WELCOME

Dr.A.K.M. Kamrul Huque

MBBS. FCPS part 1 (medicine)
FCPS part 2 trainee (DMCH)
Tips & tricks

Paper 1
 TOPIC NUMBER OF QUESTIONS

GENERAL ASPECTS OF MEDICAL PRACTICE 5

GENETICS 5

NEUROLOGY 15

GASTROENTEROLOGY 10

HEPATOLOGY 5

HEAMATOLOGY 8

PRINCIPLES OF ONCOLOGY 1-2

CLIMATE & ENVIRONMENTAL FACTORS IN DISEASE 1-2

Medical ehics,Clinical decision making & Good
medical practice
• Quality of a physicians in 21st century
• Barriers of good communications
• Practicing medicine in low resource setting(headlines)
• Medical ethics (def , types)
• principles of clinical / medical ethics
• Ethical problem with example of each
• Clinical governance
• Criteria of good prescription
• Clinical decision making
• Box 1.1,1.2,1.3( only factors) 1.6 ***
• Fig 1.1, 1.7
• Sensitivity, & specificity
• Examples of target molecules of drug ( box 2.2 receptor & example)
• Examples of pharmacokinetic variations ( box 2.5 pharmacokinetic**)
• Drugs causes withdrawal effect(box 2.3)
• Adverse drug reactions(box 2.9 ACE I,beta blocker,digoxin,opiods**)
• Common drug interactions (box 2.12)
• Novel therapeutic alternatives (box 2.16)**
• Drugs require extra caution in prescribing older people**
• Factors influencing the timing of drug therapy( box 2.20)
• Drugs require extra cautions (box2.22)
Gastroenterology
• Physiology: davidson anatomy and physiology portion***
• box 23.2****
• Nervous control of GIT**
• enzymes (box;23.1)*****
• Regulation of HCl secretion
• Functions of stomach cells
• Investigations

