Medicine

MEDICINE
Goal
The broad goal of the teaching of undergraduate students in Medicine is to have the knowledge skills
and behavioural attributes to function effectively as the first contact Physician.

Objectives

a) Knowledge 
At the end of the course, the student shall be able to:
1. Diagnose common clinical disorders with special reference to infectious diseases, nutritional
disorders, tropical and environmental diseases;
2. Outline various modes of management including drug therapeutics especially dosage, side
effects, toxicity, interactions, indications and contra-indications;
3. Propose diagnostic and investigative procedures and ability to interpret them;
4. Provide first level management of acute emergencies promptly and efficiently and decide the
timing and level of referral, if required.
5. Recognize geriatric disorders and their management.

b) Skills
At the end of the course, the student shall be able to:

1. Develop clinical skills (history taking, clinical examination and other instruments of examination
to diagnose various common medical disorders and emergencies).

2. Refer a patient to secondary and/or tertiary level of health care after having instituted primary
care;

3. Perform simple routine investigations like haemogram, stool urine, sputum and biological fluid
examinations;

4. Assist the common bedside investigative procedures like pleural tap, lumbar puncture, bone
marrow aspiration/biopsy and liver biopsy.

c) Integration
1. With community medicine and physical medicine and rehabilitation to have the knowledge and
be able to manage important current national health programmes also to be able to view the
patient in his her total physical, social and economic milieu;
2. With other relevant academic inputs which provides scientific basis of clinical medicine
e.g. anatomy, physiology, biochemistry, microbiology, pathology and pharmacology.

151
 Contents

Page No.
A. Teaching Curriculum

1. Theory Teaching Programme 153

2. Clinical Teaching Programme 167

3. Small Group Teaching Curriculum

i. Demonstration topics 168

ii. Group discussion topics

iii. Seminar topics

B. Outline of Evaluation

1. Theory evaluation
 i. Specification tables 170
&
ii. Question paper patterns

2. Clinical evaluation

 i.  Overall pattern 171

ii. Sample list of cases 177

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 A. TEACHING CURRICULUM

A.1 Theory Teaching Programme

* Theory topics are covered in the form of lectures, seminars, small group discussion and clinical
problem solving sessions. Topics enlisted are relatively more important and covered in theory
classes on priority basis.

After covering the enlisted topics, remaining classes in each term can be utilized for covering other
topics, discussions, tests and problem oriented learning sessions on respective system.

* Seminars and small group sessions are designed to cover topics of practical importance
encountered in day to day practice and investigational skills.

* Rest of the topics in each system to be read by students from standard textbooks. Questions may
appear from those topics also.

* Theory teaching schedule enlisted here shall not be taken as complete syllabus.

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 Department of Medicine - KMC, Manipal - 576 104
Theory Teaching Programme

TOPIC: 1. Haematology (Semester 3) Approximate

Hours

Introduction to Haematology: Classification of anemia, 1

clinical features & Investigations

Iron deficiency anemia 2

Macrocytic anemias 1

Hemolytic anemias: congenital and acquired 2

Aplastic anemia, Agranulocytosis & Anemia of chronic disease 1

Acute Leukaemias 1

Chronic leukaemias & Myelodysplastic syndromes 1

Polycythaemias & Myelofibrosis 1

Hodgkin’s lymphoma 1

Non-Hodgkin’s lymphoma 1

Paraproteinemias (multiple myeloma) 1

Thrombocytopenias & other Platelet disorders 1

Haemophilia and other congenital clotting disorders 1

DIC and other acquired bleeding disorders 1

Blood transfusion & Bone Marrow Transplantation 1

(Indications, techniques and complications)

Total Classes 17

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 Department of Medicine - KMC, Manipal - 576 104
Theory Teaching Programme

TOPIC: 2a. Nephrology (Semester 6) Approximate

Hours
Introduction to Nephrology:
Clinical features of Renal diseases, Renal function tests, 1
Proteinuria & Hematuria

