QUETTA INSTITUTE OF MEDICAL SCIENCES

DEPARTMENT OF MEDICAL EDUCATION

STUDENT STUDY GUIDE (2023-24)

YEAR MBBS YEAR V

BLOCK I, II & III
SUBJECT MEDICINE & ALLIED
 QUETTA INSTITUTE OF MEDICAL SCIENCES

VISION:
An efficient center of excellence for medical education, research
& healthcare, educating/qualifying healthcare professionals to
serve communities thus contributing to the overall well-being of
the society.
MISSION:
To prepare health professionals by providing comprehensive,
high quality medical education that fosters professional
competence, logical thinking, ethical values and sense of social
responsibility.
CURRICULAR ORGANIZATION & STRUCTURE:
NUMS MBBS curriculum is based on clerkships in clinical subjects of final year.
These clerkships are designed to provide students with a practical and immersive
clinical experience that will enhance their clinical skills and knowledge.
The curriculum perspective emphasizes practical clinical skills, critical thinking,
evidence based practice, patient-centered care, and a lifelong commitment to
learning, ensuring that graduates are ready for successful careers in the medical
field.
 There will be three blocks in year V, duration of which depends upon the
number and complexity of the objectives to be achieved in that module.
 The planning and delivery will be coordinated by year & module
coordinators for efficient implementation.

INTEGRATION IN MBBS YEAR-V:

 The curriculum implemented is a hybrid type of curriculum which has both
horizontal and vertical integration. Spiral integration is introduced as an
adjunct to horizontal and vertical integration.
 In Final Year MBBS, Medicine & Allied, Surgery & Allied, Paediatrics,
Obstetrics & Gynaecology will be assessed.

COMPETENCIES:

 The focus of this curriculum is on the roles of a general physician as

identified by PMDC that includes skillful, knowledgeable, community health
promoter, critical thinker, professional and role model, researcher and
leader. Competencies focused in year V are:
a. Medical Knowledge
b. Procedural skills
c. Clinical Skills
d. Problem solving
e. Communication skills
f. Professionalism
g. Research
EDUCATIONAL STRATEGIES:

a) Interactive lectures g) Team based learning

b) Teaching Ward Rounds h) Small Group Discussion
c) Case presentations i) Workshops (BLS/ACLS)
d) Case based Discussion j) Self-learning Activities
e) Short cases in OPD k) Skill Lab Activity
f) Bedside Discussion

INTERNAL ASSESSMENT:

THEORY PRACTICAL
 Throughout the year in End of Rotation Exams:
forms of class tests, module  At the end of each clinical
tests, quizes etc. rotation, a clinical exam
 At the end of each block, would be held, result of
theory paper of EOB exam which will contribute in the
will be conducted by the internal assessment for final
institute. Prof Exam.

 Two End of Block and One Pre-annual (Theory & Practical: OSCE +
Viva) exam will be conducted by the institute which contributes
towards the weighting of internal assessment i.e 20% in Final
Professional MBBS Examination.
ANNUAL PROFESSIONAL EXAMINATION:

 The University will take the Final Professional Examination at the end of the
academic year.

 There will be 300 marks theory paper and 300 marks

Medicine
of practical. Student has to pass theory and practical
&
Surgery separately with minimum 50 % marks.
However,student should pass in clinical exams /
OSCE (with 50% marks) and unobserved stations
(with 50% marks) separately.
 There will be 200 marks theory paper and 200 marks
Obstetrics &
of practical. Student has to pass theory and practical
Gynaecology
separately with minimum 50 % marks.
 There will be 100 marks theory paper and 100 marks
Paediatrics
of practical. Student has to pass theory and practical
separately with minimum 50 % marks.

COURSE EVALUATION:

 Students and faculty are precious stakeholders. Hence, their feedback also
matters to improve the quality of education. Students feedback will be
collected at the end of each block or annually via online forms for course
and faculty as well. Informal continuous feedback can also be given by the
students.
 Faculty will also submit their course feedback in order to look for
continuous improvement in the MBBS program.
YEAR OUTCOMES:
By the end of these Clerkships, students should be able to:
 Manage common medical, surgical, gynaecological and paediatric
conditions in OPD.
 Respond effectively to emergencies and trauma cases, demonstrating the
ability to think critically and act decisively.
 Communicate effectively with patients and their families, demonstrating
empathy and professionalism in delivering medical information and
discussing treatment plans.
 Collaborate with healthcare teams, including nurses and specialists, to
provide comprehensive patient care.
 Apply evidence-based medicine principles in clinical decision-making and
stay updated with the latest medical guidelines and research.
 Demonstrate proficiency in basic techniques, aseptic practices, and proper
instrument handling
 Present clinical cases that reflects critical thinking and presentation skills.
 Take timely decision to refer the cases to the specialist.

CONTACT HOURS DISTRIBUTION IN YEAR-V:

Medicine & Allied 600

Surgery & Allied 600
Obstetrics & Gynaecology 200
Paediatrics 200
Self Directed Learning 100
PATIENT AND DOCTOR SAFETY:
While rotating through medical wards and outpatient departments’ students will
be educated for patient’s safety and their own safety.

 What patient safety is; no harm to patients as defined by WHO.

 Understanding and learning from errors.

 How to manage clinical risk; clinical risk management specifically is

concerned with improving the quality and safety of health-care services by
identifying the circumstances and opportunities that put patients at risk of
harm and acting to prevent or control those risks.

 Methods for quality improvement.

 Engaging with patients and carers e.g. informed consent while examining
patients or for performing any procedure, conveying truthful information
,showing empathy etc.

 Minimising infection through improved Infection control.

 Reducing risks associated with Invasive procedures.

 Improving medication safety.

 Apply universal precautions.

 Be immunized against Hepatitis B.

 Use personal protection methods.

 Know what to do if exposed.

 Encourage others to use universal precautions.

 Promoting adherence to hand hygiene guidelines.

 Students will be taught to use protective equipment like gloves, aprons and
face masks.
 ACADEMIC CALENDAR 2023-24
5th YEAR MBBS- 9TH BATCH (SESSION 2019-2020)
ACADEMIC CALENDAR/FORECAST
ACADEMIC/EXTRA-CURRICULAR ACTIVITIES FROM TO
COMMENCEMENT OF NEW SESSION 13th NOVEMBER 2023
BLOCK I (12+3+1=16 WEEKS)
BLOCK-I 13th NOVEMBER 2023 5th JANUARY 2024
(8 WEEKS)
WINTER BREAK (TASK ORIENTED SDLs) 8th JAN 26TH JAN
(3 WEEKS)
BLOCK-1 29TH JAN 23rd FEB
(4 WEEKS)
EOB-I EXAM 26TH FEB 1st MARCH
(1 WEEK)
BLOCK II (11+1=12 WEEKS)
BLOCK- II PRE-EID 4TH MARCH 9TH APRIL
(5 WEEKS + 2 DAYS)
EID-UL-FITR HOLIDAYS 10TH APRIL 12TH APRIL

