RAPTI ACADEMY OF HEALTH SCIENCES,

GHORAHI, DANG, NEPAL

BACHELOR OF MEDICINE & BACHELOR OF

SURGERY (MBBS)

INTEGRATED BASIC MEDICAL SCIENCES

CURRICULUM

2024
PREFACE

Rapti Academy of Health Sciences (RAHS), established in 2017 through an Act of the
Parliament of Nepal, is located in Ghorahi, Dang, Nepal. Its mission is to provide
quality health services in the region, produce skilled health professionals, and
conduct research in diverse settings. RAHS is committed to developing
knowledgeable, skilled, and motivated medical graduates who are socially
responsible and dedicated to patient care.

To develop the MBBS curriculum, RAHS formed an MBBS Curriculum Development

Committee comprising five core members. A combined MBBS curriculum workshop
was conducted involving six Academies of Health Sciences. Subsequently, a
Curriculum Development Workshop was held in Kathmandu, engaging various
stakeholders to finalize the document.

The representatives from RAHS who participated in the MBBS Curriculum

Development Workshop included:

 Dr. Bikash Lamichhane, Vice Chancellor

 Professor Shyam Lamsal, Registrar
 Dr. Sagar Panthi, Dean
 Dr. Basant Lamichhane, Associate Professor and Head of the Department of
Gynecology & Obstetrics
 Dr. Suryaman Menyangbo, Associate Professor and Head of the Department
of General Surgery

To further refine the MBBS curriculum, RAHS established a new Curriculum

Committee led by Dr. Sagar Panthi, Dean, as Coordinator. The committee members
include:

 Prof. Dr. Dinesh Kumar Lamsal, Emergency Medicine

 Dr. Niraj Pandey, Head of the Department of Anatomy
 Dr. Kushal Bhattarai, Head of the Department of Biochemistry
 Dr. Nilu Manandhar, Head of the Department of Physiology

RAHS extends its gratitude to all faculty members who contributed to the
development of this curriculum.
 Rapti Academy of Health Sciences (RAHS), Ghorahi,
Dang, Nepal

Vision
RAHS will be a national leader in education, research and patient care, recognized for
supporting and empowering its students and faculty to realize their passion for
discovery, healing, health and life and its ability to transform medical education,
health care and research.
Mission

 To inspire and educate individuals to be exemplary physicians, leaders in

medicine, scholars in discovery, and adopters of innovative technology to
improve the health and well-being of all.
 Patient-centered mission is achieved by outstanding medical care and services,
groundbreaking research, and leading-edge medical and biomedical education
enriched in a diverse population.

Goals

 Excel in medical and biomedical education

 Excel in medical science and healthcare
 Provide outstanding, innovative, patient-centered care while transforming
healthcare delivery
 Achieve a diversified self-sustaining infrastructure to support future operations

Aim
Rapti Academy of Health Sciences (RAHS) has been established by an act of the
Parliament of Nepal with the following major aims:

 To produce qualified manpower in health sciences starting from undergraduate

to postgraduate studies and further.
 To provide quality education.
 To provide high-quality health service to the people of Nepal.
 To conduct research studies in health sciences.
 To expand the specialty health services and research in different parts of the
country.
FEATURES OF CURRICULUM

The curriculum is designed to be:

 Student-centered (focusing on students' learning needs rather than the

teacher's role)
 Problem-based (emphasizing practical problem-solving instead of purely
subject-focused learning)
 Integrated (combining disciplines for a holistic approach rather than teaching
them in isolation)
 Community-oriented (prioritizing community health needs over a strictly
hospital-centered approach)
 Incorporating electives (allowing flexibility and choice rather than adhering
strictly to a standard program)
 Systematic (structured and organized, moving away from the traditional
apprenticeship model)

CURRICULUM OUTLINE

The MBBS curriculum is structured into two parts:

1. Pre-Clinical Sciences (First and Second Year):

The Pre-Clinical Sciences phase encompasses the curriculum for the first and second
years of study. It includes Integrated Pre-Clinical Sciences, Community Medicine, and
an Introduction to Clinical Medicine.

During this phase, students study Anatomy, Biochemistry, Microbiology, Pathology,

Pharmacology, and Physiology. These subjects are taught in an integrated manner and
are interwoven with Community Medicine and Introduction to Clinical Medicine.
Students are also introduced to clinical knowledge and skills through a problem-
solving approach.

2. Clinical Sciences:

The Clinical Sciences curriculum is covered over the remaining two and a half years
and builds on the foundation established in the Pre-Clinical Sciences phase.
BASIC MEDICAL SCIENCES

First Year MBBS

General Concepts in Basic Medical Sciences
Molecular and Cytogenetics
Immune System and Immunology
Autonomic Nervous System
Integumentary System
Musculoskeletal System
Haemopoietic System
Cardiovascular System
Respiratory System
Community Medicine
Introduction to Clinical Medicine (ICM)

Second Year MBBS

Gastrointestinal System
Hepatobiliary System
Renal Electrolyte System
Metabolism and Endocrine System
Reproductive System
Central Nervous System and Special Senses
Community Medicine
Introduction to Clinical Medicine (ICM)
GENERAL CONCEPTS IN BASIC MEDICAL SCIENCES

ANATOMY
Demonstrate normal anatomical position, various planes, relation,
comparison, laterality & movement in our body.
Identify epithelium under the microscope & describe the various types
that correlate to its function.
Describe & identify various types of connective tissue with functional
correlation.
Describe & identify various types of muscle under the microscope
Define neuron and classify neuron on the basis of their structure and
function
Describe composition of bone and bone marrow
Describe parts, blood and nerve supply of a long bone
Enumerate laws of ossification
Describe various types of cartilage with its structure & distribution in body
Describe various joints with subtypes and examples
Explain the concept of nerve supply of joints & Hilton’s law
Classify muscle tissue according to structure & action
Describe the classification of exocrine glands.
Enumerate parts of skeletal muscle and differentiate between tendons and
aponeuroses with examples.

General Embryology
Describe the stages of human life
Explain the terms- phylogeny, ontogeny, trimester, viability
Describe spermatogenesis and oogenesis along with diagrams
Describe the stages and consequences of fertilization.
Describe cleavage and formation of blastocyst
Describe the development of trophoblast.
Describe the process of implantation & common abnormal sites of
implantation.
Describe the formation of extra-embryonic mesoderm and coelom,
bilaminar disc and prochordal plate.
Describe the formation & fate of the primitive streak.
Describe formation & fate of notochord
Describe the process of neurulation
Describe the development of somites and intra-embryonic coelom
Explain embryological basis of congenital malformations, nucleus
pulposus, sacrococcygeal teratomas, neural tube defects
Describe the diagnosis of pregnancy in first trimester and role of
teratogens, alpha-fetoprotein
Describe formation, functions & fate of-chorion: amnion; yolk sac;
allantois & decidua
Describe formation & structure of umbilical cord
Describe formation of placenta, its physiological functions, foetomaternal
circulation & placental barrier
Describe embryological basis of twinning in monozygotic & dizygotic
twins
Describe role of placental hormones in uterine growth & parturition
Explain embryological basis of estimation of fetal age.
Describe various types of umbilical cord attachments
Describe teratogenic influences; fertility and sterility.
Describe various methods of prenatal diagnosis
Describe indications, process and disadvantages of amniocentesis
Describe indications, process and disadvantages of chorion villus biopsy

CONTENTS:
General Anatomy:
Cell divisions, Introduction to anatomy - anatomical positions, planes and
terms.
Bones - classification, functions, development, growth and blood supply
of long bones.
Joints - classification, examples of each variety.
Exocrine glands – classification with examples.
General Histology:
Epithelial tissues - definition, classification, functions.
Connective tissues – classification, functions structural components.
Cartilage - classification, sites of occurrence, nutrition and growth.
Microanatomy of bone.
Muscular tissue – Classification with example.
Nervous tissue- introduction to nervous system, subdivisions
and their functions, neurons- types, structure, nerve fibres,
synapses

General Embryology:
Gametogenesis, Graafian follicle, spermatozoon - structure
Corpus luteum – formation, fate Ovulation, fertilization, implantation
Morula and blastocyst formation Bilaminar embryonic disc
Neurulation, Formation and fate of notochord
Intraembryonic mesoderm and its subdivisions (somites) Ectoderm,
mesoderm, endoderm – derivatives Folding of embryo
Embryonic-period
Placenta--Formation of placenta and chorionic villi, decidua basalis;
features and functions of placenta; placental circulation; abnormalities;
placental barrier; types of placenta.
Umbilical Cord-- Formation of umbilical cord; features of umbilical
cord.
Amniotic Cavity-- Amniotic cavity and membrane; amniotic fluid –
functions, expansions of amniotic cavity and fusion with chorion; chorion
laeve with decidua capsularis; decidua capsularis with parietalis;
obliteration of chorionic and uterine cavities; function of fused foetal
membranes to dilate cervical canal.
Abnormalities; obliteration of chorionic and uterine cavities;
abnormalities of chorion.
Formation of twins and types of twins.
Fetal period
Teratogens and teratology---Genetical and environmental factors as
causative factors for congenital malformations. Mode of actions of
teratogenes and critical periods
Prenatal Diagnosis- methods of prenatal diagnosis. Indications, process
and disadvantages of amniocentesis. Indications, process and
disadvantages of chorion villus biopsy.
PHYSIOLOGY
Introduction and scope of physiology
Functional organization of human body at different levels and function of
different organ-systems of human body.
Body fluid compartments- Classification, composition and its clinical
significance, Measurements of different body fluid compartments.
Functions of electrolytes: Dehydration and over hydration.
Define and explain terminology: Isotonic, hypertonic, hypotonic fluids
Osmotic pressure – crystalloid and oncotic. Osmosis
Cell membrane transport- Define and classify different transport
mechanisms and its Clinical application.
Cell to cell and local communication- different types of inter-cellular
connections and communication, Intracellular mechanism of signal
transduction
Homeostasis: Definition, types, control of internal environment, different
regulatory systems in homeostasis. Principles of control systems – general
characteristics and components of biological control systems, concept of
negative and positive feedback mechanism. Correction, error, gain of
homeostatic control mechanism
Bioelectricity: Terminology – Excitable cells, neurons and muscles and
their excitable properties. Functional anatomy of neurons and neuroglia.
Membrane potential: Resting membrane potential, Nernst equation and
Goldman equation. Action potential - ionic basis of its genesis and
propagation of action potential, refractory period, chronaxie, rheobase,
utilization time, spatial and temporal summation)
Receptor – Classification and functions.
Cutaneous receptors - classification and function, generator potential,
properties and transduction.
BIOCHEMISTRY
Biochemistry & medicine
Molecular logic of life
Cell & cell organelles
Carbohydrates
Amino acids & proteins
Enzymes
Lipids
Nucleotides & nucleic acids
Genes, gene expression & central dogma of molecular biology
General overview of metabolism
Vitamins
Minerals

Biochemistry & Medicine:

Upon completion of this unit, the students should be able to:
Define biochemistry
Explain the scope of biochemistry
Summarize the primary objectives of biochemistry
Identify the key biochemical tools and techniques utilized by biochemists
to achieve the objectives of biochemistry
Explain the interconnections between biochemistry and other biomedical
sciences
Describe the reciprocal relationship between biochemistry and medicine
and vice versa
Illustrate the applications of biochemical investigations in the diagnosis,
monitoring, and treatment of diseases

Molecular Logic of Life:

Upon completion of this unit, the students should be able to:
Define the concept of ‘molecular logic of life’
Explain the fundamental principles underlying the molecular logic of life
Describe the molecular structure of water
List the unique properties of water
Classify the bonds present in biological systems
Summarize the roles and significance of the bonds present in the
biological system
Cell & Cell Organelles:
Upon completion of this unit, the students should be able to:
Define and classify cell
Differentiate between the basic types of cells, i.e., prokaryotic and
eukaryotic cells
Compare the fundamental structural and functional differences between
the prokaryotic and eukaryotic cells
Identify the principal components of an eukaryotic, animal cell
Explain the structure and functions of the cell membrane
Identify various cytoplasmic organelles and explain their structures
Summarize the biochemical functions of major cell organelles
Describe the structure and functions of the nucleus
Carbohydrates:
Upon completion of this unit, the students should be able to:
Define and classify carbohydrates
Define and classify monosaccharides with examples
Define and classify disaccharides, oligosaccharides, and polysaccharides
with examples
Define homopolysaccharides and heteropolysaccharides with examples
Summarize the biomedical importance and clinical significance of key
monosaccharides
Define isomers, and isomerism
Define stereoisomers, focusing on their relevance to monosaccharides
Differentiate between the two types of stereoisomers, enantiomers and
diastereomers, with structural examples from monosaccharides
Define a chiral carbon
Illustrate the concept of chiral carbon using the structure of glucose
Explain ‘D’ and ‘L’ isomerism, using glyceraldehyde as the reference
carbohydrate
Define optical activity, optical isomers, and racemic mixtures with
reference to the monosaccharides
Describe anomerism
Identify the structural differences between alpha and beta anomers
Define mutarotation with examples
Define epimers with examples
Define glycosides glycosidic bonds

Describe the structure, biomedical importance, and clinical relevance of

important disaccharides
Explain the structures of starch and glycogen
Highlighting key structural differences between starch and glycogen
Outline the structures of cellulose and inulin
Discuss the biomedical significance of cellulose and inulin
Explain the structure of proteoglycans
Describe the functions and biomedical importance of proteoglycans
Classify glycosaminoglycans
List the key structural features, functions and biomedical significance of
the glycosaminoglycans
Amino Acids & Proteins:
Upon completion of this unit, the students should be able to:
Define amino acids
Illustrate the general structure of an amino acid
Classify amino acids based on structural characteristics, polarity,
nutritional value, and metabolic fate
Describe the optical properties of amino acids
Explain the acid-base behavior of amino acids
Define the term ‘zwitter-ion’
Describe and interpret the titration curve of an amino acid
Define ‘iso-electric pH’ with reference to the titration curve of an amino
acid
Define peptides
List the biologically active peptides and outline the function of each
Define proteins
Classify proteins based on function, chemical nature and solubility, and
nutritional value
Identify the various levels of protein structure
Define the primary structure of proteins
Define peptide bond
Illustrate the structure of the peptide bond
Describe the properties of the peptide bond
Define ‘Ramachandran’ angles
Explain the significance of the Ramachandran angles
Define secondary structure of proteins with examples
Define alpha-helix as the secondary structural element of protein
List the key features of an alpha-helix
Define beta-pleated sheets as the secondary structural elements of protein
Explain the key features of beta-pleated sheets
Enumerate the types of beta-pleated sheets
Differentiate between parallel and anti-parallel beta-pleated sheets
Compare and contrast between the alpha-helix and beta-pleated sheet
structures
Define loops, turns, and bends as the secondary structural elements of
proteins
Define super-secondary structures with examples
Define motif with examples
Define the tertiary structure of a protein with examples
Explain features of secondary str4ucture of proteins
Define domains with reference to the protein structure
Explain the key characteristics of domains
Differentiate between secondary and tertiary structures of proteins
Define quaternary structure of proteins with examples
Explain the salient features of the quaternary structure of proteins
Define denaturation and coagulation with reference to the protein
structures
Differentiate between denaturation and coagulation
Enzymes:
Upon completion of this unit, the students should be able to:
Define enzymes
Enumerate the general characteristics of enzymes
Classify enzymes with examples emphasizing on the IUBMB classification
system with examples
Enlist the general properties of enzymes
Define active site of an enzyme
Enumerate the various steps that occur at the active site during catalysis
Define activation energy and transition state
Describe the catalytic efficiency of an enzyme
Define enzyme specificity
Explain the types of enzyme specificity with examples
Identify the protein and non-protein components of enzymes
Define holo-enzyme, apo-enzyme, co-factor, co-enzyme, co-substrate, and
prosthetic group
Describe metals as enzyme co-factors with examples
Describe vitamins as co-enzymes with examples
Identify the models that explain the mechanisms of enzyme catalysis
Describe the salient features, advantages and disadvantages of lock-and-
key model of enzyme catalysis
Describer the salient features, advantages, and disadvantages of induced-
fit model of enzyme catalysis
Enumerate the various molecular mechanisms of enzyme catalysis
Describe the key features of catalysis by proximity with examples
Describe the key features of acid-base catalysis with examples
Describe the key features of catalysis by strain with examples
Describe the key features of covalent catalysis with examples
List the factors that influence enzyme activity
Describe the effects of substrate concentration, temperature, and pH on
the velocity of enzyme catalyzed reactions
Explain the basic principle of Michaelis-Menten kinetics, including its
underlying assumptions
Describe the equation of Michaelis-Menten kinetics
Define Michaelis constant (Km) and maximum velocity (Vmax)
Define Km in relation to Vmax and substrate concentration
Describe the Lineweaver-Burk plot, emphasizing on its significance
Describe the advantage of Lineweaver-Burk plot in relation to the
Michaelis-Menten plot
Apply concepts of Km and Vmax to explain the basis of competitive and
non-competitive enzyme inhibitions
Identify the different types of enzyme inhibition
Describe the salient features of different types of enzyme inhibition with
examples
Outline the mechanisms of regulation of enzyme activity
Describe the salient features of different mechanisms of regulations of
enzyme activity with examples
Enumerate the practical applications of enzyme in diagnostics, therapy,
analysis, genetic engineering, and industry with examples
Define plasma functional and non-functional enzymes with examples
Identify the clinical conditions that are associated with elevated plasma
non-functional enzymes
List out clinically important enzymes that are used in relation to disease
characterization
Discuss the clinical significance of clinically important enzymes used in
relation to diseases
Define iso-enzymes
List the characteristics that distinguish different iso-enzymes of an
enzyme
Enumerate the iso-enzyme patterns of key enzymes (lactate
dehydrogenase, creatine kinase, alkaline phosphatase, and acid
phosphatase)
Explain the clinical significance of the iso-enzymes of lactate
dehydrogenase, creatine kinase, alkaline phosphatase, and acid
phosphatase
Outline the diagnostic enzyme patterns in diseases such as myocardial
infarction, liver diseases, muscle diseases, and cancer
Lipids:
Upon completion of this unit, the students should be able to:
Define lipids
List out the general characteristics of lipids based on Bloor’s criteria
Describe the biomedical significance of lipids
Classify lipids with examples
Define simple lipids
Explain the types of simple lipids with examples
Define complex lipids
Describe the types of complex lipids with examples
Define fatty acids
Classify fatty acids based on carbon number, degree of saturation, and
chain length with examples
Describe the system of nomenclature for fatty acids
Identify essential fatty acids
Explain the biochemical basis of the essentiality of essential fatty acids
Outline the functions of essential fatty acids
Describe the deficiency of essential fatty acids, emphasizing on the
biochemical basis of their manifestations
Explain the structural basis of cis-trans isomerism in fatty acids
Describe trans-fatty acids, emphasizing on their adverse effects on health
Describe the structures of phosphatidic acid and phospholipids
Illustrate the structures of glycerophospholipids with examples
Illustrate the structures of sphingophospholipids with examples
Outline the general functions of phospholipids
Describe the structure of glycolipids with examples
Outline the general functions of glycolipids
Describe the general structure of a lipoproteins
Identify various types of lipoproteins
Explain the functions of various types of lipoproteins
Define phospholipase.
List the classes of phospholipases and describe their biomedical
importance
Illustrate the biochemical structures of biological membranes
Explain the arrangement and stability of lipid bilayers, monolayers,
micelles, and liposomes in biological membranes, emphasizing on their
biomedical significance
Outline the structural features and properties of triacylglycerol
Outline the structural features and properties of cholesterol
Nucleotides & Nucleic Acids:
Upon completion of this unit, the students should be able to:
Define nucleic acids
Define deoxyribonucleic acid (DNA) and ribonucleic acid (RNA)
Classify nitrogenous bases with examples
Outline the structural features of purines and pyrimidines
Identify the specific purines and pyrimidines in DNA and RNA
Describe the structural composition of nucleosides and nucleotides
Outline the structural differences between a nucleoside and a nucleotide
List out key modified purines and pyrimidines
Illustrate the structures of modified purines and pyrimidines
Explain the biomedical significance of modified purines and pyrimidines
Define synthetic nucleotide analogs
Describe the clinical applications of synthetic nucleotide analogs
Identify the key characteristics of nucleotides
Describe poly-functionality as a characteristic feature of nucleotides,
emphasizing on their biomedical significance
Describe UV absorption as a characteristic feature of nucleotides,
emphasizing on their biomedical significance
Explain the structure of DNA, emphasizing on the double-helical model
proposed by Watson and Crick
Identify various DNA conformations, emphasizing on their key structural
features
Outline the hierarchical organization of DNA, from DNA double helix to
metaphase chromosome
Describe the structure and function of histone proteins
Differentiate between a DNA and an RNA
Identify the various types of RNA
Describe the structure and function of mRNA, rRNA, tRNA, and small
RNAs
Genes, Gene Expression & Central Dogma of Molecular Biology:
Upon completion of this unit, the students should be able to:
Define central dogma of molecular biology
Define the key elements of central dogma of molecular biology
Define gene and gene expression
Distinguish between gene expression and DNA replication
General Overview of Metabolism:
Upon completion of this unit, the students should be able to:
Define metabolism
Define anabolism and anabolic pathway, catabolism and catabolic
pathway, and amphibolism and amphibolic pathway, with examples
Outline the overview of transport and metabolism of carbohydrates, lipids,
and amino acids across and within organs at the subcellular level
Explain how cells regulate the flux of metabolites through metabolic
pathways
Outline the overview of regulation of substrate movement, storage, and
release in the fed and fasting states
Outline the primary metabolic characteristics (major pathways,
substrates, end products, and key enzymes) of liver, brain, heart, adipose
tissue, muscle, kidney, and erythrocytes
Illustrate the overview of metabolic interconnections between adipose
tissue, liver, and extra-hepatic tissues
Define glycolysis
Define anaerobic and aerobic glycolysis, and differentiate between these
Enumerate the biochemical steps of glycolysis, emphasizing on its
regulated/rate-limiting/committed steps
Explaining the various factors that regulate the rate of glycolysis
Identify the potential fates of pyruvate under aerobic and anaerobic
conditions
Calculate the ATP yields of glycolysis under aerobic and anaerobic
conditions
Describe the reaction catalyzed by the pyruvate dehydrogenase complex
Explain the regulation of pyruvate dehydrogenase complex
Enumerate the biochemical steps of the tricarboxylic acid (TCA) cycle,
emphasizing on its regulated steps
Calculate the ATP yield of TCA cycle
Identify the biochemical significance of the TCA cycle
Describe the anaplerotic role of TCA cycle
Describe TCA cycle as a metabolic hub for carbohydrate, lipid, and
protein/amino acid metabolism
Vitamins:
Upon completion of this unit, the students should be able to:
Define vitamins
Outline the defining characteristics of vitamins
Classify vitamins with examples, emphasizing on their biochemical names
Describe the fat-soluble vitamins (A, D, E, and K) outlining the overview
of their chemical properties, metabolism, biochemical functions, daily
requirements, deficiency manifestations, and potential toxicities
Describe the water-soluble vitamins (C, B1, B2, B3, B5, B6, B7, B9, B12)
outlining the overview of their chemical structures, metabolism,
biochemical functions, daily requirements, deficiency manifestations, and
potential toxicities
Minerals:
Upon completion of this unit, the students should be able to:
Outline the general significance of minerals in biological systems
Classify minerals with examples
Define principal elements and trace elements with examples, highlighting
their key differences
Describe major macro-minerals (calcium, phosphorus, magnesium,
sodium, potassium, chlorine, sulfur), outlining the overview of their
metabolic roles, biochemical functions, daily requirements, deficiency
manifestations, and potential toxicities
Describe essential micro-minerals (iron, copper, iodine, manganese, zinc,
molybdenum, cobalt, fluorine, selenium, chromium), outlining the
overview of their metabolic roles, biochemical functions, daily
requirements, deficiency manifestations, and potential toxicities
MICROBIOLOGY