Glomerulonephritis & Acute nephritic syndromes 2

Nephrotic syndrome 1

Kidney in systemic diseases 1

Urinary tract infections, Urinary calculi &

Urinary tract obstruction 1

Acute renal failure 2

Chronic renal failure 2

Drugs and the kidney & Polycystic disease 1

Renal replacement therapy 1

Total Classes 12

TOPIC: 2b. Fluids and Electrolytes (Semester 6) Approximate

Hours
Shock - Classification & General management 1

Introduction to Sodium and water balance, Dehydration 1

Hyponaetraemia, Hypernatraemia and Phosphate problems 1

Hypokalaemia, Hyperkalaemia and Magnesium problems 1

Acid - Base disorders 2

Total Classes 6

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 Department of Medicine - KMC, Manipal - 576 104
Theory Teaching Programme

TOPIC: 3a. Gastroenterology (Semester 7) Approximate

Hours

Introduction to G I Disorders : Symptoms & Signs 1

Investigation of GIT problems & oral cavity disorders 1

Reflux oesophagitis & Motility disorders 1

Gastritis & Non-ulcer dyspepsia 1

Peptic Ulcer disease 2

Malabsorbtion syndromes and their evaluation 2

Inflammatory bowel disease & Diverticulosis 2

Irritable bowel syndrome 1

Acute abdomen, Intestinal obstruction and Peritonitis

Medical Aspects 1

Total Classes 12

TOPIC: 3b. Nutrition (Semester 7) Approximate

Hours

Dietary requirements & Clinical assessment of Nutrition 1

Vitamins (excluding vit D, B 12 & Folic Acid) 2

Minerals & Trace elements (excluding Iron & Iodine) 1

Malnutrition in adults : Under nutrition & Obesity 1

Enteral & parenteral nutrition 1

Total Classes 6

156
 Department of Medicine - KMC, Manipal - 576 104
Theory Teaching Programme

TOPIC: 4a. Liver & Pancreas (Semester 9) Approximate

Hours
Approach to Jaundice & LFT 1

Acute hepatitis including Fulminant hepatitis 3

Chronic Hepatitis 2

Drugs, toxins and liver diseases 1

Cirrhosis & its complications including G I Bleeding 3

Ascites & Budd-Chiari syndrome 2

Hemochromatosis & Wilson’s disease 1

Liver abscess & Liver tumors 2

Acute Pancreatitis 1

Chronic Pancreatitis & Pancreatic function tests 2

Gastrointestinal TB 1

Total Classes 19

TOPIC: 4b. Tuberculosis (By Pulmonary Medicine) Approximate

Hours
History and Epidemiology 1

Pathogenesis 1

Pathology of Tuberculosis 1

Diagnosis of Tuberculosis 1

Treatment of Tuberculosis 1

Drug Resistance in Tuberculosis 1

Total Classes 6

157
 Department of Medicine - KMC, Manipal - 576 104
Theory Teaching Programme

TOPIC: 5. Cardiology (Semester 8) Approximate

Hours

Introduction to cardiovascular illness, Cardiac symptoms

including Chest Pain 1

Rheumatic fever 1

Valvular heart disease 4

Infective endocarditis 1

Cardiac arrhythmia 3

Ischaemic heart disease 4

Preventive cardiology and Lipids 1

Myocarditis, Cardiomyopathy & Pericardial diseases 2

Pulmonary hypertension, Atrial myxomas, Aortic aneurysm 2

TOPIC: 5. Cardiology (Semester 9)

Cardiac failure 2

Hypertension 2

Congenital heart disease 2

Cardiac arrest and CPR 1

DVT & Pulmonary thromboembolism 1

Total Classes 27

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 Department of Medicine - KMC, Manipal - 576 104
Theory Teaching Programme