BLOCK-II POST-EID 15TH APRIL 24TH MAY

(6 WEEKS)
EOB-II EXAMS 27TH MAY 31ST MAY
(1 WEEK)
BLOCK III (9+2=11 WEEKS)
BLOCK-III PRE-EID 3RD JUNE 14TH JUNE
(2 WEEKS)
EID-UL-ADHA 17TH JUNE 21ST JUNE

BLOCK-III POST-EID 24TH JUNE 9TH AUGUST

(7 WEEKS)
EOB-III EXAMS 12TH AUGUST 23RD AUGUST
(2 WEEKS)
PREP LEAVE FOR ANNUAL EXAMS 26TH AUGUST 23RD SEPTEMBER
(4 WEEKS)
ANNUAL/PROF EXAM DATE BY NUMS 24TH SEPTEMBER 2024
 1200 1500 1600
DAY / 1355-
0830-1200 - 1215-1305 1305-1355 1410-1500 - -
TIME 1410
1215 1600 2100

MEDICINE – PAEDS-LGIS SURGERY– LGIS

MON
MORNING CLINICAL ROTATION

LGIS

EVENING CLINICAL ROTATION

SELF DIRECTED LEARNING
MEDICINE – SURGERY– LGIS
TUES OBS/GYNAE -
BREAK

LGIS LGIS

BREAK
MEDICINE –
WED PAEDS-LGIS
SURGERY– LGIS
LGIS

MEDICINE – OBS/GYNAE -
THURS SURGERY– LGIS
LGIS
LGIS

1315-
0830-1130 1130-1145 1145-1315 1400-1500
1400

SGD (CBL)
FRI MEDICINE (A)
MORNING PRAYER
CLINICAL BREAK SURGERY (B) SURGERY– LGIS
GYNAE (C) BREAK
ROTATION
PAEDS (D)
CLINICAL SKILLS LAB (E)
 CLERKSHIP ROTATION PLAN

FINAL YEAR MBBS 9th Batch CLINICAL ROTATION PLAN 2023-24

MORNING TIME (MON TO THURS): 8:30-12:00 HRS
(FRIDAY TIME): 8:30-11:30 HRS
EVENING TIME: 16:00-21:00 PM
WARD TEST WILL BE CONDUCTED AT THE END OF EACH ROTATION BY
DEPARTMENT.
Medicine & Allied Surgery & Allied

Gynae

Paeds
Surg
Med
Weeks Date
Rehab Derma Psy Radio Ortho Anesth

1st 13th-17th Nov A B C D E1 E2 E3 F1 F2 F3

2nd 20th-24th Nov A B C D E1 E2 E3 F1 F2 F3
3rd 27th Nov-1st Dec A B C D E3 E1 E2 F3 F1 F2
4th 4th-8th Dec A B C D E3 E1 E2 F3 F1 F2
5th 11th-15th Dec A B C D E2 E3 E1 F2 F3 F1
6th 18th-22nd Dec A B C D E2 E3 E1 F2 F3 F1
7th 25th-29th Dec F A B C D1 D2 D3 E1 E2 E3
8th 1st-5th Jan F A B C D1 D2 D3 E1 E2 E3
WINTER BREAK
9th 29th Jan-2nd Feb F A B C D3 D1 D2 E3 E1 E2
10th 5th-9th Feb F A B C D3 D1 D2 E3 E1 E2
11th 12th-16th Feb F A B C D2 D3 D1 E2 E3 E1
12th 19th-23rd Feb F A B C D2 D3 D1 E2 E3 E1
EOB-I
13th 4th-8th March E F A B C1 C2 C3 D1 D2 D3
14th 11th-15th March E F A B C1 C2 C3 D1 D2 D3
15th 18th-22nd March E F A B C3 C1 C2 D3 D1 D2
16th 25th-29th March E F A B C3 C1 C2 D3 D1 D2
17th 1st-5th April E F A B C2 C3 C1 D2 D3 D1
18th 8th-12th April E F A B C2 C3 C1 D2 D3 D1
19th 15th-19th April D E F A B1 B2 B3 C1 C2 C3
20th 22nd-26th April D E F A B1 B2 B3 C1 C2 C3
21st 29th-3rd May D E F A B3 B1 B2 C3 C1 C2
22nd 6th-10th May D E F A B3 B1 B2 C3 C1 C2
23rd 13th-17th May D E F A B2 B3 B1 C2 C3 C1
24th 20th-24th May D E F A B2 B3 B1 C2 C3 C1
EOB-II
25th 3rd-7th June C D E F A1 A2 A3 B1 B2 B3
26th 10th-14th June C D E F A1 A2 A3 B1 B2 B3
EID HOLIDAY
27th 24th-28th June C D E F A3 A1 A2 B3 B1 B2
28th 1st-5th July C D E F A3 A1 A2 B3 B1 B2
29th 8th-12th July C D E F A2 A3 A1 B2 B3 B1
30th 15th-19th July C D E F A2 A3 A1 B2 B3 B1
31st 22nd-26th July B C D E F1 F2 F3 A1 A2 A3
32nd 29th-2nd Aug B C D E F1 F2 F3 A1 A2 A3
33rd 5th-9th Aug B C D E F3 F1 F2 A3 A1 A2
34th 12th-16th Aug B C D E F3 F1 F2 A3 A1 A2
35th 19th-23rd Aug B C D E F2 F3 F1 A2 A3 A1
36th 26th-30th Aug B C D E F2 F3 F1 A2 A3 A1
 INTRODUCTION TO MEDICINE
Medicine is a broad based specialty dedicated to providing primary and specialized care to adults.
Therefore, it forms a key component of the undergraduate curriculum and is taught throughout
the five years with increased emphasis in last three years. Its primary focus is on building
knowledge, skills and attitudes of the students for the practice of medicine not only at the primary
care level but to advance to postgraduate studies for clinical practice, medical education and
research.
Our aim is to prepare future doctors for independent practice after graduation as a general
practitioner who can provide patient centered medical care with highest standards of
professionalism.

This study guide will help you to visit the most essential topics, system wise, in an orderly manner
in the subject of medicine to help you to understand and appreciate each component of the
course with its relation to other programs that will help you in your future life as a doctor. Thus
chances of getting lost and missing important topics in the vast complex subject of medicine will
be reduced. The guide is based on system based approach, which is the way curriculum is
distributed for this course.

