)  Chronic osteomyelitis  Giant Cell tumor  Multiple exostosis  Osteochondroma  Osteosarcoma  Ewing's tumor  T.green stick & adult  Colle's fracture  Scaphoid fracture  Pelvis fracture (anterior and posterior)  Dislocation hip  Fracture shaft of femur adult/child  Fracture neck femur  Trochanteric fracture  Condylar fracture femur & tibia  Patella fracture  Ankle fracture  Calcaneal fracture  fracture spine.B spine  Secondaries in spine  Pathological fracture  Rickets  Osteoarthritis  Genu valgum & varum  Cubitus varus and valgus  Perthe’s disease  CDH  Spondylolisthesis  Ankylosing spondylitis  Kyphosis  Scoliosis  T.B hip .

E.P Urethra  Stricture  Urethral valve .K prosthesis  Hip disarticulation  Below elbow prosthesis  Prosthesis with fillers  Above elbow prosthesis Walking & Mobility Aids  Walking stick  Axillar crutch  Elbow crutch  Walker .polycystic diseases  Renal calculi: Nephrocalcinosis  Renal parenchymal diseases: Pyelonephritis/ tuberculosis  Renal vascular disease & renal hypertension  Tumors: Adenocarcinoma and Wilm's Bladder and Prostate  Extrophy/ urachal anomalies  Bladder calculi/ diverticula  Bladder tumor  B.Radiology THEORY Kidney  Congenital anomalies: Renal agenesis/ dysplasisa/ ectopic/ duplication malrotation fusion/ ureterocele  Benign lesions: Simple cyst/ cystic diseases.  Trauma  Posterior urethral valves Ortho  Denis splint  Denis browne shoe  AFO  KAFO  Soft cervical collar  Hard cervical collar  Arch support  Thomas heel  MCR Chappals  Heel wedges  Heel and sole correction for shortening Prosthesis  Syme's prosthesis  PTB prosthesis  Orthopaedic shoe  A.

Base arid Blood Gases .how to read and analyze  Monitoring during anesthesia  Basics of Cardiopulmonary resuscitation (CPR).  Rollator  Tripod & Quadripod  Wheelchair Anesthesiology THEORY  Introduction to anesthesia  Preoperative evaluation. epidural and regional nerve blocks  Endotracheal intubation  Post anesthetic complications and care  Fluid and electrolyte balance  Acid. mandible and maxilla. Advanced life support (ALS)  Post CPR management Dental Surgery SPECIFIC OBJECTIVES General Dentistry:  Recall anatomy of teeth. premedication and preoperative preparation  General anesthesia inhalation agents  General anesthesia inhalation agents  Neuromuscular blocking agents  Pharmacology of local anesthetics  Spinal. Basic life support (BLS).  Recall physiology of mastication and describe causes and pathways of pain arising in the oral cavity  Demonstrate methods of examining patients with dental problems. Practical Dentistry: . Recognize the difference between deciduous and permanent teeth and distinguish between healthy and diseased oral structure.

leukoplakia. and oral mucosa. sarcoma of bones of oral cavity  Perform reduction and immobilization of simple fractures of jaws. carcinoma of gums.  Examine the hard and soft structure of the oral .  Administer local anesthesia required for extraction of teeth  Extract loose teeth and drain simple dental abscess perform biopsies  Render primary dental care for dental and gingival conditions management initially and refer unmanageable cases of gingivitis. pericoronitis. sub-mucosal fibrosis. epulis.cavity. recognize gross abnormalities and pathology and development defects. dentigenous cysts. Preventive Dentistry:  Plan and implement school health programs in oral hygiene conjunction with their similar activities in Community Medicine. fractures of mandible and maxilla.  Advise the patients on simple preventive dental care. pulpitis. .

Anatomy of female reproductive organs 2. Normal puerperium 15. Amniocentesis 7. Structure and function of cervix in pregnancy and labour 2. Female pelvis and Fetal skull 10. Normal labor and Mechanisms of Labor 11. Rhesus Isoimmunization . 2nd. Fundamentals of reproduction. 3. Amniotic fluid. Postnatal psychiatric disorders GYNECOLOGY 1. Pregnancy induced hypertension 8. Gynecological diagnosis. Embryogenesis 3.Gynecology and Obstetrics Semester V OBSTETRICS 1. 3rd stages of labor. Methods to evaluate fetal health & maturity during period 4. Complications of 3rd stages of labor:  PPH. Umbilical cord and anomalies 8. Infections of lower genital tract including genital tuberculosis 9. PID 10. Antepartum haemorrhage 6. Diseases of vagina and vaginal discharge 8. Sexually transmitted infections. Paedratic gynecology 7. Active management of labour 3. Physiological changes in pregnancy 4. Development and malformations of female genital tract 6. Placenta. Puerperal pyrexia.Fertilization. Partogram 12. HIV. Subinvolution. Active management of 1st. Abnormal Puerperium  Puerperal sepsis. Diagnosis of Pregnancy and minor problem of pregnancy 5. postpartum collapse 14. 13. Anaemia in pregnancy 7. Fetomaternal circulation 9. menstrual disorders and premenstrual syndrome 5. Retained Placenta. Abnormal labour  Prolonged labour  Obstructed labour  CPD 5. Breast complications. Thromboembolism 16. Diabetes mellitus in pregnancy 9. Intrapartum fetal monitoring. Physiology of Menstruation. Antenatal care 6. Gynecological history and physical examination 2. AIDS Semester VI OBSTETRICS 1. Puberty and pubertal abnormalities 4.

