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SYLLABUS
GUIDE FOR YEAR 2009
SYLLABUS
OF FIRST PROFESSIONAL M.B.B.S.
PART-I
SYLLABUS OF FIRST PROFESSIONAL M.B.B.S.
PART-II
SYLLABUS OF SECOND PROFESSIONAL M.B.B.S.
SYLLABUS OF THIRD PROFESSIONAL M.B.B.S.
SYLLABUS OF FOURTH PROFESSIONAL M.B.B.S.
SYLLABUS OF THIRD PROFESSIONAL M.B.B.S.
(A)
SPECIAL PATHOLOGY
The course
outline is as follows:-
1.
BLOOD VESSELS & HEART
§
Atherosclerosis
§ Etiology
and pathogenesis
§ Early
lesion
§ Late and
complicated lesion
§ Vessels
affected
§
Complications
§
Monckeberg's medial calcific sclerosis
§
Arteriolosclerosis.
§
Hypertension
§
Classification
§ Causes
of secondary hypertension
§ Vascular
changes in hypertension.
§ Common
pathogenetic mechanisms of vasculitis.
§ Aneurysm
§
Classification
§
Etiology.
§
Atherosclerotic aneurysm
§
Pathogenesis.
§ Type of
vessel involved.
§
Morphological & clinical features.
§ Varicose
veins
§ Common
sites
§
Predisposing factors
§ Clinical
features.
§ Benign
and malignant tumours of blood vessels.
§
Pathogenesis of ischemic heart disease.
§
Myocardial infarction
§ Sequence
of changes in myocardial infarction (M.I)
§ Pattern
of elevation of biochemical markers used in the evaluation
of M.I
§
Complications.
§ Causes
of sudden cardiac death.
§
Cor-pulmonale
§
Predisposing disorders.
§
Rheumatic Endocarditis
§
Bacterial Endocarditis
§ Etiology
§
Pathogenesis
§
Morphological & clinical features.
§
Complications
§
Myocarditis.
§
Morphological and clinical features of myocarditis.
§
Cardiomyopathy
§ Dilated
§
Hypertrophic
§
Restrictive.
§
Pericarditis.
§ Clinical
and morphological feature of pericarditis.
§ Primary
& secondary cardiac tumours.
§ Fallot's
tetralogy
§
Coarctation of aorta
2.
HEMATOPOIETIC AND LYMPHOID SYSTEMS
§ Stages
in the formation of red blood cell and white blood cells.
§ Normal
values of red cell count
§
Hemoglobin level
§ Packed
cell volume
§ MCH
§ MCV
§ MCHC
§ WBC
Count
§ Platelet
count.
§ Anemia
§
Classification
§ Causes
§
Etiology, Blood picture, clinical features and Lab Diagnosis of;
§ Iron
deficiency anemia
§
Megaloblastic anemia.
§ Folate
deficiency anemia.
§ Vit. B12
deficiency anemia.
§ Anemia
of chronic disease
§
Nutritional deficiency anemia.
§
Hereditary spherocytosis
§
Incidence
§ Etiology
§
Pathogenesis
§
Morphological and Clinical features
§
Thalassemia.
§
Classification
§
Pathogenesis
§ Blood
picture
§ Clinical
and genetic features.
§
Hemolytic anemia
§
Glucose-6-phosphate dehyrogenase deficiency.
§
Immunohemolytic anemia.
§ Warm and
cold antibodies immunohemolytic anemias.
§ Aplastic
anemia
§ Etiology
§
Pathogenesis
§ Clinical
features
§ Lab.
Diagnosis
§
Neutropenia
§
Agranulocytosis.
§
Leukocytosis.
§
Infectious mononucleosis
§
Epidemiology
§
Morphology
§ Clinical
features
§ Acute
and chronic nonspecific lymphadenitis.
§ Non-hodgkin's
lymphoma
§
Classification (real and working formulations)
§
Hodgkin's disease
§
Classification
§ Clinical
stages
§ Etiology
and pathogenesis
§ Leukemia
§
Prognostic factors of acute lymphoblastic and acute myeloblastic leukemias.
§
Pathophysiology of chronic myeloid and chronic lymphocytic leukemias
§ Multiple
myeloma
§ Etiology
§
Pathogenesis
§
Morphology
§ Clinical
features
§
Disseminated intravascular coagulation
§ Etiology
§
Pathogenesis
§ Clinical
features
§
Laboratory diagnosis
§ Causes
of decreased production and decreased survival of platelets.
§
Idiopathic & thrombotic thrombocytopenic purpura
§ Value of
following tests in the assessment of bleeding disorders
§ Bleeding
time
§ Clotting
time
§
Platelets count
§ Platelet
function test
§ Partial
thromboplastin time
§
Prothrombin time
§ Mixing
test studies
§
Polycythemia
§ Etiology
§
Pathogenesis
§ Clinical
significance
§ Lab.
Diagnosis
§ ABO and
Rhesus blood groups
§
Screening of Donors
§ Hazards
of blood transfusion and their prevention.
3.
RESPIRATORY SYSTEM
§
Micro-organisms causing upper respiratory tract infection.
§ Etiology
and clinical features of;
§ Rhinitis
§ Nasal
polyps
§ Acute
pharyngitis
§ Acute
tonsillitis
§ Acute
bacterial epiglottis
§ Acute
laryngitis
§ Pleural
effusion
§
Hemothorax,
§
Hydrothorax
§
Pleuritis,
§
Pneumothorax
§
Chylothorax
§
Malignant & benign tumours of nasopharynx and larynx.