TEACHING HOURS

TOTAL CONTACT HOURS OF MEDICINE & ALLIED

Class Total Hrs

1st Year MBBS 50

2nd Year MBBS 50

3rd Year MBBS 165

4th Year MBBS 210

Final Year MBBS 630

 FACULTY DETAILS OF MEDICINE DEPARTMENT

Head Of Department Nephrology Brig. Ashfaq Altaf

Professor Neurology Brig. Imran Ahmad
Associate Professor CCM Brig. Kaswar Sajjad Ansari
Associate Professor Gastroenterology Col. Syed Fayyaz Mehmood
Assistant Professor Medicine Lt.Col Asif Ullah Khan
Assistant Professor Medicine Lt.Col Uzma Qayyum
Assistant Professor Cardiology Lt.Col Waseem Raja
Senior Registrar Medicine Lt.Col Hassan Shabbir
Senior Registrar Rehab. Medicine Maj. Ijaz Ahmad
Senior Registrar Medicine Maj. Rabia Sadiq
Senior Registrar Medicine Maj. Aiman Sabir
Senior Registrar Medicine Maj. Fraz Tahir
Registrar Medicine Maj. Hafiz Muhammad Umer
Registrar Medicine Maj. Asma Malik
Registrar Medicine Maj. Faisal Shabbir Sheikh
Registrar Medicine Maj. Muhammad Hamza Zaheer
Registrar Medicine Maj. Haseeb Nasir
Registrar Medicine Maj. Muhammad Ishfaq Ahmad
Registrar Medicine Maj. Soban Ahmed Tariq
Registrar Medicine Maj. Dr. Nazia Sharif (FC)
Registrar Medicine Dr. Maryam Saleem
Registrar Medicine Dr. Syed Zaeem Ali Shah
Registrar Medicine Dr. Sammara Sarwar
Registrar Medicine Dr. Zarmina Idress
Registrar Medicine Dr. Iqra Zeb Qureshi

MODULE COORDINATOR FINAL YEAR MBBS

Senior Registrar Maj. Rabia Sadiq
CURRICULAR MAP MEDICINE DEPARTMENT
MBBS YEAR-V
 Department of Medicine, CMH Quetta (QIMS)
List of Lectures in Medicine for Final Year MBBS 2023-24

Block l
S No Topic Instructor Themes
1 Breaking Bad News Brig Imran Ahmad Foundation Theme
Effective patient counseling about
2 Maj Rabia Foundation Theme
Diseases & Compliance to Treatment
Patient-Doctor Relation ethical issues Foundation Theme
3 Brig Imran Ahmad
Dos and Don’ts
How to approach & evaluate a Patient
4 Maj Rabia Foundation Module
with Fever
How to approach & evaluate a Patient
5 Brig Imran Ahmad Foundation Module
with Jaundice
How to approach a patient with acute
6 Lt Col Asif Ullah Foundation Module
dyspnea
How to approach a patient of chest
7 Lt col Raja Wasim Foundation Module
pain
8 Normal /Abnormal ECG pattern Lt Col Raja Wasim CVS
9 Acute heart failure Lt col Raja Wasim CVS

10 Library CVS
11 ACS / MI Lt Col Raja Wasim CVS

12 Cardiomyopathies Lt Col Raja Wasim CVS

Arrhythmias (AF, VF, heart block, SVT,
13 Lt Col Raja Wasim CVS
VT)
14 CBL CVS

15 Hypertension Lt Col Raja Wasim CVS

Valvular Heart Diseases – I Lt Col Raja Wasim
16 CVS
MS, MR
17 Valvular Heart Diseases – II AS, AR Lt Col Raja Wasim CVS
Congenital Heart Diseases VSD, ASD, Lt Col Raja Wasim
18 CVS
TOF
19 Dyslipidemia Lt Col Raja Wasim CVS

20 Infective Endocarditis Lt Col Raja Wasim CVS

21 CBL Lt Col Raja Wasim CVS

22 Acute Pericarditis/ chronic pericarditis Lt Col Raja Wasim CVS

23 Rheumatic Fever Lt Col Raja Wasim CVS

24 Library Lt Col Raja Wasim CVS

25 Chronic Heart Failure/ Cor- pulmonale Lt Col Raja Wasim CVS

26 CBL Lt Col Raja Wasim CVS

27 Asthma Lt Col Asif Ullah Respiratory

TB/diagnosis, management, MDR and Lt Col Asif Ullah
28 Respiratory
XDR TB
29 Interstitial Lung Diseases Lt Col Asif Ullah Respiratory

30 Sarcoidosis Lt Col Asif Ullah Respiratory

31 Viral pneumonia/ COVID Lt Col Asif Ullah Respiratory

32 Bacterial Pneumonia Lt Col Asif Ullah Respiratory

33 CBL Lt Col Asif Ullah Respiratory

34 Lung Abscess Lt Col Asif Ullah Respiratory

35 Chronic Obstructive Airway Disease Lt Col Asif Ullah Respiratory

36 Library Lt Col Asif Ullah Respiratory

37 Pulmonary thromboembolism Lt Col Asif Ullah Respiratory

38 ARDS Lt Col Asif Ullah Respiratory

Respiratory Failure ICU care including Lt Col Asif Ullah
39 oxygen therapy ( non invasive to Respiratory
invasive ventilation)
40 CA Bronchi Lt Col Asif Ullah Respiratory

41 CBL Lt Col Asif Ullah Respiratory

42 Acute Hepatitis Col Syed Fayyaz GIT/Liver

43 Chronic Hepatitis B, C Infection Col Syed Fayyaz GIT/Liver

44 Library Col Syed Fayyaz GIT/Liver

45 Cirrhosis of Liver/ Ascites Col Syed Fayyaz GIT/Liver

Portal Hypertension Col Syed Fayyaz GIT/Liver

46
Complication and management
47 Hepatic Encephalopathy Col Syed Fayyaz GIT/Liver

Auto immune hepatitis/Primary biliary Col Syed Fayyaz GIT/Liver

48
cirrhosis
Liver Abscess (pyogenic, amoebic and Col Syed Fayyaz GIT/Liver
49
hydatid cyst of liver )
50 Wilson disease /Hemochromatosis Col Syed Fayyaz GIT/Liver

51 CBL Col Syed Fayyaz GIT

52 Pancreatitis Col Syed Fayyaz GIT

53 Dyspepsia / GERD & Peptic Ulcer Col Syed Fayyaz GIT

54 Acute & Chronic Diarrhea Col Syed Fayyaz GIT

Irritable bowel syndrome/ functional Col Syed Fayyaz
55 GIT
disorder of GIT
56 Library Col Syed Fayyaz GIT

57 Inflammatory Bowel disease Col Syed Fayyaz GIT

58 Upper GI Bleed Col Syed Fayyaz GIT

59 Lower GI Bleed Col Syed Fayyaz GIT

60 CBL Col Syed Fayyaz GIT

 BLOCK-I
MODULE: INTRODUCTION TO MEDICINE
TOPIC: SYMPTOMATOLOGY / COMMON CLINICAL PRESENTATION
LEARNING STRATEGIES CBL/ Bed side training/SDL
ASSESSMENT TOOL MCQ/SEQ/SAQ/OSPE/Long case/Short case