Historical evolution of microbiology and its pivotal contributions to the

advancement of medical sciences.
Taxonomy and nomenclature of bacteria, fungi, viruses and animal
parasites.
Introduction and General Features of Bacteria, Virus, Fungi and Parasites.
Metabolism, Growth and Multiplication of Bacteria
Microbial Pathogenesis [Host Factors and Agent Factors]
Various Staining methods and culture media used in microbiology.
Normal Flora
Sterilization, Disinfection and Decontamination
Anaerobes And Methods oF Anaerobiosis
Antimicrobial Agents
Laboratory Diagnosis of Bacterial, Viral, Fungal and Parasitic Infections
Bacteriology of Water and Milk
Antimicrobial Resistance, Hospital Acquired Infection and Antimicrobial
Stewardship
Hospital Infection Control Committee and Biomedical Waste
Management

CONTENTS:
Historical Perspectives and Contribution of Microbiology To Medical
Sciences- [History Of Different Scientists and Their Contribution In Field
Of Microbiology- Antonie Van Leuwenhoek, Joseph Lister, Edward
Jenner, Alexender Fleming; Koch Postulates And Koch Phenomenon]
Introduction, Nomenclature and Classification of Microbes- [Differences
Between Prokaryotic and Eukaryotic Cells, Fungi, Bacteria, Viruses And
Parasites; General Characteristics of Bacteria, Fungi, Viruses And
Parasites]
Introduction to Bacteriology [Classification of Bacteria, Morphology Of
Bacteria And Bacterial Spore]
Bacterial Growth Requirements, Bacterial Growth Curve, Metabolism,
Multiplication
Different Staining Techniques and Culture Media Used in Microbiology
Sterilization [Introduction, factors affecting sterilization, different
physical methods of sterilization and their uses]

Different chemical methods of sterilization, uses and their sterilization

control.
Normal Microbial Flora 0f The Body - [Definition, Anatomical
Distributions, Factors Influencing Normal Flora, Beneficial Role and
Harmful Effects]
Gram Positive Cocci- [Types, Morphological Characters, Clinical Diseases,
Laboratory Diagnosis]
Gram Positive Bacilli- [Types, Morphological Characters, Clinical
Diseases, Laboratory Diagnosis]
Gram Negative Cocci- [Types, Morphological Characters, Clinical
Diseases, Laboratory Diagnosis,]
Gram Negative Bacilli [Clinically Important Gram-Negative Bacilli,
Enterobacteriaceae, Pseudomonas, Acinetobacter, Hemophilus, Vibrio
and Remaining Gram-Negative Bacilli]
Principles Of Laboratory Diagnosis of Bacterial Infections- [Specimen
Collection, Storage and Transport, Methods of Diagnosis]
Anaerobiosis: [Definition, Classification and Method of Anaerobiosis and
Anaerobic Culture]
Microbial Pathogenecity [Infection and Their Classification,
Epidemiological Pattern of Infection, Mode of Transmission of
Microorganism, Virulence Factors and Mechanism of Pathogenesis, Host-
Parasite Relationship]
Overview Of Parasites of Medical Importance and Their Identification-
[Introduction, General Characteristics, Classifications Of Medically
Important Parasites and Laboratory Diagnosis]
Overview Of Medically Important Fungi and Their Identification-
[Introduction, General Characteristics, Classifications 0f Medical
Important Fungi and Laboratory Diagnosis]
Overview Of Viruses [General Properties, Classification, replication and
laboratory diagnosis of viruses]
Bacteriophage- [Morphology, Life Cycle, Significance of Phages in
Medical Microbiology, Phage Therapy]
Antimicrobials [Classification, Mechanism of Action of Common
Antibiotics]
Antibiotic Susceptibility Test, Reliability of Tests, Factors Influencing
Susceptibility Tests and Antibiotic Resistance in Bacteria
Hospital Acquired Infections, Antimicrobial Stewardship and Infectious
Waste Management [Introduction, Prevalence, Common Causative
Agents, Source and Mode of Infection, Diagnosis and Control]
PATHOLOGY
Cellular adaptations, cell injury and cell death
Inflammation and Repair
Hemodynamic disorders, Thromboembolism, Shock
Neoplasia
Contents:
Cellular Adaptations:Atrophy, hypertrophy, hyperplasia, metaplasia -
definitions, examples and mechanism
Cell Injury:
Reversible and irreversible - mechanism and changes produced in
different types of degeneration including fatty change in liver and heart
Necrosis - definition, types, examples and morphology
Apoptosis – definition, mechanism, pathways
Differences between necrosis and apoptosis

Pathologic Calcification : Definition, types, mechanism, examples

Inflammation and Repair:
Definition, acute and chronic inflammation: morphological types,
vascular and cellular response, chemical mediators and their role in
inflammation
Granuloma: definition, description, diseases
Wound healing: mechanisms, factors affecting wound healing

Shock, Oedema, Thrombosis, Embolism, Infarction and

Chronic Venous Congestion:
Shock: definition, morphological changes in target organs and
etiopathogenesis.
Oedema: pathogenesis
Thrombosis: types, pathogenesis, morphology, fate of thrombus
Embolism: definition, types, sequelae
Infarction: sites, types, consequences
Chronic venous congestion: gross and microscopic changes in lungs, liver,
spleen
NEOPLASIA:
Definitions of neoplasia: dysplasia, carcinoma in situ and allied
definitions
Benign - malignant neoplasia: differences
Mode of spread of malignant tumors with suitable examples
Histogenetic classification: epithelial, mesenchymal, totipotent
Hallmarks of cancer
Aetiopathogenesis, oncogenesis and clinical presentation of tumors:
benign-malignant
Paraneoplastic syndromes: brief discussion
Laboratory diagnosis of tumors
PHARMACOLOGY
General Pharmacology:
Introduction, Definition and Terminology, Sources of drugs
Dosage forms, Routes of drug administration
Pharmacokinetics:
Absorption: passage across cell membrane, factors affecting absorption,
Bioavailability and bioequivalence
Distribution: protein binding, prolongation of drug action
Metabolism: first pass metabolism (presystemic metabolism), different
phases of metabolism, enzymes induction and enzyme inhibition with
their clinical significance
Excretion: routes of drug excretion, process of drug excretion
Clinical Pharmacokinetics- First and Zero order Kinetics, Clearance,
Plasma half life, dose & doses schedule

Pharmacodynamics:
Principles of drug action, mechanism of drug action, Receptors and
receptor occupation theory, concept of agonists and antagonists
Dose response relationship: dose response curve, potency, efficacy,
therapeutic index,
Combined effect of drugs: Synergism, Antagonism
Interactions- Drug-drug and drug-food interactions in detail
Factors modifying drug action: Discuss in detail
Adverse drug effects: different types of adverse drug reaction, special
forms of drug toxicity,
Rational use of medicine and concept of essential medicines: Discuss in
detail
Pharmacovigilance: (International, National, Regional
Pharmacovigilance centers and their functions)
Drug regulation in Nepal: Discuss briefly
MOLECULAR and CYTOGENETICS

ANATOMY
Describe the various modes of inheritance with examples
Draw pedigree charts for the various types of inheritance & give examples
of diseases of each mode of inheritance
Describe multifactorial inheritance with examples
Describe the genetic basis & clinical features of Achondroplasia, Cystic
Fibrosis, Vitamin D resistant rickets, Hemophilia, Duchene’s muscular
dystrophy & Sickle cell anemia
Describe the structure of chromosomes with classification
Describe the structural and numerical chromosomal aberrations
Explain the terms mosaics and chimeras with example
Describe the genetic basis & clinical features of Down’s syndrome, Edward
syndrome & Patau syndrome
Describe technique of karyotyping with its applications
Describe the Lyon's hypothesis

CONTENTS

Genetic Terms, Symbols Used in Pedigree Chart

Mendelian inheritance (single gene and multifactorial patterns)
Chromatin and Chromosomes (morphology and classification)
Chromosomal aberrations (numerical and structural)
Autosomal disorders of chromosomes (Patau’s, Edward’s, and Down’s
syndromes)
Sex-chromosomal disorders (Turner’s, Klinefelter’s, and Fragile-X
syndromes, metafemales)
Cystic fibrosis

PHYSIOLOGY
Growth and Development
Disorders of Normal Growth
Physiology of Aging
Growth and Development:
Physical growth: prenatal period, birth to puberty, pubertal growth.
Skeletal age and physical maturity
Organ growth: differential growth of specific organs and tissues i.e. brain,
head, lymphoid tissue, visceral, reproductive organs at various ages.
Growth spurts in human life: infancy, late puberty. Growth rates in boys
and girls, mental growth and IQ.
Factors influencing growth: genetic, nutritional, hormonal
Disorders of Normal Growth: Abnormalities of foetal and postnatal
growth Hereditary short stature
Physiology of Ageing: Definition, Changes in various systems and
mechanisms involved. Factors affecting ageing, theories of ageing process
Yoga: Definition, types and different techniques of yoga, Physiological
roles of yoga, changes after yoga

BIOCHEMISTRY
Purine & pyrimidine metabolism
Replication & repair
Gene expression: transcription
Gene expression: translation
Mutation
Regulation of gene expression
Recombinant DNA technology
Human genome project & bioinformatics
Biochemistry of AIDS & cancer
Gene therapy
Purine & Pyrimidine Metabolism:
Upon completion of this unit, the students should be able to:
▪ Outline the biochemical steps of de-novo and salvage pathways of
purine nucleotide synthesis
▪ Identify the key inhibitors of purine nucleotide synthesis and explain
their biomedical significance
▪ Explain the regulation of purine nucleotide synthesis
▪ Outline the biochemical pathway of degradation of purine nucleotides
▪ Discuss the regulation of purine degradation
▪ Discuss about the diagnostic aspects of serum uric acid levels
▪ Describe the disorders of purine metabolism
▪ Outline the biochemical pathway of pyrimidine nucleotides synthesis
▪ Describe the regulation of pyrimidine nucleotides
▪ Outline the biochemical pathway of degradation of pyrimidine
nucleotides
▪ Describe metabolic disorders related to the metabolism of pyrimidine
nucleotide
Replication and Repair:
Upon completion of this unit, the students should be able to:
Define replication
Illustrate semi-conservative replication
Outline the sequence of steps of the replication process in prokaryotes
Define origin of replication
Identify the origins of replication origins in prokaryotes and eukaryote
Describe the process of strand separation
Define replication fork and replication bubble
Identify the proteins involved in strand separation in prokaryotes and
eukaryotes, and enumerate the functions of each
Define DNA supercoils and explain their effects on replication
Classify the types of DNA supercoils
Define and classify topoisomerases
Explain the mechanisms different types of type of topoisomerases use to
manage supercoils
Describe the structural features of DNA polymerase
Classify DNA polymerase
Explain the functions of different types of DNA polymerases in
prokaryotes and eukaryotes
Define leading strand, lagging strand, and Okazaki fragments,
Explain the process of DNA polymerization for both leading and lagging
strands
Define primers and primase
Describe the structure of primase and explain its role in DNA replication
Illustrate the structure of the replication fork, identifying the location and
functions of each component
Define DNA ligase
Explain the role played by DNA ligase during the process of replication
Define telomeres and telomerase
Describe the structure of telomeres and telomerase and outline their
functions
Outline the mechanism of telomerase and discuss the clinical significance
of this enzyme
Compare and contrast the replication processes in prokaryotes and
eukaryotes
Identify the different types of DNA damage
Describe each type of DNA damage in terms of structure of damage and
the specific damaging agents
Define DNA repair and classify DNA repair mechanisms
Explain each type of DNA repair mechanism in terms of the DNA-
damaging agents, DNA lesions, detailed repair mechanisms, and diseases
associated with defective repair pathways
Gene Expression: Transcription:
Upon completion of this unit, the students should be able to:
Define gene and gene expression
Define transcription within the framework of gene expression
Define template strand and coding strand
Describe the structure of RNA polymerase
Identify different types of RNA polymerase in both prokaryotes and
eukaryotes, summarizing the function of each type
Illustrate and explain the steps of the transcription cycle
Define promoter and pre-initiation complex
Identify the base sequences that define the promoter regions in both
prokaryotes and eukaryotes
Explain the mechanisms of chain termination in both prokaryotes and
eukaryotes
Define post-transcriptional modifications
List out the sequence of events involved in the post-transcriptional
modifications of mRNA, tRNA, and rRNA
Define splicing, introns, and exons
Describe the sequence of events involved in the splicing process
Define alternative splicing and explain its biomedical importance
Compare and contrast the process of transcription in prokaryotes and
eukaryotes
Compare and contrast the process of post-transcriptional modifications in
prokaryotes and eukaryotes
Gene Expression: Translation:
Upon completion of this unit, the students should be able to:
Define gene and gene expression
Define translation within the framework of gene expression
Define genetic code and codon
Define and describe the characteristic features of the genetic code with
suitable examples
Define and discuss about initiation and termination codons in protein
synthesis
Define Wobble base pair and summarize the Wobble hypothesis
Enumerate and describe the four key relationships within the Wobble
hypothesis
Enumerate and describe the essential components required for the
process of translation
Illustrate and describe the stages of translations
Enumerate and describe mechanisms of post-translational modifications
Compare and contrast the process of translation in prokaryotes and
eukaryotes
Compare and contrast the process of post-translational modifications in
prokaryotes and eukaryotes
Mutation:
Upon completion of this unit, the students should be able to:
Define mutation and mutagens
Identify and describe the different types of mutagens with relevant
examples
Classify mutations with examples
Define point mutation
Identify and define the different types of point mutation
Describe the clinical consequence of different types of point mutation
Define frame-shift mutation, trinucleotide repeat expansion, and splice
site mutation
Explain the clinical consequences of frame-shift mutations, trinucleotide
repeat expansion, and splice site mutation
Regulation of Gene Expression:
Upon completion of this unit, the students should be able to:
Define gene and gene expression
Define regulation of gene expression
Describe the significance of regulation of gene expression
Classify genes based on their expression profiles
Define housekeeping genes and regulated genes with examples
Identify the types of regulated genes
Define inducible genes and repressible genes with examples
Define positive regulation of gene expression and negative regulation of
gene expression with examples
Define de-repression with examples
Define positive regulators of gene expression and negative regulators of
gene expression with examples
Define de-repressor with examples
Define regulatory sequences and regulatory molecules in the context of
gene expression regulation
Define cis-acting and trans-acting regulators
Identify the types of temporal responses to regulatory signals in gene
expression
Illustrate and discuss the key concept underlying each type temporal
responses to regulatory signals in gene expression with examples of
responsive genes
Outline the key characteristics of prokaryotic gene expression and its
regulatory mechanisms
Define bacterial operon and explain the structure and function of a
bacterial operon
Define cistron and discuss polycistronic mRNA in prokaryotes
Describe the lac operon model
Outline the distinctive features of eukaryotic gene expression and its
regulatory mechanisms
Identify and describe the multiple levels at which eukaryotic gene
expression is regulated (viz., transcriptional, co-/post-transcriptional,
translational, and DNA-level)
Compare and contrast the regulatory processes in prokaryotic and
eukaryotic gene expression
Recombinant DNA Technology:
Upon completion of this unit, the students should be able to:
Define recombinant DNA and recombinant DNA technology
Outline the fundamental principles underpinning recombinant DNA
technology
Explain the technical components of recombinant DNA technology
Identify and describe the applications of recombinant DNA technology in
medicine and research
Discuss essential genetic engineering techniques such as nucleic acid
isolation and purification, nucleic acid blotting, DNA sequencing,
polymerase chain reaction (PCR), production of monoclonal antibodies,
construction of gene libraries, site-directed mutagenesis, and protein
engineering
Define nucleic acid probes
Identify and discuss about the different types of nucleic acid probes
Illustrate the steps and methods for the isolation and purification of
nucleic acids
Human Genome Project and Bioinformatics:
Upon completion of this unit, the students should be able to:
Define Human Genome Project
Explain the overarching significance of Human Genome Project in
modern medicine
Outline the goals, timeline, key milestones and achievements of the
Human Genome Project
Define and explain Sanger sequencing and next-generation sequencing
Describe the application of bioinformatics in processing and analyzing
sequencing data
Define bioinformatics
Explain the significance of bioinformatics in genomic medicine and
research
Identify major bioinformatics databases
Define and discuss about the principles of sequence alignment,
annotation, and data mining within the scope of bioinformatics
Identify commonly used genome analysis tools and outline their
functional relevance
Biochemistry of AIDS and Cancer:
Upon completion of this unit, the students should be able to:
Define HIV and AIDS
Describe the structural features and genomic organization of HIV
Explain the stages of the HIV life cycle
Illustrate the impact of HIV on immune function, particularly on CD4+ T
cells
Describe the strategies HIV employs to evade the host immune response
Discuss the significance of opportunistic infections in the progression to
AIDS
Explain the roles of reverse transcriptase, integrase, and protease in the
HIV life cycle
Outline the biochemical mechanisms underlying HIV-induced cell death
and immune dysfunction
Analyze the role of viral proteins such as gp120, gp41, and Tat in disease
pathogenesis
Explain the biochemical principles behind diagnostic tools like ELISA,
Western blot, and PCR
Discuss the significance of disease progression markers such as viral load
and CD4+ T-cell count
Define tumor and cancer
Explain the biochemical basis of tumorigenesis and carcinogenesis
Differentiate between benign and malignant tumors
Describe the hallmarks of cancer with an emphasis on biochemical
changes
Discuss the roles of oncogenes and tumor suppressor genes in cancer
progression
Explain the biochemical mechanisms behind mutations in key genes like
p53, Rb, and Ras
Describe the role of epigenetic modifications, including DNA methylation
and histone changes, in cancer
Explain the Warburg effect and its relevance to altered cancer cell
metabolism
Describe the changes in glucose, lipid, and amino acid metabolism in
cancer
Discuss how metabolic pathways are targeted for cancer therapy
Illustrate the biochemical processes involved in cancer invasion and
metastasis
Identify key biochemical markers used in cancer diagnosis and
monitoring
Explain the principles behind molecular diagnostic techniques like PCR
and next-generation sequencing (NGS)
Gene Therapy:
Upon completion of this unit, the students should be able to:
Define gene therapy and explain its significance in modern medicine
Summarize the historical development and major milestones in the field
of gene therapy
Discuss about somatic and germline gene therapy
Explain the fundamental principles of gene delivery systems
Identify and discuss about the types of therapeutic genes
Discuss about in vivo and ex vivo gene therapy approaches
Classify gene therapy vectors
Explain the benefits and challenges of viral vectors
Discuss the roles of non-viral delivery methods
Describe the methodologies used in gene editing
Explain the steps involved in introducing therapeutic genes into target
cells
Explain the applications of gene therapy in modern medicine
Identify the current limitations of gene therapy

MICROBIOLOGY
Microbial Genetics
Bacterial Genetics-I [Introduction to Genetic Materials, Mutations And
Repair Molecular Diagnostic Techniques]
Bacterial Genetics-II [Mechanism of Gene Transfer- Transformation,
Transduction And Conjugation]

PATHOLOGY
Genetic disorders: Brief introduction and examples

PHARMACOLOGY
Targeted therapy: Describe in brief
IMMUNE SYSTEM and IMMUNOLOGY
ANATOMY
Describe microanatomy of lymph node, spleen, thymus, and tonsil.
Describe Mucosa Associated Lymphoid follicles/Tissues.
Describe the origin, course, termination, tributaries, and area of drainage
of the thoracic duct.
Describe the gross features and explain the development of the spleen,
tonsils, and thymus.

