Professional Documents
Culture Documents
Syllabus
Essentials of Clinical Medicine
1. Introduction to medicine – Understanding the scope of medicine. History taking – History of
present illness, Past history, drug history, personal history, family history, gyn and obst history,
occupational history, history of immunization. Physical examination –General survey, mental
status of patient, decubitus, physique of patient, face, skin, edema, hands, clubbing,
koilonychias, feet, neck, breast, temperature, pulse, respiration, tongue. Provisional diagnosis.
Investigations and Diagnosis and management and treatment of disease.
2. Cardiovascular system (CVS) – Cardinal symptoms in cardiovascular system and their
differential diagnosis with detailed explanation. Examination of CVS in very detail – Pulse in
detail, Examination of neck veins, Examination of heart – Inspection – JVP, CVP etc. , palpation –
Palpation of neck veins, PMI on chest . Auscultation – Cardiac rate, rhythm and auscultation of
Mitral area, pulmonary area, tricuspid area and aortic area. Explanation of S1, S2, S3 and S4.
(Gallop and summation gallop etc), what is murmur? Investigations in CVS – CXR, ECG, Stress
test, 2D‐echo, 3D‐echo, Colour Doppler, Coronary angiography etc. Explanation of biochemical
markers in CVS. Explanation of IHD in detail, D/D, complete management of Patient with IHD –
Drugs, dose etc. Observe the bypass surgery on LCD projector. Hypertension – Under standing
the concept of blood pressure ‐ FC and t.p.r. etc. Classification of Hypertension, common factors
incriminated in hypertension, causes in secondary hypertension. Clinical manifestations and
complications of hypertension. Investigations in HT. Management of hypertension ‐ different
groups of antihypertensive – indications and contra‐indications, dose frequency etc. Acute
myocardial infarction – AMI‐ Pathphysiology – different clinical presentations – D/D – Changes in
ECG – Types of AMI, biochemical markers – Complete management of AMI. Complications of
AMI. Heart failure ‐ CCF – Clinical features with explanation, D/D, Investigations, complete
management of CCF. Prognosis. Rheumatic Heart Disease (RHD) – Rheumatic fever,
Epidemiology, Pathogenesis, Management of RF, Valvular deformities – Types – Mitral stenosis,
mitral regurgitation, aortic stenosis and aortic regurgitation – effects – Sings and symptoms –
investigations – ECG, 2D‐echo‐CXR‐ Management.(medical and surgical) Observe the Mitral
valve replacement surgery on LCD projector (MVR). Congenital Heart Diseases – VSD, ASD and
PDA in detail. Bacterial endocarditis – ABE and SABE – Etiology and pathology, Clinical features,
investigations – ESR, CRP, 2D‐echo, EC and Management.
3. Respiratory system (RS) – Common symptoms in respiratory system with complete D/D.
Examination of RS – anterior rhinoscopy – air sinuses – pharynx – Examination of chest in detail.
Inspection – shape, movement, respiration – types , venous prominence etc. Palpation –
temperature, tenderness, position of trachea, movement of chest, vocal fremitus. Percussion –
shifting dullness, hepatic, cardiac dullness. Auscultation – Vesicular breath sounds, bronchial
breath sounds, crackles, wheeze, rhonchi, plural rub etc. Investigations in RS – CXR, what is CT
scan? What is MRI? What is Thoracocentesis?. What is Bronchoscopy? Asthma – etiology, Types,
pathogenesis, clinical features, D/D, ultra‐modern management. Pneumonia – Introduction –
routes of transmission of microorganism, Epidemiology, clinical features, typical and atypical
pneumonia, CXR details in pneumonia. T/T. Chronic bronchitis and emphysema – etiology,
pathology, C/F, investigations – CXR, ECG and 2D‐echo details. T/T.
4. Gastrointestinal system – Cardinal sings/symptoms of the system with D/D in detail.
Examination of system – oral cavity and tongue. Examination of abdomen ‐ detailed
examination. Palpation – Superficial and deep. Palpation of each abdominal organ like – Liver,
spleen, kidneys, stomach, colons etc. Percussion – in detail. Auscultation – minor. P/R
examination. Investigations in GIT – Gastroscopy, proctoscopy, colonoscopy with biopsy. Barium
swallow, meal, enema. X ray erect abdomen. USG etc. Diseases of esophagus. Gastritis – Acute
and chronic in detail. Duodenal ulcers – Etiology and pathogenesis, C/F, Investigations,
Management. Inflammatory Bowel Diseases – IBD ‐ Etiology and pathogenesis, changes in UC
and CD as seen in colonoscopy. C/F, Diagnosis and treatment. Abdominal tuberculosis – Primary
and secondary in detail, C/F, Investigations, D/D, Treatment. Intestinal amoebiasis –
Pathogenesis, C/F, T/T, complications etc. Irritable Bowel Syndrome – IBS in detail.