§
Atelectasis
§
Classification
§
Pathogenesis
§
Restrictive & obstructive lung disease
§ Etiology
pathogenesis, morphology & clinical features of;
§ Asthma.
§ Various
types of emphysema
§ Chronic
bronchitis.
§
Bronchiectasis.
§ Adult
respiratory distress syndrome.
§
Restrictive lung diseases.
§
Sarcoidosis
§
Hypersensitivity pneumonitis.
§
Idiopathic pulmonary fibrosis.
§
Goodpasture's syndrome.
§
Thromboemboli.
§
Pulmonary infarction.
§
Pulmonary hypertension and vascular sclerosis.
§ Acute
bacterial pneumonia.
§
Micro-organisms causing atypical pneumonia.
§
Etiology, pathogenesis & clinical features of;
§
Tuberculosis of the lung.
§
Pneumoconiosis
§ Fungi (candida,
pneumocystis carinii) causing lung infections.
§
Bronchogenic carcinoma and mesothelioma
§
Classification
§ Etiology
§
Pathogenesis
§ Clinical
features
4. THE
ORAL CAVITY AND GASTROINTESTINAL TRACT
§
Oral cavity
§
Leukoplakia.
§ Oral
cancer
§ Risk
factors
§
Morphology
§ Clinical
feature
§ Benign
and malignant tumours of salivary glands.
§
Pleomorphic adenoma.
§ Clinical
features
§
Morphology
§
Esophagus
§
Predisposing factors of esophagitis.
§
Carcinoma of the esophagus
§
Stomach
§
Etiology, pathogenesis, morphological and clinical features of ;
§ Acute
gastritis
§ Chronic
gastritis.
§ Peptic
ulcer.
§ Gastric
carcinoma
§ Risk
factors
§
Pathogenesis
§
Morphology
§ Clinical
features and diagnosis
§
Prognosis
§
Intestine
§
Etiology, pathogenesis, morphological and clinical features of;
§
Hirschsprung's disease
§ Celiac
sprue
§ Tropical
sprue
§ Ischemic
bowel disease.
§ Crohn's
disease
§
Ulcerative colitis.
§ Acute
appendicitis
§ Major
causes of intestinal obstruction.
§ Clinico-pathological
features of following diseases of intestine
§
Amebiasis
§
Tuberculosis
§ Typhoid
§ Non-neoplastic
polyps of intestine.
§ Adenomas
§
Classification on the basis of epithelial architecture.
§ Clinical
and morphological features
§
Colorectal carcinoma.
§
Classification
§ Etiology
§
Pathogenesis
§
Morphological and clinical features
§ Aster-Coller
classifications of carcinoma of the colon and rectum.
§
Carcinoid tumour
§ Peak
incidence
§ Most
prevalent sites in the gut
§
Morphological features
§ Clinical
features of carcinoid syndrome.
§
Etiology, pathogenesis, morphological and clinical features of tumours of
appendix.
§
Liver and Biliary Tract
§
Liver
§ Pathway
of bilirubin metabolism and its elimination from the body
§ Jaundice
§
Classification
§ Causes
§ Clinical
features
§ Lab
diagnosis
§
Intrahepatic and extrahepatic biliary obstruction.
§
Etiology, pathogenesis, morphology, clinical features and complication of;
§ Hepatic
failure
§
Cirrhosis
§ Viral
hepatitis A,B,C,D and E
§ Route of
transmission
§
Incubation period
§ Clinical
features.
§
Potential outcome of acute infection.
§ Carrier
state
§ Acute
and chronic hepatitis.
§
Etiology, morphological and clinical features of liver abscess.
§ Drugs
and toxins causing hepatic injury
§
Pathogenesis of alcohol liver disease.
§
Morphological and clinical features of alcoholic hepatitis and cirrhosis.
§
Classification, etiology, pathogenesis, morphological and clinical features
of;
§
Hemochromatosis.
§
Secondary hemochromatosis.
§ Wilson's
disease.
§ Alpha-1
antitrypsin deficiency.
§ Neonatal
hepatitis.
§ Primary
and secondary biliary cirrhosis.
§
Hepatocellular carcinoma
§
Epidemiology
§
Pathogenesis
§
Morphology
§ Clinical
features
§
Biliary tract
§
Pathogenesis and risk factors of cholelithiasis.
§
Morphological and clinical features of acute and chronic cholecystitis.
§ Clinical
and morphological features of gall bladder cancer.
§
Pancreas.
§ Acute
and chronic pancreatitis
§ Etiology
§
Pathogenesis
§
Morphology
§ Clinical
features.
§ Clinical
and morphological features of carcinoma of pancreas.
5. THE
URINARY SYSTEM
§
Etiology, pathogenesis, clinical features and complications of;
§ Azotemia
§ Uremia
§ Acute
renal failure
§ Chronic
renal failure
§
Polycystic kidney disease (its Classification)
§
Glomerulonephritis (its Classification)
§
Nephrotic and nephritic syndrome
§ Acute
pyelonephritis.
§ Chronic
pyelonephritis.
§
Hydronephrosis
§
Pathogenesis and clinical course of acute tubular necrosis.
§ Benign
and malignant nephrosclerosis
§
Characteristics of various types of renal stones
§
Pathogenesis, clinical features and lab diagnosis of nephrolithiasis
§
Epidemiology, morphology, clinical features and prognosis of Wilm's tumour
§
Classification, Epidemiology, morphology, clinical features and prognosis of
renal cell
carcinoma
§
Etiology, morphology & clinical features of cystitis.