LEARNING OUTCOMES
COURSE CONTENT By the end of this module, students should be able to:
Symptomatology of Knowledge:
following:  Correlate clinical findings to anatomical structures.
• CVS disease  Correlate clinical features to etiology in terms of congenital,
• Respiratory diseases traumatic, inflammatory, neoplastic or miscellaneous.
• GI diseases  Discuss basic pharmacology of drugs being used in a medical unit.
• CNS diseases  List the investigations.
• Locomotor diseases  Outline management plan.
• Renal diseases
• Common endocrine
Diseases.
Approach to patient Skills/Attitude:
with:  Take the relevant history.
• Fever, Headache  Perform general physical examination.
• Cyanosis, Jaundice  Perform systemic examination of different systems.
• Chest pain  Show empathy and sympathy while examining the patient.
• Unconsciousness  Recognize the right to consent and privacy of the patient.
• Dyspnea, Dyspepsia  Present findings of the history and examination in logical order
• Hematemesis,Malena verbally as well as in written form.
• Bleeding per rectum
• Vomiting, Diarrhea
• Fits, Anorexia and
weight loss
• Oedema, Ascites
• Acute Poisoning
• Anemia
• Critically ill patient
• PUO
 MODULE: CARDIOVASCULAR SYSTEM
TOPIC: HYPERTENSION
DOMAIN KNOWLEDGE
LEARNING STRATEGIES Lecture & bedside teaching/CBL/SDL
ASSESSMENT TOOL MCQ/SEQ/SAQ/OSPE/Long case/short case
LEARNING OUTCOMES
COURSE CONTENT By the end of this module, students should be able to:
 Define diagnostic criteria for hypertension.
Hypertension:  Provide pathophysiological basis of hypertension.
 Propose lifestyle modifications and nonpharmacological options
Causes, Types,
for patients with hypertension.
Diagnosis and
Management.  Diagnose primary hypertension from secondary hypertension.
 Rationalize the need for achieving recommended BP goals in
treatment of hypertension.
 Classify antihypertensive drugs.
 Choose appropriate antihypertensive drug considering their
indications for use.
 Recognize types of hypertension, hypertensive urgency and
emergency.
TOPIC: ISCHEMIC HEART DISEASE
Define:
ACS/MI: • Acute coronary syndrome (ACS)
• Angina
Diagnosis, • Unstable angina pectoris (UA)
Complications and • Non-ST segment elevation myocardial infarction(NSTEMI)
Management • ST segment elevation myocardial Infarction
• Provide pathophysiological basis of cardiac ischemia.
• Diagnose ACS and MI.
• List complications of MI
• Analyze the pharmacological management in the treatment of ACS.
• Differentiate between male and female signs and symptoms of ACS.
• Examine ACS modifiable and non-modifiable risk factors.
• Discuss coronary revascularization procedures and nursing care.
 TOPIC: HEART FAILURE
LEARNING STRATEGIES Lecture & bedside teaching/Case ppt/SDL
ASSESSMENT TOOL MCQ/SEQ/SAQ/OSPE/Long case/short case
LEARNING OUTCOMES
COURSE CONTENT By the end of this module, students should be able to:
• Define Heart failure.
LVF • Provide pathophysiological basis of Heart failure.
CCF • Diagnose Heart failure.
Cor-pulmonale • List complications of Heart failure
• Analyze the pharmacological management in the treatment of
Heart failure.
TOPIC: ENDOCARDIAL DISEASE
• Identify signs/symptoms of infective endocarditis.
Infective • Differentiate between types of IE in relation to its pathophysiology.
endocarditis. • Diagnose suspected and confirmed IE on the basis of criteria used.
• Manage infective endocarditis
• List its complications.
TOPIC: PERICARDIAL DISEASES
• Differentiate between types of Pericarditis on the basis of its
Constrictive etiology and pathophysiology.
pericarditis • Identity acute and chronic complications of Pericarditis.
Pericardial effusion • Identify the clinical manifestation of Pericarditis with diagnostic
approach of Pericarditis.
• State principles of management of Pericarditis.
• List common causes and understand mechanism of pericardial
effusion.
• Recognize early signs of pericardial tamponade.
• Justify the role of echocardiography in the diagnosis of pericardial
effusion.
TOPIC: CYANOTIC HEART DISEASES
 Congenital heart • Identify common etiologies and risk factors for cyanotic heart
diseases (brief). defects.
 Atrial Septal Defect • Diagnose cyanotic heart defects based on clinical manifestations &
 Ventricular Septal appropriate diagnostic methods.
Defect
• Explain the pathophysiology, manifestations, diagnosis &
 Patent Ductus
management of acyanotic congenital cardiac anomalies.
Arteriosus
 Fallot’s tetralogy • Elaborate the pathophysiology, manifestations, diagnosis &
 Other causes of management of obstructive congenital anomalies.
cyanosis • Explain the pathophysiology, manifestations, diagnosis and
management of cyanotic heart disease.
• Identify the implications of cardiac anomalies for respiratory care.

TOPIC: VALVULAR HEART DISEASES

• List causes of Valvular Heart Disease.
Mitral valve disease • Describe Etiology, pathogenesis and hemodynamics of mitral/aortic
Aortic valve disease valve disease.
• Outline management plan.
• Illustrate clinical features of rheumatic fever.
RHEUMATIC FEVER: • Diagnose Rheumatic fever on the basis of its Pathogenesis.
Diagnosis & • Devise the prevention and treatment plan of rheumatic fever.
treatment.
TOPIC: CARDIOMYOPATHIES
• Identify signs/symptoms of cardiomyopathies.
CARDIOMYOPATHIES- • List its relevant investigations, treatment plan and its
Brief review complications.

TOPIC: INVESTIGATIONS
• Review the electrophysiology of the heart as it relates to the ECG.
ECG • Interpret normal ECGs.
• Identify common errors in ECG recording.
• Recognize common characteristics of abnormal heart rhythms.
• Identify abnormal heart rhythms.
• Differentiate between life threatening and non-lifethreatening EKG
rhythms.
• Identify components of the ECG waveform.
• Employ a systematic process to evaluate and analyze ECG rhythm
strips.
• Recognize common ECG dysrhythmias.
• List the common causes, consequences and patient management
strategies for ECG dysrhythmias.
• Provide physiological basis of the rate, rhythm and axis of ECG.
 TOPIC: INVESTIGATIONS
LEARNING STRATEGIES CBL & bedside teaching
ASSESSMENT TOOL MCQ/SEQ/SAQ/OSPE/Long case/Short case
LEARNING OUTCOMES
COURSE CONTENT By the end of this module, students should be able to:
• Plan patient preparation for ECG.
• Select clinical protocol.
ETT, ECHO,
• Explain the role of a pre-contrast Scan.
CT Angiography
& • Outline a contrast administration Protocol.
Cardiac Catheterization- • Identify access site anatomy, including femoral artery and
Overview
vein, internal jugular vein, and brachial artery.
• List disease conditions (and Surgical correction) involving
these Anatomic structures
• Appreciate atherosclerotic disease of the iliofemoral system
and knowledge of surgical revascularization anatomy,
including Aortobifemoral graft, Fem-fem bypass, and Fem-pop
bypass.
• Demonstrate understanding of basic aspects of cardiac
ultrasound, including physical principles, instrumentation,
cardiovascular anatomy, cardiovascular physiology, and
cardiovascular pathophysiology.
• Give an overview of cardiac CT Angiography acquisition.
• List the indications and C/I of cardiac investigations.
 DOMAIN SKILLS/ATTITUDE
ASSESSMENT TOOL OSPE/Long case/Short case
LEARNING OUTCOMES By the end of CVS module, students should be able to:
1. Take history & perform clinical examination of a patient with:
 Hypertension
 ACS/MI
 Heart Failure
 Infective endocarditis
 Pericarditis/Pericardial effusion
 Cyanotic heart defects.
 Valvular Disease
 Rheumatic Fever
2. Perform the following Examinations and Clinical Procedures (either Observe, Assist, Under
supervision or Independently):
 CVS examination
 Systemic & relevant general physical
 ECG
 CVP placement
 ETT placement
 Echocardiography
 Exercise Treadmill Test
 Pacemaker placement
 Defibrillator use
 Thallium Scan
 Cardiac catheterization
 Angiography
3. Understand the importance of consent for examination and tests.
4. Practice empathy and respect for privacy, autonomy & confidentiality of patient.
 MODULE: PULMONOLOGY
TOPIC: ALLERGIC DISORDERS OF RESPIRATORY SYSTEM
DOMAIN KNOWLEDGE
LEARNING STRATEGIES Lecture & bedside teaching (Case presentation)/SDL
ASSESSMENT TOOL MCQ/SEQ/SAQ/OSPE/Long case/short case

