Medicine (Paper – I)

Topic Number
General Aspects of Medical Practice 4-6
Genetics 4-6
Neurology 12-18
Gastroenterology 8-12
Hepatology 4-6
Haematology 8-12
Principles of oncology 1-3
Climatic & Environmental factors in diseases 1-3
GENETICS
You should have an understanding of the structure and function of chromosomes and genes
and knowledge of the principles of inheritance of chromosomal and genetic disorders.
Examples of topics that might be included:
● Chromosomal basis ofinheritance
● Chemical basis ofinheritance
● Manipulating and trackinggenes
● Single genedisorders
● Chromosomaldisorders
● Multifactorialdisorders
● Geneticcounseling
● Perinataldiagnosis
● Genetherapy

GENERAL ASPECTS OF MEDICALPRACTICE

You should have a sound understanding of attributes of a good physician.
Examples of topics that might be included :
● Doctor-patientrelationship
● General aspects of historytaking
● General physicalexamination
● Medicalethics
● Socio-demographic influences on pathogenesis and management ofdiseases
● Cost awareness inMedicine
4.7 Envenomation - Snakebite, scorpion & other stingers. Biological basis, pathophysiology of
envenomation.
Example of topic that might be included:
● Venomoussnakes
● Mode of action ofvenoms
● Anti snakevenins
GASTROENTEROLOGY

Clinical Science
You should understand the:
● Structure and function of the gastrointestinal and hepatobiliarytract
● Neurohormonal control of gutmotility
● Secretory and absorptive functions of the gastro-intestinal tract andliver
● Symptoms and signs of gastrointestinal, hepatobiliaryand pancreaticdiseases
● Genetics of the more common gastrointestinal and liver disorders
● Clinical pharmacology of drugs used in gastrointestinal disorders including their actions,
interactions and adverse effects

Examples of topic that might be included :

● Control of gastric acidsecretion
● Autonomic control of gutfunction
● Effects of cholinergic, adrenergic and serotonergic agents on gutfunction

Disorders of the mouth, tongue and salivary glands

You should have an understanding of:
● Mouth ulcers, periodontal and salivarydisorders
● Oral manifestations of systemic and dermatologicaldisorders

Examples of topic that might be included:

● Causes of mouth ulcers and theirmanagement
● Skin disorders commonly involving the buccalmucosa

Disorders of the esophagus and stomach

You should be familiar with the following disorders:
● Achalasia
● Carcinomas
● Dyspepsia
● Pepticulceration
● Gastrointestinalhemorrhage

Examples of topic that might be included:

● Control of HCL secretion by the parietalcells
● Role of Helicobacter-associated gastritis in peptic ulcer disease
● Management of acute upper gastrointestinalbleeding
Functional disorders
You should have knowledge of:
● Functional chest pain and functionaldyspepsia
● Irritable bowel syndrome and functional abdominalpain
● Functional constipation anddiarrhoea
● Neural control of viseral nociception and gutmotility
● Role of emotional and psychosocial factors inillness
● Management of chronic pain and the use of pain-modifying drugtherapy
Disorders of the small intestine
You should have knowledge of:
● Malabsorptionsyndromes
Examples of topic that might be included:
● Investigations commonly used in the assessment of suspected malabsorption

Disorders of the liver, biliary tree and pancreas

You should have knowledge of:
● Bilirubin metabolism and the enterohepatic circulation of bile acids
● Causes of jaundice andcholestasis
● Common pancreatic disorders includingcarcinoma
● Fulminant liverfailure
● Acute and chronichepatitis
● Drugs, toxins, alcohol and theliver

Examples of topic that might be included:

● Aetiology, clinical and histopathological features of acute and chronic parenchymal
disorders of theliver
● Aetiology, presentation and management of acute and chronic pancreatitis

Inflammatory bowel diseases and gut infections

You should be familiar with:
● Infectivegastroenteritis
● Parasitic and protozoal gutinfections
● Ulcerativecolitis

Examples of topic that might be included :

● Causes, investigation and management of acute and chronic entericdisorders

Colorectal disorders
You should have knowledge of:
● Polyps
● Carcinomas
● Anorectaldisorders
NEUROLOGY
Neuroanatomy
You are not expected to have detailed knowledge of
neuroanatomy.Questionswithananatomicalbiaswillbeconfined to circumstances where an
understanding of anatomical structure is of critical importance in appreciating the localization
of a particular neurologicalproblem.
Examples of topics that might be included:
● The clinical features of a lesion in different parts of thebrain
● The manifestations of a particular nerve root or peripheral nervedisorder
● The organization of pathways within the spinalcord