§ Clinical
features, etiology and morphology of transitional cell carcinoma of the
urinary
bladder.
6. MALE
GENITAL SYSTEM
§
Hypospadias
§
Undescended testis
§
Urethritis (Gonococcal, Non gonococcal)
§ Etiology
§ Route of
infection
§
Pathogenesis
§
Diagnosis
§
Etiology, pathogenesis and natural history of;
§
Prostatitis
§
Prostatic hyperplasia
§ Causes,
pathogenesis and clinical features of scrotal swelling.
§
Testicular adnexa
§
Varicocele
§
Hydrocele
§
Spermatocele
§ Testis
and epididymis
§
Inflammation (Orchitis)
§
Epididymitis
§ Causes,
pathogenesis and relevant investigations of male inferitlity.
§
Classification, pathogenesis, morphology, clinical features and prognosis of
the
tumours of
the male genital tract (Prostate ,Testis)
7.
FEMALE GENITAL SYSTEM
§ Causes,
routes of infection & methods of diagnosis of sexually transmitted diseases.
§ Route of
infection, pathogenesis and Lab diagnosis of;
§
Gonorrhea
§ Syphilis
§
Chlamydia
§ HPV
§ Herpes
simplex
§
Trichomonas vaginalis.
§ Cervical
intraepithelial neoplasia
§
Neoplasms of cervix
§ Causes,
pathogenesis and clinical features of dysfunctional uterine bleeding with
special
reference to endometrial hyperplasia,endometrial polyp and carcinoma.
§
Etiology, clinical features and pathogenesis of;
§
Adenomyosis
§
Endometriosis
§ Ectopic
pregnancy
§ Toxemia
of pregnancy.
§
Classification, pathogenesis, morphology, clinical features and prognosis of
the tumours of
the female
genital tract (uterus, ovary and Gestational trophoblastic tumours).
8.
BREAST
§ Etiology
and causes of lump in the breast
§
Etiology, Pathogenesis, Morphology and clinical features;
§ Mastitis
§
Fibrocystic disease of the breast
§
Intraductal papilloma
§ Benign
tumours of the breast (Fibroadenoma and Phyllodes tumour)
§
Gynaecomastia
§
Carcinomas of the breast (Ductal and Lobular)
9.
MUSCULOSKELETAL SYSTEM
§
Pathogenesis and clinical features of ;
§
Achondroplasia.
§
Osteogenesis imperfecta.
§
Osteoporosis.
§ Acute
and chronic osteomyelitis
§ Common
causative micro-organism
§ Common
routes of spread
§
Complications.
§ Common
sites involved in tuberculous osteomyelitis
§
Pathogenesis, morphological and clinical features of Paget's disease (osteitis
deformans).
§ Benign
and malignant bone forming tumours.
§ Common
sites, morphological and clinical features of osteogenic sarcoma.
§ Benign
and malignant cartilaginous tumours.
§
Chondrosarcoma
§ Peak
incidence
§ Common
sites of origin
§
Morphological and clinical features.
§ Most
frequent sites, clinical and morphological features of giant cell tumours of
bone.
§ Ewing's
sarcoma
§ Peak
incidence
§ Common
sites of origin
§
Chromosomal abnormality
§
Morphological and clinical features.
§
Pathogenesis, morphological and clinical features of osteoarthritis
§
Rheumatoid arthritis
§
Pathogenesis
§
Morphological and clinical features
§ Lab
Diagnosis
§ Gout.
§
Classification
§
Pathogenesis
§
Morphological and clinical features
§ Lab
Diagnosis
§
Pathogenesis, morphological and clinical features of;
§ Duchenne
muscular dystrophy
§ Myotonic
dystrophy
§
Congenital myopathies
§
Inflammatory myopathies
§
Myasthenia gravis.
§ Lipoma
and lipasarcoma.
§
Rhabdomyosarcoma
§ Peak
incidence
§
Histological variants
§ Frequent
sites
10.
ENDOCRINE SYSTEM
§
Pituitary.
§ Causes
of hyperpituitarism.
§
Morphology and clinical features of;
§
Pituitary adenomas.
§
Acromegaly
§
Gigantism.
§ Causes
of hypopituitarism.
§
Etiology, pathogenesis and clinical features of;
§
Sheehan’s syndrome
§ Dwarfism
§
Etiology, clinical features, pathogenesis and lab findings in inappropriate
secretion of
ADH.
§
Adrenal Cortex and Medulla
§ Adrenal
cortical hyperfunction. (CUSHNG’S SYNDROME)
§
Etiology, pathogenesis clinical features and lab diagnosis of;
§ Conn’s
syndrome
§
Adrenogenital syndrome.
§ Causes
of hypofunction of adrenal cortex.
§
Etiology, pathogenesis and clinical features of Addison’s disease.
§ Tumours
of adrenal medulla and cortex.
§ Clinical
features and diagnosis of pheochromocytoma.
§
Thyroid
§ Etiology
and clinical features of hyperthyroidism.
§ Etiology
and clinical features of hypothyroidism including Cretinism and Myxedema.
§
Investigation / lab tests for diagnosis of thyroid dysfunction.
§ Goiter
and its types
§
Etiology, pathogenesis and clinical features of diffuse and multinodular
goiter.
§ Causes
of solitary thyroid nodule and its diagnostic approach.
§
Thyroiditis
§ Types
§
Pathogenesis
§
Morphology
§ Clinical
features
§
Etiology, pathogenesis, morphology and clinical features of;
§
Follicular adenoma
§
Papillary carcinoma
§
Follicular carcinoma
§
Medullary carcinoma.