TOPIC: 6. Respiratory Medicine (Semester 8) Approximate

Hours

Introduction to respiratory illness- pulmonary symptoms and signs 1

Pulmonary defense, effect of smoking and PFT 1

UR infections ,Allergic rhinitis, Acute Bronchitis 1

Pneumonias 3

COPD 2

Bronchiectasis & Cystic fibrosis 1

Bronchial asthma & Pulmonary Eosinophilia 2

Interstitial lung disease, Sarcoidosis & Pneumoconiosis 2

Lung & Mediastinal tumors 2

Pleural diseases 2

Respiratory failure, ARDS , Oxygen therapy and mechanical ventilation 2

Total 19

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 Department of Medicine - KMC, Manipal - 576 104
Theory Teaching Programme

TOPIC: 7a. Molecular Biology, Genetics, Approximate

Immunology & Recent advances (Semester 4) Hours

Chromosomes & Chromosomal disorders. 2

Genes, Cloning, Basic genetics of Cancer, Applications

of Molecular Genetics, genetic engineering and Gene therapy, genetic counselling 3

HLA system in health and disease, Cell mediated & Humoral

immunity, immune deficiency diseases (except AIDS) 2

Immunization in adults 1

Hypersensitivity reactions, Anaphylaxis & Autoimmunity 1

Organ Transplantation & Drugs used for

Immunosuppression 1

Total Classes 10

TOPIC: 7b. Miscellaneous (Semester 4) Approximate

Hours

Geriatrics: Biology of aging, Evaluations of Elderly 2

Geriatric patients: Common problems 3

Anti oxidants in health and diseases 1

Principles of Clinical Pharmacology 1

Rational drug use, Drug interactions and

Adverse drug reactions 2

Drug therapy in patients with impaired renal,

hepatic function and in pregnancy/lactation 1

Total Classes 10

160
 Department of Medicine - KMC, Manipal - 576 104
Theory Teaching Programme

TOPIC: 8. Neurology (Semester 8) Approximate

Hours

Introduction to Nervous system - Investigations done in

Nervous system problems including LP, CT, MRI, NCV 2

Headache & Facial pain 2

Cranial Nerve problems - Facial palsy, Ocular palsies,

Papilloedema, Retrobulbar neuritis, Nystagmus & Vertigo 3

Cerebrovascular disorders 3

Cerebral tumors & Raised ICT 1

Meningitis, Encephalitis, Brain abscess, Neurocysticercosis 2

Epilepsy 2

Coma, Head injuries & Brain death 2

Movement disorders 2

Demyelinating disorders 2

TOPIC: 8. Neurology (Semester 9)

Paraplegia and other spinal cord problems (Quadriplegia,

CV anomaly, Syringomyelia, Myeloradiculopathy) 2

Neuropathies including GBS 2

Degenerative diseases - Dystrophies, Spinocerebellar, MND 2

Myasthenia gravis and Myopathies 2

CNS complications of Alcohol, Lathyrism &

other Neurotoxins 1

Total Classes 30

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 Department of Medicine - KMC, Manipal - 576 104
Theory Teaching Programme

TOPIC: 9. Endocrine & Approximate

Metabolic Disorders (Semester 8) Hours

Introduction: 1

Hypothyroidism 1

Hyperthyroidism 1
Approach to Goiter & Thyroid malignancies 1

Calcium metabolism, Hyper & Hypoparathyroidism, Vit D 2

Syndromes of pituitary hypofunction & Small stature 1

Syndromes of pituitary hyperfunction 1

Diabetes insipidus & SIADH 1

Cushing’s syndrome 1

Addison’s disease 1

Phaeochromocytoma & Conn’s syndrome 1

Hypogonadism, Impotence & Hirsutism 1

Lipid disorders 1

Amyloid disorders & Porphyrias 1

Diabetes Mellitus

Introduction, classification, Aetiopathogenesis 1

Clinical features, Investigations, diagnosis 1

Treatment 1

Complications of Diabetes & their management 1

Surgery and Diabetes, Pregnancy and Diabetes 1

Total Classes 20

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 Department of Medicine - KMC, Manipal - 576 104
Theory Teaching Programme

