M.B.B.

S CURRICULM

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FOREWORD
It gives me immense pleasure to write the foreword for the AIIMS
Bhubaneswar undergraduate medical curriculum 2018. Since its inception
in 2012, AIIMS Bhubaneswar was following the curriculum of AIIMS,
New Delhi. The curriculum for community and family medicine was
prepared by the faculty of that department in collaboration with all the
six new AIIMS and incorporated. After my joining the institute nearly
two years ago, an effort was made to critically analyse the curriculum,
receive feedback from stake holders, identify the elements that needed
to be removed, introduced or changed and come up with a modified,
revamped curriculum, taking in the best elements of different curricula
in India and elsewhere.

Claude Bernard once said “it is what we know already that often prevents us from learning“.
This is so true of curricular development. Not only must the content be relevant and current, it
must also be delivered in a manner that is attractive and can relate to the aspirations of the new
age learner. Assessment methods should not only be appropriate but also feasible so that faculty
are not overloaded and can manage their teaching assignments with the focus and commitment
they deserve. Changing a curriculum becomes very challenging because many faculty have learnt
and have been exposed to limited types of curricula and hence find it difficult to accept and adapt
to what is not familiar to them. Therefore, change should be made with care and due diligence
should be paid to whether the infrastructure, logistic support and faculty training are in place to
effect the envisaged changes. I strongly believe these are in place at AIIMS Bhubaneswar.

My sincere thanks to the Department of Medical Education, Jawaharlal institute of Post-

Graduate Medical Education & Research, Puducherry for training our faculty members on
curriculum development and various principles of medical education. My thanks are also due to
the members of the Board of Studies (UG) and to the Academic Committee for their comments
and criticism which improved this document immensely. My appreciation goes to the Medical
Education Unit of AIIMS Bhubaneswar for undertaking this enormous task and successfully
completing it despite many hurdles. I believe every curriculum should come with an expiry date
and I hope, after three years, we will redo this exercise so that, our medical UG curriculum will
always stay updated.

Director
AIIMS Bhubaneswar
M.B.B.S CURRICULM M.B.B.S CURRICULM

Academic Committee Medical

Dr. P. Satish chandra
Director, NIMHANS, Bangalore, Karnataka (Chairman)
Education Unit,
Dr. (Prof.) Prasanna Kumar Patasani AIIMS, Bhubaneswar S. No Contents Page No.
Hon’ble Member of Parliament (Member)
Dr. Saurav Sarkar
Dr. Showkat Ali Zargar 01. Introduction and Overview of The curriculum 02
SKIMS, Srinagar, Jammu & Kashmir (Member) Dr. Rituparna Maiti
Dr. Jayanta Mitra 02. Curriculum for patient safety 30
Dr. K. Srinath Reddy
President, Public Health Foundation of India (Member)
Dr. Sweta Singh 03. Anatomy 36
Prof. Samir Brahmachari
DG, CSIR and Secretary, DSIR, Govt. of India (Member) Dr. Debapriya Bandopadhyay 04. Physiology 64
Prof. Madhusudan Chakraborty, Dr. Prabhas Tripathy 05. Biochemistry 86
Director, IIT Bhubaneswar, Representative of Ministry of
Human Resource Development (Member) Dr. Priyadarshini Mishra
06. Pathology 113
Dr. Gitanjali Batmanabane Dr. Suravi Patra
Director, AIIMS, Bhubaneswar (Member Secretary) 07. Microbiology 129
Dr. Somanath Padhi
08. Pharmacology 154
Board of Studies Dr. Vinay Hallur
09. Forensic Medicine & Toxicology 173
(Undergraduate) Dr. Mukund Sable
Dr. Ramadass Balamurugan 10. Community Medicine 191
Dr. D. Basu
Professor of Patholoy, Department of Pathology,
JIPMER Puducherry Dr. Upendra Hansdah 11. OTO-Rhinolaryngology (E.N.T.) 227

Dr. Nalin Mehta Dr. Amit kumar Satapathy 12. Ophthalmology 235
Professor of Physiology, Department of Physiology,
AIIMS New Delhi 13. General Medicine 247
Dr. Aparna Agrawal
Director-Professor of Medicine,
14. Dermatology & Venereology 265
Lady Hardinge Medical College, New Delhi
15. Psychiatry 269
Dr. Shaji Thomas
Director - Professor of Surgery, 16. General Surgery 277
Lady Hardinge Medical College, New Delhi

Dr. Sitanshu Sekhar Kar 17. Orthopaedics 303

Addl. Prof of Preventive & Social Medicine,
JIPMER Puducherry 18. Anaesthesiology 307

Dr. Shyama Kanungo 19. Obstetrics and Gynaecology 312

Professor of Obstetric & Gynaecology and Supdt,
S.C.B Medical College and Hospital, Cuttack 20. Pediatrics 348
Dr. Sudhir Kumar
Professor and Head, Dept of Orthopedics, School of
Medical Sciences, Sharda University, Greater Noida

Dr. Avijit Hazra

Professor of Pharmacology, Institute of Post Graduate
Medical Education & Research, (IPGME&R) Kolkata
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UNDERGRADUATE CURRICULUM B. Goals and objectives of undergraduate course (MBBS)

AIIMS BHUBANESWAR  At the end of the MBBS course, the learner shall be able to:

2018 1. Diagnose and manage common health problems of the individual and the community
appropriate to his/her position as a member of the health team at primary, secondary and
A. General considerations and teaching approach tertiary levels.
1. Graduate medical curriculum is oriented towards training students to undertake the 2. Practice preventive, promotive, curative and rehabilitative medicine in respect to the commonly
responsibilities of a physician of first contact who is capable of looking after the preventive, encountered health problems;
promotive, curative and rehabilitative aspect of medicine.
3. Practice Evidence Based Medicine, appreciating the rationale for different therapeutic modalities
2. The training would be broad based and flexible, aiming to provide an educational experience and be familiar with the administration of “essential drugs” and their common side effects;
of the essentials required for health care in our country as well as be of such quality so as to
be able to meet internationally acceptable standards. 4. Appreciate the psycho-social, cultural, economic and environmental factors affecting health
and develop humane attitude towards the patients/relatives, in discharging one’s professional
3. The educational experience would emphasize health, wellness and community orientation. responsibilities;
4. Enough experiences will be provided for self-learning. Methods and techniques that would 5. Be familiar with the various National Health Programs, and the ways in which they are being
ensure this process would become a part of teaching-learning process. implemented, and actively participate in implementation of these programmes;
5. Adequate emphasis would be placed on cultivating logical and scientific habits of thought, 6. Acquire basic management skills in the area of materials, financial and human resources;
clarity of expression and independence of judgment,as well as the ability to collect and
analyse information and correlate them. Every attempt would be made to encourage students 7. Demonstrate communication skills, both verbal and written to establish effective
to participate in small group discussions and seminars, to enable them to develop personality, communication with the clients (patients, relatives and general public), health team partners,
character, expression of ideas and other characteristics which are necessary for a medical and scientific community;
graduate to function either in solo practice or as a team leader. 8. Practice medical ethics in patient care, service delivery, and research.
6. Faculty members should avail of modern educational technology while teaching the students 9. Develop attitude for self learning and acquire necessary skills including the use of appropriate
and in order to attain this objective. The Medical Education Unit shall organise CMEs and technologies, for pursuing self directed learning for a life time.
Workshops for faculty development and provide learning experinces and traning to the
teachers. Duration of the Undergraduate medical course years
The total duration of undergraduate MBBS course will be including Internship
7. To derive maximum advantage out of this revised curriculum, the vacation period to students
in one calendar year should not exceed one month, during the 4 ½ years course. New Elements to be introduced
8. Students will be trained to be a: 1. Foundation Course
• Clinician who understands and provides preventive, promotive, curative, palliative and 2. Horizontal and vertical integration of systems and topics
holistic care with compassion. 3. Early clinical exposure
• Leader and member of the health care team and system with capabilities to collect, 4. Early community exposure
analyze and synthesize health data.
5. Electives for 8 weeks
• Communicator with patients, families, colleagues and community.
6. Skill Development & Training including Basic Life Support, First Aid, Trauma care etc.
• Lifelong learner committed to continuous improvement of skills and knowledge.
7. Patient safety protocols
• Professional, who is committed to excellence, is ethical, responsive and accountable to
8. Adoption of contemporary education technologies
patients, community, and the profession.
9. Humanities and languages

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10. Computer and technology in Medicine b. Regular periodical examinations shall be conducted throughout the course, by individual
11. Exit OSCE at the end of internship Departments.

12. Evening clinics and clerkship c. At the end of each semester, an end-semester examination would be conducted by the
department concerned.
13. Feedback after each Professional exam and Internship
14. Only internal examiners for Professional examinations d. Dean’s office will notify the dates of the end semester examination
e. A student has to pass a minimum of n-1 tests conducted in the department and the end
Examination: semester examination (n= total number of exams). The calculation would be as per the
Regulations – formula ∑(n-1)/ n-1.

Examination Regulations – f. For first M.B.,B.S. students, the pattern of internal assessment will be as below:
Weekly tests – Each week there will be a test which may consist of either Theory/ Viva/
Minimum criteria for qualifying to appear in professional examinations. Practical. It is expected that there will be at least 15 theory/viva tests and 5 practical tests
(total of at least 20 tests/academic year). Each test will carry 25 marks. The total number
1. Attendance:
of tests are designated as “n”.
a. 75% attendance in each subject for appearing in the examination is compulsory
End-semester examinations –
inclusive of attendance in non-lecture teaching i.e. seminars, group discussions, tutorials,
1st end semester (in January): 2 Theory papers: 100 marks each
demonstrations, practicals, hospital posting and bed side clinics etc.”
Practical and viva: 80 +20 = 100 marks
b. Even if there is shortage of attendance in one subject, he/ she will be detained for the full Pre- professional exam (in 1st week of June): 2 Theory papers: 100 marks each
examination and will appear in supplementary examination. Practical and viva: 80 +20 = 100 marks
c. A 3% relaxation in attendance may be considered in special cases depending on the Calculation of Internal marks -
Director’s discretion on a case to case basis, provided the candidate has passed his/her
internal examination Eligibility for 1st MBBS

d. Students cannot appear in part or separately in individual subjects during the first 1. "Weekly tests (if "X" is the marks ):
appearance in each Professional examination.
• Each test carries 25 marks
e. If a student is debarred to appear in the first Professional Examination due to insufficient
attendance, he/she would require to start the classes afresh for the next regular examination • X Obtained
of next batch. o Total marks obtained by the candidate minus 3 least scores or, ∑n-3 least scores
f. For other Professional examination he/ she should have to show the required number of • X total
hours before being allowed to sit in the next Professional Examination. o If n is the total number of tests conducted, then total marks for all weekly tests is
2. Marks for passing examination: nX25 minus 75

a. Students must secure at least 50% of total marks to pass in any examination conducted 2. 1st End Semester exams
in any subject (theory and practical separately).
• Y obtained
b. If a candidate fails either in theory or in practical/clinical Examination of a subject he
/ she will be declared failed in that subject and he / she will have to appear for both o Total marks obtained by the candidate
theory and practical / clinical Examination again. • Y total
3. Internal Assessment/Formative Assessment: o 300 OR 200 (Theory)+ 100 (Practical)

a. It shall be based on day to day assessment (see note), evaluation of student assignment,
preparation for seminar, clinical case presentation etc.

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3. 1st End Semester exams 1st Pre-professional Examination: Commences 1st week of June
3rd End Semester Examination: Commences 2nd week of December
• Z obtained
4th End Semester Examination: Commences 3rd week of April
o Total marks obtained by the candidate
5th End Semester/Pre-professional Examination: Commences 2nd week of October
• Z total
6th End Semester Examination: Commences 1st week of May
o 300 OR 200 (Theory)+ 100 (Practical)
7th End Semester/Pre-professional Examination: Commences 1st week of November
The candidate is eligible if 8th End Semester Examination: Commences 1st week of May

X Obtained + Y Obtained +Z obtained ≥50% of X Total + Y Total +Z Total 9th End Semester/ Pre-professional Examination: Commences 2nd week of October

g. An improvement examination will be conducted by the concerned department for 4. Professional Examinations:
candidates failing to qualify for a professional examination. If a candidate scores > 50% a. All professional examinations shall be conducted by Controller of Examination, AIIMS,
for theory and practical separately, he/she will be allowed to appear in the Supplementary Bhubaneswar.
examination of the current batch( This will be reflected in the result and attempt certificate).
Failing which he/she will have to appear with the next batch. b. Theory papers will be prepared by external subject experts as prescribed in each subject,
which would be vetted by in house faculty. For setting of question paper, external subject
h. Day to day records should be given importance during internal assessment. The marks for expert shall use the model question paper as a guide. At least 70% of the theory paper
the record book submitted are to be included in the practical internal assessment. should be from ‘must know’ portions, 25% from ‘desirable to know’ portions and 5% from
i. Marks from internal assessment will not be carried into Professional examination. ‘nice to know’ portions.

j. Pre professional examination is mandatory. c. The distribution of marks across subjects in the various Professionals (Theory and Practical)
is given in the table later, along with the assessment scheme of theory and practical for the
1. Students not coming for pre professional examination will loose out on (n-1).
various subjects in subsequent pages.
2. For Director's discretion these students would not be considered.
d. Examiners – 4 faculty from the individual departments would be the examiners for the
k. Students sitting in supplimentary examination without appearing professional examination Professional examination. The senior most internal examiner may be designated as
would be reflected in certificate. Chairman of the exam in that subject. The Chairman shall draw the guidelines for conduct
of examination to be followed by other examiners to ensure uniformity. In allied subjects
NB: (e.g orthopaedics, dermatology etc) 1 examiner would be there for a particular subject. In
Internal assessment shall relate to different ways in which students participation in learning case there are less than 4 faculty in a Department then external examiners may be called
process during semesters is evaluated. E.g for.
i. Preparation of subject for students seminar; e. Except Head of the department of subject concerned, all other faculty with requisite
ii. Preparation of a clinical case for discussion; qualifications and experience shall be appointed internal examiners by rotation in their
iii. Clinical case study/problem solving exercise; subjects. An Assistant Professor of 5 years of teaching experience after obtaining PG degree
may be considered for appointment as examiner.
iv. Participation in Project for health care in the community (planning stage to evaluation);
v. Proficiency in carrying out a practical or a skill in small research project; Observers (External Subject Experts) –
vi. Multiple choice questions (MCQ) test after completion of a system/ teaching; Each item All examiners shall be appointed by the Controller of Examination from the panel of examiners
tested shall be objectively assessed and recorded. Some of the items can be assigned as with the approval of the Director or by the controller of examination only provided the Director
home work/ vacation work. may at his discretion delegate the authority to him. The appointed external subject expertwould
be invited to check the examination process. He/She would be from a Government Medical
Roster for End Semester Examinations to be notified by Dean’s Office College Hospital preferably from an INI. He/She would pay a surprise visit to the department
during the course of Professional examination for a day or two. The observer would submit
1st End Semester Examination: Commences 4th January
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a confidential report to the Director of the Institute on the conduct of the examination. The 6. Candidates who fail in an examination but obtain pass marks in one or more individual
Director would assess the report and inform the Department, concerned if required. subjects shall be exempted from re-examination in the passed subjects.

No person shall be appointed as external subject expert, unless he/she has at least five year 7. The candidates have to pass in all the subjects of a particular professional examination, in
teaching experience after obtaining PG degree in the subject concerned from recognised order to be allowed to appear in the next professional examination
medical institution/college.
8. Rules for re-evaluation of Answer papers
Honorary/Emeritus/Visiting Professors or part time/ad-hoc teachers are not eligible to be
There is no provision for revaluation of answer papers. However, re-totaling is allowed in
appointed as internal examiners
the failed subjects after paying requisite fee (non-refundable) in account section.
N:B. The internal examiner in a subject shall not accept external examiner ship for a college
9. Number of attempts:
from which external subject expert appointed in the same year. External observers shall rotate
at an interval of 2 years. The student who does not qualify/ pass MBBS 1st Professional examination in 3 attempts
including regular and supplementary exams OR 3 years after joining whichever is later and 2nd
5. Rules for supplementary examination:
Professional examination, 3rd Professional and 4th Professional examination in 4 attempts ie.
1st Professional students – Those candidates who are unsuccessful in 1st Professional 2 regular plus 2 supplementary examination (for all subjects), in each phase, then the name
examination will be permitted to appear in the supplementary examination in the concerned of such student will be struck off from the rolls of the institute.
subject, which will be held after 6 weeks of final exams.
10. If a candidate does not appear in an examination due to illness,he/she should be required
A student has to pass in all 3 subjects in the 1st Professional examination (including supplementary to submit certificate from the consultant of AIIMS for first time and if repeated then it should
examination) in order to be allowed to attend classes/clinics of 3rd semester. be certified by the medical board of the institute ( Medical board is to be constituted by the
Dean). The Dean is authorised to take a decision whether it is a genuine case or not. If the
A student, who has failed both; i.e. professional and supplementary examination, will have to
Dean is satisfied, then this will not be counted as an attempt, otherwise it will be counted as
attend classes with the junior batch and qualify as per rules
an attempt on account of absenteeism.
2nd Professional students - Those candidates who are unsuccessful in 2nd Professional
11. Punishment for malpractice:
examination will be permitted to appear in the supplementary examination in the concerned
subject, which will be held after 6 weeks of final exams. Sl.No. Crime Punishment
1. Electronic gadget found in Student should be debarred from subsequent exam of
3rd Professional students - Those candidates who are unsuccessful in 3rd Professional
exam hall( including smart same subject for 1 year till next annual/supplementary
examination will be permitted to appear in the supplementary examination in the concerned
watch) exam, whichever is earlier.
subject, which will be held after 6 weeks of final exams.
2. Printed material / including Student should be debarred from subsequent exam of
Appearance for a supplementary examination will be counted as an attempt
(any sort of ) writing on same subject for 1 year till next annual/supplementary
4th Professional - Compartmental examination will be conducted for the 4th Professional body part, question paper exam, whichever is earlier.
MBBS candidates who have failed in only one subject of the 4th professional. 3. Transfer of answer sheet/ Student should be debarred from subsequent exam of
This compartmental examination will not be counted as an attempt. copies same subject for 1 year till next annual/supplementary
exam, whichever is earlier.
Students who could not appear in December because of emergency issues like:

a. Bereavement in immediate family 4. Talking inside examination 10% deduction of marks

hall Invigilator will inform and endorse in the answer sheet.
b. Illness at the time or just preceding Controller of examination and HOD concerned should
c. Accident be informed.
The compartmental examination will be conducted in 2nd/3rd week of February
12. In case of any unforeseen situation not covered under these guidelines the decision of
Supplementary examination will be conducted in May for candidates who fail in more than the Director, AIIMS, Bhubaneswar shall be final.
1 subject.

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Summative Examination
Theory Examination
Anatomy, Physiology, Biochemistry, Pathology, Pharmacology, Microbiology, FMT,
Ophthalmology, ENT, CM&FM, OBG, Paediatrics.

Each Paper will offer 100 marks (be it 1 paper or 2 papers)

Distribution of marks in the various
Section A
Professional Examinations
Long Answer Question (Structured) 10 marks
Short Notes/Short Answers  (8 x 5 marks) 40 marks
Subject Theory Theory Marks Practicals and Viva
Voce Marks
Section B
Anatomy 2 papers 200 100
Long Answer Question (Structured)  10 marks
Physiology 2 papers 200 100 Short Notes/Short Answers (8 x 5 marks) 40 marks
Biochemistry 2 papers 200 100
Medicine Paper I & Paper II 100 marks each
Pharmacology 2 papers 200 100
Section A
Pathology 2 papers 200 100
Long Answer Question (Structured)  10 marks
Microbiology 2 papers 200 100 Short Notes/Short Answers  (6 x 5 marks) 30 marks
FMT 1 paper 100 100
Section B
CM 2 papers 200 200
Long Answer Question (Structured) 10 marks
ENT 1 paper 100 100 Short Notes/Short Answers  (6 x 5 marks) 30 marks
Ophthalmology 1 paper 100 100 Section C(Dermatology - Paper I)/ D(Psychiatry - Paper II)

Medicine 2 papers 200 200 Short Notes/Short Answers (4 X 5 marks) 20 marks

Surgery 2 papers 200 200 Surgery Paper I & Paper II 100 marks each

OG 2 papers 200 200 Section A

Paediatrics 1 paper 100 100 Long Answer Question (Structured)  10 marks

Total 2400 1800 Short Notes/Short Answers  (6 x 5 marks) 30 marks

Section B
Long Answer Question (Structured)  10 marks

Short Notes/Short Answers (6 x 5 marks) 30 marks

Section C (Orthopaedics - Paper I)/(Anaesthesia - Paper II)

Short Notes/Short Answers  (4 x 5 marks) 20 marks

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Practical Examination Dermatology  20 marks

Anatomy, Physiology, Biochemistry, Pathology, Pharmacology, Microbiology, FMT Spotters

Practical – 80 marks (Customised as per Departmental Requirement) Psychiatry  20 marks

Viva
Viva – 20 marks (Must face all examiners)
Paediatrics  (100 marks)
Ophthalmology & ENT  100 marks
Practical 80 marks Cases  60 marks

Long Case – 1 30 marks Long Case – 1  30 marks

Short Case – 2 (2 x 10 marks) 20marks Short Case – 2  (2 x 15 marks) 30 marks
Spotters  (2 x 5 marks) 10marks Viva (4 Stations) (4 x 10 marks) 40 marks
Instruments (2 x 5 marks) 10marks Neonatal Resuscitation
X ray & Chart (2 x 5 marks) 10marks Instruments & Drugs
Viva  20 marks X Ray
CM & FM  200 marks Nutrition/ Immunisation/ Social paediatrics
Long Case – 1 40 marks Obstetrics & Gynaecology  200 marks
Short Case – 1 20 marks
Obstetrics 100 marks
Viva  40 marks
Long Case  50 marks
Problem Solving  100 marks
Practical & Viva voce  40 marks
Surgery  200 marks Pelvis & Skull  10 marks
General Surgery  160 marks Drugs  10 marks
Long Case – 1 60 marks USG & specimen 10 marks
Short Case – 2  (2 x 30 marks) 60 marks CTG, Instruments, Partograph  10 marks
Viva & Skills (4 x 10 marks) 40 marks Record  10 marks
Orthopaedics  20marks Gynaecology  100 marks
Cases  (2 x 10 marks) 20 marks Long Case 50 marks
Anaesthesia  20 marks Practical & Viva voce 40 marks
Viva Contraceptive  10 marks

Medicine  200 marks Instruments  10 marks

General Medicine  160 marks Specimen  10 marks

HSG & USG  10 marks
Long Case – 1 60 marks
Record  10 marks
Short Case – 2  (2 x 30 marks) 60 marks
Spotters – 2  (2 x 10 marks) 20 marks
Viva  20 marks

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1st & 2nd SEMESTER (11 months)

JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
8-9 9-10 10-11 11-12 12PM -1 PM 1-2 PM 2-3 3-4 4-5 PM
AM AM AM PM PM PM
1 2 3 4 5
Mon Internal Assessment (All Dissection L -P L-A Co-
st Mondays except 3rd ) scholastic
1 activities
6 7 8 9 100 11 12 1 2 3 4 5   Every 3rd Monday –
Prof
Integrated teaching/Early LUNCH
nd
2 Clinical Exposure
6 7 8 9 10   11 12 13 14 15 16 1  
Prof Tues L-P L-B Dissection/ L-A Biochemistry (Practical /
rd Histology Tutorials)
3
2 3 4 5 6   777 8 4 10 11 12 Prof
  Wed L-A L-P Dissection/ Demonstration/ L-B Biochemistry
th
Histology Tutorials- (Practical /Tuto-
4 Anatomy rials)
1 2 3 4 5   6 7 8 9 10 11 Prof
 
Thurs L-P L-A Dissection/ L-A Physiology
Histology (Practical /Tutorials)
I N T E R N S H I P

Fri L-B L-P Dissection/ Demonstration/ Physiology

1st Prof: Anatomy, Physiology, Biochemistry Histology Tutorials- (Practical /Tutorials)
2nd Prof: Pathology, Pharmacology, Microbiology, FMT Anatomy

Sat(2nd Medical Humanities

3rd Prof: Ophthalmology, CM&FM, Otorhinolaryngology
and 4th)
4th Prof: Medicine, Surgery, O&G, Paediatrics Sat(1st,3rd Early Community Exposure
and 5th) (Community Medicine Department)

ANATOMY:
LECTURES: 5 hours/week; 5x4/month; 5x4x11= 220 hours
PRACTICAL/DISSECTION: 2 hours/day; 2x5/week; 2x5x4/month; 2x5x4x11= 440 hours
DEMOSTRATION/ TUTORIAL : 2 hours/weak, 2x4/month; 2x4x11 = 88 hours

Total clock hours = 220+440+88= 748 hours

PHYSIOLOGY :
LECTURES: 5 hours/week; 5x4/month; 5x4x11= 220 hours
PRACTICAL/TUTORIALS: 6 hours / week; 6x4/ month; 6x4x11= 264 hours
Total clock hours = 220 + 264 = 484 hours

BIOCHEMISTRY :
LECTURES: 3 hours/week; 3x4/month; 3x4x11= 132 hours
PRACTICAL/TUTORIALS: 5 hours / week; 5x4/ month; 5x4x11= 220 hours
Total clock hours = 132 + 220 = 352 hours

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INTEGRATED TEACHING/ EARLY CLINICAL EXPOSURE : 3 hours / month ; 3x11= 33 hours PATHOLOGY:
WEEKLY EXAMS : 3 hours / week ; 3x3/month; 3x3x11= 99 hours rd th
3 & 4 SEMESTER: LECTURES: 3/Week= 3X4/Month= 12X10= 120 Hours
EARLY COMMUNITY EXPOSURE: 5 hours/week; 10 hours /month; 5x2x11 = 110 hours
PRACTICALS: 2/Week = 2X4/Month = 8X10= 80/YR=
MEDICAL HUMANITIES: 5 hours/week; 10 hours /month; 5x2x11 = 110 hours
80X 3 Hours =240 Hours/2= 120 Hours
3rd SEMESTER 5 MONTHS th
5 SEMESTER: LECTURES: 3/Week= 4X12/Month= 12X 4.5 = 54 Hours
  8-9 9-10 10-1 1-2 2-3 3-4 4-5
RACTICALS: 2/Week= 2X4/Month= 8X4.5X2 =
MON PATHO PHARMA CLINICS PRACTICALS: PATHO/MICRO
72 Hours/2= 36 Hours
TUES MICRO SURG/FMT CLINICS PRACTICALS: PHARMA/FMT rd th th
Total Clock Hours (3 4 & 5 SEMESTER)
(DENTAL/FMT)
WED MED PHARMA CLINICS PATHO O&G
LUNCH PAEDS LECTURES : 120+54= 174 Hours
THURS CM&FM MICRO CLINICS PRACTICALS: PATHO/MICRO PRACTICALS : 120+36 = 156 Hours
FRI PATHO PHARMA CLINICS PRACTICALS: PHARMA/FMT 330 Hours
SAT FMT CM&FM CLINICS   MICROBIOLOGY:
rd th
3 & 4 SEMESTER: LECTURES: 2/Week; 2X4=8/Month; 8X10 = 80 Hours
4 SEMESTER 5 MONTHS
th

  8-9 9-10 10-1 1-2 2-3 3-4 4-5

PRACTICALS: 2/Week = 2X4/Month = 8X10= 80 X 3 Hours =

MON PATHO PHARMA CLINICS PRACTICALS: PATHO/MICRO 240 Hours/2= 120 Hours
th
PRACTICALS: 5 SEMESTER: LECTURES: 3/Week, 3X4=12/Month= 12X4.5 = 54 Hours
TUES MICRO PATHO CLINICS
PHARMA/CM&FM
MODULAR TEACHING PRACTICALS: 2/Week= 2X4/Month= 8X4.5X2 =
WED MED O&G CLINICS TH
LUNCH 4 SEM 72 Hours/2=36 Hours
THURS CM&FM MICRO CLINICS PRACTICALS: PATHO/MICRO rd th th
Total Clock Hours (3 4 & 5 SEMESTER)=
PRACTICALS:
FRI PATHO PHARMA CLINICS LECTURES: 80+54= 134 Hours
PHARMA/CM&FM
SAT SURG/FMT CM&FM CLINICS   PRACTICALS: 120+36= 156 Hours
272 Hours
5th SEMESTER 4.5 MONTH PHARMACOLOGY:
rd
8-9 9-10 10-1 1-2 2-3 3-4 4-5 3 SEMESTER: LECTURES: 3/Week= 3X4/Month= 12X5= 60 Hours
MON PATHO PHARMA CLINICS FMT PRACTICALS: PATHO/MICRO th
4 SEMESTER: LECTURES: 2/Week= 2X4/Month= 8X5 = 40 Hours
TUES MICRO CM&FM CLINICS MED PRACTICALS: PHARMA/FMT
PRACTICALS: 2/Week = 2X4/Month = 8X10=
WED FMT PHARMA CLINICS OG PRACTICALS: PATHO/ FMT 80 X 3 Hours= 240 Hours/2= 120 Hours
LUNCH
THURS PHARMA MICRO CLINICS SURG PRACTICALS: PHARMA/FMT th
5 SEMESTER: LECTURES: 2/Week, 2X4=8/Month= 8X4.5 = 36 Hours
FRI PATHO SURG CLINICS PATHO PRACTICALS: FMT/ MICRO
PRACTICALS: 2/Week= 2X4/Month= 8X4.5X2 =
SAT MICRO CM&FM CLINICS   72 Hours/2= 36 Hours

16 17
M.B.B.S CURRICULM M.B.B.S CURRICULM

rd th th
Total Clock Hours (3 4 & 5 SEMESTER) MEDICINE:
rd
LECTURES= 100 + 36 = 136 Hours 3 SEMESTER: LECTURES: 1/Week=4/Month=4X5= 20 Hours
PRACTICALS= 120 + 36= 156 Hours th
4 SEMESTER: LECTURES: 1/Week=1X4/Month=4X5= 20 Hours
292 Hours th
5 SEMESTER: LECTURES: 1/Week=1X4/Month=4X4.5= 18 Hours
FMT: 58 Hours
rd
3 SEMESTER: LECTURES: 3/2 Week= 3X2=6/Month= 30 Hours
30+5= 35 Hours SURGERY:

PRACTICALS: 2/Week = 2X4/Month = 8X5 = 40 X 3 Hours= 120 3rd SEMESTER: LECTURES: 1/2 Week; 2/Month =2X5= 10 Hours
Hours/2= 60 Hours 4th SEMESTER: LECTURES: 1/2 Week; 2/Month=2X5= 10 Hours
th th
4 SEMESTER: LECTURES: 1/2 Week= 1X2/Month= 2X5 = 10 Hours 5 SEMESTER: LECTURES: 2/Week; 8/Month; 8X4.5= 36 Hours
th
5 SEMESTER: LECTURES: 2/Week= 2X4/Month= 8X4.5= 36 Hours
OBSTETRICS & GYNAECOLOGY:
PRACTICALS: 4/Week= 4X4/Month= 16X4.5X2 = rd
3 SEMESTER: LECTURES: 1/Week; 4/Month; 4X5= 20 Hours
144 Hours/2= 72 Hours
4th SEMESTER: LECTURES: 1/Week; 4/Month; 4X5= 20 Hours
Total Clock Hours (3rd, 4th & 5th SEMESTER)
th
5 SEMESTER: LECTURES: 1/Week; 4/Month; 4X4.5= 18 Hours
LECTURES= 25+20+36= 81 Hours
PRACTICALS= 60+72=
132 Hours 38 Hours

213 Hours
PAEDIATRICS:
rd
COMMUNITY MEDICINE: 3 SEMESTER: LECTURES: 1/ 2Week; 2/Month; 2X5= 10 Hours

1st and 2nd SEMESTER: EARLY COMMUNITY AND CLINICAL TOTAL = 10 Hours

EXPOSURE: 2/Week= 2x11X5= 110 Hours MODULAR TEACHING 4th SEM WEDNESDAY POST LUNCH):
rd
3 SEMESTER: LECTURES : 2/Week= 2X4/Month= 8X5= 40 Hours 1/Week; 4/Month; 4X5X3 Hours= 60 Hours
th
4 SEMESTER: LECTURES: 2/Week= 1X4/Month= 8X5= 40 Hours DENTAL:
rd
PRACTICALS: 2/Week= 2X4/Month = 8X5X3 Hours= 3 SEMESTER: LECTURES: 5 Hours
120/2 = 60Hours
th
5 SEMESTER: LECTURES – 2/Week= 2X4/Month= 8X4.5 Hours= 36 Hours MEDICINE:

Would inculd other medical Departments like Cardiology, Neurology, Pulmonary Medicine,
Total Clock Hours (3rd, 4th & 5th SEMESTER)
Endocrinology, Nephrology, Gastroenterology, Transfusion Medicine, Nuclear Medicine,
LECTURES: 80+36 = 116 Hours Emergency Medicine.
PRACTICALS: 60 Hours
176 Hours

18 19
M.B.B.S CURRICULM M.B.B.S CURRICULM

6th SEMESTER (5.5 MONTHS) 2.5 months

3 months
8-9 9-1 1-2 2-3 3-4 4-5
 
8-9 9-1 1-2 2-3 3-4 4-5
  PRACTICALS: CM&FM/EYE TUTORIALS/RADIOLOGY/
MON ENT CLINICS
PRACTICALS: CM&FM/EYE TUTORIALS/RADIOLOGY/ INSTRUMENTS/OPERATIVES
MON OPHTH CLINICS
INSTRUMENTS/OPERATIVES MED/ PRACTICALS: CM&FM/EYE
MED / PRACTICALS: CM&FM/EYE TUES CLINICS
TUES CLINICS PAED TUTORIALS/RADIOLOGY/INSTRUMENTS/OPERATIVES
PAED TUTORIALS/RADIOLOGY/INSTRUMENTS/OPERATIVES th
WED O&G CLINICS ELECTIVES 7 SEM
BLS/ TLS/ FIRST AID/ ETHICS/ PATIENT SAFETY/
WED SURG CLINICS th PRACTICALS: CM&FM/ ENT
LUNCH COMMUNICATION/ DIETETICS 6 SEM LUNCH
THU CM&FM CLINICS CM&FM TUTORIALS/RADIOLOGY/INSTRUMENTS/
THU CM&FM CLINICS CM&FM ENT OPHTH OPERATIVES
PRACTICALS: CM&FM/ ENT
FRI OPHTH CLINICS OPHTH/CMFM O&G CM&FM OPHTH/
FRI OPHTH CLINICS TUTORIALS/RADIOLOGY/INSTRUMENTS/
CMFM
OPERATIVES
SAT MED CLINICS  
SAT SURG CLINICS  
2.5 months
OPHTHALMOLOGY:
8-9 9-1 1-2 2-3 3-4 4-5
 
LECTURE: 7/2 Week; =14 Hours =14X11= 144 Hours;
PRACTICALS: CM&FM/EYE TUTORIALS/RADIOLOGY/
MON ENT CLINICS
INSTRUMENTS/OPERATIVES CLINICS: 2 Month; 2X4=8 Week=8X6= 48 Days= 48X4= 192 Hours
MED / PRACTICALS: CM&FM/EYE
TUES CLINICS TUTORIALS/RADIOLOGY/INSTRUMENTS/OPERATIVES= 2/Week;
PAED TUTORIALS/RADIOLOGY/INSTRUMENTS/OPERATIVES
BLS/ TLS/ FIRST AID/ ETHICS/ PATIENT SAFETY/
WED O&G CLINICS th 2X4=8/Month; 8X11Month=88 Days/2; 8X3/2=264Hours/2=132 Hours
COMMUNICATION/ DIETETICS 6 SEM
LUNCH PRACTICALS: CM&FM/ ENT Total Clock Hours: LECTURE= 144 Hours
THU CM&FM CLINICS CM&FM TUTORIALS/RADIOLOGY/
INSTRUMENTS/OPERATIVES CLINICS= 192 Hours
PRACTICALS: CM&FM/ ENT
FRI OPHTH CLINICS OPHTH/CMFM TUTORIALS/RADIOLOGY/ TUTORIALS= 132 Hours
INSTRUMENTS/OPERATIVES
468 Hours
SAT SURG CLINICS  
ENT:
7th SEMESTER (5.5 MONTHS)
3 months LECTURE: 1/Week; 4/Month; 4X11=  44Hours;

8-9 9-1 1-2 2-3 3-4 4-5 CLINICS: 1.5 MONTH; 1.5X4=6 Week= 6X6= 36 Days= 36X4= 144 Hours
 
MON OPHTH CLINICS
PRACTICALS: CM&FM/EYE TUTORIALS/RADIOLOGY/ TUTORIALS/RADIOLOGY/INSTRUMENTS/OPERATIVES = 2/Week;
INSTRUMENTS/OPERATIVES
MED / PRACTICALS: CM&FM/EYE 2X4=8/Month; 8X5 Month =40Days; 40X2=80 Hours/2= 40 Hours
TUES CLINICS
PAED TUTORIALS/RADIOLOGY/INSTRUMENTS/OPERATIVES
th Total Clock Hours: LECTURE= 44 Hours
WED SURG CLINICS LUNCH ELECTIVES 7 SEM
CLINICS= 144 Hours
THU CM&FM CLINICS CM&FM ENT OPHTH
TUTORIALS= 40 Hours
FRI OPHTH CLINICS OPHTH/CMFM O&G CM&FM
228 Hours
SAT MED CLINICS  

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M.B.B.S CURRICULM M.B.B.S CURRICULM

COMMUINITY MEDICINE: MEDICINE:

th th
6 SEMESTER: 3 MONTHS 6 SEMESTER: 3 MONTHS: LECTURE: 3/2Week; =6/Month; 6X3 = 18 Hours

LECTURE: 7/2 Week; =14/Month; 14X3 =42 Hours; 2.5MONTHS: LECTURE: 1/2Week; 2/Month; 2X2.5 = 5 Hours
th
PRACTICALS: 2/Week, 2X4/Month; 8X3X3=72Hours/2=36 Hours; 7 SEMESTER: 3MONTHS: LECTURE: 3/2Week; =6/Month; 6X3 = 18 Hours

CLINICS: 3 Month = 3X4 Week = 3X4X6 Days = 3X4X6X4 = 2.5MONTHS: LECTURE: 1/2Week; 2/Month; 2X2.5 = 5 Hours
TOTAL CLOCK Hours= 46 Hours
0 Hours/2 = 144 Hours

2.5 MONTHS PAEDIATRICS:

LECTURE: 1/2Week; 2/Month; 2X11= 22 Hours
LECTURE: 5/2Week;=10/Month; 10X2.5 =25 Hours

PRACTICALS: 2/Week= 2X4/Month=8X2X2.5 = 20 Hours/2 = 10 Hours SURGERY:

th
th
7 SEMESTER: 3 MONTHS 6 SEMESTER: 3MONTHS: LECTURE: 1/Week; 1X4=1/Month; 4X3 = 12 Hours
2.5MONTHS: LECTURE: 2/Week; 2X4=8/Month; 8X2.5 = 20 Hours
LECTURE: 7/2Week; =14/Month; 14X3 =42 Hours
th
7 SEMESTER: 3MONTHS: LECTURE: 1/Week; 1X4=4/Month; 4X3 = 12 Hours
PRACTICALS: 2/Week, 2X4/Month; 8X3X3=72Hours/2=36 Hours
2.5 MONTHS LECTURE: 2/Week; 2X4=8/Month; 8X2.5 = 20 Hours
CLINICS: 3Month= 3X4 Week = 3X4X6 Days = 3X4X6X4 =
TOTAL CLOCK Hours = 64 Hours
288 Hours/2 = 144 Hours
OBSTETRICS & GYNAECOLOGY:
2.5 MONTHS
LECTURE: 1/Week; 4/Month; 4X11= 44 Hours
LECTURE: 5/2Week; = 10/Month; 10X2.5 =25 Hours

PRACTICALS: 2/Week= 2X4/Month=8X2X2.5 = 20Hours/2 = 10 Hours BLS/ TLS/ FIRST AID/ ETHICS/ PATIENT SAFETY/ COMMUNICATION/ DIETETICS
th
6 SEMESTER: 1/Week; 4/Month; 4X5.5= 22; 22X3= 66 Hours
(6 & 7 SEMESTER) LECTURES=
th th
134 Hours

PRACTICALS= 92 Hours ELECTIVES

th
CLINICS= 288 Hours 7 SEMESTER: 1/Week; 4/Month; 4X5.5=22; 22X3= 66 Hours

TOTAL Hours = 514 Hours

(3rd 4th & 5th SEMESTER): TOTAL Hours = 176 Hours

(1st & 2nd SEMESTER): TOTAL Hours = 110 Hours

Total Clock Hours (1st TO 7th SEMESTER) = 110+ 514+ 176 = 800 Hours

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M.B.B.S CURRICULM M.B.B.S CURRICULM

8th and 9th SEMESTER (10 Months) OBSTETRICS & GYNAECOLOGY:

LECTURE: 2/Weeks; 8/Months; 8X10= 80 Hours
  8-9 9-1 1-2 2-3 3-4 4-5
OPERATIVES/RADIOLOGY/ TUTORIALS ETC= 3/2Weeks; =6/Months; 8X10X2= 120 Hours
MED
STUDENT SEMINAR/ MODEL
ALL5Months/ CLINICS= 1 Months; 1X4=4 Weeks; 4X6= 24 Days; 24X3= 72 Hours
MON MED CLINICS LUNCH QUESTIONS & ANSWERS/
SURG ALL
TUTORIALS
5Months 3Months; 3X4=12 Weeks; 12X6=72 Days; 72X4= 288 Hours
MED
TUES SURG CLINICS MED ALL O&G / PAEDS
PAEDIATRICS:
WED O&G CLINICS PAEDS / SURG SURG
LECTURE: 1/Weeks; 4/Months; 4X10= 40 Hours
PAEDS/
THURS CLINICS MED O&G
MED/ TUTORIALS ETC= 1/2Weeks; 2/Months; 2X10X2= 40 Hours
FRI MED CLINICS SURG O&G MED/SURG
CLINICS=0.5Months; 0.5X4=2 Weeks;2X6=12 Days; 12X3= 36 Hours
SAT SURG CLINICS   1.5 Months; 1.5X4= 6 Weeks; 6X6=36 Days; 36X4= 144 Hours

MEDICINE: MEDICINE:
rd th th
LECTURE: 7/2Weeks; 14/Months; 14X10=140 Hours Clock Hours: (3 , 4 & 5 SEMESTER) LECTURES= 58 Hours
th th
TUTORIALS ETC= 5/2Weeks; =10/Months; 10X10= 100 Hours (6 & 7 SEMESTER) LECTURES= 46 Hours
th th
CLINICS= 4 Months; 4X4=16Weeks; 16X6= 96 Days; 96X4=384 Hours (8 & 9 SEMESTER) LECTURES= 140 Hours

3Months; 4X3=12Weeks; 12X6=72 Days;72X3= 216 Hours TUTORIALS=100 Hours

CLINICS =
600 Hours
SURGERY:
TOTAL Hours = 944 Hours
LECTURE: 7/2 Weeks; 14/Months; 14X10= 140 Hours;

TUTORIALS ETC= 5/2Weeks; =10/Months; 10X10= 100 Hours; MEDICINE ALLIED:

th th
CLINICS= 2.5 Months; 2.5X4=10Weeks; 10X6= 60 Days; 60X3= 180 Hours (8 & 9 SEMESTER) LECTURE= 60 Hours

3.5 Months; 3.5X4=14Weeks; 14X6= 84 Days; 84X4= 336 Hours

PSYCHIATRY:

SURGERY ALLIED: LECTURE – 30Hours;

LECTURE: 1/Weeks; 4/Months; 4X5= 20 Hours CLINICS – 1.5 Months; 1.5X4= 6Weeks; 6X6=36Days; 36X3= 108 Hours

1.5 Months; 1.5X4= 6Weeks; 6X6=36Days; 36X4= 144 Hours

MEDICINE ALLIED:
TOTAL CLOCK Hours= 252+30= 282 Hours
LECTURE: 1/Weeks; 4/Months; 4X10= 40 Hours,

1/Weeks; 4/Months; 4X5= 20 Hours

24 25
M.B.B.S CURRICULM M.B.B.S CURRICULM

DERMATOLOGY & VENEROLOGY : OBSTETRICS & GYNAECOLOGY:

LECTURE – 30 Hours; Clock Hours:
rd th th
CLINICS- 1.5 Months; 1.5X4=6Weeks; 6X6=36 Days; 36X3= 108 Hours (3 , 4 & 5 SEMESTER) LECTURES= 58 Hours
th th
0.5 Months; 0.5X4=2Weeks; 2X6=12 Days; 12X4= 48 Hours (6 & 7 SEMESTER) LECTURES= 44 Hours
th th
TOTAL CLOCK Hours= 108+48+30= 186 Hours (8 & 9 SEMESTER) LECTURES= 80 Hours

TUTORIALS= 120 Hours

SURGERY:
rd th th CLINICS= 1 Month; 1X4=4Weeks; 4X6= 24Days; 24X3= 72 Hours
Clock hours: (3 , 4 & 5 SEMESTER) LECTURES= 56 Hours
th th 3Months; 3X4=12Weeks; 12X6=72Days; 72X4= 288 Hours
(6 & 7 SEMESTER) LECTURES= 64 Hours
th th TOTAL CLOCK Hours= 662 Hours
(8 & 9 SEMESTER) LECTURES= 140 Hours

TUTORIALS= 100 Hours PAEDIATRICS:

rd th th
CLINICS=
516 Hours Clock Hours: (3 , 4 & 5 SEMESTER) LECTURES= 10 Hours
th th
TOTAL CLOCK Hours= 876 Hours (6 , 7 SEMESTER) LECTURES= 22 Hours
th th
(8 & 9 SEMESTER) LECTURES= 40 Hours
SURGERY ALLIED:
th th TUTORIALS= 40 Hours
(8 & 9 SEMESTER) LECTURE= 20 Hours
CLINICS=
180 Hours
ORTHOPAEDICS:
TOTAL CLOCK Hours = 292 Hours
LECTURE = 15 Hours

CLINICS = 1Months= 4Weeks; 4X6=24Days; 24X3= 72 Hours ELECTIVES - 66 CLOCK HOURS

1Months= 4Weeks; 4X6=24Days; 24X4= 96 Hours PULMONARY MEDICINE

TOTAL CLOCK Hours= 183 Hours GASTROENTEROLOGY

CARDIOLOGY
ANAESTHESIOLOGY:
MEDICAL ONCOLOGY
LECTURE = 5 Hours
SURGICAL ONCOLOGY
CLINICS = 1MONTH = 4Weeks; 4X6=24Days; 24X4=96 Hours RADIODIAGNOSIS
TOTAL CLOCK Hours= 101 Hours RADIOTHERAPY
BLOOD BANK & TRANSFUSION MEDICINE
PLASTIC SURGERY
NEUROSURGERY
UROLOGY
DENTAL SURGERY

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M.B.B.S CURRICULM M.B.B.S CURRICULM

AND ALL OTHER SUBJECTS IN UNDERGRADUATE STUDIES A STUDENT WANTS TO

OPT FOR

Total days

2 months
2 months
2 months
2 months
3 months
6 months

4 months

2 months

3 months
7 months

1 month
10 days
• MAXIMUM OF 5 STUDENTS WOULD BE ALLOWED IN A SUBJECT AT A TIME IN ANY

35.5
20

37
PARTICULAR DEPARTMENT

7
CLINICS:

15 days
15 days
15 days
15 days
2 & 1/2

5 days

5 days
5 days
8th Sem & 9th Sem (11)

1
3
MEDICINE – 7 Months

11 months
SURGERY – 6 Months

O&G – 4 Months

PAEDIATRICS – 2 Months

CM&FM – 3 Months

OPHTHALMOLOGY - 2 Months

ENT – 2 Months

6th Sem & 7th Sem (11 & 1/2)

15 days
15 days
15 days

1 & 1/2
1 & 1/2
ANAESTHESIOLOGY – 1 Month

1
1

3
1
ORTHOPAEDICS – 2 Months

11 & 1/2 months

DERMATOLOGY – 2 Months

PSYCHIATRY - 3 Months

TRAUMA & EMERGENCY MEDICINE – 15 Days

DENTAL – 10 Days

RADIOTHERAPY – 8 Days

RADIODIAGNOSIS – 7 Days

5th Sem (14 & 1/2)

3rd Sem & 4th Sem

10 days
15 days
15 days
15 days

15 days

1 & 1/2
1 & 1/2
2 & 1/2

3 days

2 days
13
1
1
3

Anaesthesia
Psychiatry
Medicine

CM&FM

Ophthal
Surgery

Derma

Dental
Ortho
Paeds
O&G

TEM

ENT

RD
RT
28 29
M.B.B.S CURRICULM M.B.B.S CURRICULM

CURRICULUM FOR PATIENT SAFETY washing and hospital infection control can easily be added into the curriculum of microbiology as
elements are already being taught. In case departments do not want to use the normal working
Background and Introduction hours, as the schedule is already packed, they may also look at engaging students on Saturday
Patient safety is an essential part of patient care that is not addressed during medical afternoons (2-4 p.m.) or after normal working hours (4.30-5.30 p.m.). The arrangement will be left
undergraduate and postgraduate training in India. Though awareness of patient safety issues has to the individual departments to work out.
come into the limelight in the recent past, this has to be consolidated by way of introducing For each broad topic - the coordinator from the pre and para clinical departments will
a formal curriculum in patient safety for medical undergraduates. which will be broadly based prepare a lesson plan, in consultation with other faculty members and the MEU, if necessary.
on the WHO curriculum on patient safety, using the principles, tactics and major thrust areas Help in preparing lesson plans will be provided by the MEU and templates will be provided. The
identified in it using a combination of case-based learning (with de-identified examples from respective department can provide the reading material, background information, anonymised
AIIMS Bhubaneswar), active learning methods and interactive lectures for delivering the content. case studies as required. Preparation of lesson plans will permit the programme to continue even
Specific outcomes expected under each broad heading, the time needed for delivery of content if the main persons coordinating it initially are not able to do so at a later stage. It is hoped that
and training will be proportioned under each department. As assessment drives learning, it is there will be adequate discussions at the department at level before the programme is started so
expected that what is taught will be tested during the formative exams and when possible in the that there will be consensus and ownership at all levels. The final lesson plan may be submitted
summative exams as well. to the MEU which will be coordinating the implementation of the curriculum on patient safety.
The onus of implementing the curriculum will be with individual departments under the Note: Clinical departments will not need to submit lesson plans as all aspects of patient safety
leadership of the respective heads of individual departments. However, in each department, a can be discussed during clinics, using opportunities provided by individual cases that are being
single junior or mid-level faculty member will be nominated to coordinate the implementation of discussed. However, it must be reiterated that discussing aspects of patient safety whenever the
the curriculum at the departmental level. This faculty member may or may not belong to Medical clinics are being taken will necessitate a change in mind-set of teachers which must be encouraged
Education Unit (MEU) of AIIMS Bhubaneswar. MEU will advise, inform and provide assistance by departmental heads. Residents taking clinics should also be asked specifically to discuss issues.
to these faculty members for planning, conduct and assessment. It is hoped that the patient Feedback from residents and students will also be useful to gauge whether this method is effective.
safety curriculum will evolve and continue to do so incorporating new information, methods and During ward-leaving tests, OSCEs and other types of assessment, any one question pertaining to
systems and prepare undergraduates of AIIMS Bhubaneswar to become champions of patient an aspect of patient safety may be included. The coordinator from the clinical departments will
safety once they graduate. observe, facilitate and take feedback from faculty and students which will be used for further fine-
Overall Objectives of the Curriculum tuning the training.

At the end of the medical undergraduate course in AIIMS Bhubaneswar the graduate should Date of starting: This curriculum will be implemented from this year onwards (2017).
be able to: Evaluation of the curriculum
1. Appreciate the concept of patient safety and understand its importance in terms of avoidable Evaluation will be done by obtaining a formal written feedback from faculty and students.
suffering and cost A long-term follow-up will be planned after the first year, as changes will have to be made to
2. Follow safety practices and comply with institutional procedural guidelines when providing accommodate logistic issues. Topics in patient safety allocated to various departments, time
healthcare allocation and broad methods of teaching-learning are given in the following table.

3. Develop a culture of reporting medical errors

4. Assist in improving patient safety in all healthcare situations throughout his/her professional
life.

Flexibility in the implementation of the curriculum

As the present medical curriculum is already being overloaded with newer “must know”
areas, individual departments will be encouraged to include these topics into what is already
being taught. For example, adverse drug reactions (ADR) and monitoring of ADRs are already in
the curriculum of pharmacology; medication safety may be added when this is being taught. Hand

30 31
M.B.B.S CURRICULM M.B.B.S CURRICULM

Table 1. Topics or patient safety with the departments responsible for training, time Broad Topic Time Allotted Dept. responsible T-L method
allocated for the topics and suggested methods of teaching-learning process

Broad Topic Time Dept. T-L method Clinical There will be no

Allotted responsible (semesters 6-9) specific time
Pre-clinical allotted as the
Workplace safety depts. will be ENT Healthcare worker safety;
(semester 1-2)
expected to demonstration, clinics
Basics of patient 2 hours Anatomy Interactive lecture incorporate any
safety Case based learning Infection control Ophthalmology Hand-washing; demonstration,
one aspect of
clinics
Working as a team 2 hours Game, group discussion patient safety as a
Site-marking, OT routine into their Orthopaedics Demonstration in wards, OT
Communicating 2 hours Game, group discussion
check-list clinical teaching in
effectively
addition to the
Workplace and 3 hours Physiology Survey and report topics assigned to
Medication safety Paediatrics Clinics
workforce safety writing/ presentation them.
Safe & 3 hours Biochemistry Visit to incinerator,
Cleanenvironment STP Survey and report/ presentation Injection Safety Medicine Clinics

Fire-safety 6 hours Community Med Demonstration, Drill - hands on

Para-clinical Medication safety
(semester 3-5) Infection control Surgery Clinics - during evening rounds
Hand-washing 1 hour Microbiology Practical - demo and practice reinforcement on proper
Infection control 4 hours Microbiology Survey and report techniques for dressings
writing/ presentation Communicating Obs & Gyn Clinics
Talk - field visit effectively
Transfusion safety 2 hours Pathology Visit to me blood bank Workplace safety Dermatology Clinics
Observation of blood
transfusion Case-based learning
Communicating 2 hours Pathology Role-play Workplace safety Pulmonary Clinics
effectively Case-based learning Medicine
(Transcribing Workplace safety Anaesthesiology Equipment check, medications
errors; Laboratory check - in OTs - demonstration
practices to prevent
errors) Radiation safety Radiodiagnosis Clinics
Medication safety 5 hours Pharmacology Practical exercise
Reporting of observed medication Fire safety 2 EMSD Reinforcement of fire safety
errors - mock drill during posting in
Injection safety 1 hour Practical exercise EMSD
Medico-legal 4 hours Forensic Case Based Learning - Group Patient safety 10 hours Will be Modular teaching - with inputs
Issues arising from Medicine discussion using examples from module (5 day module) coordinated by from all departments (module
communication and AIIMS Bhubaneswar MEU will be planned by MEU)
medical errors

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M.B.B.S CURRICULM M.B.B.S CURRICULM

Medical Humanities Course AIIMS Bhubaneswar

Broad Topic Time Allotted Dept. T-L method
Introduction to Course:
responsible
Internship To be included in the intern’s diary for Medicine though being a technical and scientific field, has also long been known as the art of
certification by unit chief medicine. But the art of medicine, though essential for good medicine, has been ignored by both
medical technology and medical science. Healthcare practitioners can be educated to be more
receptive to creative input and innovative thinking in order to retain originality and prevent stifling
Medication safety Medicine Prescription audit of ten prescriptions
by repetition.
written by them; (self audit) discuss with
unit chief The Medical Humanities course of AIIMS Bhubaneswar aims to promote creative thinking and
Reporting medication/medical errors develop new perspectives on patient experience and medical practice among medical students.
observed during posting It will serve 3 main goals :
Paediatrics Prescription audit of ten prescriptions 1. To understand the humane aspects of medicine through the study of history, philosophy and
written by them; (self audit) discuss with sociology.
unit chief
Reporting medication/medical errors 2. To develop understanding of the connection between medicine and the creative arts.
observed during posting
3. To inculcate insightfulness and compassion in future healthcare professionals.
Transfusion safety Obs & Gyn Demonstration following guidelines for
blood transfusion MEDICAL HUMANITITES (110 hrs )
Reporting medical errors observed
during posting Sr. No. Topic Hours

Hospital infection Surgery Demonstration of safe injection 1. History of Medicine and key issues in history of medicine 04
practices, safe practices during minor 2. Introduction of portfolio and its management 04
procedures
3. Introduction to history of technological devices and their influence in 10
Reporting medical errors observed
medicne
during posting
4. Introduction to disciplines contributing to medical humanities with case 04
Working as a team Community Demonstrate qualities of working as a studies as examples of interdisciplinary nature of medicine
Communicating medicine team, leadership during activities
5. Themes and issues relevant to medicine and humanities 10
effectively Patient education initiatives;
provide information to patients on 6. Development of writing and oral presentation skills for different 10
contraception, diet, antenatal care, audiences and formats
immunization etc., 7. Computer 20
8. English 18
9. Local language 30

34 35
 M.B.B.S CURRICULM

ANATOMY
GOALS AND OBJECTIVES
• Comprehend the normal disposition, inter-relationships, gross, functional and applied
anatomy of various structures and organs in the body.

• Comprehend the basic structure and connections between various parts of the central nervous
system so as to analyse the integrative and regulative functions and should be able to locate
the site of lesions according to the deficits encountered.

• Recognize and state the micro-anatomical features of various tissues and organs of the human
body with functional correlation as a prerequisite to understanding the altered state in disease
processes.

• State the development of various organs of the human body, differentiate abnormal
development and interpret the formation of various congenital anomalies.

• State the features of normal postnatal growth and development and recognize any variation

• State the basic principles of medical genetics and understand the basis of genetic disorders.

• Identify the radiological features of normal human body structures in routine radiological

ANATOMY
investigations.

• Project the outline of the internal structures on the surface of the body.

Activities:
• Large and Small Group Teaching, Integrated teaching, Problem-Based learning

• Practical classes on surface anatomy, dissection and histology,

• Demonstration of bones, charts, embryology models, radiology plates and museum specimens

• Use of multimedia for teaching

• Student participation in the form of seminar presentation, giving assignments and maintaining
practical records

• Formative and Summative assessments in the form of MCQs, Short Answer types, Structured
and Modified Essay Questions, Practical and Viva voce.

GUIDELINES FOR INTRODUCTION OF UNIFORM EXAMINATION/EVALUATION

PATTERN
THEORY:
1. Attempts should be made to examine/ evaluate the different branches of Anatomy.

• 70% of the total marks to be allotted to level 1 (Must know) of the course content.