LEARNING OUTCOMES
COURSE CONTENT By the end of this module, students should be able to:
• Relate abnormalities of physiology of ventilation & respiration to
obstructive pulmonary diseases.
• Discuss the incidence, etiology, risk factors associated with asthma,
Bronchial Asthma pathophysiology and progression of asthma.
• Debate the short and long term complications of obstructive diseases.
• Evaluate the prognosis of disease
• Establish diagnosis of asthma through a focused history and physical
exam.
• Advise investigations & workup of patient.
• Describe the procedure of pulmonary function tests & enlist criteria
for diagnosing asthma and grading severity.
• Advise medication keeping in mind their mechanism of drug action,
particularly SABA and ICS, Benefits, risks, limitations, Use patterns,
compliance, device use.
• Evaluate the different medication delivery methods (& relevant
compliance/ educational issues).
• Advise management plan for patients with acute exacerbations.
• Justify Nonpharmacological treatment.
• List Complications of drug therapy.
TOPIC: INTERSTITIAL LUNG DISEASE
 Define and classify ILD.
 Discuss the etiology & pathophysiology of ILD.
ILD/ DPLD/EAA/IPF  Determine the evaluation plan of patients with DPLD including
exposure history, signs & symptoms, and results of diagnostic tests.
 Critique current treatment of the DPLDs and their side effects.
 Understand the importance of non pharmacologic therapies
including lifestyle changes and multidisciplinary care interventions.
 • Review the epidemiology of sarcoidosis.
• Recognize diverse clinical presentations of sarcoidosis on the basis of
Sarcoidosis its pathophysiology.
• Describe the clinical predictors for disease progression & outcomes.
• Devise a diagnostic pathway from a differential diagnosis.
• Propose plan for drug therapy and investigating the disease.
TOPIC: INFLAMMATORY DISEASES
DOMAIN KNOWLEDGE
• Review etiology, pathogenesis, risk factors and clinical features of TB.
• Identify the components of a clinical evaluation of a patient with TB.
• Advise lab investigations like Chest X-ray, Monteux test
Tuberculosis • Prioritize the objectives of TB case management.
• Outline control and prevention modalities.
Diagnosis,
• List drug therapy and side effects of first and 2nd line anti TB drugs.
Treatment 9DS- TB,
• List DOTS
MDR- TB, XDR- TB
• Define diagnostic criteria of MDR TB.
• Devise treatment of multidrug resistant (MDR) and extensively
drug-resistant tuberculosis (XDR TB).
• Evaluate the prognosis of TB & treatment of opportunistic infections.
• List the aims of treatment of recommended doses of first-line anti-TB
drugs for adults.
• Develop treatment regimens for new and previously treated patients
taking into consideration
• Significance of standard regimens for defined patient groups,
including special populations like pregnant women, children, and HIV
infected patients.
• Manage drug therapy and its complications.
• Diagnose Pneumonia on the basis of its clinical features &
Pneumonia presentation relating to its etiology and pathophysiology.
• Assessment of • Advise relevant investigations on the basis of differential diagnosis.
disease severity • Devise management plan.
CURB65 • Propose plan for prevention and follow up.
• Management of • Discuss Pneumonias in specific populations: Immunocompromised &
hospital acquired pneumonias.
disease and its
complications.
 • Provide pathophysiological basis of lung abscess due to various
etiological factors.
• Diagnose lung abscess based on clinical presentation.
Lung Abscess • Generate differential diagnosis based on clinical assessment of
patient.
• Suggest appropriate lab investigations including chest X-ray, sputum
examination and hematological studies.
• Devise plan for drug therapy, drainage and surgical intervention for
management of lung abscess.
TOPIC: OBSTRUCTIVE AIRWAY DISEASE
• Provide pathophysiological basis of COPD due to various etiological
factors.
• Diagnose lung abscess based on clinical presentation
COPD • Generate differential diagnosis based on clinical assessment of patient
• Suggest appropriate lab investigations including chest X ray, sputum
examination and hematological studies.
TOPIC: RESPIRATORY EMERGENCIES
Adult Respiratory • Diagnose the patient on the basis of its clinical features and
Distress Syndrome, presentation relating to its etiology & pathophysiology.
Pulmonary • Advise relevant investigations.
Thromboembolism, • Devise management plan.
Acute Corpulmonale • Propose preventive measures and follow up.

• Define diagnostic criteria of respiratory failure of varied etiology.

• Differentiate between acute, chronic, and postoperative respiratory
Respiratory failure on the basis of pathophysiology.
• Recognize the signs & symptoms of respiratory failure.
Failure
• Apply alveolar gas equation to evaluate respiratory failure.
• Recognize the changes in blood gases that accompany respiratory
failure and other investigations.
• Review major treatment strategies for respiratory failure and their
monitoring.
 TOPIC: TUMORS
DOMAIN KNOWLEDGE
• Elaborate plan for diagnosis of common types of lung cancers
Carcinoma Lung based on clinical presentations and radiological appearance.
• Etiology & risk factors • Describe the grading & staging systems for lung carcinomas.
for development of CA
• Propose plan for chemotherapy, surgical interventions &
lung.
radiotherapy for management of lung carcinomas.
• Pathophysiology and
• Suggest alternate treatment modalities like stenting and laser
classification of lung
cancers. therapy.
• Alternate treatment • Evaluate prognosis and need for palliative care.
modalities like stenting
and laser therapy.

TOPIC: MISCELLANEOUS
• Classify pneumothorax based on etiological factors.
• Provide Pathophysiological basis of clinical manifestations and
Pneumothorax: differential diagnosis of pneumothorax.
Causes • Develop plan for diagnosing and managing a patient of
Diagnosis pneumothorax, including emergency treatment.
Management • Identify measures for prevention of recurrence.

• Analyze the etiology & pathogenesis of bronchiectasis.