TOPIC: 10. Infectious Diseases (Semester 6) Approximate

Hours
Introduction 1
Streptococci, Enterococci & Staphylococci infections 1
Enteric fever & other salmonella infections 1
Cholera, E. coli & Food poisoning 1
Shigella, Campylobacter, Proteus & Pseudomonas infection 1
Brucellosis, Plague and Leptospirosis 2
Herpes simplex, Varicella, CMV, EB & Coxsackie infection 1
Influenza, Measles, Rubella & Mumps (in adults) 1
Arbovirus infections - Dengue, Yellow fever, KFD and
Japanese Encelephalitis 1
Rabies 1
Retroviral infection: HIV & AIDS (including 3
associated infections)
Fungal infections: an overview &
Systemic fungal infections 1
Malaria 1
Amoebiasis 1
Filariasis & Intestinal Nematodes & Cestodes 1

TOPIC: 10. Infectious Diseases (Semester 9)

PUO 2
Nosocomial infection & Infections in a immuno
compromised host 1
Septicaemia 1
Total Classes 22

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 Department of Medicine - KMC, Manipal - 576 104
Theory Teaching Programme

TOPIC: 11a. Rheumatology (Semester 7) Approximate

Hours
Rheumatoid arthritis 2
Osteoarthritis 1
Seronegative arthritis 2
SLE 1
Vasculitic disorders & Erythema nodosum 1
Systemic sclerosis, Dermato & polymyositis 1
Crystal deposition diseases 1
Back pain, Neck pain & Disc disorders 1
Osteoporosis and Miscellaneous 1
Total Classes 11

TOPIC: 11b. Poisoning, Bites & Approximate

Environmental Diseases (Semester 7) Hours
Introduction to Poisoning :
General principles in Toxicology 1
Insecticide poisoning 1
Poisoning due to Sedative drugs, rodenticidal poisoning 1
Analgesic poisoning, Cyanide poisoning 1
Heavy metal poisoning, Paraquet poisoning 1
Snake and other venomous bites 1
Heat stroke, Hyperpyrexia & Hypothermic injuries 1
Drowning, Electric shock, lightning & Radiation
injury 1
Total Classes 8

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 Department of Medicine - KMC, Manipal - 576 104
Theory Teaching Programme

TOPIC: 12. Psychiatry (taken by Approximate

department of Psychiatry) Hours
Introduction (Definition & Scope of Psychiatry.
Historical development and overview of Modern Psychiatry.) 1
ICD-10 classification of Mental Disorders 1
Learning and Remembering 1
Motivation and defense mechanisms 1
Emotions and stress 1
Personality and Intelligence 1
Principles of Etiology and causes of abnormal behavior 1
Organic Mental Disorders 1
Substance use disorders 1
Schizophrenia and related disorders 1
Mood disorders - Depression 1
Mood disorders - Mania 1
Anxiety disorders (Phobia, Panic, G.A.D., OCD) 1
Stress - related, dissociative and somatoform disorders 1
Personality, eating, sleep and sexual disorders 1
Mental Retardation 1
Psychiatric disorders of childhood 1
Social and preventive Psychiatry 1
Forensic Psychiatry 1
Psychopharmacology and E.C.T. 1
Total Classes 20

165
 Department of Medicine - KMC, Manipal - 576 104
Theory Teaching Programme

TOPIC: 13. Dermatology Approximate

(taken by department of Skin) Hours

Introduction to Dermatology 1

Scabies 1

Fungal infections 1

Viral Infections 1

Bacterial Infections 1

Dermatitis 1

Leprosy 2

Sexually Transmitted Diseases (excluding HIV) 2

Bullous Skin Diseases 1

Psoriasis, Lichen Planus 1

Cutaneous Drug reactions 1

Acne & Seborrhoeic dermatitis 1

Total Classes 14

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 A. 2. Clinical Teaching Programme

Orientation programme:

At the beginning of 3rd semester medicine clinical posting 2 weeks orientation is given for students, as an
introduction to the clinical phase. A series of clinical lectures, which give an outline of the knowledge and
skills needed in the clinical phase, is delivered. This is aimed at preparing the students to do what is
expected of them during real patient encounters in wards

Clinical postings

Students should reach the wards by 9.30 AM.