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M.B.B.S CURRICULM M.B.B.S CURRICULM

• 20% of the total marks to be allotted to level 2 (Desirable to know) of the course content. ANATOMY THEORY PAPER (2 Papers, 100 Marks each, Total 200 Marks)
• 10 % of the total marks to be allotted to level 3 (Nice to know) of the course content Paper I – 100 marks  Time: 3 Hours
2. Long answer question (LAQ) to be chosen from among the lecture topics outlined. Section-A: 50 Marks

3. Questions may be prepared from all the three levels keeping in mind guideline- 1. General Anatomy - 5-8 Marks
General Histology- 5-8Marks
PRACTICALS:
General Embryology- 8 Marks
1. Gross Anatomy, Surface Anatomy and Histology will be evaluated by practical examination. Genetics- 5 Marks
2. Attempts should be made to include all regions of the body, for evaluation purposes. Upper Extremity- 10-12 Marks

3. Should be designed to examine the skills of the student to identify the structures in the Lower Extremity- 10-12 Marks
body, and to test his/her competence in correlating with the applications. Section-B: (50 Marks)

VIVA VOICE/ ORALS: Abdomen, Pelvis & Perineum

The following subdivisions of Anatomy will be included to evaluate the knowledge as well as the (With related histology and embryology)
communication skill of the student:
Paper II – 100 marks  Time: 3 Hours
1. Osteology
Section A: 50 Marks
2. Radiology
Head & Neck and Face- 40 Marks
3. Embryology
Special senses- 10 Marks
4. Neuroanatomy
(With related histology and embryology)
INTERNAL ASSESSMENT
Section B: (50 Marks)
• Internal Assessment: It is a sort of training towards professional examination. It includes
Thorax- 25 Marks
periodic test conducted by department and end semester examination notified through
Dean’s Office. These assessments in theory and practical will be held as given below. Neuroanatomy- 25 Marks
(With related histology and embryology)
• Monthly internal Assessments will be done at Department level, 100 marks each (Pattern of
examination will be decided at the department level). • Long Answer Type can be Structured or Modified type.
(One question of 10 Marks in each section)
• End-Semester Examinations (3) will be notified by Dean’s Office, 100 marks for theory and
100 marks for practical and viva. • Short Note (Five Questions of 5 Marks each in each section)

• Evaluation of Practical records will be done during internal assessment only. • Short Answer can be Compare and Contrast, Enumerate, Explain with reason, Mechanism
etc. type. (Five Questions of 3 Marks each in each section)
• Syllabus for exam will be topics covered during that period only. The pre-Professional Internal
Assessment notified by Dean’s Office will include the entire syllabus. • Questions may be framed from all levels assessing recall, understand and application
abilities.
Professional Examination (Distribution of Marks)
• Each Section will comprise of
• Theory: (Two papers of 100 Marks each) 200 Marks
one Long answer question (10 marks)
• Practical & Viva: (Practical:70 Marks and Viva :30 Marks) 100 Marks Five Short notes (5x5=25 marks)
Five Short answer/Brief answer type (5x3=15 marks)
Total: 300 Marks
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M.B.B.S CURRICULM M.B.B.S CURRICULM

ANATOMY PRACTICAL AND VIVA (100) CONTENTS

• Practical - 80 marks 1. General Anatomy
Histology- 30 Marks 2. Upper limb
Spotting- 20 marks 3. Thorax
Commenting- 10 marks
4. Lower Limb
Genetic Charts- 5 Marks
5. Abdomen, Pelvis & Perineum
Gross Anatomy 45 marks
6. Head & Neck and Special Senses
Limb- 15 marks
7. Histology
Viscera- 15 Marks
8. Embryology
Sections- 10 marks
Surface Anatomy- 5 Marks 9. Genetics
Gross Anatomy spotting to be taken during internal assessment only 10. Neuroanatomy
• Viva -20 Marks

Osteology- 8 Marks
Brain- 4 Marks
Embryology Models- 4 Marks
Radiology- 4 Marks

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M.B.B.S CURRICULM M.B.B.S CURRICULM

General Anatomy General Histology

Sl. Sl. Desirable to
Topic Must know Desirable to know Nice to know Units Must know Nice to know
No No know
01. Introduction to Subdivisions of anatomy, anatomical History of 01. Introduction Relevance of histology to Medicine, Principles of light Golgi staining,
Anatomy terminology, positions and planes anatomy, And Different types of microscopes, and electron Cryostat
Embalming Microscopy Light microscope, Magnification/ microscopy,
techniques Resolution, Microtome and H&E Special stains
02. Cartilage Definition, types, structure and staining
function, distribution 02. Cell Definition and Classification of cell Diseases of cell
03. Bones Classification of bones, parts of bone, Laws of ossification Factors affecting organelles, Classification of Primary organelles
ossification, blood supply growth of bone, Tissues
Wolff’s law, Bone
graft 03. Epithelial Characteristics of different types of Cell Junctions Ultrastructure,
04. Joints Definition, classification, nerve supply Close packed and Tissues I Epithelium, Basement Membrane, Metaplasia,
of joints- Hilton’s law, blood supply of loose packed Surface modifications of cell Hyperplasia
joints, lubricating mechanism of joints position membrane
05. The Muscular Structural classification of muscle, Shunt and spurt 04. Epithelial Glandular Epithelium-Types of
System Parts of a skeletal muscle, Principles muscles Tissues II Glands, classification with examples
of sensory and motor innervation
of muscles, Blood supply of muscle, 05. Connective Connective tissue-Types and Nutrition of
Introduction to the terms, Muscle Tissue I Composition Generalized
action Connective Tissue
06. The Classification of vascular and Concepts of throm-
06. Connective Structure and classification with Ossification of
Cardiovascular lymphatic systems, Pulmonary, bosis, infarction,
Tissue II examples of Cartilage and Bone Bone
& lymphatic systemic and portal circulation, Layers aneurysm, embo-
System of blood vessel, Types of blood vessels, lism, Lymphoedema 07. Lymphoid/ Distribution, Lymph Node, Spleen, Splenic Types of Immunity
Factors affecting venous return, End- and lymphangitis, Immune Thymus, Tonsils Circulation, Blood
arteries, Components and function of spread of tumours System Thymic Barrier
the lymphatic system, anastomosis via lymphatics
07. The Nervous Classification of nervous systems Types of synapses Neurotransmit- 08. Muscle Tissue Types of Muscles, Structural Red and White Hyperplasia and
System (CNS,ANS,PNS).Components and ters Organization Muscle fibres, Hypertrophy
classification of nervous tissue with Nerve injuries Nutrition,
their functions, Autonomic Nervous and regeneration Myoneural
system, Peripheral Nervous system of nerve, Nerve Junction
grafting
09. Nervous Tissue Structure and Classification of Structure of
08. Skin and Types, Structure in brief with pilo-se- Cleavage lines, Skin grafts
Neurons and Neuroglia Cells, Myelin, Types
Fascia baceous unit, Functions, Appendages, Langer’s lines, skin
Peripheral nerves, Ganglia and nuclei and structure of
superficial fascia- definition, layers, creases,
Synapses, Blood
distribution of fat , function, pannicu-
flexure lines, Brown Brain Barrier
lus carnosus, Deep fascia- Definition,
fat
distribution, features, modification, 10. Blood Vessels Basic structure of blood vessels, Type Atherosclerosis
function and applied anatomy of Vessels

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M.B.B.S CURRICULM M.B.B.S CURRICULM

Systemic Histology 03. First and Second Fertilization, Cleavage, Blastocyst, Spontaneous Mosaicism,
11. Skin Skin Layers and Appendages Renewal of Vitiligo, Acne Week Inner & outer cell mass, abortion, Ectopic Chimera
Epidermis, Implantation and its abnormal sites, pregnancy

Keratinisation, Formation of Germ Disc

04. Third Week Gastrulation, Formation of SacrococcygealTer-
Cutaneous
Notochord, Neurulation, atomas
receptors
Development of Somites &
12. Oral Cavity Tongue, Taste buds, salivary glands
Intraembryonic coelom, Foetal
and lips
membranes, Differentiation and
13. Digestive Oesophagus. Stomach, small Derivatives of germ layers, Folding
System Intestine, large intestine, Appendix, of embryo
Liver, Pancreas and Gall Bladder 05. Placenta and Formation, Types, Functions Twinning Placental (Graft
14. Respiratory Epiglottis, Trachea, Bronchus and Blood-Air Barrier, Umbilical Cord and Fate of foetal membranes, Versus Host
System Lung parenchyma Hyaline Membrane Placenta and Umbilical cord, Foetal Reaction)
disease circulation
06. The Foetal Growth of the foetus in general Estimation of foetal Prenatal diagnostic
15. Male Testis, Epididymis, Vas Deferens, Blood testis barrier
with reference to weight & major age techniques
Reproductive Prostate, Seminal Vesicle Male infertility Period
features, Parturition
System
07. Birth defects Causative factors & Mechanisms, Preventive
16. Female Ovary, Uterus, vagina, Mammary Female infertility
Critical period of development, measures and
Reproductive gland, placenta, umbilical cord
Teratogens, Multifactorial genetic counselling
System
inheritance
17. Urinary System Kidney, Ureter, Urinary Bladder and 08. Body Cavities Diaphragmatic
Subdivisions of Intra Embryonic
urethra and Diaphragm Hernias and
Coelom, Serous Membrane,
18. Special Sense Eyelid, cornea, retina Eventration
Cardiogenic Area, Development of
Organs
Diaphragm
19 Endocrine Pituitary, Thyroid, parathyroid and Related Applied
Systemic Embryology
System adrenal gland anatomy
09. Musculoskeletal Limb buds development, Amelia,
General Embryology System Phocomelia
development of muscles
Sl. Units Must know Desirable to know Nice to know 10. Cardiovascular Angiogenesis and establishment
No System of cardiogenic area, Heart
01. Introduction Relevance of Embryology to Ontogeny in loop formation, position and
medicine; Male and female relation to differentiation. Formation of major
reproductive system; Stages of Phylogeny blood vessels, Foetal circulation
pregnancy and its outcome, & changes at birth, Congenital
Critical periods of development, anomalies of CVS
Terminlogy- Cranial, Rostral, Caudal, 11. Respiratory Tracheo-bronchial Diverticulum, Respiratory
Dorsal, Ventral, Medial, Lateral System distress syndrome
Development of larynx, trachea,
02. Gametogenesis Spermatogenesis and Oogenesis, Seminal fluid Infertility
bronchi & lungs, Lung maturation
Menstrual cycle & Ovulation, analysis,
Tracheo­esophageal fistulas
Spermiogenesis, Sex determination Pregnancy test

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M.B.B.S CURRICULM M.B.B.S CURRICULM

12. Digestive Body cavities & serous Congenital Clinical Genetics

(Alimentary) membranes, Division of Hypertrophic presentation in Sl.
System primitive gut (Foregut, Midgut Pyloric Stenosis. premature births Units Must know Desirable to know Nice to know
No
& Hindgut) and its derivatives, Atresia of gut tube, and neonatal 01. Introduction History: Medical and Clinical
rotation of the gut, Meckel’s Omphalocoele, period genetics, Pattern of inheritance,
diverticulum, Development of Hernia, Situs
Pedigree charts /symbols
Liver & Extrahepatic Biliary System, inversus, rotational
02. Chromosomes Structure and Classification of Mutagens
Pancreas, Spleen abnormalities,
and Genes Human Chromosomes, Sex
Developmental
Chromatin and Lyon Hypothesis,
anomalies of
Karyotyping, Structure of DNA,
Hepatobiliary
RNA, Genetic Code, Gene Mutation,
System and
Cell division.
Pancreas
03. Genetic Single Gene Disorders,
Diseases Chromosomal Disorders and
13. Urogenital Differentiation of intra-embryonic Congenital Ambiguous Multifactorial Disorders
System mesoderm, development of anomalies of genitalia &
04. Diagnosis Of Indications and Investigations of Genetic Screening
Kidneys, Ureter, Urinary Bladder Urogenital System hermaphroditism
Genetic Prenatal diagnosis
And Urethra, Suprarenal gland,
Cloaca and its derivatives, Gonads: Diseases
Testis & Ovary & associated glands, 05. Genetic Definition, Indications and Human Gene Therapy,
Descent of Gonads, Derivatives of Counseling genome project Cloning
Mesonephric and Paramesonephric
Ducts, External genitalia. Upper Limb
Sl.
14. Face & Pharyngeal Arches, Development Related congenital
Units Must know Desirable to know Nice to know
Pharyngeal of Face, Oral Cavity, Palate & anomalies No
Apparatus associated anomalies. 01. Pectoral Region Surface identification of relevant Brachial plexus Features of
And Axilla skeletal features, Pectoral, Injuries Breast Cancer
15. Nervous System Neural tube and brain vesicles, Congenital Sequence of
Clavipectoral and Axillary fascia, with anatomic
Ventricular system, Neural crest, malformation of Myelination
Muscles of Pectoral Region, correlations
Hypophysis cerebri, Development CNS
Mammary Gland, Boundaries and
of cerebellum, Peripheral nervous
Contents of Axilla, Brachial plexus
system: somatic and autonomic,
02. Front Of Arm Identification of relevant skeletal Epitrochlear lymph Fracture of the
Principles of neurobiotaxis,
And Cubital features, Subcutaneous structures, nodes, Nerve Humerus
Functional components of cranial Fossa injuries
Deep fascia, Muscles, Nerves and
nerves, Neural Tube defects
Arteries of front of arm, Cubital
16. Organs Of Eye: Embryologic source of Common “TORCH” group Fossa, Anastomosis around the
Special Senses each component and their fate, anomalies of the of infection and its elbow joint
Development of Ear eye and ear complication 03. Scapular Region Identification of relevant skeletal Nerve injuries,
17. Integumentary Skin and its appendages, Pigmentary And Back of The features, Deep fascia, Ligaments,
Scapular
Development and anomalies of disorders and Arm. Muscles, Nerves and blood vessels of
System Anastomosis
Mammary Gland dermatoglyphics, back of arm and scapular region,
Icthyosis Quadrangular and triangular spaces

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M.B.B.S CURRICULM M.B.B.S CURRICULM

04. Front Of Identification of relevant skeletal Volkman’s Pulp space Lower Limb
Forearm And features, Subcutaneous structures, Ischaemic infection Sl.
Palm Contracture, Units Must know Desirable to know Nice to know
Deep fascia and its modifications No
Dupuytren’s 01. Anterior Dermatomes, Subcutaneous Femoral hernia, Abnormal
Muscles, Synovial sheaths of long
Contracture and Medial structures, Great Saphenous Vein- Referred pain Obturator
flexor tendons, Nerves and blood
Compartment of course & tributaries, Deep Fascia, around Hip artery, Meralgia
vessels, Palmar spaces of hand,
Thigh Muscles, Blood vessels, Lymph and Knee Joint Paresthetica,
Vinculae, Flexor retinaculum of
Nodes and Lymphatics, Femoral and Accessory Femoral Artery
wrist, Carpal Tunnel Syndrome, Claw
Triangle & Adductor Canal, Inguinal Obturator Nerve Catheterization,
Hand
Ligament.
05. Back Of Identification of relevant Skeletal Wrist Drop,
02. Gluteal Region Cutaneous innervations and muscles Sacral Plexus and
Forearm And features, Subcutaneous structures,
Pseudo-ganglion in Gluteal region, blood vessels, IM its branches,
Dorsum of Deep fascia and its modifications, injections, Sciatica Pudendal block,
Hand
Muscles, Fascial compartments and Trendelenburg’s
structures passing through them, Sign
Nerves and Blood vessels
03. Back of Thigh Dermatomes, Subcutaneous Anastomosis
06. Joints of The Sternoclavicular And Joint dislocation, Subacromial structures, Hamstring Muscles around Hip Joint
Shoulder Girdle Acromioclavicular Joints: Adhesive Bursitis Sciatic Nerve and its branches
and Shoulder Identification of relevant skeletal capsulitis, Blood Vessels
Joint features, Ligaments, Intra­articular Rotator cuff Tear 04. Popliteal Fossa Superficial structures, Boundaries Popliteal Pulse and Sural Nerve Grafts.
structures, Movements, Nerve supply and contents, Anastomosis around Aneurysm
Shoulder Joint: Identification of knee joint
relevant skeletal features, relation
05. Leg (Anterior, Dermatomes, Subcutaneous Foot drop, Fibular Graft
Ligaments, Intracapsular structures,
lateral and structures, Great and Small Compartment
Movements, Nerve and arterial Ossification of
Posterior Saphenous Vein, Deep Fascia and its syndrome
supply, Bursae related to the joint Fibula
compartment modification, Muscles, Blood vessels,
of Leg) and Nerves
07. Elbow, Radio- Elbow Joint-Identification of relevant Pulled elbow,
Dorsum of Foot
ulnar, Wrist And skeletal features, Articular surfaces, Tennis Elbow
Joints Of The relation, Ligaments, Nerve and blood 06. Sole Plantar aponeurosis, layers of Sole, Calcaneal spur
and Golfer’s
Hand supply and Movements Plantar arterial arch, Cutaneous Plantar Fasciitis
elbow, Weight
innervation
Proximal and Distal Radio­Ulnar transmission to
Joints-Identification of relevant upper limb, Colles 07. Hip Joint Type, Articulating bones, Ligaments, Femoral neck Congenital
skeletal features, Capsule, Ligaments, fracture, Carrying Movements & Muscles involved, Fracture, dislocation of hip,
Intra-articular structures, Movements angle Relations, Nerve and Blood supply, Dislocation of Hip Perthe’s test,
Bursae related to the joint Joint Nelaton’s Line,
Middle Radio­Ulnar Joint
Wrist Joints: Identification of Bryant’s Triangle
relevant skeletal features, Ligaments, 08. Knee Joint Type, ligaments, muscles, Meniscus tear, Patellar
Movements Movement, Locking & Unlocking, Cruciate ligament dislocations,
First Carpometacarpal Joint :Type Relations, Factors for stability of tear, Housemaid’s Knee Joint
and movements joint, Nerve and Blood supply, knee, Baker’s cyst replacement
Bursae related to the joint

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M.B.B.S CURRICULM M.B.B.S CURRICULM

09. Ankle Joint Type, Articulating bones, ligaments, Pott’s Fracture, Dislocation of 04. Pericardium and Parts of pericardium, Pericardial Referred pain in Pericardial
Relations, Movements & Muscles, Ligament Tear Ankle Joint Heart sinuses, External & Internal ischemic heart effusion, Aortic
Nerve and Blood supply features of heart, Fibrous skeleton diseases Window,
10. Joints of Foot Subtalar, Midtarsal and Tarso- Ligaments around of Heart , coronary circulation, Coronary
metatarsal joints : Types, Articulating the joint Nerve supply of pericardium and angiography
bones and movements heart
11. Arches of Foot Skeletal frame work of foot, Flat foot, Morton’s Weight
Abdomen
Classification & Components of Metatarsalgia, Transmission
arches, Factors for maintenance of Sl. Desirable to
CTEV, Units Must know Nice to know
Arches No know
12. Venous and Major Veins and Perforators, Venesection, Deep Vein 01. Ant. Abdominal Wall Relevant Surface anatomy and Holden’s line, Langer’s lines,
lymphatic Varicose veins, Inguinal and Popliteal Trendelenburg test Thrombosis & Ext. Genitalia Osteology, Abdominal planes Extravasation of Incisions of
Drainage of group of lymph nodes and quadrants , Dermatomes, urine, abdomen
lower Limb Layers of anterior abdominal Caput Medusae and Incisional
Thorax wall, Flat muscles , Rectus sheath Hernia,
Sl. and contents, Inguinal canal and Torsion of
Units Must know Desirable to know Nice to know
No hernias, spermatic cord, testis, testis, Umbilical
01. Thoracic Wall Skeletal features, Intercostal Spaces Pleural tapping Skeletal deformity layers of scrotum, Cremasteric hernia
including muscles, nerves, arteries of chest reflex,
and veins. Joints of the thorax, Porto-Caval Anastomosis,
Intercostal nerve block, Mechanism Lymphatic Drainage
of respiration
02. Abdominal Cavity Orientation of abdominal viscera, Peritoneal recesses
02. Mediastinum Definition, divisions, boundaries and Mediastinal Oesophagoscopy
and Peritoneum Disposition of peritoneum with (fossae), Ascites
contents of each Mediastinum Syndrome,
Mediastinitis, peritoneal folds including greater
Detail about the following
and lesser omentum, greater and
structures : Trachea, Oesophagus, Aortic Aneurysm,
lesser sac, Nerve supply of the
Thoracic Duct, Thymus, Vena Cava, Tracheostomy,
peritoneum and Referred pain,
Azygos Venous System, Arch of
Venacaval Functions of peritoneum
Aorta, And Descending Thoracic
obstruction
Aorta, Sympathetic chain 03. Stomach External features and Relations Gastric ulcer and Traube’s space
and collateral
& Stomach bed, Blood supply, Vagotomy
circulation
Lymphatic drainage, Nerve
03. Pleura and Parts of pleura, Lines of pleural Pleurisy, Mendelson’s
supply
Lungs reflection, Pleural recesses, Haemothorax, syndrome, Pan
04. Duodenum, External features, relations, Paraduodenal
Paracentesis Thoracis, surfaces and Chylothorax, Coast Tumour,
Jejunum, Ileum Internal features, Blood supply, fossa,Ligament of
borders of lungs, lobes of lungs, root, Empyema, Segment
Nerve supply and lymphatic Treitz,
fissures and Relations, Blood supply, Pneumothorax, pulmonary
Nerve supply, lymphatic drainage of Foreign Body resection drainage Duodenal ulcer &
pleura and lungs, Bronchopulmonary Aspiration, cap
segments Bronchoscopy, 05. Caecum, Vermiform External features, including Appendicitis
Surgical Appendix relations, position, Internal
significance of lung and Colon features, Blood supply, nerve
abscess supply and lymphatic drainage

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M.B.B.S CURRICULM M.B.B.S CURRICULM

06. Liver External features, relations, Liver Biopsy Pelvis

Blood supply, Nerve supply,
Sl. Desirable to
Lymphatic drainage, Segments, Units Must know Nice to know
No know
Peritoneal ligaments and Bare
01. Perineum Boundaries, Subdivisions, Colle’s Rupture of Perineal tear,
areas
fascia & Perineal membrane urethra & Episiotomy,
07. Extrahepatic Components, External and Callot’s triangle, Urogenital diaphragm, Perineal extravasation of Prolapse of pelvic
Biliary internal features, Relations, Blood Murphy’s sign body, Pelvic diaphragm, Perineal urine, Ischiorectal organs
Apparatus supply, Nerve supply, Lymphatic pouches: Boundaries, contents, Abscess
drainage. Gall Bladder and Nerve supply of the perineum,
Common Bile Duct Boundaries & contents of
08. Pancreas Parts ,External features and Anatomical basis of Ischiorectal Fossa
relations, Blood supply, Nerve Obstructive jaundice.
02. Pelvis Types of Bony pelvis, Pelvic Urinary stress Dimensions of female
supply and Lymphatic drainage,
Fascia, Pelvic diaphragm, Nerves incontinence pelvis
Duct system of pancreas
& sacral plexus, Vessels, Sacroiliac
09. Spleen Gross features with relations and Splenomegaly, joints
peritoneal supports, blood supply, Splenectomy
lymphatic drainage, Functions 03. Urinary External features & relations Neurogenic Suprapubic cystostomy
Bladder (in male and female), Internal bladder
10. Kidney and Kidney: External features Morrison’s features, support, Nerve supply,
Ureters including relations, Coverings, parallelogram, Blood supply and Lymphatic
internal features, Blood supply, Ureteric colic drainage
Nerve supply and lymphatic
drainage, 04. Prostate, Male External features, relations, Benign prostatic Per rectal examination,
Ureter: Extent, course & Urethra and Internal structure, Blood supply, hypertrophy, Urethral
terminations, Parts and Relations, Seminal Lymphatic drainage, Age changes Carcinoma Catheterization
Blood supply and Lymphatic Vesicle of prostate gland prostate
drainage
05. Ovary, Uterus External features, relations, Upper and lower Hysterosalpingography
11. Supra Renal External features, relations; Blood and Fallopian Position, ligaments, Blood uterine segments
Gland supply Tube supply, Nerve supply and Lymph Prolapse of
drainage of ovary, uterus and uterus,
12. Diaphragm Attachment, Openings, Nerve Subphrenic spaces Phrenic nerve
Fallopian Tube, Supports of uterus Hysterectomy,
supply, Functions injury, Hiccup
13. Portal Vein Formation &Tributaries, Parts & Portal Hypertension Tubectomy
Relations, Porto­Caval Anastomosis
06. Sigmoid Goss anatomy including relations Per rectal Hirschsprung’s Disease
14. Aorta, Inferior Extent, Course & Termination, IVC obstruction, Colon, and External and internal features, examination,
Vena cava Relations, Branches and Aortic aneurysm Rectum and Blood supply, Nerve supply and Haemorrhoids,
Tributaries
Anal Canal Lymphatic drainage Anal Fissure and
15. Posterior Muscles, Fascia, lumbar plexus, External Vertebral Fistula in ano,
Abdominal Sympathetic trunk and pelvic Venous Plexus Perianal abscesses
Wall splanchnic nerves.

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Head & Neck 10. Eyeball Layers and Chambers of Eyeball, Reflexes Argyll-Robertson
Optic Nerves and pathway, Lesions of Optic Pupil
Sl.
Units Must know Desirable to know Nice to know Intrinsic muscles of Eyeball, pathway
No
Ciliary Nerves and Vessels
01. Scalp Layers, Vessels, nerves and
lymphatic drainage, applied 11. Nose and Structure and features, Nerve Little’s Area and
anatomy of each layer Paranasal supply, Blood supply of different Kiesselbach’s Plexus
Sinuses areas of Nose, Olfactory Nerve,
02. Face and Cutaneous Innervation, Muscles Bell’s Palsy, Plane for Superficial
Paranasal Sinuses with their
Parotid of Facial Expression, Vascular Frey’s Syndrome Parotidectomy
functions
Region supply and lymphatic drainage,
Parotid Gland, Extra-cranial 12. Temporal and Boundaries and Communication, Fracture of spine of
Part of Facial nerve, Lacrimal Infratemporal Contents, Muscles of Mastication, sphenoid, Ankylosis
Apparatus, Eyelid Region Temporo-mandibular Joint, of Temporo-
Boundaries and Contents of mandibular Joint
03. Cervical Components with their tracings, Cold Abscess
Pterygo-palatine Fossa
Fascia attachments and modifications,
Fascial planes, Spaces in neck and 13. Submandibular Boundaries and Contents, Sialolithiasis
their contents. Region Submaxillary and Sublingual
salivary glands, submandibular
04. Posterior Boundaries, Subdivisions, Subclavian Steal Accessory phrenic ganglion, Ganglions-Locations
Triangle Contents syndrome, Wry nerve and Connections, Hypoglossal
neck Nerve
05. Anterior Boundaries, Subdivisions, 14. Oral Cavity Tongue, Lips, Palate, Teeth, Lesion of XII nerve Alternate taste
Triangle of Contents pathway
Neck Thymus and Thyroid Gland
15. Pharynx Introduction, Parts/Divisions, Mechanism of
06. Deep Sympathetic Trunk, IX, X and XI Relations, internal features, Deglutition
Dissection of Nerves, Muscles, Blood vessels, Muscles, Blood supply, Nerve
Neck Lymph nodes supply, Lymph nodes and
Lymphatics, Killian’s Dehiscence
07. Suboccipital Boundaries and Contents of Cisternal Puncture
Triangle and Triangle, Deep Muscles of Back of 16. Larynx Components Cartilages, Hoarseness of Laryngoscopy
Back of Neck Neck Ligaments, internal features, Voice, Laryngotomy
Muscles , Blood supply,
08. Cranial Cavity Cranial fossae, Meninges and Pituitary Tumour Lymphatic drainage, Nerve supply
Dural Folds, Dural Venous
Sinuses, Pituitary Gland, 17. Ear Parts and features of External, Otitis Externa, Otitis Tests for Deafness
Cavernous Sinus Thrombosis, Middle and Internal Ear, Blood Media, Otosclerosis
and Nerve supply, Lymphatic
09. Orbit and Its Bony Orbit-Boundary, fascia Applied anatomy of
drainage, VII and VIII Nerve
Contents bulbi, ligaments, Extra-ocular III,IV and VI Cranial
(Course, Branches and Applied
muscles and LPS, Nerves (III, Nerves
anatomy)
IV and VI Cranial Nerves and Visual axis
18. Joints of The Craniovertebral joints
ophthalmic nerve) and Vessels of Orbital axis Head
Orbit, movements of eyeball
and Neck

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M.B.B.S CURRICULM M.B.B.S CURRICULM

Neuroanatomy 07. Cerebellum External Features and Cerebellar lesions,

Morphological classification of signs and symptoms
Sl.
Units Must know Desirable to know Nice to know Cerebellum with connections, Anatomical
No
Internal features i.e. cellular correlations
01. Introduction Development of neural tube
organisation and nuclei. Blood
and its derivatives, Subdivisions:
supply, Afferents and efferents
CNS, PNS and AN,; Neurons
of all the cerebellar peduncles,
and Neuroglia types and
Functions of Cerebellum
functions
08. Diencephalon Thalamus, Hypothalamus, Connections of
02. Peripheral Cranial and Spinal nerves, Metathalamus, Epithalamus, Thalamus and
Nervous Nerve endings: receptors, Subthalamus, Morphology hypothalamus.
System and Relations of thalamus, Lesions of the
effectors
Classification and, Blood supply thalamus and
Hypothalamic nuclei, and hypothalamus and
03. CNS: Spinal External features and Coverings, Lumbar puncture;
Cord functions their effects
Internal features, Sections of Lesions at various
spinal cord at: cervical, thoracic, levels and their 09. Cerebral Lobes, Poles, Borders,
lumbar & sacral regions, Blood effects. Hemispheres Surfaces, Sulci and Gyri, Major
supply; Brodmann’s Areas, Blood supply
of brain- Circle of Willis: Central
04. Medulla External and internal features, Medullary syndromes and cortical branches, Venous
Oblongata Cranial nerve nuclei, Sections at drainage
the motor decussation, sensory 10. White Matter White matter: Types of fibres, Lesions of Internal • Upper and
decussation and at the level of Cerebral Internal capsule and Corpus Capsule, Agenesis of Lower Motor
of Olive, Floor of the fourth Hemispheres Callosum in Detail Corpus Callosum Neuron Paralysis
ventricle, Inferior cerebellar
peduncle, Blood supply
11. Basal Ganglia Morphology and Relations, Basal ganglia lesion
Connections of basal ganglia
05. Pons External and internal features, Pontine
Extrapyramidal system:
Floor of fourth ventricle, haemorrhage,
Components and functions
Sections through upper and
Millard-Gubler
lower pons, Cranial nerve 12. Limbic Parts, Connections and Lesions of Limbic • Circuit of Papez,
syndrome and
nuclei, Middle cerebellar System Functions system
Foville’s Syndrome Wernicke–
peduncle, Blood supply
Korsakoff syndrome
13. Reticular Definition, Components and Lesions of Reticular
06. Midbrain External features, internal Weber’s syndrome
Activating Functions Activating System
features, Cerebral aqueduct, and Benedict’s
System
Sections at the level of superior syndrome
and inferior colliculi, Nuclei of 14. Meninges Dura mater: Cranial and spinal Applied anatomy
cranial nerves, Blood supply And Blood differences, Arachnoid mater, of the Meningeal
Supply Pia mater, Spaces in between vessels
them, Meningeal vessels

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15. Cerebrospinal Choroid plexus, Production, Hydrocephalus, Ventriculo- MODEL QUESTION PAPER
Fluid: Circulation and Absorption of Peritoneal and
Arnold-Chiari ANATOMY
the CSF Ventriculo-Atrial
Malformations PAPER-I
Shunts
16. Fourth Extent, Boundaries, Features Cerebello-Pontine • Cisternal Total Marks- 100 Time: 3 hours
Ventricle of Floor, Communications, Angle puncture
• Answer all questions.
Relations • Queckenstedt’s
test • Answer the questions in the same serial order strictly.
• Illustrate your answers with well labelled diagram wherever necessary.
17. Lateral and Extent and Parts, Relations, • Choroid fissure
Third Ventricle Communications • Tel choroidae • Answer each section in a separate answer book.

18. Cranial General Concepts, Cranial nerve Effect of lesions of

SECTION A
Nerves nuclei, Functional components, Cranial Nerves
Course and distribution General Anatomy, General Histology, General Embryology, Genetics, Upper Extremity and
19. Autonomic Sympathetic and Horner’s syndrome Lower Extremity
Nervous Parasympathetic:– Components,
1. Describe in detail the mammary bed, structure, blood supply and lymphatic drainage of
System Functions and Regulation
mammary gland.  [2+3+2+3=10]

2. Write short notes on: [5×5 marks=25]

Relevant skeletal features and Surface Anatomy and radiology to be included in discussion of a. Blood supply of long bone.
Corresponding Sections.
b. Medial longitudinal arch of foot.
c. Features of Down’s syndrome.
d. Derivatives of neural crest cells.
e. Transitional epithelium.

3. Answer in brief:  [5×3 marks=15]

a. Explain the embryological basis of non-rejection of placenta during pregnancy
b. Explain the anatomical basis of foot drop.
c. List the features of Erb’s palsy.
d. Clinical significance of End-arteries.
e. Compare and contrast anterior and posterior cruciate ligaments.

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SECTION-B Model Question Paper

ANATOMY
Abdomen, Pelvis & Perineum (with related histology and embryology)
PAPER-II
1. Describe in detail the Uterus under following headings. [3+3+2+2=10] Total Marks- 100  Time: 3 hours
• Parts and relations • Answer all questions.
• Supports • Answer the questions in the same serial order strictly.
• Blood supply and lymphatic drainage. • Illustrate your answers with well labelled diagram wherever necessary.
• Developmental anomalies. • Answer each section in a separate answer book.

2. Write short notes on:  [5×5 marks=25] SECTION A

a. Formation and contents of Rectus sheath Head& Neck, Face and Special senses (with related histology and embryology)
b. Relations of Second part of Duodenum
1. Describe in detail the Thyroid gland under following headings. [3+2+2+3=10]
c. Microscopic structure of adrenal gland
• Parts and Relations
d. Rotation of mid-gut
• Blood supply
e. Hepato-renal pouch
• Microscopic structure
3. Answer in brief: [5×3 marks=15] • Developmental anomalies
a. Explain the anatomical basis of vertebral metastasis in carcinoma of prostate.
2. Write short notes on:  [5×5 marks=25]
b. Compare and contrast superficial and deep perineal pouch
a. Lymphatic drainage of tongue
c. Explain the anatomical basis of referred pain in ureteric colic.
b. Relations of cavernous sinus
d. Enumerate the contents of pudendal canal.
c. Functional component and nuclei of facial nerve
e. List the functions of Sertoli cells
d. Microscopic structure of Layers of Retina
e. Cleft lip and palate

3. Answer in brief: [5x3 marks=15]

a. Which layer is known as dangerous layer of Scalp and why?

b. Explain with reason the safety muscle of larynx.
c. Enumerate the derivatives of second pharyngeal arch.
d. Mechanism of Ludwig angina.
e. List the features of Horner’s Syndrome

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M.B.B.S CURRICULM M.B.B.S CURRICULM

SECTION B Recommended Books:

Gross Anatomy
(Thorax and Neuroanatomy (with related histology and embryology)
1. Susan Strandring: Gray’s Anatomy: The anatomical basis of clinical practice, Churchill
1. Describe in detail the parts, relations, and blood supply of internal capsule. Add a note on
Livingstone Elsevier.
vascular lesions of internal capsule. [3+2+2+3=10]
2. Dutta A.K. Human Anatomy vol. I-III Current Publisher.
2. Write short notes on: [5×5 marks=25]
3. Romanes. Cunningham’s Manual of Practical Anatomy vol. I-III, Oxford.
a. Branches and distribution of left coronary artery
4. R.S Snell. Clinical Anatomy by regions.Lippincot Williams and Wilkins.
b. Microscopic structure of cerebellum
c. Structures in floor of fourth ventricle Histology
d. Boundaries and contents of Superior Mediastinum. 1. Young B. and Heath J. Wheater’s Functional Histology.Churchill Livingstone.
e. Bronchopulmonary segments 2. Difiore’s. Atlas of histology with functional co-relation.
3. Answer in brief: [5×3marks=15] Genetics
a. Compare and contrast media and lateral medullary syndrome. 1. J. S Thompson and Thompson. Genetics in medicine. W.B. Saunders and Co.Philadelphia,
b. Rational of preconception supplementation of folic acid. London.

c. Clinical Basis of motor aphasia. Embryology

d. List the features of Tetralogy of Fallot. 1. TW Sadler. Langman’s Medical Embryology. Lippincotts, Williams and Wilikins.
e. Source of development of arch of aorta
2. Keith L Moore and T.V.N. Persaud. The Developing Human. Saunders.

Neuroanatomy

1. Richard S. Snell. Clinical Neuroanatomy for Medical Students. Williams and Wilkins.

2. Vishram Singh. Clinical Neuroanatomy.Elsevier.

Surface anatomy

Halim. and A.C. Das. Surface Anatomy Lucknow. ASI, KGMC.

General Anatomy

A.K.Datta

Reference book for all- Gray’s Anatomy (41st Edition)

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PHYSIOLOGY
GOAL
Imparting a comprehensive knowledge of functioning of cells, organs and organ systems of hu-
man body to understand physiological basis of health and disease.

COURSE OBJECTIVES :
Knowledge:
1. Explain the normal functioning of all the organ systems of the body.

2. Describe the contribution of each organ system to the maintenance of homeostasis

3. Elucidate the physiological aspects of normal growth and development

4. Describe the physiological response and adaptations to environmental stresses

5. Explain the physiological principles underlying pathogenesis and treatment of disease.

Psychomotor and clinical Skills:

1. Perform experiments designed for study of physiological phenomena and for assessment of

PHYSIOLOGY
function

2. Analyse and interpret experimental/investigative data critically

3. Distinguish between normal and abnormal data derived as a result of test which student has
performed and observed in the laboratory

4. Acquire a list of clinical skills at the introductory level

Integration:

1. Acquire an integrated knowledge of organ structure and function.

2. Understand the regulatory mechanisms and pathophysiology of diseases.

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M.B.B.S CURRICULM M.B.B.S CURRICULM

COURSE MUST KNOW (70%) GOOD TO KNOW (20%) NICE TO KNOW COURSE MUST KNOW (70%) GOOD TO KNOW (20%) NICE TO KNOW
CONTENT (10%) CONTENT (10%)
GENERAL Introduction to Features, process and Consequences of NERVE-MUSCLE Neuromuscular Myasthenia gravis,
PHYSIOLOGY Physiology and functional importance of feedback failure of homeostatic PHYSIOLOGY Junction of skeletal Lambert-Eaton
organization of human mechanisms mechanisms with muscle, neuromuscular syndrome
body. examples transmission Neuro-muscular
Concept of Homeostasis blockers
and characteristics of
NERVE INJURIES Transneuronal
control systems
Chromatolysis, Wallerian degeneration
degeneration
CELL PHYSIOLOGY: Cytoskeleton and Clinical application
Physiology of the cell and molecular motors of fluid-mosaic SKELETAL, CARDIAC & Dystrophin-glycoprotein Duchenne’s and
cell organelles model of cell SMOOTH MUSCLES- complex, Size principle, Becker’s Muscular
Physicochemical G-proteins, second membrane structure dystrophies
Types and subtypes,
properties of cell messengers (especially of in vitro
structure, properties, Oxygen Debt, Heat
membrane Cell cycle and fertilization).
features of each muscle liberated during various
Transport across cell its regulation. Role of Patch clamp
Excitation contraction phases of contraction,
membrane Apoptosissites and its technique in study of
coupling in skeletal muscle Fenn effect
Intercellular role in physiology. membrane transport
and relaxation
communication Role of diffusion in proteins
dialysis Rigor Mortis
Failure of apoptosis NERVE-MUSCLE Isotonic versus isometric Body mechanics
Drugs that block various and its role in PHYSIOLOGY contractions
transport mechanisms the development
and their clinical use. of cancer, Factors affecting force
neurodegenerative of skeletal muscle
and autoimmune contraction, skeletal
diseases muscle fibre types, Motor
unit
Lysosomal storage
diseases Smooth muscle:
Structure, distribution,
Body fluid compartments Measurement of body Intravenous fluids types, molecular
- Classification, normal fluid compartments and their therapeutic mechanism of contraction,
values, composition and Indications and uses in fluid and properties, regulation, and
their important functions. physiological basis of electrolyte disorders disorders.
oral rehydration therapy.
BLOOD PLASMA-normal volume, Diseases affecting Plasmapharesis and
composition, plasma plasma protein its clinical relevance
NERVE Principles of bioelectricity Electrotonic potentials Demyelinating
protein concentration and concentration
MUSCLE Genesis of RMP Propagation of action diseases
their functions. Bone marrow structure
PHYSIOLOGY Action potential, potential Drugs that block Consequences of
and cellular elements.
compound action Strength-duration curve action potentials and hypoprotenemia
potentials. RBC- Method of
Axoplasmic flow their clinical use
NEURON- normal count, determination of life
Effect of hypoxia, physiological variations, span of R.B.Cs. Gower-I & II
Structure, types and pressure and local morphology, Principles hemoglobins
properties. Erythropoietin-source,
anesthetics on different of hemopoiesis , Hemoglobinopathies
Classification of stimuli, functions and
nerve fibres erythropoiesis and its
nerve fibers, Saltatory regulation
Nerve growth factors regulation,
conduction.

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M.B.B.S CURRICULM M.B.B.S CURRICULM

COURSE CONTENT MUST KNOW (70%) GOOD TO KNOW (20%) NICE TO KNOW (10%) COURSE CONTENT MUST KNOW (70%) GOOD TO KNOW (20%) NICE TO KNOW (10%)

BLOOD Hemoglobin- HbA1C Landsteiner’s law, ABO Bombay blood group, Autologous
physiological types, System – type A & B MN blood group transfusion
functions, fate of antigen, ABO system system, kernicterus and Other important
Polycythemia: Primary & & inheritance, relation exchange transfusion blood groups
hemoglobin
secondary. to transfusion, cross Cold antibodies
Anemia: classification,
causes, physiological matching major &
minor.
basis of symptoms
and principles of Rh System – inheritance,
management Rh incompatibility &
Blood indices, PCV & Erythroblastosis foetalis.
ESR Blood transfusion:
indications, storage of
BLOOD WBC- Physiological basis Consequences of blood & changes during
Normal count, of vaccination, failure of cell mediated storage, transfusion
reactions.
classification, complement and humoral immunity
features, functions, system, components Lymphokines CARDIOVASCULAR Functional anatomy Excitation-contraction Stokes-Adams
physiological and and functions of SYSTEM of cardiac muscle, coupling in myocardium Syndrome
pathological variations reticuloendothelial Endogenous pyrogens properties of cardiac Sick-sinus syndrome
(in brief), system AIDS muscle, cardiac
Granulopoiesis staes Organ transplantation innervation
and regulation CONDUCTING
Graft rejection
SYSTEM-Components
Immunity: of conducting system,
definition, types origin and spread
of immunityInnate of cardiac impulse,
& Acquired & pacemaker potential
their mechanism,
B lymphocytes, ECG: Physiologic Cardiac arrhythmias Long QT syndrome
Tlymphocytes & their basis of ECG, ECG changes in Holter monitoring
types, concept of method of recording, myocardial infarction
antigen & antibody, characteristics of normal and alterations in the
cell mediated & ECG ionic composition of the
humoral immunity, body fluids
Primary & secondary
response, CARDIOVASCULAR CARDIAC CYCLE- Jugular venous pulse, Abnormal pulse types
SYSTEM pressure – volume arterial pulse
BLOOD PLATELETS: structure, Thrombocytopenia Disseminated changes in different Murmurs
functions purpura. intravascular phases, Functional basis
Hemostasis coagulation of heart sounds Heart
Thrombosis and
Blood component rate & its regulation
Tests for hemostasis thrombolysis
therapy.
Haemophilia. Anticoagulants Cardiac output: normal Measurement of cardiac
Effects of splenectomy.
BLOOD GROUPS- commonly used & their values, physiological output – principles
Basis, inheritance and mechanism of actions variations, factors
importance of the affecting cardiac output,
blood groups. regulation

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COURSE CONTENT MUST KNOW (70%) GOOD TO KNOW (20%) NICE TO KNOW (10%) COURSE CONTENT MUST KNOW (70%) GOOD TO KNOW (20%) NICE TO KNOW
(10%)
CARDIOVASCULAR Cardiovascular RESPIRATORY Pulmonary Circulation V/Q abnormalities, Pulmonary wedge
SYSTEM regulatory mechanisms SYSTEM Ventilation perfusion ratio clinical conditions pressure and its
Nutrition and (V/Q) associated with clinical implications
metabolism of the heart abnormal dead space
volumes
CIRCULATION Hemodynamics of Mayer’s waves and
circulation Traube -Hering wave Diffusion of Gases Atelectasis, Adult
Sympathetic vasodilator Exchange of respiratory respiratory distress
Neural and local control gases at alveolar-capillary syndrome
of circulation system
membrane, factors
Blood pressure: Normal Hypertension, Physiological basis of affecting diffusion.
levels, measurement, Hypotension treatment Carriage of oxygen, role Carbon monoxide
determinants, short term of Hemoglobin, oxygen poisoning
& long-term regulation dissociation curve &
Capillary circulation, Lymphatic system: factors affecting it.
tissue fluid formation. Anatomy & structure, RESPIRATORY Carriage of carbon Carbon-dioxide CO2 narcosis
formation of lymph, SYSTEM dioxide dissociation curve
composition of lymph, Control of Breathing : Abnormal breathing Oxygen therapy
functions of lymphatic Neural control – higher patterns O2 toxicity,
system, lymph flow & centers, reflexes. hyperbaric O2
Respiratory adjustments
factors affecting it. therapy
Chemical control – in exercise.
Pathophysiological basis central & peripheral Hypoxia, cyanosis and
of edema chemoreceptors, role of dyspnea Artificial respiration
Regional circulation: Cutaneous, visceral, Methods of CO2, O2, H+ Pulmonary function tests
Physiologic anatomy, muscle and fetal and measurement of
factors affecting, special neonatal circulation regional circulation ENVIRONMENTAL Body temperature Heat cramps Hypothermia
features: coronary and PHYSIOLOGY regulation : in cold and Heat exhaustion and its clinical
cerebral circulation hot environment Heat stroke applications
Shock – classification, Physiological basis of Physiological responses to High altitude pulmonary
pathophysiologic basis, treatment of shock high altitude and cerebral edema
Compensatory Physiological responses Graded decompression
mechanisms, to high atmospheric
Uncompensated shock pressure
RESPIRATORY Physiologic anatomy - Non-respiratory Cystic fibrosis Space physiology
SYSTEM Functions of respiratory functions of lung EXERCISE Energy dynamics in Classification of physical
system exercise activity based on energy
PHYSIOLOGY
Mechanics of breathing: Asthma, COPD and Cardiorespiratory changes expenditure
Ventilation : Inspiratory difference between in exercise Effect of training
& expiratory muscles, obstructive and EXCRETORY KIDNEY- renal capsule, Reno-renal reflex
intrapleural pressure restrictive lung diseases SYSTEM nephron segments and Renal hypertension
Lung volumes and their functions, difference
capacities. between cortical
and juxtamedullary
Pulmonary ventilation, nephrons, peculiarities
alveolar ventilation, of renal circulation, Juxta
alveolar dead space glomerular apparatus

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COURSE CONTENT MUST KNOW (70%) GOOD TO KNOW (20%) NICE TO KNOW (10%) COURSE CONTENT MUST KNOW (70%) GOOD TO KNOW (20%) NICE TO KNOW (10%)

Glomerular filtration Concept of clearance STOMACH-Gastric Vomiting, pernicious Zollinger-Ellison

rate and its regulation glands, gastric anemia, peptic ulcer Syndrome,
juice- volume, pH, NSAIDS
Renal tubular Regulation of fluid Diuretics – composition, functions
reabsorption and electrolyte balance physiological basis of and regulation.
secretion Regulation of acid-base action
balance SMALL INTESTINE- Peyer’s patches Malabsorption
URINARY BLADDER- Cystometrogram, Pathophysiology Intestinal glands, (‘M’ or microfold syndrome
Nerve supply, disorders of micturition of renal failure composition, functions cells), adynamic ileus,
Micturition reflex. Hemodialysis & and regulation of Ileocecal valve
Peritoneal dialysis intestinal juice,
GASTRO- Functional anatomy of Enteric nervous system- APUD Cells movements of small
INTESTINAL gastrointestinal tract and components, functions intestine
SYSTEM innervation of G.I.T. and regulation;
PANCREAS- Steatorrhea
Basic electric rhythm, composition, functions
migrating motor and regulation of
complex; pancreatic juice.
Movements of the
GIT-Mastication, GASTRO- LIVER- Microscopic Pre-hepatic, hepatic Liver function tests
deglutition, peristalsis, INTESTINAL structure, functions of and post hepatic
receptive relaxations, Barium meal studies, SYSTEM liver, composition of jaundice and their
antral contractions, endoscopy bile, cellular mechanism features
segmentations, of bile formation,
pendular, villi Cholecystectomy,
enterohepatic
movements; Cholelithiasis or
circulation of bile salts,
haustrations, gallstones
control of secretion,
defecation. concentration & storage
GI HORMONES- Motilin , VIP, GIP and of bile in gall bladder.
Gastrin, secretin, CCK- Ghrelin Filling & evacuation of
PZ, (source, stimuli, gall bladder,functions of
inhibition, actions) gall bladder

SALIVARY GLANDS- Xerostomia, Sialorrhoea LARGE INTESTINE- peristaltic rush, mass Aganglionic
innervation, salivary Functions of large peristalsis, Gastrocolic megacolon or
composition, functions intestine, defecation and ileoileal reflexes, Hirschpung’s disease
and regulation reflex, dietary fiber constipation and
diarrhea
GASTRO- Phases of deglutition Dysphagia
INTESTINAL (swallowing), NUTRITION Concept of balanced Recommended dietary Pre-biotics and Pro-
SYSTEM mechanism. diet - factors affecting allowances biotics
ESOPHAGUS- functions Achalasia cardia, Gastroesophageal caloric requirements - Nutrition under special Glycemic index
of lower esophageal reflux disease. requirements of various conditions – pregnancy,
sphincter nutrients, sources, daily lactation, growing child.
needs.

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M.B.B.S CURRICULM M.B.B.S CURRICULM

COURSE CONTENT MUST KNOW (70%) GOOD TO KNOW (20%) NICE TO KNOW (10%) COURSE CONTENT MUST KNOW (70%) GOOD TO KNOW (20%) NICE TO KNOW (10%)

NERVOUS SYSTEM Introduction to Transport across Blood NERVOUS SYSTEM Functions of Obesity
neurophysiology Brain barrier Hypothalamus
Cerebrospinal fluid Lumbar puncture Limbic system- Kluver-Bucy syndrome Effect of Sex
Neuroglial cells Hydrocephalus components and Addiction hormones on
Neurotransmitters and functions behaviour
neuromodulators
Ascending reticular
activating system-
Sensory Receptors- Signal detection,
Clasification and components & function
transmission and
properties interpretation of Electroencephalography Clinical uses of EEG
Synapse- types, synaptic stimulus intensity (EEG) ( Brief )
transmission and and processing of Neurophysiology of Genesis of slow wave Sleep disorders
properties information sleep sleep and REM sleep
Ascending sensory Cerebral cortex-Lobes,
pathways functional areas and
their functions
Thalamus Thalamic syndrome
Learning and memory Long-term potentiation Alzheimer’s disease
Somatosensory cortex Cortical plasticity Effect of cortical Long-term depression and senile dementia
and association areas lesions
Neurophysiology of Language disorders
NERVOUS SYSTEM Physiology of pain Central inhibition and Headache speech
sensation counter-irritants Herpes zoster ANS ANS-Functions of Horner’s syndrome
Endogenous pain Tic Douloureux sympathetic and
Physiological basis of parasympathetic
regulatory mechanisms use of Analgesics divisions.
Organization of motor Spinal processing of
system and Motor cortex information SPECIAL SENSES Functional anatomy of Processing of colour Glaucoma and
Reflexes- classification, the eye and optics vision physiological basis of
Physiology of
characteristics and Retina: Photoreceptors, Colour blindness treatment
locomotion
properties signal transduction and
perception, color vision
Nystagmus
Descending pathways Physiological basis of visual field defects
neural deficits caused Central visual pathway
and visual cortex
by lesions at various
levels of the neuraxis Physiology of hearing, Tests of hearing Meniere’s disease
external ear and middle
ear
Basal ganglia Parkinson’s disease Chorea and Athetosis Audiometry
Cochlea: Structure and
signal transduction
Cerebellum Cerebellar disorders Auditory pathways and
auditory cortex
Posture and equilibrium Disorders of gait Vestibular apparatus:
Structure & Function

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M.B.B.S CURRICULM M.B.B.S CURRICULM

COURSE CONTENT MUST KNOW (70%) GOOD TO KNOW (20%) NICE TO KNOW (10%) COURSE CONTENT MUST KNOW (70%) GOOD TO KNOW (20%) NICE TO KNOW (10%)

Physiology of olfaction Disorders of the taste REPRODUCTIVE Biological rhythms

SYSTEM
Physiology of gustation Disorders of the smell
Growth, development Theories of aging
and aging
ENDOCRINE Mechanism of hormone
SYSTEM action Sex determination and Factors affecting Male infertility
Hypothalamo-pituitary differentiation, spermatogenesis
axis MALE-endocrine
functions of testes
ENDOCRINE Anterior Pituitary- Gigantism and regulation of Blood-testis barrier
SYSTEM Hormones secreted Acromegaly testosterone, male
from it their regulation Dwarfism pubertal changes.
and actions Functions of sertoli cells
Posterior Pituitary- Diabetes insipidus Composition and
Hormones and their Syndrome of functions of semen
actions and regulation inappropriate secretion
of ADH ( SIADH) FEMALE-oogenesis, Menstrual disorders,
actions of estrogen Menopause
Thyroid Gland- Hyper and and progesterone,
Biosynthesis, actions hypo-thyroidism phases and hormonal
and regulation of regulation of menstrual
thyroid hormones cycle, indicators for
Parathyroid Glands- Imbalance of calcium ovulation
Plasma calcium and homeostasis Maternal changes Pregnancy tests IVF methods
phosphorus regulation during pregnancy,
by PTH, Vit.D3 and functions of placenta,
Calcitonin parturition reflex,
Adrenal Cortex- Cushing’s disease Basis and features lactation
Biosynthesis, actions Addison’s disease of Adrenogenital Contraception
and regulation secretion Conn’s syndrome syndrome YOGA Physiology of yoga Yoga in health & disease
of hormones secreted
from adrenal cortex
Suggested Topics for Integration:
Adrenal Medulla
• Diabetes mellitus
Pancreas-cells of Islets Physiological basis Oral hypoglycemic
• Anaemia
and their secretions. of complications of agents
Actions and regulation diabetes mellitus • Thyroid
of insulin secretion, • Coronary circulation and myocardial infarction
types of diabetes
• Jaundice
mellitus, basis and
features of diabetes • Cerebellar disease
mellitus. • Dialysis
Regulation of blood
• Acid-base balance
glucose

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M.B.B.S CURRICULM M.B.B.S CURRICULM

Practicals: Cardiovascular system

Haematology: • Recording and analysis of 12 lead electrocardiogram

• Measurement of blood pressure
• Preparation and examination of peripheral blood smear and identification of cells
• Determination of the effect of posture on blood pressure
• Determination of differential leucocyte count
• Determination of the effect of exercise on blood pressure
• Determination of total red blood cell count
• Determination of physical fitness of a subject using screening tests
• Determination of total leucocyte count
• Measurement of blood flow in the forearm by venous occlusion plethysmography and to
• Determination of reticulocyte count
demonstrate the effect of (a) Exercise, (b) Arterial occlusion, and (c) Temperature
• Determination of osmotic fragility of erythrocytes
• Clinical examination of the human cardiovascular system (CVS)
• Determination of platelet count
• Demonstration of the properties of cardiac muscle in the frog
• Determination of eosinophil count
• Study of the factors controlling inotropic and chronotropic functions in isolated perfused
• Determination of haemoglobin concentration of blood frog’s heart
• Determination of erythrocyte sedimentation rate and packed cell volume and calculation • Demonstration of exercise stress test
of the absolute values
• Determination of ABO and Rh blood groups Respiratory system:
• Determination of bleeding time, clotting time • Recording of chest movements by a stethograph and to study the effects of speech,
• Determination of Prothrombin time, activated partial thromboplastin time and fibrinogen swallowing, coughing, breath-holding and hyperventilation
time • Determination of various lung volumes and lung capacities
• Examination of bone marrow smear • Determination of maximum voluntary ventilation (MVV) and forced expiratory volume
(FEV) by spirometry
Nerve and Muscle:
• Examination of human respiratory system
• Study of salient features of electromyography • Predicting VO2 max using the Harvard Step test
• Study of phenomenon of human fatigue • Effects of hypoxia on various systems in the human body
• Mosso’s ergograph,
G.I.T & Metabolism:
• Handgrip dynamometer / ergograph for isometric work
• Estimation of conduction velocity of sensory and motor nerves • Determination of resting metabolic rate in human
• Measurement of mechanical efficiency at different grades of exercise • Clinical examination of the abdomen
• Study of excitable and contractile properties of a nerve muscle preparation • Study of the movements of isolated segment of mammalian small intestine and the effects
of: (i) Ions, (ii) Neurotransmitters, and (iii) Cold in vitro
• Demonstration of work performed by skeletal muscle in vitro under (i) After loaded
conditions, and (ii) Free loaded conditions Reproductive system :
• Demonstration of muscle fatigue and neuromuscular transmission in an amphibian model
• Changes in vaginal exfoliation cytology and cervical secretion during different phases of
• Demonstration of compound action potential in a frog’s sciatic nerve reproductive cycles in human and in rat Pregnancy tests
• Determination of strength duration curve in frog’s nerve muscle • Pregnancy tests

• Determination of sperm count, motility and morphology in a human sample

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Neurophysiology: ASSESSMENT:
• Examination of nervous system The 3rd Friday of every month is designated for internal assessment of Physiology
• Examination of cranial nerves The Pre-Professional examination will have 2 theory papers of 100 marks each and Practical
• Human electroencephalography: Method of recording and identification of different types examination of 100 marks.
of EEG waves
The professional examination will have 2 theory papers of 100 marks each and practical and
• Assessment of autonomic function viva of 100 marks. In each paper 10 marks questions will be from the topics of integrated
• Determination of reaction time in a human subject teaching.

Special senses: Theory paper I topics:

General Physiology, Nerve-Muscle physiology, Blood, Respiratory physiology, Cardiovascular
• Determination of visual acuity and astigmatism
physiology, Gastrointestinal physiology, Nutrition
• Blind spot in the field of vision
Theory paper II topics:
• Clinical assessment of colour vision
Renal physiology, Environmental physiology, Endocrinology, Reproductive physiology,
• Perimetry
Neurophysiology, Special senses, Yoga and exercise physiology
• Audiometry
• Demonstration of visual and auditory evoked potentials Paper I distribution of marks:
Section A –  (50 marks)
Teaching learning methodology:
(General Physiology, Nerve-Muscle physiology, Blood, Gastrointestinal physiology and
Large group teaching:
nutrition)
• Didactic lectures 1 Structured Long answer Question  10 marks
• Student’s seminars 8 Short Answer questions  5 marks each
Small group teaching: Section B  (50 marks)
• Structured Interactive Tutorials (Respiratory physiology, cardiovascular physiology, Environmental physiology,)
• Practical demonstrations 1 Structured Long answer Question  10 marks
• Case based discussions 8 Short Answer questions  5 marks each
Learning Resource Materials: Paper II distribution of marks:
Textbooks, Reference books, Practical Record Section A  (50 marks)
Recommended textbooks: (Renal physiology, Endocrinology, Reproductive physiology)
Textbook of Medical Physiology by A.C.Guyton & Hall 1 Structured Long answer Question  10 marks
Understanding medical Physiology by R.L.Bijlani 8 Short Answer questions  5 marks each
Reference books: Section B  (50 marks)
Review of Medical Physiology by W.F.Ganong
(Neurophysiology, Special senses, Yoga and Exercise physiology)
Physiology by Berne and Levy
1 Structured Long answer Question  10 marks
8 Short Answer questions  5 marks each

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M.B.B.S CURRICULM M.B.B.S CURRICULM

MODEL QUESTION PAPER 8. Explain the mechanism by which primary hemostatic plug is formed.  (5 marks)

PHYSIOLOGY 9. Explain the pathophysiological basis of erythroblastosis fetalis. How can it be

PAPER I prevented? (4+1=5marks)

Time: 3 hours Max. Marks: 100

ANSWER ALL QUESTIONS

Each Section to be answered in a separate answer book.
Illustrate your answers with suitable diagrams wherever appropriate.