• Diagnose bronchiectasis based on clinical features radiological & lab
investigations.
Bronchiectasis • Generate Differential diagnosis of bronchiectasis
• Develop plan for diagnosing & managing a patient of bronchiectasis,
including drug therapy, surgical intervention and physiotherapy.
• Assess prognosis required measures for prevention.

• Elaborate, epidemiology & risk factors and preventive measures for

pulmonary embolism.
Pulmonary • Recognize the clinical features & presenting symptoms of pulmonary
Embolism embolism.
• Evaluate various modalities of investigations for diagnosis and
differential diagnosis.
• Develop plan for pharmacological and surgical management of a
patient with pulmonary embolism.
 DOMAIN KNOWLEDGE
• Apply basic concepts of important anatomic features and physiologic
function of the visceral and parietal pleural membranes to explain
Pleural Effusion occurrence of pleural effusions
Types & Causes • Differentiate between transudative and exudative effusions based on
etiology, pathophysiology and risk factors.
• Diagnose effusion based on clinical features and investigations.
• Manage effusion appropriate to the underlying cause.

TOPIC: EXAMINATION OF CHEST

DOMAIN KNOWLEDGE
LEARNING STRATEGIES Lecture, CBL & bedside teaching, Case ppt

ASSESSMENT TOOL MCQ/SEQ/SAQ/OSPE/Long case/short case

LEARNING OUTCOMES
COURSE CONTENT By the end of this module, students should be able to:

• Justify Significance of chest auscultation in clinical examination

• Apply basic concepts of anatomy and physiology of heart and lungs
Chest Auscultation
and related structures in relation to auscultation
• Correlate biological changes of the aging process to the altered
physical findings on chest and lung examination.

TOPIC: INVESTIGATIONS
• Identify anatomical features of heart and lungs on a chest x-ray.
 Chest X- Ray • Interpret Arterial Blood Gases findings.
 Arterial Blood • Learn the concept of atelectasis and the ability to recognize it on a
Gases chest x-ray.
• Justify reasons that make lung cancer unresectable pulmonary
nodule.
 TOPIC: THERAPY
DOMAIN KNOWLEDGE
LEARNING STRATEGIES CBL
ASSESSMENT TOOL MCQ/SEQ/SAQ/OSPE/Long case/short case
• Differentiate between ventilation, internal respiration, and external
respiration.
• Identify the major muscles of respiration.
Oxygen Therapy: • Identify factors affecting external and internal respiration.
Various means & • Define hypoxemia and hypoxia.
implications • Identify the indications dangers, problems and contraindications
for oxygen therapy
• Elaborate preventive measures for injury when working with oxygen.
• Differentiate between low flow and high flow oxygen delivery
systems.
• Identify different oxygen delivery devices.
• Evaluate physiological basis of pulse oximetry, its indications and
limitations.
• Emphasize primary objective of airway maintenance
Ventilator • List the indications for mechanical ventilation(MV)
Techniques
• Identify ventilation strategies.
different modes
and terms used in • Alternative modes of MV and the basic principles of non-invasive
mechanical ventilation.
ventilation such as
IPPV, PCV, PEEP,
CPAP, BIPAP, NIPPV
Etc
 DOMAIN SKILLS/ATTITUDE
ASSESSMENT TOOL OSPE/Long case/Short case
LEARNING OUTCOMES By the end of Pulmonary module, students should be able to:
1. Take history & perform clinical examination of a patient with:
 Bronchial Asthma, ILD
 Tuberculosis, Pneumonia, Lung Abscess
 COPD, Respiratory Failure
 CA Lung
 Pneumothorax, Bronchiectasis
 Pulmonary embolism
 Pleural Effusion
2. Perform Respiratory system examination.
3. Explain the methods to use inhaler/spacer.
4. Teach the patient how to use a nebulizer.
5. Provide emergency treatment to the patient with Pneumonia.
6. Perform the correct procedure for carrying out chest auscultation
7. Recognize normal breath sounds
8. Identify Adventitious lung sounds: Wheezes, Crackles, Squeak, Pleural rub and Stridor.
9. Appreciate the appearance of pulmonary edema and the differences between cardiogenic and
noncardiogenic causes.
10. Recognize atelectasis on a chest x-ray.
11. Appreciate the difference findings of atelectasis and pneumonia.
12. Recognize pleural effusions and Pneumothorax appear on CXR
13. Recognize the signs of COPD, benign pulmonary nodule.
14. Perform the following Examinations and Clinical Procedures (either Observe, Assist, Under
supervision or Independently):
Peak Flow meter use, Nebulization, Oxygen saturation measurements, Pleural tap,
Pleural biopsy, Spirometry, Bronchoscopy, Endotracheal suction
How to initiate O2 therapy, Under water seal aspiration.
3. Understand the importance of consent for examination and tests.
4. Practice empathy and respect for privacy, autonomy & confidentiality of patient.
 MODULE: GASTROENTEROLOGY, LIVER & PANCREAS
TOPIC: DYSPEPSIA/INDIGESTION
DOMAIN KNOWLEDGE
LEARNING STRATEGIES Lecture & bedside teaching (case presentation)

ASSESSMENT TOOL MCQ/SEQ/SAQ/OSPE/Long case/short case

LEARNING OUTCOMES
COURSE CONTENT By the end of this module, students should be able to:
• Identify the causes of Dyspepsia, GERD and Peptic Ulcer.
Dyspepsia/ Gerd/ • Generate differential diagnosis of Dyspepsia, GERD and
Peptic Ulcer Peptic Ulcer.
• Establish definitive diagnosis based on laboratory
investigations. Develop treatment plan for Dyspepsia,
GERD and Peptic Ulcer.
• Evaluate prognosis of the patient of Dyspepsia, GERD &
Peptic Ulcer.

TOPIC: GASTROINTESTINAL BLEEDING

• Differentiate between upper and lower GI bleeding.
Upper GI Bleeding • Assess the patient on the basis of signs and symptoms.
Lower GI Bleeding • Outline the management plan.
• Outline the risk factors for death in Upper GI bleeding.
• Assess the Prognosis.

TOPIC: DIARRHEA
Acute & Chronic Diarrhea • Differentiate between Acute and Chronic Diarrhoea on the
Inflammatory Bowel Disease basis of its etiology.
Ulcerative Colitis • Outline the risk factors for Acute and Chronic Diarrhoea.
Crohn’s Disease • Assess the patient on the basis of sign and symptoms.
• Outline the investigations and management plan.
Irritable Bowel Syndrome
• Discuss the prognosis.
Malabsorption
Sprue Tropical
Coeliac Disease
 TOPIC: TUMOURS
• Classify Upper and lower GI tumours.
Upper GI Malignancy • Differentiate between benign and malignant tumours on
Lower GI Malignancy the basis of its etiology and clinical features.
• List risk factors.
• Outline investigations and management of tumours.

TOPIC: CHRONIC LIVER DISEASE

DOMAIN KNOWLEDGE
LEARNING STRATEGIES Lecture & bedside teaching (case presentation)
ASSESSMENT TOOL MCQ/SEQ/SAQ/OSPE/Long case/short case
LEARNING OUTCOMES
COURSE CONTENT By the end of this module, students should be able to:

• Elaborate the causes of Ascites.