§
Undifferentiated.
§ Types of
MEN syndromes.
§
Parathyroid
§ Etiology
and clinical features of hyperparathyroidism and hypoparathyroidism.
§ Primary,
secondary and tertiary hyperparathyroidism.
§ Calcium
homeostasis
§ Causes
of hyper and hypocalcemia.
11.
SKIN
§ Macule,
papule, nodule, plaque, vesicle, bulla, blister, putsule,
scale,lichenification, excoriation,
hyperkeratosis, parakeratosis, acanthosis,dyskeratosis, acantholysis,
papillomatosis, lentiginous
spongiosis.
§
Morphological and clinical features of urticaria.
§
Etiology, pathogenesis morphological and clinical features of;
§
Eczematous dermatitis.
§ Contact
dermatitis
§ Atopic
dermatitis
§
Photoeczematus eruptions
§ Primary
irritant dermatitis
§ Erythema
multiforme..
§
Psoriasis.
§
Pemphigus
§ Bullous
pemphigoid.
§
Premalignant epithelial lesions.
§ Types of
warts and their most frequent locations.
§
Predisposing factors, morphology, clinical features and prognosis of;
§ Squamous
cell carcinoma
§ Basal
cell carcinoma.
§ Types,
clinical and morphological features of;
§
Nevocellular Nevi
§
Dysplastic nevi.
§
Malignant melanoma
§
Classification
§ Frequent
site of origin
§ Clinical
and morphological features.
12.
NERVOUS SYSTEM
§ Clinico-pathological
features of hydrocephalus.
§ Cerebral
edema (vasogenic & cytotoxic).
§ Types of
herniation of brain and their clinical significance.
§
Intra-cranial hemorrhage.
§
Etiologic agents, clinical and morphological features of;
§ Acute
purulent meningitis
§ Acute
lymphocytic meningitis
§ Chronic
meningitis
§ Brain
abscess
§
Tuberculosis meningitis.
§ Viral
encephalitis
§ Clinico-pathological
features of Guillain Barre syndrome.
§
Polyneuropathies
§ Toxic
neuropathy
§
Important intracranial tumours (astrocytoma,oligodendrogliomas, ependymoma,
medulloblastoma and meningioma)
§ Clinical
significance of glial tumours.
§ Frequent
metastatic tumours to the brain
§ Primary
peripheral nerve sheath neoplasms
RECOMMENDED BOOKS
1. Pathological Basis of Disease
by Kumar, Cotran, Robbins.
7th. Ed.
2. Medical Microbiology and Immunology
by Levinson and Jawetz,
9th Ed.
Mc Graw-Hill
3.
Ackerman’s Surgical Pathology
4.
Clinical Pathology Interpretations
by A.H. Nagi
5.
Theory and Practice Of Histololgical Techniques
by John D Bancroft
6.
District Laboratory Practice in Tropical Countries
by Monica Cheesburgh,
2nd
Ed. Part I & II
7.
Online Journals and Reading Materials through HEC Digital Library
Facility.
(B)
COMMUNITY MEDICINE
The course
outline is as follows :
Concept
of Health & Disease
§ Concept
of health
§
Definition of health (Dimensions, physical, mental, social and spiritual).
§ Spectrum
of health
§
Determinants of health. Responsibility for health
§
Indicators of health
§ Concept
of disease. Concept of causation (all theories including ecological triad,
agent, host &
environmental factors).
§ Spectrum
of disease. Iceberg phenomenon.
§ Natural
history of disease. Levels of prevention.
§ Disease
elimination and eradication. Disease surveillance.
Introduction to Public Health and Health Systems in Pakistan
Background and Concepts:
§
Definitions and concepts in Public Health
§
Development of Public Health in Pakistan.
§
Economics and Health. Health Policy and planning in Pakistan.
§ “Health
for all”, background , concepts and progress.
§ “Primary
Health Care”: Concepts and progress.
§ The
National Disease Control programmes; policies, strategies and operations.
Health
System in Pakistan:
§ The role
of Federal and Provincial Governments in Health care.
§ The
District Health System, in the context of devolution.
§ The
Physician as a manager:
§
Functions of manager, management of material, human and financial resources.
§
Leadership and motivation.
Partners in Health:
§ The
public and private sector.
§
Nongovernmental Organizations and International Agencies.
§
Resources for health. Community Mobilization.
Epidemiology and disease control
§ General
epidemiology and research methodology.
§
Background and concepts, uses, basic measurements in epidemiology
(morbidity, mortality, disability and fatality).
§
Epidemiological methods (descriptive, analytic and experimental).
§
epidemiological transition. Association and causation.
§
Investigation of an outbreak or an epidemic.
§
Screening for disease. Community diagnosis.
§ Research
and survey methodology.
§
Introduction to qualitative research methodology.
Prevention and control of Infectious diseases
§
Definitions to differentiate between:
§
Infection, contamination, pollution, infestation
§
Infectious disease, communicable disease, contagious disease
§ Host,
Immune and susceptible persons
§
Sporadic, Endemic, Epidemic, Pandemic
§
Epizootic, Exotic, Zoonosis
§ Contact,
fomites, Carriers, Insect Vectors, Reservoir of infection
§
Incubation period, Infective period, Generation time
§ Cross
infection, Nosocomial infection, Opportunistic infections, Iatrogenic
(Physician
induced) disorders
§
Surveillance, Eradication, Elimination.
Dynamics of infections disease Transmission
§
Reservoir and source of infection, Escape of organism, Mode of transmission,
Entry into
the body,
Susceptible host, Immunity (different types of immunity and immunization)
Control
of infection.