SECTION B
SECTION A
(Respiratory physiology, cardiovascular physiology, environmental physiology)
(General Physiology, Blood, Nerve and Muscle, Gastrointestinal physiology and nutrition)
1. Define cardiac cycle and give its normal value. With the help of diagram, describe the left
1. Draw a neat labelled diagram of neuromuscular junction. With the help of a flow chart, ventricular pressure, volume and acoustic changes in a single cardiac cycle. Explain the
illustrate the steps of neuromuscular transmission. State the action of any 3 drugs acting at physiological basis of split heart sound. (½+2+2+2+2+½ = 10marks)
the neuromuscular junction.  (3+4+3=10 marks)
2. With the help of flow chart explain how sino-aortic reflex regulates the blood pressure.
2. Describe briefly the events that occur during Wallerian degeneration of the axon. (5marks)

 (5 marks) 3. Describe the transport of carbon dioxide by blood.  (5marks)

3. Describe the secretion of acid by the gastric mucosa.  (5 marks) 4. Compare and contrast pacemaker potential and ventricular muscle action potential.(5marks)

4. Explain, why dehydration is common and usually fatal in children, if not treated 5. Describe the chemical regulation of respiration.  (5marks)
immediately.  (2½ marks) 6. Classify hypoxia. Describe the features of different types of hypoxia with examples.(5 marks)
Explain why oral rehydration solution is administered in dehydration? (2½ marks) 7. Describe the mechanisms of temperature regulation in a hot environment.  (5 marks)
5. Write the composition, physiological and clinical significance of dietary fibres. 8. Explain the pathophysiology of pulmonary edema. (5 marks)
 (2+1⅓+1⅓=5marks)
9. Draw a graph of changes in intrSapulmonary and intrapleural pressure occurring during
inspiration and expiration. (5 marks)
6. Explain the physiological basis of:  (1+1+1+1+1+1=5 marks)
a) Achalasia cardia
b) Achlorhydria
c) Steatorrhea
d) Prolonged clotting time in obstructive jaundice
e) Hirschsprung disease

7. With the help of a flow chart, explain the mechanism of cell mediated immunity 
 (5 marks)

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M.B.B.S CURRICULM M.B.B.S CURRICULM

MODEL QUESTION PAPER

PHYSIOLOGY
SECTION B
PAPER II
Time: 3 Hours Max. Marks: 100 (Neurophysiology, Special senses and Yoga)

ANSWER ALL QUESTIONS 1. Name the deep nuclei, functional lobes and functions of cerebellum. Describe the afferent
and efferent connections of intermediate zone of the cerebellum. Enumerate any four
Each Section to be answered in a separate answer book.
cerebellar disorders. (1+1+2+3+3)
Illustrate your answers with suitable diagrams wherever appropriate.
2. Explain myotatic reflex with well labelled diagram. (5 marks)
SECTION A
3. Describe the origin, course and termination of dorsal column medial lemniscus pathway.
(Renal physiology, Endocrinology, Reproductive physiology)  (5 marks)

1. Explain the actions of insulin on muscle and liver. With the help of flow chartexplain the 4. Compare and contrast between upper motor neuron paralysis and lower motor neuron
consequences of its deficiency. (3+3+4 = 10 marks) paralysis. (5 marks)

2. Name the hormones involved in calcium homeostasis. Describe the action of anyone. 5. Describe the features and suggest the corrections of refractory errors. (5 marks)

 (2+ 3= 5 marks) 6. Explain how semi-circular canals and otolith organs are stimulated.  (5 marks)
3. Describe the actions of testosterone.  (5 marks)
7. Draw a neat labelled diagram of Organ of Corti and explain the basis of travelling wave
4. Briefly explain how the following conditions affect GFR: (1+1+1+1+1=5marks) theory of sound transmission. (5 marks)

a. Afferent arteriolar constriction 8. Trace the olfactory pathway. (5 marks)

b. Severe efferent arteriolar constriction
9. Describe in brief the cardiorespiratory changes during exercise. (5 marks)
c. Ureteral obstruction
d. Hypo-proteinemia
e. Pregnancy

5. Describe the innervation of urinary bladder and micturition reflex.  (2½ + 2½=5marks)

6. Compare and contrast metabolic and respiratory acidosis.  (5 marks)

7. Explain the physiological basis of  (2½+2½=5marks)

a. oral contraceptive pills

b) immunological pregnancy tests

8. With the help of flow chart, describe the process of milk ejection reflex.  (5 marks)

9. Describe the actions of thyroid hormone on cardiovascular system.  (5 marks)

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 M.B.B.S CURRICULM

BIOCHEMISTRY
OBJECTIVES FOR UNDER GRADUATE MEDICAL EDUCATION
At the end of the 1st MBBS course, the student shall be able to have the following knowledge and
skills.

Knowledge:
At the end of the course, the student shall be able to
• Describe the molecular and functional organization of a cell and lists its sub cellular
components.
• Delineate structure, function and inter-relationship of bio-molecules and consequences of
deviation from normal.
• Summarize the basic and clinical aspects of Enzymology with emphasis on diagnostic enzymes.
• Describe digestion & assimilation of nutrients and consequences of malnutrition; integrate
the various aspects of metabolism, their regulation and inborn errors of metabolism
• Describe mechanisms involved in maintenance of body fluid, electrolyte and pH homeostasis
• Outline the molecular mechanisms of gene expression and regulations, the principles of

BIOCHEMISTRY
genetic engineering and their application in medicine.
• Summarize the molecular concept of defence and their application in medicine.
• Outline the biochemical basis detoxification, environmental health hazards, mutagens and
carcinogenesis
• To familiarize themselves with the principles of various conventional and specialized laboratory
investigations, instrumentation analysis and interpretation of a given data.
• Interpret normal and abnormal levels of common biochemical parameters.
• Outline the calorie intake, mention sources of micronutrients and vitamins, special dietary
needs and restrictions.

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

• Make use of glucometer, reagent kits and urine strips to perform biochemical analysis relevant
to clinical screening and diagnosis
• Analyze and interpret investigative data
• Demonstrate the skills of solving scientific and clinical problems and decision making
• Prepare a diet plan and advice for normal individuals and certain disease conditions

87
88
Integration:

DURATION
M.B.B.S CURRICULM

evaluation and revision.

Duration of the course: 2 semesters
events with structure and function of the human body in health and diseases.

Innovative sessions include projects, seminars, structured discussion, integrated teaching, formative
The knowledge acquired in Medical Biochemistry shall help the students to integrate molecular

Total number of hours: 240 (Lectures: 160 Hours & Practicals and Innovative sessions: 80Hours)

BIOCHEMISTRY CURRICULUM CONTENT

S/N TOPIC MUST KNOW (A) MUST KNOW (B) NICE TO KNOW T-L METHOD DURATION

1. CELL 1. Cell organelle, structure 1. Diseases associated with 1. Unusual membrane 1. Integration with 2 hrs
and fucntion. organelle structure and Anatomy and
2. Cell membrane, transport 2. Fractionation of organelles disorder associated Physiology
across the cell membrane in brief and their marker with cell membrane.
enzymes

CHEMISTRY OF BIOMOLECULES:

2. PROTEIN 1. Classification of aminoacids 1. Properties of amino acids, 1. Isoelectric 1. Lectures 6 hrs

based on structure, ionic properties of amino precipitation (2 practical)
metabolic fate, nutritive acids, isoelectric pH and its using salts, heavy 2. Practical on protein
value importance; Buffering action metals and organic 6hrs
precipitation and (2 practical)
2. Nutritional value, limiting of amino acids and proteins solvents. colour reactions
amino acids and mutual 2. Peptide bonds; Biologically 2. Protein sequencing of Biuret and
supplementation. important peptides, 3. Denaturation Ninhydrin tests
3. Structural organization of 3. Protein; classification 4. Precipitation of 3. Plasma protein
proteins based on composition and proteins electrophorosis
4. Primary, Secondary, solubility, shape, function 3hrs
4. Demonstration of (1 practical)
Tertiary and Quaternary 4. Denaturation, coagulation; Hb electrophoresis
structure precipitation of protein and different
5. Structure of insulin, 5. Haemoglobinopathies: patterns obtained.
collagen Myoglobin and Different types and HbS in
haemoglobin detail ( Hb electrophoresis
6. Protein folding in brief, sicking test)
prion diseases 6. Thalassemia : Alpha and
7. Plasma proteins beta thalassemia in brief
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M.B.B.S CURRICULM
90
3. CARBOHY- 1. Classification 1. Properties and reactions of 1. Glycosidic bonds-N Lectures 5 hrs
DRATES 2. Monosaccharides carbohydrates linked and O linked
2. Alcohol and acid with examples
3. Disaccharides
derivatives of monosacchar 2. Amino sugars, deoxy
4. Oligosaccharides aides and their uses sugars with examples
Practical
M.B.B.S CURRICULM

5. Polysaccharides : 3. Artificial sweeteners 3. Blood group antigens-

Homopolysaccharides, Basic composition and
Heteropolysaccharides 4. Sialic acid
Types Monosaccharide 6hrs( 2
Glycosaminoglycan-
composition, distribution 4. Carbohydrates in cell and disaccharide practical)
and function membrane polysaccharide

6. Dietary fibre-Definition,
types function and clinical
significance
CHEMISTRY OF BIOMOLECULES:
4. LIPIDS 1. Definition, classification 1. Prostaglandins- derivatives, 1. Phospholipases- Lectures 6 hrs
of Lipids biological importance, uses. Clinical highlights:
2. Simple lipids- Viper venom,
composition and function Respiratory distress Integration with
syndrome Physiology for
3. Compound lipids-
Membrane transport
phospholipids, glycolipids
and lipoproteins,
their composition and
functions Chemistry & 3hrs
Properties of Lipids (1 practical)
4. Fatty acids: Definition,
Alpha, beta and omega
numbering system,
classification; clinical
significance of MUFA
& PUFA; Essential fatty
acids, Trans fatty acids.
Chemical reaction of fatty
acids

5. Cholesterol: Structure,
biologically important
compounds derived
6. Micelles and Liposomes,

5. ENZYMES 1. Definition , IUBMB 1. Iso-enzymes: Definition Lectures 7 hrs

Classification with separation and examples –
examples, coenzymes and CPK & LDH.
cofactors 2. Therapeutic enzymes Practical on Serum Am- 6 hrs
2. Concept of active site, ylase estimation, LDH ( 2 practical )
3. Enzymes used in laboratory
specificity of enzyme estimation
techniques
3. Enzyme Kinetics 4. Enzyme inhibitors of
4. Factors affecting enzyme therapeutic importance
activity , km value and its
significance
5. Enzyme inhibition :
Competitive, non-
competitive, and
uncompetitive with
examples, Suicidal
inhibition, Allosteric
inhibition and feedback
inhibition with examples of
drug action.
6. Enzyme regulation in
biological systems-
compartmentalization,
allosteric regulation,
covalent modification,
zymogen activation,
induction, repression &
depression.
91
M.B.B.S CURRICULM
92
S/N TOPIC MUST KNOW (A) MUST KNOW (B) NICE TO KNOW T-L METHOD DURATION
CHEMISTRY OF BIOMOLECULES:
6. ENZYMES 1. Clinical enzymology:
Diagnostic importance of
enzymes: Functional &
M.B.B.S CURRICULM

Non-functional enzymes.
2. Other enzymes of
diagnostic importance:
Transaminases( AST.,
ALT, ALP, GGT, NTP, ACP,
Amylase, Lipase, Choline
esterase, Enolase

DIGESTION AND ABSORPTION

7. CARBOHY- 1. Digestion, Absorption, 1. Significance of dietary fibre Lectures 1 hr
DRATES Glucose transporters and 2. Lactose intolerance-
their applied aspects. congenital and acquired

8. LIPIDS 1. Digestion, Absorption 1. Malabsorption, steatorrhea 1. Diagnostic tests for Lectures 1 hr

2. Role of bile salts and malabsorpation
micelle
9. PROTEIN 1. Digestion & Absorption, Lectures 1 hr
Meister cycle
2. Nitrogen balance
METABOLISM IN HEALTH AND DISEASE CONDITIONS
10. METABOLISM 1. Overview of Glycolysis- 1. Fate of pyruvate, PDH 1. Artificial sweeteners Lectures 10 hrs
OF CARBO- aerobic and anaerobic, reaction, lactic acidosis 2. Pentosuria, polyol
HYDRATES Regulation, Rappaport with two examples Case studies, OSPE
pathway and its and spotters
Leubering shunt and its 2. Fructose and galactose importance 3 hrs
applied aspect metabolism

2. Gluconeogenesis: 4. HMP shunt pathway: 1. Types of bonds sugars Principles and use of 3 hrs
Definition, Substrates, Tissues operating, participate in the cell (pratical)
reactions and key enzymes, oxidative phase in detail 1. Urine strips for
regulation, significance, & mention the products glucose and
Glucose-alanine cycle, Cori of non oxzidative phase 2. Glucometer
cycle significance of HMP
3. Glycogen metabolism shunt pathway, G6PD,
and Von Gierke’s disease Transketolase, their applied
in detail.Regulation aspect
of glycogenesis and 5. Uronic acid pathway-
glycogenolysis products and their
importance.
6. Insulin: Receptor,
mechanism of action,
insulin release, actions
of insulin related to
metabolism in brief
S/N TOPIC MUST KNOW DESIRABLE TO KNOW NICE TO KNOW T-L METHOD DURATION
11. METABOLISM 1. TCA cycle- overviews, 1. GTT : Indications, 1. Lectures 10 hrs
OF CARBOHY- regulation, importance and procedure, interpretation,
DRATES applied aspects, Anaple- Types a of GTT curves,
rotic reactions, Amphibolic Mini GTT, extended GTT,
role IV GTT & GCT in brief
2. Blood sugar regulation, 2. Perform test for 9 hrs
Diabetes Mellitus- estimation of (3 practical)
Diagnostic criteria and glucose from
monitoring of glycaemic blood/ plasma,
control and complications, CSF
Metabolic derangements,
other causes of
hyperglycaemia and
hypoglycaemic, Glycemic
index of food, Acute &
Chronic complications of
DM ( Biochemical basis)
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M.B.B.S CURRICULM
94
12. METABOLISM 1. Fatty acid oxidation : Beta 1. Fatty and biosynthesis: Fatty 1. Elongation and Lectures 10 hrs
OF LIPIDS oxidation: definition, fatty acid synthase complex, desaturation of fatty
acid transport & carnitine, reactions, regulation acids
steps, Energetics, regulation 2. Oxidation of odd chain fatty 2. Oxidation of Estimation of
& disorders. α - oxidation acid & fate of propionyl CoA unsaturated fatty Cholesterol and
and Ω- oxidation 9 hrs
M.B.B.S CURRICULM

acid: in brief, TG and their

3. Adipose tissue: Adipokines, (3 practical)
2. Ketone bodies: Formation interpretation,
Hormone sensitive lipase 3. Inborn errors
& Utilization, Metabolic associated, lipid Amniotic fluid
background of ketoacidosis 4. Fatty liver: causes, storage disorders:
Lipotropic factors. analysis
in DM and starvation and Niemanna Pick, Tay
differential diagnosis by 5. Cholesterol : Synthesis upto Sach’s, Gaucher’s,
laboratory mevalonate in detail and Fabry’s disease in
3. Lipoproteins: Definition, mention the intermediates brief.
general structure of of important reactions
lipoproteins, classification, upto cholesterol synthesis
separation ,regulation of cholesterol
synthesis.
4. Lipoprotein Metabolism
of chylomicrons, VLDL
& LDL, Metabolism
of HDL, Reverse
cholesterol transport and
atherosclerosis, Lp(a) and
its significance.
5. Dyslipidemia

S/N TOPIC MUST KNOW (A) MUST KNOW (B) NICE TO KNOW T-L METHOD DURATION
METABOLISM IN HEALTH AND DISEASE CONDITIONS

13. METABOLISM 1. Cholesterol: Metabolic 1. Eicosanoids: Prostaglandins Lectures 3 hrs

OF LIPIDS fate: Formation of bile & Thromboxanes; major
salts and its significance, steps of formation;
mention other biologically Biochemical actions
compounds derived from & therapeutic uses.
cholesterol. Leukotrienes & Lipoxins.

2. Lipid profile: Dietary

management & role of
statins
14. METABO- 1. Dynamic state of body 1. One carbon metabolism, 1. Histidine metabolism Lectures 8 hrs
LISM OF proteins, body amino acid Metabolism of serine, and associated inborn
AMINO pool, inter organ transport glycine and other reactions. errors
ACIDS of amino acids 2. Metabolism of sulphur 2. Glutamic acid, GABA,
2. Reactions: transamination, containing amino acids: Glutamine
oxidative deamination, Metabolism Cysteine 3. Aspartic acid, Practical:-
Non oxidative deamina- Glutathione, Taurine, Asparagine Total protein, 3 hrs
tion, transdeamination Transulfuration, PAPS; Estimate of Albumin (1practical)
Metabolism of Methionine, 4. Metabolism of
3. Formation and detoxifica- and AG ratio
Transmethylation, inborn Arginine , NO,
tion of ammonia
errors associated Polyamines
4. Urea cycle- regulation,
energetics, disorder of urea 3. Branched chain amino acid 5. Organic acidurias
cycle Hyperammonemia, metabolism( 1st two steps
Biochemical basis of only) & MSUD
management of hyperam-
monemia.
5. Metabolism of glycine; 4. Synthesis of catecholmines,
compounds synthesized VMA formation and
and inborn errors excretion and its significance
6. Metabolism of aromatic
amino acids, phenyl ala- 5. Biologically important
nine and tyrosine; com- amines
pounds synthesized inborn
errors associated 6. Amino acids and amino
acid derivative acting as
7. Metabolism of Tryptophan
neurotransmitters
and compunds ( niacin,
melatonin, serotonin,
indoxyl) in brief. Harnup
disease and its diagnosis.
Effect of PLP on Trypto-
phan metabolism. FIGLU
excretion test
95
M.B.B.S CURRICULM
96
S/N TOPIC MUST KNOW (A) MUST KNOW (B) NICE TO KNOW T-L METHOD DURATION
METABOLISM IN HEALTH AND DISEASE CONDITIONS
15. ELECTON 1. Bioenergetics 1. High energy compunds: 1. Disorders of Lectures 4 hrs
TRANSPORT 2. ETC: Components and definition and examples mitochondria and
CHAIN ( ETC) sites of ATP synthesis: 2. Brown adipose tissue effect of Inihibitors.
M.B.B.S CURRICULM

Chemiosmotic hypothesis
Mechanism of oxidative
phosphorylatin: ATP
synthase inhibitors
16. INTEGRATION 1. Integration of metabolism, Lectures 2 hrs
OF Adaptations in starvation:
METABOLISM Lifestyle diseases, BMI
obesity, Metabolic
syndrome( Mention NASH,
PCOS)
17. METABOLISM 1. Heme synthesis: Heme 1. Porphyrias: Types, enzyme 1. Diagnostic tests for Lectures 3 hrs
OF HEME sysnthetic pathway, defects, manifestations and different porphyrias.
regulation and effects of investigations of blood and
lead poisoning urine( acute intermittent Case studies 2 hrs
2. Heme catabolism: porphyria in detail and
formation and fate others in brief)
of bilirubin ( uptake, 2. Neonatal Practical on serum 3 hrs
conjugation, secretion); hyperbilirubinemia, bilirubin estimation.
formation and fate kernicterus and biochemical
of urobilinogen and basis of treatment in brief.
stercobilinogen
Integration with 1hrs
3. Serum bilirubin: Types, physiology.
Blood levels in healthy
subjects, properties,
estimation.
4. Jaundice: Definition,
classification, causes &
differential diagnosis by
biochemical tests

18. FAT SOLUBLE 1. VITAMIN A: different 1. VITAMIN K: Chemicals 1. Pharmacological uses Lectures 3hrs
VITAMINS chemical forms, forms, dietary sources, of fat soluble vitamins.
dietary sources, RDA biochemical functions,
Vitamin A: Absorption, RDA and deficiency
transport and storage, manifestations, Vitamin K
functions of Vitamin administration to preterm
A, Wald’s visual cycle. babies.
Deficiency manifestation 2. VITAMIN E : Chemical
and its prevention; forms, Biochemical func-
Hypervitaminosis tions ( focus lipid peroxida-
tion and antioxidant func-
tion in brief) and deficiency
manifestations.
S/N TOPIC MUST KNOW (A) MUST KNOW (B) NICE TO KNOW T-L METHOD DURATION

METABOLISM IN HEALTH AND DISEASE CONDITIONS

19. FAT SOLBLE 1. VITAMIN D: Chemical
VITAMINS nature, dietary sources,
RDA vitamin D active
form of vitamin D- its
formation and actions,
deficiency manifestation in
children and adults and its
prevention, its interaction
with parathyroid
20. WATER 1. THIAMIN 1. RIBOFLAVIN 1. Transketolase assay to Lectures 6 hrs
SOLUBLE 2. VITAMIN B12 2. PYRIDOXINE detect deficiency of
VITAMINS 3. FOLIC ACID 3. PANTOTHENIC ACID vitamin B1.
4. VITAMIN C chemicals 4. NIACIN 2. Antivitamins
nature, dietary sources, 5. BIOTIN
RDA, coenzyme form, 6. Chemical nature, dietary
biochemical functions, sources, RDA, role as
deficiency manifestations coenzymes Biochemical
functions, deficiency
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M.B.B.S CURRICULM

manifestations.
98
21. MINERALS 1. IRON 1. Classification of minerals 1. Anemia due to Lectures 8 hrs
2. CALCIUM based on RDA mineral and vitamin
3. PHOSPHORUS 2. Iodine deficiencies
4. MAGNESIUM 3. Potassium 2. Hereditary Electrolyte estima- 3 hrs( 1
4. Sodium Hemochromatosis, tion practical)
5. COPPER
M.B.B.S CURRICULM

siderosis
6. ZINC Dietary sources, 5. Chloride
3. Cobalt
RDA, Absorption, transport 6. Selenium
and storage, excretion, 4. Chromium
7. Fluoride
biochemical functions, 8. Manganese
Blood levels in healthy
9. Magnesium
subjects, regulation of
blood levels, causes of 10. Dietary sources,
deficiency ad deficiency functions, deficiency
manifestations. Disorders manifestations in brief.
of an excess state wherever
applicable.

22. HOMEOSTATIC 1. ACIDE BASE BALANCE: 1. Anion gap assessment 1. Acids bases, pH, pK, Lectures 3 hrs
MECHANISMS Body buffers, respiratory of acid base balance by Buffers, Henderson-
IN THE BODY & rental regulation f blood blood gas parameters Hasselbach’s equation.
pH . Disorders of acid base
balance
Case studies, 2 hrs
OSPE

S/N TOPIC MUST KNOW DESIRABLE TO KNOW NICE TO KNOW T-L METHOD DURATION

METABOLISM IN HEALTH AND DISEASE CONDITIONS

23. FLUID AND 1. Regulation of osmolality 1. Lab diagnosis of Lectures 2hrs

ELECTROLYTE and maintenance of electrolyte imbalance
BALANCE fluids in the various body
compartments and related
disorders.

24. NUCLEOTIDE 1. Nucleotide chemistry, 1. Synthesis of dNTPs ( deoxy 1. De novo purine Lectures 3 hrs
CHEMISTRY purine and pyrimidine nucleotide triphosphates). synthesis and in brief-
AND bases, nucleosides, 2. Nucleotide analogues & source of constituent
METABOLISM nucleotides, major and folic acid antagonists. atoms, rate limiting
minor ones and their 3. Lesch Nyhan syndrome steps
importance. 2. Pyrimidine synthesis
4. Hypouricemia
2. Purine metabolism: Salvage and degradation,
pathway, catabolism, Orotic aciduria
primary and secondary
Hyperuricemia, Gout,
Biochemical principles of
treatment of Gout.

25. NUCLEIC 1. Structure and organization 1. Minor RNAs and their 1. Mitochondrial DNA Lectures 18 hrs
ACIDS of DNA; Different types of applied aspects 2. Telomerase
RNA, difference between 2. Synthesis of rRNA primary 3. RNA editing with an
DNA & RNA. tRNA transcript example
2. DNA REPLICATION – 3. DNA repair mechanism 4. Ribosomes &
Process of replication in examples of DNA repair Polysomes
eukaryotes, inhibitors and defects. 5. Ame’s test
uses 4. Reverse transcriptase 6. Protein targeting
3. TRANSCRIPTION: 5. Ribozyme
Process of transcription in
eukaryotes, inhibitors, post
transcriptional modification
4. TRANSLATION: Genetic
code Different phases of
translation in eukaryotes,
post translational
modifications, inhibitors,
protein targeting
99
M.B.B.S CURRICULM
100
S/N TOPIC MUST KNOW (A) MUST KNOW (B) NICE TO KNOW T-L METHOD DURATION
METABOLISM IN HEALTH AND DISEASE CONDITIONS
26. NUCLEIC ACIDS 1. Regulation of gene
expression in prokaryotes
(Lac Operon )
M.B.B.S CURRICULM

2. Regulation of gene
expression in eukaryotes
(gene amplification, gene
rearrangement)
3. Mutations: Definition,
types with examples,
Mutagens

27. RECOMBINANT 1. Recombinant DNA 1. Gene therapy, RFLP, DNA 1. Biochemical Lectures
DNA technology, applications in finger printing. Application basis of inherited
TECHNOLOGY clinical medicine in clinical medicine disorders and Practical 6 hrs ( 2
screening of practical)
2. Vectors DNA extraction and
3. Blotting techniques genetic disorders. PCR
(Southern, Northern 2. Model of
& Western). DNA and inheritance
diagnostics

28. IMMUNOLOGY 1. Introduction to 1. Hypergammaglobulinemia 1. AIDS ( structure Lectures 8 hrs

immunology 2. Biochemical diagnosis of of HIV virus,
2. antigen presentation multiple myeloma major genes
3. B cell and Humoral and antigens). Demonstration of 3 hrs( 1
immunity Natural course ELISA, CLIA and practical)
of HIV infection immunoturbidimetry
4. T cell and cellular
immunology of during practical
immunity
AIDS, Laboratory
5. Cytokines diagnosis &
6. Immunoglobulin: Types, monitoring,
structure( general structure Biochemical basis
and structure of IgM & IgA of retroviral therpy.
& functions

7. Antibody diversity and class

switching
8. Hypersensitivity reaction
9. Auto immunity
10. Monoclonal antibodies
and their uses
11. Immunological techniques
and their applications

29. BIOCHEMISTRY 1. Cell cycle, Cyclins and 1. Tumour markers 1. Anticancer drugs Lectures 4 hrs
OF CANCER apoptosis
2. Aetiology of cancer,
carcinogenesis: Oncogenic
virus; Oncogenes; Tumour
suppressor genes

S/N TOPIC MUST KNOW (A) MUST KNOW (B) NICE TO KNOW T-L METHOD DURATION

METABOLISM IN HEALTH AND DISEASE CONDITIONS

30. CLINICAL 1. Liver function tests and 1. ELECTROPHORESIS of 1. RADIOACTIVITY: Lectures 6hrs
BIOCHEMISTRY interpretation serum proteins; Multiple Radioactive isotopes
2. Renal function tests and myeloma & Bence Jones used in Medicine,
interpretation Proteins Diagnostic, Practical 12 hrs
3. Gastric function test, 2. CHROMATOGRAPHY therapeutic
and diagnosis of and research ( 4 practical)
Pancreatic function test and
intestinal function test. inherited disorders of applications;
Liver enzymes,
metabolism (Example : Radiation hazards
4. Cardiac markers Urine examination,
Aminoaciduria) Blood urea
5. Metabolism of alcohol
3. colorimetry Creatinine
6. Reference ranges
of commonly used 4. Spectrophotometry
biochemical tests 5. Principles of automation
6. Blood collection-
principles and vials used
7. Pre and post analytical
101
M.B.B.S CURRICULM

errors.
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PRACTICALS
10 hrs

Based on principles of various conventional and specialized laboratory investigations and

2 hrs

3 hrs

3 hrs
1 hr
instrumentation, to substantiate and clarify the theoretical concepts with experimental evidences.

Integrated teaching
Lectures and OSPE
Practical bench work, demonstrations, session on analyses and interpretation of data and case
discussions (on the practical) with the help of clinical and scientific problems will be conducted.

& field visits.

The student should demonstrate the skill
Lectures

Lectures

Lectures
• Of performing basic biochemical tests important in clinical investigations

• Of performing the biochemical analysis making use of conventional techniques/ instruments

environmental toxins
that can be useful in clinicalscreening and diagnosis as well as analysis and interpretation of

food additives and

investigative data.
1. Brief mention of
• Of solving clinical problems and decision making.

Topics for Practical / Demonstration:

Duration
Sl.
Topic Teaching /learning method (No. of
No.
Generation, Types, lipid

2. Antioxidants: Different Sessions)

1. Calculations for total

1. Laboratory Instrumentation Demonstration / laboratory visit 1
2. Colour reactions of amino acids Demonstration in small groups 1
peroxidation.
1. Free radicals:

and proteins
calories.

3. Practical on protein precipitation, Demonstration in small groups 1

types

fractionation, denaturation
4. Carbohydrates: Reactions; Practical bench work 2
reducing property, Oxidation,
thyroid Thyroid function tests
posterior ) and Hypothalamic
and mechanisim of hormone

Reduction, Dehydration and

xenobiotics: different phases

individuals and special cases

7. Gonadal steroid hormones.

1. SDA, Calorific value, BMR.

5. Adrenal cortical hormones
1. Classification of hormones

condensation
2. Balanced Diet for normal
and adrenal function test

Safe & Clean Environment

3. Malnutrition(PEM) and
2. Pituitary ( anterior and

4. Parathyroid hormones
3. Thyroid hormone and

5. Characterization of lipids with Demonstration in small groups 1

8. Pancreatic hormones

Biotransformation of
6. Adrenal medullary

1. Detoxification and

Qualitative tests for lipids

and interpretation

35. PATIENT SAFETY STP & Incineration

6. Principles of Colorimetry Practical bench work 1

and standardization of the
hormones
function

Colorimeter
obesity
action

7. Estimation of Plasma glucose with Practical bench work 1

standard curve
8. Oral Glucose tolerance test Practical bench work with case 1
ANTIOXIDANTS
33. FREE RADICALS
ENDOCRIONOLOGY

32. XENO-BIOTICS

discussion /Interpretation for diagnosis

34. NUTRITION

of Diabetes mellitus
9. Serum Urea estimation Practical bench work 1
AND

10. Serum Creatinine estimation Practical bench work with case 1

discussion on abnormal renal Function
31.

tests

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11. Total Protein estimation, Albumin Practical bench work, Case study 1 Distribution of Topics
estimation, calculation of A/G oriented interpretation of results
Paper –I
ratio
12. Serum Amylase estimation Practical bench work and 1 Section A:
Interpretation of report
1. Cell, Cell Membrane,Transport across membrane and associated disorders
13. Serum lactate dehydrogenase Practical bench workCase studies on 1
activity Isoenzymes and Clinical enzymology 2. Chemistry and metabolism of Carbohydrate, Lipids and Proteins

14. Estimation of total cholesterol and Practical bench work 1 3. Bioenergetics and ETC
HDL cholesterol 4. Haemoglobin and Myoglobin
15. Estimation of Triglycerides Practical bench work, Case studies on 1 5. Haem Synthesis, degradation and Porphyrias
and calculation of LDLc by Lipid profile
Frieldewald’s formula Section B:
16. Urine Analysis (Normal) Practical bench work 1 1. Enzymes, Clinical Enzymology
17. Urine Analysis (pathological) Urine Analysis 2 2. Vitamins

18. Liver function tests Liver function tests 2 3. Minerals

19. Estimation of serum Uric acid Practical bench work 1 4. Water and electrolyte balance and disorders
5. Plasma Proteins
20. Gastric juice analyses Practical bench work and 1
Interpretation of report Paper – II
21. Plasma protein electrophoresis Demonstrationand Interpretation of 1
different patterns obtained Section A:
22. Chromatography for separation Demonstration 1 1. Acid- base balance and disorders
of sugar 2. Immunology
23. Cerebrospinal fluid analyses Practical bench work 1
3. Free radicals and anti-oxidants
24. Amniotic fluid analyses Demonstration with case discussion 1
4. Xenobiotics, Detoxification and Environmental Biochemistry
25. Electrolyte estimation and Demonstration in small group in 1 5. Nutrition
Interpretation of electrolyte Hospital laboratory
imbalance Section B:
26. ELISA techniques Demonstration for thyroid function 1 1. Hormones
test
2. Function tests : Liver, Kidney,Thyroid, Gastric
27. Extraction of DNA and Gel Demonstration in small group 1
electrophoresis of DNA 3. Nucleotide and Nucleic acids, its metabolism and repair
28. PCR technique Demonstration in small group 1 4. Recombinant DNA technology and DNA Diagnostics
29. Case reports on Liver function Demonstration in small group 4 5. Cancer Biochemistry and Tumour Markers
tests and interpretation, Renal
function tests and interpretation,
Plasma Proteins(Types; functions;
separation; Abnormal patterns
in clinical diseases; A:G ration;
Acute phase proteins) Cardiac
Markers, Thyroid function tests
and interpretation

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BIOCHEMISTRY QUESTION PAPER BLUE PRINT: MODEL QUESTION PAPER

Question paper pattern: BIOCHEMISTRY
Two theory papers of 100 marks each (Total marks = 200) PAPER-I
Paper -I & Paper - II Duration: 3 hours Total Marks: 100
Duration - 03 Hours each INSTRUCTIONS:
Each paper will have 2 sections,
• Answer all questions
A & B of 50 marks each.
• Answer Sections A and B in separate answer booklets.
Biochemistry theory paper of each section will be as follows:
• Write answers in sequence.
1. Structured essay question (SEQ) - 1 question X 10 = 10 marks • Strike off all blank pages.
SEQ is to be given with a case study and objective questions can be framed is ranging from 1-3 • On additional answer sheets, do not write your registration number.
marks • Mention the number of additional answer sheets used and the sheet number on page
one of the main answer booklet.
2. Short answer questions - 8 questions x 5 = 40 marks

• Out of the 8 questions, 2 are to be framed from the integrated topics. SECTION A
• 5 marks question can be split in to 2 or more and marks distributed accordingly. 1. A 45-year old man was rushed to emergency after he complained of chest pain. His
• Questions in this section can be asked for diagnosis, compare and contrast, reasoning, biochemical investigations showed RBS 99 mg/dL, serum total cholesterol 485 mg/dL &
biochemical basis and flow charts. LDL 372 mg/ dL along with ECG changes.

• The topics allotted to the section A & B of paper -1 and Paper - II should be adhered to. i) What is your provisional diagnosis?
ii) What are the parameters included in lipid profile? (2)
• All topics must be covered is sitting up the question paper.
iii) Describe briefly the role of LDL in development of Atherosclerosis. (3)
• The weightage of questions should be as follows:
iv) Which lipid is known as “Good lipid” and why? (2)
70% from the “must ‘know “section v) What other biochemical parameters you would like to estimate to confirm your
diagnosis in the above case?
25-28% from the” desirable to know “section

2-5% from the “nice to know” section. 2. Short notes  (5x8=40)

a. What are the glycogen storage diseases? Why is there hyperuricaemia in Von
Gierke’s disease?  (3+2)
b. Describe the structural organisation of electron transport chain with suitable
diagrams.(5)
c. Compare and Contrast between the biochemical processes in Microsome and
lysosomes? Write briefly about Zellweger Syndrome.  (3+2)
d. Mention the rate limiting steps of gluconeogenesis. What is the biochemical basis
of regulation of blood glucose level in our body?  (3+2)
e. Name the primary ketone body. Describe briefly the formation of ketone bodies
and their utilization in the body.  (1+2+2)

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f) Write an account of the high-energy compounds in metabolism. What are MODEL QUESTION PAPER
uncouplers?(3+2)
BIOCHEMISTRY
g) Write different structural organisation of protein. Explain the secondary structure
with appropriate examples. (5) PAPER-II
Duration: 3 hours  Total Marks: 100
h) Illustrate with diagram the co-operative binding of Hb with Oxygen.  (5)
INSTRUCTIONS:
SECTION B • Answer all questions
1. Mention the synthesis and activation process of Cholecalciferol. Write briefly the action of • Answer Sections A and B in separate answer booklets.
Vit.D on serum Calcium and phosphorus level. Write RDA of Vit.D in children and adults. • Write answers in sequence.
Mention serum level of Calcium and Phopshorus.(4+3+1+2)
• Strike off all blank pages.
2. Write short notes  (2X2.5=5) • On additional answer sheets, do not write your registration number.
i) Regulation of Iron absorption • Mention the number of additional answer sheets used and the sheet number on page
ii) Actions and target sites of Vitamin D one of the main answer booklet.

3. Compare and contrast:  (2X2.5=5) SECTION A

i) Transamination and Deamination 1. A 24 year old man was admitted to the casualty in a confused state with deep gasping
ii) NAD and NADP breathing. His blood sugar level was found to be 480mg%, blood pH was 7.0, HCO3- was
20mEq/L and Pco2 was 34mEq/L. His father is a Diabetic. (1+2+2+2+2+1=10)
4. Justify the importance of plasma protein electrophoresis in diagnosis (2X2.5=5)
a. Give your provisional diagnosis.
i) Multiple myeloma
b. Mention two important abnormal urinary findings in this case.
ii) Chronic liver disease
c. Write the name of the tests by which the above mentioned urinary findings can
5. Explain Wald’s cycle with suitable diagram and Disorders associated with Vitamin A be identified.
deficiency.  (5)
d. Define buffer.Write the most important extracellular buffer in the human body.
6. Write briefly the biochemical basis of  (2.5X 2=5) e. The biochemical findings show compensated or uncompensated state of the
i) Vitamin B12 deficiency results in folic acid deficiency disorder?

ii) Tryptophan deficiency results in folic acid deficiency. f. Define anion gap and mention its normal level.
g. What will be the anion gap in this case.
7. Enumerate the steps of muscle contraction and relaxation events. Write 2 inherited
conditions associated with defective contractile proteins.  (5) 2. Write short notes on ( 2X 2.5=5)
8. Define Isoenzymes? Enumerate the Isoenzymes of LDH. Mention some uses of Isoenzyme a. Oxidative stress and natural antioxidants of the body
in clinical set-up. (1+2+2) b. Phase 1 and 2 Detoxification reactions
9. Compare and contrast between competitive and non-competitive enzyme inhibition. What
3. Explain with diagram/flowchart (2X2.5=5)
is suicide inhibition?  (3+2)
a. Type 1 Hypersensitivity reaction
b. Antigen presentation to CD4+ cells

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4. Compare and contrast:  (2X2.5=5) SECTION B

a. Marasmus and Kwashiorkor 1. A 34 year lady notices a round swelling on the right side of the neck that moves with
b. Bicarbonate buffer and Phosphate buffer deglutition. On examination it was found to be a thyroid swelling. The TFT values are as
follows:  (1+1+2+2+2+2)
5. Give reasons/Justify:  (2X2.5=5)
a. Metabolic acidosis leads to rapid breathing. TSH-15.2mIU/ml (Normal 0.36-5.5 mIU/L)
b. HIV infection leads to severe immunodeficiency T4- 58nmol/L (Normal 70-150 nmol/L)
6. Write true or false and justify: (1X5=5) T3- 1.1nmol/L (Normal 0.9- 2.8 nmol/L)
a. Bicarbonate buffer is a biochemically efficient buffer. a. Give your diagnosis on the above condition.
b. Rh Incompatibility is a type2 hypersensitivity reaction b. Name the enzyme which brings about the oxidation of Iodine for thyroid
c. Glutathione protects RBC membrane hormone synthesis.
d. Uric acid doesn’t give positive Benedict’s test results. c. Name two antibodies associated with thyroid disorders.
e. Increased anion gap identifies metabolic acidosis with net acid gain d. Explain the reason for T3 being within normal range.
7. Explain the following : (2X2.5=5) e. What is grave’s disease?
a. Mantoux test is a Type 4 hypersensitivity reaction f. Explain the importance of estimation of free T4 and free T3.
b. Protein is not considered as an ideal source of energy 2. What is polymerase chain reaction? Describe the principle and steps. Give an account of
8. Write with examples: (1X5) the applications of PCR.  (1+2+2=5)

a. What are proteins of high biological value? Give example. 3. Name the inhibitors and its use in clinical practice  (1x5=5)
b. Autoimmune disorders
a. DNA Replication
c. Increased basal metabolic rate
b. Translation
d. Limiting amino acid
c. Thyroxine
e. Lipid peroxidation
d. mRNA
9. Fill in the blanks and justify (1X5) e. Xanthine oxidase
a. ……………..are part of Cell Mediated Immunity.
4. What are vectors in recombinant DNA technology? Describe the uses and characters of any
b. Respiratory Quotient of Carbohydrates is………..
two of them.  (2+3=5)
c. Hemoglobin is an…………………buffer
d. Diarrhoea leads to ……………….anion gap 5. A 65 year old obese lady attended the medicine OPD with complains of indigestion,
nausea, bloating of abdomen fatty “clay” colour stool, dark yellow colour urine, and
e. Vaccination is an example of………………..immunity
itching over body since 6 months. On examination her sclera looked yellow and there was
tenderness over the right hypochondrial region. (1×5=5)

The physician advised LFT to be done.

i) Give your probable diagnosis

ii) What will be the level of serum total bilirubin in this case?

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iii) Name two enzymes expected to be raised in this disease.

iv) Give reasons for the discolouration of the stool and urine as complained by the patient.

v) What is “delta”bilirubin?

6. What is the difference between RNA editing and splicing? (5)

7. How will you do an antenatal screening and diagnosis for sickle cell anaemia? (5)

8. Explain the following : (2X2.5=5)

a. Clearance tests are done to diagnose glomerular dysfunction.
b. Zone specific steroidogenesis occurs in Adrenal cortex.

9. Write the biochemical basis of the following :  (1X5=5)

i) Water deprivation test doesn’t assess tubular function of kidney.

ii) Irreversible GPCR activation leads to the diarrhoea associated with cholera
iii) In presence of both Lactose and Glucose ,the Lac Operon is inactivated.
iv) Pentagastrin test is done to assess the acid secretion in stomach.
v) DNA methylation is a method of regulation of gene expression.

PATHOLOGY

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PATHOLOGY COURSE CONTENTS

GOAL GENERAL CONSIDERATION:
The broad goal of the teaching of undergraduate student in Pathology is to provide the students The curriculum/course content shall include the topics in following categories: up to 70%
with a comprehensive knowledge of the pathologic basis of disease, in order to enable of the content as a whole and chapter-wise should be from MUST KNOW category; 20-
him/her to achieve complete understanding of the natural course, clinical manifestations, 25% should be from DESIRABLE TO KNOW category; and remainder 5% should be from
complications and sequele of disease. NICE TO KNOW category. Accordingly, the THEORY LECTURES and FINAL (SUMMATIVE)
ASSESSMENT should be as per the above.
OBJECTIVES
The CHAPTER WISE course contents as per the category are as follows:
1. KNOWLEDGE
The topics for PRACTICAL (Pr) will be covered as a lecture during 1st hour of the Practicals
At the end of the course, the student should be able to:
followed by demonstration of gross specimens, microscopic slides, OSPE charts, instruments,
• Describe the structure and ultra structure of a pathologically altered cell, mechanisms of or clinicopathological discussion (pertaining to the topic) to be covered in next 2 hours (Total
cell degeneration, cell death and repair and be able to correlate structural and functional duration of practical 3 hours, twice weekly). The goal should be to maintain the temporal
alterations. correlation between the theory topics and the corresponding practical.
• Explain the pathophysiologic processes which govern the maintenance of homeostasis,
mechanisms of their disturbance and the morphological and clinical manifestations A. GENERAL PATHOLOGY:
associated with it.
1. CELL INJURY:
• Describe the mechanisms and morphologic patterns to tissue response to injury so
• MUST KNOW: Causes and mechanism of ischemic, toxic, free- radical/reperfusion induced
that she/he can appreciate the pathophysiology of disease processes and their clinical
injury; pathogenesis and pathology of reversible and irreversible cell injury; hyaline and fatty
manifestations.
change (Pr). Necrosis: compare and contrast between different morphological patterns and
• Correlate normal and altered morphology (gross and microscopic) of different organ their clinical correlation; gangrene (dry and weight) (Pr); compare and contrast between
systems in common diseases to the extent needed for understanding of disease processes necrosis and apoptosis; mechanism of apoptosis and their clinical implications, compare
and their clinical significance. and contrast between dystrophic and metastatic calcification; pigment deposition such as
melanin, bilirubin, haemosiderin and anthracotic pigments (Pr).
2. SKILLS
At the end of the course, the student should be able to: • DESIRABLE TO KNOW: Necroptosis.

• Describe the rationale and principles of commonly followed technical procedures of the • NICE TO KNOW: Cellular ageing, Telomeres
diagnostic laboratory tests and interpretation of the results. • Pr: Practical topics
• Perform the simple bed-side tests on blood, urine and other biological fluid samples.
2. INFLAMMATION AND REPAIR:
• Draw a rational scheme of investigations aimed at diagnosing and managing the cases of
• MUST KNOW: Features and causes; vascular events, cellular events in acute inflammation;
common disorders.
cells and mediators of inflammation; morphological variant and outcome (ulcer, granulation
• Understand biochemical/physiological disturbances that occur as a result of disease in tissue) (Pr) of acute inflammation; chronic inflammation (Pr): causes, types, non-specific
collaboration with pre clinical departments. and granulomatous (Pr) with examples; cutaneous wound healing and repair by primary
and secondary union and factors modifying them; fracture healing.
3. INTEGRATION
• DESIRABLE TO KNOW: Growth factors, scar formation, keloid.
At the end of training, he/she should be able to integrate the causes of disease and relationship
of different etiological factors (social, economic and environmental) that contribute to the • NICE TO KNOW: Cell cycle and Stem cells.
natural history of diseases most prevalent in India.
• Pr: Practical topics

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3. HEMODYNAMIC DISTURBANCES: 6. GENETIC DISORDERS:

• MUST KNOW: Pathogenesis and types of edema (Transudate vs Exudate); hyperaemia vs • MUST KNOW: Basic concepts of genetic disorders (mutations, autosomal dominant,
congestion; chronic venous congestion (Pr): Lung (with heart failure cells), Liver (Nutmeg recessive, X-linked disorders) and some common examples. Down syndrome, Turner
Liver) and Spleen (Gamna Gandy bodies); normal haemostasis, Virchow triad, coagulation syndrome and Klinefelter syndrome.
cascade; thrombosis; infarct (Pr): red vs pale; embolism: formation, types and fate, effect
• DESIRABLE TO KNOW: Karyotyping
on tissues; Shock: pathogenesis, types and organ specific changes.
• NICE TO KNOW: Pedigree chart analysis
• DESIRABLE TO KNOW: Rare causes of thrombophilia (antiphospholipid antibody
syndrome, Factor V Leiden mutations, etc) • Practical topics: None
• Pr: Practical topics • Redundant topic: All other rare genetic disorders, storage disorders, mutation analysis,
molecular diagnosis, etc.
4. GROWTH DISTURBANCE AND NEOPLASIA:
7. INFECTIOUS DISEASE:
• MUST KNOW: Cellular adaptation (Pr): Atrophy, Hypertrophy, Hyperplasia, Metaplasia,
Dysplasia and Intraepithelial Neoplasia including carcinoma in situ, premalignant • MUST KNOW: Tuberculosis, Leprosy and HIV/AIDS to be included with HORIZONTAL
conditions. Neoplasia: Causes, Classification, Histogenesis and molecular basis, Biological INTEGRATION with Microbiology.
behaviour, Benign versus Malignant (Pr), Nomenclature. Malignant Neoplasms: Grade
and Stage, metastasis and invasion. Carcinogenesis: Environmental carcinogens, viral, • DESIRABLE TO KNOW (Pr): Actinomyosis, Mycetoma, Rhinosporidiosis, Hydatid disease,
chemical, occupational, hereditary. Gross and microscopic features, clinical correlation, Molluscum contagiosum; Parasitic diseases: Malaria, Filaria, Amoebiasis
mode of spread and prognosis of common benign and malignant tumors (Pr). • Pr: Practical topics
• DESIRABLE TO KNOW: Laboratory diagnosis of cancer, Tumor markers, Paraneoplastic • Redundant topic: All other bacterial, viral disease, Leishmania, Parasitic disease, etc.
syndromes.
8. INFANCY AND CHILDHOOD:
• NICE TO KNOW: Newer diagnostic tool in cancer: immunohistochemistry, flow cytometry,
karyotyping • DESIRABLE TO KNOW: Cystic fibrosis, Tumors: Neuroblastoma, Wilm tumor,
Sacrococcygeal Teratoma.
• Pr: Practical topics, Soft tissue tumours of both benign/malignant (compare and
contrast) • Redundant topic: Nutritional disorders - Protein Energy Malnutrition, Vitamin deficiency.

5. IMMUNOLOGY: 9. MISCELLANEOUS DISORDERS (for student symposium):

• MUST KNOW: Immune system: organization (central and peripheral organs), cells, • Occupational and environmental pathology.
molecules and regulation; T and B cell receptor; Human Leukocyte Antigen/MHC;
mechanism of different hypersensitivity reactions with examples; central and peripheral • Alcohol and health
tolerance; autoimmune diseases: both organs specific and systemic with specific examples • Smoking and its effect
like SLE; Amyloidosis: classification, morphology (Pr), diagnosis;.
• Obesity & its relation with disease
• DESIRABLE TO KNOW: Immunology of Sjogren syndrome, Hashimoto thyroiditis,
pathology of transplant rejection, graft versus host reaction. • Diet and its relation to cancer & atherosclerosis

• Pr: Practical topics • Nutritional disorders - Protein Energy Malnutrition, Vitamin deficiency.

• Redundant topic: Immune deficiency: primary and secondary, tumor-host interaction,

tumor immunology.

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B. HEMATOPATHOLOGY: • Pr: Practical topics

• MUST KNOW: Constituents of blood and bone marrow, regulation of hematopoiesis. • Redundant topic: Pulmonary hypertension
Anemia (MODULE) (Pr) (OSPE charts): Classification and clinical features, Laboratory
3. HEAD and NECK and GASTROINTESTINAL PATHOLOGY:
approach. Nutritional anemia: Iron deficiency, Vitamin B12 and Folate deficiency. Hemolytic
Anemia: Classification and Laboratory diagnosis. Thalasemia, Haemoglohinopathies like • MUST KNOW: Oral pathology: Leukoplakia, Premalignant conditions and Carcinoma.
Sickle cell anemia, Hereditary Spherocytosis. Aplastic Anemia, Pancytopenia. Leukemoid Salivary gland pathology: Common benign and malignant tumors (pleomorphic adenoma,
reaction, Leukemia (Pr) (OSPE): Acute and Chronic - classification (myeloid and lymphoid) Warthin tumor, Mucoepidermoid carcinoma, Adenoid cystic carcinoma) (Pr). Barrett
and diagnosis. Multiple myeloma. Esophagus. Gastritis - types, H. Pylori vs. autoimmune gastritis. Benign vs malignant gastric
ulcer (Pr), Tumors of stomach: carcinoma (Pr), MALT lymphoma. Inflammatory diseases
• DESIRABLE TO KNOW: G6PD deficiency, Acquired hemolytic anemia: PNH,
of intestine: Typhoid vs Tubercular ulcer, Amoebic colitis, Ulcerative colitis (Pr) vs Crohn’s
Leukoerythroblastic blood picture, Autoimmune hemolytic anemia, hemolytic disease of
disease, Appendicitis (Pr). Intestinal tumors: Polyps (Pr), adenoma-carcinoma sequence.
newborn, MDS, Approach to a bleeding child, ITP, Coagulation disorders like Hemophilia,
Von Willebrand Disease, DIC. • DESIRABLE TO KNOW: Coeliac disease, GIST, Carcinoid
• NICE TO KNOW: Hirschsprung disease
• NICE TO KNOW: Flow cytometry in leukemia, Rare thrombophilic states - APLA
syndrome • Pr: Practical topics
• Redundant topic: Nasopharyngeal carcinoma, Laryngeal lesion, Ischemic bowel ds.
• Practical topics: Blood transfusion practice: Grouping, Cross Matching, Donor selection,
and Component Therapy, Rational Use of blood transfusion, adverse reactions and 4. LIVER AND BILIARY PATHOLOGY:
transmissible infections.
• MUST KNOW: Jaundice: types, aetiopathogenesis (Pr/OSPE), and differential diagnosis
C. SYSTEMIC PATHOLOGY: Viral Hepatitis: Acute and Chronic, Cirrhosis: Etiology, classification, Post necrotic,
alcoholic, metabolic (Wilson), Morphology, complications. Alcoholic liver disease,
1. CARDIOVASCULAR PATHOLOGY: NAFLD. Gall bladder diseases (Pr): Cholecystitis, cholelithiasis, carcinoma. Tumors of
• MUST KNOW:, Rheumatic heart disease, & Infective endocarditis, Vegetation in heart liver: hepatocellular carcinoma, metastasis.
• DESIRABLE TO KNOW: LFT, Portal hypertension, Liver failure
• Hypertension, Pathogenesis, pathology and morphology of atherosclerosis and ischemic
heart disease (acute myocardial infarction) (Pr) • NICE TO KNOW: Neonatal cholestasis, biliary atresia, Molecular classification of
hepatic adenomas, carcinomas.
• DESIRABLE TO KNOW: Vasculitis (Classification and selected entities), aneurysms,
• Pr: Practical topics
pericarditis
• Redundant topic: Vascular disease of liver, acute fatty liver of pregnancy, Pancreatitis
• NICE TO KNOW: Cyanotic and acyanotic heart disease (VSD, Fallot tetrology)
and Pancreatic tumors
• Pr: Practical topics
• Redundant topic: Cardiomyopathis, cardiac tumours, and others. 5. LYMPHORETICULAR PATHOLOGY:

• MUST KNOW: Lymphadenopathy - Causes, Lymphoma: Hodgkin and Non-Hodgkin

2. RESPIRATORY PATHOLOGY:
- classification scheme and morphology of selected lymphomas, Diseases of spleen -
• MUST KNOW: Structure of bronchial tree and alveoli, defence mechanism, normal and splenomegaly, Hypersplenism
altered lung function, concept of obstructive and restrictive lung disease, Pneumonia • Pr: Practical topics
(lobar vs bronchopneumonia) (Pr), Lung Abscess. Chronic Obstructive Pulmonary disease:
• Redundant topic: Rare causes of lymphadenopathy, rare lymphomas
Emphysema, Chronic Bronchitis, Bronchial Asthma, Bronchiectasis (Pr). Lung tumors (Pr):
aetiopathogenesis and types (including newer prognostic and therapeutic markers). 6. URINARY TRACT PATHOLOGY:
• NICE TO KNOW: Mesothelioma, Interstitial lung disease, Hyaline Membrane Disease • MUST KNOW: Structure and function of normal glomerulus, glomerular response to injury,
and ARDS. Nephritic vs Nephrotic syndrome (OSPE), Glomerlonephritis: Acute Post streptococcal/

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post infectious, Crescentic/RPGN, Nephrotic Syndrome (MCD, MGN, • NICE TO KNOW: Pituitary hyperfunction tumors, Hyperparathyroidism
• MPGN, and FSGS), diabetic nephropathy, chronic renal failure, polycystic kidney disease • Pr: Practical topics.
(Pr), Urinary tract infection and Pyelonephritis, Obstructive uropathy, Hydronephrosis,
Nephrolithiasis. Renal tumors: Renal cell carcinoma (Pr), Benign hyperplasia of prostate, 10. NEUROPATHOLOGY:
carcinoma prostate (Pr). • MUST KNOW: CSF and its disturbance, inflammatory disorders: Meningitis (Pyogenic,
• DESIRABLE TO KNOW: Acute tubular necrosis, benign and malignant nephrosclerosis, Tubercular, Viral, Others) with CSF charts (Pr) and Brain abscess. CNS tumors: Astrocytoma
Urinary bladder: cystitis, urothelial carcinoma and Meningioma (Pr): classification
• NICE TO KNOW: Gleason scoring for carcinoma prostate • NICE TO KNOW: Cerebrovascular accident, hemorrhage, aneurysm, Oligodendroglioma,
ependymoma
• Pr: Practical topics: Renal function tests, Urinalysis
• REDUNDANT TOPIC: Neurodegenerative / demyelinating disorder, muscular dystrophy,
7. REPRODUCTIVE SYSTEM PATHOLOGY: neuropathies

• MUST KNOW: Diseases of cervix: Cervical carcinoma (Pr), PAP stain, Screening and • Pr: Practical topics
diagnosis (CIN). Hormonal influences and histology of different phases of Endometrium.
11. SKIN TUMORS:
Endometrial hyperplasia and carcinoma (Pr), Smooth muscle tumor (Pr), Endometriosis/
adenomyosis (Pr). Hydatidiform mole (Complete vs partial) (Pr) and Choriocarcinoma, • Squamous cell carcinoma, basal cell carcinoma, malignant melanoma (Pr)
Ovarian tumors (Pr). Diseases of breast- fibrocystic disease, Fibroadenoma, Breast • Molecular mechanism of melanoma pathogenesis (NICE TO KNOW)
Carcinoma, Phylloides tumor, Tumors of testis.
• Pr: Practical topics
• DESIRABLE TO KNOW: Molecular basis of endometrial carcinoma
• NICE TO KNOW: Uncommon ovarian and testicular tumors, DUB PRACTICAL SKILLS
• REDUNDANT: Pelvic inflammatory disease, Vulval and vaginal diseases, Genital Acquisition of Skills:
tuberculosis. Paget disease of vulva. Semen analysis and investigation of infertility.
The students should be able to:
• Pr: Practical topics
• Acquire knowledge to collect, store and transport materials for various pathological tests
8. MUSCULOSKELETAL PATHOLOGY: including histopathology, Cytopathology, hematopathology, Blood bank and clinical
• MUST KNOW: Osteomyelitis - Acute, chronic, tuberculous. Tumors: Classification, pathology in a proper manner.
Osteosarcoma (Pr), Chondrosarcoma (Pr), Giant cell tumor (Pr), Ewing’s sarcoma. • Describe accurately and arrive at a logical diagnosis of common macroscopic findings in
• DESIRABLE TO KNOW: Rheumatoid arthritis (Panus), Gout, Paget disease of bone, a pathological specimen such as pneumonia, cirrhosis, gangrene etc.
• Osteoporosis, Osteoarthritis. • Specimens (gross appearance) such as pneumonia, cirrhosis, gangrene etc.
• NICE TO KNOW: Rickets, Osteomalacia
• Interpret and arrive at a conclusive diagnosis in the microscopic analysis of common
• REDUNDANT: Tuberculous. Jaw- Ameloblastoma. diseases like tuberculosis, carcinoma, acute inflammation, etc.
• Pr: Practical topics
• Perform with accuracy and reliability various commonly performed hematological
9. ENDOCRINE PATHOLOGY: procedures such as Hemoglobin estimation, peripheral smear staining and reporting. At
the same time, they will acquire knowledge on recent techniques of automation during
• MUST KNOW: Non neoplastic lesions of thyroid: Colloid Goitre (Pr), Autoimmune their visit to lab.
thyroiditis (Hashimoto thyroiditis (Pr), thyrotoxicosis/Grave disease), tumors of thyroid
(papillary, follicular, and medullary) (Pr). • Calculate red cell indices and interpret the significance as well as common hematological
abnormalities (microcytic hypochromic anemia, megaloblastic./macrocytic anemia/
• DESIRABLE TO KNOW: MEN syndrome, phaeochromocytoma
pancytopenia) in CBC charts.

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• Perform independently complete examination of urine and detect abnormal findings and DISTRIBUTION OF MARKS (SUMMATIVE ASSESSMENT)
interpret the results. They should also have an exposure to diagnostic kits available for
urine tests. A. THEORY: Two papers (I and II)  100x2=200 marks

• Perform independently grouping of blood. B. PRACTICALS  80 marks

• Aware of the procedure for common tests like ESR, PCV, vacutainers, bone marrow C. VIVA  20marks
examination, semen analysis and interpret abnormal findings. TOTAL MARKS  300 marks
• Interpret abnormal laboratory (biochemical, hematological and serological) values of
common diseases. GENERAL CONSIDERATION:

• Adopt universal precautions for self protection and patient safety. • 60-70 % of question topic should be from MUST KNOW category.

• Modified Essay Question/CASE BASED QUESTION (STRUCTURED) should be from MUST

Practicals
KNOW category.
1. Up to 15 hours (maximum) will be devoted to practical skills pertaining to haematology,
• Total number of SHORT ANSWER QUESTION (SAQ) is 16 in each paper of which maximum
clinical pathology, and blood banking as mentioned below:
5 or 6 should be from DESIRABLE/NICE TO KNOW category.
• Perform a complete urine examination and detect abnormalities and correlate clinically.
• Undue repetition should be avoided and near total representation of the entire course content
• Perform with accuracy and reliability various hematological procedures such as Hemoglobin should be there.
estimation, peripheral smear staining and reporting and blood grouping.
• OBJECTIVE ASSESSMENT of PROCEDURE PRACTICAL SKILLs by checklist.
• Observing or performing under guidance tests like ESR, PCV, bone marrow examination,
and interpret abnormal findings. • MODEL ANSWER PAPER should be prepared by the EXAMINER framing the question paper.