• Upper GI endoscopy (BOX 23.6)****

• Test Of GI function (box 23.12)(bile acid,pancreatic exocrine
function,mucosal inflammation***)
• Test involving radioisotope(box 23.13)(test & isotope)****
• Confirmatory and gold standard test for : achalasia cardia ,
GERD,Barret esophagus, coeliac disease, pancreatic exocrine
deficiency
• Features suggestive of oral cancer(box 23.25**)
• Alarmimg features of dyspepsia(box 23.15)**
• Achalasia (pathophysiology, CF, ix)
• Methods &diagnosis of Helicobacter pylori(box 23.34)***
• Risk factors of oesophageal carcinoma(box 23.31), gastric carcinoma
(box23.39), colorectal carcinoma(fig 23.47)**
• Causes of subtotal villus atrophy(23.43)***,Dyspepsia(drug cause),
protein losing enteropathy (23.48 ) ,***,lower GI bleeding(23.18)
• Clinical features & paraneoplastic features associated with Ca
stomach
• Common causes & Complications of acute pancreatitis (box
23.80,23.81)***
• Glasgow criteria (box 23.78)
• Features of chronic pancreatitis & Ca head of pancreas
• Investigation in chronic pancratitis (23.84)*
..Features of malabsorption of different nutrients( box 23.20,fig 23.22)
• Features & diagnostic tests of acute small bowel ischemia, acute
colonic ischemia.*
• Coeliac disease*** ,Dermatitis herpetiformis, tropical sprue(rx)
• CD & UC ,difference ( box 23.61)***BOX 23.63
• Medical management of active & fulminant UC( fig 23.66, box 23.68)
• IBD **Features associated with active and inactive IBD(fig 23.63)*
• IBS (23.74,23.75) **
• Whipples disease (cf, dx)*
• Consequencence of ileal resection( fig23.44)*
• Gastrointestinal polyposis syndrome( box 23.54 neoplastic*****)
• Extraintestinal feature of FAP (Box 23.55)**
• Indication of H. pylori testing (23.36)
Hepatology
• Interpretation of physical sign in cirrhosis
• Liver structure & microstructure**
• Functions of ITO cell**
• Non parenchymal liver cell( fig 24.3)
• Storage of vitamins and minerals*
• Liver functions test( box24.5**)
• Causes of acute & chronic liver injury( fig 24.11)
• Causes of acute liver failure (fig 24.15 drugs)*
• adverse prognostic criteria(box 24.18)& complications of acute liver
failure (box 24.20)**
• Congenital non hemolytic hyperbilirubinaemia(box 24.12)*
• Causes of cholestatic jaundice(24,14)
• Causes & pathogenesis of ascities**
• Hepatorenal syndrome(box 24.25)
• SBP**
• CLD , Hepatic encephalopathy(box 24.16,26,27)**
• Portal HTN , causes (fig 24.21 sinusoidal**), complications (box24.33)
• Emergency mx of variceal bledding (fig 24.34)**
• HBV , HCV Phases of chronic HBV infection (box 24.39)
• Liver abscess (Difference between pyogenic and amoebic) ,NAFLD
• PBC*** ,PSC,***
• Autoimmune hepatitis**
• Haemochromatosis (cf , cause, inv,mx) **
• Wilson disease****
• Gilberts syndrome**
• Alpha 1 antitrypsin deficiency ( fig24,41)*
• Budd chiari syndrome**
• HCC, Hepatopulmonary synd
• Pregnancy related liver diseases (maternal medicine – acute fatty
liver of preg***)
• NAFLD & NASH ( fig 24.31***)
• IgG4 associated cholangitis ( closely related to autoimmune
pancreatitis)
• Alc hepatitis (Ig A , biopsy finding)**
• Indications of liver transplant assessment(box 24.61)
• Drugs induced hepatotoxicity (24.57}***
• Risk factors and complications of gallstone diseases(24.62,24.64)
• Important boxes 24.3, 24.54,**
• Important fig 24.4, 24.5**
Genetics
• Features & examples****
• - AD
• - AS
• -XLD
• -XLR
• Multifactorial / polygenic disorders- examples
• Three synd.**
• -down
• - turner
• -klinefelters
• Prenatal testing and diagnosis***
• Disease associated with triplet and other repeat expansions(box3.2)
• Chromosome & contiguous gene disorders (box 3.3 only names)
• Pedigree ***(fig 3.8)
• Imprinting disorders (box 3.8 only names)
• Box 3.9 ***
Oncology
• Cell cycle
• Tumour markar****( box 7.4)
• Oncological emergency :
• SVC obstruction (box 7.15)**
• Rx of hypercalcemia (box 7.17)**
• Tumour lysis synd****
• Adverse effects of chemotherapy & radiotherapy
• Infections causes malignancy
• Cytotoxic chemotherapy flow chart
• Paraneoplastic syndrome(box 7.10) **
• Tumour suppressor gene, oncogene example
• Hormone secreting tumour
• Box 7.9, 7.10, 7.13, 7.18
Haematology
• Hematopoietic organs in different age
• Erythropoiesis and factors*
• Components of Hb*
• Microcytosis,Macrocytosis, Target cells, Howell-jolly bodies,
papenheimers, basophilic stippling found in…(box 25.2)***
• Causes of increased BT,PT,APTT**
• Hb – oxygen dissociation curve –fig 25.5**
• Causes of Secondary aplastic anemia( causes- box-25.62)*
• Indications of thrombophilia testing (box25.5)
• Causiology--
• Thrombophilia
• Erythrocytosis(box 25.8)
• Lymphadenopathy**
• Splenomegaly (massive)**
• Non-thrombocytopenic purpura(box 25.13)
• Pancytopenia**
• Thrombocytosis (box. 25.15)**
• Mx of the splenectomised patient (box25.37)