CONTENTS
Lymphatic System -components
Thoracic duct- origin, course, termination, tributaries & area of drainage
Gross features and development of Spleen, Tonsil and Thymus
Microanatomy of Lymph node, Spleen, Tonsil and Thymus

PHYSIOLOGY
Spleen and Lymph Nodes, Lymph and Tissue Fluids
Immunology- Plasma Cells and Immune Scenario, Immunoglobulins
Innate and acquired immunity
Plasma Cells and Immune Scenario
Spleen and Lymph Nodes: Functions of reticuloendothelial system
Lymph and Tissue Fluids: Formation and functions
Immunology: Introduction. Role of B & T lymphocytes and macrophages
in immunity, Concepts of function of interleukins and complement system
Immunoglobulins: Types, plasma concentration, functions, special
features
Plasma Cells and Immune Scenario: Development, morphology,
functions, antibody production

MICROBIOLOGY
Immunity
Antigens
Antibody
Components And Structure of Immune System
Immune Response
Complement System
Hypersensitivity
Immunological Disorders And Autoimmunity
Vaccine And Immunoprophylactic agents

CONTENTS:

Immunity [Introduction, Basic Concept Role Of Immunity In Health And

Diseases, Mechanism Of Innate, Acquired, Active, Passive Immunity]
Structure of Immune System [Components and their Function]
Antigens [Introduction, Antigenic Specificity, Biological Claasses,
Hapten, Carrier, Epitope, Heterophilic Antigens]
Immunoglobulins [Introduction, Structure, Classes And Functions Of
Immunoglobulin]
Complement System [Properties Of Complement, Component Of
Complement, Complement Pathways, Regulation, Biological Effects]
Cellular Immune Response
Humoral Immune Response
Antigen- Antibody Reactions [Agglutination and Precipitation, Types of
ELISA And Neutralization Test]
Hypersensitivity Reactions-I [Classifications, Mechanisms of Type-I and
Type-II]
Hypersensitivity Reactions-II [Mechanisms of Type-III and IV]
Immunological Disorders & Auto Immunity [Primary, Secondary
Immune Deficiency Diseases, Mechanisms of Autoimmunity,
Autoimmune Diseases],Vaccines And Immunoprophylactic Agents
[Introduction, Basic,Concepts, Types of Vaccines, National Immunization
Schedule Of Nepal]
Transplant Immunology- [Introduction, Classifications, Types of Graft
Rejection and Factors influencing it, Mechanism and Prevention of Graft
Rejection]
PATHOLOGY

Normal immune response

Hypersensitivity reactions
Autoimmune diseases
Immunology of transplantation
Acquired immunodeficiency syndrome (AIDS)
Amyloidosis
Contents:
Normal immune response: Introduction to innate and adaptive immunity
Hypersensitivity reactions: Classification, types, examples
Autoimmune diseases: Mechanism of autoimmunity, general principles
and features of autoimmune diseases, examples
Immunology of transplantation: Mechanism of recognition and rejection
of allografts,
Acquired immunodeficiency syndrome (AIDS): Epidemiology, etiology,
pathogenesis, natural history, clinical features
Amyloidosis: Properties of amyloid protein, pathogenesis and
classification

PHARMACOLOGY
Introduction to immune system
Immunomodulators: Immunostimulants, Immunosupressants
Monoclonal antibodies: Discuss in brief
 AUTONOMIC NERVOUS SYSTEM

ANATOMY
Compare and contrast the sympathetic and parasympathetic nervous
systems
Describe differences between sympathetic and spinal ganglia

PHYSIOLOGY
Organisation of Nervous System
Physiological Role of Autonomic Nervous System
ANS: Functional organization: Explain functional organization- division
and distribution, Transmitters and receptors in ANS, Higher control of
autonomic nervous system, Physiological role of autonomic nervous
system in the control of various body functions.

BIOCHEMISTRY
Neurotransmitters
Neuropsychiatric disorders

Neurotransmitters:
Upon completion of this unit, the students should be able to:
Define neurotransmitters
Outline the important criteria of a neurotransmitter
Classify neurotransmitters with key structural feature of each class and
examples
Describe the basics of synaptic transmission, and neuromuscular
transmission
Outline the critical steps of synaptic and neuromuscular transmissions
Describe the structural, functional and clinical aspects of various
neurotransmitter receptors
Describe the metabolism of acetylcholine
Outline the biological role of acetylcholine
Explain the biochemical basis of organophosphate poisoning and
myasthenia gravis
Describe the metabolism of catecholamines
Outline the biological roles of catecholamines
Explain the diagnostic implications of homovanillic acid, and
vanillylmandelic acid
Describe the metabolism of indolamines
Outline the biological role of indolamines
Define paraneoplastic syndrome, carcinoid tumors, and carcinoid
syndrome
Explain the pathophysiology and diagnostic aspects of carcinoid
syndrome
Describe the metabolism of GABA
Outline the biological role and clinical implications of GABA
Describe the metabolism of nitric oxide
Outline the biological role and clinical implications of nitric oxide
Neuropsychiatric Disorders:
Upon completion of this unit, the students should be able to:
Define neuropsychiatric disorders
Explain the significance of neuropsychiatric disorders in healthcare
Identify major neuropsychiatric disorders
Correlate neurotransmitter imbalances with specific neuropsychiatric
disorders
Explain the role of oxidative stress and mitochondrial dysfunction in
neuropsychiatric disorders
Discuss the role of neurotrophic factors in maintaining neuronal health
and their dysregulation in neuropsychiatric conditions
Understand the genetic and epigenetic factors influencing
neuropsychiatric disorders
Discuss the monoamine hypothesis and the role of serotonin,
norepinephrine, and dopamine in the pathophysiology of depression and
anxiety
Explain the role of hypothalamic-pituitary-adrenal axis dysregulation in
stress-related disorders
Correlate dopamine hyperactivity in the mesolimbic pathway and
hypoactivity in the prefrontal cortex with symptoms of schizophrenia
Discuss the glutamate hypothesis of schizophrenia
Understand the role of ion channel dysfunction and mitochondrial
abnormalities in bipolar disorder
Describe the role of amyloid-beta plaques, tau protein
hyperphosphorylation, and cholinergic deficits in Alzheimer’s disease
Discuss the biochemical basis of oxidative stress and neuroinflammation
in Alzheimer’s disease
Explain the role of dopamine depletion in the substantia nigra and the
basal ganglia in Parkinson’s disease
Discuss the significance of alpha-synuclein aggregation (Lewy bodies)
Explain the biochemical basis of biomarkers used in neuropsychiatric
disorders

PHARMACOLOGY
Introduction to autonomic nervous system
Cholinergic transmission and cholinergic drugs (parasympathomimetic drugs):
Classification, mechanism of action, indications, adverse effects, Drugs for
Myasthenia gravis
Anticholinergic drugs: Classification, mechanism of action, indications, adverse
effects, Treatment of Organophosphorous poisoning
Adrenergic transmission and adrenergic drugs: Classification, mechanism of
action, indications, adverse effects
Adrenergic receptor anatagonists (antiadrenergic drugs): Classification,
mechanism of action, indications, adverse effects
Ganglion stimulants and blockers: Classification, mechanism of action,
indications, adverse effects
MUSCULOSKELETAL SYSTEM

ANATOMY

Upper Limb
Describe attachment, nerve supply & action of pectoralis major and
Pectoralis minor.
Describe the location, extent, deep relations, structure, age changes, blood
supply, lymphatic drainage, microanatomy and applied anatomy of
breast.
Describe development of breast
Describe boundaries and contents of axilla
Describe the origin, extent, course, parts, relations and branches of
axillary artery & tributaries of axillary vein.
Describe, identify and demonstrate formation, branches, relations, area of
supply of branches, course and relations of terminal branches of brachial
plexus.
Describe the anatomical groups of axillary lymph nodes and specify their
areas of drainage
Explain the anatomical basis of clinical features of Erb’s palsy and
Klumpke’s paralysis
Describe, identify and demonstrate the position, attachment, nerve supply
and actions of trapezius and latissimus dorsi.
Describe the arterial anastomosis around the scapula and mention the
boundaries of triangle of auscultation.
Describe the deltoid and rotator cuff muscles
Describe the attachment of serratus anterior with its action and
innervation.
Describe the shoulder joint for– type, articular surfaces, capsule, synovial
membrane, ligaments, relations, movements, muscles involved, blood
supply, nerve supply and applied anatomy.
Describe the muscle groups of upper arm with emphasis on biceps and
triceps brachii.
Describe origin, course, relations, branches (or tributaries), termination
of important nerves and vessels in arm.
Describe the boundaries and contents of cubital fossa. Describe the
important muscle groups of ventral forearm with attachments, nerve
supply and actions.
Describe origin, course, relations, branches (or tributaries), termination
of important nerves and vessels of forearm. Explain anatomical basis of
carpal tunnel syndrome.
Enumerate the small muscles of hand with nerve supply and actions.
Describe the movements of thumb and muscles involved
Describe course and branches of important blood vessels and Nerves in
hand.
Describe fibrous flexor sheaths, ulnar bursa, radial bursa and digital
synovial sheaths
Describe the fascial spaces in the palm and Palmer aponeroses and their
applied aspects.
Describe the important muscle groups of dorsal forearm with
attachments, nerve supply and actions
Describe origin, course, relations, branches (or tributaries), termination
of important nerves and vessels of back of forearm.
Describe the type, articular surfaces, capsule, synovial membrane,
ligaments, relations, movements, blood and nerve supply of elbow joint,
proximal and distal radio-ulnar joints, wrist joint & first Carpometacarpal
joint.
Describe Sterno-clavicular joint, Acromio-clavicular joint,
Carpometacarpal joints & Metacarpophalangeal joint.
Demonstrate surface projection of: Cephalic and basilic vein, Palpation of
Brachial artery and Radial artery.
Identify & demonstrate important bony landmarks of upper limb: Jugular
notch, sternal angle, acromial angle, spine of the scapula, vertebral level
of the medial end, Inferior angle of the scapula.
Describe the development of upper limb

Contents

Upper Limb – Gross Anatomy

Bones: clavicle, scapula, humerus, radius, ulna, carpals and metacarpals
Side determination: parts, immediate relations; capsular attachments and
blood supply of bones. Identification of bones in an articulated hand.
Boundaries, contents, applied aspects of: axilla, cubital fossa, anatomical
snuff box, carpal tunnel.
Axillary lymph nodes:
Subgroups, relations, applied aspects.
Joints:
Types, subtypes, ligaments, movements of sterno-clavicular, acromio-
clavicular joints.
Type and subtypes: capsular attachments, ligaments, movements,
muscles involved, blood supply, nerve supply and applied aspects of:
shoulder joint, elbow joint, radio-ulnar joints, first carpo- metacarpal
joint, wrist joint, carpo-metacarpal joint.

Palm: fascial spaces in the palm and Palmer aponeroses and their applied
aspects. Actions and nerve supply of interossei and lumbricals.
Flexor – extensor compartments: Contents of arm and forearm.
Muscles:
Origin, insertion, nerve supply and actions of Trapezius, Latissimus dorsi,
pectoralis major, pectoralis minor, deltoid, biceps brachii, pronator teres,
supinator, adductor pollicis.
Nerves:
Origin, root value, course, branches, distribution and applied anatomy of
– axillary, radial, median, ulnar nerves.
Brachial plexus: Formation, parts, branches and applied aspects
Arteries:
Origin, course, termination and branches of – axillary, brachial, radial,
ulnar arteries, palmar arches.
Veins:
Formation, tributaries, termination, position, applied anatomy of - basilic,
cephalic, median cubital veins.
Radiological Anatomy--X-rays of shoulder, elbow, and wrist
Surface Anatomy: Acromion process of scapula, medial and lateral
humeral epicondyles, olecranon process of ulna, head of radius bone,
and styloid processes of radius and ulna bones. Brachial, radial, and
ulnar arteries, and superficial and deep palmar arches Cephalic, basilic,
and median cubital vein.

Lower Limb
Describe and demonstrate origin, course, relations, branches (or
tributaries), termination of important nerves and vessels of anterior thigh.
Describe and demonstrate major muscles with their attachment, nerve
Supply and actions.
Describe and demonstrate boundaries, floor, roof and contents of femoral
triangle.
Explain anatomical basis of Psoas abscess & femoral hernia
Describe the adductor canal with its contents.
Describe and demonstrate origin, course, relations, and branches (or
Tributaries), termination of important nerves and vessels of gluteal
region.
Describe anatomical basis of sciatic nerve injury during gluteal
Intramuscular injections
Explain the anatomical basis of Trendelenburg sign.
Describe and demonstrate the hamstrings group of muscles with their
Attachment, nerve supply and actions
Describe and demonstrate the origin, course, relations, and branches (or
Tributaries), termination of important nerves and vessels on the back of
Thigh.
Describe and demonstrate the boundaries, roof, floor, contents and
Relations of popliteal fossa.
Describe and demonstrate the type, articular surfaces, capsule, synovial
membrane, ligaments, relations, movements and muscles involved, blood
and nerve supply, bursa around the hip joint.
Describe dislocation of hip joint and surgical hip replacement.
Describe anatomical basis of complications of fracture neck of femur.
Describe and demonstrate major muscles of anterolateral compartment
of leg with their attachment, nerve supply and actions.
Describe and demonstrate origin, course, relations, branches (or
tributaries), termination of important nerves and vessels of anterior
compartment of leg.
Describe and demonstrate the type, articular surfaces, capsule, synovial
membrane, ligaments, relations, movements and muscles involved, blood
and nerve supply, bursa around the knee joint.
Explain the anatomical basis of locking and unlocking of the knee joint.
Describe knee joint injuries with its applied anatomy.
Explain anatomical basis of Osteoarthritis.
Describe and demonstrate the major muscles of back of leg with their
attachment, nerve supply and actions.
Describe the origin, course, relations, branches (or tributaries),
termination of important nerves and vessels of back of leg.
Explain the concept of “Peripheral heart”.
Describe factors maintaining importance arches of the foot with its
importance.
Explain the anatomical basis of Metatarsalgia & Plantar fasciitis.
Describe the type, articular surfaces, capsule, synovial membrane,
ligaments, relations, movements and muscles involved, blood and nerve
supply of tibiofibular and ankle joint.
Describe the subtalar and transverse tarsal joints.
Describe Fascia lata, venous drainage, Lymphatic drainage, Retinacula &
Dermatomes of lower limb.
Explain anatomical basis of enlarged inguinal lymph nodes, varicose veins
and deep vein thrombosis.
Identify the bones and joints of lower limb seen in anteroposterior and
lateral view radiographs of various regions of lower limb.
Identify & demonstrate important bony landmarks of lower limb: -
Vertebral levels of highest point of iliac crest, posterior superior iliac
spines, iliac tubercle, pubic tubercle, ischial tuberosity, adductor tubercle,
Tibial tuberosity, head of fibula, Medial and lateral malleoli, Condyles of
femur and tibia, sustentaculum tali, tuberosity of fifth metatarsal,
tuberosity of the navicular.
Identify & demonstrate palpation of femoral, popliteal, post tibial, anti
tibial & dorsalis pedis blood vessels in a simulated environment.
Identify & demonstrate Palpation of vessels (femoral, popliteal, dorsalis
pedis, post tibial), mid inguinal point, Surface projection of: femoral
nerve, Saphenous opening, Sciatic, tibial, common peroneal & deep
peroneal nerve, Great and small saphenous veins.
Describe basic concept of development of lower limb.

Contents

Lower Limb – Gross Anatomy

Bones: Hip bone, femur, tibia, fibula, patella, tarsals and metatarsals: Side
determination, parts, immediate relations, capsular attachments, blood
supply.
Identification of bones in an articulated foot.
Boundaries, Contents, applied aspects of: femoral triangle, adductor
canal, popliteal fossa.
Thigh and leg: Compartments and contents. Identification of structures in
gluteal region, dorsum of foot.
Hip joint, knee joint, ankle joint: Type, subtype, capsular attachments,
ligaments, movements-muscles involved, nerve supply, blood supply and
applied aspects.
Arches of foot: Formation, supports, applied anatomy.
Lymph nodes: Inguinal group, popliteal groups – subgroups, afferents,
efferents and applied aspects.
Muscles:
Origin, insertion, nerve supply, actions of: gluteus maximus, gluteus
medius, triceps surae, biceps femoris, semimembranosus, rectus femoris,
adductor magnus, popliteus, tibialis anterior and tibialis posterior.
Nerves: Origin, root value, course, branches, applied aspects of: sciatic,
common peroneal (common fibular), tibial, femoral and obturator.
Arteries: Origin, course, branches of: femoral, popliteal, arteria dorsalis
pedis, peroneal(fibular), anterior and posterior tibial, plantar arch.

Veins: Origin, termination, tributaries, applied aspects: long and short

saphenous veins, popliteal, femoral.
Radiological Anatomy
X-rays of hip, knee, and ankle
Surface Anatomy-Anterior superior iliac spine, pubic tubercle, greater
trochanter of femur, adductor tubercle, patella, medial and lateral
malleoli, femoral, popliteal, arterial and posterior tibial, and dorsalis
pedis arteries, long and short saphenous, and femoral veins.

Physiology
Functional organization of striated muscles, Neuromuscular
transmission, Excitation contraction coupling (ECC), Mechanical events
during muscle contraction, Denervated muscle, Types of muscle fibers
Functional organization of striated muscle (Histological and functional
organization): Muscle cell, sarcomere and organization of contractile
proteins and sarcoplasmic reticulum.
Neuromuscular transmission: Structure of neuromuscular junction
(NMJ), motor neuron and motor unit, Synthesis, storage and release of
Ach, Steps in neuromuscular transmission, Concept of end plate potential
and miniature end plate potential, Clinical significance of NMJ disorders.
Excitation contraction coupling (ECC): Sarcotubular system in skeletal
muscle  Concept of E-C coupling  Molecular basis of muscle contraction
and relaxation  Physiological basis of rigor mortis
Mechanical events during muscle contraction: Isotonic and isometric
contraction, effect of two or more stimuli on muscle contrction- titanic
contraction, preload and after load, effect of load on velocity of
contraction, effect of length on tension developed.
Denervated muscle: Neurotropic factor/s and their role in maintenance of
structure and function of the striated muscle (fibrillation and paralysis),
reinnervation, cross innervations, EMG and strength duration curve,
chronaxie and rheobase
Types of muscle fibers: Structural and functional differences between slow
and fast twitch muscle fibers Effect of exercise and training on skeletal
muscle structure and function. Physiological basis of fatigue.
Physiology of smooth muscle: Structure, types, mechanism of contraction
and relaxation, properties of smooth muscle and effect of neural, humoral
and local factors on it.
Physiology of cardiac muscle: Cardiac muscle properties, Contraction and
relaxation mechanism: Sarcotubular system, E-C coupling: source and
role of Ca2+, Comparison among three types of muscles

BIOCHEMISTRY
Muscle: structure & functions
Muscle metabolism

Muscle: Structure and Functions:

Upon completion of this unit, the students should be able to:
Identify the three major muscle types and differentiate between them
based on structural and functional characteristics
Define and describe the structural components of muscle, including A & I
bands, Z line, sarcomere, thick and thin filaments, actin, and myosin
Explain the functional significance of the structural components of muscle
Explain calcium metabolism
Summarize the distribution of calcium in the body
Outline the roles of key hormones in calcium homeostasis
Describe the biochemical basis and pathophysiology of hypocalcemia and
hypercalcemia
Explain the molecular mechanisms of skeletal muscle contraction
Define cross-bridge cycle and power-stroke
Describe the role of calcium in skeletal muscle contraction
Explain the biochemical basis of rigor mortis
Outline the molecular mechanisms underlying smooth and cardiac muscle
contraction
Describe the regulatory processes that control contraction in smooth and
cardiac muscles
Define and classify muscular dystrophies
Describe the pathophysiology, clinical features, and biochemical markers
of various muscular dystrophies
Explain the diagnostic approaches used to identify muscle dystrophies
Muscle Metabolism:
Upon completion of this unit, the students should be able to:
Identify and discuss about the primary sources of ATP for muscle
contraction
Outline the biochemical reactions involved in synthesizing creatine from
its precursors
Explain the formation of creatinine from creatine
Describe the relevance of creatinine in muscle metabolism and clinical
diagnostics
Describe the structure of glycogen
Distinguish between liver glycogen and muscle glycogen
Outline the steps involved in glycogen synthesis and breakdown
Explain the regulation of glycogen synthesis and breakdown
Define and classify glycogen storage diseases
Summarize the clinical and biochemical features of each type of glycogen
storage disease
Differentiate between slow-twitch (red) and fast-twitch (white) skeletal
muscle fibers, highlighting their structural, functional, and metabolic
characteristics

MICROBIOLOGY
Gas Gangrene
Infectious Arthritis
Osteomyelitis

Contents :
Infectious Arthritis – [Causative Organisms, Pathogenesis, Laboratory
Diagnosis]
Osteomyelitis- [Causative Organisms, Acute & Chronic, Pathogenesis and
Laboratory Diagnosis]
Gas Gangrene [ Clostridium Perfringens, Morphology, Pathogenecity,
Laboratory Diagnosis

PATHOLOGY
MUSCULO-SKELETAL SYSTEM
a. Bone

Congenital disorders
Fracture
Osteomyelitis
Metabolic disorders of bone
Paget disease of bone
Bone tumors and tumor like lesions
b. Joints
c. Soft tissue

Tumors
Muscular dystrophies
Polymyositis, Myasthenia gravis
Peripheral nerves
Contents:
a. Bone:
Congenital disorders: Achondroplasia, Osteogenesis imperfecta,
Osteopetrosis
Fracture: Types, morphology of healing, factors delaying the healing
Osteomyelitis: Aetiology, pathogenesis, clinical features and compli-
cations
Metabolic disorders of bone: Osteoporosis - Classification, pathogenesis,
morphology, clinical features
Osteopenia, Osteomalacia and rickets - Classification, pathogenesis,
morphology, clinical features
Paget disease of bone
Bone Tumors and tumor like lesions: Classification, gross and
microscopic features, clinical features and X-ray findings of: Ewing’s
Sarcoma, Giant cell tumor (Osteoclastoma), Osteosarcoma, chon-
drosarcoma
b. Joints:Rheumatoid arthritis, Gout, Osteoarthritis: Aetiopathogenesis,
morphological features and complications

c. Soft Tissue:
Tumors: Lipoma , fibrosarcoma, rhabdomyosarcoma: Gross and
microscopic features
Muscular Dystrophies: Definition, mode of inheritance, clinical features,
morphology and investigations
Polymyositis, Myasthenia gravis
Peripheral nerve sheath tumors: Schwannoma, neurofibroma

PHARMACOLOGY
Nonsteroidal anti-inflammatory drugs: Classification, mechanism of
action, indications, adverse effects
Drugs used for treatment of Rheumatoid arthritis: Classification of drugs,
the mechanism of action, indication, adverse effects
Antigout drugs: Classification of drugs, the mechanism of action,
indication, adverse effects
Antibiotics in reference to bones: Discuss in brief
Treatment of tetanus: Discuss in brief
Skeletal muscle relaxants (Central and peripheral): Classification of
drugs, the mechanism of action, indication, adverse effects
INTEGUMENTARY SYSTEM
ANATOMY
Describe structure & function of skin with its appendages
Describe superficial fascia along with fat distribution in body
Describe modifications of deep fascia with its functions

PHYSIOLOGY
Skin: Functions, Sweat Glands: Types, control of secretion, functions.
Thermoregulation: Mechanism, receptors, hypothalamic thermostat.
Physiological responses on acute exposure to hot and cold environment.
Disorders of thermoregulation - hypothermia, hyperthermia, fever.