Ultrasound in obstetrics 13. TORCH infection in pregnancy 7. Hyperemesis gravidarum 5. Heart diseases in pregnancy 4. Prenatal diagnosis and genetic counseling 16. Uncertain gestational period 18. Fibroid .. Adolescent gynecology & precocious puberty 3. Hepatitis and Jaundice in pregnancy 6. Ante-partum fetal surveillance 2.GYANECOLOGY 1. Contraception I: Natural method. UTI 6. Barrier method. Maternal injuries form birth GYNAECOLOGY 1. 10. Recurrent 2. Subfertility/ Infertility including genital tuberculosis 5. Hormonal control. Utero-vaginal prolapse 11. Therapeutic termination of Pregnancy and complications. Use of hormones in gynaecology 5. Ultrasound in gynaecology Semester VIII OBSTRETICS 1. Molar pregnancy 3. Instrumental delivery: Forceps. Endometriosis/adenomyosis Semester VII OBSTRETICS 1. Dysfunctional uterine bleeding 4. Adolescent pregnancy 17. Intra-partum fetal surveillance 3. Induced. 2. IUCD. Ectopic pregnancy 4. Polycystic ovarian disease 9. Ovulation failure and induction of ovulation 8. Emergency. Primary amenorrhoea and secondary anenorrhoea 2. Perinatal mortality 15. Cord prolapse 10. Unstable lie 9. Pregnancy spontaneous. Maternal mortality and safe motherhood 14. Sexual disorder 3. Tuberculosis in pregnancy . Transverse lie 8. Male contraception. Intersexuality 4. vaginal birth after • 1 caesarean section 1 12. Male infertility 6. Operative delivery: Caesarian delivery. Ventouse 11. Cardiovascular changes in pregnancy 5. Twins & Multifetal pregnancy 7. Assisted reproductive technology 7.

Post-Caesarean pregnancy 13. Caesarean Section 27. Malaria in pregnancy 11. Induction of labour 22. 31. Neonatal resuscitation 29. Postmaturity/Prolonged pregnancy 21. Genital prolapse. Fibroid uterus. Thyroid dysfunction in pregnancy 10. Intra uterine growth restriction 14. Ovarian tumor 6. Cervical intraepithelial neoplasia 3. Screening of gynecological cancer 2. HRT and related controversies 14. Gyanaecological diseases in pregnancy: Ca cervix. Post-dated pregnancy 12. Premature rupture of membranes 19. Obstetric shock 18. Gestational trophoblastic disease 7. Intra-uterine death and Bad obstetric history 16. Forceps and Ventouse 26. Drugs in pregnancy 25. Chemotherapy 11. Abnormal uterin action 34. Preterm labour 20. VIN 8. Analgesia in labour GYNECOLOGY 1. Epilepsy in pregnancy 9. Occito-posterior position . Care of the terminally ill patients 13. Pruritus vulvi 10. Elderly primigravida and grand multipara 15. Ca cervix 4. 8. Obstructed labor and uterine rupture 17. Critical care in obstetrics 36. Radiotherapy 12. Brow and Face presentation 33. Surgical diseases in pregnancy: Acute abdomen in pregnancy 24. Contracted pelvis and Cephalo-pelvic disproportion 30. Ca endometrium 5. Post-menopausal bleeding 15. Dyspareunia . Ovarian tumor. Shoulder dystocia 35. Breech 32. retroversion 23. Destructive operations in obstetrics 28. Vulvular cancer 9.

Cs 4. Recurrent pregnancy loss  Anti-phospholipid syndrome  Cervical incompetence  Uterine anomalies 4.urinary fistula 2. Urogynaecology  Anatomy of continence  Urodynamic studies  Stress urinary incontinence  Detrussor hyper. Antenatal fetal surveillance  Bio.Semester IX GYNECOLOGY 1. Operative gynaecology  Preoperative preparation and postoperative care  D&C  Bartholin's cyst  Hysterosalpingography  Hysteroscopy  Laparoscopy  Manchester Operation/Abdominal sling operation  Staging laparotomy for ovarian cancer  Hysterectomy  Complete perineal tear  Surgical conditions encountered during gynaecological procedures OBSTRETICS 1. Broad ligament hematoma 5. Inversion of uterus 3.reflexia  Genito. Menopause  Pathophsiology of menopause  Short and long term effect of menopause  HRT and Controversy related to its use  Osteoporosis 3.physical profile  Non stress test . USG 6. Rupture of the uterus 2. Chrome pelvic pain 5.