2. Remainderl30-135 hours of the entire practical shall be devoted to Identify and interpret gross A. THEORY  200 marks
and microscopic feature of pathological specimens and slides (as mentioned as Pr in course
contents). This will also include discussion of case studies based on the real case scenario 4. Paper I (two Sections)
and appropriate laboratory findings of patients along with gross and microscopic findings • Section A (General Pathology)  50 marks
wherever applicable to learnclinicopathological correlation (OSPE charts).
i) Modified Essay Question (Must be Structured)  10 marks
3. Upto 3 hours each (total 12 hours) may be devoted for REVISION PURPOSE before formative
and final/summative assessment. ii) Eight Short answer questions (5marks each)  40 marks

EXAMINATION PATTERN • Section B (hematopathology, Childhood disease)  50 marks

• Three FORAMTIVE examinations (two + one prefinal): 2 hours each i) Modified Essay Question (Must be Structured)  10 marks

• 1st: General Pathology and Hematology- Short answer, very short answer, MCQ ii) Eight Short answer questions (5 marks each)  10 marks

• 2nd : All systemic pathology: Short answer, very short answer, MCQ. 5. Paper II (two Sections)

• 3rd (PRE FINAL): Entire syllabus (same as SUMMATIVE type) • Section A (Systemic 1)  50 marks

• Internal assessment marks will NOT be added to final examination marks. i) Modified Essay Question (Must be Structured)  10 marks
• Interna assessment is only for eligibility for appearing FINAL/SUMMATIVE exam. ii) Eight Short answer questions (5marks each) 40 marks

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M.B.B.S CURRICULM M.B.B.S CURRICULM

• SECTION B (SYSTEMIC 2) 50 marks MODEL QUESTION PAPER

i) Modified Essay Question (Must be Structured)  10 marks PATHOLOGY
ii) Eight Short answer questions (5 marks each)  40 marks
PAPER I
(General Pathology, Hematology, Childhood diseases)
B. PRACTICALS  80 marks
Time: 3 hours Maximum marks= 100
• SPOTTERS(N=15) (X2)  30 marks
Answer all questions SECTION WISE separately and in SERIAL ORDER. Illustrate your answer
o Gross specimen with suitable labelled diagrams

o Microscopic slides
SECTION-A
o OSPE charts
1. A 29 year old male presented with persistent low grade fever and cough since last 3 months
o Instruments associated with night sweat and weight loss. On examination, he had matted right cervical
group of lymph nodes with draining sinus and cheese like purulent material. His erythrocyte
• Slide for comments  10 marks
sedimentation rate was 100mm/ 1st hour.
(identification/diagnosis with justification and level diagram)
a. What is the most probable diagnosis? Explain with reasons  [2]
• Compare and contrast (N=2) (5x2)  10 marks
b. Draw a labelled diagram depicting the likely morphological changes in this case.  [3]
• Cause and effect (N=2) (5x2) 10 marks
c. Discuss in brief the immunological mechanism associated with this morphology.  [3]
• PROCEDURE/PRACTICAL SKILLS d. Enumerate the pertinent laboratory investigations to reach at a diagnosis.  [2]
o Peripheral smear staining and comment  10 marks
2. Answer the following questions with appropriate illustrations wherever applicable  [8x5=40]
o Urine examination (case based)  5 marks
a. Draw a labelled diagram of T cell receptor
o Blood grouping  5 marks
b. Mention the systematic approach to laboratory diagnosis of cancer
• VIVA  20 marks c. Compare and contrast in tabular format between dystrophic and metastatic calcification
d. Enumerate the various morphology and staining pattern of amyloid
e. Draw a pedigree chart of Autosomal dominant disease with examples
f. What is Telomere? Briefly discuss its role in aging.
g. Draw labelled diagrams depicting different mechanisms of Graft versus host disease
h. Mention in tabular format the difference between cutaneous wound healing by primary
and secondary intension.

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SECTION- B MODEL QUESTION PAPER

1. A 34 year old male presented with generalised malaise and fatigue along with vague PATHOLOGY
upper abdominal discomfort since last three months. On examination, he had atrophic PAPER II
glossitis, conjuctival pallor and lemon yellow coloured sclera. Upper gastrointestinal
(Systemic Pathology)
endoscopy revealed a flattened gastric regae. Peripheral smear examination showed
pancytopenia with ovalomacrocyte. Time: 3 hours Maximum marks= 100
a. What is the most probable diagnosis? Explain with reasons. [2] Answer all questions SECTION WISE separately and in SERIAL ORDER. Illustrate your
b. Enumerate with a labelled diagram the sequence of laboratory investigations to reach at answer with suitable labelled diagrams
a diagnosis in this case.  [4]
c. Discuss in brief the aetiopathogenesis of this condition.  [4]
SECTION-A
1. A 59 year old male, known type 2 diabetic for the last 15 years presented with gradually
2. Short answer type questions:  [8x5=40] decreasing urinary output (30 ml/day, serum urea=134mg/dl, serum creatinine=4.5 mg/dl),and
ascites. His fasting plasma glucose was 234 mg/dl, HbA1c=9.5%. His ultrasound abdomen
a. Mention in tabular form the differences between leukemoid reaction and chronic myeloid
showed bilateral shrunken kidneys with altered cortico-medullary distinction.
leukemia.
b. What are the differential diagnoses of microcytic hypochromic anemia? Enumerate the a. What is the most probable diagnosis? Explain with reasons. [2]
laboratory diagnostic parameters to differentiate between them. b. Discuss with labelled diagrams depicting the sequential morphological changes in the
c. What is a reticulocyte? Mention the various pathophysiologic conditions associated with kidneys.  [4]
abnormal count. c. Draw a flowchart depicting aetiopathogenesis of diabetic microangiopathy with
d. Draw a labelled schematic diagram depicting pathogenesis of spherocytosis. examples.  [4]

e. What is Landsteiner law? Enumerate the various complications of mismatched blood 2. Answer the following questions with appropriate illustrated diagrams wherever applicable.
transfusion.
[8x5=40]
f. Enumerate the common pediatric solid tumors. Mention with diagram the gross and
microscopic features of Wilm tumor. a. Enumerate the gestational trophoblastic diseases. Mention in tabular form the
differences between partial and complete mole.
g. What is leukoerythroblastic blood picture? Enumerate four causes for the same.
b. Draw a labelled diagram of gross and microscopic feature of seminoma testes.
h. Draw a labelled diagram of the peripheral smear finding in acute myeloid leukemia and
mention the tests to confirm the diagnosis. c. Cervical intraepithelial neoplasia: pathology and screening technique used.
d. Enlist the various prognostic markers in carcinoma of breast.
e. What is dense deposit disease? Mention the pathogenesis with a flow chart.
f. Enumerate the epiphyseal tumors of the bone and draw a labelled diagram on giant cell
tumor.
g. Enumerate the risk factors and briefly outline the pathogenesis of endometrial
carcinoma.
h. Classify Hodgkin lymphoma. Draw diagrams depicting morphological variants of Reed
Sternberg giant cell

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M.B.B.S CURRICULM

SECTION- B
1. A 34 year old female presented with bleeding per rectum associated with crampy abdominal
pain. On colonoscopic examination, she had an ulceroproliferative growth in the rectum
along with numerous polyps throughout the colon.

a) What is the most probable diagnosis? Explain with reasons. [2]

b) Discuss the pathogenetic mechanism linking the patient diagnosis.  [5]
c) Discuss in brief the different type of polyps in the gastrointestinal tract.  [3]

2. Answer the following questions with appropriate illustrated diagrams wherever applicable
[8x5=40]

a) What are COPDs? Draw a flow chart depicting the pathogenesis of bronchial asthma.
b) What is Aschoff body? Draw a labelled diagram highlighting various types of vegetations
seen in heart.
c) Pathology and clinical implications of Buerger disease.
d) Enumerate the different types of gall stones with examples. Briefly highlight the
pathogenesis of gall stone formation.
e) Briefly outline the recent classification and clinical significance of hepatic adenoma.
f) Classify bronchogenic carcinoma. Briefly mention the molecular alteration and
implication in adenocarcinoma.
g) Enumerate common salivary gland neoplasms. Discuss the gross and microscopic
MICROBIOLOGY
appearances of Warthin tumor.
h) Define hypersplenism and mention four common important causes of the same.

Learning Resource:
• Kumar, Abbas, Aster: Robbins and Cotran Pathologic Basis of Disease, Vol I and II, South
Asia Edition, Elsevier, 2014.

• Kumar, Abbas, Aster: Robbins Basic Pathology: First South Asia Edition, Elsevier, 2017.

• Bharadwaj and Deb: Boyd’s Textbook of Pathology, 10th Edition, Lippincott Williams and
Wilkins.

• Tejinder Singh: Atlas and Text of Hematology, 3rd Edition, Avichal Publishing Company.

• Tejinder Singh and K. Uma Chaturvedi: Practical Pathology (with viva voce questions), 3rd
edition, Arya Publications.

• Gross specimen catalogues, slides, OSPE charts, and instrument

• Vinay Kamal. Textbook of Pathology, CBS Publishers and Distibutors Pvt. Ltd., First edition,
2017

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MICROBIOLOGY 4. Apply methods of sterilization and disinfections to control and prevent hospital and
community infections.
OBJECTIVES
5. Apply methods of infection control, hand hygiene, standard precautions in their hospital
The broad goal of the teaching of undergraduate students in microbiology is to provide an practice to control and prevent hospitalacquired infections and patient’s safety.
understanding of the natural history of infectious diseases in order to deal with the etiology,
pathogenesis, laboratory diagnosis, treatment and control of infections in the community. c. Affective domain:
The student shall understand infectious diseases of national importance in relation to the
SPECIFIC LEARNING OBJECTIVES
clinical, therapeutic and preventive aspect.
a. Cognitive domain
1. Interpret laboratory investigations for the diagnosis of infectious diseases and to correlate
At the end of the course the student shall be able to: the clinical manifestations with the etiological agent.
1. State the infective microorganisms of the human body and describe the host parasite 2. Recommend laboratory investigations regarding bacteriological examination of food,
relationship. water, milk and air
2. List pathogenic microorganisms (bacteria, virus, parasites, fungi) and describe the 3. More emphasis on analytical interpretation of integrated topics which are important from
pathogenesis of the diseases produced by them. public health view.
3. State or indicate the modes of transmission of pathogenic and opportunistic organisms • Tuberculosis, Sexually transmitted diseases, HIV, Hepatitis, Malaria, Dengue, Influenza
and their sources, including insect vectors responsible for the transmission of the infection. etc.)
4. Describe the mechanisms of immunity to infections. 4. Involvement of other specialties like pathology, radiodiagnosis, medicine, surgery,
pediatrics etc.to teach such diseases in integrated manner.
5. Acquire knowledge on suitable antimicrobial agents for treatment of infections and scope
of immunotherapy and different vaccines available for prevention of communicable 5. Also, interpretation of syndromic approach for diagnosis of infectious diseases needs to be
diseases. emphasized. This will help to understand the diagnosis and management on clinical level.
6. Plan laboratory investigations for the diagnosis of infectious diseases and to correlate the
clinical manifestations with the etiological agent. COURSE CONTENT
7. Awareness of principles of biomedical waste management in the hospital as well as at The student must know the following principles in:
primary care level.
General Microbiology:
8. Acquire knowledge of the emerging and reemerging infectious agents.
• General concepts of infectious diseases prevalent in India (morbidity, mortality data)
b. Psychomotor domain • Significant milestone in history of infectious diseases
At the end of the course the student shall be able to: • Definitions pertaining to infectious diseases, (e.g.: host, parasite, endogenous, exogenous
infection transmission, routes, source, reservoir etc)
1. Use the correct method of collection, storage and transport of clinical material for
microbiological investigations. • Classification of microbes from clinical view point
• Normal human microbial flora and its importance in health and disease.
2. Identify the common infectious agents with the help of laboratory procedures and use
antimicrobial sensitivity tests to select suitable antimicrobial agents. • Bacterial cell morphology, physiology and genetics in relation to virulence and human
infections.
3. Perform commonly employed bedside tests for the detection of infectious agents suchas
• Sterilization, disinfections and standard precautions in patient care and disease prevention
blood film for malaria, filaria, gram staining, albert staining and acid-fast staining. Stool
including hand hygiene.
sample for ova and cyst.
• Bacteriophage: Structure, role in virulence and antibiotic resistance.

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• Antimicrobials, mode of action, testing, interpretation of results and rational use, • Protozoal infections prevalent in India:
mechanism of resistance. • Intestinal, Blood, Genital, &Other protozoal infections

Immunology: • Helminths (Intestinal and tissue) prevalent in India.

• Cestodes
• Immune apparatus, lymphoid organs, Immunobiology
• Nematodes
• Antigen and antibody.
• Trematodes
• Antigen-Antibody reactions, serological and immunological assays.
• Opportunistic Parasitic infections
• Cell and humoral immunity in health and disease
• Hypersensitivity Mycology:
• Immunodeficiency diseases General properties and classification of fungal diseases, pathogenesis, approach to laboratory
• Tumor immunity / transplant immunity and auto-immunity diagnosis (sample collection, identification), antifungal agents and opportunistic fungal
• Immunoprophylaxis infections.

Bacteriology: Applied Microbiology:

• Common Gram positive / negative cocci / bacilli, associated with human infections CNS Infections: Acute and chronic meningitis, encephalitis and brain abscess. PUO/FUO:
Infective and non-infective causes and approach to diagnosis of sepsis, diarrhoeal diseases
• Mycobacteria.
(including food poisoning) respiratory tract infections (upper & lower) UTI, skin, soft tissue,
• Anaerobic bacteria bone and joint infections eye and ear infections, sexually transmitted infections, Infections
• Spirochetes in immuno-compromised individuals, congenital infections, Healthcare associated Infections
and its prevention. (Standard precautions and hospital waste management) including patient’s
• Chlamydia, Rickettsia, Mycoplasma
safety. Zoonotic diseases and emerging diseases Bacteriology of food, water and milk
• Miscellaneous bacteria of clinical importance.

Virology:
SKILLS
The student should be able to perform the following skills independently:
• General properties, structure, replication, classification.
• Virus, host interaction and pathogenesis 1. Collection of relevant clinical samples.
• Antiviral agents • Blood/ urine/ sputum/ body fluids etc. for bacterial and fungal culture
• General concepts in laboratory diagnosis of viral infections. • Samples for viral diagnosis (culture/ PCR)
• Common clinically important DNA and RNA viruses such as: Herpes viruses, Adenovirus, • Swabs for microscopy and aerobic culture
Poxvirus, Parvovirus, Papillomavirus, Polyomavirus, Picomavirus, Orthomyxovirus,
• Blood and other samples for serological test Storage and transport of the clinical
Paramyxovirus, ARBO viruses, Rabies virus, HIV, Hepatitis viruses, Rotavirus etc.
specimens
• Prion and oncogenic viruses
2. Preparation of smears from clinical material
• Viral infections in immunocompromised patients
• Miscellaneous virus of medical importance: Coronavirus, Ebolavirus, Zika virus etc. 3. Microscopic Examination -

Gram stain, special stains, Ziehl - Neelsen stain

Parasitology
Stool for ova and cyst
• General concepts and definition of key terms, classifications, infections of national
Blood smear for parasites (MP, Mf, LD bodies).
• prevalence.

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M.B.B.S CURRICULM

Albert stain for diphtheria

8. Antibiotic sensitivity testing.

METHODS OF ASSESSMENT:

TEACHING LEARNING METHODS:

Under supervision (Demonstration purpose)

Sequential organization of contents and their division

Practical: Practical exercise, record review and viva voce
4. Standard precautions: hand wash, asepsis and antisepsis.

Case based exercise, self-learning tools, interactive learning

7. Serological tests: VDRL, HIV, Hepatitis, ASO, RF, Widal Test.

Theory: Long answer, short answer and multiple choice questions

India ink preparation for capsulated organisms (Ex: Cryptococcus)

6. Interpretation of Microbiology reports: Culture/ microscopy/ serology

Modified Z-N stain for M. leprae, coccidian parasites KOH for fungal elements

Didactic lectures, small group discussion, tutorial, Practical including demonstration,

5. Biomedical waste disposal: Disposal of Needle, sharps and other infectious materials

and Applied microbiology in relation to infections and diseases of various systems of the body.
including Bacteriology, Immunology, Mycology, Virology, Rickettsia, Chlamydia, Parasitology
The areas of study in Microbiology will include General Microbiology, Systemic Microbiology

A) GENERAL MICROBIOLOGY:
No
Topic of lecture Must know (MK) Desirable to know(DK) Nice to Know (NK)
1. Introduction and Definitions: Medical Microbiology, pathogen, commensal, Microorganisms as models in To cover Anton van
Historical background symbiont etc. Molecular Biology and Leuwenhoek, Pasteur,
In History: Scope to cover the importance of Med. Genetic engineering. Lister, Koch, Fleming
Microbiology on diagnosis and prevention of contributions in detail
inf ectious diseases with important milestones. Koch’s postulates.

2. Morphology of bacteria Bacterial cell and its organelles, morphological classification, Dark ground illumination, Electron microscopy
and Classification methods of studying bacteria, staining methods & their principlesphase contrast and
Grams & Ziehl Neelsen staining, their importance in presumptive fluorescent microscopy
diagnosis, negative staining. Principles and applications of all
microscopes.

3. Physiology of bacteria Nutrition, respiration (anaerobic & aerobic)and growth of Important constituents of Chemostat, Turbidostat
including growth bacteria, growth curve, physical factors influencing growth. culture media.
requirements & Culture media: Definition, classification and application.
metabolism

4. Sterilization Definition of sterilization, disinfection, asepsis, antiseptics. Working and Efficacy testing Plasma sterilization,
Ubiquity of bacteria, modes of killing microbes and preventing of autoclave, inspissator and Ethylene oxide
them, factors determining selection of the mode, factors hot air oven.
adversely affecting sterilization. Enumeration of physical methods
of sterilization including principle& their application .
Central Sterile Supply Department (CSSD)- concept only.

5. Disinfectants Asepsis and antisepsis, modes of Action of chemical agents on Dyes, soaps and detergents.
microbes. Phenols, Halogens, Aldehydes, Acids, Alcohol, heavy Concentration and contact
metals, oxidizing agents etc. Standard precautions . time.
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M.B.B.S CURRICULM
136
No Topic of lecture Must know (MK) Desirable to know(DK) Nice to Know (NK)
6. Waste disposal Definition of waste, classification, segregation, transport and About common treatment Working of incinerator
disposal. facility site of waste disposal plant, Hydroclaving
M.B.B.S CURRICULM

7. Bacterial genetics and Introduction - codon, Lac operon, mutation, transformation, Concept of Antibiotic Policy Antibiotic policy,
drug resistance to transduction &conjugation, R factor, mode of action of and antibiotic stewardship formulation
antimicrobial agents. antimicrobials on bacteria, mechanism of drug resistance and
antimicrobial susceptibility tests, steps taken to minimize
emergence of resistant strains

8. Host parasite Commensal, pathogenic and opportunistic organisms, their Antigenic variation ------
relationship and pathogenic factors and modes of transmission. extrinsic factors leading to
bacterial infections Microbial factors: spores, capsule, toxins, enzymes, intracellular establishment of infection.
parasitism, etc. Types of infection: primary, secondary, general,
local, natural, nosocomial, iatrogenic, zoonotic.

9. Normal flora Introduction - various sites, types and role Fecal microbiota -------
transplantation, probiotics

10. Methods of Principles of laboratory diagnosis of infectious diseases. General PCR, RIA, DNA probes. Automated culture &
identification of procedures for collection transport, processing of specimens for Immunofluorescence identification system.
bacteria. microbiological diagnosis. MALDI-TOF
Diagnosis of infectious
diseases (direct and
indirect)

11. Patient Safety Physical methods of sterilization like autoclave, Hot air Oven Detailed description of Quality assurance
demonstration of various disinfectants (High, Intermediate and biomedical wastes (according
Low) and antiseptics (alcohol-based hand Rub) Health care to current guidelines)
associated Infection. Hand hygiene, Infection control

B) IMMUNOLOGY

No. Topic Must know Desirable to know Nice to know

1. Introduction Definition of immunity, types of immunity, factors Herd immunity Toll like receptor Pathogen
responsible, mechanism of innate immunity, active and associated molecular
passive immunity, local immunity. pattern

2. Antigens, HLA Definition, types, antigen determinants, properties of Nature of determinants, e.g. of HLA typing methods
antigen. haptens, e.g. of cross- reactive
MHC- concept, class-I, II & III functions, indication of typ- antigen.
ing, MH restriction.

3. Antibodies Definition, nature, structure& physical and biological Understand isotypic, allotypic Pepsin digestion,
properties of immunoglobins. and idiotypic markers, abnormal amino acid sequence,
immunoglobulin classes, immunoglobins. immunoglobin domain,

4. Serological Definition, characteristics, titre, sensitivity& specificity, Techniques of precipitation and Immune electron
Reactions antigen-antibody interaction-primary, secondary & their uses, blocking antibodies, microscopy.
tertiary, prozone phenomenon, principle, types and antiglobulin reactions,
application of precipitation, agglutination, enzyme complement fixation, co-
immunoassay, radioimmunoassay, immunofluorescence agglutination, techniques of EIA, IF
test, neutralization and opsonization.

5. Immune Types, development, role of --thymus, bone marrow, Mechanism of immunoregulation, Theories of antibodies
Response lymph nodes& spleen, cells of lymphoreticular system, techniques of monoclonal antibody formation, clonal selection
morphology and role of T subsets, NK cells, B cells, formation, detection of CMI, types theory
plasma cells and macrophages, B&T cell activation, antigen of immunotolerance.
processing and presentation, primary and secondary
immune response, principle and uses of monoclonal
antibodies types, role of T cell and macrophages, definition
of immune tolerance and mechanism of tolerance.
Lymphokines and their role
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M.B.B.S CURRICULM
138
No. Topic Must know Desirable to know Nice to know
6. Complement Definition, components, synthesis, activation, pathways, & Regulation of complement Measurement
biological functions, activation deficiency of complement
components,
M.B.B.S CURRICULM

7. Hypersensitivity Definition, classification & difference between immediate and Tests for anaphylaxis TypeV Desensitization
delayed reaction, mechanism & types of anaphylaxis, atopy, hypersensitivity in anaphylaxis,
examples of anaphylactic reaction, manifestations of anaphylaxis, Schwartzman
mechanism of type-II, Type-III &delayed hypersensitivity. phenomenon

8. Autoimmunity Definition, classification, examples Mechanism Pathogenesis

9. Transplantation & Types of transplants, mechanism of transplant rejection, graft Type of tumor antigens, Immune response to
tumor Immunology rejection, GVH reaction, immune surveillance. tumors, tumor antigens,
mechanism of Immune
response to tumors.

10. Immuno Deficiency Classification, examples, Disease manifestations Laboratory tests for
detection,

C) BACTERIOLOGY :

No Topic/ hours Must know Desirable to know Nice to know

1. Staphylococci Classification, morphology, culture, isolation, biochemical Special test for culture Coagulase negative
(1 hour) reaction &identification, viability, antigens virulence, diseases, & identification of S . aureus, Staphylococci
pathogenesis, lab diagnosis, prevention & control,
MRSA
2. Streptococci Classification, morphology, culture isolation, biochemical reaction Immune response to S . pyogenes Antimicrobial resistance of
Pneumococci identification, viability, virulence, diseases, pathogenesis, lab S Pneumomae
(3 hour) diagnosis, prevention & control

3. Neisseria Morphology, classification, culture, identification, pathogenesis, Antigens, virulence factors Drug resistance,
(1 hour) diseases, lab diagnosis, prevention Commensal
& control of N. meningitidis& N. gonorrhoeae Neisseria
4. C. diphtheriae Morphology, viability, virulence, diseases , pathogenesis , lab Classification, Culture & isolation, Schick test, Danysz
(1 hour) diagnosis, prevention & control biochemical reaction, immune phenomenon
response.
5. M. tuberculosis Classification, morphology, Culture & isolation on LJ Media, Biochemical reaction, immune Drug susceptibility &
(2 hours) identification, viability, virulence, diseases, pathogenesis, lab response newer methods of
diagnosis, prevention & control identification

6. Atypical Classification, morphology, viability, virulence, diseases, Culture & isolation Biochemical tests for
M ycobacteria pathogenesis, lab diagnosis, prevention & control identification

(lhour)
7. M . leprae Classification, morphology, pathogenesis, lab diagnosis, Isolation, viability, virulence factors Immune response
(1 hour) prevention & control,

8. Bacillus Classification, morphology, Culture & isolation, viability, Biochemical reactions Bioterrorism
(1 hour) virulence, diseases , pathogenesis , lab diagnosis, prevention &
control
9. Anaerobes Classification, morphology, methods of anaerobiosis, viability, Non sporing anaerobes Biochemical reactions for
(1 hours) diseases, pathogenesis, lab diagnosis, prevention & control identification

10. Clostridium Morphology, viability, virulence, diseases, pathogenesis, lab Culture, isolation &biochemical Antibiotic associated
welchii, tetani, diagnosis, prevention & control reactions diarrhea
botulinum
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M.B.B.S CURRICULM

(1 hour)
140
No Topic/ hours Must know Desirable to know Nice to know
11. Enterobacteriaceae Classification, morphology, viability, virulence, Culture & isolation,
(1 hour) diseases , pathogenesis , lab diagnosis biochemical reactions, Antigens Hemolytic uremic syndrome

12. Salmonella typhi & Classification, morphology, culture, isolation & Antigens Antigenic variation
M.B.B.S CURRICULM

parat yphi biochemical reactions viability, virulence, diseases, Non-typhoidal Salmonella, Typhoidal
pathogenesis , lab diagnosis, prevention & control& vaccines
(2 hour) immune response
13. Shigella(l hour) Classification, morphology, Culture, isolation & Antigens Drug resistance
biochemical reactions viability, virulence, diseases,
pathogenesis , lab diagnosis, prevention & control&
immune response

14. Vibrio & Campylobacter Classification, morphology, Culture, isolation & Halophilic Vibrio Cholera vaccine
(2 hour) biochemical reactions viability, virulence, diseases,
pathogenesis , lab diagnosis

15. Pseudomonas Morphology, Culture, isolation & biochemical Hospital acquired infection due to Drug resistance
(1 hour) reactions viability, virulence, diseases, lab diagnosis Pseudomonas

16. Miscellaneous bacteria List of clinically relevant species, morphology, lab Culture & isolation --
(2 hours) diagnosis

17. Spirochetes (2 hours) Classification, morphology, viability, diseases Culture & isolation, immune response Non venereal treponematoses
Lyme disease
18. Actinom ycetes & Morphology, lab diagnosis Classification, culture & Epidemiology
Nocardia(l hour) isolation

19. Rickettsia (1 hour) Classification, morphology and lab diagnosis Q fever

20. Chlamydia & Classification, morphology and lab diagnosis Ureaplasma

Mycoplasma (2 hour)

21. Bacteriology of air, Method of air, water & milk culture for presence of Presumptive coliform
water, milk and food bacterial pathogen identification
(1 hour)

D) MYCOLOGY:

No Topic Must know Desirable to know Nice to know

1. Introduction to Nature of fungus (definition, differences with Growth requirements, Industrial importance of fungi,
Mycology bacteria),characteristics of fungi, common terminologies, Ecological & medical importance, mycotoxins
brief account of types of sporulation and morphological
classification of fungi. Methods of identification, Infections
produced, Lab Diagnosis, processing of skin, hair and nail,

2. Agents of Superficial Enumerate, predisposing factors, morphological features, Colony characteristics of Morphology on
mycosis Lab. Diagnosis dermatophytes Lactophenol cotton blue mount.

3. Agents of Predisposing factors for Mycetoma, Rhinosporidiosis, Chromoblastomycosis Slide culture technique
Subcutaneous Pathogenesis, Lab. Diagnosis
Mycosis

4. Systemic mycosis Classification, predisposing factors, Cultural characteristics Candida auris

Opportunistic fungal Candida, Cryptococcus, Histoplasma
infections morphology, pathogenesis, lab. Diagnosis Classification,
predisposing factors, M ucor, Aspergillus, Pneumocystis
carinii
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M.B.B.S CURRICULM
 E) VIROLOGY

142
No Topic lecture Must know Desirable to know Nice to know

1. General Virology Size, shape, symmetry, structure, resistance & Viral replication Bacteriophages
classification of viruses, pathogenesis.
M.B.B.S CURRICULM

2. Laboratory Collection of samples, transport & methods of Cultivation of virus Concept of viral load & detection.
diagnosis diagnosis
of viral infections

3. Virus host Viral immunity, interferon, viral vaccines Newer viral vaccines Chemoprophylaxis & chemotherapy
interaction of viral diseases
immunity

4. DNA viruses Morphology, pathogenesis, laboratory diagnosis, Pox viruses Polyoma viruses
Papilloma prevention and control Epidemiology of DNA viruses
Adenovirus
Herpes viruses
(Herpes simplex,
Varicella zoster,
CMV, EBV)
Parvovirus

5. Orthomyxoviruses Morphology, epidemiology, antigenic shift & drift, Avian influenza Drug resistance
pathogenesis, laboratory diagnosis, prevention and
control

6. Paramyxoviruses Morphology, pathogenesis, laboratory diagnosis, Epidemiology -----

prevention and control

No Topic lecture Must know Desirable to know Nice to know

7. Picornaviruses: Morphology, pathogenesis, epidemiology, laboratory Rhinovirus , Hand foot & mouth disease ECHO virus
polio & Non-polio diagnosis, prevention and control virus
enteroviruses

8. Rabies virus Morphology, pathogenesis, laboratory diagnosis, Chandipura ,Ganjam& other Rabies Lassa fever virus
prevention and control related viruses

9. Hepatitis viruses Morphology, pathogenesis, epidemiology, laboratory Molecular epidemiology Hepatitis G

diagnosis, prevention and control

10. Arboviruses Dengue, chikungunya, Japanese encephalitis, Molecular epidemiology Uncommon West Nile virus
KFD, CCHF -classification, arboviruses in India, Arboviruses causing hemorrhagic fever &
Pathogenesis, laboratory diagnosis and control encephalitis

11. Human oncogenic List of oncogenic viruses Mechanism of oncogenesis Viral markers of oncogenesis
viruses Anti & proto oncogenes

12. Slow viruses & List of Slow & Emerging viruses pathogenesis & Characteristics of slow virus Laboratory
Emerging viruses associated diseases diagnosis

--------
13. Retroviruses Morphology, pathogenesis, epidemiology, laboratory HIV 2
diagnosis, prevention and control
--------
143
M.B.B.S CURRICULM
 M.B.B.S CURRICULM M.B.B.S CURRICULM

List of Lectures (Department of Microbiology)

Geographical distribution, habitat, morphology, life cycle, pathogenesis, laboratory diagnosis, treatment and control of following par-
asites: E. histolytica, free living amoeba, Giardia lamblia, Leishmania donovani, Plasmodium spp, Toxoplasma gondii, Taenia solium,
Taenia saginata, Echinococcus granulosus, Schistosoma, Ascaris lumbricoides, Ancylostoma duodenale, Enterobius vermicularis and

Nonpathogenic amoeba
SL Topics Topics

Nice to know
Immunity to parasitic

Onchocerca & Loa loa

No

Plasmodium knowlesi
Chilomastix mesnili

Clonorchis sinensis
1. Introduction to Microbiology 25. MHC & Transplant Immunity

H. diminuta
2. Morphology & classification of 26. E. histolytica

T. trichiura
diseases
bacteria

B. coli
3. Physiology, growth & metabolism of 27. Free living amoeba,
bacteria
4. Sterilization physical Methods-1 28. Flagellates & Ciliates
Desirable to know
Emerging parasitic infections

5. Sterilization physical Methods -2 29. Intestinal Sporozoa

Cryptosporidium, Isospora,

Fasciola hepatica, Paragonimus

6. Disinf ection & Standard precaution 30. Malaria - 1
7. Bacterial genetics -1 31. Malaria-2
Trypanosomes

Larva migrans
8. Bacterial genetics -2 32. Toxoplasma & Babesia

Cysticercosis

D. medinensis
Cyclospora
Trichomonas

westermani
9. Bacterial virulence 33. Hemoflagellates- 1
E . dispar

Babesia

10. Common Culture media methods & 34. Hemoflagellates -2

Antimicrobial susceptibility test
of terminologies, epidemiology, pathogenicity and
Parasitology

11. Methods of bacterial identification 35. Helminths: Gen f eatures & properties
Parasites: their nature, classification, explanation

12. Introduction to immunity 36. Intestinal nematodes: (A. lumbricoides,

Taenia saginata & solium, Echinococcus granulosus

A. duodenale, A. lumbricoides, E. vermicularis, S.

E. vermicularis, Trichuris trichiura)
13. Antigen 37. Intestinal nematodes: (Ancylostoma
duodenale, S trongyloides stercoralis,
Must know

Trichinella spiralis )
14. Immune System Structure & function - 38. Tissue nematodes classification

W. bancrofti, B. malayi T. spiralis

&filariasis
Giardia and Trichomonas
laboratory diagnosis.

Amoebic infections

15. Immune System Structure & function - 39. Tissue nematodes: II Guinea worm &
Malarial parasites

Larva migrans
Schistosomiasis
Leishmaniasis

16. Antibody 40. Cestodes-l (T. saginata, T. solium)

Misc. Pathogenic protozoa Toxoplasma

stercoralis

17. Antigen-antibody reaction: I 41. Cestodes -2 E. granulosus, D. latum & H.

nana
18. Antigen-antibody reaction: 2 42. Trematodes
Introduction to Medical

19. Antimicrobial resistance: I 43. S treptococcus - part 1Gr A

E. histolytica , Free living
Topic of lecture

Intestinal nematodes

Tissue nematodes

20. Antimicrobial resistance-2 44. S treptococcus -2 GR B, C, D

Hemoflagellates
Wuchereria bancrofti

21. Complement 45. Pneumococcus

Parasitology

Trematodes
Flagellates

Cestodes

22. Introduction to parasitology 46. S taphylococcus

amoeba

Malaria

23. Immune Response 47. Neisseria

24. Hypersensitivity 48. C. diphtheriae
No.

10.
1.

3.

5.

8.
7.
2.

4.

6.

9.

144 145
M.B.B.S CURRICULM M.B.B.S CURRICULM

SI. Topics Topics SI. Topics Topics

No No
49. Patient Safety 71. H. influenzae 93. Adeno, Parvo 117. Normal Microbial Flora
50. Hand hygiene 72. Mycoplasma - 94. Pox, Papova- 118. Skin, Soft tissue, bone Inf ection

95. Herpes- part l(simplex) 119. Eye & Ear Inf ections
51. Bacillus 73. Actinomycetes, Nocardia
96. Herpes 120. Diarrhoea & Food Poisoning
52. Introduction to Enterobacteriaceae & 74. Rickettsia
E. coli 97. Orthomyxovirus 121. Zoonoses
53. Klebsiella, Enterobacter, Proteus 75. Yersinia, Pasteurella, Francisella 98. Paramyxovirus 122. HAI

54. Shigella 76. Miscellaneous Bacteria-1 99. Picorna -1 123. CNS Infections

55. Salmonella- I 77. Miscellaneous Bacteria-2 100. Picorna-2 124. BSI & Inf ective Endocarditis

56. Salmonella- II 78. Introduction to Mycology - 101. Arbo-2 Dengue, CCHF & other viral 125. Emerging & Reemerging Infections
hemorrhagic fevers
57. Introduction to Anaerobes, C. 79. Superficial mycoses Dermatophytes 102. Arbo-3JE, Y. F, KFD 126. Immunoprophylaxis
perfringens 103. Infective Hepatitis- (A, E) 127. Infections of Respir. tract
58. Other Clostridia & Non-sporing 80. Subcutaneous mycoses
anaerobes 104. Rhabdo- 128. Bacteriology of Air, Water, Milk

105. Hepatitis - B 129 . Bordetella

59. Vibrio- I 81. Candida
106. Hepatitis - C
60. Vibrio -II 82. Cryptococcosis
107. Oncogenic & emerging Viral infections
61. Pseudomonas, Burkholderia 83. Deep mycoses -
108. HIV -1
62. M. Tb. - I 84. Opportunistic mycoses I
109. HIV -2
63. M. Tb. - II 85. Opportunistic mycoses-11
110. Miscellaneous Viruses -1Corona,
64. M. leprae 86. Patient safety
Rubella-
65. Brucella 87. Introduction to Virology 111. Miscellaneous Viruses - 2Prion, SSPE

66. Spirochete -1 (T. pallidum ) 88. Cultivation of viruses 112. Viral Diarrhoea

67. Spirochete -2 (T. pallidum) 89. Viral Replication 113. UTI

114. Congenital Inf ections-

68. Borrelia, Leptos pira- 90. Virus host interaction
115. Recent Advances in Diagnostic
69. NTM 91. Lab diagnosis of viral inf ection-
Microbiology-
70. Chlamydia 92. Bacteriophage 116. PUO

146 147
148
4.
2.

6.

9.
5.
3.

8.
7.
1.

10.
No.
M.B.B.S CURRICULM

Virology
Mycology
Parasitology
Immunology

Patient safety
Topics for Tutorial

General Microbiology

Systematic Bacteriology

Hospital acquired inf ection

Emerging and re-emerging infectious diseases
Inf ectious disease syndromes (Applied Microbiology)
TUTORIALS /SYMPOSIA/SEMINARS (Including student presentation) :

4
4

4
2
2

2
8

1
12
Hrs

Suggested topics for integrated teaching with departments involved & duration
SI Topics Departments involved Totald
No. duration
1. Tuberculosis Microbiology Pathology Pathogenesis& Pulmonary Medicine Extra PSM Epidemiology 3 & ½ hrs
Organism & its Lab histopathological features medicine Pulmonary pulmonary & prevention
diagnosis Tuberculosis tuberculosis

2. Eye & ear Microbiology Normal Ophthalmology ENT 1 & 1h hrs

infection flora Organisms Mode of transmission, Mode of transmission,
involved Clinical presentation, Clinical presentation,
Lab diagnosis differential diagnosis differential diagnosis
Treatment Treatment
3. HIV infection Microbiology Medicine PSM 3 hrs
Virology & Clinical presentation, D/D, Epidemiology &
pathogenesis of HIV Management prevention
virus
Lab diagnosis 2 classes

4. CNS Infection Microbiology Neurology 3 hrs

Etiology, Clinical presentation, D/ D,
Lab diagnosis Management

5. STDs Microbiology Obs & Gynae Dermatology 1.5 hrs

Etiology, presentation, presentation, D/ D,
Management
Lab diagnosis D/ D, Management
6. Diarrhoea & Microbiology Medicine / Pediatrics 1.5 hrs
dysentery Etiology, Clinical presentation, D/ D,
Management
Lab diagnosis
7. Skin & soft Microbiology Dermatology
tissue infection Clinical presentation, D/ D,
Etiology,
Management
Lab diagnosis
8. Viral Hepatitis Microbiology Gastroenterology Clinical 3 hrs
Virology, feature, complication and
epidemiology, management
pathogenesis and
149
M.B.B.S CURRICULM

diagnosis
150
summative (Prof essional) Assessment
Question Paper Paper I (100 Marks) - Time 3 hours
pattern
Part A - 50 marks
&
Division of syllabus Part B - 50 marks
M.B.B.S CURRICULM

Paper II (100 Marks) - Time 3 hours

Part A - 50 marks
Part B - 50 marks
In each part the questions will be framed as follows:
1. Modified structured long question: 10 marks
2. Short notes/ short answer type question: 8x5=40 Marks
Paper wise division of topics
Paper I
1. General Microbiology,
2. Immunology,
3. Systematic Bacteriology
Paper II
1. Virology,
2. Parasitology,
3. Mycology
4. Applied Microbiology
Viva-voce: Total 20 marks
The viva -voce examination will be conducted in two tables (10 marks each) and will be structured to cover
all the portions covered during the period and test the student on applications, problem-solving, rather than
recall only.

Practical: Total 80 marks

Practical examination includes spotting, different bacterial staining procedures, identification of bacterial
strains using conventional methods and stool examination for ova/ cyst
Time:3 Hours 

g. Widal test
laboratory.

d. Transduction
c. Bacterial spore
Answer the following: 

2. Short answer questions.

f. Type-I hypersensitivity
b. Sterilization by moist heat
the stool resembled ‘rice water1.

h. Direct complement pathway.

d. Describe the laboratory diagnosis.
e. Which drugs are used for the treatment?

e. Difference between exotoxin and endotoxin

a. Contribution of Robert Koch to Microbiology
PAPER I

c. What is the pathogenesis of the above disease?

SECTION A
MICROBIOLOGY

1. Read the clinical history and answer the following questions:

MODEL QUESTION PAPER

a. What is the probable diagnosis and name the causative agent?

b. Mention the method of sample collection and transportation of the sample to the

151
M.B.B.S CURRICULM

Total Marks:100

(8X5=40)
(1+2+2+4+1=10)
days. On clinical examination he was severely dehydrated. The macroscopic appearance of
A 24 year old man was admitted in medical ward with a history of diarrhea for the past two
M.B.B.S CURRICULM M.B.B.S CURRICULM

SECTION-B MODEL QUESTION PAPER

1. Read the clinical history and answer the following questions: MICROBIOLOGY
A 33-year-old woman presented with a 1-month history of cough, fever, reduced appetite PAPER II
and weight loss. She had taken an incomplete course of antitubercular therapy about a year Time:3 Hours  Total Marks:100
prior with partial improvement in symptoms.
SECTION A
Answer the following: (1+3+3+3=10)
1. Describe the morphology of Rabies virus. Discuss the laboratory diagnosis and prophylaxis
a. What is the most probable diagnosis? of Rabies.  (2+4+4=10)
b. Describe the culture media used.
2. Write short notes  (8X5=40)
c. Describe the mechanisms of drug resistance to 1st line drugs?
a. Interferon
d. Name the drugs that can be used for the treatment of this patient?
b. Viral cultivation
2. Structured short answer questions. (8X5=40)
c. Prophylaxis of polio.
a. Antigenic structure of Streptococcus pyogenes d. Serological diagnosis of HIV infection.
b. MRSA e. Serological markers of Hepatitis B virus infection
c. VDRL test f. Varicella zoster
d. Helicobacter pylori g. Lab diagnosis of Dengue fever
e. EHEC h. Antigenic variation in Influenza virus
f. NK cell
SECTION B
g. Lepromin test
h. Laboratory diagnosis of Diphtheria 3. Discuss the life cycle, pathogenesis and laboratory diagnosis of Leishmania donovani
infection.  (3+2+5 =10)

4. Short answer questions.  (8X5=40)

a. Life cycle of Fasciolahepatica

b. Rhinosporidiosis
c. Dermatophytes
d. Cryptococcal meningitis
e. Cysticercus cellulose
f. Free living amoeba
g. Mycotoxin
h. Mycetoma

152 153
 M.B.B.S CURRICULM

PHARMACOLOGY
GOAL
The goal of teaching pharmacology to undergraduate students is to impart the knowledge, skills
and attitudes that a student should learn in order to prescribe drugs safely and effectively and
ethically to maintain this competence throughout his/her professional life.

OBJECTIVES
A) Knowledge & Intellectual skills
At the end of the course, the learner shall be able to:

1. Understand the general principles of drug action and handling of drugs by the body in
normal individuals including children, elderly, women during pregnancy & lactation;
special situations like renal, hepatic disease and genetic variations.

2. Prescribe drugs rationally by:

a. Understanding the importance of both non-drug treatment and drug treatment.

b. Selecting and prescribing a drug(s) based on suitability, tolerability, efficacy and cost
according to the needs of the patient for prevention, diagnosis and treatment of

PHARMACOLOGY common ailments.

c. Choose the most appropriate formulation for the clinical condition.
d. Use antimicrobials judiciously for therapy and prophylaxis.
e. Avoid simultaneous use of drugs resulting in harmful interaction (s).

3. Prescribe drugs for the control of fertility and be aware of the effects of drugs on the foetus.

4. Apply pharmacokinetic principles in clinical practice pertaining to the drugs used in

commonly encountered clinical conditions and essential medicines.

5. Prescribe rationally, in a legible manner, using appropriate format and terms, medicines
for common ailments and all National Health programmes.

6. Foresee, prevent and manage adverse drug events and drug interactions

7. Understand and implement the essential medicines concept for improving the community
health care.

8. Understand the principles of drug pricing and be able to make cost-effective selection in
the context of individual patient care as well as procurement systems.

9. Apply principles of evidence based medicine in making therapy decisions involving drugs.

10. Describe the clinical presentation and management of common poisonings including
bites and stings.

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M.B.B.S CURRICULM M.B.B.S CURRICULM

11. Judiciously use “over the counter” drugs and be aware of ill effects of the social use of 3. Motivate patients with chronic diseases to adhere to the line of management outlined by
intoxicants. the healthcare provider.

12. Cognizant of the activities under national programmes related to monitoring of drugs 4. Appreciate the relationship between the cost of drugs and patient compliance.
and devices (such as Pharmacovigilance Programme of India, Adverse Event Following
5. Exercise caution in prescribing drugs likely to produce dependence and recommend the
Immunization Programme, Hemovigilance Programme of India and Materiovigilance
line of management.
Programme of India).
6. Evaluate the ethics, scientific procedures and social implications involved in the
13. Understand the common operational aspects of medication safety such as the 5 rights
development and introduction of new drugs.
in drug use, injection safety, high alert medication (HAM), ‘sound alike and look alike’
medication and handling of cytotoxic medication. 7. Appreciate the role of counselling in making pharmacotherapy more acceptable in
situations in which drug use can be distressing as in cancer chemotherapy.
14. Understand the legal aspects of prescribing drugs.
TEACHING-LEARNING (TL) METHODS
B) Psychomotor Skills:
The above-mentioned objectives will be covered using theory lectures, small group discussions,
At the end of the course, the learner shall be able to:
clinical case scenarios, problem-solving exercises, computer-assisted learning, tutorials and any
1. Write a correct, complete and legible prescription for common ailments including the other teaching-learning method which the teacher chooses to select. An overlap between theory
diseases in the National Health Programmes. and practical classes will serve to reinforce and complement the two. Points not covered in theory
can be covered during practical classes.
2. Calculate the drug dosage using appropriate formulae for an individual patient.

3. Administer the required dose of different drug formulations using appropriate devices and COURSE CONTENT
techniques (e.g., hypodermic syringes, inhalers, transdermal patches etc.).
MUST KNOW CATEGORY
4. Advice and interpret the therapeutic monitoring reports of important drugs.
General Pharmacology:
5. Recognize and report adverse drug reactions to suitable authorities.
Pharmacology: Definition, scope, various branches. General principles and mechanism of
6. Analyse critically, drug promotional literature for proprietary preparations, in terms of the drug action. The concept of therapeutic index and margin of safety. Drug nomenclature.
(a) pharmacological actions of their ingredients (b) claims of pharmaceutical companies (c) Clinical pharmacology - Basic concepts. Scope and relevance of clinical pharmacology. Routes
economics of use (d) rational or irrational nature of fixed-dose drug combinations. of administration of drugs, drug delivery system. Pharmacokinetics - Absorption, distribution,
metabolism, excretion. Bioavailability and bioequivalence. Factors modifying drug action and drug
7. Retrieve drug information from appropriate sources, especially electronic resources.
dosage. Drug interactions, pharmacogenomics, and pharmacogenetics. Adverse drug reactions
8. Recognize, through use of appropriate information resources (printed and electronic), and Pharmacovigilance. Therapeutic drug monitoring and adherence. Essential drug and fixed-
potentially dangerous drug-drug interactions in multiple drug use situations and suitably dose drug combinations, pharmacoeconomics, rational drug use, P - drugs. Phases of clinical
modify drug choices and doses to avoid harm trials. Drugs and drug combinations that are banned in India.

C) Attitudes & Communication skills: Autonomic Pharmacology:

At the end of the course, the learner shall be able to: General principles of autonomic neurotransmission. Systemic actions of neurotransmitters. Various
types and subtypes of receptors and their agonists and antagonists, therapeutic indications,
1. Communicate to patients regarding the optimal use of drug formulations, devices and
contraindications and common side effects of agonists and antagonists. Pharmacotherapy of
storage of medicines.
organophosphorus and atropine poisoning. Pharmacotherapy of glaucoma, Alzheimer’s disease
2. Follow the drug treatment guidelines laid down for diseases covered under the National and myasthenia gravis. Pharmacology of skeletal muscle relaxants.
Health Programmes and be capable of initiating, monitoring treatment, recording progress,
and assessing outcomes.

156 157
M.B.B.S CURRICULM M.B.B.S CURRICULM

Autacoids and related drugs: Respiratory system:

Definition, Pharmacological actions of autacoids. Histamine, prostaglandins, leukotriene and Anti-asthmatic drugs - classification, mechanism of action, common side effects, contraindications,
5-HT – receptors, agonists, antagonists, pharmacological actions, indications, adverse effects and drug interactions and management of asthma based on severity. Drug delivery devices used in
contraindications. Pharmacotherapy of migraine. Non-steroidal Anti-inflammatory Drugs (NSAIDs) asthma. Pharmacology of Antitussives, expectorants and mucolytic agents.
- classification, pharmacological actions, indications, contraindications, adverse effects and drug
interactions of commonly used drugs, Management of overdose and toxicity. Pharmacology of Gastrointestinal system:
drugs used in the treatment of rheumatoid arthritis and gout.
Drugs for peptic ulcer - classification, mechanism of action, uses, adverse drug reactions,
contraindications. Pharmacotherapy of GERD. Anti - H. Pylori drugs, Antiemetic and Prokinetic
Central Nervous System:
drugs - mechanism of action, use, side effects and adjuvant antiemetics. Pharmacology of drugs
Antiepileptic drugs - Classification, pharmacological actions, uses, adverse effects, contraindications used in constipation and diarrhoea, principles for using ORS.
and selection of appropriate drug of various types of epilepsy. Sedative & Hypnotics - Classification,
pharmacological actions, uses, adverse effects and contraindications, Management of Insomnia. Drugs acting on the Endocrine system:
General anaesthetics - Cardinal features merits & demerits of commonly used anaesthetics,
Pharmacology of Thyroid hormones and anti-thyroid drugs - Management of thyroid storm and
drug interactions, balanced anaesthesia, neuroleptanalgesia, dissociative anaesthesia and
myxoedema coma. Pharmacology of drugs used in diabetes - Management of hypoglycaemia and
pre-anaesthetic medication. Local anaesthetic agents -Pharmacological actions, adverse drug
diabetic ketoacidosis. Pharmacology of Sex hormones - analogues and antagonists - Pharmacological
reactions, indications and management of complications. Opioid analgesics - Opioid receptors
approaches to contraception. Pharmacology of drugs acting on uterus - Pharmacology of
and their subtype, classification, pharmacological actions, indications, contraindications, adverse
Adrenocortical hormone analogues and antagonists. Pharmacology of drugs affecting calcium
effects and drug interactions of commonly used agents, Management of Opioid poisoning and
balance - Pharmacotherapy of osteoporosis.
de-addiction. Non-steroidal Anti-inflammatory Drugs (NSAIDs) - classification, pharmacological
actions, indications, contraindications, adverse effects and drug interactions of commonly used Chemotherapy:
drugs, Management of overdose and toxicity. Pharmacology of drugs used in the treatment of
rheumatoid arthritis and gout. Drugs used in the treatment of Parkinson’s disease - classification, General principles of chemotherapy, classification of chemotherapeutic agents and rational use
indications, contraindications, adverse effects and drug interactions and management of drug- of antimicrobial agents. Chemotherapeutic agents - classification, mechanism of action, side
induced Parkinsonism. Pharmacology of ethanol and management of methanol poisoning. effects, indications, mechanism of resistance and drug interactions of penicillins, cephalosporins,
Pharmacology of drugs used for psychosis, anxiety, depression, and manic-depressive illness. other β-lactams, β-lactamase inhibitors, aminoglycosides, broad-spectrum antimicrobial agents,
Drugs of addiction, abuse, dependence and principles of deaddiction of commonly abused agents quinolones, sulphonamides, macrolides etc. Antitubercular drugs and antileprotics. Antifungal
like alcohol, opioids, cocaine, cannabinoids etc. drugs. Antiretroviral drugs and antiviral drugs. Antimalarial, antiamoebic and other antiprotozoals.
Anthelminthic drugs.
Cardiovascular system:
Anticancer drugs –
Antihypertensive drugs - classification, mechanism of action, uses, adverse effects, drug interactions
and the basis of combination therapy, Management of hypertensive emergencies. Pharmacology Principles of cytotoxic chemotherapy, endocrine therapy and targeted therapy; examples of major
of anti-anginal drugs, management of angina pectoris and myocardial infarction. Drug therapy for groups of cytotoxic drugs with their broad mechanisms of action and indications, use of hormonal
heart failure including cardiac glycosides. Pharmacology of diuretics and antidiuretics. drugs in cancer, examples of more commonly used targeted drugs (e.g. receptor tyrosine kinase
inhibitors and monoclonal antibodies like trastuzumab) with their advantages over conventional
Drugs affecting blood and blood formation: chemotherapy, precautions and toxicity amelioration for cytotoxic drugs.

Anti-anaemic drugs: Haematinics and Haematopoietic growth factors including erythropoietin. Toxicology:
Drugs affecting coagulation, bleeding and thrombosis. Pharmacology of vitamin K and other
haemostatics. Pharmacology of anticoagulants and their antidotes. Pharmacology of Fibrinolytics General principles in the management of poisoning including snake bite and insect stings. Chelating
and antifibrinolytics. Hypolipidaemic drugs - classification, mechanism of action, indications and agents and management of heavy metal poisoning. Management of overdosage of commonly
adverse drug reactions. used therapeutic agents and their antidotes.

158 159
M.B.B.S CURRICULM M.B.B.S CURRICULM

Miscellaneous: NICE TO KNOW CATEGORY

Immunomodulators. Drug therapy in special situations (pregnancy, lactation, paediatrics, geriatrics, General Pharmacology: Pharmacokinetics - a brief overview of compartment models. Membrane
renal and hepatic diseases). Dermatological pharmacology - Principles of drug application, vehicles Transporters. Chronopharmacology. Pharmacoepidemiology.
and formulations, keratolytic agents, drug therapy of bacterial, viral, fungal infections and allergic
Central Nervous System: Designer drugs. Drugs used in Multiple Sclerosis. Nicotine Dependence.
skin disorders, Management of psoriasis. Vitamins. Essential Medicine list. Commonly used fixed
Management of stroke.
drug combinations. National health programs (communicable and non -communicable diseases).
Drug interactions and their mechanism.Activities under PvPI & AEFI programmes. Cardiovascular system: Mechano-pharmacology: Drug-eluting stents.

Respiratory System: Pharmacotherapy of Pulmonary arterial hypertension.

DESIRABLE TO KNOW CATEGORY
Chemotherapy: Antibiotic stewardship. National treatment guidelines for antimicrobial use in
General Pharmacology: Drugs and drug combinations that are banned in India. Molecular
infectious diseases, Cancer chemotherapy - Monoclonal antibodies -nomenclature, uses, adverse
mechanism of drug action. Drug regulation & drug acts, legal aspects, inventory control. Drug
effects.
dose relationships and basic principles of bioassay and bio standardisation. Pharmacoeconomics.
Drug abuse in sports. Miscellaneous: Pleiotropic effects of drugs (Melatonin, Metformin etc). Tolerogens. Antioxidants.
Autonomic Pharmacology: Drugs acting on autonomic ganglia.
Theory
Autacoids and related drugs: Pharmacology of platelet activating factor and bradykinin. Drugs
SI. Allotted
for vertigo. Systems
No. teaching hours
Central Nervous System: Endogenous opioid peptides and their functions. Pharmacotherapy of 1. General Pharmacology 14
osteoarthritis. CNS stimulants and cognition enhancers. Drugs used in the treatment of Alzheimer’s
2. Autonomic Nervous System 12
dementia.
3. Local Anaesthetics and skeletal muscle relaxants 02
Cardiovascular system: Pharmacology of antiarrhythmic drugs. Vasoactive peptides and nitric
4. Cardiovascular System 14
oxide. Pharmacological management of peripheral vascular diseases. Plasma expanders and
management of shock. 5. Autacoids 06
Drugs affecting blood and blood formation: Erythropoietin and its analogues 6. Drugs affecting blood and blood formation 07
7. Central Nervous System 19
Respiratory system: Management of COPD.
8. Endocrinology 16
Gastrointestinal system: Emetics. Digestants and gallstone dissolvent. Anti-obesity drugs.
Appetite stimulants. Drug therapy for inflammatory bowel diseases and Irritable bowel syndrome. 9. Gastrointestinal system 06
10. Respiratory system 03
Drugs acting on the Endocrine system: Pharmacology of hypothalamic and pituitary hormones.
Drugs in the management of infertility. Management of erectile dysfunction. Pharmacology of 11. Drugs acting on kidney 03
melatonin & analogues. Glucagon. 12. Chemotherapy (including cancer chemotherapy) 28
Chemotherapy: Newer antimicrobial agents. 13. Miscellaneous (Immunomodulators, Chelating agents,
Miscellaneous: Vaccines and sera. Antiseptics and disinfectants. Therapeutic gases. Ocular Drugs in dermatology, Drugs in hepatic & renal disorders,
12
pharmacology other than antiglaucoma drugs. Phases of clinical trials and ethical considerations Drugs in pregnancy & lactation, Monoclonal antibodies in
in drug development including Declaration of Helsinki, the role of institutional ethics committee pharmacotherapy, Vitamins, Vaccines, Antiseptics & disinfectants)
and informed consent in clinical studies Total
theory
142
teaching
hours

160 161
M.B.B.S CURRICULM M.B.B.S CURRICULM

Students’Seminar 13. Medication safety 06

Sl. No. Topic / System Allotted hours 14. Therapeutic Problems 18
1. General Pharmacology 03 a) Discussion on real hospitalised cases
2. ANS 03 b) Discussion on simulated clinical problems
3. CNS 03 16. Prescription writing (General guidelines, Respiratory system, 25
cardiovascular system, Blood & autacoids, Gastrointestinal
4. CVS 03 system, Endocrine, Emergency Medicine)
5. Endocrine 03 17. Criticise, correct and rewrite (CCR) prescriptions 06

Total hours 15
18. Patient-doctor communication (including Informed consent 06
Practical process for procedures and research)
Total practical teaching hours 135
Sl. No. Topic / System Allotted teaching
hours Total Teaching Hours: 142+15 +135 = 292 hours
1. Handling of common dosage forms and drug delivery devices 16
and safe injection practice: Recommended books for undergraduates
(Use of metered dose inhalers, dry powder inhalers, compressed 1. Basic and Clinical Pharmacology by Bertram G Katzung
air nebulizers, transdermal patches, suppositories and pessaries,
2. Principles of Pharmacology by H L Sharma, K K Sharma
eye-ear-nasal drops, insulin pen injectors, various routes of
injection (ID, SC, IM and IV), setting up of an IV drip. Students 3. Essentials of Medical Pharmacology by K D Tripathi
will be given access to manikins to develop safe injection skills.) 4. Pharmacology and Pharmacotherapeutics by Goodman & Gilman (reference)
3. Calculation of drug dose and percent solution 06 5. Clinical Pharmacology by Laurence, Bennet & Brown.
4. Study of absorption and bioavailability 03
5. Dose Response Curve, ED50 calculation 03
6. ADR reporting and causality analysis 09
7 Computer Assisted Learning (CAL) 16
a) Effect of miotics & mydriatics on rabbit eye
b) Matching Bioassay
c) Effect of drugs on frog heart, ANS Charts
d) Effect of drugs on the ciliary movement of frog oesophagus

8. The concept of essential medicine, selection of P drug 03

9. Critical appraisal of drug promotional literature 06

10. Critical appraisal of fixed-dose drug combinations 03

11. Drug labelling 03

12. Pharmacoeconomic analysis of drugs 06

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Summative Assessment
ASSESSMENT
CRITERIA CONDITION
Formative Assessments
Question Paper pattern Paper I (100 Marks) – Time 3 hours
CRITERIA CONDITION Part A – 50 marks
&
Number of 05 Part B – 50 marks
examination Division of syllabus
Paper II (100 Marks) – Time 3 hours
Time of 3rd Mid-semester examination (Sept-Oct)
examination Part A – 50 marks
3rd End semester examination (Nov - Dec) Part B – 50 marks
4th Mid-semester examination (Feb - March) In each part the questions will be framed as follows:
4 End semester examination (April- May)
th 1. Modified structured long question: 10 marks
2. Short notes/ short answer type question: 8x5=40 Marks
5th End semester examination (October)
Paper wise division of topics
Method of Mid-semester examinations:
assessment Paper I
Multiple Choice Questions, Modified Structured / Short notes / Short Part A
answer type questions, Spotters / OSPE etc. Marks for practical record
1. General Pharmacology including Drug Discovery & clinical trials
book will be included under practical marks. No viva-voce will be
conducted during mid-semester examination. 2. Drugs acting on Autonomic Nervous System
3. Drugs acting on Cardiovascular system
End semester examinations: 4. Drugs acting on Kidney (Diuretics & Anti-diuretics)
Theory, practical and viva-voce – same pattern as summative assessment. Part B
Duration Theory- 2 hours 30 minutes. Practical (writing part) – 1 hour 5. Autacoids and related drugs
6. Skeletal Muscle Relaxants
Maximum marks • Theory – MCQ (25 Marks), Main theory (50 Marks)- Total-75 Marks
7. Local Anaesthesia
• Practical -50 Marks, Viva -25 Marks – Total 75 marks 8. Drugs acting on Central Nervous System
Question paper 1. Modified structured Long question – 10 Marks
pattern Paper II
2. Short notes/ short answer type question – 8x5=40 Marks Part A
3. MCQs – 25x1=25 Marks (No negative marking) 1. Hormones and Related drugs
2. Drugs acting on Respiratory system
3. Drugs affecting blood and blood formation
4. Drugs acting on gastrointestinal system
5. Miscellaneous topics
i) Immunomodulators
ii) Drugs acting on the skin and mucous membrane
iii) Antiseptics, Disinfectants an ectoparasiticides
iv) Chelating agents
v) Vitamins, Vaccines and sera
vi) Drug therapy in paediatric, geriatric and pregnancy
Part B
6. Antimicrobial Drugs
7. Chemotherapy of neoplastic diseases

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Assessment Method Theory paper correction: One examiner will correct one part. MODEL QUESTION PAPERS
Viva-voce: Total 20 marks PHARMACOLOGY
The viva-voce examination will be conducted in two tables (10 marks PAPER I
each) and will be structured to cover all the portions covered during Time: 3 hours Max. Marks: 100
the period and test the student on applications, problem-solving,
rather than recall only. Answer all questions. Answer sections A & B in separate booklets.
Practical: Total 80 marks
SECTION A
1. Graphical calculation of ED50 or AUC/Bioavailability – 10 Marks
2. Prescription writing / CCR – 10 marks 1. A 45 years old male patient with chronic heart failure (Stage C, NYHA Class IV) was treated
3. Clinical problem – 10 marks with frusemide, ramipril, metoprolol and combination of hydralazine & nitrate. As the
4. Experimental pharmacology charts or graphs – 10 marks symptoms were persisting, the treating physician decided to start digoxin. After giving the
5. ADR reporting / critical appraisal of promotional literature or oral loading dose of digoxin, the patient was on a maintenance dose of 0.25 mg daily. On the
FDC – 10 marks third day, the patient complained of nausea and vomiting and ECG showed ventricular
6. OSPE / Spotters – 10 marks ectopics.  (2+2+2+2+2=10)
7. Communication skill – 10 marks
8. CAL exercise – 10 marks a. Why the patient developed ventricular ectopics?
b. Why was a loading dose of digoxin given?
c. How should ventricular ectopics be treated?
d. Suggest one investigation (other than ECG) in this scenario with rationale.
e. What is present status of Digoxin in the treatment of heart failure?