BIOCHEMISTRY
Melanin & Albinism:
Upon completion of this unit, the students should be able to:
Describe the biochemical pathway of melanin synthesis
Identify the different types of melanin
Explain the structural and functional differences of different types of
melanin
Outline the physiological functions of melanin
Identify the factors influencing melanin production
Define and classify albinism
Describe the biochemical basis of albinism
Explain the biochemical and molecular diagnostic approaches for
identifying albinism

MICROBIOLOGY

Introduction to Skin infections

Bacterial Skin Infections- Staphylococcus aureus, Bacillus anthracis,
Streptococcus pyogenes, Pseudomonas aeruginosa, Leprosy
Viral Infections of the skin
Fungal Infection of the skin
Parasitic Infection of the Skin
CONTENTS:

Introduction To Skin Infections [Types Of Infections, Common Etiological

Agents, Staphylococcus aureus, Streptococcus pyogenes Its
Complication]
Staphylococcus aureus [ Morphology, Culture, Virulence Factors,
Pathogenecity, Clinical Manifestations, Laboratory Diagnosis]
Streptococcus pyogenes [Morphology, Culture, Virulence Factors,
Pathogenecity, Clinical Manifestations, Laboratory Diagnosis]
Bacillus anthrasis [Morphology, Culture, Pathogenecity, Clinical
Manifestations, Laboratory Diagnosis]
Pseudomonas aeruginosa [Morphology, Culture, Virulence Factors, Risk
Factors, Clinical Manifestations, Laboratory Diagnosis]
Viral Infections Of The Skin [ Varicella Zoster- Clinical Features,
:Laboratory Diagnosis, Viral Exanthematic Diseases]
Leprosy [Mycobacterium Leprae- Morphology, Pathogenecity, Clinical
Classifications, Laboratory Diagnosis, Lepromin Test]
Superficial Mycoses [ Causative Agents, Distribution, Clinical Features
And Laboratory Diagnosis]
Dermatophytosis [Classification, Clinical Features And Laboratory
Diagnosis]
Subcutaneous Mycoses [ Mycetoma, Chromomycosis, Sporothrix
schenkii- Source, Types Of Infection, Clinical Features, Laboratory
Diagnosis]
Dracunculus medinensis- [Introduction, Causative Agents, Morphology,
Clinical Features, Laboratory Diagnosis]
Trichinella spiralis & Larva Migrains- [Introduction, Causative Agents,
Morphology, Clinical Features, Laboratory Diagnosis]
PATHOLOGY
Inflammatory dermatoses
Blistering disorders
Leprosy
Disorders of pigmentation
Epidermal tumors

Contents:
Inflammatory dermatoses
Acute inflammatory dermatoses: Urticaria
Chronic inflammatory dermatoses: Psoriasis, Lichen planus
Blistering disorders
Inflammatory blistering disorders: Pemphigus, bullous pemphigoid
Non-inflammatory blistering disorders: Epidermolysis Bullosa,
porphyria
Leprosy
Classification: Tuberculoid and Lepromatous leprosy
Pathogenesis, immunology, complications, microscopic features and
diagnosis

Disorders of pigmentation
Melanocytic nevus
Melanoma
Epidermal tumors
Squamous papilloma
Squamous cell carcinoma
Basal cell carcinoma

Pharmacology
Anti-leprosy drugs: Classification, mechanism of action, indications,
adverse effects
Drug treatment of scabies: Classification, mechanism of action,
indications, adverse effects
Cutaneous drug reactions: Discuss briefly
HAEMOPOIETIC SYSTEM
PHSIOLOGY
Blood as a Body Fluid: Composition, physical characteristics and
functions of blood. Principles of separation blood constituents,
measurement of volume
Plasma: Composition, Plasma proteins: types, concentrations, properties,
functions, Concept of Starling forces.
Red Blood Cells: Overview of hematopoiesis. Erythrocytes: morphology,
functions, fate, osmotic fragility. Erythropoiesis: definition, stages,
Regulation and the factors affecting of erythropoiesis. Normal count,
PCV, ESR, MCV, MCH, MCHC, fragility, hemolysis, RBC indices and
clinical usefulness.  Destruction of RBCs, physiological basis of hemolytic
jaundice. Anaemia : Physiological basis of causes and treatment, RBC
indices in different types of anemias, Types of polycythemia: polycythemia
or polycythemia vera, secondary polycythemia (secondary
erythrocytosis), Apparent (relative) polycythemia.
White Blood Cells: Leucopoiesis: stages of leucopoiesis  Regulation of
leucopoiesis  Morphology, types and functions of leucocytes: eosinophils,
basophils, neutrophils, monocytes and lymphocytes, Variations in blood
count of eosinophils, basophils, neutrophils, monocytes and lymphocytes
 Concept of phagocytic mechanism, leukemia and its types
Platelets: Thrombopoiesis: developmental stages  Regulation of
thrombopoiesis  Structure and functions of platelets  Normal count &
variations  Role of platelets in hemostasis  Clinical conditions of platelet
dysfunctions
Blood Groups: Agglutinogens, agglutinins, Landsteiner’s law, ABO group,
Rh group. Blood transfusion: relation to blood groups, indications,
hazards. Inheritance, erythroblastosis foetalis, hemolytic disease of the
new-born.
Hemostasis: Introduction to hemostasis  Prevention of blood coagulation
in circulation, Physiology of coagulation – intrinsic and extrinsic
mechanism, clot retraction, fibrinolysis, Hemorrhagic (bleeding)
disorders, tests for clotting. Natural and other anticoagulants.
BIOCHEMISTRY
Hemoglobin: structure & functions
Iron metabolism
Folic acid & vitamin B12 metabolism
Regulation of blood pH: basics
Glycolysis in red blood cells
Pentose phosphate pathway
Plasma proteins
Hemoglobin: Structure & Functions
Upon completion of this unit, the students should be able to:
Explain the structure of porphyrins and heme
Illustrate the biochemical steps involved in the biosynthesis of heme
Explain the regulation of heme biosynthesis
Define and classify porphyrias
Explain the clinical and laboratory presentations of each type of porphyria
Explain the structures of myoglobin and hemoglobin
Differentiate between the structure and function of hemoglobin and
myoglobin
Discuss about the binding of oxygen to hemoglobin
Illustrate and interpret the oxygen-hemoglobin dissociation curve
Explain the factors influencing oxygen affinity
Identify the chromosomal locations of globin genes
Describe the expression profiles of globin genes across different life stages
Identify the different types of hemoglobin based on the expression profiles
of globin genes
Identify and discuss about the different variants of hemoglobin based on
its interaction with CO2, CO, the oxidation state of its iron, etc
Define and classify hemoglobinopathies
Describe the molecular basis of sickle cell anemia and thalassemia
Relate the molecular abnormalities in sickle cell anemia and thalassemia
with their clinical and pathological findings
Describe the laboratory diagnosis of sickle cell anemia and thalassemia
Iron Metabolism
Upon completion of this unit, the students should be able to:
Identify common dietary sources of iron
Specify the recommended daily dietary allowance of iron
Explain the physiological and biochemical functions of iron
Describe the iron metabolism in terms of the processes like absorption,
transport, storage, and excretion of iron in the body
Discuss about the factors influencing iron absorption
Explain the functions of key proteins and transporters, such as transferrin,
ferritin, and ferroportin, in iron metabolism
Define and classify anemia
Explain the biochemical and pathophysiological basis of iron deficiency
anemia
Describe the clinical and pathological picture of iron deficiency anemia
Explain the laboratory diagnosis of iron deficiency anemia
Define hemosiderosis and hemochromatosis
Identify the various types of hemochromatosis based on etiology
Enumerate the clinical features and complications associated with
hemochromatosis
Explain the pathophysiology of iron toxicity in iron overload conditions
Folic Acid & Vitamin B12 Metabolism
Upon completion of this unit, the students should be able to:
Describe the chemical structure of folic acid
Identify the biologically active forms of folic acid
List the dietary sources of folic acid
Specify the recommended daily allowance of folic acid
Explain the absorption, transport, and metabolism of folic acid
Illustrate the biochemical functions of the biologically active forms of folic
acid
Discuss the clinical manifestations of folic acid deficiency
Enumerate the risk factors associated with the deficiency of folic acid
Define folate trap and discuss its biochemical relevance
Explain the FIGLU test, emphasizing on its biochemical basis and its
diagnostic significance
Describe the chemical structure of vitamin B12
Identify the biologically active forms of vitamin B12
Enumerate the dietary sources of vitamin B12
Specify the recommended daily allowance of vitamin B12
Describe the absorption, transport, storage, and metabolism of vitamin
B12
Explain the biochemical roles of vitamin B12
Describe the deficiency manifestations of vitamin B12
Highlight the risk factors contributing to vitamin B12 deficiency

Regulation of Blood pH: Basics

Upon completion of this unit, the students should be able to:
Define acids, bases, pH, acidemia, alkalemia, acidosis, and alkalosis
Enumerate the mechanisms that maintain blood pH
Define buffers
Identify key buffer systems in the body
Describe the biochemical properties and physiological significance of
bicarbonate and phosphate systems
Illustrate the Henderson-Hasselbalch equation and explain the
components of this equation
Using bicarbonate buffer system in the Henderson-Hasselbalch equation,
illustrate the interaction between respiratory and renal components in pH
regulation
Define alkali reserve, anion gap, respiratory acidosis and alkalosis,
metabolic acidosis and alkalosis, and mixed acid-base disturbances.
Outline the levels of compensatory mechanisms for acid-base imbalances
Interpreting the compensatory mechanisms for acid-base imbalances
using the Henderson-Hasselbalch equation for the bicarbonate buffer
Metabolism in Red Blood Cells: Glycolysis
Upon completion of this unit, the students should be able to:
Describe the composition and structure of the red blood cell membrane
Explain the functions of membrane lipids, proteins, and the membrane
skeleton of RBC
Enumerate the fundamental metabolic needs of red blood cells
Identify the pathways in RBC involved in glucose metabolism
Illustrate the biochemical steps of glycolysis, emphasizing on the
specialization of this pathway in RBC
Describe the Rapoport-Luebering shunt and production of 2,3-
bisphosphoglycerate
Explain the biological significance of 2,3-bisphosphoglycerate
Calculate the energy yield of glycolysis in RBC, emphasizing on the
importance of glycolysis as the sole energy source in this cell
Discuss the impact of glycolytic enzyme deficiencies on RBC metabolism,
emphasizing on the pathophysiology of associated hemolytic anemias
Explain the fate of lactate produced during glycolysis in RBC
Metabolism in Red Blood Cells: Pentose Phosphate Pathway
Upon completion of this unit, the students should be able to:
Identify the various metabolic pathways for glucose utilization
Enumerate the primary pathways for glucose oxidation
Illustrate the biochemical reactions of HMP shunt pathway,
differentiating between the oxidative and non-oxidative phases
Explain the regulation of HMP shunt pathway
Interpret the clinical importance of glucose-6-phosphate dehydrogenase
(G6PD)
Illustrate the reaction steps catalyzed by transketolase and transaldolase
Explain the clinical significance of RBC transketolase activity
Identify the metabolic roles of the HMP shunt pathway
Explain the metabolic and cellular functions of NADPH
Describe the pathophysiology of G6PD deficiency
Explain the biochemical basis of chronic granulomatous disease, with an
emphasis on the role associated with NADPH
Plasma Proteins
Upon completion of this unit, the students should be able to:
Define plasma and serum
Enumerate the plasma proteins
Explain the fundamental principles underlying the method for separating
the plasma proteins (electrophoresis)
Identify the various types of plasma proteins based on electrophoretic
separation
Describe the biochemical characteristics, functions, and clinical relevance
of prealbumin, globulins (alpha, beta, and gamma) and fibrinogen
Explain the general functions of plasma proteins
Define the acute phase response and acute phase reactants
List the major acute phase reactants and describe their biochemical
properties, functions, and clinical and diagnostic relevance
PATHOLOGY
Anemia
Hemorrhagic diathesis
Coagulation disorders
Immune thrombocytopenic purpura
Disseminated Intravascular Coagulation
Blood Groups, Blood Banking – Blood Transfusion
Lymphadenitis
Leukemia
Lymphoma
Multiple myeloma
Splenomegaly

Contents:
Anemias
Definition, classification based on aetiology and morphology
Iron deficiency anemia: Aetiology, laboratory diagnosis
Megaloblastic anemia: Aetiology, laboratory diagnosis
Aplastic anemia: Aetiology, laboratory diagnosis
Thalassemia: Aetiopathogenesis, laboratory diagnosis, complications
Sickle cell anemia: Aetiopathogenesis, laboratory diagnosis

Haemorrhagic Diathesis
Basic screening tests, significance of the tests
Coagulation disorders
Hemophilia, Christmas disease
Idiopathic Thrombocytopenic Purpura
Aetiopathogenesis, laboratory diagnosis
Disseminated Intravascular Coagulation
Definition, aetiopathogenesis
Blood Groups, Blood Banking, Blood Transfusion
Blood Grouping and cross matching; Blood transfusion reactions
Lymphadenitis
Definition and causes
Reactive and tuberculous lymphadenitis, Sarcoidosis: Gross and
microscopic features
Leukemia
FAB classification of acute leukemias
Differences between myeloblast and lymphoblast
AML, ALL, CML and CLL: clinical presentations, peripheral blood
smear and bone marrow findings.
Lymphomas
Classification with special reference to ‘Working International
Formulation for Non-Hodgkin’s lymphoma
Hodgkin’s Lymphoma and Non-Hodgkin’s Lymphoma: Gross and
microscopic features

Multiple myeloma
Clinical manifestations, aetiopathogenesis, morphology, laboratory
diagnosis
Splenomegaly
Causes, Morphology; Hyperspleenism

MICROBIOLOGY
Bacteremia, Septicemia, Fungamia, Viremia
Brucellosis, Leptospirosis, Borelliosis
Scrub typhus
Malaria, Filariasis, Kalazar
Dengue And Other Viral hemorrhagic fever
Rest Blood borne Parasites

CONTENTS:

Blood Stream Infections (Bacteremia, Fungaemia, Viremia And

Septicemia)
Brucellosis [Causative Agents, Morphology, Clinical Manifestations,
Laboratory Diagnosis]
Leptospirosis [Causative Agents, Morphology, Clinical Manifestations,
Laboratory Daignosis]
Borreliosis And Plague [Causative Agents, Morphology, Clinical
Manifestations, Laboratory Daignosis]
Scrub Typhus [Causative Agents, Morphology, Clinical Manifestations,
Laboratory Diagnosis]
Dengue Fever [Causative Agents, Morphology, Clinical Manifestations,
Laboratory Diagnosis]
Viral Hemorrhagic Fever [Causative Agents, Morphology, Clinical
Manifestations, Laboratory Diagnosis]
Cytomegalovirus & Epstein Barr Virus [Introduction, Morphology,
Clinical Manifestations, Laboratory Diagnosis]
Ebola virus [Introduction, Morphology, Clinical Manifestations,
Laboratory Diagnosis]
Malaria-I [Morphology, Life Cycles, Pathogenesis]
Malaria-II [Clinical Features, Complications, Laboratory Diagnosis,
Prevention]
Filariasis [Morphology, Life Cycles, Pathogenesis, Clinical Features,
Laboratory Diagnosis, Prevention]
Visceral Leishmaniasis [Morphology, Life Cycles, Pathogenesis,
Clinical Features, Laboratory Diagnosis, Prevention]
Trypanosomiasis [Morphology, Life Cycles, Pathogenesis, Clinical
Features, Laboratory Diagnosis, Prevention]
Toxoplasmosis [Morphology, Life Cycles, Pathogenesis, Clinical
Features, Laboratory Diagnosis, Prevention]
PHARMACOLOGY
Haematinics: Definition, types of hematinics, describe the mechanism of
action, indications and adverse effects
Therapy for anemia: Mention the drugs used for the treatment of anemias.
Disuss the pharmacological management for anemias.
Coagulants: Classification of drugs, the mechanism of action, indication,
adverse effects
Anticoagulants: Classification of drugs, the mechanism of action,
indication, adverse effects, antidotes
Fibrinolytics & Antifibrinolytics: Classification of drugs, the mechanism
of action, indication, adverse effects
Antiplatelet agents: Classification drugs, the mechanism of action,
indication, adverse effect
Therapy for malaria: Classification of antimalarial agents their
mechanism of action, indications, adverse effects, management for
malaria due to plasmodium vivax and plasmodium falcifarum,
Prophylactic regimens for malaria, recent treatment modalities
Therapy for kalazar and filaria: Introduction, describe the drugs used in
detail.
Treatment of malignancies of blood and lymphoid tissues:
Antineoplastic drugs:Introduction,Classification of Anti-neoplastic drugs
and general MOA,ADRs in general and their management
CARDIOVASCULAR SYSTEM
ANATOMY
Describe boundaries and contents of the superior, anterior, middle and
posterior mediastinum.
Differentiate between blood vascular and lymphatic system
Differentiate between pulmonary and systemic circulation
List general differences between arteries & veins
Explain functional difference between elastic, muscular arteries and
arterioles
Describe portal system giving examples
Describe the concept of anastomoses and collateral circulation with
significance of end-arteries
Explain function of meta-arterioles, precapillary sphincters, arterio-
venous anastomoses.
Define thrombosis, infarction & aneurysm
Heart & Pericardium
Describe & demonstrate subdivisions, sinuses in pericardium, blood
supply and nerve supply of pericardium.
Describe & demonstrate external and internal features of each chamber of
heart.
Describe & demonstrate origin, course and branches of coronary arteries.
Describe & demonstrate the formation, course, tributaries and
termination of coronary sinus.
Mention the extent, branches and relations of arch of aorta & descending
thoracic aorta
Mention the parts, position and arterial supply of the conducting system
of heart.
Describe fetal circulation and changes occurring at birth.
Describe embryological basis of:
Atrial septal defect, 2) ventricular septal defect, 3) Fallot’s tetralogy.
Describe developmental basis of congenital anomalies, transposition of
great vessels, dextrocardia, patent ductus arteriosus and coarctation of
aorta.
Mention development of aortic arch arteries, SVC, IVC and coronary sinus
Demonstrate surface marking of heart borders, apex beat & surface
projection of valves of heart.

CONTENTS:
Divisions of Mediastinum and Their Contents
Pericardium: Parts, sinuses, blood supply, nerve supply, lymphatic
drainage, development, applied anatomy.
Heart--Surfaces, borders, positions, relations.
Internal structures: right atrium, right ventricle, left atrium, left ventricle,
interatrial septum - development and anomalies, interventricular septum
- development and anomalies.
Conducting system of heart.