§
Controlling the reservoir-notification, early diagnosis treatment,
isolation,
quarantine, disinfections.
§
Interruption of transmission.
§ The
susceptible host (active & passive immunization,Combined Chemoprophylaxis,
Nonspecific
measures).
§ Health
advice to travelers.
§ National
case management guide lines.
Epidemiology, control and prevention of infectious diseases of Public Health
importance.
§ Diseases
transmitted throug h inhalation
§ Diseases
transmitted through faeco-oral route
§
Arthropod borne diseases.
§ Diseases
of animals conveyed to man.
§ Diseases
due to direct contact
Epidemiology, control and prevention of non-infectious diseases of Public
Health
importance.
§
Hypertension,
§ Coronary
heart disease
§ Cancers,
§ Injuries
§ Diabetes
mellitus
§ Obesity
§
Rheumatic fever and heart disease.
Biostatistics
§ Concepts
and uses
§ Data and
its types
§ Rates,
ratios and proportions
§ Crude,
specific and standardized rates.
§
Collection and registration of vital events in Pakistan
§ Sources
of health related statistics
§ Measures
of central tendency, (Mean, Median, Mode),
§ Measures
of dispersion (Range, Standard deviation, Standard error)
§ Normal
curve
§ Methods
of data presentation (tables, graphs & diagrams).
§
Interpretation of data (t-test and Chi-square test)
§ Sampling
and its various techniques.
§ Health
Management Information System
Demography and Population dynamics
§ Concept,
demographic principles and demographic processes
§ Census,
definition, methodology, types.
§
Determinants of fertility, mortality
§
Population pyramid, and its interpretation.
§
Demographic transition, demographic trap and its public health importance.
§
Demographic and social implication of high population growth.
§ Social
mobilization
§
Urbanization
Food
and Nutrition
§ Concepts
(nutrition, nutrient, food, diet).
§ Food
groups and their functions.
§ Role of
fiber in diet.
§ Balanced
diet.
§
Malnutrition at all stages of life its types causes and prevention.
§ Common
nutritional problem of public health importance and their prevention
and
control.
§ Dietary
requirements of normal human being at different stages of life.
§ Food
hygiene, pasteurization, fortification, additives & adulteration and
preservation
§ Food
poisoning
§
Assessment of nutritional status of a community.
Reproductive and child health
§ Safe
mother hood, and its components. (ante -natal, post-natal, family planning &
emergency
obstetric care).
§ Maternal
mortality, causes and prevention.
§ Infant
care: growth and development. Breast feeding,
§ Common
causes of morbidity and mortality, their prevention
§ And
control.
§ Child
care: health promotion strategies. Common ailments, home accidents,
child
mortality prevention .
§
Strategic approaches of integrated management of childhood illness (IMCI).
§
Adolescent health
§
Reproductive tract infections: guidelines for management of STD’s.
Health
of school age children.
§ Role of
teachers and role of doctor in maintenance of health
§
Procedures for determining health status of school age children.
§ Common
health problems of school children.
Environmental Health Sciences
§ Air:
Composition of air. Causes of Air pollution. Purification of Air. Diseases
caused by
impurities in air and their prevention.
§ Water:
Sources of Water. Daily water requirement. Water pollution its causes
and
prevention. Purification of Water.
§ Water
quality Standards. Diseases due to polluted water.
§ Waste
disposal: contents, hazards and safety measures for solid and liquid;
domestic,
industrial
and hospital waste.
§ Climate:
Climate and weather. Global environmental concerns
§ Green
house effect, depletion of ozone layer, acid rains.
§ Effect
of extremes of temperature, humidity, atmospheric pressure on human
health and
their prevention.
Radiation:
Sources, types, causes , hazards and prevention.
Healthful
housing. Urban and rural slums. Refugee camps and hostels.
Noise :
Definition, causes, acceptance level, hazards and control.
Occupational Health
§
Concepts, of occupational health, occupational medicine and occupational
hygiene.
§
Ergonomics and its importance.
§
Occupational hazards. Principles of control.
§ General
principles of occupational disease prevention.
§
Organization of occupational health services.
§ Health
Insurance and Social Security Schemes
Arthropods and their public health importance
§ Common
arthropod borne diseases
§ Control
of arthropods of medical importance.
§
Insecticides and their public health importance
Prevention and control of parasitic diseases of public health importance
Snake
Bites: personal protection and
management
Mental
Health
§ Concept.
Common mental health problems, their causes, prevention and control.
§ Juvenile
delinquency
Behavioral Sciences and lifestyle
§ Concept,
attitudes, health and illness behaviour.
§ Drug
abuse, addiction and smoking
§ Child
abuse and child labour
§ Role of
physical exercise in health and disease.
Information, Education and Communication (IEC)
§ Concept.
Aims and objectives
§
Approaches used in public health
§
Contents, principles and stages of health education
§
Communication methods, barriers and skills in health education
§
Planning, organizing and evaluating a health education programme
§ Social
marketing
Disaster
§
Definition, classification, (natural disasters like earthquake, floods.
§ Epidemic
of communicable diseases, man made disasters.
§
Accidents, thermo nuclear warfare, causes and prevention),
§
Magnitude and effects of disaster and public health consequences
§
Disaster: preparedness and management
Medical
Ethics
§
Background concepts and components
§ National
recommended guidelines.
PRACTICAL AND COMMUNITY BASED TRAINING
§ Student
should have practical experience in questionnaire development, data
collection, compilation, presentation, analysis and report writing.