Write short notes/answer on the following:  (8x5=40)

2. Select the most appropriate route of drug administration for the following scenario. Justify
with reasons.
a. A 30-year-old man requiring an irritant drug parenterally.
b. A 25-year-old woman requiring hypersensitivity testing for penicillin G. (2 ½ +2 ½)

3. Explain the following terms. Mention the critical consequences of inhibiting these processes
with suitable examples.  (2 ½ + 2 ½)
a. Enterohepatic circulation
b. Biotransformation

4. Discuss the role of beta blockers and prostaglandin analogues in the pharmacotherapy of
glaucoma. (2 ½ + 2 ½)

5. Explain with a diagram: Neural control of urinary bladder and role of alfa blockers in benign
hypertrophy of prostate.

6. a) Why Adrenaline (Not Noradrenaline) is given in Anaphylactic shock?

b. Why Dopamine preferred over Noradrenaline in cardiogenic shock?  (2 ½ + 2 ½)

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7. What are the effects of furosemide and thiazide on serum calcium level? What is the 14. Discuss the role of sumatriptan in the treatment of an acute attack of a migraine. Name two
rationale for using furosemide in hypercalcemic states?  (3+2) drugs used for prophylaxis of a migraine with rationale.  (3X2)

8. What are the important differences between Verapamil and Nifedipine? Why is long-acting 15. Why can local anaesthetics not provide good analgesia in inflamed tissue? What are the
dihydropyridine (DHP) preferred over short-acting DHP in Myocardial infarction?  (3+2) common complications of spinal anaesthesia?  (2 ½ +2 ½)

9. What is a hypertensive emergency? How is hypertensive emergency treated?  (1+4) 16. What are the advantages of SSRI over TCAs? What are the therapeutic uses of SSRI?  (2+3)

17. Explain second gas effect and its clinical implication with the help of a diagram.  (5)
SECTION B
18. A patient with bipolar disorder was on Lithium for last one year. His mood was stable but
10. An epileptic patient on Phenytoin for the past two years was brought to the hospital with a
presented with a complaint of weight gain and on examination, goitre was found.  (3+2)
continuous attack of seizures. Relatives gave a history of stopping Phenytoin for the past 7
days. Gums were found to be hypertrophied and bleeding. Peripheral smear showed a. What is the reason of developing goitre?
megaloblastic anaemia.
b. What will be your future treatment strategy?
a. What is the diagnosis?
b. Mention the line of management.
c. Why the patient developed megaloblastic anaemia?
d. Name two drugs used for petit mal epilepsy.  (2+5+2+1=10)

Write short notes/answer on the following:  (8x5=40)

11. The anaesthetist injected succinylcholine I.V. for endotracheal intubation before an elective
abdominal surgery. The patient developed prolonged apnoea.  (2+2+1)
a. What is the reason for this prolonged apnoea?
b. What is the line of management for recovery?
c. Suggest two alternative agents for the procedure.

12. A psychiatric patient was on a large dose of Haloperidol (20mg), thrice daily for the past one
week. He developed rigidity, tremors of the skeletal muscles, mask-like face, shuffling gait
and bradykinesia.
a. What is the diagnosis?
b. What drugs are used for correction of these effects?
c. Name two other drugs responsible for such side effects.  (1+2+2)

13. A 50 years old chronic alcoholic opted for de-addiction. He was hospitalized and was put
on Disulfiram 500 mg per day. Ten days later he was allowed to visit his family where he
attended a cocktail party.
a. What signs and symptoms you expect in this patient?
b. What is the underlying mechanism?
c. Name two other drugs causing a similar reaction.  (2+2+1)

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MODEL QUESTION PAPERS 7. What are the differences between Domperidone and Metoclopramide? Why has cisapride
been banned from clinical use?  (3+2)
PHARMACOLOGY
8. Choose a right chelating agent for the following conditions with reason:  (2½ + 2½)
PAPER II
Time: 3 hours  Max. Marks: 100 a. Transfusion siderosis in thalassemia patients
b. Wilson’s disease
Answer all questions. Answer sections A & B in separate booklets.
9. Name the common immunosuppressants used in organ transplantation. What are the
SECTION A adverse effects of immunosuppressant therapy?  (2+3)

1. A 50-year-old man presents with weight loss despite increased appetite. He has polyuria
and polydipsia. His fasting blood glucose is 170 mg/dl and 2-hour postprandial glucose is
250mg/dl.  (3+2+1+4=10) SECTION B
a. What is the drug of choice for this patient? Justify With Reasons. 1. A 36-year-old man weighing 50 kg presents with evening rise of temperature, cough with
expectoration and weight loss for the past one month. Sputum microscopy reveals acid-fast
b. How is treatment initiated and titrated with this drug?
bacilli and chest radiography shows cavitary lesions.  (3+3+3+1=10)
c. If the patient was started on this drug, gradually titrated to a maximum dose and now
fails to be controlled, how can therapy be modified to obtain a better control? c. Explain the treatment for this patient according to the national programme.

d. Compare and contrast the mechanism of action of the drug of choice and the drug d. If this patient becomes a defaulter during therapy and later presents after one year how
started later. should he be treated?
e. List three serious adverse effects of this therapy and mention ways to prevent/reduce
Write short notes/answers for the following:  (8X5=40)
each of them.
2. Explain the rationale for the following treatment strategies with glucocorticoids. Name a f. Mention briefly the mechanism of action of one first-line agent for this disease.
clinical condition where each of these strategies is employed.  (2½ + 2½)
Write short notes/answers for the following:  (8X5=40)
a. Alternate day therapy
b. Mega dose pulse therapy 2. Explain the pharmacotherapy for the following conditions
a. Filariasis
3. Which drug/regimen is preferred over the other for the respective condition? Explain with
reasons.  (2½ + 2½) b. Visceral Leishmaniasis  (2½ + 2½)

a. Streptokinase versus Alteplase as fibrinolytic for acute myocardial infarction. 3. For each of the following patients, select the most appropriate antimicrobial for prophylaxis.
Mention the dose and duration of treatment.  (2½ + 2½)
b. Enoxaparin versus unfractionated heparin for deep vein thrombosis.
a. A 50-year-old man scheduled for abdominal surgery
4. Outline the pharmacotherapy of  (2½ + 2½)
b. A person travelling to an endemic area for malaria
a. Status asthmaticus
4. Which drug/ regimen is preferred over the other for the respective condition? Explain with
b. Thyrotoxic crisis
reasons.  (2½ + 2½)
5. Discuss one treatment regimen (with dose and duration) each for the following conditions: a. Albendazole versus Praziquantel for neurocysticercosis.
a. Emergency contraception  ( 2½ + 2½ ) b. Griseofulvin versus Fluconazole for candidiasis.
b. H. pylori infection
5. Explain the adverse effects that are common to most of the anticancer agents. Mention the
6. Explain the use of different drugs for the treatment of gastroesophageal reflux disease with ways to prevent/ reduce each of them.  (2 ½ + 2 ½)
the help of a diagram.  (5)

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6. Explain the pharmacological rationale for

a. Once a day aminoglycoside therapy
b. Combining trimethoprim with sulphamethoxazole  (2½+ 2½2)

7. Mention two serious adverse effects of the following drugs/group of drugs. Explain the ways
to avoid/ reduce each adverse effect.  (2½ + 2½)
a. Fluoroquinolones
b. Tetracyclines

8. Mention whether the following patients require chemotherapy. Wherever indicated

mention the therapy.  (2½+ 2½)
a. A 40-year-old man suspected to have avian influenza
b. A 50-year-old woman with herpes zoster for the past two days.

9. Which drug or group of drugs is preferred over the other for the respective condition?
Explain with reasons.  (2½ + 2½)

FORENSIC MEDICINE
a. Ampicillin versus amoxicillin for sinusitis
b. Metronidazole versus vancomycin for pseudomembranous enterocolitis

&
TOXICOLOGY

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FORENSIC MEDICINE & TOXICOLOGY 2. Chapter: Indian Legal System

GOAL Must Know

Offences, Cognizable and non – cognizable offences, Criminal and Civil cases, Criminal
The teaching of forensic medicine & toxicology in under graduate aims at producing physicians
Procedure Code, Courts in India and their Powers: Supreme Court, High Court, Sessions
who would understand their medicolegal responsibilities in the practice of medicine & uphold
Court, Additional Sessions Court, Magistrate’s Court. Inquest: definition, different types
medical ethics in high regard. Also, they would acquire knowledge of laws related to medicine &
of inquest, procedures of police inquest, magistrate inquest, Summons, conduct money,
its application in civil and criminal matters related to medico legal issues.
Witness, Rules of giving evidence, Evidence – Oral and Documentary, Medical evidence,
Medical certificates, Dying declaration, Dying deposition, Conduct of doctor in witness box.
LEARNING OBJECTIVES
Desirable to Know
At the end of the course in Forensic Medicine, the learner shall be able to:
Procedure of criminal trial, Perjury, Summon case, Warrant Case, Jury system, Jury trial,
1. Identify, examine and prepare report or certificate in medico-legal cases / situations in Corner’s court, Corners inquest, Medical examiners system, Difficulties of detection of crime
accordance with the law of land. Maintenance of medico-legal register like accident register, in India.

2. Perform medico-legal post-mortem examination and interpret autopsy findings and results of Nice to Know
other relevant investigations to logically conclude the cause, manner and time since death. Investigation of the scene of death
3. Be conversant with medical ethics, etiquette, duties, rights, medical negligence and legal
3. Chapter: Thanatology
responsibilities of the physicians towards patients, profession, society, state and humanity at
large. Must Know
4. Be aware of relevantllegal / court procedures applicable to the medico-legal / medical practice. Autopsy type, Aim & objects of Medico legal autopsy, Rules of Medico legal autopsy, Visit to
Scene of Crime, Contents of P.M report, Procedure of Conducting Post mortem examination,
5. Preserve and dispatch specimens in medico-legal / post mortem cases and other concerned Skin Incision, Method of removal of organs (Virchow, Rokitansky, Lettulle, Ghon), Preservation
materials to the appropriate Government agencies for necessary examination. of viscera, Obscure autopsy, Negative autopsy, Examination of skeletal remains, Autopsy
6. Manage medico-legal implications, diagnosis and principles of therapy of common poisons. instruments, Osteometric board.

7. Be aware of general principles of environmental, occupational and preventive aspects of Definition of death and it’s types: Somatic & cellular, Modes of death, Manner of death:
toxicology. Natural and unnatural death, Gordon classification of death, Sudden Death, Suspended
animation, Signs of death, Brain stem death, changes in skin, changes in the eyes, Muscular
flaccidity, and Contact flattening, Cooling of the body (Algor Mortis), Post mortem caloricity,
FORENSIC MEDICINE & TOXICOLOGY
Post mortem staining, Fluidity of cadaveric blood, Cadaveric changes in muscle, Rigor
THEORY mortis, Condition simulating rigor mortis (Heat stiffening, Cold stiffening), Cadaveric
spasm, Putrefaction, Marbling of Skin, Gas stiffening, Adipocere formation, Mummification,
A. Forensic Pathology
Maceration, Putrefaction in water and burial, Estimation of time since death. Exhumation,
1. Chapter: History of Forensic Medicine Second Autopsy, Death certification

Must Know Desirable to Know

History, Definition of Forensic Medicine, Medical Jurisprudence, State Medicine, Morbid anatomy of Heart and it’s blood supply, Types of occlusion, Sequelae of coronary
occlusion, Post mortem demonstration of Myocardial infarction, Pulmonary embolism,
Medical Ethics and Medical Etiquette. Vagal Inhibition of sudden death, Agonal thrombi, Post mortem Clot, Psychological autopsy,
Examination of mutilated bodies and fragmentary remains, Post mortem damage by predators,
Desirable to Know
Entomology of the cadaver, Examination of Decomposed body, Examination of a deceased of
Development of Forensic Medicine in India AIDS, Criterial for Brain death certification, Process of preservation of dead body, Presumption
of death and survivorship, Embalming.

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Nice to Know 6. Chapter: Infanticide, Starvation and Neglect, Death associated with Surgery & Anesthesia,
Cause of death as per international classification of diseases – WHO guidelines, Autopsy Custodial death
room photography, Autopsy and disposal of Radioactive corpse, National Human Right Must Know
Commission’s recommendation on autopsy,
Definition of Infanticide, feticide, still birth, dead born, live born, age of viability & its medico
4. Chapter: Violent Asphyxial Death legal significance, signs of live birth & separate existence, proof of live birth, hydrostatic
tests & its importance, other tests for separate existence, acts of commission & omission,
Must Know development of fetus, Haase’s Rule, autopsy findings in still birth, dead born, live born,
Anoxia and it’s types, pathophysiology of asphyxia, Signs & symptoms of Asphyxia, Medico Munchausen’s syndrome by proxy, starvation & its medicolegal aspects.
legal interpretation of post mortem findings of in asphyxia deaths, hanging and strangulation:
Desirable to Know
Definitions, types, causes of death, postmortem findings and medico legal aspects of death,
examination and dispatch of ligature material, Hyoid bone & its fracture, sexual asphyxia, Circumstance of death in starvation, malnutrition, infanticide related law, Abandoning of
lynching, suffocation, smothering, overlaying, gagging, choking, Café Coronary, traumatic children and concealment of birth, Precipitate labour, Battered baby syndrome, Sudden
asphyxia, Burking, Bansdola, Mugging, Drowning: definition, types, pathophysiology, clinical infant death syndrome (SIDS), Cot death.
features, post mortem findings and medico legal aspects, Diatoms test, Gettlers test. Nice to Know
Desirable to Know Role of autopsy surgeon in custodial death & death on the OT table.
Floatation of body in water, asphyxia Stigmata, burial alive, judicial hanging, positional
asphyxia. B. Clinical Forensic Medicine
7. Chapter: Identification
5. Chapter: Thermal Deaths & Electrocution, lightning
Must Know
Must Know
Definition corpus delicti., Identification of living persons: race, age, sex, religion, complexion,
Different classification of burns, rule of Nines, causes of death due to Burn, age of burn
stature, tattoo marks, identification of dead, unknown persons, intersex, sex chromatin,
injuries, Autopsy findings, Medico legal aspects of death due to burns, antemortem and
nuclear sexing, concealed sex, centre of ossification, importance of dentition in medico legal
postmortem differentiation of burns, scalds and its medicolegal aspects, pathophysiology
field, development of teeth & age estimation from it, bite mark, metopic Syndrome, age of
of Hypothermia, frost bite, trench foot, immersion foot, autopsy findings of death due to
adult, Medicolegal importance of age, Bertillon system, , lip prints, hair & fiber, anthropometry,
sun stroke, heat Exhaustion, heat cramp (Miners Cramp) Types of fatal electrocution, factors
dactylography, footprints, scars, poroscopy
influencing effects of electricity, mechanism of death, autopsy findings in electrocution, Joule
burns, Lightning. Desirable to Know
Desirable to Know Deoxyribonucleic acid (DNA) fingerprinting, Superimposition, Medico legal information from
blood.
Characters of burns produced by various agents, Legal provisions in relation to Dowry death,
Autopsy findings in death due to cold, Judicial electrocution, Circumstances of lightening Nice to Know
death.
Symphyseal surface in estimating age, forensic odontology, animal bite marks.
Nice to Know
8. Chapter: of the injured and the injuries
Neonatal cold injuries, Spontaneous combustion, Preternatural combustibility, Burns by
Radioactive substances, Burns by X ray, Iatrogenic electrocution, Must Know
Definition: Wound, injury, assault, battery, hurt, Simple hurt, Grievous hurt, Dangerous injury,
Homicide, Dowry death, classification of injury, mechanism of production of mechanical
injuries, differences between antemortem and post mortem wounds, wound healing,
Important sections of the Indian Penal Code relating to offences against the human body,
Abrasion and it’s type, Fate of abrasion, Medico legal aspects of abrasion, Bruise ( contusion )

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and factors influencing the production, Migratory and ectopic bruise, fate of bruise, patterned Nice to Know
bruising, Differentiation between antemortem and post mortem bruising, Medico legal aspect Rape by a female on male, Social bearing of male homosexuality,
of bruising, Lacerated Wound and its type, Incised looking wound, Features of laceration,
Differences between antemortem and post mortem laceration, Incised/cut/ slice wound,
C. Medical Jurisprudence (legal aspects of medical practice)
Features of incised wound, Bevelled cuts, Hesitation Cuts, Defense Wound, Chopping wound,
Types and features of Stab wound, Factors influencing size, shape and configuration of stab 10. Chapter: Medical Ethics and Law
wound, Cut throat wound, Immediate or direct causes of Death, Firearm: Types, parts of
Must Know
cartridge and their functions, Gun powder, Mechanism of bullet wound production, characters
of wound produced by Rifled and smooth – bored firearms, Exit wounds by rifled and smooth State medicine, Medical council of India, Declaration of Geneva, Charka’s oath, Hippocratic
bored weapons, Direction of fire, Autopsy in firearm fatalities, Suicide, accident or homicide, oath, State medical council, Duties of Medical practitioner to his patient, Professional
Mechanism of production of injuries by bomb blast, Autopsy in explosion fatalities, Medico Secrecy, Privileged communication, Duties of Medical practitioner towards one another,
legal considerations in explosion injuries, Injuries of the Scalp including forensic anatomy Duties of patient towards fellow physician, Professional misconduct, Professional Negligence,
of the scalp, Fracture of the skull including forensic anatomy of the skull, Mechanism of Doctrine of Res Ipsa Loquitur, Doctrine of common Knowledge, Precaution against charge
production of Skull fracture, Intracranial hemorrhages, Mechanism of production of cerebral of negligence, Contributory Negligence, Product Liability, Novus Actus interveniens, Medical
injuries, Medico legal aspect of Coup and Countercoup injuries, Concussion of Brain, Spinal Maloccurance, Therapeutic Misadventure, Ethical Malpraxis, Consent, Type of consent, Rule
injuries with their medicolegal aspects, Mechanism of vehicular accident, Pattern of injuries of Informed consent, Therapeutic privilege, Vicarious liability.
to the Driver, Front seat occupant and rear seat occupant of Motor car, pattern of injuries to
Desirable to Know
the pedestrians, motor cycle and pedal cyclist.
Euthanasia, Medical Records, Transplantation of Human organ act, Consumer protection act.
Desirable to Know IPC related to medical practice, Prenatal Diagnostic Technique act.
Forensic anatomy of skin, wounds by glass, fractures of bones and dislocation of joints, unusual
Nice to Know
circumstances in firearm injuries, various tests for firearm residues, head injuries in boxer,
injuries of face, neck, abdomen, extremities and genitals, fabricated and self-inflicted wound. Composite negligence, Corporate negligence, Defensive Medicine, ESI act, Workmen’s
Compensation act, Protection of Human Right act, Malingering, Medical Indemnity Insurance,
Nice to Know Human Experimentation, Biomedical Waste Rules, NHRC and Doctor, Doctor and Media,
Aircraft and railway injuries, relationship of disease with trauma, work and crime, weapon: its Ethics related to HIV patients.
medicolegal importance, use and abuses
D. Forensic Psychiatry
9. Chapter: Medicolegal aspects of sex and sex related offence
11. Chapter: Forensic Psychiatry
Must Know
Must Know
General consideration, Male genitalia, Female external genitalia, Impotence, Sterility,
Frigidity, Examination of a person towards determination of his sexual capacity, Sterilization, Definition of Forensic Psychiatry, Various terms in the mental health act, Signs and Symptoms
Artificial insemination, Surrogate mother, Virginity and Defloration, Pregnancy, Delivery, of Mental Diseases with their medico legal importance, Delusion: definition and types,
Legitimacy, Paternity, Atavism, Superfecundation, Superfoetaion, Sexual offence, Rape, medicolegal importance, Hallucination, Illusion, Phobia, Obsession, Impulse, Mania,
Proposed amendment to law relating Sexual offences including Rape and related provision, Delirium, Somnambulism, Bulimia, Anorexia nervosa, Mental retardation, Psychosis,
Examination of Victim of Rape, Examination of the accused of rape, Incest, Unnatural sexual Neurosis, Classification of mental disorder, Diagnosis of Insanity, Differences between True
Crimes, Paraphilias, Sodomy: Examination of Passive agent, Examination of active agent, & Feigned insanity, Psychopath, Lucid interval, Dementia, Restrain of Mentally ill, Civil &
Buccal coitus, Tribadism, Bestiality, Sexual perversion, Abortion, MTP act, Criminal Abortion, Criminal responsibility of the mentally ill, Testamentary capacity, Mc Naughten Rule, Section
Doctors duty in a case of criminal abortion. 84 IPC,

Desirable to Know Desirable to Know

Seminal fluid examination, Semen bank, Test tube baby, Drugs induced Psychosis, Automatism, Somnolentia.

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Nice to Know Desirable to Know

Association of Cerebral tumor, pregnancy, and epilepsy with psychosis, Durham rule, Curren’s Formic acid, Boric acid, Detergent or Chemical suicide, Caustic alkalis, Lye, Miniature(Button)
rule, American Law Institute rule. batteries, Ammoniacal vapour, Chemical Burn.

E. Forensic Science laboratory (FSL) 3. Chapter: Inorganic Irritant poisons

Must Know Must Know
Definition of DNA fingerprinting, Application of DNA profiling in Forensic Medicine, Locard’s Phosphorus: varieties, mechanism of action, clinical features and management of poisoning,
exchange principle, Hazards of blood transfusion. post mortem appearance and medico legal aspects of the poisoning.
Desirable to Know Arsenic: Different poisonous compound of arsenic, mechanism of action, metabolism, clinical
Examination, preservation, identification of blood and its medicolegal aspects, Saliva, Vaginal features, fatal dose, fatal period, diagnosis, and management, postmortem appearance,
swab, Examination of skin, nail, tooth pulp, medicolegal importance. Difference between Arsenic poison and cholera.

Nice to Know Mercury: Action, Poisonous compounds, Clinical features of acute mercury poisoning, fatal
Technique of DNA fingerprinting, Polygraph, Narcoanalysis, Hypnosis, Word association, dose, fatal period, management of mercury poisoning, postmortem appearance, Hydrargyrism
Brain mapping (Brain fingerprinting) (chronic mercury poisoning), Acrodynia or pink disease, Minimata disease.

Lead: Action, Poisonous compounds, Clinical features of acute lead poisoning, fatal dose, fatal
F. Toxicology period, management of lead poisoning, postmortem appearance, Chronic lead poisoning
(plumbism; saturnism)
1. Chapter: General Toxicology
Desirable to Know
Must Know
Copper; Poisonous compounds, sign and symptoms, fatal dose, fatal period, management of
Forensic toxicology, define poison, Ideal Homicidal Poison, Ideal suicidal poison, Cattle
copper poisoning and post mortem appearance, Chronic poisoning of copper. Iron; Poisonous
poison, Arrow poison, Abortifacient, Domestic household poison, Classification of poison,
Route of administration of poisons, Action of Poison, Factors modifying the action of poison, compounds, sign and symptoms, fatal dose, fatal period, management of Iron poisoning and
Fate of poison in the body, Elimination of poison in the body, Diagnosis of poisoning, Diagnosis post mortem appearance, Metal fume fever.
of Chronic poisoning, Legal duties in case of poisoning, General principle of management of Nice to Know
poisoning, Emetics, Procedure of Gastric lavage, Antidote: Physical, chemical, physiological
Iodine, Chlorine, Powdered glass, Thallium; Poisonous compounds, sign and symptoms, fatal
antidote, chelating agent, universal antidote, medico legal autopsy in case of poisoning,
dose, fatal period, management of Iron poisoning and post mortem appearance. Manganese,
preservation and dispatch of routine viscera in chemical analysis.
Potassium permanganate, Barium, Antimony, Nickel, Cadmium (Ouch – Ouch disease)
Desirable to Know
4. Chapter: Organic Irritant poisons
History of toxicology from ancient times, a view point about the poisoner, sale of poison
in India, Indian Penal Code and Poison, The opium Act- 1857, The opium Act- 1878, The Must Know
dangerous drug act - 1930, NDPS act – 1985 Active principle(s), clinical features, fatal dose and fatal period and medico legal aspects of:
Ricinus communis, Croton tiglium, Abrus precatorius, Semecarpus anacardium, Calotropis,
2. Chapter: Corrosive poisons
Epidemiology, anatomy/ identification of poisonous snake and non-poisonous snakes,
Must Know
composition of the venom, classification of poisonous snakes, clinical features and management
Classification and mechanism of action, Sources, properties, mechanism of action, fatal of snake bite, Post mortem appearance and medico legal aspect of snake bite.
dose and fatal period, clinical features and management of Sulphuric acid, Nitric acid and
Hydrochloric acid poisoning, Post mortem appearance and medico legal aspects in such Desirable to Know
cases, Vitriolage, Sources, properties, mechanism of action, fatal dose and fatal period, clinical Capsicum, Ergot, Scorpion, Spider
features and management of Carbolic acid, Oxalic acid poisoning, Post mortem appearance,
Phenol Marasmus
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Nice to Know 8. Chapter: Deliriant poison

Plumbago rosea and Zeylanica, Claviceps purpurea, Bees and Wasps, Centipedes, lizards, Must Know
Ants, Cantharides (Spanish fly)
Types, active principles, mechanism of action, clinical features, fatal dose, fatal period,
5. Chapter: Agrochemical poisons management of Dhatura poisoning. Alkaloids, Road poison, Different preparation of Cannabis,
symptoms of intoxication, fatal dose, fatal period, management of cannabis poisoning, features
Must Know of chronic cannabis poisoning, Run amok,
Classification, sources, properties, mechanism of action, clinical features, diagnosis, and
Desirable to Know
management of organophosphorus poisoning, postmortem appearance and medicolegal
aspects of the same, Carbamate poisoning. Cocaine: mechanism of action, signs & symptoms, management of cocaine poisoning, post
mortem appearance, Cocaine habit, Magnan’s symptoms.
Desirable to Know
9. Chapter: Drug dependence and abuse
Medicolegal aspects of organochlorine compounds like DDT, Endrin (plant penicillin), Sources
and clinical features and management of Paraquat poisoning, Rodenticides like aluminum Must Know
phosphide (fumigants), zinc phosphide, Method of abuse, hazards of drug abuse, Designer drug, Drug dependence, symptoms of
Nice to Know drug dependences, management and rehabilitation, Types of dependences, Body packer
syndrome (Surgical mules), Body stuffer syndrome.
Chlorophenoxyacetate (plant hormone), Chlorate (weed killer), Pyrethrins & pyrethroids,
Dinitro compounds, Fluoride. Desirable to Know
Cotton fever, Drug abuser’s elbow, volatile substance abuse, Huffing, bagging, Sniffing,
6. Chapter: CNS depressant poisons
Investigation of drug abuse death, Autopsy findings in such deaths, Turkey skin,
Must Know
Nice to Know
Alcohol, types and various concentration, Consumption, absorption, elimination, with Toxicologic radiology (Radio opaque poison, Drug abuser)
medicolegal interpretation, Stages of alcoholic intoxication, fatal dose, fatal period, Alcholic
withdrawal syndrome, Drunkenness, Ethanol and vehicular accident, Breath analyzer, Ethanol 10. Chapter: Spinal poison
& crime, Widmark’s formula, collection and preservation of sample, alcoholism and drug
Must Know
dependency, Methanol: source, mechanism of action, clinical features, management, fatal
dose and fatal period, postmortem appearance, medicolegal aspects. Hazards of alcohol, Sources, active principle, Mechanism of action, clinical features, fatal dose, and fatal period,
Opium & opioids, Sources, properties, preparation, mechanism of action, metabolism, management of Strychnine poisoning.
clinical features, postmortem appearance, medicolegal aspects.
Desirable to Know
Desirable to Know Sources, active principle, Mechanism of action, clinical features, fatal dose, and fatal period,
Barbiturate poisoning, Heroin, kerosene poisoning, management of peripheral nerve poison, Conium Maculatum (Hemlock)

Nice to Know 11. Chapter: Cardiac poison

Ethylene glycol, Isopropanal, Chloroform, Ether, Pethidine, Methadone, Fentanyl,
Must Know
Methaquolone, Chloral hydrate, Bromides, Paraldehyde, Turpentine, Naphthalene.
Oleander, Aconite, Nicotine, - Sources, active principle, clinical features, management, fatal
7. Chapter: Psychotropic Drugs dose, fatal period, medicolegal aspects

Desirable to Know Desirable to Know

Psychoactive drug classification, Antidepressant, methamphetamine, cyclic antidepressant, Sources, active principle, clinical features, management, fatal dose, fatal period, medicolegal
monoamine oxidase inhibitors, Benzodiazepine, Hallucinogens (LSD, Phencyclidine) aspects of cerbera odallam, Quinine, Cleistanthus collinus

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12. Chapter: Asphyxiant 3. Prepare dying declaration.

Must Know 4. Give evidence in a court of law as an expert witness.

Hydrocyanic acid and its salt, Sources, mechanism of action, clinical features, fatal dose and 5. Collect and do proper labeling, preservation and dispatch of medicolegal specimens.
fatal period, diagnosis and management of poisoning, postmortem appearance and medico
legal aspects. Carbon monoxide poisoning: clinical features, management, post mortem 6. Witness, record the findings and issue a report for a medicolegal autopsy.
appearance and medico legal aspects, War gases, Biological warfare
7. Diagnose and manage common acute and chronic poisonings.
Desirable to Know
Pratical Exercises
Carbon dioxide, Hydrogen sulphide, Sulphur dioxide, Methane, Methyl isocyanate,
1. Medicolegal autopsies: Witnessing and recording (10 cases)
13. Chapter: Food poisoning 2. Age estimation of an individual by physical, dental and radiological examination.
Nice to Know 3. Examination of skeletal remains.
Food poisoning, details of bacterial food poisoning, Botulism, Poisonous food (Lathyrus
4. Study of:
Sativus, Mushrooms, Argemone Mexicana), Fish and Marine animal
a. Lethal weapons.
14. Chapter: Miscellaneous poisoning
b. Wet specimens/models/photography/microslides like sperm, diatoms, hairs, human and
Nice to Know animal RBCs.
Acetyl salicylic acid, paracetamol, water intoxication, Insulin, NSAID, Antihistaminic, c. Poisons.
Sulphonamides, Formaldehyde, Carbon tetrachloride.
5. Medical certificates/medicolegal reports, physical fitness, sickness and death certificates, injury
report, drunkenness, sexual offences.
PRACTICALS
6. Students should be taken to courts whenever possible to acquaint themselves with the court
1. Demonstration of ten medicolegal autopsies (RTA, Assault, Hanging, Drowning, Poisoning, proceedings.
Infanticide, Burn, Dowry death, Electrocution, Lightening, Snake bite)
Suggested topics for integrated teaching
2. Age estimation from bones, X-rays and dentition.
1. Death and Brain stem death (With Anesthesia department)
3. Injuries and weapons.
2. Organ transplant (With Surgical disciplines)
4. Examination of intoxicated persons (Drunkenness Certificate).
3. Snake & Scorpion bite (With Medicines)
5. Examination of victim and accused in sexual offences.
4. Child abuse (With Pediatrics)
6. Specimens of poisons.
5. Drug abuse and substance abuse (With Psychiatric department)
Practical Skills
6. Criminal abortion and MTP act (With O&G department)
1. Examine and prepare proper certificates in the following medicolegal situations:
7. Organophosphorus poisoning (With Pharmacology and Medicine department)
a.Injured patient.
8. Sudden death (With Pathology department)
b.Sexual offences.
c.Determination of age. Teaching Learning Methods:
d.Intoxicated patient.
Didactic lecture, Structured interactive sessions, Small group discussion, Problem based exercises,
2. Prepare proper certificates of birth and death. seminar by student, Video clips, Written case scenario, Self-learning tools, demonstration, practical

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Learning Resource materials 3. Examination of a case of Drunkenness and prepare a Medico-legal report

Text books, Reference books, Practical note books, Internet resources, Video films etc. 4. Examination of Accused and Potency certification in a case of sexual assault /Examination of
the Victim in a case of sexual assault.
Suggested books
5. Examination and report of bones
1. Dr.K.S.N.Reddy- The essential of Forensic Medicine & Toxicology 34thEdition 2017.
Published by-K.Saguna Devi, H,No. 16-11-15/2/2, Saleem Nagar Colony, No.1, Malapet, 6. Age determination from X-ray with reasons.
Hyderabad-500036.
7. Age determination from dental examination.
2. Modi‘s Textbook of Medical Jurisprudence and toxicology- Edited by BV Subramanyam,
8. Medical certification of cause of death.
Butterworths India, New Delhi.25th edition, 2016.
9. Interpretation of the autopsy reports.
3. Dr. C.K.Parikh- A text book of Medical Jurisprundence, Forensic Medicine & Toxicology, CBS
Publishers, Delhi, Seventh Edition, 2016. 10. Interpretation of age of the fetus
4. Dr. Apurba Nandy- Principles of Forensic Medicine,2013, New Central Book Agency (P) ltd. 11. Weapon examination and medico-legal report writing
Calcutta.
12. Wet specimen examination
5. Dr. KrishanVij- Text book of Forensic Medicine & Toxicology- Principles and Practice, BI
Churchill Livingston, New Delhi, 6th edition, 2014. 13. Examination of a case of simulated poisoning case.

6. V.V. Pillay. Text book of Forensic Medicine and Toxicology . 18th Edition, Paras Medical 14. Breaking of death or bad news to the patient and relative
Publishing, Hyderabad, 2017. 15. Informed consent for Major surgery and blood transfusion
7. Putul Mahanta. Modern Textbook of Forensic Medicine & Toxicology, Jaypee Publisher, 1st Ed,
Short OSPE’S / Spotter (10 marks)
2014
1. Wet specimen
Reference Books:
2. Weapon.
1. Knight’s Forensic Pathology, 4th Edition, 2016, Edited by Pekka Saukko and Bernard Knight,
Arnold Publication, London, Co-published by Oxford Publications, USA 3. Photograph/Image

Method of Assessment: 4. Poison.

By internal assessment and evaluation 5. Appliance/Autopsy instrument

Internal assessment: (1) By periodic test one at the end of each term(3rd, 4th and one pre-final 6. Summon/ Medical certificate/ Medico-legal report.
test) (2) By seminars, group activity/assignments, (3) Practical tests and viva voce one at the end of
7. Viscera Packing.
each term(3rd, 4th and one pre-final test)
8. Interpretation of the age of foetus
Evaluation: At the end of 5th semester of MBBS, one theory paper with two sections (Sec. A &
B, each of 50 totaling to 100 marks) and one practical examination (80 marks with viva voce (20 9. Slides
marks).
Internal assessment:
OSPE’s (Any Seven of the following exercises, 10 marks each)
1. By periodic test one at the end of each term (3rd, 4th & pre-final test)
1. Medico-legal report writing in Injury case 2. Practical tests and viva voce one at the end of each term (3rd, 4th pre-final test)
2. Medico-legal report writing in Age determination case

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EXAMINATION SCHEDULE AND DISTRIBUTION OF MARKS MODEL QUESTION

Total Marks- 200 Theory-100  Practical-100 PAPER
For Internal assessment examination is held three times ordinarily in following dates- FORENSIC MEDICINE & TOXICOLOGY
a. IIIrd End Semester Examination Time: 3 hours Max. Marks: 100
b. IVth End-semester Exam
INSTRUCTIONS
c. Vth End-semester(Pre-final) Exam.
1. Use blue/black ball pointpen
Marks distribution for each semester exam –Theory: 50 marks & Practical: 50 marks
2. All questions are compulsory
Marks distribution for IInd Professional Final Exam.
3. The number to the right indicates marks
Total Theory Practical + Viva voce
4. Draw diagram wherever necessary
200 100 80+20=100
5. Answered each section in the respective answer book only. Answer written in the inappropriate sectional
Theory paper consists of two sections– Sec. A & B answer book will not be assessed in any case.
A. Forensic Medicine 50 marks 6. Do not write anything on the blank portion of the question paper. If written anything, such type of act
B. Toxicology 50 marks considered as attempt to resort to unfair means.
Both sections have to be answered on separate sheet
SECTION A
Suggested pattern and marking for paper of 100 marks
1. An unmarried female student of age about 19 years is brought to the casualty around 5 pm by
Section Question Pattern of Number of Marks Time her friends with complaints of severe pain abdomen and bleeding per vagina. As per her
Question question history, she had undergone treatment by a quack doctor in the forenoon for missed period of
Sec. A 1 Structure long 01 01 x 10=10 03 Hours 45 days. (4+4+2=10)
answered
question(LAQ a. Write duties of Doctor in this case keeping in mind the responsibilities towards the
2 Short answeres 08 8 x 5 each=40 investigating agencies.
question (SAQ) b. Mention signs suggestive of recent abortion
Sec. B 3 Structure long 01 01 x 10=10 c. Enumerate four immediate causes of death due to criminal abortion
answered
question(LAQ) 2. Write short notes on: (8x5 = 40 Marks)
4 Short answeres 08 8 x 5 each=40
a. Blanket consent is invalid in the eyes of law. Explain with reasons.
question (SAQ)
Total 100 marks 03 hours b. Explain how Post-mortem lividity is helpful to determine the cause of death.
c. Mention why medico-legally bruise is less valuable than abrasion.
Passing:
d. Differentiate between entry wound and exit wound in rifled firearm.
A candidate must obtain 50 percent aggregate with 50 percent theory and 50 percent in
e. Chloride level of right chamber of heart declines in fresh water drowning. Explain why?
practical +Viva. If a candidate fails either in theory or in practical Examination of a subject he /
she will be declared failed in that subject and he / she will have to appear for theory and practical f. Write various external injuries found in Battered baby syndrome.
Examination again. g. Define Professional negligence and explain ingredients of it.  (2+3)
h. Classify Sexual offences. Enumerate materials to be collected as evidence from a rape
victim.

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SECTION B
3. A person was found in disoriented condition in a train at Bhubaneswar Railway station. On
enquiry, he told that he was given cream biscuits to eat by a co-passenger following which he
became drowsy and lost all his belongings.  (1+3+2+4=10)

a. What could be the name & nature of poison?

b. Mention its signs and symptoms.
c. How will you manage this case?
d. Write the legal duties and responsibilities of the CMO in this case?

4. Write short notes on:  (8X5 = 40)

a. Mention five contraindications of Gastric lavage with reasons.

b. Mention disadvantages of decline of RBC Cholinesterase level in diagnosis of
Organophosphate poisoning.
c. Write the mechanism of action and treatment of cyanide poisoning
d. Write how drunkenness affects driving?
e. Write the differentiating features in autopsy findings between Viper and cobra bite in
case of person survived for two days
f. Differentiate between Strychnine poisoning and Tetanus
COMMUNITY
g. Mention five common sources of Lead poisoning. Write haematological changes in
Chronic lead poisoning. 
h. Mention external Autopsy findings in drug abuse death.
(2½ +2½)
MEDICINE

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COMMUNITY MEDICINE for common diseases and specific population groups using appropriate tools and
technologies.
GOAL:
2.3.2. Interact effectively with other members of the health care team and participate in the
The broad goal of teaching Community Medicine is to prepare the students to function effectively as organization of health care services and implementation of national health programs.
a community physician and provide comprehensive care to individuals, families and communities
through organized health care. 2.3.3. Plan strategies for prevention and control of diseases in the paradigm of national
health programs applying principles of health management.
OBJECTIVES:
3. Course Content:
2.1 Cognitive Domain
3.1. General concepts in Public Health, Community Medicine and Family Medicine
2.1.1. Identify various concepts of health & diseases and levels of prevention for health-
3.2. Principles and Practices of Health Promotion
related events and conditions.
3.3. Epidemiology, Biostatistics and Research Methodology
2.1.2. Compare various epidemiological methods and their application in rational decision
making. 3.4. Demography and Population Health

2.1.3. Identify appropriate biostatistics methods and apply it to make inference in health 3.5. Public Health Nutrition
and medicine in respect to hospital and community data.
3.6. Environment and Occupational Health including disaster management.
2.1.4. Describe the demography pattern of the country and its relation to health and identify
3.7. Health Care Delivery Systems in India, Health Planning and Management Including
sources of vital statistics.
Health Policies, International Health.
2.1.5. Identify the role of environment and occupation in health and disease
3.8. Health Care Delivery for Specific Population Groups: Reproductive Health, Child
2.1.6. Recognize the health problems of general population and special groups.
Health, Adolescent Health, Geriatric Health, Tribal Health, Urban Poor, Migrants,
2.1.7. Compare and contrast the health care delivery system in India including organization People with Disability groups including related National Health Programs.
and function at each level of care
3.9. Communicable Diseases including related National Health Programs.
2.2. Psychomotor Domain
3.10. Non-Communicable Diseases including related National Health Programs
2.2.1. Elicit the clinic-social history and conduct examination for diagnosis and treatment at
3.11. Family Medicine
individual level and to identify factors determining health of individual and family.

2.2.2. Diagnose and manage common health problems and emergencies at the individual, 3.1. General concepts in Public Health, Community Medicine and Family Medicine
family and community levels keeping in mind the existing health care resources and
in the context of prevailing socio-cultural beliefs. Must Know

2.2.3. Diagnose and manage common nutritional problems at the individual and community • Concept and definitions of health
level and conduct nutritional assessment surveys. • Dimensions and determinants and indicators of health

2.2.4. Collect, analyze, interpret and present simple community and hospital-based data. • Concept and definitions of disease including epidemiological tetrad, Concept of disease
prevention, including level of prevention and control
2.2.5. Conduct environmental assessment of defined community and relate them with
• History of medicine and evolution of public health
prevailing morbidity and mortality.
• Concept of social medicine, social epidemiology and common social problems
2.3. Affective Domain
• Investigation of an epidemic and control measures
2.3.1. Formulate and implement health communication and health education programme • Differences and similarities in public health, community medicine and clinical medicine

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• Concept of wellbeing and spectrum of health • Modes of transmission and measures for prevention and control of communicable and
• Quality of life indices non-communicable diseases.

• Need, principles and uses of screening tests. • Principal sources of epidemiological data.

• Accuracy and clinical value of diagnostic and screening tests (sensitivity, specificity, • Various types of epidemiological study designs.
predictive values). Planning, collecting, analyzing and interpreting data to reach a • Definition, calculation and interpretation of the measures of frequency of diseases and
community diagnosis. mortality.
• Know about the measures of association and criteria of causality.
Expected Skills
• Use of biostatistics, type of data, normal distribution, measures of central tendency and
 Able to link with social model of disease causation beyond medical model of disease measure of depression,
 Should be able to investigate an epidemic and apply prevention and control measures • Interpretation of tests of significance, standard errors t teat and chi square tests, types of
 Evaluation of a screening programme errors
• Formulating hypothesis and research questions
3.2. Principles and Practices of Health Promotion
• Study designs & its utility for finding answers for research question
Must know • Sampling techniques, sample size calculation
• Types and barriers of communication, • Data Collection Techniques: Qualitative or quantitative methods
• Different methods used for health education • Preparation of protocol for research
• Interview techniques • Use of reference management softwares
• Steps of counseling
Desirable to Know
• Role of humanities in community medicine
• The derivation of normal values and the criteria for intervention in case of abnormal
• Communication
values.
• Principles of sociology in health promotion
• Planning an intervention programme with community participation based on the
• Approaches to health education community diagnosis.

Expected Skills • Applications of computers in epidemiology

• Knowledge about various techniques in qualitative research and operational research
 Should be able to communicate with family members at home and patients at clinic or
techniques.
at homes
 Should be able to elicit the tetrad of disease in family visits Nice to know
 To organize and actively engage in community care program focusing on health promotion • Spearman’s and Pearson’s correlation coefficient, ANOVA
and maintaining health
• Systematic review techniques.
3.3. Epidemiology, Biostatistics and Research Methodology • Other nonparametric tests of significance, survival analysis
Must know
Expected Skills:
• Use of basic epidemiological tools to make a community diagnosis of the health situation
 Use epidemiology as a scientific tool to make rational decisions relevant to the community
to formulate appropriate intervention measures.
and individual patient intervention.
• Epidemiology: definition, concepts and its role in health and disease. Definition of the
 Collect, analyze, interpret and present simple community and hospital-based data.
terms used in describing disease, transmission and control.
 Interpret the indicators of morbidity, mortality measurement and vital statistics
• Natural history of a disease and its application in planning intervention.
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 Selecting a sample for study using an appropriate sampling technique. • Social and cultural practices in nutrition and health
 Calculation of sample size for prevalence studies. • Nutritional Programme including ICDS
 Apply appropriate tests of significance to make a correct inference. • Nutritional Requirement of special groups
 Simple analysis and presentation of data with use of basic statistics. • Food Hygiene
• Junk food and Food Toxicants
3.4. Demography and Population Health
• Food adulteration and Prevention of food adulteration act
Must know • Food fortification
• Demography cycles • Food processing additives
• Sex ratio and Population pyramid
Desirable to know
• Fertility related statistics
• National Nutrition Policy
• Contraceptive methods
• Nutritional Rehabilitation
• Surveillance
• Nutritional rehabilitation Centre
• Community-based monitoring
• Social audit Nice to know

Desirable to know • Slaughter House sanitation

• Nutrition in special situation-disasters, fairs
• Demography indicators
• National population policy Expected Skills:

Nice to know  Nutritive values of common Indian foods

 Nutritional assessment of Individual, family and community
• Dependency ratio
 Plan diet for Male, female, Pregnant Lady, Diabetic patient, Obese patient etc
• Newer contraceptive methods
 Dietary survey and calculation
Expected Skills:  Identification of common nutritional problems and their prevention and control
 Calculate and interpret indicators related to demography
3.6. Environment and Occupational Health including disaster management

3.5. Public Health Nutrition Must know

Must know • Role of vectors in the causation of diseases.

• Identifying features of and mode of transmission of vector borne diseases.
• Macro and micro nutrients- physiological functions, dietary sources
• Methods of vector control with advantages and limitations of each.
• Recommended Dietary Allowances or Intake age per age, sex and activity
• Mode of action, dose and application cycle of commonly used insecticides.
• Classification of Major Food and their Nutritive value
• Awareness of the concept of safe and wholesome water.
• Nutritional Assessment of Individual, family and community- Diet Survey
• Awareness of the requirements of a sanitary source of water.
• Plan and recommended suitable diet for individual, family and community as per
economic status and availability of local food • Understanding the methods of purification of water on large and small scale with stress
on chlorination of water.
• Clinical diagnosis deficiencies - Vitamin A deficiency, Iodine deficiency disorder,
nutritional Anaemia, protein energy Malnutrition
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• Physical, chemical standards; tests for assessing quality of water.  Assessing the quality of water
• Disposal of solid waste, liquid waste, both in the context of urban and rural conditions  Procedure of household level and medium scale water purification
in the country.  Steps of water treatment procedure,
• Problems in the disposal of refuse, sullage and sewage. Sources, health hazards and  Techniques of waste disposal
control of environmental pollution.
 Water quality assessment
• Influence of physical factors- heat, humidity, cold, radiation and noise – on the health of
 Steps of biomedical waste
the individual and community. Standards of housing and the effect of poor housing on
health.  Entomology: studying characteristics of important vectors
• Management of bio-medical wastes.  Identification of common occupational hazards
• Public health aspects of global warming.  Measures to prevent and control the occupational hazards
• Identification of Hazards of occupational environment -physical, chemical and biological  Learn the steps in disaster management
hazards
3.7. Health Care Delivery Systems in India, Health Planning and Management Including
• Occupational Diseases - Pneumoconiosis, silicosis, anthracosis, etc. lead poisoning
Health Policies, International Health.
• Occupational cancers
Must know
• Occupational dermatitis
• Radiation Hazards • Explain the terms: public health, public health administration, regionalization,
comprehensive medical care, delivery of health care, planning management, evaluation.
• Prevention and control of occupational diseases
• Components of health care delivery:
• Employee State Insurance schemes and Act and Factory Act
• Describe the salient features of the National Health Policy concerning:
• Concepts of Ergonomics
(a) Provision of medical care;(b) primary health care and Health Insurance; (c) universal
• Health protection of workers
health coverage (d) health manpower development; (e) planned development of health
• Sickness absenteeism care facilities; (f) encouragement of indigenous systems of medicine.
• Social security of workers • Explain the process of health planning in India by demonstrating awareness of
• Types of disaster and Disaster cycle recommendation of different health committees such as Bhore, Mudalair etc
• Natural and man-made disasters • The health systems and health infrastructure at Centre, state and district levels.
• Health Hazard of Disaster • The inter-relationship between community development block and primary health
Centre.
• Disaster Preparedness
• The organization, functions and staffing pattern of community health centers, primary
• Disaster Mitigation and Management and its application
health Centre, rural health center and subcentre.
Desirable to know • The job descriptions of health supervisor (male and female); health workers; village
health guide; ASHA, anganwadi workers traditional birth attendants.
• Steps of management of a case of insecticide toxicity
• The activities of the health team at the primary health Centre.
• Conservation and preservation of forests
• Familiarity with management techniques: Define and explain principles of management;
• Disaster in India and work of agencies to mitigate impact
explain the three broad functions of management (planning, implementation and
evaluation) and how they relate to each other.
Expected Skills:
• Appreciate the role of national, international voluntary agencies in health care delivery
 Conduct environmental assessment of the family and community
• Millennium and Sustainable Development Goals
 Assessment of air quality and noise pollution

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• International Health Regulations • Tribal Health-role of Mobile Medical Unit (MMU)

• Urban Health • Evidence based potential innovations and solutions in healthcare
• Impact of urbanization on health and disease. Common health problems (medical, social,
Desirable to know
environmental, economic, psychological) of urban slum dwellers.
• Organization of health services for slum dwellers. Organization of health services to • Juvenile delinquency
address the common health problems in urban areas • Participation of the teachers in the school health program
• Including maintenance of records; defining healthful practices; early detection of
Desirable to know
abnormalities.
• Health system research,
Nice to know
• Operational research
• National policy for children
Expected Skills:
Expected Skills:
 Be an effective team leader and motivator. Guide and train workers. Supervision of
workers and program.  Able to enumerate different MCH activities, goals, objectives and strategies in national
 Motivating community to participate in health care. health programs
 Arranging intersectoral coordination where necessary.  Diagnose and treat according to standard and relevant guidelines
 Working in liaison with other agencies involved in health care in various National Health  Growth monitoring by different anthropometric indicators using MUAC tape, Salter scale
Program etc. and plotting growth chart
 Enumerate causes and measures for reduction of MMR, IMR, U5MR
3.8. Health Care Delivery for Specific Population Groups: Reproductive Health, Child Health,
 Demonstrate counselling skills including risk assessments in ANC clinics etc. for e.g.
Adolescent Health, Geriatric Health, Tribal Health, Urban Poor, Migrants, People with
hematological diseases, RH incompatibility and Preventive Oncology clinic at AIIMS
Disability groups including related National Health Programs
 Able to advice proper type of Contraceptive methods to the clients
Must Know
 Identify common health problems among the school children, to arrange for regular
• Integrated Child Development Services Scheme medical examination of school children
• Reproductive, maternal, neonatal, child health plus adolescent  Identification of common geriatric health problems and their prevention and control
• India Newborn Action Plan
3.9. Communicable Diseases including National Health Programs
• National Health Mission
Must know
• Integrated Management of Neonatal and Childhood illnesses,
• Rashtriya Bal Suraksha Karyakram, • Epidemiology of Communicable diseases (Respiratory, Intestinal, Arthopod-borne
Infection and Zoonoses, surface infections and Emerging and Reemerging disease,
• Rashtriya Kishori Shakti Karyakram,
including hospital acquired infection and their prevention and control with their National
• Perinatal, Neonatal, Infant - Mortality Rate Programs
• Adolescent health, • Parasitic diseases
• Feeding of infant, growth and development, • Antimicrobial Resistance strategies
• Indicators of MCH care, • Link between veterinary health and human health
• School Health and Programs
• Geriatric Health and their Programs

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Expected Skills: Nice to know

 Eliciting clinic - social history and examining the patient for diagnosis and treatment in • Newer aspects in Family Medicine
relation with Communicable disease • Family Practice- Changing Scenario
 Collection of appropriate material for microbiological, tests for locally prevalent health
conditions. Expected Skills:
 Use of appropriate method as per diagnostic tool for the diseases  Effective management of common diseases within the limited resources
 Take necessary steps in disease outbreak/ epidemics/ investigation of epidemic,  Early Identification of common medical emergencies and their appropriate referral
notification.
 Knowledge on epidemiology in health and disease and their prevention and control 4. Teaching Plan

 Should be able to list goals, objectives and strategies in national health programs 4.1 Early community health Exposure

3.10. Non-Communicable Diseases including National Health Programs Teaching learning methods will include workshop and group discussions, field visits, health
camps in community and school, group presentation by students etc.
Must know

• Epidemiology of Cardiovascular and coronary heart diseases, Hypertension, stroke, Session Domain Topic
Diabetes and Obesity, Rheumatic heart diseases, blindness and Cancers and Road Traffic
Concept of health and • Introduction to basic concepts of health and
Accident and Injuries, there prevention and control with their National programs
disease disease
• Mental Health and National Mental Health Program
Health priorities in India • Introduction to Community Medicine and Family
• Synergies for beating NCDs and promoting mental health and well-being Public health approach Medicine
vs Clinical approach • Workshop /Group discussion to discuss the
Expected Skills:
health problems of India
 Eliciting clinic - social history and examining the patient for diagnosis and treatment in
relation with Non-Communicable disease 2. • Classic success stories in public health
• Smallpox eradication
 Risk assessments and Risk Predication of common NCDs
• Cholera control (John snow) etc
3.11. Family Medicine • Difference and similarities in public health
approach and clinical approach
Must know
• Determinants of health
• Treatment of common medical disease and emergencies
• Communication skills for Indian family practitioner 3. Health Facility visit • Visit to District Hospital

• Use of behavioral sciences related to family practice 4. • Visit to Community Health Centre (CHC)
• Patient management in family practice including home visits
• Solving patient problems within a particular socio-cultural setting, harnessing available 5. • Visit to Primary Health Centre (PHC)
community services.
6. Health Facility visit • Visit to Subcenter (SC) and interaction with MPW
Desirable to know
(M/F)
• Domiciliary care
7. • Report submission, presentation and discussion
• Setting up a family practice
• Research in Family Practice
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8. Health Care Services at • Interaction with Accredited Social Health Activist 14. Determinants of Health • Role of family in individual health (Qualitative
Community Level (ASHA ) Influences of Family on methods)
Interaction with • Observation of Village Health and Nutrition Day Health
Community Health (VHND) session 15. Nutrition • Nutrition
Workers (CHWs) and Environment Visit to local market and household for
9. other stakeholders • Visit to Anganwadi Centre (AWC) and interaction Social Issues and its enumeration of commonly available food,
associated with Health with Anganwadi Workers (AWW) impact on Health their caloric value and cost.
Health Camp Cultural practices related to different food
10. School Health • Meeting with various stakeholders of Gram
Panchayat
• Concept of Panchayati Raj system 
16. • Environment-1 (Water)
• Mapping of the village with respect to
Water quality testing and methods of water
• (ASHA, AWC, SC, Gram Panchayat, PHC and
purification
CHC)

11. • Health Camp in the village 17. • Environment-2 (Air)

• Utility of Campaign approach in health care Visit to air and noise pollution centre.
delivery Demonstration for assessment of the air
• Anthropometric measurement quality
• (Height, Weight and MUAC)
• Identify health priorities of villages 18. • Social issues and its impact on health (poverty,
• Salt testing for adequate Iodination gender preference, dowry, Alcoholism, Addiction
• Water testing for quality etc.) One social issue (Gender Preference/
• Understand the determinants of health Alcoholism)
• Identify the health priorities of village/community Its impact on health will be demonstrated
through community survey
19. Planning and delivery of • Planning of Health Education session
12. • Visit to the School. Observation of -Iron
health interventions (Health
supplement program and service delivery/
education and others)
Deworming /RBSK activity.
20. • Village Walk for awareness of Health and
• Importance of school health
Hygiene
• Health delivery in school through health camps
in school
21. Delivery of Health Education at family level;
considering the findings in health camp, preparation
13. • Report submission, Presentation and Discussion
of local balanced diet , hygiene and health

22. Assessment Internal Assessment

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4.2. Teaching from 3rd to 7th Semester • Socio-economic status

4.2.1. Theory  Third Semester (40 Hours) • Hospital Sociology

• Rights of individuals and consumer’s protection Act
1. General Concepts in Public Health, Community Medicine and Family Medicine
• Social Problems
• Introduction, definitions & general concepts in public health & community medicine
• Economics, Poverty
• History of Public Health
• Social security and social assistance process, types and barriers of communication
• Changing concepts in Public Health
• Different methods used for health education
• Dimensions and determinants of health
• Interview techniques, Operational Research
• Concepts of well-being
• Steps of counseling
• Indicators of mortality, morbidity and disability
• Principles of sociology in health promotion
• Philosophy Behind “Health For All (HFA)”
• Approaches to health education
• Elements of “Primary Health Care” (PHC)
• Family health history & individual Medico - Social History - Taking
• Public health in developed countries, developing countries and countries with transitional
• Behaviour Change Communication
economies - history, development & policies
• Information, Education, Communication
• Risk factors, risk Groups, iceberg of diseases, spectrum of diseases
• Theories of disease causation Fourth Semester (40 Hours)
• Natural history of disease 3. Environment and Occupational Health, Disaster management
• Monitoring and surveillance 3A. Occupational health
• Concepts of prevention, modes of intervention
• Concepts of ergonomics
• Classification of diseases
• Identification of hazards of occupational environment - physical, chemical and biological
• Dynamics and modes of disease transmission hazards
• Diseases prevention and control • Occupational Diseases - Pneumoconiosis, silicosis, anthracosis, etc.,
• Investigation of an epidemic • Occupational cancers, Occupational dermatitis, Radiation Hazards, Occupational
• Community diagnosis hazards of agricultural workers
• Concepts of screening • Industrial toxicology

2. Principles and Practices of Health promotions, Social Sciences, Humanities and • Industrial accidents
Communications • Sickness absenteeism

• Social factors influencing health of people, concepts in sociology • General measures of prevention & control of occupational diseases

• Role of emotions in health and disease, learning, intelligence • Social security and labour laws, employee state insurance schemes and act and factory
act
• Personality, motivation and theories
• Medical evaluation of workers
• Social Psychology
• Social Organization 3B. Disaster Management

• Family in health and disease • Types of disaster and Disaster cycle

• Cultural factors in health and disease • Health Hazard of Disaster

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• Disaster Preparedness, Disaster Mitigation and Management and its application • Micronutrients: Vitamins
• Natural and Man-Made Disasters, Bioterrorism • Micronutrients: Minerals

3C. Environment • Major Foods and their Nutritive Value

• Dietary goals and balance diet
• Concept of safe and wholesome water
• Nutritional requirements of special groups: Mothers, Children and the Elderly
• Water pollution and requirements of a sanitary source of water.
• Nutritional deficiency diseases of public health importance - Vitamin a deficiency, iodine
• Methods of purification of water on large and small scale with stress on chlorination of
deficiency disorder, nutritional anaemia and programs related to them
water.
• Protein Energy Malnutrition, Severe Acute Malnutrition and Management of Severe
• Water quality and standards
Acute Malnutrition Children
• Surveillance of drinking water quality
• Social and cultural practices in nutrition and health
• Hardness of water and treatment
• Junk food and food toxicants
• Swimming pool sanitation
• Public health aspects of food hygiene & sanitarytion: Regulation of eating establishments,
• Rain water harvesting slaughter house sanitation
• Assessment of air quality and pollution • Nutritional assessment and surveillance of a community
• Assessment of ventilation, lighting, noise and radiation • Plan and recommended suitable diet for individual, family and community as per
• Assessment of humidity, air temperature, air velocity economic status and availability of local food
• Public health aspects of global warming. • Food Adulteration and Prevention of Food Adulteration act
• Standards of housing and the effect of poor housing on health • Food Processing, Food Additives, Preservatives, Food fortification
• Disposal of solid waste • Food safety and Food Safety and Standards Act
• Disposal of excreta both in the context of urban and rural conditions in the country • Nutrition during Special Situations : Disasters, fairs and festivals, Community feeding of
• Modern sewage management of sewage and sullage children

• Conservation and preservation of forests • Nutritional programmes in India including ICDS, National Nutrition Policy

• Environmental assessment of the family and community 5. Demography and Population Health
• Management of bio-medical wastes. • Demography cycles, Demographic Indicators like sex ratio and Population Pyramid,
• Water, sanitation and hygiene Dependency
3D. Entomology • Fertility related Statistics
• Role of vectors in the causation of diseases. • Health aspects of Family Planning and Welfare concept: Eligible Couple, Target Couple,
Couple Protection rate
• Identifying features of and mode of transmission of vector borne diseases.
• National population policy
• Methods of vector control with advantages and limitations of each.
• Contraceptive Methods - I
• Mode of action, dose, application cycle and techniques of commonly used insecticides.
• Contraceptive Methods - II
• Steps of management of a case of insecticide toxicity
• MTP Act
4. Public Health Nutrition
• Surveillance, Unmet Needs of Family Planning, Community Need Assessment Approach,
• Classification of major food and their nutritive value Social Marketing
• Macro and micro nutrients- physiological functions, dietary sources, recommended • Evaluation of Family Planning
dietary allowances or intake age per age, sex and activity
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Fifth Semester (36 hours) • Summarizing the data: measures of central tendency and variability

6. Epidemiology and Biostatistics • Introducing Inferential Statistics: Gaussian distribution and Central limit theorem,
Confidence Interval
6A. Epidemiology
• Inferential Statistics: Estimation and hypothesis testing
• Introduction, definition and uses of epidemiology • Inferences with Single mean
• The Essential “Building Blocks” of epidemiology and research methodology • Inferences with Single population proportion
• Measurements of disease frequency and outcomes in epidemiology • Hypothesis Testing: The difference between two population means
• Sources of information in epidemiology • Hypothesis Testing: The difference between two population proportions
• Measures of association & effect • Chi-square Test
• Errors of measurement, confounding and bias • Sample Size determination
• Architecture of epidemiological (research) designs (epidemiologic methods) • Sampling methods
• Descriptive studies (including ecological studies) & epidemiological distribution according • Simple correlation and regression
to person, place & time
• Advanced regression models
• Cross - Sectional Studies
• Life Tables and Survival Analysis
• Case Control Studies
• Non-parametric tests
• Cohort Studies
• Which statistical procedures to use depending upon exposure and outcome variable
• Experimental (Intervention) Studies
Sixth and Seventh Semester: (132 Hours)
• Non-Randomized Trials
• Planning, design and conduct of epidemiological surveys 7. Health Care Delivery for Specific Population Groups and their related National Health
Programs
• Epidemiological basis of public health surveillance for disease
• Association and causation 7A. Maternal Health
• Uses of epidemiology • Introduction to Maternal and Child Health
• Writing the research findings • Risk approach in MCH
• Writing the research proposal • Maternal health care-antenatal care
• Critical appraisal of a published article • Maternal health care-post natal care
• Ethical issues in epidemiology & medical research • Indicators of MCH care - I (Maternal mortality)
• Qualitative research: an overview
7B. Child Health
• Applications of computers in epidemiology
• Intranatal Care & Neonatal Care
• Use of reference management software
• Low birth weight babies & small for date babies
6B. Statistics
• Kangaroo Mother Care
• Introduction to Biostatistics • Feeding of Infants
• Fundamental principles of data management • Care of Under Five Children- Growth and Development
• Populations and samples • Indicators of MCH care - II (IMR, Under-5 MR etc.)
• Descriptive statistics: displaying the data • Psycho-social problems in children

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7C. Adolescent health- Health problems, ARSH Clinic 8b. Health Care Infrastructure

7D. Geriatric health- Health problems, social problems, various schemes for geriatrics • Health systems and health infrastructure at Centre, state and district levels.