Blood vessels: artery – large & medium size and vein.

Arch of aorta; superior vena cava.
Microscopic structure of heart and blood vessels.
Development of various chambers of the heart.
Development of major arteries and veins.
Congenital anomalies of heart and major vessels.
Foetal circulation and changes at birth.
Blood supply of heart.
Surface Anatomy
Heart, arch of aorta, pulmonary trunk, superior and inferior vena cava,
innominate veins
Radiological Anatomy-X-ray chest A.P. view

PHYSIOLOGY
Heart - a Mechanical Pump: Design of systemic and pulmonary
circulation. Introduction of the terms: pressure, flow, resistance. Types of
blood vessels, their functions, Cardiac autonomic innervations
Properties of Myocardiac Cells: Site of generation of cardiac impulse:
pacemaker tissue, mechanisms of spontaneous generation of impulses,
specialized conducting system, its importance, electrical properties of
working myocardial cells, molecular basis of contraction and excitation,
contraction coupling. All - or - none phenomenon, length-tension
relationships. Frank-Stralings Law, neural influences, effect of Ca2+ ions
and chemicals on myocardial contractility.
Cardiac Cycle: Cardiac events: Mechanical and electrical events, pressure-
volume relationship.
Electrocardiography: Definition, uses, principle, mechanism of ECG wave
generation, ECG recording techniques.
Cardiac Output: Definition, normal values and variations, major
determinants of cardiac output and regulation. Regulation of heart rate
and stroke volume. Fick’s principle and its application.
Haemodynamics of Circulation: Definition of terms – pressure, flow,
resistance, velocity. Laminar flow, turbulent flow, Reynold’s number,
Poiseuille law, factors affecting blood flow and resistance, critical closing
pressure. Local regulation of blood flow to tissues - Neural, humoral and
autoregulation. (role of vasoconstrictors and vasodilators),
Arterial Blood Pressure and Its Regulation: Definition, normal value,
variations, measurement, mean arterial pressure, determinants. Cardio-
vasomotor centers, higher influences Regulation of BP Short term reflex
control - baroreceptors, their significance. Mechanism of reflex control,
its limitations. Role of chemoreceptors, CNS ischemic response Long term
control - Regulation of blood volume and pressure- Role of kidneys ,
RAAS, , ANP ADH, Reabsorption of tissue fluid .
Microcirculation Functional anatomy, mechanism of formation and
absorption of tissue fluid (Starling’s forces) mechanism and routes of
absorption of tissue fluid, Origin of lymphatics, Formation, circulation
and functions of lymph. Edema.
Regional Circulation: Coronary, cerebral, cutaneous, splanchnic, fetal.
Normal values, special features, regulation.
Cardiovascular Changes During Exercise: Cardiovascular changes during
exercise, Beneficial effect of tracing an HR, SV, BP and blood flow in
muscle. Effect of ‘G’ on cardiovascular functions.
Heart Sounds: Normal, Murmurs - origin of systolic and diastolic
murmurs in relation to cardiac cycle and their hemodynamic effects
Arterial Pulse: Normal, abnormal, types, characteristics.
Hypovolemic Shock - Pathophysiology Definition and causes,
compensatory mechanisms – short term and long term. Decompensation
in shock

BIOCHEMISTRY
Fatty acid & triacylglycerol metabolism
Cholesterol metabolism
Ketone body metabolism
Lipoprotein metabolism
Eicosanoids metabolism
Metabolism in the cardiac muscle & cardiac biomarkers

Fatty Acid & Triacylglycerol Metabolism

Upon completion of this unit, the students should be able to:
Define fatty acid synthesis and differentiate it from fatty acid oxidation
Identify the tissues where fatty acid synthesis primarily occurs
Outline the metabolic significance of fatty acid synthesis
Outline the biochemical steps of fatty acid synthesis
Explain the process of citrate transport from mitochondria to the
cytoplasm
Illustrate and explain the carboxylation reaction of acetyl-CoA
Describe the regulation of carboxylation reaction of acetyl-CoA
Illustrate the sequential reactions in the fatty acid synthase complex (with
palmitate as the end product)
Describe the role of reducing equivalents (NADPH) in fatty acid synthesis
and outline its sources
Explain the processes of elongation and desaturation of fatty acids
Discuss the regulation of fatty acid synthesis
Enumerate clinical disorders associated with impaired fatty acid synthesis
Explain the biochemical basis, clinical manifestations, and diagnostic
markers of the disorders of fatty acid synthesis
Describe the structure of triacylglycerol (TAG)
Explain the metabolic functions of TAG
Identify the primary tissues involved with the subcellular locations for
TAG synthesis
Describe the reactions steps involved in TAG synthesis
Describe the regulation of TAG synthesis
Define lipolysis
Describe the reaction steps involved in hydrolysis of TAG
Explain the regulation of lipolysis
Describe the fate of glycerol and free fatty acids released during lipolysis
Correlate the metabolic shifts between TAG synthesis and lipolysis and
vice versa under different metabolic conditions
Discuss the clinical implications of dysregulated TAG synthesis and
lipolysis in various metabolic disorders
Explain the biochemical basis of hypertriglyceridemia and its association
various metabolic disorders
Define fatty acid oxidation
Explain the physiological and metabolic roles of fatty acid oxidation
Enumerate different types of fatty acid oxidation
Define beta oxidation of fatty acids
Outline the steps involved in beta oxidation of saturated fatty acids
Calculate the energy yield from the complete oxidation (beta oxidation) of
a saturated fatty acid, such as palmitic acid
Outline the oxidation of unsaturated fatty acids and odd-chain fatty acids
and describe how this differs from the oxidation of saturated fatty acids
Outline the process of peroxisomal oxidation of fatty acids and
differentiate it from the mitochondrial oxidation
Define α-oxidation and ω-oxidation of fatty acids and identify their
metabolic significance
Explain the regulation of fatty acid oxidation
Identify the various disorders of fatty acid oxidation and describe their
biochemical basis, clinical manifestations and diagnostic features
Cholesterol Metabolism
Upon completion of this unit, the students should be able to:
Describe the structure of cholesterol and its physicochemical properties
relevant to its biological functions
Identify the dietary sources of cholesterol
Illustrate the pathway of cholesterol biosynthesis
Explain the regulation of cholesterol synthesis
Describe the processes of transport and distribution of cholesterol in the
body
Identify the various fates of cholesterol
Define hypercholesterolemia and hypocholesterolemia
Identify various disorders of cholesterol metabolism
Discuss the clinical and biochemical findings and in disorders of
cholesterol metabolism
Interpret the laboratory investigations related to cholesterol levels
Ketone Body Metabolism
Upon completion of this unit, the students should be able to:
Define and list out the ketone bodies
Illustrate the biochemical pathway of ketone body synthesis (ketogenesis)
Explain the regulation of ketogenesis emphasizing on the conditions that
stimulate ketogenesis
Outline the metabolic significance of ketone bodies
Illustrate the biochemical pathway of ketone body utilization (ketolysis)
Discuss the role of the liver in ketone body metabolism
Define ketosis and ketoacidosis
Explain the biochemical basis of diabetic ketoacidosis
Describe the clinical manifestations, laboratory findings for ketoacidosis
Interpret the laboratory tests used to measure ketone levels in blood and
urine
Lipoprotein Metabolism
Upon completion of this unit, the students should be able to:
Define lipoproteins
Describe their general structure of lipoproteins
Define apolipoproteins
Identify different apolipoproteins found in the structure of lipoproteins
and enumerate their functions
Classify lipoproteins
Outline the biochemical functions of each class of lipoproteins
Illustrate the metabolisms of chylomicrons, very low density lipoproteins,
low density lipoproteins, and high density lipoproteins
Define reverse cholesterol transport
Outline the key enzymes and receptors involved in lipoprotein
metabolism
Discuss the clinical significance of abnormalities in lipoprotein
metabolism
Define and classify inherited disorders of lipoprotein metabolism
Explain the biochemical aspects of the pathophysiology of atherosclerosis
and ischemic heart disease
Interpret laboratory findings related to lipid profiles
Eicosanoids Metabolism
Upon completion of this unit, the students should be able to:
Define and classify eicosanoids
Describe the biochemical origin of eicosanoids from arachidonic acid
Explain the release of arachidonic acid from membrane phospholipids
and its regulation
Outline the cyclooxygenase, lipoxygenase and cytochrome P450 pathways
involved in the eicosanoids synthesis
Differentiate between COX-1 and COX-2 enzymes
Describe the roles of eicosanoids in physiological and pathological
processes
Explain the mechanisms of action of prostaglandins, thromboxanes, and
leukotrienes
Interpret laboratory findings related to eicosanoid metabolism and their
diagnostic significance
Metabolism in the Cardiac Muscle & Cardiac Biomarkers
Upon completion of this unit, the students should be able to:
Describe the unique metabolic demands of cardiac muscle
Identify the primary energy substrates for cardiac muscle metabolism
Explain the role of fatty acid β-oxidation for cardiac muscles
Outline the significance of glucose metabolism in cardiac muscles
Discuss the metabolic adaptations of cardiac muscles during various
physiological and pathological states
Define cardiac biomarkers and describe their significance in diagnosing
and monitoring cardiac diseases
Describe the biochemical aspects of myocardial infarction and explain the
basis of re-perfusion injury mediated by the free radicals
List the key cardiac biomarkers
Explain the clinical relevance of each type of cardiac biomarkers in the
context of myocardial infarction, heart failure, and other cardiac disorders
Discuss the emerging cardiac biomarkers and their potential clinical
applications

MICROBIOLOGY
Acute Rheumatic Fever And Rheumatic Heart Disease
Infective Endocarditis
CONTENTS:

Rheumatic Fever And Rheumatic Carditis [Aetiopathogenesis, Clinical

Features, Laboratory Diagnosis]
Infective Endocarditis-I [Classification, Predisposing Factors And
Causative Agents]
Infective Endocarditis- II [ Collection Of Appropriate Specimen,
Laboratory Diagnosis]

PATHOLOGY
Atherosclerosis
Hypertension
Inflammatory disease of blood vessels
Rheumatic heart disease
Infective endocarditis
Myocardial infarction
Cardiomyopathies
Myocarditis
Congestive cardiac failure
Congenital heart disease
Diseases of pericardium
Contents:
Atherosclerosis:Risk factors, aetiopathogenesis, gross and microscopic
features of atheromatous plaques, complications, aneurysms
Hypertension:Definition, classification, aetiopathogenesis,
morphological changes, complications
Inflammatory Disease of Blood Vessels:Thromboangitis obliterans; types
of vasculitis
Rheumatic Heart Disease:Aetiopathogenesis, gross and microscopic
features, complications
Infective Endocarditis:Aetiopathogenesis, gross and microscopic
features, complications
Myocardial Infarction:Aetiopathogenesis, gross and microscopic features,
complications
Cardiomyopathies:Types
Myocarditis:Aetiology, pathology
Congestive Cardiac Failure:Pathophysiology
Congenital Heart Disease:Examples, Fallot’s tetralogy
Diseases of the Pericardium:Acute pericarditis – Aetiology,
pathology
PHARMACOLOGY
Introduction to cardiac physiology
Cardiac glycoside:Source, Chemistry and MOA,Actions and therapeutic
uses, Toxicity, Drug interaction,Treatment of Congestive cardiac failure
Anti-anginal drugs:Pathophysiology of angina, classification of anti-
anginal drugs,Pharmacology of individual agents and toxicity
Anti-arrhythmic drug:Electrophysiology of heart, pathophysiology of
arrhythmic and Classification of anti-arrhythmic drugs
Antihypertensive drugs: Pathophysiology of hypertension,Classification
of drugs used in hypertension,Management of hypertension

Drugs used for Myocardial infarction: definition, Classification,

Mechanism of action, Adverse effects, Contraindications and Therapeutic
Uses.

Therapy of hyperlipoproteinaemias:Classification, Mechanism of action,

Adverse effects, Contraindications, Therapeutic Uses and Drug
interactions
RESPIRATORY SYSTEM

ANATOMY

Thoracic cage
Describe the boundaries of thoracic inlet, cavity and outlet.
Describe extent, attachments, direction of fibers, nerve supply and actions
of intercostal muscles.
Describe origin, course, relations and branches of a typical intercostal
nerve.

Describe & demonstrate features of nasal septum, lateral wall of nose,

their blood supply and nerve supply.
Describe location and functional anatomy of paranasal sinuses and
anatomical basis of sinusitis
Describe the morphology, identify structure of the wall, nerve supply,
blood supply and actions of intrinsic and extrinsic muscles of the larynx
Mention the blood supply, lymphatic drainage and nerve supply of pleura,
extent of pleura and describe the pleural recesses and their applied
anatomy.
Identify side, external features and relations of structures which form root
of lung & bronchial tree and their clinical correlate.
Describe a Broncho-pulmonary segment.
Mention the blood supply, lymphatic drainage and nerve supply of lungs.
Describe the extent, length, relations, blood supply, lymphatic drainage
and nerve supply of trachea.
Describe origin, course, relations, tributaries and termination of superior
venacava, azygos, hemiazygos and accessory hemiazygos veins.
Describe the attachments, openings, nerve supply & action of the
thoracoabdominal diaphragm.
Describe development of pleura & lung.
Demonstrate surface marking of lines of pleural reflection, lung borders
and fissures and trachea.

CONTENTS:
Thoracic Cage
Skeletal framework – Components (thoracic vertebrae, ribs or
costae, and sternum), and congenital and acquired anomalies
Intercostal space: boundaries, contents and applied aspects
Intercostal muscles –Nerve-supply and actions
Intercostal nerves- origin, course, relations and branches of a typical
intercostal nerve
Origin, course and branches/ tributaries of:
1) anterior & posterior intercostal vessels
2) internal thoracic vessels
Origin, course, relations and branches of
1) atypical intercostal nerve
2) superior intercostal artery, subcostal artery
Superior thoracic aperture (thoracic inlet)
Inferior thoracic aperture (thoracic outlet)

Nasal Cavity: Lateral wall of nasal cavity: boundaries, gross

features, blood supply, nerve supply lymphatic drainage,
applied anatomy.
Nasal septum: formation, blood supply, nerve supply, applied
anatomy.
Paranasal Air Sinuses: Names, sites of opening of various air
sinuses and functions. Maxillary air sinus: Boundaries, blood
supply, nerve supply, lymphatic drainage, applied anatomy.
Larynx: Names of cartilages. Names of intrinsic muscles,
innervations and actions. Parts and features of cavity of larynx
with blood supply, nerve supply, lymphatic drainage, applied
anatomy.
Trachea: gross features, relations, blood supply, nerve supply,
applied anatomy.
Pleura: parts, relation, blood supply, nerve supply, applied
anatomy. Pleural recesses
Bronchial tree and bronchopulmonary segments and their
applied anatomy. Bronchi: right & left.
Lungs: Root and hilum of lung, blood supply, nerve supply,
lymphatic drainage and applied anatomy of lungs.
Microanatomy of epiglottis, trachea and lungs.
Development of pleura, lung and bronchial tree.
Diaphragm: Development, attachments, relations, blood-
supply, nerve-supply, applied aspects, and structures passing
through its major openings.
Azygous vein- formation, course, termination & tributaries
Surface Anatomy: Sternal angle, xiphoid process, counting of
ribs Pleura and lungs
Radiological Anatomy: Chest X-rays A.P, P.A & lateral views,
X-rays of skull showing paranasal air sinuses

PHYSIOLOGY

Functional Anatomy of Respiratory System: Overview of respiratory

system, Functional anatomy, composition of air in atmosphere and
alveoli, gas laws
Mechanism and Mechanics of Breathing: Movements of thoracic cage
during respiration. Muscles involved and their nerve supply. Intrapleural,
intrapulmonary pressures and volume changes during inspiration &
expiration. Pressure-volume inter-relationships. Lung compliance,
surfactant, airway resistance. Work of breathing.
Spirometry: Lung volumes – capacities: definitions, normal values,
significance.
Pulmonary Circulation: Functional anatomy, distribution, special features
& factors influencing.
Pulmonary Gas Exchange: Alveolocapillary membranes, diffusion
capacities, partial pressure gradients, factors influencing diffusion of
gases. Measurement of diffusion capacity using carbon monoxide. Applied
physiology – shunt and alveolocapillary block. Ventilation – perfusion
ratio and its importance in respiratory diseases.
Gas Transport: Oxygen transport: factors influencing the combination of
haemoglobin with oxygen. Oxygen dissociation curve: plot, features,
physiological advantage of its shape, factors affecting the shift of curve,
Bohr effect. Carbon dioxide transport: tissue production, carriage in blood
and release at the lungs. Role of red blood cell, chloride shift, role in acid-
base balance, Haldane effect. Carbon monoxide transport and its effects
Regulation of Respiration: Neural regulation: medullary respiratory
centers (DRG & VRG)  Pontine respiratory centres (Apneustic &
pneumotaxic)  Impulses from higher centres (voluntary & limbic control)
Chemical regulation: effect of PO2, PCO2 & H+ concentration on
respiration
Respiration in Unusual Environments: Types of hypoxia, High altitude
hypoxia, Acclimatization, space flight. Deep sea diving – nitrogen
narcosis. Hyperbaric oxygen and oxygen toxicity.
Abnormal Breathing: Abnormal respiratory patterns: Define, provide
features and explain physiological basis of apnea, hyperpnea, tachypnea,
dyspnea, Cheyne-stoke‘s breathing, Biot‘s breathing
Principles of Artificial Respiration: Definition, types, principles,
indications, advantage and disadvantages, Oxygen therapy; respiratory
failure.
Principles of Lung Function Tests and non-respiratory functions of the
respiratory system
Applied respiratory physiology Cyanosis and Asphyxia. Pneumothorax,
Emphysema, Restrictive and Obstructive Pulmonary Diseases.

BIOCHEMISTRY
Biological oxidation and oxidative phosphorylation
Oxidative stress & antioxidant system
Respiratory regulation of acid base balance

Biological Oxidation & Oxidative Phosphorylation:

Upon completion of this unit, the students should be able to:
Define bioenergetics and explain he basic principles of bioenergetics
Define biological oxidation
Explain the significance of biological oxidation in cellular metabolism
Describe the basic principles of oxidation-reduction (redox) reactions and the
concept of electron transfer in biological systems
Describe the types of enzymes catalyzing the biological oxidation reduction
reactions with examples
Define substrate level phosphorylation and oxidative phosphorylation
Define electron transport chain
Identify the sources of electrons that flow through the ETC
Identify the components of electron transport chain in the inner mitochondrial
membrane
Illustrate the flow of electrons through different components of the electron
transport chain
Describe the significance of flow of electrons in the ETC
Define proton motive force and describe its role in generating ATP
Explain the chemiosmotic theory
Illustrate the structure of ATP synthase complex, and outline the sequence of
events taking place at this enzyme
Identify the various inhibitors of ETC and oxidative phosphorylation
Discuss the biochemical consequences of impaired oxidative processes and their
links to metabolic disorders
Oxidative Stress & Antioxidant System:
Upon completion of this unit, the students should be able to:
Define oxidative stress
Explain the role of oxidative stress in cellular damage, emphasizing on the effects
of reactive oxygen species (ROS)
Define and classify reactive oxygen species (ROS)
Describe the formation of ROS in biological systems, emphasizing on the sources
of ROS production
Describe the biochemical mechanisms by which ROS cause cellular damage
Explain the role of oxidative stress in the development of various diseases
Identify the various components of endogenous antioxidant defense system
Explain the roles of various components of endogenous antioxidant defense
system
Describe the laboratory methods used to measure oxidative stress
Discuss the methods used to assess antioxidant capacity
Explain how oxidative stress biomarkers are used in diagnosing and monitoring
diseases associated with oxidative damage
Respiratory Regulation of Acid Base Balance:
Upon completion of this unit, the students should be able to:
Define acid, base, pH, acid-base balance, acidemia, alkalemia, acidosis, and
alkalosis
Describe the role of the respiratory system in maintaining blood pH
Define respiratory acidosis and alkalosis
Describe the underlying causes and pathophysiology of respiratory acidosis and
alkalosis
Explain the compensatory mechanisms of respiratory acidosis and alkalosis
Interpret arterial blood gas (ABG) reports to diagnose respiratory acid-base
disturbances and account for the various levels of their compensation
MICROBIOLOGY
Introduction to Upper And Lower Respiratory Tract Infections
Host Defense, Normal Flora And Laboratory Diagnosis of Respiratory
Tract Infections
Bacterial Respiratory Infections- Streptococcus pyogenes, Streptococcus
pneumoniae, Corynebacterium diphtheriae, Bordetella pertussis,
Mycobacterium tuberculosis, Klebsiella pneumoniae, Mycoplasma
pneumoniae, Legionella pneumophila
Fungal Respiratory Infections- Aspergillosis, Pneumocystis jirovecii,
Cryptococcus neoformans, Histoplasma capsulatum, Zycomycosis
Viral Respiratory Infections- Measles, Mumps, Rubella, Coronavirus,
Adenovirus, Influenza virus, Parainfluenza virus
Parasites as respiratory pathogen- Paragonimus westermani

CONTENTS:

Normal Flora, Host Defense Mechanism And Potential Pathogens Of The

Upper And Lower Respiratory Tract
Streptococcal Pharyngitis [Causative Agents, Morphology, Virulence
Factors, Pathogenesis, Clinical Manifestations, Sequelae, Laboratory
Diagnosis]
Diphtheria [Causative Agents, Morphology, Virulence Factors,
Pathogenesis, Clinical Manifestations, Laboratory Diagnosis]
Bordetella pertussis [Morphology, Virulence Factors, Clinical
Manifestations, Laboratory Diagnosis]
Streptococcus pneumoniae [Causative Agents, Morphology, Virulence
Factors, Clinical Manifestations, Laboratory Diagnosis]
Hemophilus influenzae [Causative Agents, Morphology, Virulence
Factors, Clinical Manifestations, Laboratory Diagnosis]
Pneumonia [Introduction, Classification, Causative Agents And Their
Morphology, Pathogenesis, Clinical Features, Laboratory Diagnosis] (K.
pneumoniae)
Atypical Pneumonia [Introduction, Causative Agents And Their
Morphology, Pathogenesis, Clinical Features, Laboratory Diagnosis]
Tuberculosis [Introduction, Causative Agents, Morphological Features,
Types, Pathogenesis, Clinical, Manifestations, Laboratory Diagnosis,
Treatment]
Atypical Mycobacteria [Morphological Features, Clinical Manifestations,
Laboratory Diagnosis]
Systemic Mycoses [Causative Agents- Histoplasma capsulatum,
Coccidioides imitis, Paracoccidiodes imitis- Morphological Features,
Pathogenesis, Clinical Manifestations, Laboratory Diagnosis]
Cryptococcosis [Morphological Features, Virulence Factors, Risk Factors,
Pathogenesis, Clinical Manifestations, Laboratory Diagnosis]
Aspergillosis [Morphological Features, Virulence Factors, Risk Factors,
Pathogenesis, Clinical Manifestations, Laboratory Diagnosis]
Zygomycosis & Penicilliosis [Morphological Features, Virulence Factors,
Risk Factors, Pathogenesis, Clinical Manifestations, Laboratory
Diagnosis]
Pneumocystis jirovecii [Morphological Features, Risk Factors,
Pathogenesis, Clinical Manifestations, Laboratory Diagnosis]
Influenza Virus And Parainfluenza Virus [Morphology, Classification,
Antigenic Variation, Epidemiology, Pathogenesis, Clinical Features,
Laboratory Diagnosis, Prophylaxis]
Mumps [Morphology, Epidemiology, Pathogenesis, Clinical
Manifestations, Complications, Laboratory Diagnosis, Prophylaxis]
Measles [Morphology, Epidemiology, Pathogenesis, Clinical
Manifestations, Complications, Laboratory Diagnosis, Prophylaxis]
Rubella And Respiratory Syncytial Virus [Morphology, Epidemiology,
Pathogenesis, Clinical Manifestations, Complications, Laboratory
Diagnosis, Prophylaxis]
Coronavirus [Morphology, Epidemiology, Pathogenesis, Clinical
Manifestations, Laboratory Diagnosis, Prophylaxis]
Adenovirus And Rhinovirus [Morphology, Epidemiology,
Pathogenesis, Clinical Manifestations, Laboratory Diagnosis,
Prophylaxis]
Paragonimus westermani [Morphology, Life Cycle, Pathogenesis,
Laboratory Diagnosis]

PATHOLOGY
Lesions of upper respiratory tract
Atelectasis
Bronchial asthma
Bronchiectasis
Hyaline membrane diseases and Adult respiratory distress syndrome
Chronic Obstructive Pulmonary Disease (COPD) and Cor-Pulmonale
Emphysema
Pneumonia
Lung abscess
Tuberculosis
Pneumoconiosis
Tumors of lung
Lesions of pleura

Contents:
Lesions of Upper Respiratory Tract:Nose, nasopharynx: Inflammatory
lesions, tumors,Larynx: Inflammatory lesions, tumors of larynx
Atelectasis:Definition, types, morphology pathogenesis and
complications
Bronchial Asthma:Mechanism and pathogenesis.
Bronchiectasis:Pathogenesis, gross and microscopic features,
complications
Hyaline Membrane Disease and Adult Respiratory Distress
Syndrome:Definition, pathogenesis
Chronic Obstructive Pulmonary Disease and Cor-Pulmonale :Chronic
Bronchitis: Aetiology, gross and microscopic features
Emphysema:Definition, types, pathogenesis
Pneumonia:Types, aetiopathogenesis, stages, complications
Lung Abscess:Aetiopathogenesis, morphology
Tuberculosis:
Aetiopathogenesis, primary complex – definition, Ghon’s focus –
morphology
Secondary tuberculosis - types of lesion
Fibrocaseous, cavitary and miliary tuberculosis
Gross and microscopic features, complications
Pneumoconiosis:Definition, pathogenesis: Anthracosis, asbestosis,
silicosis
Bronchogenic Carcinoma:Aetiology, gross and microscopic features:
Squamous cell carcinoma, adenocarcinoma, small and large cell
carcinomas
Pleural Lesions:Mesothelioma, pleural effusion, pneumothorax

PHARMACOLOGY

Autocoids: Describe about histamines, antihistamines,

prostaglandins,leucotrienes
Cough- Pathophysiology of cough, discuss about the drugs used in cough
Bronchial asthma- Overview, Classification, discuss the drugs individual
drugs. Management of different types of asthma.
Antitubercular drugs: Classification of antitubercular drugs, In detail
about antitubercular drugs, DOTs regimen. Discuss about the National
policies to control tuberculosis.
Chemotherapeutic agents:
Antimicrobial drugs: General considerations
Beta lactams (Penicillins, Cephalosporins): Classification, spectrum of
activity, mechanism of action, mechanism of resistance indication and
adverse effects and drug interactions of penicillins and cephalosporins.
Sulfonamides, cotrimoxazole: Classification, mechanism of
action,indication and adverse effects of sulphonamides. Describe in detail
about cotrimoxazole
Aminoglycosides: Classification, mechanism of action, indication and
adverse effects of aminoglycosides.
Macrolides: Classification, mechanism of action, indication and adverse
effects of macrolides
Tetracyclines, Chloramphenicol and drugs used in Enteric fever
Quinolones and Fluroquinolones: Classification, mechanism of action,
indication and adverse effects.
Drugs used for fungal infection: Classification, mechanism of action,
indication and adverse effects of different classes of antifungal agent.
Antimicrobial resistance: Definition, global impact, mechanism of
antimicrobial resistance, mechanism of resistance, ways to combat
resistance
SECOND YEAR MBBS

GASTROINTESTINAL AND HEPATOBILIARY SYSTEM

ANATOMY

Describe & demonstrate the Planes (transpyloric, transtubercular, subcostal, lateral

vertical, linea Alba, linea semilunaris), regions & Quadrants of abdomen
Describe the Fascia, nerves, blood vessels & muscles of anterior abdominal wall
Describe the formation of rectus sheath and its contents
Describe the extent, boundaries, contents of inguinal canal.Explain the anatomical
basis of inguinal hernia.
Describe the Lumbar plexus for its root value, formation & branches
Describe the 1) morphology, relations, blood supply and applied anatomy of palatine
tonsil 2) composition of soft palate
Describe the components and functions of Waldeyer’s lymphatic ring
Describe & demonstrate the morphology, nerve supply, embryological basis of nerve
supply, blood supply, lymphatic drainage and actions of extrinsic and intrinsic muscles
of tongue.
Describe & demonstrate the external appearance, relations, blood supply, nerve
supply, lymphatic drainage and applied anatomy of esophagus.

Describe the major viscera of abdomen under following headings (anatomical

position, external and internal features, important peritoneal and other relations,
blood supply, nerve supply, lymphatic drainage and applied aspects)

Identify and name the different peritoneal folds and pouches, along with their
explanations.
Mention the clinical importance of Calot’s triangle
Describe & identify the formation, course relations and tributaries of Portal vein,
Inferior vena cava & renal vein
Describe & identify the origin, course, important relations and branches of abdominal
aorta, coeliac trunk, Superior mesenteric, inferior mesenteric & common iliac artery
Explain the areas where portosystemic anastomoses are found.
Embryology/Histology of GIT
Describe the microanatomical features of Gastro-intestinal system: Esophagus,
Fundus of stomach, Pylorus of stomach, Duodenum, Jejunum, Ileum, Large intestine,
Appendix, Liver, Gall bladder and Pancreas.
Describe & identify the microanatomical features of Cardiooesophageal junction.
Describe the development and congenital anomalies of: Foregut, Midgut & Hindgut

CONTENTS:

Regions and quadrants of abdomen Umbilicus: normal position, umbilical hernia

Lumbar vertebrae, sacrum and coccyx, XII rib, and hip bone
Anterior abdominal wall: Flat muscles
Rectus sheath: Formation, boundaries and contents, Rectus abdominis
Inguinal canal: boundaries, contents in males and females, inguinal hernias

Oral cavity:
Teeth: dental formulae, microscopic structure of adult tooth
Palate: development and gross features
Tongue: development, gross features, blood-supply, microscopic structure
Salivary glands: development, gross features, microscopic structure

Pharynx:
Gross features, parts, relations, innervation.

Oesophagus:
Extent, normal constrictions, blood supply, nerve supply, lymphatic drainage,
microscopic structures
Stomach: gross features, relations, blood-supply, nerve-supply,
lymphatic drainage, microscopic structure, applied aspects.

Duodenum: gross features, relations of different parts, blood-supply, nerve-supply,

lymphatic drainage, microscopic structure, applied aspects.

Jejunum and Ileum: gross features, regional differences between jejunum and
ileum, blood-supply, microscopic structure.

Large Intestine: Parts, cardinal features, Differences between small and large
intestines, Blood supply and nerve supply.

Caecum and Appendix: position, gross features, applied aspect, microscopic

structure of appendix
Colon: parts, gross features, nerve supply, blood supply, and lymphatic drainage

Rectum and anal canal: parts, gross features, nerve supply, blood supply, and
lymphatic drainage

Pancreas: Parts, position, relations, blood supply, lymphatic drainage, development,

applied anatomy, microscopic structures.
Posterior abdominal wall: Muscles and fasciae- Thoracolumbar fascia, Abdominal
aorta: Extent and branches, Inferior vena cava: formation and tributaries, Lumbar
plexus: Formation and branches

Gastrointestinal tract: development and congenital anomalies

Surface anatomy: Anterior superior iliac spine, iliac crest, and posterior superior
iliac spine, Stomach, duodenum, pancreas, ileo-caecal junction, caecum, Base of
appendix, and McBurney’s point.

Radiological anatomy of Gastrointestinal System

HEPATOBILIARY SYSTEM

Liver, Gall bladder, Bile duct and Hepato-portal System: Gross features, applied
anatomy,

Microscopic structure - liver and gall bladder.

Hepatobiliary Apparatus: Parts, gross anatomy. Development, congenital anomalies
of hepatobiliary system.
Surface anatomy: Inferior border of liver, fundus of gall bladder

PHYSIOLOGY

Introduction to Gastrointestinal Physiology: Functions of gastrointestinal

system, individual parts, enteric nervous system, innervation of the gut,
regulation of GI function, general overview
Oral Cavity: Salivary secretion – mechanism of formation, composition,
regulation, functions, mastication, digestion in the mouth.
Physiology of Deglutition: Definition, stages, neural control.
Stomach: Overview of functions. Physiology of gastric secretion -
mechanism, composition, functions, control. Experimental procedures to
elucidate phases of gastric secretion. Gastric motility - characteristics,
control, gastric emptying, antral pump mechanism. Gastric mucosal
barrier Digestion & absorption in stomach.
Pancreatic Secretions (exocrine) Composition, Functions, Regulation of
pancreatic juice secretion
Small Intestine: Exocrine and endocrine secretions, their regulation and
functions, movements, functions and their control.
Large Intestine: Movements, functions and control
Gastrointestinal Hormones: Secreto-motor functions of GI hormones
Physiology of Vomiting: Reflex mechanism involved
Defecation: Mechanism, control.
Liver Functions: Carbohydrate, fat & protein metabolism, synthesis of
proteins, and clotting factors, formation of urea, storage. Detoxification of
drugs, hepatic macrophage- defense mechanism, hemolysis of R.B.C.,
endocrine (release of Erythropoietin & thrombopoietin).
Mechanism of Formation of Bile. Bile formation, secretion, regulation &
enterohepatic circulation.
Gall Bladder: Functions. Regulation of gall bladder contraction -
mechanism.
Liver Function Tests: Physiological basis.

BIOCHEMISTRY
Biochemical principles of nutrition
Digestion & absorption of carbohydrates
Digestion & absorption of proteins
Digestion & absorption of lipids
Biochemistry of starvation & obesity

Biochemical Principles of Nutrition:

Upon completion of this unit, the students should be able to:
Identify the major classes of nutrients and outline their biochemical
significance
Identify the proximate principles of diet
Define energy balance
Describe how the body regulates energy intake, expenditure, and storage
Define basal metabolic rate (BMR)
Identify the factors that influence BMR
Discuss the energy expenditure related to BMR
Outline the energy expenditure related to different levels of physical
activity
Define specific dynamic action and respiratory quotient
Define balance diet and describe the principles of balanced diet
Define recommended dietary allowance and explain how this is
determined for different age groups, genders, and physiological states
Define over nutrition
Describe the pathophysiological correlation between over nutrition and
related metabolic diseases
Define malnutrition
Discuss the impact of malnutrition on biochemical pathways,
emphasizing on the protein-energy malnutrition (PEM)
Describe the biochemical methods used for assessing nutritional status
Outline the general management of nutritional disorders and explain the
role of clinical biochemistry in therapeutic dietetics
Discuss the biochemical principles behind therapeutic diets for managing
over nutrition and malnutrition

Hepatobiliary System
Gluconeogenesis,
Glycogen metabolism
Uronic acid pathway
Bile acid metabolism
Bilirubin metabolism & jaundice
Liver function tests
Gluconeogenesis
Upon completion of this unit, the students should be able to:
▪ Define gluconeogenesis and discuss the physiological of
gluconeogenesis
▪ Identify the tissues responsible for gluconeogenesis
▪ Enumerate the various substrates of gluconeogenesis
▪ Illustrate the biochemical steps of gluconeogenesis from lactate
▪ Outline the gluconeogenesis pathways for different substrates
▪ Describe the energetics of gluconeogenesis
▪ Explain the regulation of gluconeogenesis
▪ Define and illustrate the reactions of Cori cycle and glucose-alanine
cycle
▪ Discuss the significance of Cori cycle and glucose-alanine cycle
▪ Explain the integration of gluconeogenesis with other metabolic
pathways
▪ Identify the pathological conditions that impair gluconeogenesis and
explain the biochemical basis of hypoglycemia due to impaired
gluconeogenesis

Glycogen Metabolism
Upon completion of this unit, the students should be able to:
▪ Describe the structure of glycogen
▪ Distinguish between liver glycogen and muscle glycogen
▪ Define glycogenesis and glycogenolysis
▪ Outline the steps involved in glycogenesis and glycogenolysis
▪ Explain the regulations of glycogenesis and glycogenolysis
▪ Define and classify glycogen storage diseases
▪ Summarize the clinical and biochemical features of each type of
glycogen storage disease

Uronic Acid Pathway

Upon completion of this unit, the students should be able to:
▪ Define the uronic acid pathway
▪ Enumerate the metabolic roles of uronic acid pathway
▪ Outline the key biochemical steps of the uronic acid pathway
▪ Explain the regulation of the uronic acid pathway
▪ Discuss the clinical significance of the uronic acid pathway
▪ Identify the diseases associated with abnormalities in the uronic acid
pathway, such as mucopolysaccharidoses
▪ Explain the biochemical basis of diseases associated with
abnormalities in the uronic acid pathway
▪ Describe the diagnostic approaches to identifying diseases associated
with abnormalities in the uronic acid pathway
▪ Relate the uronic acid pathway to other metabolic pathways
Bile Acid Metabolism
Upon completion of this unit, the students should be able to:
▪ Define bile acids and explain their roles in the digestion and absorption
of dietary lipids
▪ Identify various types of bile acids and describe their chemical
structure
▪ Define bile salts and differentiate them physiologically from the bile
acids
▪ Outline the biochemical pathway for bile acids synthesis from
cholesterol and explain how different types of bile acids are formed in
the body
▪ Describe the regulatory mechanisms that control bile acid synthesis
▪ Outline the enterohepatic circulation of bile acids
▪ Discuss the pathophysiology of disorders related to bile acid
metabolism
▪ Identify the clinical features and diagnostic approaches for disorders
related to bile acid metabolism
Bilirubin Metabolism & Jaundice
Upon completion of this unit, the students should be able to:
▪ Describe the structure of bilirubin and correlate with its physiological
state and functions
▪ Illustrate the pathway of synthesis of bilirubin from its precursor
▪ Identify and define the different forms of bilirubin and explain their
clinical significance
▪ Describe the transport of unconjugated bilirubin from the site of its
synthesis to the liver and explain the hepatic uptake of this bilirubin
▪ Explain the reactions accounting for the conjugation of bilirubin in the
liver
▪ Illustrate the secretion of conjugated bilirubin from the hepatocytes
into the bile and its subsequent excretion into the duodenum
▪ Describe the conversion of conjugated bilirubin into urobilinogen in
the gut
▪ Illustrate the enterohepatic circulation of urobilinogen
▪ Outline the further modification of urobilinogen into stercobilin (stool)
and urobilin (urine)
▪ Identify the normal levels of various forms of bilirubin in the blood and
explain the factors that influence this
▪ Define hyperbilirubinemia
▪ Identify the disorders of the bilirubin metabolism and explain the
clinical features and laboratory findings of the disorders of bilirubin
metabolism
▪ Define jaundice, clinical jaundice and latent jaundice
▪ Classify jaundice based on its underlying pathophysiology and based
on the biochemical findings of hyperbilirubinemia
▪ Explain the pathophysiology of various types of jaundice
▪ Outline the clinical features and laboratory findings of each other types
of jaundice
▪ Define physiological jaundice/neonatal jaundice and explain its
biochemical basis
Liver Function Tests
Upon completion of this unit, the students should be able to:
▪ Outline the functions of liver and define liver function tests
▪ Explain the clinical significance of liver functions tests diagnosing liver
diseases
▪ Classify liver function tests into categories based on synthetic,
excretory, and detoxification functions, and the markers of liver
damage
▪ Clinically interpret serum albumin as an indicator of liver synthetic
capacity
▪ Describe the clinical significance of prothrombin time (PT/INR) in
assessing hepatic synthesis of clotting factors
▪ Explain the clinical utility of serum bilirubin levels (total, direct, and
indirect) in assessing liver excretory function
▪ Describe the role of urine bilirubin and urobilinogen levels in
evaluating liver function
▪ Discuss the clinical interpretation of various enzymes used in detecting
cholestasis
▪ Explain the clinical importance of serum ammonia levels as indicator
of detoxification function of the liver
▪ Discuss the clinical significance of various enzymes in the serum in
detecting hepatocellular injury
▪ Clinically Interpret the biochemical/laboratory findings in different
types of liver diseases/jaundice
MICROBIOLOGY
Normal Flora of the gut

Gastrointestinal infections- Diarrhoea, Dysentery, Food Poisoning

Bacterial infection of the gut including Escherichia, Salmonella, Vibrio,

Shigella, Helicobacter, Campylobacter, Clostridium difficile, etc.