Neurophysiology
Detailed knowledge of neurophysiology is not expected but, as
withneuroanatomy,certainaspectsofthesubjectareparticularly relevant to the understanding of
neurological disease and may be tested.
Examples of topic that might be included:
● The formation, circulation, absorption and content of the cerebrospinalfluid
● Aspects of cerebral bloodflow
● Functions of basal ganglia, hypothalamus,cerebellum
● Muscle tone,reflexes

Cell Biology
Questions in this area will relate to advances in the cellular mechanisms of certain
neurological disease process which have provided better understanding of disease
mechanisms and which might, in the future, lead to more rational therapy.
Examples of topic that might be included:
● The role of the dopaminergic and cholinergic systems in variousdisorders
● The role of other neurotransmitters in certain diseases, for example, in Alzheimer'sdisease
Neuropharmacology
You are expected to have some knowledge of new drug developments in neurology, as well as
the established drug therapies.
Examples of topic that might be included :
● The role of some recently introducedanticonvulsants
● Thepresentstatusofimmunosuppressanttherapyinmultiple sclerosis

Neuropathology
You are not expected to have a detailed knowledge of
neuropathology.Youwillbeexpectedtohaveoutlineknowledgeof the pathological aspects of some
common diseases, for example, multiple sclerosis, Parkinson's disease and Alzheimer's disease,
CNS tuberculosis, peripheral neuropathies, neuromuscularjunctionfailure.
Clinical Neurology
Questions in the field of clinical neurology will test your knowledge of the more common
disorders. There will be emphasis on clinical features, which have been shown to be of
diagnostic value. The choice of subject matter will be influenced by areas of recent advance,
particularly those which have either led to better definition of disease entities, nor have led to
their improved management.
In the field of cerebrovascular Medicine, examples of topic that might be included:
● Epidemiological aspects, in particular the risk factors for stroke
● The evidence for the role of anti-platelet agents in transient ischemicattacks

CLINICAL HAEMATOLOGY
You will be expected to have knowledge of the following:
● Physiology, control and function of formed bloodelements
● Bone marrow structure andfunction
● Applications of biochemistry, genetics, immunology, and virology to blooddisorders
● Effects of age and pregnancy on blooddisease
● Splenomegaly, lymphadenopathy, and theircauses
● Principles and hazards of blood and blood product replacementtherapy
● Principles of marrowtransplantation
● Adverse effects of drugs on the blood andmarrow
Iron metabolism
You should have an understanding of:
● Physiology of iron, including itsabsorption
● Ironoverload
● Iron deficiency states including diagnosis, causes and treatment
● Iron metabolism, including anaemias of chronic disorders and sideroblasticanaemias

Megaloblasticanaemias
You should understand the physiology of vitamin B12 and folic acid and the mechanisms and
investigation of deficiencies and their management.
Examples of topics that might be included:
● B12deficiency
● Folatedeficiency

Haemolyticanaemias
You shouldunderstand:
● Mechanisms of shortened red cellsurvival
● Features and management of congenital and acquired haemolyticstates
● Molecular pathology of thalassaemia and common haemoglobinopathies
 Examples of topics that might be included:
● Causes ofhaemolysis
● Diagnosis of haemolyticanaemia

Other anaemias
● Anaemias complicating systemicdisease
● Aplasticanaemia
● Myelodysplasticsyndromes

Polycythaemia and myeloproliferative disorders

You should know the causes, investigation and management of polycythaemia and
myeloproliferative disorders.

White cell disorders

You should understand the:
● Physiology ofleucocytes
● Leucocytosis andleucopenia
● Acute and chronic leukaemias, including diagnosis, management andprognosis
● Lymphoproliferative diseases including Hodgkinsdisease, non-Hodgkin's lymphomas, and
plasma celldyscrasias
Disorders of haemostasis
You should possess knowledge of
● Platelet function andcoagulation
● Thrombocytopenia and impaired plateletfunction
● Thrombocytosis
● Common congenital and acquired disorders of coagulation (especially anticoagulant
therapy and disseminated intravascularcoagulation)

CLIMATICANDENVIRONMENTAL FACTORS IN DISEASE

■ Globalwarming
■ Disasters
■ Arsenicosis
■ IDG
■ Drowning, Electrocutionetc.
Example (s) of topic that might be included:
■ Effect of globalwarming
■ Pathophysiology ofarsenicosis
■ Effect ofelectrocution
■ Effect ofdrowning
PRINCIPLES OF MEDICAL ONCOLOGY
You should have a good understanding of pathogenesis of neoplasia, behavior of the cancer
cells and principles of management of neoplastic disorders.
Examples of topic that might be included :
● Etiology ofneoplasms
● Staging ofneoplasms
● Paraneoplasticsyndromes
● Principles ofchemotherapy
● Principles of endocrinetherapy
● Management of cancerpain