7E. Tribal health – specific health problems and service delivery approach • Inter-relationship between community development block and primary health Centre.
• Organization, functions and staffing pattern of community health centers, primary health
7F. Programs
Centre, rural health center and subcentre
• Janani Surakshya Yojana,
• Job descriptions of health supervisor (male and female); health workers; village health
• Janani Sishu Surakshya Karyakram guide; ASHA, Anganwadi Workers traditional birth attendants
• Integrated Management of Neonatal and Childhood Illnesses (IMNCI) • Organization of health services for slum dwellers. Organization of health services to
• India Newborn Action Plan address the common health problems in urban areas
• Rashtriya Bal Suraksha Karyakram,
8c. Planning and Management
• Rashtriya Kishori Shakti Karyakram
• Planning Cycle
• Reproductive, maternal, neonatal, child health plus adolescence
• General Concepts in Management Sciences
• National Rural Health Mission
• Modern Management Techniques
• National Urban Health Mission
• Logistics and Finance Management
• National Program for Health Care of Elderly, National Policy on Older Persons
8d. International Health-
8. Health Care Delivery Systems in India, Health Planning and Management Including
Health Policies, International Health. • Organizations, International health Regulation, Public Health Emergency of International
Concern
8a. Health care of the Community
9. Communicable Diseases including National Health Programs
• Explain the terms: public health, public health administration, regionalization,
comprehensive medical care, delivery of health care, planning management, evaluation. 9a. Respiratory infections

• Components of health care delivery • Respiratory Infections - I

• National Health Policy • Respiratory Infections - II
• Universal health coverage • Respiratory Infections - III
• Health manpower development • Respiratory Infections - IV
• Planned development of health care facilities
9.b. Intestinal Infections
• Indigenous systems of medicine
• Different health committees • Intestinal Infections - I

• Primary health care in india • Intestinal Infections - II

• Sustainable Development Goals • Intestinal Infections - III

• Evaluation of health services • Intestinal Infections - IV
• Urban health
9c. Arthropod Borne Infections
• Impact of urbanization on health and disease. Common health problems (medical, social,
environmental, economic, psychological) of urban slum dwellers. • Arthropod Borne Infections - I

• Health Insurances • Arthropod Borne Infections - II

• Voluntary health agencies • Arthropod Borne Infections - III

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9d. Zoonoses 10b. Programs

• Zoonoses - I • National Mental Health Program

• Zoonoses - II • National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular
• Zoonoses - III Diseases and Stroke

• Zoonoses - IV • National Programme for Control of Blindness

11. Family Medicine

9e. Surface Infections
• Treatment of common medical disease and emergencies
• Surface Infections - I
• Solving patient problems within a particular socio-cultural setting, harnessing available
• Surface Infections - II
community services
• Surface Infections - III
• Patient management in family practice including home visits
• Surface Infections - IV
• Use of behavioral sciences related to family practice
9f. Emerging and Reemerging Infections • Public Mental health
• Public Dental Health
9g. Hospital Acquired infections
4.2.2. Practical
9h. Programs
4th Semester: (20 session x 3 hours)
• Revised National TB Control Program
Public health Nutrition, Environment, Occupational Health, Demography
• National Leprosy Eradication Programme
• National Vector Borne Disease Control Programme • Nutritive value of food and food labelling
• National AIDS Control Programme • Planning of balanced and therapeutic diets
• Integrated disease surveillance program • Exercise on nutrition
• Visit to milk pasteurization plant
10. Non-Communicable Diseases including National Health Programs
• Visit to the Dietetic center at Capital Hospital
10a. Diseases • Visit to Slaughter house
• Cardiovascular and coronary heart diseases • Nutrition Exercise: PEM, Vit. A
• Hypertension • Occupational Health Models/Equipment
• Stroke • Family planning specimen
• Diabetes • Entomology
• Obesity • Water Exercises
• Rheumatic heart disease • Study of the Model Instrument in Environment
• Blindness • Visit to the Water Treatment Plant
• Cancer • Demographic Exercises
• Road traffic accidents • Visit to air pollution monitoring station
• Mental health • Visit to bio-medical waste center

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6th Semester (32 session x 3 hours and 10 session x 2 hours) 7th Semester (32 session x 3 hours and 10 session x 2 hours)

1. Epidemiological and Biostatistics Exercise 1. Family Health Advisory Services (FHAS)

• Measures of Mortality • Introduction to Family Health Advisory Services

• Measures of Morbidity • Map of the Village with the Index House Location
• Vital Statistics • Demography
• Analysis in epidemiological studies • Socio Economic Status
• Cohort study and case control study • Housing and Environment
• Presentation of data • Nutrition
• Normal distribution curve • Dietary intake of the family - 24 hours recall - field
• Measures of central tendency • Diet planning for the family & amp; intervention - Class
• Measures of dispersion • Health assessment of family member
• Confidence interval • Social habits and family relationship
• Hypothesis testing and test of significance i • Family diagnosis and community diagnosis
• Hypothesis testing and test of significance ii • Preparation of family data and presentation
• Screening Exercises • Review of health records and interaction with health workers
• General and Communicable Disease, epidemiology, demography exercises • Health Education Session (Roleplay)
• Immunization and calculation of vaccine requirements • Initiatives in Swachh Bharat Abhiyan

2. Clinico-Psycho-Social Case Review (CPSCR) 2. Maternal and child health practical

• Antenatal care 3. Outbreak Investigation

• Postnatal care 4. Palliative care

• Infant 5. Entomology Revision
• Malnutrition
6. Spotters on Environment-Revision
• Low Birthweight Weight
7. Revision of Immunization Spotters
• Breast feeding
• Diarrhea 8. Revision of General and Communicable Disease Epidemiology, Demography and Biostatistics
exercises
• ARI
• Measles 4.2.3. Clinical/Community posting (6th and 7th Semester) – 240 hours
• Under-five child
A. Research posting
• Adolescent
• How to develop research question and hypothesis
• Anemia
• Review of literature
• Geriatric
• Development of interview schedule/ Questionnaire
• Tuberculosis
• Development of protocol
• Lactating women
• Importance of ethics in research
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• Confounding, Bias 5. Assessment Plan

• Data Collection 5.1. Formative assessment
• Data entry and Analysis 5.1.1. Theory: Semester examination in 2nd semester, end of 3rd ,4th ,5th, and 6th semester
• Presentation 5.1.2. Practical: End posting assessment at the end of posting at the end of 2nd, 4th and
6-7th Semester
B. Visit to Clinics

• Non-Communicable Disease (NCD) clinic: hypertension, diabetes, osteoarthritis, 5.2. Summative assessment (Total Marks = 300)
hypothyroidism 5.2.1. Theory (Total Marks = 200)
• Immunization- Universal Immunization Program, Animal bite management, Yellow fever  Two papers (Paper I & Paper II)
vaccination,
 Each paper has two sections (Section A & B)
• Integrated Counselling and Testing Centre (ICTC)- Pretest and Posttest counselling, STI/
 Each section has one long question (10 marks) and eight short questions (5 marks each)
RTI Management
 Maximum marks for each paper is 100 (Total: 200)
• DOTS clinic- Treatment of TB patients under Daily Regimen (Cat-1,2,4)
• Preventive oncology Blue print for framing final professional theory question paper

C. Case Based Discussion on Common diseases presenting in Urban Health Centre i) The paper should have weightage of 70% marks from must know areas, 20% from
desirable to know and 10% from nice to know areas.
• Medicine
ii) Topic wise weightage should be as follows
• Ophthalmology
Paper 1
• Obstetrics and Gynecology
• Pediatrics Topic Marks allotted
• Skin General concepts in Public Health, Community Medicine and Family
20
• Psychiatry Medicine
Principles and Practices of Health Promotion 10
D. CPSCR presentation
Epidemiology, Biostatistics and Research Methodology 10
• Malnutrition, Under-five, antenatal case, post-natal case, Geriatric, Infant, Pneumonia,
Diarrhoea, TB Demography and Population Health 10
Public Health Nutrition 10
E. Visit to Health Facility, Data Collection and Presentation
Environment and Occupational Health including Disaster Management 15
• Visit to Anganwadi center, Interaction with Anganwadi worker and ASHA, Outreach
immunization Health Care Delivery Systems in India, Health Planning and Management
25
Including Health Policies, International Health
• Visit to subcentre and MPW(M/F) interview
• Visit to PHC
• Visit to CHC- Data collection, Presentation
• Visit to District HQ hospital and ICTC
• Visit to regional vaccine store
• Visit to District Tuberculosis Unit (DTU)
• Visit to school for school health and preparation for health education
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Paper 2 MODEL QUESTION PAPER

Topic Marks allotted COMMUNITY MEDICINE
Health Care Delivery for Specific Population Groups: Reproductive Health, 25 PAPER I
Child Health, Adolescent Health, Geriatric Health, Tribal Health, Urban Time: Max marks: 100
Poor, Migrants, People with Disability groups including related National
Health Programs, SECTION A
Communicable Diseases including related National Health Programs 35
1. A health worker reported 77 cases of diarrhoea from a single village with a population of
Non-Communicable Diseases including related National Health Programs 25 780.All the cases had occurred within a period of 8 days. How medical officer in charge of
15 the concerned primary health centre should conduct the investigation? Enlist and describe
Family Medicine
control measures which should be undertaken ? [6+4 = 10]

5.2.2. Practical (Maximum marks = 200) 2. Answer the following . [8 questions x 5 marks=40]

a. Write four different types of non-probability sampling. Write advantages of non-

Sl No. Topic Duration Marks
probability sampling over probability sampling
1. Problem solving
b. Mention the ideal way of presenting following type of data with pictorial representation
a. Biostatistics exercises 45 mins 20  (1x 5)
b. Epidemiology exercises
20 i) Number of cases of diarrhea in an outbreak over three weeks
c. Spotters (environment, entomology, demography)
/ OSCE 30 ii) Causes of under-five mortality
d. Health communication and health education iii) States of origin of MBBS students admitted in a medical college
15
exercises
iv) Prevalence of hypertension in different age groups
e. Health management exercises 15
v) Distribution of hemoglobin level among school children
2. Short case in AIIMS Hospital (one) 20 mins 20
c. Enlist the major data sources of infant mortality rate in India. Explain the best source
3. Long case in the Community (one) 45 mins 40
with justification. (3+2)
4. Grand Viva 15 min 40
d. Define replacement level of fertility. Explain its relation to population stabilization (2+3)
Total 200
e. Represent diagrammatically the “web of causation” of hypertension in a 45 year-old
6. Feedback: Structured feedback for each module will be taken from students, faculty and desk job worker
senior residents to improve the teaching learning methods
f. Write steps of disaster management.
6.1. Early community exposure
g. Illustrate schematically a health education program for prevention and control of
6.2. Theory teaching – module wise malaria in a rural community.
6.3. Practical – module wise h. Describe the importance of food labelling as a public health tool
6.4. Clinical community posting – for each aspect of training

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SECTION B MODEL QUESTION PAPER

3. As medical officer in-charge of a Primary Health Centre, you notice that village health and COMMUNITY MEDICINE
sanitation committees are not functioning properly.  [4+3+3 = 10] PAPER II
a. What are the functions of village health and sanitation committee. Enumerate roles of
Time: Max marks: 100
various stakeholders in this committee?
b. Discuss common challenges in the functioning of these committees
SECTION A
c. Develop a framework for monitoring and supervision by medical officer in charge 1. ou have been newly posted as a district tuberculosis officer in a tribal district of Odisha where
the indicators related to tuberculosis control are very poor. Answer the following questions
4. Write short notes on  [8 questions x 5 marks=40]  (4+4+2 = 10)

a. Food fortification. Give two examples of food fortification. Write importance of food a. Current challenges in implementation of tuberculosis control programme in remote
district.
fortification as a strategy for prevention of micronutrient deficiency.  (2+1+2)
b. Enumerate newer initiatives undertaken in the program for management of drug
b. Role of pre-employment medical examination for improving occupational health
resistance tuberculosis.
c. Enumerate the steps of behavior change communication process
c. Enlist innovations related to Information technology in improving programme outcomes.
d. Discuss determinants of diseases using epidemiological wheel theory taking example of
one communicable and one noncommunicable disease 2. Answer the following  [8 questions x 5 marks=40]

e. Mention the strategies of Entomological surveillance for dengue control in an urban a. Management of diarrhea in a 9-month-old child at the household level
area. b. Enlist different types of cancer registry in India and compare their salient features (2+3)
f. Discuss role of ASHA in community mobilization for maternal health care services c. Enumerate activities undertaken at primary health centre for prevention and control of
common cancer under national programme
g. Calculate annual vaccine requirement for a PHC with the birth rate of 30/1000
d. Explain with illustration different levels of prevention of non-communicable diseases
population and infant mortality rate of 45/1000 live births
h. Enlist opportunities for convergence of different stakeholders during Village Health and e. Enumerate strategies adopted for polio eradication. Write reasons for success of polio
Nutrition Days (VHNDs). eradication from India  (2+3)
f. Mention chemoprophylaxis regimen under Revised National Tuberculosis Control
Program. Enumerate other important measures for prevention of transmission  (2+3)
g. Write characteristics of an ideal screening test
h. What are the common causes of preventable blindness? Enlist strategies of National
Program for Control of Blindness (NPCB).  (2+3)

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SECTION B Annexure-1
1. A 50 years old auto driver residing in a slum with three children and wife, with a monthly Suggested integrated teaching plan
income of Rs 3000/- came to urban primary health centre with complains of severe
headache and uneasiness for last seven days. His blood pressure was 170/100mm Hg. On Topics Semester Participating Number Content details Assessment
examination, mild pallor was observed and other systems were found to be normal. Departments of Hours
[2+2+3+3=10] Tuberculosis 6th semester CMFM, 8 hrs Pathogenesis, MCQs
a. Write the plan of immediate management of the patient? Microbiology, diagnosis, treatment,
Pulmonary prevention, RNTCP
b. Enlist the complications which may be expected in the patient
Medicine.
c. Enumerate investigations required for this patient and prepare a follow up plan.
Malaria 5th semester CMFM, 4 hrs Pathogenesis, QUIZ
d. Write individual and health system challenges in long term management of the Microbiology, diagnosis, treatment,
patient. Medicine, prevention,
Paediatrics. NVBDCP
2. Answer the following.  [8 questions x 5 marks=40]
HIV/AIDS 6thsemester CMFM, 12 hrs Pathogenesis, MCQs
a. Integrated vector management for control of dengue Microbiology, diagnosis, treatment,
b. What are the barriers in implementation of the national mental health program? Pharmacology, prevention, NACP
c. Syndromic management of Sexual Transmitted Infections (STIs)/ Reproductive Skin,
Tract Infections (RTIs) and its rationale (3+2) Medicine.

d. Enlist dangers signs in a newborn under Integrated Management of Newborn and Hypertension 6th semester CMFM, 4 hrs Aetiology, Clinical QUIZ
Childhood Illness (IMNCI). Pharmacology, Features, Clinical
Medicine, OBG Assessment, Plan of
e. Enumerate different types of surveillance in Integrated Disease Surveillance Project
Management
(IDSP). Mention any four diseases under IDSP surveillance (3+2)
Diabetes 6th semester CMFM, 4 hrs Aetiology, Clinical QUIZ
f. How biomedical waste should be segregated at source? Mellitus Pharmacology, Features, Clinical
g. Describe three delay model of maternal mortality Medicine, OBG Assessment, Plan of
h. Enlist vaccine recommended for international traveller and its significance. Management
Malnutrition 4th semester CMFM, 8 hrs Causes & risk factors OSCE
in children Paediatrics, , Clinical
Biochemistry, Assessment, Plan of
Anatomy Management

Anaemia 4th semester CMFM, 15 days Aetiology, SA Tests

Pathology, Diagnosis, Clinical
Medicine, Assessment, Plan of
Management, NIPI
Paediatrics,
programme
OBG,
Physiology,
Transfusion
Medicine

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Topics Semester Participating Number Content details Assessment

Departments of Hours
Road traffic 7th semester CMFM, Surgery, 6 hrs Epidemiology, SA Tests
injuries Anaesthesia, Clinical Assessment,
Orthopaedics Plan of Management,
Prevention and
control
Breast cancer 7th semester CMFM, 4 hrs Aetiology, Clinical QUIZ
Surgery, Features, Clinical
pathology, Assessment, Plan of
Radiology, Management
Medical
Oncology
Cervical 7th semester CMFM, OBG, 4 hrs Aetiology, Clinical QUIZ
cancer Pathology Features, Clinical
Assessment, Plan of
Management
Oral cancer 7th semester CMFM, 4 hrs Aetiology, Clinical QUIZ
Dentistry,
Pathology,
Features, Clinical
Assessment, Plan of OTO-
Oncology Management

Depression 7th semester CMFM,

Psychiatry
4 hrs Risk factors, Clinical
Features, Clinical
QUIZ RHINOLARYNGOLOGY
Assessment, Plan of
Management (E.N.T.)
Annexure-2
Recommended text books (gement inPrimaryHealth Care,WHO).

1. Murtagh’s General Practice by John MLatest Editions)

2. Park’s textbook of preventive and social medicine by K. Park

3. Textbook of public health and community medicine by Rajiv Balwar (AFMC),WHO

4. Oxford Textbook of Public Health by R. Detels, R. Beaglehole, M.A. Lansang and M. Gulliford.

5. Basic Epidemiology by R. Beaglehole, R. Bonita and T. Kjeirstrom

6. Statistics at Square One by M J Cambell & TDV Swinscow

7. National health Programmes of India by Dr DK Taneja

8. On Being In Charge, Guide for manaurtagh AM.

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OTO-RHINOLARYNGOLOGY (E.N.T.) TOPICS AND THEIR ALOTTED CLOCK HOURS

GOAL Sl. Topics Must Desirable Nice to Hours of Lec/Tut

No. Know to Know know Teaching /Clin
The undergraduate student should acquire adequate knowledge and skills to examine, diagnose Diseases Of Ear
and treat common ENT diseases/disorders and ENT emergencies and able to comprehend and
implement the principles of rehabilitation of the persons with impaired hearing. 1. Anatomy of Ear  2 Lecture
2. Peripheral Receptors and  1+3 Lecture
OBJECTIVES Physiology of Auditory and +
Vestibular Systems Tutorial
Knowledge 3. Audiology and Acoustics  1+3 Lecture
At the end of the course, the student should be able to: 4. Assessment of Hearing  Tutorial
5. Hearing loss  Lecture
1. Describe the basic pathophysiology/etiopathogenesis of common ENT diseases and
emergencies. 6. Assessment of vestibular function  1 Lecture
2. Adopt the rational use of commonly used drugs, keeping in mind their adverse reactions. 7. Disorders of the vestibular system 
3. Suggest common investigative procedures and their interpretation. 8. Diseases of the External ear  1 Lecture
9. Eustachian tube and its disorders 
Skills
10. Disorders of the middle ear 
At the end of the course, the student should be able to: 11. Cholesteatoma and Chronic otitis  2+3 Lecture
media +
1. Examine and diagnose common ENT problems including the pre-malignant and malignant
12. Complications of Suppurative  2+3 Tutorial
disorders of the head and neck.
Otitis Media
2. Manage ENT problems at the first level of care and be able to refer whenever necessary.
13. Otosclerosis  1 Lecture
3. Assist/carry out minor surgical procedures like ear syringing, ear dressings, nasal packing etc.
14. Facial Nerve and its Disorders  1 Lecture
4. Assist in certain procedures such as tracheostomy, endoscopies,wound dressings and
15. Meniere’s Disease  1 Lecture
removal of foreign bodies.
16. Tumours of External Ear  1 Lecture
TOPICS FOR INTEGRATION: 17. Tumours of Middle Ear and 
Mastoid
Thyroid diseases
18. Acoustic Neuroma 
Orbital complications of sinusitis 19. The deaf child  1 Lecture
Allergic rhinitis 20. Rehabilitation of the Hearing  1 Lecture
Impaired
Patient Safety protocol
21. Otalgia  1 Lecture
22. Tinnitus 
Diseases of Nose and Paranasal Sinuses
23. Anatomy of Nose & paranasal  1 Lecture
sinuses
24. Physiology of Nose & paranasal  1 Lecture
sinuses

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Sl. Topics Must Desirable Nice to Hours of Lec/Tut Sl. Topics Must Desirable Nice to Hours of Lec/Tut
No. Know to Know know Teaching /Clin No. Know to Know know Teaching /Clin
25. Diseases of External Nose and Nasal  1 Lecture 48. Acute and chronic pharyngitis  2 Lecture
vestibule 49. Acute and chronic tonsillitis 
26. Nasal septum and its diseases 
50. Head and Neck Space infections  1 Lecture
27. Acute and chronic rhinitis  3 Tutorial
28. Granulomatous diseases of Nose 51. Tumours of Nasopharynx &  1 Lecture

Oropharynx
29. Miscellaneous Disorders of Nasal 
Cavity 52. Tumours of the Hypopharynx and 
Pharyngeal pouch
30. Allergic Rhinitis  1 Lecture
53. Snoring and sleep apnoea  2 Tutorial/
31. Vasomotor and other forms of 
Integration
nonallergic rhinitis
Diseases of larynx and trachea
32. Nasal polypi  1+3 Lecture
+ 54. Anatomy and physiology of larynx  1 Lecture
Tutorial 55. Laryngotracheal Trauma  1 Tutorial
33. Epistaxis  1 Lecture
56. Acute and Chronic inflammations  1 Lecture
34. Trauma to face  1 Tutorial of larynx
35. Acute sinusitis  1 Lecture
57. Congenital Lesions of Larynx and Stridor Rest 1 Lecture
36. Chronic sinusitis  stridor Must Desirable to
Know know
37. Complications of sinusitis  3 Tutorial
58. Laryngeal paralysis 
38. Benign and malignant neoplasms of JNA - Rest - 1+3 Lecture
nasal cavity Must  + Inte- 59. Benign tumours of Larynx  1 Lecture
Know gration/ 60. Cancer of Larynx 
39. Neoplasms of paranasal sinuses  Tutorial
61. Voice and speech disorders 
40. Proptosis 
62. Tracheostomy and other proce-  3 Tutorial
Diseases of the oral cavity and salivary glands
dures for Airway management
41. Anatomy of oral cavity  1 Lecture
63. Foreign bodies of air passages 
42. Common disorders of the oral cavity 
Thyroid gland and its disorders
43. Tumours of oral cavity Premalig- Rest -
nant le- Nice to 64. Thyroid gland and its disorders,  3 Tutorial/
sion Must Know thyroid swelling Integration
know
44. Non-neoplastic disorders of salivary  1 Lecture Diseases of Oesophagus
glands 65. Anatomy and physiology of  1 Lecture
45. Neoplasms of salivary glands  oesophagus

Diseases of Pharynx 66. Disorders of oesophagus 

46. Anatomy and physiology of pharynx  2 Lecture 67. Dysphagia  1 Lecture
47. Adenoids and other inflammations  68. Foreign bodies of food passages 
of the nasopharynx

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Sl. Topics Must Desirable Nice to Hours of Lec/Tut Sl. Topics Must Desirable Nice to Hours of Lec/Tut
No. Know to Know know Teaching /Clin No. Know to Know know Teaching /Clin
Recent advances. Instruments:
69. Laser surgery, radiofrequency  3 Tutorial 91. OPD instruments  1 Tutorial
surgery and hyperbaric oxygen 92. Tonsillectomy  2
therapy
93. Mastoidectomy  6
70. Cryosurgery 
94. Septoplasty  1
71. Chemotherapy for head and 
95. Tracheostomy  2
neck cancer
72. HIV infection/AIDS and ENT 1 Lecture 96. DL/Bronchoscope/  1

manifestation oesophagoscope
Charts:
Operative surgery
97. Audiogram  1 Tutorial
73. Myringotomy  1 Tutorial 98. Tympanogram  1
74. Mastoidectomy all types  6 99. BERA  1
75. Tympanoplasty  1 100. Spotters  1
76. Septal Surgeries  3
40hrs lectures, 80hrs tutorials, 120hrs clinics
77. Diagnostic Nasal Endoscopy and  6
Endoscopic Sinus Surgery ASSESSMENT
78. Direct Laryngoscopy/  1 Theory - 100marks
Bronchoscopy/Oesophagoscopy
Practical - 100marks
79. Tonsillectomy & Adenoidectomy  2
Total 200marks
80. Thyroid surgery  2
Theory
81. Proof puncture/Caldwell luc/Inf  1
nasal antrostomy One paper with two section A & B -100 MARKS
Section A (EAR & NOSE)-50MARKS
Radiology in ENT
1. One long question-10 marks
82. Xray  4 Tutorial
2. Five short notes 5x8=40 marks
83. CT Nose PNS/Mastoids 
Section B (THROAT AND HEAD NECK)-50MARKS
Clinical Methods in ENT and Head Neck Surgery
1. One long question-10 marks
84. Clinical methods of ENT & Neck  8ds- 24hrs Clinics 2. Five short notes 5x8=40 marks
85. Neck Mass  4ds-12hrs Note: Long Answer Questions (LAQ) should be from must know area. Total number of SAQs is 16
of which 4 to 6 should be from desirable to know areas.
86. Thyroid Swelling  2ds-6hrs
Practical
87. Ear cases – Mucosal COM  10ds-30hrs
Total 100 MARKS
88. Nose cases – DNS, Nasal Polyp  9ds – 27hrs Cases: 70 marks- One long case-40marks, two short case -15x2=30
89. Chronic tonsillitis  6ds – 18hrs Radiology (X-rays)-10 marks

90. Revision  3hrs Charts & clinical photography-10 marks

Viva voce & Instruments-10 marks
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MODEL THEORY PAPER

OTO-RHINOLARYNGOLOGY
Time: 3 hours Max.  Total: 100 marks

Answer all the questions

Illustrate your answer with suitable diagrams whenever necessary

Section A (Ear & Nose)

1. A 35 year old female gives history of decreased hearing in both ears without any history of
ear discharge. She also gives history of worsening of hearing during her last pregnancy. On
Rianne’s test, she hears better when the 512Hz tuning fork placed over the mastoid process
for the both the ears and Weber test is lateralized to left ear. What is the most probable
diagnosis of her ear condition? Discuss the management of this case. Enumerate six causes
for sensory neural hearing loss.  (2 + 5 + 3 = 10)

2. Short notes  ( 8 x 5 = 40 )
a. Etiopathogenesis and management of serous otitis media
b. Bell’s palsy
c. Management of allergic rhinitis
d. Rhinosporidiosis
e. Management of Meniere’s disease
f. Management of septal hematoma
OPHTHALMOLOGY
g. Prevention and management of ototoxicity
h. Kieselbach’s plexus

SECTION B (throat & head neck)

1. A case of carcinoma of larynx presents to emergency department with respiratory distress
and noisy breathing. What immediate surgical procedure is required to relief his symptoms.
Describe the indications, operative procedure, and immediate post-operative complications
of the above required surgical procedure.  (2 + 3 + 3 + 2= 10)

2. Write short note on:  (8 X 5 = 40)

a. Clinical features and management of peritonsillar abscess
b. Indications and complications tonsillectomy
c. Vocal Nodule
d. Evaluation of dysphagia
e. Ludwig’s angina
f. Indications and complication of rigid Oesophagoscopy
g. Laryngomalacia
h. Puberphonia
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OPHTHALMOLOGY 3. Diagnose and treat common problems affecting the eye

GOAL: 4. Interpret ophthalmic signs in relation to common systemic disorders

The broad goal of the teaching of students in ophthalmology will be to provide such knowledge 5. Assist/observe therapeutic procedures such as subconjunctival injection, corneal/
and skills to the students that shall enable him to practice as a clinical and as a primary eye conjunctival foreign body removal, nasolacrimal duct syringing and dacryocystectomy
care physician and also to function effectively as a community health leader to assist in the 6. Provide first aid in major ophthalmic emergencies
implementation of National Programme for the prevention of blindness and rehabilitation of the
visually impaired. 7. Assist to organize community surveys for a visual check-up

8. Assist to organize primary eye care service through primary health centres
OBJECTIVES
9. Use effective means of communication with the public and individual to motivate for
A. KNOWLEDGE
surgery in cataract and for eye donation
At the end of the course, the student should have knowledge of
10. Establish rapport with his seniors, colleagues and paramedical workers, so as to effectively
1. Common problems affecting the eye function as a member of the eye care team

2. Principles of management of major ophthalmic emergencies INTEGRATION:

3. Main systemic diseases affecting the eye The undergraduate training in Ophthalmology will provide an integrated approach towards other
4. Effects of local and systemic diseases on patient’s vision and the necessary action required disciplines especially Neurosciences, Otorhinolaryngology, and General Medicine.
to minimize the sequelae of such diseases
CURRICULUM CONTENT
5. Adverse drug reactions with special reference to ophthalmic manifestations
Basic Plan for undergraduate teaching:
6. Magnitude of blindness in India and its main causes
The teaching of undergraduate students is done through Theory lectures, Seminars and
7. National programme of control of blindness and its implementation at various levels demonstrations

8. Eye care education for prevention of eye problems In addition, problem-based exercise is given to the students. Common problems like acute red
eye, progressive & sudden loss of vision are discussed with the active participation of students.
9. Role of primary health centre in organization of eye camps

10. Organization of primary health care and the functioning of the ophthalmic assistant

11. Integration of the national programme for control of blindness with the other national
health programmes

12. Eye bank organization

B. SKILLS

At the end of the course, the student should be able to

1. Elicit a history pertinent to general health and ocular status

2. Assist in diagnostic procedures such as visual acuity testing, examination of eye, tonometry,
staining for corneal pathology, confrontation perimetry, subjective refraction including
correction of presbyopia and aphakia, direct ophthalmoscopy, conjunctival smear
examination and Cover test

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 LIST OF THEORY LECTURES: CURRICULUM CONTENT (Theory)

Sr. No. Topics TOPICS MUST KNOW DESIRABLE TO KNOW NICE TO KNOW
1. Anatomy of the eye
LIDS AND OCULAR -Anatomy and -Ptosis -Symblepharon
2. Physiology of the eye ADENEXA physiology -Blepharospasm -Ankyloblepharon
3. Visual acuity and refractive errors -Hordeolum(external -Lagophthalmos -Benign and malignant
4. Diseases of conjunctiva and internal) tumours and surgical
-Cryptophthalmos
5. Diseases of cornea -Blepharitis management
-Coloboma
-Chalazion
6. Lens and cataract
-Trichiasis
7. Glaucoma
-Distichiasis
8. Optic nerve and neuro-ophthalmology
-Entropion
9. Strabismus
-Ectropion
10. Diseases of lids
-Pre-septal cellulitis
11. Retina
12. Sclera CONJUNCTIVA -Anatomy and -Naevus -Sjogren’s syndrome
physiology -Xerophthalmia -Keratoconjunctivitis
13. Uvea and diseases affecting uveal tissue
-Conjunctivitis sicca
14. Injuries to eye
-Concretions
15. Lacrimal apparatus and diseases affecting it
-Pterygium
16. Community Ophthalmology
-Pinguecula
17. Lasers and ophthalmology
18. Orbit and its diseases CORNEA -Anatomy and -Neurotropic -Corneal dystrophies
physiology Keratopathy -Corneal degenerative
19. Ocular pharmacology
-Inflammations -Superior limbic changes
20. Surgical instruments in Ophthalmology
-Corneal ulcer keratoconjunctivitis -Refractive surgeries
LIST OF SEMINARS (from following topics): -VitA deficiency -Vernal keratopathy -Keratoprosthesis
-Exposure keratitis -Aphakic and -Tumours of cornea
Sl. No.  Topics pseudophakic bullous
- zCorneal blindness
1. Extraocular muscles and ocular motility keratopathy
2. Physiology of vision -Eye banking
3. Systemic diseases affecting the eye SCLERA -Episcleritis -Staphyloma -Congenital
4. Recent advances in ophthalmology -Scleritis abnormalities
5. Common ocular diseases -Tumours
6. Community Ophthalmology
7. National Blindness Control Programmes and Eye Banking

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TOPICS MUST KNOW DESIRABLE TO KNOW NICE TO KNOW TOPICS MUST KNOW DESIRABLE TO KNOW NICE TO KNOW
RETINA -Anatomy and -Retinopathy of -Medullated nerve fibre
UVEAL TRACT -Anatomy, physiology -Vogt-Koyanagi Harada -Fuchs heterochromic
physiology prematurity -Coloboma of choroid
and classification syndrome iridocyclitis
-Retinal detachment - Age-related macular and retina
-Anterior uveitis -Sympathetic - Albinism
ophthalmitis -Diabetic retinopathy degeneration -Phakomatosis
-Intermediate uveitis -Masquerade
-Hypertensive -Myopic degeneration -Hereditary dystrophies
-Posterior uveitis -Central serous choroi- Syndrome
dopathy retinopathy -Retinitis pigmentosa of the retina
-Endophthalmitis -Tumours
-Occlusive arterial -Macular hole
-Panophthalmitis -Uveal effusion
and venous disorder
syndrome
-Retinoblastoma
LENS -Anatomy and -Developmental -Recent advances in
OPTIC NERVE -Papilloedema -Traumatic optic -Congenital
physiology cataract cataract surgery
-Optic neuritis neuropathy abnormalities of the
-Age-related Cataract -Complicated cataract optic disc
-Optic atrophy
and its management -Congenital cataract
-Tumours of the optic
-Cataract Surgery nerve
and its complications LACRIMAL SYSTEM -Anatomy of Lacrimal -Dacryocystorhinostomy -Mikulicz Syndrome
-Optical drainage pathway - Tear film layers and
rehabilitation -Dacryocystitis abnormalities
-Diabetic cataract SQUINT -Esotropia -Vertical deviations -Squint surgeries
-Exotropia
VITREOUS -Vitreous -Vitreous degeneration -Vitrectomy -Amblyopia and BSV
haemorrhage -Vitreous substitutes ORBIT -Anatomy of orbit -Proptosis -Orbitotomy
-Orbital cellulitis -Thyroid - Orbital fractures
GLAUCOMA -Anatomy of angle -Secondary glaucomas -Glaucoma drainage ophthalmopathy
structures -Congenital glaucoma devices REFRACTIVE -Myopia -Anisometropia -LASIK
-Physiology of -Trabeculectomy -OCT and HRT ERRORS -Hypermetropia
aqueous production -Neovascular glaucoma
-Lasers in glaucoma -Astigmatism
and drainage
-Perimetry -Retinoscopy
-Classification of
glaucoma INJURIES -Non –Penetrating -Sympathetic -Intraocular foreign
injuries and ophthalmitis body and management
-Open and closed
management
angle glaucoma and
management -Chemical injuries
and management
-Anti-glaucoma drugs
-Clinical features of
open globe injuries
-Superficial foreign
bodies

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Teaching and Learning Methods

TOPICS MUST KNOW DESIRABLE TO KNOW NICE TO KNOW
COMMUNITY -Definition and types -Medico-legal aspects Promotion of eye The theory classes will be imparted via powerpoint presentations (must know topics and overall
OPHTHALMOLOGY of blindness of ophthalmology donations comprehension of the subject); Group discussion on topics, PBL and debates on clinical cases.

-NPCB Clinical Teaching:

-Vision 2020 • Theory classes and clinical teaching will be imparted to the students as per the days
-Screening eye allotted.
camps
• Students will elicit detailed history and perform a clinical examination of the patient. They
MISCELLANEOUS Symptomatic -Lasers in -Recent advances in
will be required to write case history which will be evaluated.
disturbances of vision ophthalmology ophthalmology
• Problem-based learning will be introduced in the clinical teaching-learning methodology.
Curriculum (PRACTICAL)
• Students will be evaluated at the end of their clinical posting.
MUST KNOW DESIRABLE TO KNOW NICE TO KNOW

1-To diagnose common 1-Observation of 1-Observation of

ophthalmic conditions
2-Management of acute -Procedures for cataract -Squint surgery
conjunctivitis, allergic surgery -Glaucoma surgery
conjunctivitis, xerosis, corneal
-Lid surgery
ulcer
-Pterygium surgery
3-Primary treatment of ocular
trauma -Sac surgery
4-Assessment of vision-Recording
of visual acuity, Retinoscopy
5-To perform investigative
procedures such as Tonometry,
Syringing, Direct and indirect
ophthalmoscopy, Fluorescein
staining of the cornea
6-Observation of procedures like
Ocular bandaging, Removal of
concretions, Epilation,
Corneal foreign body removal,
Chalazion incision and curettage

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ASSESSMENT MODEL QUESTION PAPER

This will consist of formative assessment and summative assessment. OPHTHALMOLOGY
The formative assessment will be the clinical end posting examinations.There will be a practical PAPER I
case-based examination and multiple choice questions.  100 marks
Summative assessment: Scheme of practical and viva examination: Total marks 100
SECTION A
Practical – 80 marks
1. A 75-year male presents with gradual diminution of vision in both eyes. Visual acuity in the
1. Each candidate examines 3 cases. One long case and two short cases. A candidate should right eye is 6/60 and left eye is 5/60. Slitlamp examination reveals grade IV nuclear sclerosis
record the visual acuity, history, clinical features, provisional diagnosis & management of in both eyes. Fundus examination is normal.
the long case. The total mark is 50 marks (long case-30 marks: 2 short cases10 x2= 20
a. What are the causes of progressive, gradual loss of vision? (5x2=10)
marks).
b. What are the stages of maturation in adult cataract?
2. A set of examiners (comprising one internal and one external), examines the candidate for
c. What other investigations are advised in this case?
two cases. Duration of the clinical examination will be 20 minutes for the long case and
10 minutes for each of the two short cases. ii) A candidate has to secure a minimum of 15 d. What are the different methods of cataract surgery?
marks out of 30 marks in the long case for passing the clinical examination. e. What are the intraoperative complications of cataract surgery?
3. Instruments – 10 marks (5x2) Write short notes on /answer the following  (8x5=40)
4. X-ray and Charts – 10 marks (5x2). 2. Discuss the clinical features and management of Acute Congestive Glaucoma (5)
5. Spotters – 10 marks (5x2) 3. A 19-year-old student complains of recurrent swelling in both the lids.
Viva – 20 marks a. What are the probable causes? (2.5)

Viva or Orals shall be conducted out of 20 marks.Oral examinations shall be conducted by two b. How will you manage this case? (2.5)

sets of examiners (internal and External) and each set will carry 10 marks. 4. A 9-year male complains of itching, redness and ropy discharge from both eyes. On
Theory Examination: one theory paper of 100 marks examination, there is papillary hyperplasia.
a. What is the probable diagnosis?  ( 1+2+2)
The ophthalmologytheory paper shall consist of two sections. Section A and Section B (should
contain one question on pre-clinical and para-clinical aspects, clinical and recent advances). b. What corneal signs are present in this case?
c. What is the treatment?
The Section A shall contain questions from Refraction, Lids, Conjunctiva, Cornea, Sclera, Uvea
Glaucoma and lens. 5. Draw and Explain (2.5+2.5)

The Section B shall contain questions from, Retina.Squint, Optic nerve, Orbit, Ocular injuries, a. Sturms conoid
Ocular surgeries, National Programmes, Eye Banking and Miscellaneous. b. Light reflex pathway

Each Section consists of 50 marks each. One structured long question: 10 marks; short notes type 6. A 40-years-old female presented with watering and discharge from the right eye of 6 months
questions 8 x5 = 40 marks;and.Total marks for each section = 50 marks (50x2=100 marks) duration. On examination, she had a swelling near the medial canthus of the eye. Answer
the following:
Question and Answers must be written as per the order on the answer sheet.
a. What is the probable diagnosis  (1+2+2)
b. How do you manage the patient
c. Enumerate the complications if not treated

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7. What are the microbiological investigations advised forbacteralcornealer and the

complications that occur if left untreated ?  (2.5+2.5)

8. Write the differences between ( 2.5+2.5)

a. Acute conjunctivitis vs acute anterior uveitis
b. Episcleritis and scleritis

SECTION B
1. A 62 year Type II diabetic mellitus patient presents with sudden diminution of vision in the
right eye.Visual acuity is 6/60 in RE and 6/12 in the left eye
c. What are the probable causes of vision loss
d. Discuss the ETDRS classification of Diabetic Retinopathy (DR)
e. Discuss the complications of diabetic retinopathy
f. Describe the treatment of DR
g. Follow-up schedule of DR  (1+3+3+2+1=10)

GENERAL
Write short notes on  (8X5=40)

2. What is Binocular Single Vision? (5)

MEDICINE
3. What is the fundus finding in hypertensive retinopathy? Draw and explain. (5)

4. Draw and write the difference between (5)

a. Tractional retinal detachment and exudative retinal detachment
b. Primary optic atrophy and secondary optic atrophy

5. Discuss these topics in the context with the National programme for control of blindness
a. VISION 2020
6. Ethical issues in Eye Banking (2.5+2.5)
7. Discuss the following  (2.5+2.5)
a. Systemic association of Retinitis pigmentosa
b. The pathological picture in Retinoblastoma

8. Describe briefly on the following

a. Comment on Optical coherence tomography (2.5)
b. Differentiate between papilloedema and papillitis (2.5)

9. Write the aetiology and management of paralytic strabismus  ( 2.5+2.5)

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GENERAL MEDICINE 15. Demonstrate empathy and humane approach towards patients and their families and respect
their sensibilities.
GOAL
16. Demonstrate communication skills in interviewing patients, providing explanations to patients
The broad goal of the undergraduate training in General Medicine is to have the knowledge, skills and families about the management and prognosis, providing counseling and giving health
and behavioural attributes to enable the graduating physician to function effectively as the first education messages to patients, families and communities.
contact physician.
17. Have an open attitude to the developments in Medicine so as to be aware of the need to
keep abreast of new knowledge.
OBJECTIVES
18. Learn and adopt new ideas and new situations where resources may be limited.
At the end of the course, the learner should be able to:
19. Understand the ethical and legal implications of his/her medical decisions.
1. Elicit a detailed clinical history, perform thorough physical examination, elicit physical
signs, correlate the clinical symptoms and physical signs to make a provisional anatomical, 20. Should be able to work in a team and acquire knowledge through team work.
physiological, etiopathological diagnosis, develop differential diagnoses and request relevant
laboratory investigations. COURSE CONTENTS
2. Diagnose common clinical disorders with special reference to infectious diseases, nutritional
MUST KNOW CATEGORY
disorders, life style diseases, tropical and environmental diseases.
Clinical methods in the practice of medicine:
3. Plan relevant diagnostic and investigative procedures and be able to interpret them.
A. Clinical approach to patients: The art of medicine, doctor-patient relationship, Communication
4. Discuss and outline the principles involved in the management of the patient and prevention skills, and doctor’s responsibilities.
of common health problems affecting the community.
B. Clinical approach to disease and care of patients: Clinical diagnostic reasoning i.e. diagnostic
5. Plan and write prescription for comprehensive treatment using the principles of rational drug possibilities based on the interpretation of history, physical findings and laboratory investigations
therapy. and principles of prevention of disease
6. Provide first level care for common medical conditions and emergencies and recognize the C. Principles of rational management: Keeping in mind the best evidence in favor of, or against
timing and level of referral, if required. different remedial measures (EBM) and patient affordability.
7. Acquire the skills and competencies to perform minor procedures under supervision like – IV
Common symptoms of disease:
cannulation, insertion of nasogastric tube, urinary bladder catheterisation, doing an ECG etc.
• Pain: pathophysiology, clinical types, assessment and management.
8. Assist common bedside procedures like pleural aspiration, bone marrow aspiration and
• Fever: clinical assessment and management.
biopsy, lumbar puncture etc.
• Cough, wheezing, chest pain, dyspnea, orthopnea, paroxysmal nocturnal dyspnea &
9. Resuscitate a patient efficiently by providing Basic Life Support in emergencies. hemoptysis.
10. Develop empathy and interest in the care for all types of patients. • Edema, facial puffiness, anasarca and ascites.

11. Learn patient safety and related topics.(like Medication safety and Injection safety) • Pallor and jaundice.
• Bleeding-gum bleed, epistaxis, skin bleed and others.
12. Understand the hopes and fears of patients and know how to handle these emotions, both
in himself / herself and others. • Anorexia, nausea and vomiting.
• Abdominal pain and distension.
13. Demonstrate skills in documentation of case details
• Constipation and diarrhea.
14. Understand patients’ rights and privileges including patients’ right to information and right to
• Hematemesis, malena and hematochezia.
seek a second opinion.
• Common urinary symptoms- dysuria, pyuria, anuria, oliguria, and loin pain.

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• Polyuria, nocturia, and enuresis. • Principles of immunization and vaccine use.

• Body pains and joint pains. • Immunodeficiency disorders-acquired.
• Headache, seizures, fainting, syncope, dizziness, and vertigo. • Clinical syndromes-diagnostic and therapeutic approach.
• Disturbances of consciousness and coma. Infections:
• Weight loss and weight gain. • The febrie patient / Fever and rash / Fever of unknown origin.
• Medical disorders and pregnancy. • Infective endocarditis.
• Medical disorders and surgery, • Intra-abdominal infections and abscesses.
• Oral and cutaneous manifestations of diseases • Acute infectious diarrhoeal diseases and food poisoning.
Nutrition and nutritional disorders: • Sexually transmitted diseases-overview and clinical approach.
• Nutritional assessment and needs. • Infections of skin, muscle & soft tissues.
• Protein energy malnutrition& Obesity. • Hospital acquired infections.
• Vitamin deficiency & excess. • Infections in immuno-compromised hosts.
• Mineral deficiency and excess. • Specific infections-epidemiology, clinical features, laboratory diagnosis, rational use of
• Diet therapy including parenteral and enteral nutrition therapy antimicrobial therapy against the following and their prevention
• Protozoal infections: Amoebiasis, Giardiasis, Malaria, Leishmaniasis, Trichomoniasis,
Fluid, electrolyte and acid base imbalance:
Toxoplasmosis, and Trypanosomiasis.
• Fluid and electrolyte balance; acidosis and alkalosis
• Common helminthic infections; Filariasis, Hookworm, roundworm,
• Acid-base disorders
• Bacterial infections:
Poisoning, stings and bites: • Common gram positive infections
• General approach to the poisoned patient. • (Pneumococcus/ Staphylococcus/Streptococcus/Tetanus).
• Poisoning by specific pharmaceutical agents-organophosphorus compounds, methyl alcohol, • Common gram-negative infections.
narcotics, aluminium phosphide, sedatives / hypnotics, plant poisons .
• Enteric fever, Cholera, ShigellosisL eptospirosis. Helicobacter pylori, Meningococcus,
• Drugs of misuse. Gonococcus .
• Snake bite and Envenomation. • Infections due to pseudomonas & other gram-negative bacteria.
• Other bites and stings -scorpion and spider. • Anerobic infections.
Specific environmental and occupational hazards: • Mycobacterial infections: Tuberculosis (Typical and Atypical), Leprosy. Viral infections:
• Heat stroke and hypothermia. • Common exanthemata e.g. Measles, mumps, rubella, chickungunya and varicella.
• Chemicals and pesticides. • Herpes simplex and herpes zoster, Influenza and other common viral respiratory infections.
• Drowning and near drowning. • Human Immunodeficiency Virus (HIV).Viral gastroenteritis. Dengue fever. Rabies.
• Heavy metal poisoning. • Other organisms: Rickettsia, Mycoplasma and Chlamydial diseases.
• Common fungal infections: Candidiasis, Aspergillosis, Histoplasmosis, Cryptococcosis,
Immune response:
Mucormycosis, and Pneumocystis jirovecii.
• Approach to infectious diseases-diagnostic and therapeutic principles.
Cardiovascular system:
• Immune defence mechanisms.
• Clinical examination of the cardiovascular system.
• Laboratory diagnosis of infections.
• Functional anatomy, physiology and investigations- ECG, X ray chest.
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• Major manifestations of cardiovascular disease- Chest pain, breathlessness, palpitation, acute • Acute kidney injury.
circulatory failure (cardiogenic shock), presyncope and syncope, Cardiac arrest and sudden • Chronic kidney disease.
cardiac death, abnormal heart sounds and murmurs.
• Urinary tract infections and pyelonephritis.
• Acute and chronic congestive cardiac failure, Corpulmonale.
• Glomerulonephritides and nephrotic syndrome.
• Rheumatic fever and rheumatic heart disease.
• Renal involvement in systemic disorders.Drugs and the kidney.
• Valvular heart disease.
Gastrointestinal tract:
• Coronary artery disease.
• Clinical examination of the abdomen.
• Common congenital heart disease in the adults: ASD, VSD, and PDA, TOF and Coarctation
of aorta. • Basic investigations: stool examination, role of imaging, endoscopy and tests of malabsorption.
• Hypertension and hypertensive heart disease. • Abdominal pain (acute and chronic), dysphagia, dyspepsia, vomiting, constipation, diarrhea,
abdominal lump, weight loss, gastrointestinal bleeding-upper and lower and approach to the
• Common cardiac arrhythmias.
patient with gastrointestinal disease.
• Deep vein thrombosis, Atherosclerosis and peripheral vascular disease.
• Diseases of the mouth and salivary glands- oral ulcers, candidiasis and parotitis.
• Pericardial disease: pericardial effusion and cardiac tamponade. Cardiomyopathy
• Diseases of the oesophagus- GERD, other motility disorders, oesophagitis, carcinoma
Respiratory system: oesophagus.
• Clinical examination of the respiratory system. • Diseases of the stomach and duodenum-gastritis, peptic ulcer disease, tumors
• Respiratory physiology and diagnostic investigations- x ray chest, sputum examination, • Disease of small & large intestine-Acute gastroenteritis & food poisoning, acute, sub-acute
pulmonary function tests. and chronic intestinal obstruction, Inflammatory bowel disease. Malabsorption syndrome.
• Cough, dyspnoea, wheezing, chest pain, haemoptysis, acute and chronic respiratory failure. Bacillary dysentery, amoebic colitis, Irritable bowel syndrome.

• Upper respiratory infections. Pneumonias. • Abdominal tuberculosis: peritoneal, nodal, and gastrointestinal.

• Bronchial asthma. Chronic obstructive pulmonary disease. Disease of pancreas:

• Pulmonary tuberculosis: different presentations. • Acute and chronic pancreatitis.
• Suppurative lung diseases: bronchiectasis and lung abscess. Hepatobiliary disease:
• Pleural diseases- effusion, empyema, and pneumothorax. • Clinical examination of the abdomen for liver and biliary disease.
• Interstitial and infiltrative lung diseases. • Functional anatomy, physiology, liver function tests, basics of role of imaging of the hepatobiliary
• Common occupational lung diseases. disease.
• Tumors of the bronchus and lung. • Major manifestations of liver disease-Asymptomatic abnormal liver function tests, Jaundice,
• Pulmonary vascular diseases - Pulmonary hypertension & pulmonary thromboembolism. Acute (fulminant) hepatic failure, ascites and Fatty liver and non alcoholic steatohepatitis

• Acute respiratory distress syndrome. • Liver abscess- amoebic & pyogenic.

• Tropical eosinophilia • Acute and chronic hepatitis-viral and toxic.

• Alcoholic liver disease.
Renal and genitourinary system:
• Cirrhosis of liver and chronic liver disease and complications-
• Renal physiology and common renal function tests: urine examination, renal function tests
and common imaging methods. • Portal hypertension and porto-systemic encephalopathy,

• Major manifestations of renal and urinary tract disease: Dysuria, pyuria, urethral symptoms, • Acute and chronic cholecystitis, and cholelithiasis.
disorders of urine volume, hematuria, proteinuria, oedema, incontinence and obstruction of
the urinary tract.

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Endocrine and metabolic diseases: Neurological diseases:

• Diabetes mellitus: including acute and chronic complications (micro and macrovascular), and • Clinical examination of nervous system.
management including complications. • Functional anatomy, physiology and investigations: EEG, basics of brain and spinal cord
• Hypo and hyperthyroidism-major manifestations, recognition, interpretation of thyroid imaging, EMG and NCV
function tests. Iodine deficiency disorders. • Major manifestations of nervous system disease: Headache and facial pain, raised intracranial
• Cushing’s syndrome and Addison’s disease – recognition. tension, faintness, dizziness, syncope & vertigo, sleep disorders, disorders of movement,
• Calcium and phosphorus metabolism: parathyroid and metabolic bone disease. ataxia, sensory disturbances (numbness, tingling and sensory loss), acute confusional states,
coma and brain death, aphasias, and other focal cerebral disorders, speech, swallowing and
• Metabolic syndrome
brain stem disturbance, visual disturbances, and sphincter disturbances.
• Wilson’s disease
• Migraine and cluster headaches.
Hematological disorders • Seizures and epilepsy.
• Definition, prevalence, etiological factor, pathophysiology, pathology, recognition, • Cerebrovascular disease.
• Investigations and principles of treatment of: • Acute and chronic meningitis.
• Anemias: iron deficiency, megaloblastic
• Viral encephalitis.
• Common haemolytic anemias (thalassemia, sickle cell and acquired hemolytic).
• Parkinson’s disease and other extrapyramidal disorders.
• Common bleeding disorders (thombocytopenia and hemophilia).
• Diseases of cranial nerves.
• Agranulocytosis and aplastic anemia.
• Diseases of spinal cord - transverse myelitis and cord compression.
• Leukemias (acute and chronic): Recognition, diagnosis, differential diagnosis and management.
• Multiple sclerosis and other demyelinating diseases.
• Lymphomas: Recognition, diagnosis, differential diagnosis and management.
• Plasma cell disorders • Dementias including Alzheimer’s disease.