9. 30 – 11.00 AM: Ward work-Students will be allotted specific beds in wards. Case clerking and follow-up
of previously seen patients. This has to be recorded in their case sheet record book(Note book) Each
semester best of these cases are recorded in the log book by students which will be marked and finally
will form a part of internal assessment.

11.00 AM-12.30 PM: Bed side clinics: Every day a student will have to present case to faculty. This is done
on rotation by all students. In addition any student maybe randomly asked to present his/her case.

Students may also be taken for rounds by faculty in respective units on some days

Undergraduate students may be allotted beds in the last two terms and involve them in ward Rounds and
ward work.

BASIC CASES FOR MBBS STUDENTS Lung abscess

General: COPD
Lymphadenopathy Bronchial asthma
Avitaminosis Bronchiectasis
PUO Anemia Bronchogenic carcinoma
Edema
Gastrointestinal Disease:
Cardiovascular disease: Hepatosplenomegaly
Mitral Stenosis Jaundice
Mitral Regurgitation Isolated splenomegaly
Aortic Stenosis Isolated hepatomegaly
Aortic Regurgitation - Abscess,
Pulmonary Hypertension - Malignancy
Tricuspid Regurgitation – Hepatitis
Congestive Cardiac Failure - Obstructive jaundice
Infective Endocarditis Ascites
Acute Rheumatic fever Cirrhosis & Portal Hypertension
Rheumatic heart disease
Renal Diseases:
Congenital Heart Disease: Acute Nephritis
Ventricular septal defect Nephrotic syndrome
Atrial Septal defect Chronic renal failure
Patent ductus arteriosus
Tetrology of fallot

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(CVS Contd.)Hypertension
Ischaemic heart disease
Cor pulmonale
Arrhythmia - Ectopics &
Artial Fibrillation
Respiratory Disease:
Pleural effusion
Pneumothorax
Hydropneumothorax
Lobar consolidation
Collapse
Fibrosis
Cavity
Pulmonary TB
Musculoskeletal and
Connective Tissue Diseases:
Rheumatoid arthritis
SLE
Central Nervous System Disorders:
Bell’s palsy
Other Cranial Nerve Palsies
Hemiplegia (CVA)
Paraplegia
Motor neuron disease
Peripheral neuropathy
Cerebellar disease
Extrapyramidal disorders
Head ache
Low backache
Meningitis
Cervical spondylosis

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Endocrine Disorders: Candidiasis
Thyrotoxicosis Psoriasis
Hypothyroidism Scabies
Diabetes mellitus Allergic Rashes
Cushings syndrome Viral Exanthema
Herpes simplex
Hematological Disorders: Herpes zoster
Anaemia Pyoderma
Leukaemias Vitiligo
Thrombocytopenia Pyoderma
Lymphomas Vitiligo
Leprosy
Purpura
Infections Diseases:
Any Other
Malaria
Enteric fever
Renal Disorders:
AIDS
CRF
Leptospivosis
Acute nephritis
Leprosy
Nephrotic syndrome
Tuberculosis
Kala Azar
Hematological Disorders:
Viral Fevers
Leukaemias
Lymphomas
Dermatology Disorders:
Anaemias
Tinea Versicolor
ITP
Tinea Corporis
Hemolytic anaemias