Field
visits
§ Visit to
BHU and RHC
§ Visit to
an NGO
§ Visit to
a primary school to asses the nutritional status of school children
§ Visit to
MCH/Reproductive Health Centre to observe the organization, and function
of the
centre and to demonstrate counseling skills in one of the following:
§
Nutritional counseling for children, pregnant and lactating women.
§
Antenatal Care
§ Family
planning services
§
Immunization, others
§ Visit to
a hospital to see the hospital waste disposal.
§ Visit to
an industry
§ Visit to
a physical/mental/social rehabilitation centre.
Skills
development lab
§ Water
purification at domestic level.
§
Contraceptives
§
Vaccination including the cold chain
§ Oral
rehydration solution
RECOMMENDED BOOKS
1. Text
book of Community Medicine by
Park J E. Latest Edition
2. Text book of Community Medicine.
6th Ed. by Ilyas Ansari.
3. Text
book of Community Medicine by
Maxie Rozani. Latest Edition
4. Medical Statistics.
2nd Ed. by R. Turkwood.
5.
Online Journals and Reading Materials through HEC Digital
Library
Facility.
(C)
OPHTHALMOLOGY
The course
outline is as follows :
General
Learning Objectives of the Ophthalmology Course:
To equip
doctors with essential knowledge, skill and attitude in order to enable
them to:
1.
Identify ophthalmic diseases including emergencies, provide primary eye
care,
refer to the appropriate center and provide follow up to the patients.
2. Perform
essential minor surgical procedures
3.
Communicate effectively with the patient, the family and the community
regarding
eye diseases and its related issues
4.
Understand medical ethics and its application pertaining to ophthalmology
and
maintaining confidentiality of the patient.
5. To
understand the prevalence and prevention of the common public health
problems
related to ophthalmology.
6.
Understand the principles of Medical Research including fundamentals of
information technology.
INSTRUCTIONAL STRATEGY
§
METHODOLOGY
-
Problem-based Learning
-
Tutorials/ Practical sessions/Skills Lab
practice
-
Clinical rotations and ward visits
-
Lectures/Seminars/CPC’s – using modern
audio visual techniques,
§ Distant
learning using electronic devices and current Information
§
Technology facilities.
COURSE
CONTENTS
§ Basic
Anatomy and the functions of the Eyeball and Orbit
§
Orbit:
Orbital Cellulitis, Proptosis
§
Lids:
Blepharitis, Stye, Chalazion, Trichiasis,
Entropion, Ectropion, Ptosis, and Common
Tumors.
§
Conjunctiva:
Infective and Allergic Conjunctivitis,
Pterygium.
§
Cornea:
Corneal Ulcers, risk factors,
complications and its management.
§
Sclera:
Episcleritis and Scleritis
§
Pupil:
Pupillary reflexes and their common
abnormalities
§
Lacrimal Apparatus:
Composition and function of Tear film,
Dry Eye
§
Excessive watering (Epiphora), Dacryocystitis (Acute & chronic).
§
Therapeutics:
Drugs used in common ophthalmic
conditions
§
Vitamin “A”:
Ocular manifestation of vitamin A
deficiency and its management.
§
Uveal Tract:
Uveitis, and its differential diagnosis
from other causes of the Red Eye.
§
Lens:
Classification of cataract,
§
Congenital Cataract (lamellar, signs and symptoms and management), Rubella
syndrome,
Acquired Cataract (senile, traumatic, drug induced), cataract due to
systemic
diseases
(clinical picture and management including visual rehabilitation).
§
Glaucoma:
Physiology of Aqueous humor formation and
its circulation.
§
Measurement of IOP
§
Definition & classification of glaucoma
§ Primary
open angle and closed angle glaucoma
§
Secondary glaucoma due to hyper-mature cataract and uveitis. Principles of
medical
and surgical management of glaucoma.
§
Vitro-Retina:
Posterior vitreous detachment, primary
retinal detachment
(common
presentation and principle of management)
§ Diabetic
Retinopathy, Hypertensive Retinopathy,
§
Retinitis Pigmentonsa, Retinoblastoma.
§
Optic Nerve:
Papilloedema, Optic Neuritis (Papillitis and Retrobulbar Neuritis),
Optic
Atrophy
§
Visual Pathway:
Introduction to Visual Field defects in
the lesions of Chiasma
and visual
Pathway.
§
Injuries:
Extraocular Foreign Bodies, Closed globe
injuries,Open globe injuries
with or
without retained Intra ocular foreign bodies
§ Burns
and Chemical Injuries
§
Sympathetic Ophthalmitis.
§
Squint and Amblyopia:
Definition, Classification and Principle
of
Management.
§
Errors of Refraction:
Introduction to Optical System of Normal
Eye
§
Emetropia, Myopia, Hypermetropia, Astigmatism, Presbyopia, Aphakia,
Pseudophakia, Anisometropia and Amblyopia.
Details
of Clinical and Practical Competence:
§ Level of
Learning:
§ Level-1
Observer status
§ Level-2
Assistant status
§ Level-3
Perform under supervision
§ Level-4
Perform Independently
§ LEVEL 4
History
Taking
-
Defects in Vision
-
Pain in and around the Eye
-
Discharging Eye
-
Abnormal appearance of the Eye and Orbit
Examination
§ Visual
Acuity, for distance and near
§ Use of a
pinhole
§
Examination of Adnexa and anterior segment of the eye.
§ Eversion
of the upper Eye Lid and Lacrimal regurgitation Test
§
Detection of the Deviated Eye
§ Ocular
Movement
§
Pupillary Reflexes (Afferant Pupillary defects)
§
Measurement of Intra ocular pressure.