• Gaisbocks Syndrome (HTN,Smoking, alcohol, diuretic therapy,low
volume polycythaemia)**
• Uses of blood components (box-25.17)**
- coagulation factors
-IVIg
-Human albumin
-Platelet concentrate
-FFP
-Cryoprecipitate
• Mode of action of antiplatelet & antithrombotic drugs(box-25.26)**
• ABO incompatiblity
• Heparin ( compared between UFH & LMWH)
• Infections during recovery from HSCT(box- 25.24)
• Factors involve in the size of red cells in anemia (Fig 25.19)
• Investigation to differentiated IDA & Anaemia of chronic
disease(box-25.30) **
• Neurological findings in B12 deficiency (box-25.33)**
• Markers of hemolysis (box-25.36)**
• Causes of hemolysis (fig-25.21)
• C/F of G6FD deficiency (box-25.38)
• Sickle cell anemia(fig -25.24)**
• Thalassema (box-25.40****)
• Leukaemia (risk factor –box-25.45)**
• Acute leukaemia –Ix**
• Outcome of adult acute leukaemia(box-25.48)
• PNH**
• CML**
• Tyrosine kinase inhibitor in CML (box-25.49)**
• MDS (box-25.51)**
• Lymphoma (type,common type,histopathological
findings, aetiology, poor prognostic factors,inv of HL box -
25.53,54,55,56)***
• Paraproteineimia
• Waldestrom macroglobunemia (1st para)
• Myelofibrosis –dx***
• Polycythaemia rubra vera –dx***
• Multiple myeloma(C/F,inv,classification,rx, box-25.58,fig-
25.37,38)***
• Antiphospholipid syndrome**(box 25.69)
• Status of BT, CT ,APTT, PT in different hematological disorder***
• Hemophilia
• DIC (box-25.70)
• ITP
• VWD
Neurology
• Examination of gait & posture
• Root values of tendon reflexes
• Functional anatomy & physiology portion( Davidson)**
• Anatomy
• basal ganglia,cerebellum,hypothalamus**
• limbic system,, cavernous sinus
• LP- Indications , contraindications***
• Physiology:***
• nerve cell, nerve fiber (classification)
• sympathetic & parasympathetic
• tract of gall, tract of burdach
• spinothalamic tract, extra pyramidal tract
• CSF circulation ,BBB
• hemisection of spinal cord and its consequence
• Cortical lobur function( box28.2)*****
• Brain stem lesions (box 28.3 with box of 23rd edition)*****
• Interpretations of CSF ( box- 28.6)**
• Patterns of sensory loss ( fig 28.18)(mid brain, thalamic)**
• Causes of chorea box -28 .17 ( drug & metabolic***)
• NCS, RNS, EMG
• MX of status epilepticus (box 28.12)***
• Facial nerve palsy
 Common causes of damage to CN 3,4,6(Box 28.19)
Examinations findings in 3rd ,4th & 6th nerve palsy (fig28.20 )**
• Classification of cortical speech problems(fig 28.19)**
• Common causes of ptosis( box 28.20)
• d/d of unilateral ptosis ( fig; 28.21)**
• Pupillary disorders ( box 28.21)***
• difference of pseudobulbar & bulbar palsy
• Nerve supply to urinary bladder
• Migraine (dx , mx)*
• Cluster headache (dx, mx)***
• Trigeminal neuralgia (dx, mx)***
• Triggers factor of seizure (box 28.27),
• causes of focal seizure box 28.28-(genetic ,infective, inflammatory**)
• Causes of GTCS box 28.29 (drugs, metabolic disease ****)
• Choice of antiepileptic drugs (box 28.38 1st line)****
• Epilepsy in pregnancy(box 28,39 pharmacokinetics effects of
pregnancy**
• BPPV (DX, IX, MX)**
• Multiple sclerosis ( typical sites, C/F – box 28.46, disease modifying
rx –only drug names)**
• NMO**
• Idiopathic PD(C/F, normal findings, mx –drug name , group)
• MSA,PSP,HD (c/f)***
• Drugs causing tremor (box 28.56)**
• Visual pathway and visual field defects***
• MND ( box 28.57. fig- 28.32, mx.-NIV? )
• Meningitis
• causes box 28.59(fungi , non infective cause ****)
• complications (box 28.61)
• Contraindications of immediate LP (fig- 28.33)**
• Causes of viral encephalitis box 28.66 (only name)
• Neurosyphilis (box -28.69 –tabes dorsalis ***)
• Tetanus C/F**
• Botulism (box 28.71 C/F , organism)
• Primary brain tumour ( only name)
• NF (Box- 28.76)*
• NPH – triad**
• IIH ***
• Findings in cervical nerve root compression & lumber nerve root
compression (fig 28.45,28.46)**
• Signs of spinal cord compression (box 28.80)**
• Causes of absent ankle jerk with planter extensor
• Causes of polyneuropathy box 24.83 (drug, vit, infective,systemic
medical conditions****)
• Common entrapment neuropathis (Box 28.86) **
• GBS**
• LEMG,MG (C/f , triggering factor,Ix ,mx) (antibody)***
• Muscle channelopathis – box 28.93 ( disease names)
• Causes of acute proximal myopathis – fig 28.51 (endocrine, drugs***
Stroke medicine
• Classifications of stroke – fig 29.1
• Circle of willis –fig: 29.2 A
• Risk factors for stroke (box 29.1)**
• Stroke syndrome – fig- 29.7****
• Indications of brain imaging box 29.7
• Mx of stroke Fig 29.8
• Complications of stroke fig – 29.9**
• SAH (c/f, ix,mx ) , fig -29,12, 29.13**
• C/F cerebral venous thrombosis (29.10)
Environmental medicine

• Effects of radiation exposure

• Hypothermia, Heat stroke *****
• Drowning, near drowning
• Humanitarian crisis, Global warming
• Causes of elevated core body temp
• Fig 12.2
• box;:12,3, 12.3, 12.7