• Blood group and transfusion: Major blood group systems and histo compatibility complex, • Motor neuron disease
concepts of transfusion and component therapy; indications for transfusion therapy, • Cerebellar disorders.
precautions to be taken during blood transfusion, hazards of transfusion and safe handling of
• Peripheral neuropathy including GBS.
blood and blood products.
• Neurological manifestations of systemic diseases.
• Disorders of coagulation and venous thrombosis.
• Nutritional and metabolic diseases of the nervous system.
• Bone marrow transplantation/stem cell transplantation.
• Myasthenia gravis and other diseases of neuromuscular junction
Disorders of the immune system, connective tissue and joints:
• Recognition of brain death.
• Introduction to the immune system and autoimmunity.
• HIV, AIDS and related disorders. Clinical pharmacology and therapeutics:
• Recognition of major manifestations of musculoskeletal disease: Joint pain, bone pain, muscle • Principles of drug therapy.
pain and weakness, regional periarticular pain, back and neck pain. • Adverse drug reactions.
• Approach to articular and musculoskeletal disorders. • Drug interactions.
• Inflammatory joint disease. Infectious arthritis. • Monitoring drug therapy.
• Vasculitides.Ankylosing spondylitis,
• Rational prescription writing.
• Systemic connective tissue diseases – systemic lupus erythematosus, rheumatoid arthritis,
• Concept of essential drugs.
progressive systemic sclerosis.Sarcoidosis.
• Musculoskeletal manifestations of disease in other systems.

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Critical care medicine: DESIRABLE TO KNOW CATEGORY

• Physiology of the critically ill patient. Immune response and infections:
• Recognition of major manifestations of critical illness-circulatory failure, shock, respiratory • Immunodeficiency disorders- congenital.
failure, renal failure, coma, sepsis, and disseminated intravascular coagulation.
• Bacterial infections: Pertussis and diphtheria, Legionella infections, Botulism, Gas gangrene
• General principles of critical care management. and clostridial infections, Brucellosis, Plague, Donovanosis (Granuloma inguinale). Syphilis
• Ethical issues related to critical care. • Viral infections: Infectious mononucleosis,.
Pain management and palliative care: • Parasitic infections: Schistosomiasis, Cestodes
• General principles of pain.assessment and treatment of pain.
Cardiovascular system
Geriatrics: • Aortic aneurysm, Aortitis
• Principles of Geriatric Medicine. • Myocarditis
• Normal ageing.
Respiratory system:
• Clinical assessment of frail elderly.
• Bronchoscopy,
• Decisions about investigations and rehabilitation.
• Obstructive sleep apnoea.
• Major manifestations of diseases in elderly.
• Diseases of the nasopharynx, larynx and trachea.
• Special issues for care of elderly.
• Diseases of the mediastinum, diaphragm and chest wall.
Medical ethics:
• Disorders of ventilation
• Principles of medical ethics
• Different concepts- health ethics, bioethics and public health ethics. Renal and genitourinary system:

• Brief introduction to perspectives of medical ethics: Hippocratic Oath, declaration of Helsinki, • Congenital abnormalities of the kidneys and urinary system.
WHO declaration of Geneva, International code of Medical Ethics, Medical Council of India • Tubulo-interstitial diseases.
Code of Ethics. • Renal vascular diseases.
• Ethics of the individual: Confidentiality, physician-patient relationship, patient autonomy, • Urinary tract calculi and nephrocalcinosis.
organ donation. Death and dying, and Euthanasia.
• Tumors of the kidney and genitourinary tract.
• Professional ethics: Code of conduct, fee charging and splitting, and allocation of resources
• Renal replacement therapy-Basics.
in health care.
• Polycystic kidney disease.
• Care of terminally ill/dying patient.
• Ethical work up of cases: Gathering information, gain confidentiality, shared decision making, Gastrointestinal tract:
informed consent.
• Tumors of small intestine.
• Research ethics: animal and experimental research, human experimentation, informed
• Tumors of the colon & rectum.
consent, and drug trials. Practice of universal precautions.
• Ischaemic gut injury.
• Bio medical waste: types, potential risks and their safe management. PEP Prophylaxis.
• Anorectal disorders.
• Hand washing.
• Diseases of the peritoneal cavity: acute and chronic peritonitis.

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Disease of pancreas: 5. Immunisation to prevent the injection related infections

• Tumors of the pancreas. 6. Prophylaxis in needle stick injury
Hepatobiliary disease: 7. Encouraging good clinical practices
• Hepatorenal failure/syndromes
Medication safety:
• Tumors of gall bladder and bile ducts.
Key areas to be covered:
Endocrine and metabolic diseases:
1. Explaining the need for medication safety
• Pituitary disorders: Acromegaly and Sheehan’s syndrome.
• Hypogonadism. Hypopituitarism and hyperpituitarism. 2. Explaining terminologies like side-effect, adverse reaction, adverse drug event, and adverse
drug reaction
• Hypothalamic disorders.Gout, haemochromatosis, porphyria
3. Prescription safety & errors
Disorders of the immune system, connective tissue and joints:
• Primary immune deficiency diseases. 4. Medication errors
• Inflammatory muscle disease. 5. Measures to ensure medication safety
• Osteoarthritis.
6. Prescription audit of ten prescriptions written by students
• Amyloidosis.
7. Reporting medication errors observed during posting
• Reactive arthritis and undifferentiated spondyloarthropathy.

Neurological diseases: DISTRIBUTION OF MARKS

• Intracranial tumours. Theory (200 Marks)
• Diseases of muscle. Paper I (100 marks) Paper II (100 marks)
Critical care medicine:
Sec A Sec B Sec C Sec A Sec B Sec C
• Scoring systems of critical care. 40 marks 40 marks 20 marks 40 marks 40 marks 20 marks
• Outcome and costs of intensive care.
Q1. 10 marks Q1. 10 marks Q1. 10 marks Q1. 10 marks
• Electrical injuries. Radiation injury (structured (structured (structured (structured
long question) long question) long question) long question)
HUMAN GENETICS
Q2. 15 marks Q2. 15 marks Q2. 15 marks Q2. 15 marks
Patient safety curriculum (Must Know)
(3 short (3 short (3 short (3 short
questions of 5 questions of 5 Dermatology questions of 5 questions of 5 Psychiatry
Injection Safety:
marks each) marks each) marks each) marks each)
Key areas to be covered:
Q3. 15 marks Q3. 15 marks Q3. 15 marks Q3. 15 marks
1. Explaining the need for injection safety (3 short (3 short (3 short (3 short
questions of 5 questions of 5 questions of 5 questions of 5
2. Standard precautions: hand hygiene, the wearing of personal protective equipment (gloves,
marks each) marks each) marks each) marks each)
glasses, shoes, etc) and safe injection practices

3. Transmission based precautions

4. Sensitization regarding the safe use and disposal of sharps

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LONG CASE
Practical (200 marks)
Medicine (160 marks) 1. The long case can be taken from any system- CNS, Cardiovascular, Respiratory, and
Abdomen. Students are expected to take a detailed history, examine the patient, give a
Long case Short case Spotters provisional diagnosis (anatomical, morphological and etiological)and differential diagnosis,
60 marks 60 marks 20 marks and formulate a management plan (relevant investigations and appropriate therapy,
10 spotters of empirical or definitive).
2 marks each Dermatology
(20 marks) 2. The candidate should write a case sheet with the above details, present the history and
(Xrays, examination details to the examiners, and justify the rationale for the diagnosis and
ECG, 4 spotters Psychiatry
management.
Instruments, Viva (with related (20 marks)
20 marks questions by Time allotted for the long case will be 45 minutes.
1 case 2 cases Clinical case Viva only
the examiner) 3. The ability to present a good history, demonstrate clinical findings properly, and present
60 marks 30 marks each scenarios,
Common Each 5 marks a rational provisional and differential diagnosis, along with depth and extent of his/her
OPD knowledge regarding the patient and the candidate’s qualities such as confidence and
problems, attitude should be assessed.
Prescription
for common Topics:
diseases)
• Nervous system- Cerebrovascular accident (hemiplegia) & Paraplegia/paresis and quadriplegia/
paresis

• Cardiovascular system- Valvular heart disease (mitral/aortic) with or without atrial fibrillation,
PAPERWISE DISTRIBUTION OF TOPICS IN GENERAL MEDICINE Infective endocarditis, Right heart failure, VSD

PAPER I PAPER II • Respiratory system- Pneumonia/consolidation, COPD, Bronchiectasis, Fibrocavitary disease

(Tuberculosis), Pleural effusion (Infective/non infective), Hydropneumothorax
Cardiology Infectious Diseases
• Abdomen/ Lymphoreticular - Anemia with hepatosplenomegaly, Fever with hepatosplenomegaly,
Neurology Endocrinology & Diabetes Generalised lymphadenopathy, Lymphadenopathy with hepatosplenomegaly, Ascites
Respiratory & TB Hematology • Weightage and marks will be given for assessing communication skills eg. breaking bad news
Gastroenterology & Liver diseases Immunology & Musculoskeletal / declaring death / informed consent for procedures, etc

Nephrology & Fluid and electrolyte Critical care SHORT CASE

Cardinal symptoms Geriatrics 1. Candidates should examine the system or part that they are assigned. They are allowed to
Patient Safety and related topics Poisonings & Bites take only a very short succinct history to justify the diagnosis. The time for the two semi-long
cases will be 40 minutes (2 x 20). Case sheet writing is not necessary.
Environmental Medicine Nutrition
Topics:
Genetics Medical Ethics
• Systemic - Acute febrile illness, Fever with splenomegaly (mild), Fever with hepatomegaly,
Fever with exanthema, Dengue fever, Scrub typhus-eschar with fever.

• Cardiovascular – General examination ( emphasis on vitals and JVP), Single valve disease
(MS/MR/AS/AR), Rheumatic fever, Coronary artery disease (stable angina), Peripheral artery
disease, VSD, Pulmonary hypertension.

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• Hematological/Lymphoreticular- Localised lymphadenopathy, Anemia-IDA/ Megaloblastic/ SAMPLE QUESTION PAPER

Hemolytic, Massive splenomegaly.
GENERAL MEDICINE
• Musculoskeletal (optional long case) - Rheumatoid arthritis, SLE, Systemic Sclerosis
(PAPER – I)
• Nervous system - Cranial nerve examination, Radial nerve palsy, Claw/ape hand, Small muscle
Total mark-100 Time-3 hours
wasting (hand), Foot drop, Peripheral neuropathy, Motor system examination, Cerebellar
system examination, Seizure disorder, Parkinsonism.
SECTION - A
• Skin in Dermatology assessment
1. A 55 year obese male, known smoker, presented to the casualty with severe chest pain,
• Endocrinology – Hypothyroidism, Hyperthyroidism, Diabetes mellitus (DM), DM with trophic profuse sweating and hypotension. Write the differential diagnosis, diagnostic approach and
ulcer/neuropathic pain, DM with claudication, Obesity/acanthosis, skin changes in other management of the case.  (3+3+4)
endocrinological diseases
2. Discuss the management of, (5X3= 15)
• Respiratory– Pneumonia/consolidation, COPD, Bronchiectasis, Fibrocavitary disease
a. Hepatic encephalopathy
(Tuberculosis), Pleural effusion, Hydropneumothorax.
b. Hyponatremia
c. Acute severe asthma

3. Write short notes on, (5X3= 15)

a. Approach to headache
b. Approach to acute confusional state
c. Hypertrophic cardiomyopathy

SECTION - B
1. Write the clinical feature, diagnosis and management of tubercular meningitis. (3 + 3+4)

2. Discus the clinical features of,(5X3=15)

a. AIDP
b. Acute kidney injury
c. Bronchiectasis

3. Write short notes on, (5x3=15)

a. Dressler’s syndrome
b. Principles of Medication safety
c. Down’s Syndrome

SECTION - C
Dermatology (20 marks)

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SAMPLE QUESTION PAPER

GENERAL MEDICINE
PAPER – II
Total mark-100 Time-3 hours

SECTION - A
1. Define AIDS. Name 3 important CNS opportunistic infections associated with AIDS and write
their clinical features and management. ( 2+ 2 + 2 + 4)

2. How will you investigate  ( 5 x 3 = 15 )

a. Iron Deficiency Anemia
b. Pulmonary Tuberculosis
c. Hypothyroidism

DERMATOLOGY
3. Write short notes on :  ( 5 x 3 = 15)
a. Diagnostic criteria of SLE
b. Hypersplenism

&
c. Fat soluble vitamin deficiency disorders

SECTION - B
1. Enumerate the etiopathogenesis, clinical features and management of Diabetic Ketoacido-
sis. 

2. Discuss the treatment of : 

a. Complicated Falciparum Malaria
(3+3+4)

( 5 x 3 =15) VENEREOLOGY
b. Sickle cell Anemia
c. Rheumatoid Arthritis

3. Short notes on : ( 5 x 3 = 15)

a. Mixed connective tissue disease
b. Death Declaration
c. Management of Neurotoxic snake bite

SECTION - C:
Psychiatry (20 marks)

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DERMATOLOGY & VENEREOLOGY Lecture: 30 hours (1 hour / day X 30 classes)

GOAL List of lecture classes

The goals of the following curriculum is to make the medical students competent in diagnosing 1. Structure and functions of skin
common skin illnesses like infections, infestations and diseases of National importance like leprosy 2. Common bacterial skin infections
and sexually transmitted infections and prescribe treatment after passing MBBS. 3. Superficial fungal infections of skin
4. Parasitic infestations of skin
OBJECTIVE OF DERMATOLOGY TEACHING FOR UG MEDICAL STUDENTS 5. Viral infections of skin
Dermatological illnesses are frequent in tropical countries and constitute major patient load in 7. Endogenous eczema & Contact dermatitis
any health set up. Some diseases like leprosy and sexually transmitted infections are of national 8. Acne
importance. The objective of undergraduate dermatology teaching is to make the medical students 9. Dermatological formulations and commonly used drugs
aware of common skin illnesses in day to day medical practice. 10. Psoriasis & other Papulosquamous disorders
11. Urticaria & Angioedema
Course contents:
12. Adverse cutaneous drug reactions
Must know topics Structure and functions of skin 13. Leprosy -1 (Introduction, Classification, Clinical features)
Bacterial infections 14. Leprosy- 2 (Diagnosis & Management)
15. Leprosy -3 (Reactions in leprosy)
Fungal infections
16. Sexually transmitted infections -1 (Introduction, History taking, Patient examination)
Viral infections
17. Syphilis (Introduction, classification & Clinical features)
Skin infestations
18. Syphilis (Diagnosis & Management)
Leprosy
19. Congenital Syphilis
Syphilis
20. Genital ulcer diseases other than syphilis
Genital ulcers other than syphilis
21. Urethral discharge syndromes
Urethral / vaginal discharge
22. Vaginal discharge syndromes
Urticaria & Angioedema 23. Syndromic management of sexually transmitted infections
24 Human immunodeficiency virus infection
Desirable to know topics Psoriasis and other papulosquamous disorders
25. Auto-immune bullous disorders
Eczema 26. Collagen vascular disorders (Introduction and classification)
Acne 27. Lupus erythematosus
Adverse cutaneous drug reactions 28. Systemic sclerosis
29. Common hair disorders
Nice to know topics Auto-immune bullous disorders 30. Common nail disorders
Hair disorders
Nail disorders Clinics 120 hours (3 hours / day X 40 classes)

1. Bed side clinical teaching in ward

2. Short case discussion in OPD

3. Introduction to common procedures done in dermatology practice

4. Introduction to dermatological instruments

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Probable topics for integration:

1. Collagen vascular disorders & Vasculitis (with Dept. of Medicine)

2. Severe cutaneous drug reactions (with Dept. of Medicine)

3. Leprosy (with Dept. of Neurology)

4. Leg Ulcer (with Dept. of Surgery)

Model Question Paper

Dermatology & Venereology

Use diagrams wherever necessary

Write short notes on: 5X4= 20

1. Borderline Tuberculoid (BT) Leprosy

2. Norweigian scabies

3. Infantile Atopic Dermatitis

PSYCHIATRY
4. Bullous impetigo

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PSYCHIATRY 4. Learning and conditioning

Components of learning, classical conditioning, operant conditioning, cognitive, social,
OBJECTIVES
biological and observational learning. Methods of effective learning, behaviour and cognitive
At the end of the course, the student should be able to: therapy.

1. Understand human behaviour and its application in patient care. Recognise differences 5. Cognitive process and memory
between normal and abnormal behaviour. Sensation, perception, illusion, memory process, short term and long term memory, causes of
forgetting and methods to improve memory.
2. Understand the concept of motivation, its impact on human behaviour and illness related
behaviour. 6. Thinking and problem solving
3. Understand different types of emotions and their impact on health of the individual. Definition of thinking, components of thinking-imagery recollection, language, steps in
problem solving, abnormalities in thinking, decision making.
4. Define learning, comprehend different types of learning and conditioning. State methods of
effective learning and demonstrate application of learning in treatment. 7. Intelligence: General concepts and techniques for assessment
Theory of intelligence, growth of intelligence, stability of intelligence, determinants of
5. Understand different cognitive processes, comprehend memory process, describe short term
intelligence, assessment of intelligence, extremes of intelligence.
memory and differentiate with long term memory., list causes of forgetting, and illustrate
methods of improving memory. 8. Personality (Principles of Personality development) and objective testing of Personality
6. Comprehend concept of thinking and its application to health care. Definition of personality, trait, factors influencing personality development, theories of
personality and personality assessment.
7. Understand nature of intelligence, explain growth of intelligence, compare role of heredity
and environment in intellectual development. Method of assessment of intelligence. 9. Doctor Patient relationship: Importance, types and skills

8. Define personality, list determinants of personality, understand different theories of personality 10. Communication skills: types, need, specific communication skills in clinical practice.
and learn methods of personality assessment.
Method Teaching Lectures & Discussion
9. Establish harmonious doctor-patient relationship.
Assessment – Nil
10. Communicate effectively with patient, his family and community.
PSYCHIATRY (VI SEMESTER)
COURSE CONTENTS
OBJECTIVES
Behavioural Sciences – II Semester
At the end of the course, the student will be able to:
1. Introduction: General introduction to Behavioural Psychology
1. Introducing concept of psychiatric disorders and their classification
What is behavioural psychology, components, individual differences and applications of
behavioural sciences in patient care and medical education. 2. Awareness of general issues about etiology of psychiatric disorders and methodology used to
study etiology of these disorders.
2. Motivation
Definition of motivation, theories, types –physiological and social motives, Maslow‘s hierarchy 3. Ability to diagnose and treat common psychiatric disorders like depression, anxiety disorders
of motives, clinical application including phobias and OCD, conversion and dissociative disorders and severe mental
disorders like schizophrenia mania, catatonia.
3. Emotion and its application to health
4. To be able to diagnose severe/suicidal cases of depression and to refer them.
Theories of emotions, type and impact on health.
5. Understand the concept of personality disorders.

6. Ability to diagnosis and treat alcohol and drug dependence and withdrawal states.

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7. Ability to diagnose common psychiatric disorders in children. 9. Drug and Alcohol dependence

8. To know the role of counselling and psychological therapies in treatment of psychiatric Concept of abuse and dependence, epidemiology of alcohol and opiate dependence;
disorders. clinical features, withdrawal symptoms including complicated withdrawal, psychosocial
complications, aetiology, outcome, treatment.
9. Demonstrate role of psychological testing in assessment of psychiatric disorders.
10. Psychiatric disorders of childhood and adolescence,
COURSE CONTENT Classification of childhood psychiatric disorders, epidemiology, clinical features, aetiology,
assessment.
1. Introduction and classification of Psychiatric disorders
11. Counselling and psychological therapies
Concept of psychiatric disorders; need for classification; types of classification e.g. atheoretical,
symptom – based; introducing the International Classification of Diseases ((ICD) and the Counselling process, skills, different counseling approaches, behaviour therapy, cognitive
Diagnostic and Statistical Manual (DSM); major categories of psychiatric disorders; diagnosis therapy and its applications.
of organic disorders.
12. Psychological testing
2. Aetiology of Psychiatric disorders What are psychological tests, standardization, reliability, validity, intelligence test, personality
Overview of contribution of different scientific disciplines to psychiatric aetiology – clinical test, application.
descriptive studies, epidemiology, social sciences e.g. role of life events, stress; genetics;
biochemical studies; pharmacology; endocrinology; physiology; neuropathology; psychology. MUST KNOW CATEGORY

3. Depression Introduction to human emotions, thinking, behaviour, personality. Application of psychology

Epidemiology, clinical features, diagnosis, overview of aetiology, co-morbidity with organic to medicine. Nature of learning; performance role of motivation in learning and methods to
disorders, course, treatment – pharmacological. make learning effective. Cognitive process: Sensory process- attention, perception, sensation
and thinking; sensory process and psychopathology; problem solving decision making and
4. Anxiety neurosis, phobia and OCD communication in thinking process; salient features of abnormal thinking. Emotion: relationship
Types of anxiety disorders; phobia, OCD, clinical features and epidemiology; diagnosis, of emotion to illness. Intelligence: Nature of intelligence; role of genetic and environmental
differential diagnosis; overview of aetiology; course; treatment – pharmacological and non- influences in intelligence. Behavioural medicine: behavioural aspects applied to illness. Coping
pharmacological. and stress: different stressors and their effects. Personality development: types of personality and
premorbid personality and its relationship with illness and behaviour. Death and dying:
5. Hysterical neurosis (Conversion and Dissociative disorders)
Reactions of terminally ill patient and family; breaking news of fatal illness /death to the family.
Epidemiology, clinical picture, diagnosis, differential diagnosis, aetiology, prognosis, treatment.
Learning and conditioning: Doctor- patient relationship. Illness behaviour. Psychological methods
6. Schizophrenia of treatment: counselling. To be aware of the security aspects as per the demands of the situation,
Epidemiology, clinical features, subtypes, diagnosis, overview of aetiology, course, treatment region: Security of the patient, doctor; physical trauma; Psychological trauma; ‘psychological
– pharmacological, role of ECT. support and first aid-psychological support during disasters.

7. Bipolar disorders DESIRABLE TO KNOW CATEGORY

Epidemiology, clinical features, diagnosis, overview of aetiology, course, treatment –
Attitudes : Nature and development of attitudes. Types of families: structure and functioning;
pharmacological.
social problems. Illness and health: Beliefs, customs, norms. Socio-economic status: Measurement
8. Personality disorders of socio-economic status. Communication skills: Communication medias. Methods of social work:
Concept of personality disorders, epidemiology, classification, assessment, overview of clinical social group work and community organisation. Introduction to psychology – Role of nature vs.
features, aetiology, prognosis. nurture in shaping. Human behaviour. Human development: Infancy to adolescence: Behavioural
expectancies and problems. Human development: adulthood to old age – adjustment in old age
to old age diseases. Learning and conditioning: Learning of adaptive and maladaptive behaviours;
Various learning methods like association, cognitive, verbal, motor and social. Cognitive process:

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Methods of improving memory; forgetting and its determinants; thinking process- concept Desirable to know – Behavioural Analysis; Understanding normal and abnormal behaviour,
formation; role of language. Emotion: Development of emotive behaviour and its physiological Prevalent social and psychological concepts around death and dying. WHO primary care
basis. Intelligence: Assessment of intelligence in clinical setting; growth of intelligence from birth classification of mental disorders. Psychosocial barriers to help - seeking for mental illnesses.
to old age. Behavioural medicine: Methods of behavioural treatment for psychosomatic diseases. Educational and statutory provisions regarding psychiatric illnesses and disability. Principles of
Coping and stress: Methods of adaptive and maladaptive coping and stress management. Illness Psycho-education. Basic psychotherapeutic skills. Mass hysteria, PTSD. Chronic Organic Brain
behaviour: Sick role; role of socio- cultural background in illness behaviour. Attitudes: theories Syndrome (Dementia). Issues related to death and dying breaking bad news, Eliciting reactions
and methods to change attitudes; measurement of attitudes. Optimal Communication with one and support.
another in team and with patients and their families, regarding security of the citizen, as per the
Assist the expert - Dealing with mass hysteria. Child psychiatric history taking. Child and
demands of the region and situation. Social security: Social assistance and social insurance; social
Adolescent Mental status examination (Primary and higher mental functions). Geriatric history
security schemes. To be aware of the disasters man-made or natural and the preparedness to
taking. Terminal care. Psychotherapeutic and behaviour modification approaches for treating
disaster & management of disasters in team-work paradigm. Mock-drill participation in disaster, in
neurotic disorders.
team work paradigm, behavioural aspects.
Nice to know- Unconscious, Subconscious, Conscious mind; Id, Ego, Superego (Psychoanalytic
PRACTICAL SKILLS Approaches).

Perform independently – Observe - Physical Methods of Treatment (E.g. ECT – Electro Convulsive Therapy) Abreaction.

Must know: Psychiatric history taking, mental status examination, higher mental functioning. TEACHING AND LEARNING METHODOLOGY
Counselling, crisis intervention. Behavioural and psychological analysis of self destructive
Lectures and discussions with patients
behaviour. Primary care for the children and adolescents and then refer to the psychiatrist/ child
& adolescent psychiatrist. Demonstrating empathy, compassion and establishing and maintaining TEXT-BOOK RECOMMENDED
rapport. Ability to recognise symptoms of anxiety; unhappiness, depression, psychosis., alcohol
and opioid withdrawal and intoxication. Meaning of Bio-psycho-social in causation and in 1. Niraj Ahuja’s Text-book on Psychiatry
Interventional Approaches. 2. Oxford Psychiatry
Unexplained physical complaints: Identify physical symptom without medical cause, elicit
stress and coping related information, educate, reassure and refer appropriately. Cognitive delays
identify developmental delay, basic education and advise; Discuss referral. Sleep educate regarding
sleep hygiene, prescribe rationally, Look for other psychiatric possibilities mental functions:
primary and higher elicit signs and symptoms of delirium. Identify early cognitive decline, educate
family, plan referral. Agitated / Violent patient Emergency management keeping forensic and
transportation needs in mind. Psychoses - Identify, provide immediate care and refer. Educate
regarding continued care in discussion with the psychiatrist. Concept of mental hygiene and
mental health promotional issues related to death and dying breaking bad news, Eliciting reactions
and support. Signs and symptoms of alcoholism, its Medical and Psychosocial impact, treatments
available. Signs and symptoms of common mental illnesses - Depression, anxiety, somatoform
disorders including conversion disorders and psychoses, dementia. Common antidepressants
and tranquilisers. Basic Counselling Principles. Child Development and Common developmental
disorders. Interplay of Psychological and physical aspects in Medical presentations. Common
causes of delirium, behavioural management and safe sedation methods. Forensic aspects of
violence, attempted suicide and suicide.

Dealing with PTSD. Developmental delay assessment. Geriatric Mental status examination (Primary
and higher mental functions).

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M.B.B.S CURRICULM

MODEL QUESTION PAPER

MEDICINE
SEC C
 (4x5=20 marks)

1. State the various somatic symptoms of depression. what are the pharmacological treatment
options for depression.

2. What is modified ECT. Write down the various indications and contraindications for use of
ECT.

3. Enumerate the various catatonic signs. What are the common causes of catatonia.

4. A 20 years female presents to OPD with 1 year history of suspiciousness, muttering to self,
hearing voices from outside, with disorganized occupational functions. There’s family history
of Psychosis in grandfather, without any history of substance use.

What is the probable diagnosis and state the different treatment options for the condition.

GENERAL SURGERY

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M.B.B.S CURRICULM M.B.B.S CURRICULM

GENERAL SURGERY • be able to work as a leading partner in health care teams and acquire proficiency in
communication skills.
NATIONAL GOALS
• be competent to work in a variety of health care settings.
At the end of undergraduate program, the medical student should be able to:
• have personal characteristics and attitudes required for professional life such as personal
• Recognize health for all as a national goal and health right of all citizens and by undergoing integrity, sense of responsibility and dependability and ability to relate to or show concern for
training for medical profession fulfill his/ her social obligations towards realization of this goal. other individuals.
• Learn every aspect of national policies on health and devote himself / herself to its practical
implementation. OBJECTIVES

• Achieve competence in practice of holistic medicine, encompassing promotive, preventive, At end of the course, the learners shall be able to:
curative and rehabilitative aspects of common diseases. • Diagnose and appropriately manage common surgical ailments in a given situation.
• Develop scientific temper, acquire educational experience for proficiency in profession and • Identify situations calling for urgent or early surgical intervention and refer at the optimum
promote healthy living. time to the appropriate centers.
• Become exemplary citizen by observation of medical ethics and fulfilling social and professional • Provide adequate preoperative, post-operative and follow-up care of surgical patients. Counsel
obligations, so as to respond to national aspirations. and guide patients and relatives regarding need, implications and problems of surgery in the
individual patient.
INSTITUTIONAL GOALS
• Provide emergency resuscitative measures in acute surgical situations including trauma.
In consonance with the national goals each medical institution should evolve institutional Should be well versed with BLS & ATLS.
goals to define the kind of trained manpower (or professionals) they intend to produce. The
undergraduate students coming out of a medical institute should: • Organise and conduct relief measures in situations of mass casualties.

• be competent in diagnosis and management of common health problems of the individual • Effectively participate in the National Health Programmes especially the Family welfare
and the community, commensurate with his/her position as a member of the health team at Programme.
the primary, secondary or tertiary levels, using his/her clinical skills based on history, physical • Discharge effectively medico-legal and ethical responsibilities
examination and relevant investigations.
• Perform simple surgical procedures.
• be competent to practice preventive, promotive, curative and rehabilitative medicine in
respect to the commonly encountered health problems.
KNOWLEDGE
• appreciate rationale for different therapeutic modalities, be familiar with the administration
System Based
of the “essential drugs” and their common side effects.

• be able to appreciate the socio-psychological, cultural, economic and environmental factors

affecting health and develop humane attitude towards the patients in discharging one’s
professional responsibilities.

• possess the attitude for continued self learning and to seek further expertise or to pursue
research in any chosen area of medicine.

• acquire basic management skills in the area of human resources, materials and resource
management related to health care delivery.

• be able to identify community health problems and learn to work to resolve these by designing,
instituting corrective steps and evaluating outcome of such measures.

278 279
280
S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method
No.
Metabolic response to injury

1. Basic concepts in homeostasis Avoidable factors that Changes in body 2 Hours Two lectures
M.B.B.S CURRICULM

compound the response composition following

to injury injury
2. Mediators of metabolic response
to injury
3. Metabolic stress response to
injury
4. SIRS

Shock and blood transfusion

1. Shock- definition and types Consequences Two integrated seminars Integrated Lecture with
of two Hours each Physiology, Surgery,
2. Ischemia reperfusion syndrome Multiorgan failure Medicine, TEM/
Anaesthesia
3. Severity of shock

4. Resuscitation

5. Haemorrhage- pathophysiology,
degree and Classification

6. Transfusion- blood and blood

products, transfusion reaction

S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method

No.
Wounds tissue repair and scars
1. Abnormal healing Normal wound healing Normal healing in 6 hours Lecture, ward round
specific tissues dressing room
2. Types of wound

3. Compartment syndrome

4. Vaccum assisted closure

5. Hypertrophic scars, Keloid and

contractures
6. Venous ulcer

7. Pressure ulcer

8. Burn 3 hours
Surgical infection

1. Causes of decreased host Koch's postulates 6 hours Integrated seminar with

response Microbiology and TEM.
2. Risk factors of wound infection Types of localized infection

3. Surgical site infection Specific wound infection

4. SIRS and MODS Treatment of surgical

infection
5. Necrotising soft tissue infection

6. Prophylactic antibiotic
281
M.B.B.S CURRICULM

7. Universal precaution
282
S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method
No.
Pediatric surgery

1. Undescended testis Inguinal hernia 12 hours Lecture

M.B.B.S CURRICULM

2. Acute scrotum Infantile pyloric stenosis

3. Abnormalities of penis Non specific abdominal

pain

4. Intussusception

5. Swallowed and inhaled foreign Esophageal atresia

body

6. Anorectal malformation Congenital diaphragmatic

hernia

7. Hirschsprung disease

8. Necrotizing enterocolitis

VASCULAR (Arterial Disorders)

1. Arterial Stenosis and Occlusion Surgical management 6 hours Lecture

Features, Investigations,
Nonsurgical management

2. Gangrene, Bedsores

3. Acute Arterial Occlusion,

Compartment syndrome, Acute
mesenteric ischemia

S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method

No.

4. Aneurysm, Abdominal aortic Peripheral aneurysm 2 hours Lecture

aneurysm,
Arteriovenous fistula

5. Thromboangitis Obliterans, Raynaud’s

disease

VASCULAR (Venous Disorders)

1. Anatomy of venous system of limbs, 4 hours Integrated Lecture with

Venous pathophysiology Anatomy

2. Varicose veins, CEAP

3. Venous thrombosis- diagnosis,

Investigations

VASCULAR (Lymphatic Disorders)

1. Anatomy and Physiology of the 4 hours Lecture

lymphatic system

2. Lymphoedema- Classification, Different surgical

pathophysiology, clinical features, procedures
investigations and management
Abdomen (Abdominal wall, hernia and umbilicus)

1. Anatomy of the abdominal wall 6 hour Lecture

283
M.B.B.S CURRICULM
284
S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method
No.
2. Abdominal hernia- anatomical causes, Specific hernia types Surgery, types of mesh 6 hour Lecture
pathophysiology, types, investigations,
management
M.B.B.S CURRICULM

3. Umbilical conditions in the adult

4. Abdominal Neoplasms of the

compartment syndrome abdominal wall

Abdomen (The peritoneum, omentum, mesentery and retroperitoneal space)

1. Anatomy and Physiology 4 hours Lecture

2. Peritonitis- Causes, Microbiology, Special forms of

types, Clinical features, diagnosis, peritonitis
management

3. Intraperitoneal abscess- Pelvic abscess,

Subphrenic abscess
4. Retroperitoneal tumors

5. Mesenteric cysts- Types, pathology,

clinical features, investigations and
treatment
Abdomen (The esophagus)

1. Surgical anatomy and physiology 3 hours Lecture

2. Corrosive injury Perforation

3. GERD, Hiatus hernia

S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method

No.
4. Oesophageal motility 1 hours Lecture
disordersAchalasia cardia, Diffuse
esophageal spasm and nutcracker
esophagus

5. Malignant Neoplasm 2 hours Integrated Seminar with

Radiation Oncology

GI Bleed

1. Upper GI Bleed 2 hours Integrated Seminar with

Gastroenterology

2. Lower GI Bleed 2 hours Integrated Seminar with

Gastroenterology

Abdomen (Stomach and duodenum)

1. Anatomy and Physiology of the 3 hours Integrated seminar with

stomach and duodenum Medicine

2. Gastritis and Peptic ulcer-

pathophysiology, clinical features,
investigations and treatment
Complications of peptic ulcer
3. Gastric Outlet Obstruction, Gastric Surgical treatment 3 hours Integrated seminar with
cancer for gastric cancer, Radiation oncology
Postoperative
complications of
gastrectomy
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M.B.B.S CURRICULM
286
S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method
No.

4. Gastrointestinal stromal Duodenal tumours 3 hours Integrated seminar with

tumor, Gastric lymphoma Radiation oncology
M.B.B.S CURRICULM

The Liver

1. Anatomy 4 hours Integrated seminar with

Microbiology
2. Amoebic liver abscess
Hydatid liver disease

3. Neoplasms of the Liver

The Spleen

1. Anatomy, Physiology and 3 hours Surgical part can be

Functions of the Spleen integrated with the
medical seminars.
2. Splenomegaly and Hypersplenism

3. Splenectomy and its

complications
The Gall bladder and bile ducts

1. Surgical Anatomy and Physiology Radiological 4 hours Lecture

investigations of the
biliary tract

2. Cholelithiasis, choledocholithiasis
and its complications, management

S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method

No.
The Pancreas

1. Anatomy and Physiology 3 hours Integrated seminar with

Medicine
2. Acute Pancreatitis

3. Chronic Pancreatitis 1 hours Lecture

4. Obstructive Jaundice, Periampullary 3 hours Clinical Case Conference

carcinoma including Carcinoma Head
of Pancreas

The Small and Large intestines

1. Intestinal tuberculosis Diverticular disease of the 1hours Lecture

small and large intestine

2. Mesenteric ischemia

3. Inflammatory Bowel
disease

4. Colorectal Malignancy 3 hours Integrated lecture with

pathology
5. Stomas Enterocutaneous fistulas Ward Teaching

Intestinal Obstruction

1. Classification, Pathophysiology, Clinical Acute intussusception, Adynamic obstruction 2 hours Lecture

features, treatment Volvulus
287
M.B.B.S CURRICULM
288
S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method
No.
The vermiform appendix

1. Acute Appendicitis Anatomy Neoplasms of the 2 hours Lecture

M.B.B.S CURRICULM

appendix
The Rectum and Anal canal

1. Surgical anatomy 3 hours Lecture

2. Anal Fissure, Haemorrhoids, Anorectal

abscesses, Fistula in ano

3. Rectal Prolapse Solitary rectal ulcer

4. Rectal carcinoma- spread, stages, clinical 2 hours Integrated seminar

features, investigations, management with Radiation
oncology
5. Malignant lesions of the anus and anal
canal- management
Skin & Subcutaneous Tissue

1. Vascular lesions: Common Vascular lesions:

vascular birthmarks Congenital -
haemangiomata and
vascular malformations
Acquired

2. Wounds: Acquired Wounds: Congenital

S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method

No.
3. Malignant lesions: Basal Cell 2 hours Lecture
Carcinoma,
Cutaneous Squamous Cell Carcinoma,
Cutaneous malignant melanoma

Head and Neck

1. Cleft lip & palate 1hour Lecture

2. Pharynx, Larynx & Neck: 1 hour Lecture

Lump in the Neck;
Branchial Cyst, Branchial fistula, Cystic
Hygroma,
Thyroglossal cyst

3. Disorders of Salivary glands: Disorders of Salivary 2 hours Lecture

a)Sublingual glands glands:
b)Submandibular glands a)Minor Salivary glands
c) Parotid glands

Cardiothoracic Surgery

1. Empyema 1hour Lecture

2. Diaphragmatic Hernia 1hour Lecture

3. Aortic Aneurysm 1hour Lecture

4. Aortic Dissection
289
M.B.B.S CURRICULM
290
S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method
No.
Perioperative Care

1. Organise preoperative care and 1hour Lecture

M.B.B.S CURRICULM

operating list

2. Understand surgical, medical and 2 hour

anesthetic aspects of assessment Integrated lecture
with anesthesia
3. Optimization of patient condition

4. Take proper consent 1hour Role play

5. History taking Ward teaching

6. Diagnose special preoperative 1hour Integrated lecture with

problems, referrals and management anesthesia

7. Acute pain management 1hour Integrated lecture with

pharmacology

8. Chronic pain management 1hour Integrated lecture with

anesthesia

9. Prepare a patient for theatre 2 hour Workshop

10. Importance of Surgical Safety 1hour Small group,Seminar, Role

Checklist play
11. Reduce intraoperative 1hour Can be taken by anesthesia
risks of positioning, venous department
thromboembolism, inf ection and
hypothermia, by using appropriate
monitoring and equipment

S. Must Know Desirable to Nice to know Hour of Teaching TL Method

No. Know
12. Operation theatre etiquettes 1hour

13. Scrubbing up, assistance role and 1hour

writing an operation note
14. Metabolic Response to starvation 1hour Workshop

15. Nutritional Assessment

16. Types of Fluids 2 hours

17. Electrolyte imbalance

18. Nutritional Requirement 1hour

19. Artificial Nutritional Support

20. Enteral Nutrition and Parenteral

nutrition
21. General management of 2 hours Lecture and ward teaching
postoperative patient
22. System specific postoperative
complications
23. Management of postoperative
complications

24. Discharge advice Ward teaching

25. Techniques of General To be taken by anesthetist

anesthesia and airway
maintenance
291
M.B.B.S CURRICULM
292
S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method
No.
26. Local and Regional To be taken by
anesthesia techniques anesthetist
M.B.B.S CURRICULM

27. Enhanced Recovery 1hour Lecture

28. Concept of day surgery

pathway

29. Principles of oncology 2 hours

30. Surgical audit & Research 1 hours

31. Bariatric and Metabolic surgery 1 hours

32. MAS & Robotic Surgery 2 hours

33. Tissue & Molecular diagnosis 1 hours

34. Career in Surgery 1 hours

Transplantation

1. Types of rejection 2 hour (for surgical Lecture

aspect discussion)

2. Indications for organ Graft Rejection Surgical principals of

transplantation Immunology organ implantation

3. Brain death HLA matching

4. Immunosuppressive
Therapy

S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method

No.
Breast

1. Anatomy, Investigations, Triple 2 hours Lecture

assessment
2. Nipple, diseases, Lecture
discharges,& Treatment
2 hours
3. Benign breast diseases Lecture
Ac & Ch Infections Treatment
4. ANDI,Mastalgia,Fibroadenoma,
Phylloides,Galactocele
5. Carcinoma ,Risk factors, 3 hours Integrated seminar with
pathophysiology, Staging oncology
6. Carcinoma, Management

Thyroid

1. Anatomy, 2 hours Lecture

Physiologv,Investigations,
2. Hypothyroidism &
Hyperthyroidism

3. Goitre Thyroiditis

4. Thyroid Malignancies 2 hours Integrated lecture with

pathology and nuclear
medicine
Parathyroid

1. Hyperparathyroidism, 1hour Lecture

Primary, Secondary
293
M.B.B.S CURRICULM
294
S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method
No.
Adrenal Glands

1. Anatomy & Physiology 1hour Lecture

M.B.B.S CURRICULM

2. Phaeochromocytoma & 1hour Lecture

Paraganglionoma

3. Adrenal
Insufficiency,Congenital
Adrenal Hyperplasia,
Ad renocortical
carcinoma
4. MEN

Trauma

1. ABCDE of trauma 16 hours Trauma Workshop

2. Primary & Secondary survey

3. Blunt Abdominal Trauma &

Penetrating Abdominal Trauma

4. Thoracic Trauma, Massive

Haemothorax, Cardiac Tamponade,

5. Musculoskeletal Trauma,
Compartment syndrome

6. Head injury, EDH, SDH

S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method

No.
7. Thoracic Trauma, Massive
Haemothorax, Cardiac Tamponade,
8. Mass casualties, Disaster
Management, Triage
9. Genitourinary Trauma

Urinary symptoms

1. Hematuria 1hour Essentials to clinical

Practice in 3rd sem
2. Pain

3. LUTS
4. Approach to a patient with LUTS 2 hours CCC 8th sem

5. Anuria and Urinary retention Acute neuropathic 2 hours Integrated seminar

bladder (Surgery and Medicine)
6. Causes of incontinence of urine Management of Types and diagnosis of 2 hours Integrated seminar
incontinence urinary fistulae (Surgery and O&G,
Neurology)
Genito urinary

Urinary Investigations

1. Urine 2 hours Integrated seminar

(pathology, biochemistry
2. Renal function test
, radiology)
3. Imaging- X-ray KUB, IVU, RGU, USG, Retrograde Antegrade pyelography,
CT, Cystoscopy ureteropyelography, DSA, MRI PET
Urethrography, TRUS,
Radioisotope scan,
Urodynamic study
295
M.B.B.S CURRICULM
296
S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method
No.
Congenital anomalies of the kidney , ureters and bladder

1. Congenital cystic kidney, Solitary kidney, Renal ectopia, 1hour Lecture, ppt
M.B.B.S CURRICULM

Ureterocele, Horseshoe kidney.

Unilateral fusion of kidney,
Congenital megaureter.
Bladder exstrophy
Hydronephrosis

1. Causes of unilateral and 1hour Lecture, ppt

bilateral hydronephrosis,
clinical features and
management
Urolithiasis

1. Types, etiology, Clinical 2 hours Integrated seminar

presentation, investigation, (pathology, surgery)
Management of renal stones
as per the location of the
stones.
Renal infection

1. Acute pyelonephritis, Chronic Renal carbuncle 2 hours Integrated seminar

Pyelonephritis, Pyonephrosis, (pathology, medicine)
Perinephric abscess, Renal
tuberculosis,
Lower urinary tract infection

Benign prostatic hyperplasia

1. Aetiology Pathophysiology Methods of prostatectomy 2 hours Lecture, ppt

Clinical features Management

S. Must Know Desirable to Know Nice to know Hour of Teaching TL Method

No.
Cancer of prostate

1. Screening 1hour Lecture, ppt

Pathophysiology
Clinical features
Management
Anomalies of the urethra and testis

1. Epispadias, Hypospadias 1hour Lecture ppt

2. Maldescent of testis, Phimosis,

Torsion
3. Varicocele, Epididymoorchitis

Malignancy of the urogenital system

1. Wilm’s tumor Papillary transitional cell tumor 1hour Lecture, ppt

Renal cell carcinoma
2. Urinary bladder Carcinoma 1hour Lecture, ppt

3. Testicular tumors 1hour Lecture, ppt

4. Penile Carcinoma 1hour Lecture, ppt

Clinical case conference

1. 5th semester 20 hours

2. 8th semester 30 hours

3. 9th semester 10 hours

297
M.B.B.S CURRICULM
M.B.B.S CURRICULM M.B.B.S CURRICULM

Approach to the patient with Skill Based Objectives

Subject Must Know Desirable to Nice to Know Skills Perform Perform Assist
know independently under the
Supervision expert
Ulcers in oral cavity Yes
Obtain a proper relevant history, and perform a Yes
Solitary nodule of the thyroid Yes humane and thorough clinical examination including
internal examinations (per-rectal and per vaginal)
Lymph node swellings in the neck Yes and examinations of all organs/ systems in adults and
Suspected breast lump Yes children
Arrive at a logical working diagnosis after clinical Yes
Acute abdominal pain Yes examination
Dysphagia Yes Order appropriate investigations keeping in mind their Yes
relevance (need based) and cost effectiveness .
Chronic abdominal pain Yes
Write a complete case record with all necessary details. Yes
Epigastric mass Yes
Write a proper discharge summary with all relevant
Right hypochrondium mass Yes information
Obtain informed consent for any examination/procedure Yes
Right iliac fossa mass Yes
Start IV lines and monitor infusions, start and monitor Yes
Renal mass Yes blood transfusion .
Inguino-scrotal swelling Yes Conduct CPR (Cardiopulmonary resuscitation) Basic Yes
life support
Scrotal swelling Yes
Pass nasogastric tube Yes
Gastric outlet obstruction Yes
Perform digital rectal examination and proctoscopy Yes
Upper gastrointestinal bleeding Yes Urethral catheterisation Yes
Lower gastrointestinal bleeding Yes Dressing of the wounds Yes
Suturing of the simple wounds Yes
Anorectal symptoms Yes
Remove small subcutaneous swelling & perform Yes
Acute intestinal obstruction Yes various types of biopsies
Obstructive jaundice Yes Relieve pneumothorax Yes
Acute retention of Urine Yes Infiltration, surface and digital Nerve blocks Incise Yes
and drain superficial abscesses Manage Lacerated
Bladder outlet obstruction Yes wounds
Haematuria Yes

Peripheral vascular disease Yes

Varicose veins Yes

New born with developmental Yes

anomalies

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M.B.B.S CURRICULM M.B.B.S CURRICULM

Skill 3RD PROFESSIONAL EXAMINATION 20__

SURGERY
Skills to be learnt initially on the models and later on performed under supervision before
Paper-I
performing independently, provision of surgical skills laboratories in the Medical Colleges
Answer each question in a separate answer booklet
will facilitate this process in addition to routine classroom and bedside teaching.
Attempt all questions
Duration- 3 hours
Teaching learning methods:
Structured interactive sessions Small group discussions Self learning tools like SECTION A
1. A 30 years old man weighing 60 kgs presented to the accident and emergency with burn injury
a. Assignments
over approximately 40% body surface area.
b. Problem based learning
i) Outline the fluid management schedule and other supportive management during the
c. Written case scenarios first 24 hours after admission ( 4 marks)

d. Simulated patient management problems, ii) What are different options of covering the burn wound (4 marks)
iii) Enumerate the different delayed complication of burn and their management. (2 marks)
Learning resource materials: Text books, Internet, CDs, Videos, Skill laboratories etc.
Suggested text Books 2. Short answer questions (6x5=30 marks)
• Bailey and love's short practice of Surgery a. Clinical features and management of Extradural hematoma
• A manual of clinical Surgery by S Das b. Branchial cyst

• Hamilton Bailey’s demonstration of clinical signs c. Treatment options in malignant melanoma

d. Diagnosis and management Tension pneumothorax
• Pye’s Surgical Handicraft
e. Difference in clinical feature and management of hypertrophic scar and keloids
f. Management of hyperkalemia.

SECTION-B
3. A 55 year old man presents to the outpatient department with a swelling on the left side of the
neck for six months duration.  (2+4+4=10marks)

i) Enumerate the causes that could lead to this presentation.

ii) How will you investigate this patient?
iii) Briefly discuss the management of pleomorphic adenoma of the parotid gland.

4. Short answer questions :  (6x5 marks)

i) Triple assessment
ii) Claudication pain and its significance
iii) Methods of performing sentinel lymph node biopsy and its significance
iv) Management of venous ulcer
v) Ankle brachial index
vi) How would you differentiate cellulitis of the leg from deep vein thrombosis

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3RD PROFESSIONAL EXAMINATION 20__

SURGERY
Paper-I
Answer each question in a separate answer booklet
Attempt all questions
Duration- 3 hours

SECTION A
1. A 50 year old lady presented with chief complaint of yellow discolouration of skin and eyes
for 25 days. She had intense itching all over the body. On examination of the abdomen her gall
bladder was not palpable. Her total bilirubin was 12 mg/dl. The direct bilirubin was 10 mg/dl
and the indirect 2 mg/dl.  (10)

a. List the possible differential diagnosis with justification of each  (4 marks)

b. Outline the preoperative management in patients specific to obstructive  ( 2 marks)
c. Briefly outline the investigations protocol in patients of obstructive jaundice with
justification for each  (4marks)

2. Short answer questions (6x5)

a. Fistula in ano

ORTHOPAEDICS
b. Management of patient with lower GI bleed
c. Options in the Investigation and surgical treatment of GERD
d. Differential diagnosis of a right iliac fossa lump and investigations to reach a diagnosis
e. Management option in pseudocyst of pancreas
f. Toxic megacolon

SECTION –B
1. A 26 years old male complains of intermittent pain in the loin with associated hematuria

a. Enumerate with justification the differential diagnosis  (2marks)

b. Outline the investigations that can be done to arrive at the diagnosis  (2 marks)
c. Enumerate the various treatment options of upper urinary tract calculi and justification of
choosing each.

2. Short answer question  (6x5 marks)

a. Cause of hydronephrosis
b. Hematuria
c. Hypospadias
d. Management of acute retention of urine in a 50 years old male
e. PUJ obstruction
f. Intravenous urography
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ORTHOPAEDICS Sl. Topic Domain Class Clinical

No Posting
GOALS Must Know Nice to Know

A medical graduate should diagnose basic Orthopaedic ailments and provide primary care till 1. 1. History of 1. History of Orthopaedics 1 Hours
Orthopaedics and terminologies used in
the patient is shifted to a higher center. He/ she should understand the principles of fractures,
2. Anatomy of Orthopaedics.
dislocations and soft tissue injury and manage as per the guidelines to prevent further damage Bone 2. Anatomy, Vascular Supply and
to the patient. He/she should also understand the Orthopaedic emergencies and golden hour ossification of Bone.
principle in Orthopaedics.
2. Fracture 1. Fracture Classification 1Hour
Classification and 2. Fracture Healing
OBJECTIVES
fracture Healing
The students, at the end of their training should be able to: 3. Fracture of Upper 1. Humerus Fracture 1. Fracture Radial 2 Hours 5 Hours
limb 2. Colle’s Fracture Head
1. Enumerate the principles of Fracture management.
3. Forearm Fracture 2. Elbow
2. Diagnose common Orthopaedic ailments. 4. Olecranon Fracture Dislocation

5. Shoulder Dislocation
3. Differentiate Orthopaedic emergency
4. Fracture around 1. Fracture Neck of Femur 2 Hours 5 Hours
4. Put splint and different plasters. Hip 2. Fracture Trochanter

5. Perform intra-articular injections procedure. 5. Fracture of lower 1. Fracture Femur 1.Fracture of 2 Hours 5 Hours
limb 2. Fracture Tibia Phalanges
6. Understand the importance compound fractures. 3. Fracture Patella
7. Reduce shoulder, elbow and small joint dislocations. 4. Fracture Pott’s
6. Compound 1. Compound Fracture 1 Hour 2 Hours
8. Know different implants used in Orthopaedics. Fracture

9. Diagnose different fractures and understand basic management. 7. Bone and joint 1. Osteomyelitis 2 Hours 5 Hours
Infection 2. Tuberculosis of bone.
10. Diagnose from clinical and radiological investigation different bone tumors. 3. Septic Arthritis
8. Bone Tumors 1. Benign Bone tumor 1. Limb Salvage 1 Hours 5 Hours
11. Understand congenital bone diseases.
2. Malignant Bone Tumor Surgery
12. Diagnose and manage bone and joint infection. 2. Prosthesis after
amputation
13. Understand bone and spine tuberculosis. 9. Arthritis 1. Osteoarthritis 1 Hour 5 Hours
14. Know the role of physiotherapy in Orthopaedics. 2. Gouty Osteoarthritis
3. Joint Replacement
15. Know different walking aids and supports. 10 Spine 1. Back Pain 1. Cervical 1 Hour 5 Hours
2. Spinal Trauma Spondylosis
3. PIVD 2. Cervical Rib
3. Whiplash injury
11. Miscellaneous 1. Tennis Elbow 1 Hour 3 hours
2. Dequervan’s disease
3. Plantar Fascitis
4. Trigger finger
5. Frozen Shoulder

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MODEL QUESTION PAPER

SURGERY
SEC C
 (4X5=20 marks)

1. Osteomyelitis.

a. Define and classify Osteomyelitis.  1 mark

b. Clinical feature and diagnosis of Osteomyelitis. 2 marks
c. Management of chronic Osteomyelitis 2 marks

2. Fracture.

a. Define fracture and classify fracture of long Bone. 2 marks

b. Enumerate the steps of fracture healing.  3 marks

3. Tension band wiring

a. What is Tension Band wiring? 2 marks

b. Write the principle of Tension Band wiring. 2 marks

ANAESTHESIOLOGY
c. Use of Tension band Wiring 1 mark

4. Long Bone.

a. Draw a labeled diagram of long bone with its blood supply. 3 marks
b. Write the causes of Nonunion in relation to blood supply of bone. 2 marks

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ANAESTHESIOLOGY S. Topic Domain Class Clinical

No Posting
GOALS:
1. Introduction to Anesthesia Must know 1Hour 1 day
The student who completes the anesthesia training is expected to acquire confidence in airway (Orientation) 1. Introduction to Anaesthesia
management skills, approach to emergency resuscitation and perioperative care in addition to
2. History of Anaesthesia Desirable to know 1Hour
pain management.
1. .History & Evolution of
anaesthesia
OBJECTIVES:
3. Pre-anaesthesia assessment Must Know 2 Hour 1 day
The students, at the end of their training should be able to: & preparation 1. Pre operative preparation
2. Nil Per Oral protocol
1. Enumerate the principles of anesthesia management in emergencies.
3. Pre-anaesthesia assessment
2. Outline the management of patient in the perioperative period.
4. Pre-medication Must Know 1Hour
3. Describe the Pharmacology of anaesthetics drugs 1. What is premedication and
drugs used
4. Outline the management of perioperative fluid, and electrolyte disturbances
2. Uses of Premedication
5. Perform skills in cardiopulmonary resuscitation 5. Anaesthesia machine & must know 2 Hour 2 day
6. Discuss the management of acute and chronic pain patients devices 1. Introduction to anaesthesia
machine and work station
7. Discuss the basics of obstetric anaesthesia Desirable to Know
8. Describe the care of the unconscious patient 2. Introduction to various
anaesthesia circuits & modes
of ventilation, vaporizers
INTEGRATION:
6. Oxygen therapy and devices Must Know 2 Hour 2 day
Management of Difficult Airway (TEM, Anesthesia, ENT) 1. Goals of oxygen therapy.
Polytrauma (TEM, Surgery, Anesthesia, Medicine) 2. Evaluation of patients
receiving oxygen therapy
Cardiac arrest (TEM, Anesthesia, Medicine) 3. Devices used for Oxygen
Fluid & electrolytes management (Medicine, Surgery, Anaesthesia) Therapy

Management of critically ill (TEM, Anesthesia, Medicine) 7. Spinal and epidural Must Know 1Hour 2 day
Anaesthesia 1. Spinal and epidural
Acute and chronic pain management (Anaesthesia, Medicine, surgery) anaesthesia
Neonatal resuscitation (Paediatrics, Anaesthesia) 2. Effects and complications of
neuraxial anesthesia
Management of obstetric emergencies (OG, Medicine, Anesthesia) 3. Monitoring and management
of patient during neuraxial
anaesthesia
Nice to Know
1. Techniques of spinal
anaesthesia

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8. Local Anaesthesia Must know 1 Hour 2 day MODEL QUESTION PAPER

1. Drugs used for local SURGERY
anesthesia, indications and
SEC C
contraindications
Each question carries 5 marks. Answer all questions. 5 x 4 = 20
2. Complications of Local
Anesthetic drugs & 1. With regards to resuscitation:
management
a. Define basic life support?  1 mark
9. General anaesthesia Must Know 2 Hour 3 day
b. Enumerate 4 ECG rhythms of cardiac arrest?  2 marks
1. Introduction of general
anaesthesia & phases c. Mention 5H and 5Ts of cardiac resuscitation?  2 marks
Desirable to know 2. With regards to blood transfusion
1. a) How it is given and reversed
a. Define massive blood transfusion 1 mark
2. b) Associated complications
b. Enumerate 4 major complications of blood transfusion 2 marks
10. Critical care medicine Must Know 2 Hour 2 day c. Name various tests of coagulation 2 marks
1. Assessment of critically ill
2. Basics of Resuscitation 3. Acid base disorder
a. Enumerate 4 causes of metabolic acidosis 2 marks
11. Obstetric Anaesthesia Must Know 2 Hour 2 day
1. Anaesthetic implications in b. What is anion gap ? 1 mark
Obstetrics c. Management algorithm of DKA 2 marks
2. Labour Analgesia
4. Trauma
12. Mechanical Ventilation Desirable to know 2 Hour 2 day
a. What is FAST 1 mark
1. Introduction to Artificial
ventilation b. Classify Shock 2 marks
2. Ventilators and their uses c. Management algorithm of hemorrhagic shock  2 marks
3. General care of patient on
Ventilator TEXT BOOKS RECOMMENDED
13. Care of unconscious patient Must Know 2 Hour 2 day 1. “The book of Anaesthesia” edited by Alan R. Aitkenhead, David J. Rowbotham, Graham
1. Assessment & Management Smith published by Churchill Livingstone.

14. Basic & Advanced life Must know 2 Hour 2 day 2. “Fundamentals of Anaesthesia” edited by Colin Pinnock, Ted Lin, Tim Smith Published by
support 1. Assessment and steps Greenwich Medical Media Ltd.
2. Defibrillation
REFERENCE BOOKS
15. Pain management Must know 1Hour 2 day 1. Fundamental Principles and practice of Anaesthesia, Ed. Petter Hurtton, Cooper
1. Acute pain management Butterworth, Published by Martin Dunitz, 2002.
2. Analgesics and uses
2. Principles and Practice of Anaesthesiology Edited David E. Longnecker Published by Mosby
Nice to know
St. Louis.
1. Chronic & Cancer pain and
their management

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OBSTETRICS AND GYNAECOLOGY

GOAL

The goal of this curriculum is to enable the undergraduate students to acquire the knowledge, skills
and attitudes in the discipline of Obstetrics & Gynaecology as essential for a general practitioner.

OBJECTIVES
I. KNOWLEDGE:

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

a. Outline the anatomy, physiology and pathophysiology of the reproductive system and the
common conditions affecting it.

b. Detect normal pregnancy, labour, puerperium and manage the problems he/she is likely
to encounter therein.