Ascites & Management • Outline the management and prognosis.

• Describe the causes, pathology and clinical features of

Hepatic Cirrhosis.
Cirrhosis Of Liver • Explain the pathogenic mechanism of Hepatic Fibrosis.
• Discuss the Management and prognosis of the condition.
• Classify Portal Hypertension according to site of vascular
Portal Hypertension Obstruction.
Hepatic Encephalopathy • Evaluate Management and prognosis of the condition.
• Correlate the causes and pathology of hepatic
encephalopathy to its clinical features.
• Outline the management and prognosis.
TOPIC: HEPATITIS
• Classify viral Hepatitis.
Hepatitis B and C Infections • Differentiate between different types of Hepatitis.
Other Forms Of Hepatitis (A, D • Interpret investigations for diagnosis of Hepatitis B and C.
and E) • Discuss their modes of transmission.
• Outline the treatment plan and prognosis.
Autoimmune Hepatitis
• List the complications.
 TOPIC: PANCREATITIS
• Elaborate the pathophysiology of Acute and Chronic
Acute Pancreatitis Pancreatitis.
Chronic Pancreatitis • Diagnose the patient on the basis of signs, symptoms and
Investigations.
• Outline the treatment plan.
• List its complications.

TOPIC: INVESTIGATIONS
Investigation & Imaging Of GI, • Interpret investigations for diagnosis of GI, Liver and
Liver & Pancreatic Disorder Pancreatic Disorder.

TOPIC: OTHER HEPATOBILIARY/ PANCREATIC DISORDERS

Hemochromatosis • Diagnose the patient on the basis of signs, symptoms and
Wilson Diseases investigation.
SBP/HRS
• Outline the treatment plan.
Metabolic Diseases Of The
Liver
Liver Abscess
HCC
CA Pancreas/
Ampullary Carcinoma
Abdominal Tuberculosis
Dysphagia & Its Evaluation
 DOMAIN SKILLS/ATTITUDE
ASSESSMENT TOOL OSPE/Long case/Short case
LEARNING OUTCOMES By the end of Gastroenterology, Liver & pancreas module,
students should be able to:
1. Take history & perform clinical examination of a patient with:
 Dyspepsia
 GI bleeding
 Diarrhea
 GI tumors
 Chronic liver disease
 Hepatitis
 Pancreatitis
2. Perform Abdominal Examination.
3. Counseling of patients with GERD & Peptic ulcer about the outcomes of diseases and how to
prevent them.
4. Counsel a cirrhotic patient.
5. Perform the following Examinations and Clinical Procedures (either Observe, Assist, Under
supervision or Independently):
 Nasogastric tube placement
 Sangstaken Tube placement,
 Ascetic tap
 Endoscopy
 Colonoscopy
 ERCP
 Liver Biopsy

6. Understand the importance of consent for examination and tests.

7. Practice empathy and respect for privacy, autonomy & confidentiality of patient.
 THE LOG BOOK / CLINICAL CARD RECORD

 The student is expected to keep a record of his/her achievements in the log book.
 The log book is a collection of evidence that learning has taken place, it is a reflective
record of achievements.
 The log book shall also contain a record of the history taking, clinical examinations and
procedures which student would have performed in 3rd, 4th & 5th year.
 It will also keep the record of students attendance during clinical rotations.
 At the end of each rotation, ward test will be conducted by the department and result
will be marked in the students logbook by the HOD and countersigned for record
keeping and internal assessment.
 Pattern for ward test can be OSCE, Long case or short case, depending upon the
availability of resources and faculty.
 Student will update their logbook regularly and will be signed by HOD at the end of each
rotation.
 Department will also keep a record of students progress throughout the year.
 QUETTA INSTITUTE OF MEDICAL SCIENCES
CLINICAL TRAINING PROGRAM DEPARTMENT OF MEDICINE FOR 5 TH YEAR
PROGRAM COORDINATOR: MAJ RABIA SADIQ

S/No History System Ward Instructor

Fever
Anemia
Week 1 Lymphadenopathy GPE 1 Lt Col Hassan
Hypertension Shabbir
Oedema
Weight loss

Chest Pain
Dyspnea
Hypertension
Week 2 Cyanosis CVS 2 Lt Col Wasim
Valvular diseases Raja
Infective endocarditis
Heart failure

Wheeze, Cough,
Sputum Production,
Tuberculosis Resp Male Lt Col Asif Ullah
Week 3 COPD HDU
Pleural effusion
CA bronchus,

Jaundice
Diarrhea
Dyspepsia
Week 4 Ascites Abdomen Female Brig Ashfaq Altaf
Vomiting and HDU /Maj Rabia
hematemesis
Melena and bleeding
PR
Headache
Stroke Brig Imran
Muscle weakness CNS Ward Ahmad /Maj
Week 5 Polyneuropathy, 17 Aimen
Wasting
Diplopia and ptosis
 Oxygen therapy Half
Respiratory batch
support ICU and in ER & Brig Kaswar/Lt
Week 6 Inotropic support emergency half Col Uzma
Care of week batch
unconscious in ICU
Shock

Three ward test will be conducted on last Friday of 2nd , 4th and 6th week on topic discussed
and result will be submitted to QIMS.

Test System Responsibility

First ward test CVS and GPE Lt Col Hassan shabbier/Maj Rabia
Second ward test Resp and abdomen Lt col Asif ullah/Maj Aimen
Third ward test CNS and ER issues Lt col Uzma/Maj Hamza

EVENING ROTATION
Please report to either indoor trainee medicine for Evening rotation or if not available then
consultant OPD.
 LEARNING RESOURCES:
 Library : Books, Journals and Internet
 Medical Wards
 OPDs
 Classroom
Student should follow this study guide to learn about the various topics listed in the
courses from different resources including formal lectures, literature search, clinical
bedside teaching along with performing certain activities to learn on your own
through meeting clinicians, performing community based assignments visiting
different departments of the hospital along with writing down your own reflections.

RECOMMENDED BOOKS:
 Practice of Medicine by Davidson.
 Clinical Medicine by Parveen J Kumar &Michaell, Clark
 Hutchison's Clinical Methods by Michael Swash. 21st edition Davidson’s
 Current Medical Diagnosis and Treatment
 Oxford Handbook of Clinical Medicine
 Macleod Clinical Methods
 Basic psychiatry by MyreSim, e. B. Gordon
 Oxford Text Book of Psychiatry
 ABC of Dermatology. Latest Edition.
 Reference Book
Harrison Clinical Methods
 Online Journals and Reading Materials through HEC Digital Library Facility
 Video Links: http://www.medcram.com/, http://www.medtube.net/
 Annual Final Professional Examination TOS (Theory)
MEDICINE PAPER – I (2024)

Time Allowed 03 hrs

Marks of theory paper 120 marks
Internal Assessment (20%) 30 marks
Total Marks 150
Passing Marks 75
MCQs:
a) Time Allowed (80 Mins)
b) Total Questions (80) Single best out of 4 options
c) Marks (1 mark each x 80) 80 marks
d) Weightage of MCQS 60
SEQs:
a) Time Allowed (100 Mins)
b) Total Questions 10
c) Marks (06 marks eachx10) 60 marks