Parasitic Infection of the gut including Giardia, Entamoeba, Cestode,

Nematode, Trematodes

Viral Gastroenteritis

CONTENTS:

Normal flora of gastrointestinal tract, pathogens, terminology (diarrhea,

dysentery, food poisoning), laboratory diagnosis

Bacterial Diarrhoea [Causative Agents, Acquisition and Transmission of

Infections, Laboratory Diagnosis]

Diarrhoeagenic Escherichia coli [Morphology, Types, Virulence Factors,

Pathogenesis, Clinical Manifestations, Laboratory Diagnosis]

Vibrio cholerae [Causative Agents, Acquisition and Transmission of

Infections, Laboratory Diagnosis]

Clostridium difficile [Morphology, Risk Factors, Pathogenesis, Clinical

Manifestations, Laboratory Diagnosis]

Helicobacter pylori & Campylobacter jejuni [Morphology, Types,

Virulence Factors, Pathogenesis, Clinical Manifestations, Laboratory
Diagnosis]

Shigellosis [Causative Agents, Mode of Transmission, Virulence Factors,

Pathogenesis, Clinical Manifestations, Laboratory Diagnosis]
Entamoeba histolytica [Morphology, Life Cycle, Pathogenecity,
Laboratory Diagnosis, Complication]

Salmonellosis & Enteric Fever [ Causative Agents, Morphology, Virulence

Factors, Pathogenesis, Clinical Manifestations, Laboratory Diagnosis]

Viral Gastroenteritis [Causative agents, Acquisition and Transmission of

Infections, Laboratory Diagnosis]

Food Poisoning [Bacterial, Viral, Mycotic]

Giardia lamblia [Morphology, Life Cycle, Pathogenecity, Clinical Features,

Laboratory Diagnosis, Prevention, Prophylaxis]

Intestinal Coccidian Parasites- Cryptosporidium parvum, Cyclospora

cayetenensis, Isospora belli [Morphology, Life Cycle, Pathogenesis and
Clinical Features, Laboratory Diagnosis, Prevention]

Taenia solium and Taenia saginata [Morphology, Life Cycle, Pathogenesis

and Clinical Features, Laboratory Diagnosis, Prevention]

Hymenolepis nana [Morphology, Life Cycle, Pathogenesis and Clinical

Features, Laboratory Diagnosis, Prevention]

Diphyllobothrium latum [Morphology, Life Cycle, Pathogenesis and

Clinical Features, Laboratory Diagnosis, Prevention]

Ascaris lumbricoides (Roundworm) [Morphology, Life Cycle,

Pathogenesis and Clinical Features, Laboratory Diagnosis, Prevention]

Enterobius vermicularis (Pinworm) [Morphology, Life Cycle,

Pathogenesis and Clinical Features, Laboratory Diagnosis, Prevention]

Hookworm [Morphology, Life Cycle, Pathogenesis and Clinical Features,

Laboratory Diagnosis, Prevention]

Strongyloides stercoralis [Morphology, Life Cycle, Pathogenesis and

Clinical Features, Laboratory Diagnosis, Prevention]
Trichuris trichuria [Morphology, Life Cycle, Pathogenesis and Clinical
Features, Laboratory Diagnosis, Prevention]

Fasciolopsis buski [Morphology, Life Cycle, Pathogenesis and Clinical

Features, Laboratory Diagnosis, Prevention]

Bacteriology of Milk & Water

Hepatobiliary System

Infective Hepatitis- A, B, C, D, E

Parasitic Infection Of The Liver- Echinococcus granulosus, Chlonorchis

sinensis, Fasciola hepatica

CONTENTS:

1. Hepatitis A and E virus: Morphology, transmission, pathogenesis,

clinical manifestations, laboratory diagnosis.
2. Hepatitis B and D virus: Morphology, transmission, pathogenesis.
3. Hepatitis B and D virus: Clinical manifestations, laboratory
diagnosis.
4. Hepatitis C virus: Morphology, transmission, pathogenesis, clinical
manifestations, laboratory diagnosis.
5. Echinococcus granulosus- [Morphology, Life cycle, Pathogenesis,
Clinical Manifestations, Laboratory Diagnosis]
6. Chlonorchis sinensis- [Morphology, Life Cycle, Pathogenesis and
Clinical Features, Laboratory Diagnosis, Prevention]
7. Fasciola hepatica- [Morphology, Life Cycle, Pathogenesis and
Clinical Features, Laboratory Diagnosis, Prevention]
8. Liver Abscess [Causative Agents, Clinical Manifestation, Laboratory
Diagnosis]
PATHOLOGY
Oral cavity

Salivary glands

Congenital abnormalities of GI tract

Esophagus

Stomach

Small Intestine

Appendix

Large intestine

Pancreas

Contents:
Oral cavity:
Inflammatory / Reactive lesions, infections

Premalignant Lesions: List, morphology

Squamous Cell Carcinoma: Aetiopathology, morphology

Salivary gland:
Sialadenitis

Pleomorphic Adenoma: Gross and microscopic features

Warthin’s tumor: Gross and microscopic features

Mucoepidermoid carcinoma: Gross and microscopic features

Congenital abnormalities of GI tract:

Atresia, fistula, duplications

Diaphragmatic hernia, omphalocele, gastroschisis

Meckel diverticulum

Pyloric stenosis
 Hirschsprung disease

Esophagus:
Achalasia, Esophagitis and related disorders

Barret’s Oesophagus: Definition, mechanism

Carcinoma of the Oesophagus: Aetiopathogenesis, gross and

microscopic features

Stomach:
Gastropathy and acute gastritis, stress related mucosal diseases

Chronic gastritis and its complications: H. pylori gastritis, autoimmune

gastritis

Peptic ulcer disease: Definition and sites of occurrences, pathogenesis,

gross and microscopic features and complications

Hypertrophic gastropathies: Menetrier disease, Zollinger-Ellison

Syndrome

Gastric polyps and tumors: Inflammatory and hyperplastic polyps, Gastric

adenoma and carcinoma: aetiopathogenesis, classification, gross and
microscopic features

Small Intestine and colon:

Malabsorption and diarrhea: Cystic fibrosis, celiac disease

Infectious enterocolitis: Tuberculosis, Typhoid fever,

Pseudomembranous colitis, Whipple disease, Viral gastroenteritis

Irritable bowel syndrome

Inflammatory bowel disease: Crohn disease, Ulcerative colitis

Amoebic Colitis: Aetiology, gross and microscopic features, complications

Necrotizing Enterocolitis: Pathogenesis and morphology

Polyps: Hyperplastic, inflammatory and hamartomatous polyps

Familial adenomatous polyposis, Hereditary non-polyposis colorectal

cancer (HNPCC)
Adenocarcinoma

Hemorrhoids and tumors of anal canal

Appendix:
Appendicitis: Pathogenesis, gross and microscopic features,
complications

Tumors of appendix: Classification

Pancreas:
Pancreatitis: Classification, aetiopathogenesis, morphology and
complications

Tumors of the pancreas: Morphology and complications

HEPATOBILIARY SYSTEM:
Liver and bile duct:
General features of liver disease

Infectious disorders

Fatty liver disease

Inherited liver disease

Cholestatic disease

Nodules and tumors

Gall bladder: Cholelithiasis, cholecystitis, Tumor

LIVER:
General features of liver disease: Mechanism of injury and repair,
Liver failure
Infectious disorders
Viral hepatitis: types, clinicopathologic syndromes
Amoebic liver abscess
Fatty liver disease
Alcoholic liver disease
Nonalcoholic fatty liver disease
Inherited liver disease
Hemochromatosis
Wilson’s disease
Alpha-1 antitrypsin deficiency
Cholestatic disease:
Pathophysiology of hyperbilirubinemia
Physiologic jaundice of newborn
Autoimmune cholangiopathies: primary biliary cholangitis, primary
sclerosing cholangitis
Nodules and tumors: Classification, Hepatocellular carcinoma,
hepatoblastoma: gross and microscopic features

Gall bladder:
Cholelithiasis: Pathogenesis, morphology, complications
Chronic Cholecystitis: Aetiology, gross and microscopic features,
complications
Carcinoma of Gall Bladder: Gross and microscopic features

PHARMACOLOGY
Peptic ulcer- Pathophysiology, drugs used in peptic ulcer, different
regimens for eradication of H. pylori
Therapy for constipation: Describe the drugs used in constipation in
detail, choice and use of purgatives.
Emetics and antiemetics: List emetics, Classify antiemetics, mention the
mechanism of actions, indications, adverse drug effects and
contraindications of major classes of antiemetics
Therapy for diarrhea: Pathophysiology of diarrhea, Rehydration therapy
( Intravenous rehydration therapy, oral rehydration therapy), Drug
therapy in diarrhea, role of probiotics in diarrhea.
Therapy for amoebiasis and giardiasis: Describe in detail about the drugs
used for the management of amoebiasis. Describe the rational for
combining nitroimidazoles and diloxanide furoate in amoebiasis. list the
drugs used in giardiasis
Anthelmintics: Introduction to helminth infections, mechanism of action,
indication, contraindication and adverse effects of antihelmintic agents.
Resistance to antihelmintics
Hepatobiliary System
Describe hepatotoxic drugs in detail.
List the drugs used in obstructive jaundice
List the drugs used in treatment of gall stone disease
RENAL AND ELECTROLYTE SYSTEM
ANATOMY
Describe the major viscera of Urinary system under following
headings (anatomical position, external and internal features,
important peritoneal and other relations, blood supply, nerve
supply, lymphatic drainage and applied aspects).
Describe the microanatomical features of Urinary system
Describe the development of Urinary system
CONTENTS:
Kidneys: development, anterior and posterior
relations of right and left kidneys, vascular segments,
and microscopic structure

Ureters: development, extent, course in males and females,

gross features, and microscopic structure

Urinary bladder: retropubic space (of Retzius), development,

gross features, relations (in males and females), blood supply,
nerve supply, lymphatic drainage, and microscopic structure

Urethra: development, gross features and relations (in

males and females), applied aspects, and microscopic
structure

Surface anatomy: Parallelogram, kidneys and ureters

Radiological anatomy: plain X-rays of KUB region, contrast X-

rays of Intravenous urography.

PHYSIOLOGY
Overview of functional anatomy of kidney:  Functional anatomy of renal
system  types of nephrons, parts of nephrons and their functions  Renal
function  Juxtaglomerular apparatus  histological modification at
different segments of nephron with their functions.
Blood supply of kidney: arrangement of arterial supply & venous drainage
in renal circulation  peculiarities of renal circulation  Mechanism of
regulation of renal blood flow (RBF)  extrinsic mechanism: sympathetic
nervous system, vaso-constrictive humoral agents and vasodilators
Glomerular Filtration: Structure of glomerulus and filtering membranes,
, mechanism of formation and composition of glomerular filtrate, factors
influencing and regulation of GFR, methods of measurement, its
physiological importance, variations.
Tubular Functions: Mechanisms of reabsorption, secretion of electrolytes
and other substances in various segments of nephrons. Role of hormones
in their absorption & secretion.
Countercurrent mechanism, generation of medullary osmotic gradient.
Mechanism of formation of acidic & alkaline urine. Water excretion –
mechanisms of concentration, dilution, water diuresis.
Micturition: Definition. Nerve supply of urinary bladder and its control.
Micturition reflex and its higher neural control
Renal Function Tests: Physiological basis.
Explain cystometrogram

BIOCHEMISTRY
Renal regulation of acid base balance
Water & electrolyte balance
Kidney function tests
Amino acid metabolism: basics
Urea cycle

Renal Regulation of Acid Base Balance:

Upon completion of this unit, the students should be able to:
Define acid, base, pH, acid-base balance, acidemia, alkalemia, acidosis,
and alkalosis
Describe the role of kidneys in maintaining acid-base balance
Differentiate between the respiratory and renal mechanisms of acid-base
balance
Discuss the renal compensatory mechanisms in response to respiratory
acid-base disturbances
Define anion gap
Define metabolic acidosis and alkalosis
Enumerate the underlying causes of metabolic acidosis and alkalosis
Explain the pathophysiology of metabolic acidosis and metabolic alkalosis
Explain the compensatory mechanisms of metabolic acidosis and
alkalosis
Interpret diagnostic laboratory findings of metabolic acidosis and
alkalosis in their varying degrees of compensatory states
Define and classify renal tubular acidosis (RTA)
Explain the pathophysiology and diagnostic features of each type of renal
tubular acidosis
Water & Electrolyte Balance:
Upon completion of this unit, the students should be able to:
Explain the significance of water and electrolyte homeostasis in
maintaining the cellular and systemic functions
Explain the distribution of body water across various body compartments
Describe the physiological roles of sodium (Na⁺) and potassium (K⁺)
Explain the mechanisms of water regulation by the kidneys
Describe sodium homeostasis and discuss the various factors that regulate
this important ion
Explain the various factors that regulate potassium homoestatis
Define hyponatremia, hypernatremia, hypokalemia, and hyperkalemia
Explain the biochemical and physiological consequences of sodium and
potassium imbalances on cellular and systemic functions
Correlate clinical symptoms with underlying water and electrolyte
disturbances
Interpret various laboratory parameters to evaluate water and electrolyte
balance
Describe the clinical manifestations and diagnostic approaches to
hyperkalemia and hypokalemia
Correlate sodium and potassium homeostasis with acid-base regulation
Explain the renal handling of sodium and potassium during acid-base
disturbances
Kidney Function Tests:
Upon completion of this unit, the students should be able to:
Outline the anatomy and physiology of the kidney
List the key functions of the kidney
Define kidney function tests
Summarize the clinical importance of the kidney function tests
Identify the major categories of kidney function tests
Define clearance and glomerular filtration rate
Explain the significance of serum creatinine and blood urea nitrogen as
the markers of glomerular filtration rate
Describe methods for its estimation of glomerular filtration rate
Describe the significance of tubular function tests
Explain the clinical relevance of reabsorption and secretion markers in
tubular dysfunction
Correlate tubular function abnormalities with associated clinical
conditions
Enumerate the components of routine urinalysis and clinically interpret
key findings in urine tests
Describe the principles and clinical applications of different tests in
assessing renal concentrating ability
Discuss the biochemical basis of electrolyte imbalances in renal diseases
Identify novel biomarkers of kidney injury and discuss about their clinical
relevance
Compare traditional markers with newer biomarkers of abnormal kidney
functions
Discuss the role of kidney function tests in diagnosing and monitoring
acute kidney injury, chronic kidney disease, and glomerular diseases
Explain the clinical significance of urine albumin-to-creatinine ratio and
proteinuria
Correlate abnormal test findings with specific renal pathologies like
nephrotic syndrome, glomerulonephritis, and diabetic nephropathy
Amino Acid Metabolism: Basics
Upon completion of this unit, the students should be able to:
Explain the importance of amino acid metabolism in maintaining
nitrogen balance and overall metabolic homeostasis
Define protein turnover and amino acid pool
Identify the various source of amino acid pool
Explain the physiological importance of maintaining the amino acid pool
Define nitrogen balance and describe its significance in health and disease
Define positive nitrogen balance, negative nitrogen balance, and
equilibrium state of nitrogen balance
Correlate various physiological and pathological conditions with changes
in nitrogen balance
Define transamination and deamination
Outline the biochemical reactions to illustrate the processes of
transamination and deamination
Identify the types of deamination reactions and outline these biochemical
reactions
Describe the physiological significance of transamination and
deamination reactions
Outline the sources of ammonia in the body and illustrate the process of
transport of ammonia in the body
Identify the potential toxic effects of hyperammonemia in different organ
systems of the body
Describe the biochemical basis of potential toxicity of hyperammonemia
Outline the biochemical pathways for ammonia detoxification,
emphasizing on the role of the urea cycle
Urea Cycle:
Upon completion of this unit, the students should be able to:
Define the urea cycle
Describe the role of the urea cycle in detoxification of ammonia
Identify the tissues, organs, and cellular compartments involved in the
urea cycle
Illustrate and explain the sequence of steps in the biochemical pathway of
urea synthesis/urea cycle
Explain the regulation of the urea cycle
Define urea cycle disorders and their genetic basis
Explain the biochemical consequences of deficiencies in specific urea cycle
enzymes
Enumerate the diagnostic tests used to evaluate urea cycle function and
detect hyperammonemia
Discuss the role of plasma ammonia and amino acid levels in diagnosing
urea cycle disorders
Describe the dietary and pharmacological approaches to manage urea
cycle disorders and explain the role of arginine and citrulline
supplementation in managing specific enzyme deficiencies
MICROBIOLOGY
Urinary Tract Infections

Acute Glomerulonephritis

Renal Tuberculosis

CONTENTS:

Urinary tract infection: [Definition, normal flora of urethra, causative

Organisms, predisposing factors, routes of infection, pathogenesis]
Urinary tract infection: [clinical manifestation and laboratory
diagnosis.]
Post Streptococcal Glomerulonephritis [Introduction, Etiology, Clinical
Presentation, Laboratory Diagnosis]

Genitourinary Tuberculosis [Morphology, Pathogenesis, Laboratory

Diagnosis, Modern Techniques 0f Diagnosis]

Schistosomiasis [Pathogenesis, Laboratory Diagnosis, Modern

Techniques 0f Diagnosis]

PATHOLOGY

Polycystic kidney
Glomerular diseases
Glomerulonephritis
Acute tubular necrosis
Renal failure
Pyelonephritis
Nephrosclerosis
Hydronephrosis
Renal calculi
Systemic Lupus Erythematosus
Tumors of kidney
Urinary bladder

Contents:
Polycystic Kidney: Classification, morphology and complications

Glomerular Diseases:
Structure of glomerulus

Pathologic responses of the glomerulus to injury

Pathogenesis of glomerular injury

Clinical presentation, morphology, aetiopathogenesis

Glomerulonephritis: Classification
Differences between nephritic and nephrotic syndrome
Acute post-streptococcal glomerulonephritis - aetiopathogenesis,
morphology
Rapidly progressive glomerulonephritis: type, aetiopathogenesis,
morphology
Chronic glomerulonephritis
Nephrotic Syndrome: Definition
Minimal change disease (lipoid nephrosis), membranous
glomerulonephritis, membranoproliferative glomerulonephritis and focal
segmental glomerulosclerosis: pathophysiology, causes and morphology
Diabetic nephropathy

Acute Tubular Necrosis: Definition, aetiopathogenesis, morphology

Renal Failure: Concept, types, causes, stages

Pyelonephritis: Definition, classification

Acute pyelonephritis: aetiopathogenesis, morphology
Chronic pyelonephritis: aetiopathogenesis, morphology, sequelae

Nephrosclerosis: Definition, classification, pathogenesis, morphology

Hydronephrosis: Definition, causes, morphology
Renal Calculi: Aetiopathogenesis, morphology
Systemic Lupus Erythematosus: Lesions in kidney
Tumors of Kidney: Classification, Wilm’s tumour, renal cell carcinoma
Ureter, Urinary Bladder and Urethra:
 Congenital anomalies
Cystitis: types, morphology
Calculi: types, morphology, complications
Tumors: Transitional cell carcinoma - aetiopathogenesis, gross and
microscopic features

PHARMACOLOGY

Diuretics: Definition. Classification and mechanism of action of diuretic,

indications, adverse effects. Diuretics acting on DCT and other K+-
Sparing diuretic

Antidiuretic agents: Describe in brief about antidiuretic hormones. List

the drugs used in different types of diabetes insipidus, describe in brief
about treatment of diabetes insipidus
Nephrotoxic drugs: List nephrotoxic drugs
Drugs used for treatment of Urinary tract infections: Discuss in brief
ENDOCRINE SYSTEM
ANATOMY
Describe the development, location, blood supply, and
microscopic structure of the pituitary gland
Describe the development, location, blood supply, and
microscopic structure of the pineal gland.
Describe the development, gross features, blood supply,
lymphatic drainage, surface markings, relations and microscopic
structure of the thyroid gland.
Explain the development, location, blood supply, and
microscopic structure of the parathyroid glands.
Describe the development, location, gross features, blood
supply, and microscopic structure of the adrenal gland.

CONTENTS:

Pituitary gland: development, location, relations, blood

supply, and microscopic structure
Pineal gland: development, location, blood supply, and
microscopic structure

Thyroid gland: development, location, gross

features, blood supply, venous drainage, lymphatic
drainage, surface marking, and microscopic structure

Parathyroid glands: development, location, blood supply,

and microscopic structure

Adrenal gland: development, location, gross

features, blood supply, and microscopic structure of
adrenal cortex
PHYSIOLOGY

Introduction to Endocrinology: Definition of hormones, classification,

general mechanisms of action, concept of second messenger.
Hypothalamus: Role of hypothalamus in the regulation of secretion of
hormones of anterior and posterior pituitary. Explain functional
organization of hypothalamo-pituitary axis
Anterior Pituitary: State Pituitary lobes and their hormones. Growth
hormone – release, functions and regulation of secretion and disorders.
Insulin like growth factors (IGFs) in growth & development
Posterior pituitary: Posterior pituitary hormones. Vasopressin -
regulation of release, physiological actions, mechanism of action,
hyperactivity, hypoactivity - clinical symptoms. Oxytocin - their functions
and regulation of secretion.
Thyroid Gland: Review biosynthesis of T3 and T4. Physiological effects,
mechanism of action, regulation of release, consequences of
hypothyroidism, hyperthyroidism.
Parathyroid Gland: Parathormone and its functions. Calcitonin, Vitamin
D. State applied aspect: hypo- and hyper-calcaemia like rickets,
osteomalacia, osteoporosis, bone remodelling
Adrenal Cortex: Glucocorticoids - names of hormones, physiological
effects, mechanism of action, regulation of secretion, consequences of
hyper and hypo secretion.
Mineralocorticoids - names of hormones, physiological effects,
mechanism of action, regulation of secretion, consequences of hyper and
hypo secretion.
Sex corticoids - names of hormones, physiological effects, effects of
excessive secretion. Summary of the effects of adrenocortical hyper and
hypo functions.
Adrenal Medulla: Review the physiological actions of epinephrine.
Stress: Definition, Physiological mechanisms (hormonal and neural) for
coping up with stress. Beneficial and harmful effects of stress.
Endocrine Pancreas: Hormones. Insulin: sites of synthesis, secretion,
transport, metablolism, regulation of release, mechanism of action,
physiological effects, consequences of deficiency and excess. Glucagon -
review secretion, transport, metabolism, physiological effects, mechanism
of action, regulation of secretion. Insulin-glucagon molar ratio and
implications in alternation. Glucose homeostasis
Pineal Gland: Hormones of pineal gland  Role in circadian rhythm.