OBSTETRICS
c. List the leading causes of maternal & perinatal morbidity and mortality.

d. Understand the principles of contraception and various techniques employed, methods

of medical termination of pregnancy, sterilization and their complications.

AND
e. Identify the use, abuse and side effects of drugs in pregnancy, pre-menopausal and
postmenopausal periods.

f. Describe the national programme of maternal and child health and family welfare and

GYNAECOLOGY
their implementation at various levels.

g. Identify common gynaecological diseases and describe principles of their management.

h. State the indications, techniques and complications of surgeries like Caesarean section,
laparotomy, abdominal and vaginal hysterectomy, Fothergill’s operation and vacuum
aspiration for Medical Termination of Pregnancy (MTP).

II. SKILLS:

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

a. Take proper history and do detailed clinical examination.

b. Examine a pregnant woman; recognize high-risk pregnancies and make appropriate

referrals.

c. Conduct a normal delivery, recognize complications and provide postnatal care.

d. Resuscitate the newborn and recognize the congenital anomalies

e. Advise a couple on the use of various available contraceptive methods and assist in
insertion and removal of intra-uterine contraceptive devices.

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M.B.B.S CURRICULM M.B.B.S CURRICULM

f. Perform pelvic examination, diagnose and manage common gynaecological problems The CHAPTER WISE course contents as per the category are as follows:
including early detection of genital malignancies.
Serial Topic Must know Desirable to know Nice to know
g. Make a cervical cytological smear and wet vaginal smear examination for Trichomonas No.
vaginalis; Moniliasis and gram stain for gonorrhoea.
BASIC SCIENCES:
h. Interpretation of data of investigations like biochemical, histopathological, radiological
1. Normal & Basic embryology, Surgical procedures Recent
ultrasound etc.
abnormal Anatomy of internal for specific anomalies advances
i. Acquire communication, decision making, patient safety and managerial skills. development, reproductive organs,
structure and Anatomy of external
III. INTEGRATION: function of female genitalia, relationship
& male urogenital to other pelvic organs.
The student shall be able to integrate clinical skills with other disciplines and bring about
systems and the Uterine anomalies
coordination of family welfare programme for the national goal of population control.
female breast. Classification and
COURSE CONTENTS diagnosis and
reproductive outcome
General considerations: The curriculum/course content shall include the topics in following and indications for
categories: up to 70% of the content from must know category, 25% from desirable to know surgical management
category and remainder 5% from nice to know category. Accordingly, the theory lectures and
final(summative) assessment should be as per the above.
2. Applied anatomy Applied anatomy as Uterine appendages Paraovarian
of the genito- related to Obstetrics cyst, Gartner’s
urinary system, and Gynaecology. duct cyst
abdomen,
pelvis, pelvic floor,
anterior abdominal
wall, upper thigh
(inguinal ligament,
inguinal canal,
vulva, rectum and
anal canal).

3. Physiology of WHO normal semen Diagrammatic Methods of

spermatogenesis parameters representation of inhibiting
spermatogenesis spermatogenes
is

4. Endocrinology Gametogenesis, Assisted Implanataion

related to male ovulation, reproductive failure
and female menstruation, techniques
reproduction. fertilisation and
implantation

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Serial Topic Must know Desirable to know Nice to know Serial Topic Must know Desirable to know Nice to know
No. No.

BASIC SCIENCES: BASIC SCIENCES:

5. Anatomy & Relationship to female Iatrogenic Recto-vaginal 10. Gametogenesis, Gametogenesis, Fetal anomalies Genetics
Physiology of urinary internal genitalia, injuries during fistula fertilization, fertilization, in molar
& lower GI (Rectum genital fistulae, stress gynaecological/ implantation & early implantation & early pregnancy
/ anal canal), tract. urinary incontinence obstetric surgeries development of development of
and its prevention embryo. embryo, physiology of
conception
6. Development, Development and Assessment of Amniocentesis
11. Normal pregnancy, The physiological Subinvolution, Pseudocyesis
structure & function structure and functions placenta and
physiological changes changes in blood, retracted nipples and
of placenta, of placenta. amniotic fluid by
during pregnancy, cardiovascular, management, breast
umbilical cord & Amniotic fluid- ultrasonography
labour & puerperium. respiratory, renal, engorgement
amniotic fluid. volume, constituents,
hepatic, urinary tract,
importance
systemic and
7. Anatomical & Changes in genital Role of hCG Role of other gastrointestinal tract
physiological tract, haematological hormones during pregnancy,
changes in female changes, weight labour and puerperium
genital tract during changes, metabolic 12. Immunology of Immunology of Immunological Role in RPL
pregnancy . changes, systemic pregnancy pregnancy, humoral diseases
changes and cellular
immunology
8. Anatomy of fetus, Basic embryology. Evaluation of Other systems
13. Lactation Physiology of lactation, Lactation suppres- Breast milk
fetal growth & Fetal development fetal growth gross
Techniques and sion banking and
development, fetal and growth at various congenital fetal
advantages of breast storage
physiology & fetal gestational ages. anomalies
feeding
circulation. Teratogenic agents and
14. Biophysical and Physiology of Clinical significance Molecular
drugs to be avoided /
biochemical changes parturition cervical of physiology of mechanisms
contraindicated in early
in uterus and cervix ripening agents, Parturition
pregnancy
during pregnancy & dosage, Bishop score
Fetal circulation
labour.
9. Physiological & Tanner staging, Puberty Newer drugs for Side effects of 15. Pharmacology of mechanism of Teratogenicity Historical
neuro-endocrinal menorrhagia, Abnormal medical management newer drugs identified drugs used action, absorption, examples of
changes during uterine bleeding-causes of AUB, MHT and MHT during pregnancy, distribution, excretion, teratogenic
puberty disorders, and management, labour, post partum metabolism, transfer drugs
adolescence, diagrammatic period of the drugs across
menstruation, representation, the placenta, effect of
ovulation, & ovulation, fertilization, the drugs on the fetus,
menopause. menopause, Problems their excretion through
of menopause breast milk, drug
dosages, indications
and contra indications
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M.B.B.S CURRICULM M.B.B.S CURRICULM

Serial Topic Must know Desirable to know Nice to know Serial Topic Must know Desirable to Nice to know
No. No. know

BASIC SCIENCES: BASIC SCIENCES:

16. Pharmacology Mechanism of action, Newer drugs in O & Newer 21. Normal and Pelvic inflammatory Structure of Newer
of identified excretion, metabolism G chemotherape abnormal diseases, genital causative diagnostic
drugs used in and dosages of utic agents microbiology of tuberculosis, sexually organisms modalities,
Gynaecology, identified drugs used, the genital tract – transmitted infections
including side effects indications bacterial, viral & (STI), STI in pregnancy
chemotherapeutic and contraindications parasitic infections including HIV -
drugs. of the drugs, including responsible for signs and symptoms,
chemotherapeutic maternal, fetal and diagnosis, management.
drugs gynaecological CDC guidelines for
17. Role of hormones Commonly used Hormonal levels History of these disorders. management of STIs
in hormonal therapy, drugs, newer
Obstetrics & indications and advances
Gynaecology. contraindications, OBSTETRICS:
dosages, mechanism
22. Physiology of normal Clinical symptoms and Congenital Recent advances
of action, metabolism,
pregnancy, diagnosis signs of early pregnancy. anomalies
excretion, side effects
of pregnancy, Dating in early that can be
18. Markers in Commonly used Role in different Newer routine antenatal pregnancy including diagnosed in
Obstetrics & markers and tumour pathological states advances care, management USG, various early pregnancy.
Gynaecology – markers-indications, of common tests to diagnose Diagnosis and
non neoplastic normal levels,uses. symptoms in pregnancy. management of
and neoplastic pregnancy, Antenatal care: fetal congenital
Diseases. investigations to Objectives of antenatal anomalies
19. Pathophysiology of Benign ovarian Fallopian tube Newer be carried out in care, clinical diagnosis PC PNDT Act
ovaries, fallopian tumours, fibroid carcinoma, uterine advances and pregnancy. of pregnancy and
tubes, uterus, uterus, adenomyosis, sarcomas, surgeries agents of differential diagnosis,
cervix, vagina endometriosis, intersex, for carcinoma vulva Monitoring of fetal
management growth by gravidogram,
and external diseases of vulva and
genitalia in healthy vagina, carcinoma investigations ,
and diseased cervix, carcinoma nutritional requirements,
conditions. endometrium, ovarian drug prescription,
carcinoma, carcinoma Immunisation during
vulva, pelvic organ pregnancy, diagnosis
prolapse, abnormal of malpresentation,
uterine bleeding antenatal fetal
20. Normal and Normal and abnormal Fetal malformations Embryology and surveillance, pelvic
abnormal pathology pathology of placenta, and anomalies histology assessment
of placenta, umbil- umbilical cord, amniotic
ical cord, amniotic fluid and fetus.
fluid and fetus.

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Serial Topic Must know Desirable to know Nice to know Serial Topic Must know Desirable to know Nice to know
No. No.
OBSTETRICS: OBSTETRICS:
29. Infections during UTI, malaria, syphilis, TORCH infections Recent advances
23. Complications of Various types of Rarer varieties of Recent
pregnancy tuberculosis, hepatitis and during pregnancy
early pregnancy abortions, definitions, ectopic pregnancy advances
HIV during pregnancy and
causes, investigations and
their management
management.
Diagnosis of ectopic 30. Preterm labour Causes, diagnosis and Newer tocolytic Recent advances
pregnancy and and principles of management drugs
management Post-dated of preterm labour and
pregnancy delivery evaluation and
24. Hyperemesis Aetiopathogenesis, Unusual complications Recent
management of postdated
Gravidarum investigations and of hyperemesis and advances
pregnancy neonatal
management management
problems of preterm
25. Hypertensive Classification, diagnosis, Management of Recent and post-term babies
disorders in investigations and complications advances, Prevention of preterm
pregnancy management of of hypertensive Doppler labour, various tocolytics
hypertensive disorders disorders and assessment 31. Hydramnios and Causes, diagnosis, Recent trends in MRI in
in pregnancy and their chronic hypertension oligohydramnios investigations and management oligoamnios
complications. and renal disease. management
Predictive tests Differential diagnosis 32. Post-caesarean Evaluation of a case of ACOG guidelines Caesarean scar
& prevention of of convulsions in a pregnancy post-caesarean for conditions to be pregnancy
preeclampsia and pregnant woman pregnancy and met
eclampsia management.
26. Anaemia in Causes, classification of Management of Recent Monitoring of a case of
Pregnancy various types of anaemias nonnutritional advances post-caesarean in labour
and their diagnosis, anaemias in pregnancy and complications of
Nutritional anaemias VBAC
and their management.
Indications for repeat
Prevention of anaemia
Caesarean section
27. Heart disease in Classification, evaluation, Surgical management Recent and complications of
pregnancy complications during during pregnancy advances Caesarean at repeat
pregnancy and labour CS Trial of labour after
Contraception Caesarean (TOLAC),
Vaginal Birth after
28. Diabetes mellitus Classification, Complications of Recent
Caesarean (VBAC).
and pregnancy diagnosis, screening for diabetes and their advances
33. Antepartum Classification, clinical Management of Component
GDM and management management
haemorrhage features, differential complications like therapy
of diabetes during
diagnosis, investigation DIC
pregnancy and labour
including USG features,
Management of neonate
management and
of diabetic mother
complications

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Serial Topic Must know Desirable to know Nice to know Serial Topic Must know Desirable to Nice to know
No. No. know
OBSTETRICS: OBSTETRICS:
34. Fetal growth Causes, diagnosis and Recent advances in Stillbirth 40. Malpresentations Causes of contracted
restriction management management surveillance and malpositions and pelvis and diagnosis and
(FGR) and CPD management.
Intrauterine fetal Diagnosis of CPD and
death (IUFD) trial of labour Definitions
of obstructed labour and
35. Antenatal fetal Procedures of antenatal Modified biophysical Recent rupture uterus, causes,
surveillance assessment, early profile advances clinical features and man-
pregnancy assessment, agement. Prevention of
assessment in late rupture uterus
pregnancy, NST,
Doppler, Biophysical 41. Normal labour Physiology,definition, Newer modalities Recent trends
profile, mechanism and conduct of labour analgesia
of normal labour
36. Rhesus negative Diagnosis, evaluation In-utero Recent Monitoring in various
pregnancy and management management of Rh advances stages and abnormal
Prevention of Rh iso-immunised fetus labour or dysfunctional
isoimmunisation labour Diagnosis and
Management of management of fetal
haemolytic disease of distress Pain relief
new born during labour Active
management of third
37. Disorders of Common types, Newer drugs Recent
stage of labour and
liver, kidneys in diagnosis and advances
complications of 3rd
pregnancy management
stage, partograph
38. Multiple pregnancy Causes, diagnosis, Mechanism of twin TRAP
differential diagnosis, to twin transfusion sequence, 42. Induction and Pre-requisites for WHO Recent
complications in ( TTTS) and recent advances augmentation of induction. recommendations advances,
pregnancy and labour management labour Various methods newer drugs
and management Management of sin- of cervical ripening
gle fetal demise successful induction
and failed induction
39. Malpresentations Causes, clinical Various types of Role of
Complications and
and malpositions findings, definitive pelvis ultrasonography
contra-indications for
and CPD diagnosis of and MRI
inductions.
malpresentations
and malpositions and Various methods /drugs
mechanism of labour in for augmentation of
such cases. labour

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Serial Topic Must know Desirable to know Nice to know Serial Topic Must know Desirable to know Nice to know
No. No.
OBSTETRICS: GYNAECOLOGY:
43. Postpartum Definition, types, Surgical management Management 47. Anatomy of fetal Anatomy of fetal Applied aspects Surgeries for
haemorrhage diagnosis and of PPH of inversion of genital tract, and its genital tract, and its Mullerian
management of PPH. uterus, newer variations, supports variations, supports of anomalies,
Retained placenta, drugs, recent of uterus, uterus, developmental recent advances
manual removal of guidelines developmental anomalies of uterus. like uterine
placenta anomalies of transplantation

44. Puerperium, and Course of normal Breast abscess and Management uterus.
its complications puerperium, management of puerperal 48. Ectopic pregnancy; Ectopic pregnancy- Rarer varieties Primary and
complications of psychosis, epidemiology, Definition, risk factors, of ectopic secondary
puerperium like breast milk early diagnosis and epidemiology, diagnosis pregnancycaesarean abdominal
puerperal sepsis and banking and management. and management- scar ectopic, cervical pregnancies
its diagnosis and storage medical, surgical, ectopic
management and
ultrasound guided.
prevention.
Breastfeeding and
common problems like 49. Physiology of Physiology of Role of hormones Recent
lactational failure menstruation, menstruation, common advances
common menstrual menstrual problems-
Care of neonate and
problem. classification , diagnosis,
infant Immunisation
management
schedule
45. Operative Indications, technique ACOG guidelines, Destructive 50. Abnormal uterine Normal menstrual Transvaginal Recent
obstetrics & complications of consent operations in bleeding pattern and physiology sonography and
episiotomy Obstetrics advances in
of menstrual cycle, sonosalpingography
Indications, technique terminologies for management
and complications of Various bleeding
Caesarean section, patterns, causes,
Forceps and vacuum investigations, diagnosis,
deliveries classification of AUB
and management
Assisted breech delivery
and breech extraction
Methods of tubectomy 51. Disorders Classification of Details of Recent
complications and failure of growth, primary and secondary management advances
rates, cervical cerclage amenorrhoea amenorrhoea,
46. Perinatal and Definition of PNMR PNMR & MMR in Recent investigations
and principles of
maternal & MMR, causes and our country, state and Government
mortality in India prevention of perinatal programmes management.
institute
and maternal mortality.

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Serial Topic Must know Desirable to know Nice to know Serial Topic Must know Desirable to know Nice to know
No. No.
GYNAECOLOGY: GYNAECOLOGY:
52. Fibroid uterus Causes, types, Conservative surgery, Recent 56. Carcinoma cervix, Aetiology, epidiomology, Chemotherapy and Recent
complications, leiomyosarcoma advances in epidemiology, risk factors, role of HPV, radiotherapy advances,
investigations, and staging diagnostic clinical staging of cancer (chemoradiation) of genetics
management
management – procedure, cervix, stage based carcinoma cervix, side
medical, surgical, treatment. management of cancer effects
minimally invasive cervix
57. Carcinoma Risk factors, types, Adjuvant therapy, Recent
53. Pelvic organ Classification, causes, Nulliparous prolapse Recent endometrium diagnosis, FIGO staging, screening advances,
prolapse diagnosis. investigations advances, management genetics
and management in POP-Q 58. Carcinoma ovary Types, classification, Prophylactic and Recent
relation to age and grading, FIGO Staging, opportunistic advances,
classification
parity. Preventive Management-surgical oophorectomy, genetics
aspects of pelvic organ staging, chemotherapy Screening for ovarian
prolapse and radiotherapy malignancies,
adverse effects of
54. Vaginal discharge, Physiological and CDC guidelines for Recent chemotherapy of
sexually pathological causes of mangement of STIs advances ovarian cancer
transmitted vaginal discharge
59. Carcinoma vulva Diagnosis, FIGO staging Principles of Recent
diseases Clinical characteristics, management advances,
investigations for genetics
diagnosis, predisposing
60. Gestational Hydatidiform molein WHO prognostic Recent
conditions and
trophoblastic disease cidence, morbid scoring of GTN advances,
management including anatomy, complications, and management genetics
NACO guidelines for investigations, chemotharapy and
HIV management, followup. indications for surgery
Invasive mole, PSTT,
55. Precancerous Etiology and pathology, HPV DNA Recent Indian choriocarcinoma
lesions of female classification, diagnosis testingprimary testing and ACS 61. Pelvic inflammatory Definition, causes, Newer diagnostic Recent
genital tract of pre-malignant and and co-testing, HPV guidelines and disease sequelae and modalities of PID and advances
(cervix, vagina, malignant lesions vaccination recommenda- management of PID genital tuberculosis
vulva) of vulva, vagina, tions Sexually transmitted
cervix, uterus and infections and their
ovary Screening for prevention
carcinoma cervix.
Genital tuberculosis
diagnosis and
management
Prevention of PID
CDC guidelines and
management
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Serial Topic Must know Desirable to know Nice to know Serial Topic Must know Desirable to know Nice to know
No. No.
GYNAECOLOGY: GYNAECOLOGY:
62. Infertility Definition of infertility ART and their Recent 66. Adolescence, Adolescence, pubertal Precocious puberty Management
and sterility, causes and success advances, pubertal changes, changes, disorders of causes and of precocious
investigation of a couple history of ART disorders of puberty, Tanner staging investigation puberty
with infertility; semen puberty
analysis
67. Operative Indications, technique Indications and Recent
62. Infertility Causes of anovulation
gynaecology and complications of techniques of advances and
and induction of
dilatation and Colposcopy, guidelines
ovulation, tests for
curettage and Hysteroscopy
ovulation & tubal
vaginal hysterectomy, and operative
patency, Management of
Ward Mayo’s operation, laparoscopy Detailed
tubal factors of infertility
management of
including recanalisation, Manchester repair,
various postoperative
Counselling for ART abdominal hysterectomy,
complications
myomectomy,
63. Menopause and Menopausal symptoms Protocol for Recent advances
oophorectomy, tubal
related problems and management of management of and guidelines
recanalisation and
menopause, MHT causes PMB for MHT
diagnostic laparoscopy
and investigations of
Staging laparotomy for
postmenopausal bleeding
endometrial and ovarian
(PMB) malignancy, diagnosis and
64. Endometriosis Aetiology, sites, Endometriosis Recent advances principles of management
pathology, classification, of recto-vaginal in management of postoperative
clinical features, physical septum, scar complications
findings, differential endometriosis
diagnosis, investigations,
prophylaxis, management CONTRACEPTION, NEONATOLOGY AND RECENT ADVANCES:
68. Contraception Cafetaria approach, WHO medical Recent
65. Genital tract Post-coital injuries, Operative Recent advances various methods of advances
(Male & Female) eligibility criteria
fistulae and and operative injuries techniques and contraception, advantages
injuries especially to urinary tract complications and side effects, and
Causes, clinical features Prevention of genital failure rates, Selection of
and diagnosis of genital tract fistulae and patients and counselling
fistulae and their injuries IUCD insertion and
management removal, temporary and
Classification, differential permanent methods of
diagnosis, investigations contraception, emergency
and management of stress contraception
urinary incontinence

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Serial Topic Must know Desirable to Nice to know Serial Topic Must know Desirable to Nice to know
No. know No. know
CONTRACEPTION, NEONATOLOGY AND RECENT ADVANCES: CONTRACEPTION, NEONATOLOGY AND RECENT ADVANCES:
69. Medical MTP Act, indications, Management of Recent acts and 75. Management of Management of National Recent advances
termination of contraindications, complications of amendments common neonatal common neonatal guidelines
pregnancy – safe various methods of first various methods problems problems
abortion – selection trimester and second of 76. Ethics and medical Ethical management, Prevetion of Recently enacted
of cases, technique trimester termination MTP jurisprudence medical jurisprudence medical errors laws
& management and their complications, and the human
of complications concurrent factor
of medical and contraception
surgical procedures,
MTP law DRAFT OF REVISED LIST OF SEMESTER WISE TOPICS

70. National health Current national health State programmes Past national health 3rd Semester (20 hours)
programmes. programmes programmes Sl. No. Topic
1 Applied anatomy of female external genitalia
71. Social obstetrics Safe motherhood Prevention Newer programmes
2 Applied anatomy of female internal genitalia
and vital statistics programmes, MMR of maternal
and its causes, perinatal and perinatal 3 Applied anatomy of extra-genital pelvic structures including supports of uterus
mortality and its causes, mortality and 4 Development and anomalies of female external genitalia
maternal and perinatal morbidity 5 Development and anomalies of female internal genitalia
morbidity, stillbirths, 6 Neuroendocrinology of reproduction – female hormones and steroidogenesis
neonatal deaths
7 Physiology of menstruation
72. Care of new Resuscitation and Neonatal Recent advances 8 Physiology of conception – gametogenesis, fertilisation and implantation
born, neonatal examination of anomalies and guidelines 9 Placenta - Structure, development, functions, placental circulation
resuscitation, newborn, feeding of
10 Fetal physiology and growth
detection newborn, immunization
of neonatal 11 Physiology of pregnancy – Changes in genital organs, breasts, skin and metabolism
malformation. 12 Systemic adaptations in pregnancy – CVS, respiratory, haematological, renal, GI,
hepatic
73. Neonatal sepsis Neonatal sepsis – Antibiotic policy, Recent advances
– prevention, prevention, detection & dosage and and guidelines 13 Immunology and endocrinology of pregnancy
detection & management. rationale 14 History taking in Obstetrics
management. 15 History taking in Gynaecology
74. Neonatal Neonatal NICU care Recent advances 16 Examination in Obstetrics
hyperbilirubinemia hyperbilirubinemia and guidelines 17 Examination in Gynaecology
– investigation – investigation & 18 Investigations in Obstetrics & Gynecology
& management management
19 Revision
including NICU
20 Revision
care.

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4th Semester (20 hours) 11 MTP – Methods and MTP Act

Sl. Topic 12 Disorders of sexual differentiation
No. 13 Primary amenorrhoea
1 Diagnosis of pregnancy 14 Secondary amenorrhoea
2 Antenatal care – Preconceptional care, antenatal visits, nutrition, lifestyle advice 15 Infections in pregnancy – Malaria, TB, TORCH
3 Antenatal care – Screening, immunisation, medications, treatment of minor ailments 16 STIs in pregnancy – syphilis, HIV, hepatitis B
4 Maternal pelvis, fetal skull, fetus in utero 17 Revision
5 Physiology and phases of parturition 18 Revision
6 Normal labour – Definition, stages, mechanism of labour
7 Clinical course and management of normal labour – 1st stage 6th semester (22 hours)
8 Clinical course and management of normal labour – 2nd stage Sl. No. Topic
9 Clinical course and management of normal labour – 3rd stage 1 Fibroid uterus – Classification, etiology, clinical features
10 Normal puerperium and breast-feeding 2 Fibroid uterus – Complications and management
11 Examination and care of newborn 3 Benign tumors of ovary
12 Physiology of puberty and menopause 4 Benign lesions of vulva, vagina and cervix
13 Disorders of puberty – precocious and delayed 5 Disorders of menstruation – Terminologies, etiology, evaluation
14 Adolescent gynaecological problems – abnormal menses, dysmenorrhoea, hirsutism, 6 Management of abnormal uterine bleeding in different age groups
neoplasms 7 Postmenopausal bleeding
15 Menopausal problems & MHT 8 Urinary disorders in gynaecology – incontinence, retention, PBS, OAB
16 Infections of individual genital and pelvic organs 9 Genital tract injuries - perineal tears, genital fistulae
17 Sexually transmitted infections 10 High risk pregnancy – Detection, antenatal, intranatal and postnatal care
18 Hyperemesis gravidarum 11 Nutritional anaemia in pregnancy – Iron deficiency, megaloblastic
19 Revision 12 Non-nutritional anemia in pregnancy – hemoglobinopathy, hemolytic, aplastic
20 Revision 13 Pregnancy with heart disease
14 Thyroid disorders in pregnancy
5th semester (18 hours)
15 Hypertensive disorders of pregnancy – Gestational hypertension, pre-eclampsia
Sl. Topic 16 Hypertensive disorders of pregnancy – Eclampsia, HELLP, chronic hypertension
No. 17 Pregnancy with gestational diabetes
1 Miscarriage 18 Pregnancy with overt diabetes
2 Ectopic pregnancy 19 Shock in pregnancy
3 Molar pregnancy 20 Blood and blood products in pregnancy – indications, transfusion safety
4 Anomalies of placenta and cord 21 Revision
5 Pelvic inflammatory disease 22 Revision
6 Female genital tuberculosis
7 Contraception – introduction, basic principles, barrier and natural methods
8 Hormonal contraceptives
9 IUCD and emergency contraception
10 Permanent contraception and newer contraceptive methods

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7th Semester (22 hours) 12 Compound presentation, cord prolapse

Sl. No. Topic 13 Abnormal uterine action
1 Prenatal diagnosis and fetal therapy 14 Contracted pelvis and CPD
2 Antepartum fetal assessment 15 Prolonged and obstructed labour
3 Intrapartum fetal assessment 16 Injuries to birth canal - Rupture uterus
4 Induction and augmentation of labour 17 Injuries to birth canal – Cervix, vagina, perineum, pelvic hematomas
5 Abruptio placentae 18 Third stage complications – Atonic PPH & traumatic PPH
6 Placenta praevia 19 Third stage complications – Retained placenta, PAS, secondary PPH
7 Polyhydramnios 20 Complications in puerperium
8 Oligohydramnios 21 Coagulation disorders in pregnancy
9 Multifetal gestation 22 Breast problems in Obstetrics and Gynecology – breast problems in puerperium, mastalgia,
fibrocystic breast disease, fibroadenoma, breast cancer, galactorrhoea
10 Post-Caesarean pregnancy
23 Critical care in pregnancy
11 Jaundice in pregnancy
24 Examination and care of LBW babies
12 Pulmonary diseases in pregnancy
25 Neonatal resuscitation and birth asphyxia
13 Urinary tract diseases in pregnancy
26 Diagnosis of early neonatal problems
14 Pregnancy with fibroid
27 Birth injuries, jaundice and infections of newborn
15 Pregnancy with ovarian tumours
28 Congenital anomalies of fetus – CNS, face, neck, thorax and CVS
16 Acute abdomen in pregnancy
29 Congenital anomalies of fetus – Abdominal wall, genito-urinary tract, GI tract, skeleton
17 Pregnancy with genital prolapse
30 Endometriosis
18 PCOS
31 Adenomyosis
19 Social and preventive obstetrics
32 Male infertility
20 National health programmes related to MCH and RCH
33 Female infertility
21 Revision
34 Genital displacements – Retroversion, chronic inversion
22 Revision
35 Pelvic organ prolapse – Risk factors, pathophysiology, types
36 Genital displacements – Clinical features and management of POP
8th & 9th Semester (80 hours)
37 Preventive oncology
Sl. No. Topic 38 Premalignant lesions of genital tract – cervix
1 PROM & PPROM
39 Premalignant lesions of genital tract – vulva, vagina, uterus
2 Preterm labour
40 Malignant tumors of cervix – risk factors, histological types, clinical features
3 Post-term pregnancy
41 Malignant tumors of cervix – FIGO staging, management
4 Fetal growth restriction
42 Malignant tumors of endometrium – risk factors, histological types, clinical features
5 Intra-uterine fetal death
43 Malignant tumors of endometrium - – FIGO staging, management
6 Recurrent pregnancy loss
44 Malignant tumors of ovary – classification, risk factors, clinical features, FIGO staging
7 Rh incompatibility and NIHF
45 Management of epithelial ovarian malignancy
8 Occipito-posterior position
46 Management of non-epithelial ovarian malignancy
9 Breech presentation
47 Malignant lesions of vulva and vagina
10 Transverse and oblique lie
48 GTN – invasive mole, choriocarcinoma, PSTT
11 Face and brow presentation

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49 Radiotherapy in Gynaecology Integrated teaching in 8th & 9th sem (2 hrs each = 50 hours)
50 Chemotherapy in Gynaecology Sl. No. Topic of integrated teaching Dept(s) for integration
51 Pre- and post-operative care in gynecological surgeries 1 Development of genital tract - any malformations Anatomy, Plastic surgery
52 Operative gynecology – abdominal and vaginal hysterectomy, radical hysterectomy, 2 Fetal physiology-fetal circulation Physiology, Neonatology
myomectomy, dilatation and curettage, endometrial biopsy, cervical biopsy
3 Fetal malformations - genesis Embryology, Radiology,
53 Operative gynecology – urogynecological surgeries, staging laparotomy, sterilization, ovarian Neonatology, Pediatric
cystectomy, others Surgery
54 Operative obstetrics – Episiotomy, Caesarean section 4 CIN Pathology
55 Operative obstetrics - Forceps delivery 5 ARF Physiology, Nephrology
56 Operative obstetrics - Ventouse delivery 6 Coagulation failure Pathology, General Med-
57 Operative obstetrics –Version, MROP, D&E, S&E, cerclage, surgical management of PPH icine
58 Pharmacotherapy in Obstetrics – Teratogeneic drugs, anti-hypertensives, anti-convulsants, 7 Diabetes in pregnancy Endocrinology
anti-diabetic drugs, anti-coagulants, anti-platelet 8 Heart disease in pregnancy Cardiology
59 Pharmacotherapy in Obstetrics – Uterotonins, tocolytics, anti-D, corticosteroids, hematinics, 9 USG in Obstetrics & Gynecology Radiology
others
10 Infections in pregnancy Microbiology, General
60 Drugs and hormones in Gynaecology – GnRH analogues, gonadotropins, androgens, anti-
Medicine
androgens, vasopressin, anti-firbinolytics, methotrexate
11 Medico-legal aspects Forensic Medicine
61 Drugs and hormones in Gynaecology – Estrogen, progestogens, aromatase inhibitors, anti-
estrogens/SERM/STEAR, anti-progestin/SPRM, dopamine agonists 12 Nutrition in pregnancy and lactation CM & FM
62 Ultrasonography and Radiology in Obstetrics 13 Evidence based obstetrics CM & FM
63 Ultrasonography and Radiology in Gynaecology 14 Drugs in pregnancy & prescribing in pregnancy Pharmacology
64 Laparoscopy in Gynaecology 15 Social obstetrics CM & FM
65 Hysteroscopy in Gynaecology 16 Thyroid disorders in pregnancy Endocrinology
66 Audit in Obstetrics and Gynaecology. 17 Acute abdomen in pregnancy Surgery
67 Evidence based medicine (EBM) in Obstetrics and Gynaecology 18 Low birth weight Neonatology
68 Research in Obstetrics and Gynaecology 19 Anaemia in pregnancy Pathology, Hematology
69 Interesting cases in O&G 20 Birth asphyxia Neonatology
70 Interesting cases in O&G 21 Jaundice in pregnancy Gastroenterology
71 Revision 22 Ovarian malignancy Surgical oncology,
Radiotherapy
72 Revision
23 Cervical malignancy Surgical oncology,
73 Revision
Radiotherapy
74 Revision 24 Endometrial malignancy Surgical oncology,
75 Revision Radiotherapy
76 Revision 25 Obstetric analgesia and anesthesia Anaesthesia
77 Revision
78 Revision Tutorials in 8th & 9th sem (2 hrs each = 20 hours)
79 Revision Sl. No. Topic of tutorials
80 Revision 1 Female pelvis and fetal skull
2 Fetus in utero & mechanism of normal labour
3 Occipito-posterior position

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4 Breech presentation TUTORIALS AND REVISION:

5 Face & brow presentation, transverse lie
Practical skills to be imparted during ward posting
6 Instruments including forceps and ventouse
Obstetrics
7 Drugs
8 Specimen a. History taking and examination of a pregnant woman.
9 Contraception
b. Monitoring progress of labour and conduct of a normal labour.
10 NST, partograph, USG, HSG
c. Management of third stage of labour, prevention and treatment of post partum
Operatives/Radiology/Model question paper & answer in 8th & 9th sem haemorrhage.
(2 hrs each = 10 hours) d. Witness caesarean section, breech delivery, forceps and vacuum delivery.

Sl. No. Topic of tutorials e. Essential care of a newborn.

1 Videos of obstetric procedures f. Non-stress testing of fetus; biophysical scoring of fetus.
2 Videos of gynaecological procedures
Gynaecology
3 Atlas - USG & endoscopic images, neonatal birth defects, abnormal placenta and cord
4 Model question paper – 2 papers of O& G a. How to take history and perform examination of female pelvic organs.
5 Model question paper – 2 papers of O& G b. Preparation of Pap smear, wet smear preparation of vaginal discharge.
c. Minor gynaecologic procedures: cervical biopsy, endometrial biopsy, dilatation &
Students’ seminars in 8th & 9th sem (2 hrs each = 40 hours)
curettage; fractional curettage.
Sl. No. Topic of seminars
d. Medical termination of pregnancy (MTP): in first & second trimesters.
1 Congenital anomalies of genital tract
e. Insertion and removal of intrauterine contraceptive device.
2 Physiology of menstruation
3 Normal labour
Operative Skills
4 Antepartum and intrapartum fetal assessment
5 Anemia in pregnancy a. Conduct of normal delivery
6 Hypertension in pregnancy b. Making and repair of episiotomy
7 Bleeding in early pregnancy
c. Insertion and removal of intrauterine device
8 Bleeding in late pregnancy
9 Fibroid uterus d. Making of Pap smear
10 Abnormal uterine bleeding e. Performing minilap tubectomy (under supervision)
11 Amenorrhoea Record Note Books: Every student must maintain a record of the practical / clinical work assigned
12 Infections in pregnancy to him / her in the record note books. These shall be submitted periodically to the respective
13 Fundal height not corresponding to period of amenoorhoea Professors. At the end of the course, the practical / clinical case record note books shall be
14 Malpresentations and malpositions submitted to the heads of the departments who shall evaluate and include the marks in the
15 PPH Internal Assessment. Records need not be submitted at the professional practical examination.
16 Infertility In respect of failed candidates, the marks awarded for records at the first attempt may be carried
17 Pelvic organ prolapse over to the next examination attempt.
18 Cervical cancer If a candidate desires, he/ she may be permitted to improve on the performance by submission of
19 Ovarian cancer fresh record note books.
20 Endometrial cancer
Summative assessment
Total clock hours for theory = 20+20+18+22+22+80+50+20+10+40 = 302 hrs Evaluation Methods - Theory, Practical and Viva

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Pattern of theory examination including distribution of marks, questions and time Scheme of Practical & Oral Examination for Obstetrics & Gynaecology
There shall be two theory papers - Paper I and II, carrying 100 marks each. PRACTICAL: Total – 200 Marks

1. Each paper will have two sections, A and B. OBSTETRIC ORAL AND PRACTICALS=100 MARKS

2. Each paper will be of 03 hours duration. 1. Obstetric Long case- : 50 marks

PAPER I: (Total marks=100) a. History : 10 marks

Topics - Obstetrics including social obstetrics and newborn care b. Clinical examination : 10 marks

Section A=50 marks c. Diagnosis and investigations : 10 marks

Section B=50 marks d. Discussion : 10 marks

PAPER II: (Total marks=100) e. Student attitude : 10 marks

Topics: Gynaecology, Family Welfare and Demography 2. Dummy pelvis and fetal skull : 10 marks

Section A=50 marks 3. Drugs : 10 marks

Section B=50 marks 4. Ultrasound (USG) & specimen : 10 marks

Each section will have: 5. NST/CTG , instruments and partograph: 10 marks

• One modified structured essay question of 10 marks = 10 marks 6. Record : 10 marks

• Eight short answer questions of 5 marks each: 40 marks

GYNAECOLOGY ORAL AND PRACTICALS=100 MARKS

1. Gynaecology Long case : 50 marks

a. History : 10 marks

b. Clinical examination : 10 marks

c. Diagnosis and investigations : 10 marks

d. Discussion : 10 marks

e. Student attitude : 10 marks

2. Contraception : 10 marks

3. Instruments : 10 marks

4. Specimen : 10 marks

5. Ultrasound (USG) & HSG : 10 marks

6. Record : 10 marks

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Teaching Aids in the department Journals:

Doll and Dummy 1. Indian Journal of Obstetrics and Gynaecology

Female Pelvis 2. British Journal of Obstetrics and Gynaecology

Gross specimens 3. American Journal of Obstetrics and Gynaecology

X-ray/ USG films/ CTG tracings / partograph Mechanisms for feedback and improvement
View box Format for feedback
VCR 1. Name:  (You can choose to leave this column blank too)
Overhead Projector 2. Semester:
Slide Projector 3. Date:
Set of instruments/forceps etc. 4. Please respond to the following:
Library for current books, e- journals and e-books of Obstetrics and Gynaecology a. Not satisfied at all/ Somewhat satisfied/ Satisfied/ Very Satisfied/ Extremely satisfied.
FOGSI (The Federation of Obstetric and Gynaecological Societies of India) Newsletter b. Your overall assessment of posting in this semester.

FOGSI website http://www.fogsi.org c. Curriculum.

d. Knowledge gained.
Other Sources of knowledge: e. Skills gained.

Books: 5. What did you like about your posting?

Standard Textbooks: 6. What you did not like about your posting?

1. Mudaliar and Menon’s Clinical Obstetrics- Orient Longman 7. How do you rate the teachers (faculty/senior residents/postgraduates) ?
2. Manual of Obstetrics (Updated Holland and Brew’s)-Daftary
8. Suggestions for improvement.
3. Howkins & Bourne-Shaw’s Textbook of Gynaecology
9. Any other comments.
Reference Books:

1. William’s Obstetrics-Mc Graw Hill

2. William’s Gynaecology-Mc Graw Hill

3. Shaw’s Textbook of operative Gynaecology

4. Practical gynaecology and Obstetrics - Parulekar

Newsletters:
FOGSI Newsletters

Internet:
RCOG Greentop Guidelines

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MODEL QUESTION PAPER SECTION B

OBSTETRICS AND GYNAECOLOGY 1. A 31 year old primigravida presents at 24 weeks of gestation with a VCCTC report of being
PAPER I HIV positive.  ( 2+3+3+2)

a. What antiretroviral drugs would you like to start?

 Full Marks=100
b. What investigations would you like to do?
SECTION A
Answer all questions: c. Management and precautions in labour
d. Plan of management for neonate
1. A 21 year old unbooked primigravida is referred at term with generalised tonic-clonic
convulsions. On examination, there is bilateral pitting pedal edema, BP is 200/120mm Hg, 2. Short Notes (8X5)
uterus corresponds to term size, cephalic presentation, FHR is 120 bpm.  (1+4+2+3)
a. Advantages of breastfeeding
a. What is the most probable diagnosis?
b. Functions of placenta
b. How will you manage her further?
c. Define maternal death and list the common causes of maternal mortality in India
c. What are the risk factors for this condition?
d. Define:
d. Enumerate changes in:
i) Caput succedaneum
i) liver
ii) Cephalohaematoma
ii) kidneys
iii) Subgaleal haemorrhage
iii) haematological system in this condition?
iv) Molding
2. Short Notes (8X5) iv) Illustrate BPD with diagram

a. i) Screening for GDM in India e. MTP Act

ii) Principles of medical nutritional therapy for gestational diabetes mellitus f. List the complications in preterm neonates

b. i) Degrees of placenta praevia g. i) Twin to twin transfusion syndrome

ii) Classification of accidental haemorrhage ii) Causes of hydrops fetalis

c. i) Uterine involution h. Classify heart diseases in pregnancy

ii) Lochia
d. Reactive non -stress test
e. Active management of third stage of labour (AMTSL)
f. Diagnosis and management of missed abortion
g. Define:
i) Severe anaemia complicating pregnancy
ii) Engagement
iii) Puerperal sepsis
iv) Induction of labour
v) Normal labour
h. Follow up of vesicular mole
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MODEL QUESTION PAPER SECTION B

OBSTETRICS AND GYNAECOLOGY 1. 45 year old multipara presented with heavy menstrual bleeding of several months duration.
PAPER II On examination, there is pallor. Vitals are stable. Per abdominal and per vaginum examination
revealed an irregularly enlarged, firm uterus corresponding to 24 weeks of gestation with
 Full Marks=100
bilateral fornices being free.  (1+3+4+2)
SECTION A a. What is the most likely diagnosis?
Answer all questions: b. List 3 common differential diagnosis with points in favour and against.
1. A 29 year old multigravida presents with amenorrhoea of 6 weeks, vaginal bleeding and history c. Outline your plan of management for her
of loss of consciousness. On examination, there is pallor, PR is 110 bpm, BP is 90/60mm Hg, d. Enumerate i) drugs for medical management ii) minimally invasive methods of
abdomen is distended, and her urine pregnancy test is positive.  ( 1+4+2+3) management of this condition
a. What is the most probable diagnosis?
2. Short Notes 8X5
b. How will you manage her?
a. Dermoid cyst
c. What are the risk factors for this condition?
b. Treatment of:
d. Enumerate the non-surgical management of this condition?
i) Imperforate hymen
2. Short Notes (8X5) ii) Bartholin’s cyst
a. i) Common causes of abnormal vaginal discharge c. Methods of first trimester MTP
ii) Management of bacterial vaginosis d. Risk factors for endometrial carcinoma
b. Chemotherapy for GTN e. Enumerate barrier methods of contraception
c. i) Screening for cancer cervix f. FIGO staging of cancer cervix
ii) Management of CIN III g. Non-contraceptive benefits of OCPs
d. Menopausal hormone therapy h. Clomiphene citrate
e. i) Degrees of pelvic organ prolapse
ii) Management of nulliparous prolapse
f. Assessment of tubal function in infertility
g. Define: Rotterdam criteria of PCOS
h. Represent diagrammatically Anatomy of female external genitalia.

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PEDIATRICS
KNOWLEDGE

At the end of the course, the student shall be able to :-

a. Describe the normal growth and development during fetal life, neonatal period, childhood
and adolescence and outline deviations thereof;

b. Describe the common pediatric disorders and emergencies in terms of epidemiology,

etiopathogenesis, clinical manifestation, diagnosis, rational therapy and rehabilitation.

c. State age related requirement of calories, nutrients, fluids, drugs, etc, in health and disease;

d. Describe preventive strategies for common infectious disorders, malnutrition, genetic &
metabolic disorders, poisonings, accidents and child abuse;

e. Outline national programs relating to child health including immunization programs.

SKILLS

At the end of the course, the students shall be able to :

a. Take a detailed pediatric history, conduct an appropriate physical examination of children

PEDIATRICS
including neonates, make clinical diagnosis, conduct common bedside investigative
procedures, interpret common laboratory investigations and plan as well as institute
therapy;

b. Take anthropometric measurement, resuscitate newborn infants with bag and mask at birth,
prepare oral rehydration solution, perform tuberculin test, administer vaccines available
under current national programs, start an intravenous line and provide nasogastric feeding
observe venesection and intraosseous infusion, if possible;

c. Conduct diagnostic procedures such as lumbar puncture, bone marrow aspiration, pleural
tap and ascitic tap; assist liver and kidney biopsy;

d. Distinguish between normal newborn babies and those requiring special care and institute
early care to all newborn babies including care of preterm and low birth weight babies,
provide correct guidance and counseling in breastfeeding;

e. Provide ambulatory care to sick children, identify indications for specialized/in-patient

care and ensure timely referral of those who require hospitalization.

INTEGRATION

The training in Pediatrics would be done in an integrated manner with other disciplines, such
as Anatomy, Physiology, Biochemistry, Pathology, Microbiology Forensic Medicine, Community
Medicine, Obstetrics, Physical Medicine and Rehabilitation etc to prepare the student to deliver
preventive, promotive, curative and rehabilitative services for care of children both in the
community and at hospital as part of a team.

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SUGGESTED TEACHING SCHEDULES TOPICS AND THEIR ALLOCATED CLOCK HOURS

3rd and 4th Semester 6th and 7th Semester

Learning Objectives Sl. Topics Hours of Mode of teaching
Teaching
At the end of these two semesters, the learner should be able to : No
1. Abnormal growth including short stature 1 hr Lecture
1. Take a detailed Pediatric history.
2. Understand normal growth and development. 2. Abnormal development including PDD 1 hr Lecture
3. Know about medical conduct during patient examination. 3. Vitamin deficiency (A&D) 1 hr Lecture
4. Conduct physical examination of children.
4. Micronutrient deficiency 1 hr Lecture
5. Perform anthropometry and interpret growth.
6. Perform developmental assessment in children. 5. PEM - 1(Defination & Classification & 1 hr Lecture
Epidemiology
Lectures 6. PEM - 2 (Mangement) 1 hr Lecture
1. Introduction to Pediatrics.
7. Acute diarrhea 1 hr Lecture
2. History taking and its schema in Pediatrics
8. Chronic diarrhea 1 hr Lecture
3. General examination including anthropometry.
4. Normal growth. 9. Malaria 1 hr Lecture
5. Normal development. 10 Enteric fever & Scrub Typhus 1 hr Lecture
6. Immunization including cold chain
11. Dengue 1 hr Lecture
7. Introduction to newborns and the normal newborn baby.
8. Temperature regulation in newborn, hypothermia, cold stress and Kangaroo Mother Care 12. Common bacterial infection in children 1 hr Lecture
(KMC).
13 Diphtheria and Pertussis 1 hr Lecture
9. Breastfeeding and lactation management.
10. Infant and child feeding (include complementary feeding). 14. Tetanus 1 hr Lecture

Clinical Training 15. Pneumonia 1 hr Lecture

Tutorials cum demonstration (during first one week). 16. Empyema Thoracis 1 hr Lecture
Topics for demonstration: 17. Wheezing disorders in children 1 hr Lecture
1. Scope of Pediatrics, learning objective and familiarization with the teaching schedule.
18. Nephrotic Syndrome 1 hr Lecture
2. History - I (Schema and reasons for history taking - including present, past and family).
19. Nephritis - AGN. 1 hr Lecture
3. History taking -II (Antenatal, natal, postnatal, development, immunization and nutrition).
4. Normal development. 20. Approach to anemia in infancy & childhood 1 hr Lecture
5. General physical examination including anthropometry and head to toe examination.
21. Approach to URTI & Bronchiolitis. 1 hr Lecture
Case discussion in ward with emphasis on history, general physical and systemic examination and
demonstration of anthropometric techniques, during next one week. 22. IMNCI Programme 1 hr Lecture
Assessment (End of Posting): Pediatric history taking and examination skills especially anthropometry.
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Clinical Training in 6th and 7th Semesters TOPICS AND THEIR ALLOCATED CLOCK HOURS

At the end of these two semesters, the learner should be able to : 8th and 9th Semester
1. Take a detailed pediatric history. Sl. Hours of Mode of
Topics
2. Conduct physical examination of children (General and Systemic) in detail. No teaching teaching
1. Low birth weight babies & Prematurity 1 hr Lecture
3. Perform anthropometry and interpret growth of the child in detail.
4. Perform developmental assessment of a child in detail. 2. Respiratory Distress Syndrome 1 hr Lecture
5. Distinguish between normal newborn babies and those requiring special care (including 3. Meconeum aspiration Syndrome 1 hr Lecture
low birth weight and preterm). Care of newborn at birth and those admitted to neonatal 4. Approach to neonatal respiratory distress 1 hr Lecture
care ward.
5. Birth asphyxia including Birth injuries & its management 1 hr Lecture
6. Counseling for breastfeeding/infant feeding.
6. Jaundice in the newborn 1 hr Lecture
Clinical Posting 7. Neonatal infections including sepsis 1 hr Lecture
Clinical demonstration - newborn (for 1 week) 8. Neonatal convulsions 1 hr Lecture
1. Neonatal history taking. 9. Neonatal hypoglycemia and hypocalcemia 1 hr Lecture
2. Newborn - Nomenclature and assessment of gestational age. 10. Approach to intrauterine infections 1 hr Lecture
3. Care of normal newborn at birth. 11. Congenital hypothyroidism and newborn screening 1 hr Lecture
4. Examination of newborn. 12. Acute liver failure including viral hepatitis 1 hr Lecture
5. Breastfeeding.
13. Chronic liver disease 1 hr Lecture
6. Identification of sick newborn (common danger signs).
14. Leukemia & Lymphoma 1 hr Lecture
7. Low birth weight including temperature regulation and asepsis.
15. Bleeding and coagulation disorder with special focus on
1 hr Lecture
hemophilia
• One day of the posting should be for immunization related services
16. Immune Thrombocytopenic Purpura 1 hr Lecture
• Pediatrics Case discussion - History taking and examination for 3 weeks in wards.
17. PALS – followed by shock management in Integrated
• Assessment (End of Posting): Emphasis on detailed history, physical examination, interpretation 1 hr Lecture
class
and correlation of abnormal physical findings and normal newborn to establish a clinical diagnosis
18. Approach to Congenital Acyanotic Heart Disease 1 hr Lecture
or differential diagnosis.
19. Approach to Congenital Cyanotic Heart Disease 1 hr Lecture
20. Approach to Rheumatic Heart Disease 1 hr Lecture
21. Congestive Cardiac Failure 1 hr Lecture
22. Urinary Tract Infection 1 hr Lecture
23. Acute Bacterial Meningitis 1 hr Lecture
24. Tubercular Meningitis 1 hr Lecture
25. Febrile Seizure & Status Epilepticus 1 hr Lecture
26. Acute Encephalitis Syndrome 1 hr Lecture

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27. Neurodegenerative disease & Neurocutaneous syn- Assessment (End of Posting)

1 hr Lecture
dromes
• Pediatric long case discussion - 50%.
28. Common genetic disorders - Down and Turners syn-
1 hr Lecture • Viva on instruments - X-ray / OSCE - 25%.
drome
29. Approach to IEM(Inborn Errors of Motabolism) 1 hr Lecture • Newborn - 25%.

30. Common poisonings in children and its management 1 hr Lecture TOPICS FOR INTEGRATED SEMINARS / TUTORIALS
31. Approach to Polyarthritis 1 hr Lecture 8th and 9th Semester
32. Approach to child with fever 1 hr Lecture
Sl. Hours of Mode of
33. Approach to child with shock 1 hr Lecture Topics Integrating Departments
No Teaching teaching
34. Approach to child with exanthematous fever 1 hr Lecture 1. Fluid & Electrolyte balance -
35. Approach to abdominal symptoms 1 hr Lecture Common dyselectrolytemia and 2 hours Nephrology Seminar
36. Approach to rickets 1 hr Lecture its management
37. Pediatric drug, dosage and rational drug therapy 1 hr Lecture 2. OBG, Neonatology, Integrated
Cerebral Palsy 2 hours
38. Approach to pubertal disorder 1 hr Lecture PMR, Eye, ENT session
39. Obesity - the new epidemic in children 1 hr Lecture 3. Convulsions including status
Integrated
epilepticus & its management 2 hours Neurology, Psychiatry
session
Clinical Training in 8th and 9th Semesters including AED
4. Approach to cholestatic jaundice 2 hours Pediatric Surgery, Integrated
At the end of these two semesters, the learner should be able to: Pathology session
5. Shock and anaphylaxis 2 hours Physiology, Integrated
1. Take detailed pediatric history, conduct an appropriate physical and developmental
Pharmacology session
examination of children including neonates, make clinical diagnosis, conduct common
6. Hypertension Integrated
bedside examinations, interpret common laboratory investigations and plan and institute 2 hours Medicine, Pharmacology
(Pediatric and Adult) session
therapy.
7. Diabetes Mellitus Integrated
2. Recognize emergencies including neonatal resuscitation and CPR and care to be instituted 2 hours Medicine, Pharmacology
(Pediatric & Adult) session
and relevant procedures performed. 8. Hypothyroidism Integrated
2 hours Medicine, Pharmacology
3. Prepare oral rehydration solution, perform tuberculin test and administer vaccines. (Pediatric & Adult) session
9. Acute Renal failure Integrated
4. Describe methods of diagnostic and therapeutic procedures such as intravenous access, 2 hours Medicine, Nephrology
(Pediatric & Adult) session
nasogastric feeding, venesection, pleural tap, ascitic tap, bone marrow aspiration, lumbar
10. Chronic Renal failure Integrated
puncture, liver and kidney biopsy, with understanding on the preparatory and post procedures 2 hours Medicine, Nephrology
(Pediatric & Adult) session
measures if any.
11. Tuberculosis (Pediatric & Adult) 2 hours Pulmonary Medicine Integrated
Clinical posting (4 weeks) session
12. HIV infection 2 hours Medicine Integrated
1. Bedside Demonstration (9.00 AM to 12.00 Noon) (at least 1 week of the 4 week posting to session
be in newborn wards) in wards and Outpatient department from 9.00 AM to 12.00 Noon. 13. Poliomyelitis and AFP surveillance 2 hours CMFM Integrated
2. Outpatient department visit at least once a week. session
3. Case discussion. 14. Vital Statistics including National Integrated
2 hours CMFM
programs in Pediatrics session
4. Clinical tutorials (12-1 PM) - Nutrition tray, demonstration of Instruments, X-ray films and
15. PDD and Learning Disability 2 hours Psychiatry Integrated
Neonatal Resuscitation, Drugs commonly used in Pediatrics, Vaccines in Pediatrics. Respiratory session
devices and their uses.

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16. Puberty, adolescent health issues 2 hours Endocrinology, Integrated 26. Rheumatic fever and heart disease.
and its management including Psychiatry, Gynaecology session
27. Acute respiratory infections including pneumonia and Empyema.
adolescent vaccines
17. Common surgical problems in the 2 hours Pediatric Surgery Integrated 28. Congenital heart disease.
newborn & children session 29. Congestive cardiac failure.
18. Approach to hemolytic anemia 2 hours Hematology Integrated 30. Meningitis.
including Thalassemia and SCD session
19. Pediatric dermatoses 2 hours Dermatology Integrated 31. Bronchial asthma.
session 32. Behavioral disorders.
20. Disorders of Sexual Development 2 hours Pediatric Surgery, Integrated 33. Childhood Tuberculosis.
Endocrinology session
LIST OF TUTORIALS (12 – 1 PM after bed side clinics)
LIST OF CLINICAL CASE TO BE DISCUSSED
1. Anthropometry, Growth Charts and its significance
1. Normal newborn.
2. Nutrition tray and its significance
2. Normal development in child
3. Malnutrition and nutritional rehabilitation
3. Low birth weight babies.
4. Immunization – Schedule and introduction to Vaccines – I
4. Temperature regulation in newborn.
5. Immunization – Vaccines – II
5. Neonatal infections.
6. Emergency Drugs and Medications including IV Fluids, ORS
6. Neonatal respiratory distress.
7. Instruments
7. Jaundice in newborn.
8. Neonatal Resuscitation
8. Malaria and typhoid fever.
9. X rays – Chest
9. Adolescent growth and disorders of puberty.
10. X rays – Limbs, Abdomen, Skull
10. Common exanthematous illness.
11. Respiratory devices and it method of use.
11. Xerophthalmia and Rickets.
12. Basic Pediatric ECG interpretation
12. Protein energy malnutrition.
TOPICS THAT THE STUDENT MUST BE FAMILIAR WITH
13. Fluid and electrolyte imbalance.
List of Instruments
14. Acute diarrhea.
Lumbar puncture needle, liver biopsy needle, bone marrow aspiration, intravenous cannula, Ryle’s
15. Persistent diarrhea.
tube, suction catheter, Foley’s catheter, face mask, nasal prongs, IV drip set, BT set, self-inflating
16. Chronic liver disease. resuscitation bag with face mask and reservoir, tongue depressor, tuberculin syringe, endotracheal
17. Seizure disorders. tube, laryngoscope.
18. Acute flaccid paralysis. X-ray films
19. Cerebral palsy and mental retardation. Pneumonia, Tuberculosis, hilar and parahilar lymphadenopathy, miliary tuberculosis, Congenital
20. Leukemias and Lymphomas. Lobar Emphysema, Pleural effusion, Pneumothorax, Normal thymus, congenital heart disease with
increased and decreased pulmonary vascularity, cardiomegaly, rickets, scurvy, hemolytic anemia,
21. Hemolytic anemias and Thalassemia.
Skull: sutural separation, enlarged sella and raised intracranial tension, intestinal obstruction,
22. Bleeding and coagulation disorders. intestinal perforation.
23. Approach to anemia especially nutritional. Miscellaneous
24. Acute glomerulonephritis and hematuria. Emergency medications, Intravenous fluids, Oral Rehydration Solution (ORS) preparations,
25. Nephrotic syndrome. Vaccines, ECG tracings.
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MODEL QUESTION PAPER SECTION – B

PAEDIATRICS 1. Classify Acyanotic congenital heart diseases. Describe about the clinical manifestation and
management of Ventricular Septal defect (VSD). (2+4+4)
Time: 3 Hrs  Max. Marks: 100
2. Short note on Japanese B Encephalitis vaccine. (5)
Instructions 3. A five year male child presented with convulsion of one hour duration. Outline the management
Answer all the questions. Draw diagram wherever necessary. Use separate answer sheets for both plan in this child. (5)

Section-A & B. 4. Short note on Kangaroo Mother Care (KMC).

SECTION – A 5. What are the principles or laws of growth & development? (5)

1. Kareena, an 18-month-old girl, is brought with complaints of patchy hyperpigmentation, 6. What are the ECG findings of Hyperkalaemia ? Outline the management of Hyperkalaemia.
flaking of skin, apathy and weakness. The parents had given history of recurrent illnesses (2+3)
over the past 8-9 months. They were not sure about her weight gain but feel that the 7. Short note on Idiopathic thrombocytopenic purpura.(5)
child is chubby. On examination she is pale, with sparse hairs over her temples which are
lustreless, with bilateral pitting pedal oedema. Her mid arm circumference is 11cm. The 8. Classify neonatal Hypothermia. How you will manage a case of severe neonatal hypothermia?
other systemic examinations are normal. (2+3)
a. What is your most likely diagnosis and write two differential diagnosis. (1.5) 9. Enumerate the complication of Measles. How you will manage these complications?  (2+3)
b. Write an approach to evaluate this patient. (2.5)
c. How you will manage this child.  (4)
d. Enumerate some new problems you may encounter once you start therapy(2)

2. Discuss briefly the complications you will assess in a child with Down syndrome on regular
follow up with you. (5)

3. Define steroid resistant nephrotic syndrome. Write the management plan for a four-year-old
child diagnosed to have the 1st episode of Nephrotic Syndrome.(1+4)

4. Write short note on clinical picture and management of congenital hypothyroidism (5)

5. Discuss the management of a child with complicated or severe malaria.(5)

6. Write a short note on Rastriya Bal Surekhya Karyakaram (RBSK). (5)

7. What is Hypernatremic dehydration? Enumerate the etiology. How will you manage it? 
 (1+ 2+2)

8. Enumerate the causes of stridor in a 2-year-old child. How will you manage a child with
moderate croup?  (2.5 +2.5)

9. Discuss the dietary management of persistent diarrhoea.  (5)

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This curriculum draws its inspiration from:

Undergraduate MBBS Curriculum, AIIMS New Delhi

Undergraduate MBBS Curriculum, Pondicherry University
MCI Curriculum
Curriculum for Under-Graduate Medical Education in Bangladesh
MSc Medical Humanities Course - Manchester University

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