TOPICS INCLUDED IN PAPER-I:

TOPICS SUB TOPICS
DERMATOLOGY Basic Dermatology , Allergy ,Dermatitis ,Infestations
Other disorders , Disorders of hairs , Sexually transmitted
diseases.
ANIMAL BITES Dog & Snake Bite-Diagnosis and Management
POISONING Paracetamol Poisoning – Diagnosis and Management/ TCA
NUTRITION Vit B12 deficiency, Folate deficiency, Metabolic syndromes
OBESITY Dyslipidemia
GENETIC DISORDER Hemoglobinopathies, Sickle cell syndromes, Thalassemias
NEUROLOGY/MUSCLE Headache , Unconsciousness, Gait/movements Disorders
DISORDERS Spinal cord disorders, Cerebrovascular accident, Seizures,
Infections of CNS, Other diseases, Motor Neuron Disease/
Polyneuropathies, Dementia
GASTROENTEROLOGY Dyspepsia/ Indigestion, Gastrointestinal Bleeding, Diarrhea,
Tumors.
 LIVER/PANCREAS Chronic Liver disease, Hepatitis, Pancreatitis, Investigation &
Imaging of GI, Liver and Pancreatic disorder, Other
hepatobiliary/pancreatic disorders

RHEUMATOLOGY/ BONES Inflammation of joints:

Rheumatoid arthritis, Osteoarthritis, Seronegative Poly
Arthritis, Arthritis/ ankylosing spondylitis, Gout, Polymyalgia
rheumatica, Systemic disorders involving joints, SLE, MCTD,
Vasculitis Dermatomycosis/ Polymyositis , Scleroderma/
Raynaud Phenomenon and Syndrome, Systemic Sclerosis,
Sjogren’s Syndrome/ Keratoconjunctivitis
ENDOCRINOLOGY Disorders of Pituitary gland and Hypothalamus
Acromegaly/ Growth hormone deficiency
Diabetes insipidus/ SIADH
Hypopituitarism/ Addison’s disease
Acute Addisonian crisis
Disorders of Thyroid Gland
Hyperthyroidism, Hypothyroidism
Disorders of Parathyroid gland
Disorders of Adrenal Gland
Cushing Syndrome ,Pheochromocytoma
Aldosterone & related conditions, MEN-I and II
DIABETES Diabetes mellitus – type-1 & type-2
Acute Complication of Diabetes Mellitus
DKA/HHS/Hypoglycemia
Chronic complications of diabetes mellitus
 Annual Final Professional Examination TOS (Theory)
MEDICINE PAPER – II (2024)
Time Allowed 03 hrs
Marks of theory paper 120 marks
Internal Assessment (20%) 30 marks
Total Marks 150
Passing Marks 75
MCQs:
a) Time Allowed (80 Mins)
b) Total Questions (80) Single best out of 4 options
c) Marks (1 mark each x 80) 80 marks
d) Weightage of MCQS 60
SEQs:
a) Time Allowed (100 Mins)
b) Total Questions 10
c) Marks (06 marks eachx10) 60 marks

TOPICS INCLUDED IN PAPER-II:

TOPICS SUB TOPICS
Phenomenology
Anxiety Disorders
Acute Anxiety states, Panic disorders, Generalized anxiety
disorders, Psychic Traumatic disorders, Obsessive-compulsive
PSYCHIATRY & MENTAL disorders, Phobic disorders
HEALTH Mood Disorders
Major depressive episodes, Stress Related Disorders,Unipolar
Bipolar, Dysthymic, Atypical, Manic episodes, Schizophrenia
Other disorders
Dissociative Disorders, Mental & Behavioural Disorders due
to General Medical Condition
Psychopharmacology
Overview of drugs used to treat psychiatric disorders and
classification of drugs
Drug Abuse
Substance Misuse and Abuse
 Anemias, Pancytopenia clinical approach
Iron deficiency ,Megaloblastic B-12 deficiency, Folic acid
deficiency, Anaemia of chronic disorder, Haemolytic anaemia
Hereditary Acquired, Aplastic anemia, etiology and
HAEMATOLOGY &
presentation, Causes & Management
TRANSFUSION MEDICINE
Transfusion
Blood groups and blood transfusion, Reactions &
Management
Generalized Lymphadenopathy
Differential diagnosis of Generalized Lymphadenopathy
Haemoglobinopathies
Sickle cell syndromes, Thalassaemias
Bleeding Disorders
ITP/ Bleeding Disorders/ DIC
Hypertension, Ischemic heart disease ,Heart failure
CARDIOVASCULAR SYSTEM Endocardial disease, Pericardial diseases, Cyanotic heart
disease , Valvular Heart Disease ,Cardiomyopathies
Investigations
Allergic Disorders of respiratory system
Bronchial Asthma, Interstitial lung diseases, ILD/
DPLD/EAA/IPF, Sarcoidosis
PULMONOLOGY
Inflammatory diseases
Tuberculosis , Pneumonia, Lung Abscess
Obstructive airway diseases
COPD
Respiratory Emergencies
Adult Respiratory distress Syndrome, Pulmonary
thromboembolism/Acute Respiratory Failure, Carcinoma
Lung , Pulmonary Embolism, Pleural effusion types & causes
Investigations
Arterial blood gases, Therapy, Oxygen Therapy, Ventilator
Techniques, Different modes and terms –IPPV, PCV,
PEEP, CPAP, BIPAP, NIPPV etc
Inflammatory Diseases
Urinary tract infections, Glomerulonephritis , Nephrotic
NEPHROLOGY, DIALYSIS & Syndrome ,Nephritic Syndrome, Renal TB
TRANSPLANT Miscellaneous
Renal artery stenosis, Renal tubular Acidosis, Nephrolithiasis
 Renal failure
AKI (Actual renal failure, CKD (Chronic renal failure)
Treatment, Dialysis, Renal Transplant
Diagnosis and management of common infectious diseases
Typhoid/ Paratyphoid Fevers, Dengue Hemorrhagic Fever
Malaria, Septicemia, Sepsis, Meningococcemia
INFECTIONS
Acquired immune deficiency syndrome
Common disease syndromes caused by different bacteria
and their drug therapy
Pneumococci, Staphylococci, Streptococci, Hemophilus
Influence, Shigella, Gonococci, Pseudomonas, Cholera
Amoebiasis/ Giardiasis
White blood cells tumors
ONCOLOGY, DISEASES OF Lymphoma
LYMPH NODES & BONE Bone marrow tumors
MARROW
Acute Leukemia, Chronic Leukemia ,Multiple Myeloma
Myeloproliferative Disorders
CRITICAL CARE & EMERGENCY
PHARMACOTHERAPEUTICS
 Table of Specification for Practical Examination- Medicine 2024
Max Marks = 240
Internal Assessment = 60
Grand Total = 300
Pass Marks = 150

 5 minutes for each station.

 15 minutes for each long case- two parallel long case