5. Hepato‐biliary system – Cardinal symptoms of system with complete D/D. Examination and
investigations are covered under GIT. Common biochemical markers of system – Bilirubin,
Direct, Indirect, SGPT, SGOT, Alkaline phosphate, Serum proteins, clotting factors. Jaundice –
definition – Types – Viral hepatitis – A, B, C, D and E in detail with investigations, management.
Cirrhosis of liver – Common causes of cirrhosis – C/F with detailed explanation, Investigations,
Treatment. Acute, chronic pancreatitis, – Etiology, pathology, C/F, Investigations, D/D,
Treatment. Cholelithiasis – Types ‐ etiology – pathogenesis, Clinical manifestation,
Complications. Acute and chronic cholecystitis – Introduction, etiology, pathology, diagnosis,
management.
6. Endocrine system – Diabetes mellitus – role of insulin – etiology in DM, Types – IDDM and
NIDDM. C/F, Investigations, Treatment of IDDM and NIDDM in detail. Explanation of
complications of DM. Hypothyroidsm – etiology and pathogenesis, clinical features of cretinism
and myxoedema. Investigations and treatment in detail. Hyperthyroidism – etiology – C/F,
Investigations, D/D, Treatment in detail.
7. Urinary system – Cardinal symptoms of system with their complete D/D. Examination of urinary
system. Biochemical markers of system. Investigations in urinary system. Acute Renal Failure –
etiology, C/F Investigations and D/D. Complications and T/T. Chronic Renal Failure (CRF) –
Introduction – stages of CRF, effects of uremia on metabolism and T/T. Glomerulonephritis –
classification – primary, secondary – subtypes. The 5 major clinical types of glomerulonephritis.
Diabetic nephropathy, post‐streptococcal glomerulonephritis, membranous glomerulonephritis.
C/F. Management. Nephrolithiasis and urolithiasis – etiology, C/F, investigations, Management.
8. Nervous system – Glasgow scale (GSL) ‐ Cardinal symptoms of CNS, functions of cranial nerves,
motor functions, sensory functions, increased intracranial pressure, cerebellar system,
autonomous nervous system etc. Examination of CNS in detail. Migraine – clinical subtypes –
pathogenesis, current treatment. Epilepsy – introduction – classification –Causes of epilepsy
related to age – T/T in detail. Stroke – definition – clinical features – different causes and their
analysis – investigations. Treatment according to cause. Parkinson’s disease – Introduction –
Pathology, C/F, T/T in detail.
9. Musculoskeletal system – osteoarthritis – C/F, Diagnosis and T/T. Rheumatoid arthritis –
Introduction, etiology, C/F, Investigations and T/T in detail. Gout – Introduction – Uric acid
metabolism – basic pathology. Complications. T/T in detail.
10. Infectious diseases – General considerations in infectious diseases. Host and tissue specisity of
organisms. Malaria – etiology and pathogenesis ‐ life cycle of malarial parasite. C/F, Cerebral
malaria, Complications of malaria. T/T of malaria in detail. RNTCP – etiology, epidemiology,
pathogenesis, C/F, Primary, secondary tuberculosis. Extra‐pulmonary tuberculosis.
Investigations, diagnosis, Treatment according to RNTCP. MDR, XDR concepts. AIDS – Definition,
etio‐pathogenesis, important co‐factors in HIV. Types of HIV infection. Clinical stages of HIV
infection. Management of HIV positive patient. NRTI, NNRTI and PIs, their different
combinations.
11. Skin in General Practice – Psoriasis – etiology and pathogenesis. Some common sub‐types of
psoriasis, complications of psoriasis, Diagnosis and treatment. Lichen Planus, acne vulgaris,
Alopecia areata, vitiligo, eczema different types of eczema.
12. Some important topics for differential diagnosis – Pulse, Vomiting, Breathlessness, Chest pain,
Haemetemesis, Anaemia, Vertigo, Emaciation and Obesity and The unconscious patient.