§
Palpation Assessment
§ Schiotz
Tonometer 1
§ Distant
Direct Ophthalmascopy for Identification of defects in Ocular Media
§ Direct
Ophthalmascopy with emphasis on disc and its abnormalities
§ Swollen
disc, cup disc and pale disc.
§
Confrontation test for field of vision
§
Familiarization with Retinoscopy
§ Indirect
Ophthalmascopy,
§ Slit
Lamp and its Uses
§ Visual
Fields and Use of Laser in Ophthalmology
Procedures
§
Irrigation of eye
§
Instillation of eye drops
§ Staining
for corneal ulcer
§ Removal
of superficial foreign bodies
§ Rational
use of topical anaesthesia
§
Preparation for operation and post operative management
§
Understand medical ethics and maintain the confidentiality of the patient
Assessment of Level of Competence:
§ To
Diagnose, treat and prevent certain common eye conditions e.g.
§
Blepheritis
§ Sty and
Chalazion
§
Dacryocystitis
§
Conjunctivitis
§ Trachoma
§ Ocular
Trauma (Corneal Foreign Body / Abrasion)
§ Ocular
Allergies
§ To
diagnose certain eye disease, initiate first aid treatment and refer them in
time
e.g.
§ Corneal
Ulcer
§ Uveitis
§ Acute
Congestive Glaucoma
§ Open or
closed globe injuries
§ Red Eye
§ To
enable them to diagnose other eye conditions and refer them to secondary or
tertiary
eye care centers for further management(Medical / Surgical) e.g.
§ Cataract
§ Squint
and Amblyopia
§
Refractive Errors
§ Tumours
(Leucocoria-white Pupil)
§ Serious
Ocular Trauma
§ Painful
or painless loss of vision.
§ To
understand the importance of prevention in Ocular Diseases
§
Deficiency Diseases resulting in ocular problems(Thyroid, Vit“A”)
§ Early
Detection of Glaucoma
§ Diabetic
Retinopathy
RECOMMENDED BOOKS
1. Parson’s Diseases of the Eye
by Ramanjit Sihala and
Radhika Tandor. 3rd Ed
2.
Ophthalmology by Renu Jogi
3.
Clinical Textbook of Ophthalmology
by Dr. Saleem Akhter
4.
Kanski’s Ophthalmology
5.
Ophthalmology Principles and Concepts
Newill F. W.
6.
Online Journals and Reading Materials through HEC Digital Library
Facility.
(D) ENT
General
Learning Outcomes of the Ophthalmology Course:
To equip
them with essential knowledge, skills and attitude to enable them to:
§ Identify
ENT diseases including emergencies, provide primary health care, refer
to
appropriate center and provide follow-up to the patients.
§ Perform
essential minor ENT procedures.
§
Communicate effectively with the patient, the family and the community
regarding disease
and its
relevant issues.
§
Understand medical ethics and its application pertaining to ENT and maintain
the
confidentiality of the patient.
§ To
understand the prevalence and prevention of the common Public Health Problem
related to
ENT in the community
§
Understand the principles of medical research including fundamentals of
Information Technology
INSTRUCTIONAL STRATEGY
§
METHODOLOGY
-
Problem-based Learning
-
Tutorials/ Practical sessions/Skills Lab
practice
-
Clinical rotations and ward visits
-
Lectures/Seminars/CPC’s – using modern
audio visual techniques,
§ Distant
learning using electronic devices and current Information
§
Technology facilities.
COURSE
CONTENTS
NOSE:
§ Anatomy
and physiology
§ History
taking and examination
§
Diseases of external nose
§
Congenital lesions, choanal atresia, meningiocoele,encephalocoele,
trauma,
cut nose, fractures, external deformities.
§
Diseases of septum
§
Epistaxis
§ Dns
§
Haematoma
§ Septal
abscess
§
Perforation
§
Rhinitis
§ Allergic
§ Atrophic
§ Hyper-trophic
§ Foreign
bodies.
§ V.m.r.