3. Small Group Teaching

Curriculum:
3. i. Demonstration topics
X-ray Abdomen:
a. X-Rays: - Renal calculus
- IVU
Chest X-rays:
- Pancreatic calcification
- Pleural effusion
- Gas under diaphragm
- Pneumothorax
- ERCP
- Hydropneumothorax
- Pulmonary Cavity & Fibrosis
Barium X-rays:
- Consolidation
- Carcinoma esophagus
- Collapse
- Achalasia cardia
- Mass lesion
- Carcinoma Colon
- Lung abscess
- Ulcerative colitis
- Secondaries
- Ileocaecal TB
- Coin lesion
- Cannon ball appearance
b. CT Scans:
- Miliary mottling
- Intracerebral Haemorrhage
- Mitral valve disease
- Cerebral Infarction
- Cardiomegaly
- Subarachnoid Haemorrhage
- Pericardial effusion
- Subdural Hematoma
- Brain tumor/ICSOL
X-ray Skull:
- Hydrocephalus
- Multiple Myeloma
- Pituitary fossa erosion
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c. Slides: - Tracheostomy tube
- Leukaemia - Insulin syringe & Needle
- Iron deficiency anaemia
- Eosinophilia d. Pathological Specimens:
- Malarial parasite - Cerebral haemorrhage
- Microfilaria - Tuberculous cavity in lung
- Leishman - Donavan body - Cirrhosis of liver
- Streptococci - Liver abscess
- Staphylococci - Typhoid ulcer in ileum
- Oval cyst - Tuberculous lymph node
- AFB - Worms (intestinal)

e. Instruments: f. Electro Cardiograms (Ecgs):

- Lumbar puncture needles Atrial fibrillation
- Liver biopsy needles Supraventricular Tachycaradia
- Aspiration Needle with three way RBBB & LBBB. Heart blocks
- Bone marrow aspiration and biopsy needle ECTOPICS (atrial & Ventricular)
- Foley’s catheter Ventricular Tachycardia
- Malecot’s catheter Ventricular Fibrillation
- Red Rubber catheter Acute myocardial infarction
- Ryle’s tube * Inferior wall
- Sengstaken Blackmore tube * Anterolateral wall
- Endotracheal tube Old myocardial infarction.
- Nasal cannula Ischaemic heart disease (others)
- Airway

3. ii. Group discussion topics

a. Investigation interpretation:
- Urine analysis
- GTT
- LFT
- RFT
- CBP & Peripheral smear
- Widal test
- Cardiac enzymes
- Electrolytes
- Cushings work up
- Thyroid Profile
- CSF analysis
- Pleural & Ascitic fluid analysis.

b. Management of common Poisonings: Organophosphorus compounds Barbiturates & snake

bite.
c. Management of Shock, Cardiac arrest, CCF and Acute LVF.
d. Management of Status asthmaticus, Pneumonias and Respiratory failure.
e. Management of Malaria, Enteric fever, Amoebiasis, Cholera, Scabies and Worm infestation.
f. Management of Status epilepticus, Cerebral oedema and Meningitis.
g. Clinical use of Antibiotics, Anti viral agents and Anti fungal agents.

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3. iii. Seminar topics (Examples)
a. Jaundice
b. PUO
c. IHD and MI
d. Hypertension
5. Diabetes
e. Localization of lesion in hemiplegia and
f. Other topics of importance

B. EVALUATION
Final MBBS: General Medicine

Specification Table for Final MBBS University Examination

( Minor variation in marks allotment permitted)

Theory Examination- Total Marks-200

Paper Content Area -Marks Questions and Marks

Paper I (Non MCQ) - 1.Cardiocavscular-22 1. Two restricted essay type

80 Marks
2. Respiratory System
Paper I MCQ – 20 including pulmonary
Marks tuberculosis-20
3. Infectious disease and
Tropical Medicine-22
4. Haematology and
Oncology-16
questions of 10 Marks each;
2. Fifteen extremely specific
questions of short Note type for
4 marks each
3. MCQ- Twenty questions 1
mark each

5. Nephrology-16

6. Electrolytes, Water and

Acid Base Disoredrs-4

Paper II (Non MCQ) - 1. Gastrointestinal tract 1. Two restricted essay type

80 Marks including Hepatology and questions of 10 Marks each;
Pancreas-22
Paper II MCQ – 20 2. Fifteen extremely specific
Marks 2. Nervous system disorders questions of short Note type for
- 22 4 marks each