§
Polyps
§ Mucous
§
Ethmoidal
§
Antrochoanal
§ Bleeding
polypus
§
Foreign body nose
§
Rhinolith
§ Maggots
§
Sinusitis
§ Acute
sinusitis
§ Chronic
sinusitis, complications
§ Fungal
infection of nose and paranasal sinuses
§ Cfs
rhinorhea
§
Tumours
§ Basal
cell carcinoma
§ Squamous
cell carcinoma
§
Pappiloma
§ Osteoma
§
Headache and its ENT causes
BUCCAL
CAVITY, ORAL CAVITY, OROPHARYNX
§ Anatomy
and physiology
§ History
and examination
§
ORAL CAVITY ULCERS:
§
Traumatic
§ Aphthus
§ Vincent
‘s angina
§
Agranulocytic
§
Tuberculous
§ Maligant
uclers
§ Thrush
§
Leukoplakia
§ Behcet’s
disease
§
Ulcerative lesions of oral cavity
§
OROPHARYNX
§ Acute
tonsillitis
§ Chronic
tonsillitis
§ Peri
tonsillitis and abscess
§
Diphtheria
§
Differential diagnosis of white patch on the tonsil
§
Tonsil/oral cavity
§ Tumours
of tonsil
§
Retro-pharyngeal abscess
§
Pharyngeal abscess acute/chronic
§ Sleep
apnea syndrome
§ AIDS
§ Ludwig’s
angina
§
LARYNX
§ Anatomy
§
Physiology
§ History
§
Examination
§ Glottic
stenosis/larynogocoele
§
Laryngomalacia
§
Truama, Foreign Body & Infections of
Larynx
§
Supraglottitis
§ Acute
laryngitis
§
Laryngotracheobronchitis
§
Diphtheria
§ Chronic
laryngitis
§
Tuberculosis
§ Syphilis
§ Leprosy
§ Non
specific chronic laryngitis
§ Vocal
nodules
§ Vocal
cord paralysis
§
Functional aphonia
§
Tumuors
§
Papilloma laryrnx
§ Polyp
§
Carcinoma larynx
§ TNM
classification
§
Tracheostomy
§
Indications
§ Contra
indications
§
Complication
§
Operation steps
§ Post op
care
§
EAR
§ Anatomy
and physiology
§ History
and examination
§ Tuning
fork tests. Pure tone audiometery/impedance audiometery
§ Pre
auricular sinus
§ Deafness
§ Pain in
the ear
§
External ear
§
Perichondritis
§ Trauma
to pinna/haematoma
§ Wax ear
§ Foreign
body ear
§ Hyper
ostosis
§
Neoplasia
§ Boil ear
§ Fungus
§ Acute
diffuse otitis externa
§
Malignant otitis externa
§
Myringitis bulliosa
§
Traumatic rupture
§
Middle ear
§ Acute
otitis media
§ Acute
necrotising otitis media
§ Serous
otitis media
§ Chronic
otitis media
i). Tubo
tympanic
ii).Mucosal disease
iii).
Attico antral
§
Complications Of Otitis Media / Mastoiditis
§
Ototoxicity
§ Acoustic
trauma
§
Traumatic perforation of tympanic membrane.
§ Deaf
child
§ Speech
therapy
§
Otosclerosis
§ Vertigo
§
Meniere’s disease
§ Facial
nerve paralysis
§
Eustachean tube dysfunction
§
HEAD & NECK
§ Cleft
palate
§ Hare lip
§
Thyroglossal cyst / sinus
§ Pre
auricular cyst / sinus
§ D/D of
mass neck
§ Lesions
of salivary glands
PRACTICAL SKILLS:
By the end
of the clerkship in the department of ENT, the student should be able
to:
§ Obtain
an appropriate history.
§ Perform
a complete regional examination
§ Identify
common E.N.T. Head & Neck problems for a given patient and outline
appropriate management plans.
§ Identify
problems needing referral to an Otola ryngologist.
GENERAL
SKILLS:
The
students should be able to:
§
Demonstrate the use of the head mirror for adequate illumination of the
nasal
cavity
§ Examine
the oropharynx and the neck
§ Examine
Larynx by indirect laryngoscopy
§
Examination of postnasal space by posterior rhinoscopy.
SPECIAL
SKILLS:
§ Use the
tongue blade to aid inspection of the buccal/cavity.
§ Use the
finger palpation examination of the oral cavity and tongue
§ Palpate
the neck to assess the lymph-nodes and salivary glands in the neck.
§
Examination of cranial nerves
§ Identify
structures (of the neck, sinuses and ear) on X-ray (MRI, CT Scan)
§
Demonstrate the appropriate use of nasal speculum
§
Demonstrate the use of otoscope to aid in examination of the external
auditory
canal and
the tympanic membrane.
§ Learn
pneumatic otoscopy. (Use of Seigle’s speculum)
§
Demonstrate the use of tuning fork and interpret the findings
§
Interpret pure tone and speech audiometry
§
Syringing of ear.
§ Removal
of wax from ear
§ Anterior
nasal packing
Observe
the Following Operations and the Use of the Listed Instruments
§ Abscess
incision drainage/ haematoma
§
Reduction of fracture nose
§ Septal
correction surgery
§ Antral
wash out
§ Cald
Well Luc’s operation
Introduction to New Procedures
§ Nasal
packing (anterior)
§
Tracheostomy
§
Laryngotomy
§
Management of obstructed airway
§ Foreign
body in tracheo-bronchial tree and Larynx
§ Ear
operations
Instruments
§ Ear
instruments like myringotome and ear speculum
§
Walsham’s Forceps
§ Ashe’s
Forceps
§ Trocar
and Cannula
§ Nasal
Speculum
§ Freer
elevator
§ Suction
Tube
§ Luc’s
forceps
§ Tilly
Nasal Dressing Forceps
§ Bayonet
Nasal Forces
§ Myle’s
Retrograde Perforator.
§ Nasal
Snare
§ Balenger
Swivel Knife
§
Eustachean Catheter
§ Sinus
forceps
§
Endotracheal tube, cuffed, non-cuffed
§ Mc Gill
forceps
§
Tracheostomy tubes
§ Tracheal
dilator
§
Retractors
§ Cricoid
hook
§
Endoscopes
§
Laryngoscopes
§
Bronchoscopes
§
Oesophagoscopes
§
Nasopharyngoscope (Rigid/flexible)
§ Adenoid
curette
§ Boyle
Davis mouth gag
§ Tonsil
holding forceps
§ Tonsilar
artery forceps
§ Tonsil
snare
§ Knot
pusher
RECOMMENDED BOOKS
1. Text
book of ENT by Logan Turner.
Latest Ed.
2.
Diseases of ENT by Dhengra.
Latest Ed.
3. Text
Book of ENT by Masud.
4.
Oxford Hand Book of ENT by
Prescott.
5.
Online Journals and Reading Materials through HEC Digital Library
Facility.
|
Punjab
Medical College Faisalabad, Pakistan.