3. Endocrinology, Metabolic 3. MCQ- Twenty questions 1

disorders including diabetes mark each
mellitus and Nutrition - 20

4. Immunology, Connective
tissue disorders and
Rheumatology- 12

5. Miscellaneous Topics
(Genetics, Geriatrics,
Theory Evaluation
Total marks - 250

A . Final Examination

1. Theory paper: 100 marks × 2 papers - Total 200 marks (including MCQS of 20 Marks each)
2. Viva voce: Total 20 marks
a. X-rays
b. Specimens
c. ECG
d. Instruments and Procedure
e. Common drugs
f. Common emergencies
B. Internal Assessment: Total 30 marks
9th semester sessional examination 10 marks
Average of all other sessional exams 15 marks
Performance in the seminar 2.5 marks
Psychiatry and dermatology marks 2.5 marks
• Seminar Marks will be awarded by the moderator and handed over to the department office after the
seminar / group discussion
• sessional examinations in Medicine will be conducted at the end of 4th, 6th, 8th and 9th Semester
• Minimum marks prescribed by the university in int. assessment is compulsory to appear for university
examination.
C. Clinical Evaluation:
TOTAL MARKS 130

A. Final Examination - 100 marks

1. Long case: History and full examination and detailed case sheet writing.
Case will have findings in the history and examination.
60 mins - 50 marks

2. Short cases: These are common illness, which are encountered in day to day practice.

i. Diagnostic problem:
Patient with findings on examination
15 min - 20 marks

ii. Therapeutic problem:

Patient with common medical problem is kept
Eg.: Diabetes, Hypertension, IHD, PUO etc.
Aim is to evaluate candidate’s approach to a given problem. He is expected to take relevant
history, do a brief specific examination, and discuss management plan for that case.
15 min  -  20 marks

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3. Clinical problem solving 5 min  -  5 marks

4. Laboratory data interpretation 5 min  -  5 marks

B. Clinical Internal Assessment - 30 marks

1. 9th semester end posting examination : 10 Marks

2. 9th semester grand viva( Instruments, Procedures, drugs, xrays,problem solving ,Lab data, ECG: 10 Marks
3. Other semester end posting examinations : 5 marks
( including psychiatry and dermatology)
4. Log book : 5 marks

Summary of clinical examination pattern

Case Time Marks
Long case 60 mins 50 marks
Laboratory data
Interpretation 5 min 5 marks
Short case 1 15 min 20 marks
Short case 2 15 min 20 marks
Clinical problem
solving 5 min 5 marks
Total: 3 cases 100 min 100 marks

APPENDIX 1
Sample list of long case and short cases
Long case (L) - For detailed history, examination, and case sheet writing (preferably case with positive
findings in both history and examination)
Short cases (S) -
1. One for examination with positive findings. No need to write detailed case sheet.
2. Therapeutic problem - a common complaint or illness like Diabetes or Hypertension etc. with or
without findings.
For both (Long and Short) cases candidate is expected to Enumerate and discuss diagnosis
investigations and management plan.

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C.V. S.:
R.H.D. L/S
C.C.F. L/S
Hypertension L/S
I.H.D. L/S
Congenital heart disease ASD/VSD/PDA/
Fallots tetrology L/S
Pericardial disease L/S
R. S.: Fevers:
Pulmonary TB L/S Typhoid L/S
Bronchiectasis L/S Malaria L/S
Pneumonia L/S TB L/S
Lung abscess L/S PUO L/S
Bronchial asthma L/S
Pleural effusion L/S Nervous system:
COPD L/S Hemiplegia L/S
Bronchogenic CA L/S Paraplegia L/S
Pneumothorax L/S
Hydropneumothorax L/S Short cases in Neurology:
Facial palsy
Abdomen: Unconscious pt
Hepatomegaly L/S Bulbar palsy
Splenomegaly L/S Ataxia
Hepatosplenomegaly L/S Ophthalmoplegia
Jaundice L/S Cerebellar disease
Ascites L/S Foot drop
Cirrhosis with Sciatica
Portal hypertension L/S Cervical spondylosis
Hepatitis L/S back ache
Parkinsonism
Endocrine: H/O Convulsion
Diabetes L/S Tremors
Hypothyroidism L/S Meningitis
Hyperthyroidism L/S
Cushings syndrome S

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