BIOCHEMISTRY

Hormones: basics
Pituitary hormones
Thyroid hormones
Hormonal regulation of calcium homeostasis
Endocrine pancreas: Insulin & Glucagon
Adrenal cortex
Regulation of blood glucose & diabetes mellitus

Hormones: Basics:
Upon completion of this unit, the students should be able to:
Define hormones
Describe the general characteristics of hormones
Differentiate between endocrine, paracrine, autocrine, and intracrine
modes of hormone action
Classify hormones with examples
Differentiate between tropic and non-tropic hormones, with examples
Identify the different types of hormone receptors
Explain the signal transduction cascade with respect to the different types
of hormone receptors
Illustrate the signaling pathways mediated by cell surface receptors
Explain the genomic mechanism of intracellular receptors
Pituitary Hormones:
Upon completion of this unit, the students should be able to:
Outline the anatomy of pituitary gland and its functional division
Explain the hypothalamic-pituitary axis and its role in regulating pituitary
hormone secretion
List the hormones secreted by the anterior pituitary gland
Explain the biochemical synthesis, secretion, and regulation of each
anterior pituitary hormone by hypothalamic releasing and inhibitory
factors
Describe the physiological functions and feedback regulations of anterior
pituitary hormones
Discuss the feedback regulation with respect to the anterior pituitary
hormones
List the hormones secreted by the posterior pituitary gland
Explain the synthesis of posterior pituitary hormones in the
hypothalamus and their transport and storage in the posterior pituitary
Discuss the regulation of secretion of posterior pituitary hormones
Describe the physiological functions of posterior pituitary hormones
Identify clinical conditions associated with excess or deficiency of anterior
and posterior pituitary hormones
Explain the biochemical tests used to assess clinical conditions associated
with excess or deficiency of anterior and posterior pituitary hormones
Thyroid Hormones:
Upon completion of this unit, the students should be able to:
Outline of anatomy of thyroid gland and its functional units (thyroid
follicles)
Outline the process of thyroid hormone synthesis, storage, secretion, and
transport in the blood
Explain the biochemical steps of thyroid hormone synthesis
Discuss the regulation of thyroid hormone synthesis and secretion by the
hypothalamic-pituitary-thyroid axis
Identify the major plasma proteins involved in thyroid hormone transport
Explain the cellular mechanism of action of thyroid hormones t
Describe the physiological roles of thyroid hormones
Classify thyroid disorders and describe the biochemical basis, clinical
features, and laboratory findings in common thyroid disorders
Explain the biochemical aspects and clinical significance of thyroid
hormone resistance syndromes and subclinical thyroid disorders
List the biochemical tests used to assess thyroid function
Interpret thyroid function test results in various clinical contexts
Explain the biochemical rationale behind iodine supplementation in
iodine-deficient populations
Hormonal Regulation of Calcium Homeostasis:
Upon completion of this unit, the students should be able to:
Explain the physiological importance of calcium in the human body
Identify the normal range of serum calcium levels and differentiate
between total calcium and ionized calcium
Outline the distribution of calcium in the body
Identify the hormones that regulate the calcium homeostasis in the body
Describe the sources, synthesis, secretion, and mechanism of action of
parathyroid hormone, calcitriol, and calcitonin
Explain how PTH regulates serum calcium levels
Describe vitamin D in in the regulation of serum calcium levels
Explain the physiological actions of calcitonin in reducing serum calcium
levels and its significance
Illustrate the feedback regulation of calcium homeostasis through the
interaction of PTH, vitamin D, and calcitonin, and explain how
hypocalcemia and hypercalcemia trigger hormonal responses to restore
calcium balance
Discuss the causes, biochemical changes, clinical features, and laboratory
findings in hypocalcemia and hypercalcemia
Explain the role of PTH-related protein (PTHrP) in malignancy-
associated hypercalcemia
Correlate the pathophysiology of calcium dysregulation with bone
disorders such as osteoporosis, osteomalacia, and rickets
List and interpret the biochemical tests used to assess calcium
homeostasis
Explain the biochemical rationale for monitoring calcium levels during
treatment of calcium disorders
Endocrine Pancreas: Insulin & Glucagon:
Upon completion of this unit, the students should be able to:
Describe the structure and cellular organization of the pancreas with
emphasis on the islets of Langerhans
List the hormones secreted by the different cells of islets of Langerhans
Describe the structure of insulin
Explain the synthesis of insulin
Outline the roles and clinical significance of C-peptide
Illustrate the mechanism of glucose-stimulated insulin secretion from
pancreatic beta cells
Describe the factors that regulate insulin secretion
Explain the molecular mechanism of insulin action, including the role of
the insulin receptor and intracellular signaling pathways
Enumerate the physiological effects of insulin on carbohydrates, lipids
and proteins metabolism
Describe the structure of glucagon
Describe the synthesis of glucagon
Identify the factors that regulate the synthesis and secretion of glucagon
Explain the cellular and molecular mechanism of glucagon action
Discuss the physiological effects of glucagon on carbohydrates, lipids and
proteins metabolism
Adrenal Cortex:
Upon completion of this unit, the students should be able to:
Outline the gross and histological structures of adrenal cortex and
Identify the histological layers of adrenal cortex and enumerate the
hormones synthesized by each layer
Outline the biochemical pathway of steroid hormone synthesis from
cholesterol
Illustrate the regulation of steroidogenesis
Describe the synthesis, secretion, and transport of cortisol in the blood
Explain the metabolic, anti-inflammatory, and immunosuppressive
effects of cortisol
Discuss the circadian rhythm of cortisol secretion and the factors that
influence its release
Outline the clinical consequences of cortisol excess and deficiency
Describe the synthesis, secretion, and transport of aldosterone in the
blood
Explain the regulation of aldosterone synthesis and secretion
Describe the physiological role of aldosterone in sodium retention,
potassium excretion, and water homeostasis
Discuss the clinical consequences of aldosterone excess and deficiency
Explain the synthesis and secretion of adrenal androgens
Describe the physiological role of adrenal androgens in males and females
Discuss the clinical consequences of adrenal androgen excess and
deficiency
Correlate the biochemical findings with clinical conditions in the various
disorders of adrenal cortex and interpret laboratory tests used in the
diagnosis of these disorders
Regulation of Blood Glucose and Diabetes Mellitus:
Upon completion of this unit, the students should be able to:
Explain the normal range of blood glucose levels in fasting and
postprandial states
Describe the sources of glucose in the body (dietary intake, glycogenolysis,
and gluconeogenesis)
Outline the various modes of regulation of blood glucose
Identify the key hormones that participate in the blood glucose regulation
and explain their actions
Explain the role of the liver, skeletal muscles, and adipose tissue in
maintaining blood glucose levels during fed and fasting states
Define and classify diabetes mellitus
Explain the pathophysiology of type I and type II diabetes mellitus
Explain the biochemical basis of hyperglycemia and glucose toxicity in
diabetes mellitus
List the clinical features of diabetes
Identify the acute and chronic complications of diabetes mellitus and
correlate the biochemical basis of diabetic complications with clinical and
laboratory findings
Enumerate the diagnostic criteria (WHO, World Health Organization &
ADA, American Diabetes Association) for diabetes mellitus, prediabetes,
and impaired glucose tolerance
Define glycated/glycosylated hemoglobin and outline how this is formed
in the RBC
Interpret the biochemical significance of HbA1c
Enumerate the immunological markers of type I diabetes mellitus
Define hypoglycemia
Identify the common causes of hypoglycemia
Describe the physiological mechanisms to counteract hypoglycemia and
explain the role of counter-regulatory hormones
Outline the symptoms of hypoglycemia and discuss the principles of its
management
Define gestational diabetes mellitus
Discuss the biochemical basis, diagnostic criteria and clinical significance
of gestational diabetes
Explain the biochemical rationale behind diabetic dietary
recommendations, including glycemic index and glycemic load

PATHOLOGY
Pituitary gland
Thyroid gland
Parathyroid gland
Endocrine pancreas
Adrenal gland

Contents:

Pituitary Gland:
Hyperpituitarism: Causes and brief discussion of pituitary adenoma -
somatotropic adenoma, Corticotropic adenoma
Hypopituitarism: Causes and brief discussion on Sheehan’s syndrome,
Empty Sella Turcica’s syndrome
Posterior pituitary syndromes: Prolactinoma, Diabetes insipidus
Hypothalamic suprasellar tumor: Craniopharyngioma

Thyroid Gland:
Hyperthyroidism: Causes
Thyrotoxicosis, Grave’s disease: aetiology, morphology
Hypothyroidism: Cretinism, myxoedema
Goiter: Types, pathogenesis, morphology
Thyroiditis: Hashimoto’s, Subacute lymphocytic thyroiditis,
Granulomatous – aetiology, pathogenesis, morphology
Tumors: Classification, gross and microscopic features of – Thyroid
adenoma, follicular carcinoma, papillary carcinoma, medullary
carcinoma, anaplastic carcinoma

Parathyroid Gland:
Primary and secondary hyperparathyroidism
Brown tumour of Hyperparathyroidism Hypoparathyroidism
Tumors: Parathyroid adenoma – causes, gross and microscopic
features

Endocrine pancreas:
Diabetes mellitus: Classification, aetiopathogenesis, clinical features,
complications
Pancreatic neuroendocrine tumors: Insulinoma, Gastrinoma

Adrenal Gland:
Cushing’s syndrome: Causes, aetiopathgenesis, morphology, clinical
features
Primary hyperaldosteronism, Adrenogenital syndrome
Adrenocortical insufficiency: Addison’s disease, Waterhouse-
Friderichsen syndrome
Adrenocortical neoplsasms: adenoma, carcinoma - gross and microscopic
features
Adrenal medulla: Neuroblastoma, Pheochromocytoma
Multiple endocrine neoplasias

PHARMACOLOGY
Hormones:
Introduction and general mechanism of action of hormones
Hormones of Anterior pituitary- Describe in detail about GH, GnRH,
Gonadotrophines, Prolactin, ACTH, CRH and TSH.
Hormones of thyroid and Anti-thyroid drugs: Introduction to thyroid
gland, synthesis, secretion, metabolism and physiological effects of
thyroid hormones, classification, mechanism of action, indications of
antithyroid drugs. Management of thyroid disorders.
Corticosteroids: Overview of corticosteroids, classification of
corticosteroids, mechanism of action, indications and adverse effects of
corticosteroids, mention about the practical considerations of
corticosteroid therapy.
Insulin: Introduction, Physiological functions, types of insulin,
mechanism of action, indication and adverse effect of insulin, insulin
administration and dosage, insulin resistance and sensitivity. Insulin in
special population.
Oral antidiabetics and management of Diabetes mellitus and its
complications: Introduction to diabetes mellitus, mechanism of action,
indications, adverse effects, of oral antidiabetic agents, management of
diabetes mellitus and its complications.
Agents used for maintaining calcium balance: Calcium homeostasis,
describe in brief about the agents used for maintaining calcium balance.
Clinical application of calcium balance agents.
REPRODUCTIVE SYSTEM
ANATOMY
Male Reproductive System
Describe coverings, internal structure, side determination, blood supply,
nerve supply, lymphatic drainage & descent of testis with its applied
anatomy
Describe parts of Epididymis
Describe Penis under following headings: (parts, components, blood
supply and lymphatic drainage)
Explain the anatomical basis of Varicocoele
Describe coverings, internal structure, side determination, blood supply,
nerve supply, lymphatic drainage of Scrotum, seminal vesicles, vas
deferens and prostate with their applied anatomy

Female Reproductive System

Describe & demonstrate the (position, features, important peritoneal and
other relations, blood supply, nerve supply, lymphatic drainage and
clinical aspects of) important male & female pelvic viscera
Describe the uterine changes occurring during the menstrual cycle
Describe the synchrony between the ovarian and menstrual cycles
Describe the origin, course, important relations and branches of internal
iliac artery
Describe the branches of sacral plexus
Describe the superficial & deep perineal pouch (boundaries and contents)
Describe & identify perineal body
Describe the boundaries, content & applied anatomy of Ischiorectal fossa
Describe the anatomical basis of perineal tears, episiotomies, perianal
abscesses, and anal fissures.
Describe the development of male & female reproductive system
CONTENTS:
Male Reproductive System:
Blood supply and lymphatic drainage of: Scrotum, epididymis, seminal
vesicle, spermatic cord, penis.
Gross and microscopic features of testes, vas deferens, prostate.
Male genital system:- development, developmental anomalies.

Female Reproductive System:

Uterus, broad ligament, supports of uterus and other features.
Gross features - ovary, fallopian tube, external genitalia.
Breast - morphology, structure, lymphatic drainage, blood supply,
development and age changes.
Microscopic structure - ovary, oviduct, uterus, cervix, vagina, breast.
Development - female genital system, congenital anomalies.
Skeletal Plevis: Types, features, difference in sexes, various diameters.
Parts, sexual dimorphism.

Pelvic Diaphragm: Levator ani and connection with defecation,

micturition and pregnancy.

Perineum: Spaces, contents, applied, anatomy; Perineal Body and

urogenital diaphragm.
Radiological anatomy of Reproductive system

PHYSIOLOGY
Introduction: Sexual differentiation, development of sex organs
Physiology of puberty.
Male Reproductive System: Primary and accessory organs, their
functions. Spermatogenesis, its regulation. Role of Sertoli cells
Testosterone: transport, metabolism, mechanism, physiological actions.
Control of testicular function - feedback mechanism, abnormalities.
Female Reproductive System: Primary & accessory sex organs, Oogenesis.
Physiology of menstrual cycle: ovarian cycle, uterine cycle, vaginal,
cervical cycle. Role of hormones Physiology of ovulation and its detection.
Ovarian hormones: estrogen and progesterone; physiological actions,
mechanism of action. Control of ovarian function – feedback mechanism,
menopause, abnormalities.
Physiology of Fertilization and Implantation. Transport of sperms in
female genital tract, capacitation, acrosomal reaction, species specificity,
fertilization, prevention of polyspermia. Transport of fertilized ovum-
zygote-blastocyst. Day of implantation, formation and functions of
fetoplacental unit
Physiology of Pregnancy: Endocrine changes, functions of placenta,
changes in mother during pregnancy, tests for pregnancy.
Physiology of Parturition: Factors which determine onset of parturition,
Mechanism of uterine contractions - Role of oxytocin.
Physiology of Lactation: Hormones involved in growth and development
of breast during pregnancy and their actions. Onset of lactation, and
factors involved in its maintenance. Role of oxytocin, prolactin.
Mechanism of lactation.
Physiological Basis of Contraceptive Methods: Physiological basis of
various methods of contraceptives and emergency ‘pill’. Male and female
contraceptive methods.

BIOCHEMISTRY
Hormones related to reproduction
Carbohydrate metabolism: lactose, galactose & fructose metabolism
Amino acid metabolism: specific amino acids (alanine)
Amino acid metabolism: specific amino acids (glycine)
Amino acid metabolism: specific amino acids (aspartic acid & glutamic
acid)
Amino acid metabolism: specific amino acids (phenylalanine & tyrosine)
Amino acid metabolism: specific amino acids (tryptophan)
Amino acid metabolism: specific amino acids (methionine)
Inborn errors of metabolism: basics
Inborn errors of metabolism: phenylketonuria
Inborn errors of metabolism: alkaptonuria
Inborn errors of metabolism: cystinuria
Inborn errors of metabolism: homocystinuria
Inborn errors of metabolism: maple syrup urine disease
Inborn errors of metabolism: methylmalonic aciduria
Inborn errors of metabolism: tyrosinosis
Inborn errors of metabolism: hartnup disease

CONTENTS:
Hormones Related to Reproduction:
Upon completion of this unit, the students should be able to:
Identify the various male and female reproductive hormones
(gonadotropins and sex steroids) and explain their roles in male and
female reproductive physiology
Describe the hypothalamic-pituitary-gonadal axis and its regulation of
reproductive hormones males and females
Describe the synthesis, secretion, and regulatory control of follicle-
stimulating hormone (FSH) and luteinizing hormone (LH)
Explain the roles of FSH and LH in males and females
Interpret the clinical significance of altered FSH and LH levels in various
reproductive disorders
Describe the synthesis and metabolism of estrogens in females and males
Explain the physiological actions of estrogens in females and males and
summarize the clinical implications of hypoestrogenism and
hyperestrogenism in both sexes
Describe the synthesis, secretion, and regulation of progesterone in
females
Explain the physiological roles of progesterone in the menstrual cycle,
pregnancy, and lactation and discuss the clinical significance of
progesterone levels
Describe the synthesis and metabolism of androgens and explain their
physiological roles in males and females
Interpret the clinical significance of altered androgen levels in disorders
such as hypogonadism
Identify the common fertility tests used to evaluate male and female
reproductive health and discuss the biochemical basis of infertility in both
gender groups
Interpret the biochemical changes during ovulatory and anovulatory
cycles and explain the clinical significance of hormonal imbalances in
female infertility
Describe the hormonal changes during pregnancy and explain the role of
reproductive hormones in maintaining pregnancy and preparing for
childbirth and lactation
Carbohydrate Metabolism: Lactose, Galactose & Fructose
Metabolism:
Upon completion of this unit, the students should be able to:
Identify the dietary sources of lactose, galactose and fructose
Explain the physiological importance of lactose, galactose and fructose in
human metabolism
Identify the sites of lactose synthesis, specifically in the mammary glands
during lactation
Describe the synthesis of lactose in the lactose synthase complex
Discuss the hormonal regulation of lactose synthesis
Illustrate the metabolic pathway of galactose
Discuss the biochemical basis of disorders related to galactose metabolism
Interpret the diagnostic tests for these disorders
Describe the metabolic pathway of fructose
Discuss the biochemical basis of fructose metabolism disorders
Describe the diagnostic approaches for disorders of fructose metabolism
Explain the impact of fructose over-consumption on metabolic disorders
Amino Acid Metabolism: Specific Amino Acids (Alanine):
Upon completion of this unit, the students should be able to:
Outline the structural features of alanine
Outline the source of alanine
Explain the biosynthesis of alanine and its catabolism
Discuss the physiological roles of alanine
Outline glucose-alanine cycle and describe its biomedical significance
Discuss the regulation of alanine metabolism and summarize the
metabolic adaptations of alanine utilization during exercise and stress
Correlate alanine metabolism with nitrogen metabolism, urea cycle, and
glucose metabolism
Discuss alanine metabolism in conditions such as prolonged
fasting/starvation, muscle wasting/catabolic states, and liver dysfunction
Amino Acid Metabolism: Specific Amino Acids (Glycine):
Upon completion of this unit, the students should be able to:
Outline the structural features of glycine
Explain the pathways of synthesis and cleavage of glycine
Outline and describe the metabolic fates of glycine
Explain the role glycine in one-carbon metabolism
Describe the physiological roles of glycine in the synthesis of heme,
purines, creatine, glutathione
Explain the function of glycine as an inhibitory neurotransmitter in the
CNS
Discuss the regulation of glycine metabolism (synthesis and cleavage)
Correlate glycine metabolism with other metabolic pathways
Explain the significance of glycine in maintaining redox balance through
glutathione synthesis
Describe the biochemical basis, clinical features, and diagnostic
approaches for metabolic disorders involving glycine (non-ketotic
hyperglycinemia or glycine encephalopathy, hyperoxaluria type 1)
Explain the impact of glycine metabolism dysregulation on ammonia
metabolism and its contribution to encephalopathy
Outline the diagnostic tests for evaluating disorders of glycine metabolism
Discuss therapeutic strategies for managing glycine-related disorders,
including dietary modifications and enzyme replacement therapies
Amino Acid Metabolism: Specific Amino Acids (Aspartic Acid &
Glutamic Acid):
Upon completion of this unit, the students should be able to:
Outline the structural features of aspartic acid and glutamic acids and
discuss their structural interrelationship
Explain the biosynthesis of aspartic acid and glutamic acid
Illustrate the metabolic fates of aspartic acid
Describe the regulation of aspartic acid metabolism in various
physiological states
Explain the metabolic fates of glutamic acid
Illustrate the interconversion of aspartic acid and glutamic acid
Correlate aspartic acid and glutamic acid metabolism with amino acid
metabolism, energy metabolism, and neurotransmission
Describe the role of aspartate and glutamate in the malate-aspartate
shuttle, nitrogen transport and disposal, and maintaining acid-base
balance
Outline formation of asparagine and glutamine from aspartic acid and
glutamic acid and discuss their metabolic significance
Discuss the hormonal and enzymatic regulation of aspartic acid and
glutamic acid metabolism under conditions such as fasting, starvation,
and stress
Describe the role of aspartic acid and glutamic acid metabolism in
neurodegenerative diseases, hyperammonemia and inherited disorders
affecting the urea cycle
Amino Acid Metabolism: Specific Amino Acids (Phenylalanine
& Tyrosine):
Upon completion of this unit, the students should be able to:
Outline the structural features of phenylalanine and tyrosine and discuss
their structural interrelationship
Discuss the physiological roles of phenylalanine and tyrosine
Illustrate the hydroxylation of phenylalanine to tyrosine and discuss the
regulation of this reaction
Describe the metabolic fate of phenylalanine in various conditions,
emphasizing on the condition where tyrosine synthesis is impaired
Explain the catabolism of tyrosine to fumarate and acetoacetate
Outline the synthesis of various products from tyrosine (catecholamines,
melanin, thyroid hormones)
Discuss the enzymatic regulation of phenylalanine and tyrosine
metabolism under normal physiological conditions and explain how
dietary intakes of phenylalanine and tyrosine influences their metabolic
pathways
Describe the biochemical basis, clinical manifestations, and diagnostic
approaches for disorders of phenylalanine and tyrosine metabolism
(phenylketonuria, alkaptonuria, tyrosinemia)
Outline the laboratory investigations for diagnosing metabolic disorders
involving phenylalanine and tyrosine
Explain the principles of dietary and pharmacological management for
disorders like PKU and tyrosinemia
Amino Acid Metabolism: Specific Amino Acids (Tryptophan):
Upon completion of this unit, the students should be able to:
Outline the structural features of tryptophan
List the dietary sources of tryptophan and its daily nutritional
requirement
Discuss the physiological roles of tryptophan
Identify the two major metabolic fates of tryptophan (kynurenine pathway
and serotonin and melatonin synthesis pathway)
Outline the steps in the kynurenine pathway and explain the significance
of NAD⁺ synthesis from tryptophan and its metabolic roles
Discuss the regulation of the kynurenine pathway
Describe the conversion of tryptophan to serotonin and outline its
metabolic/physiological roles
Discuss the further conversion of serotonin to melatonin in the pineal
gland and its metabolic/physiological roles
Discuss the biochemical basis, clinical features, and diagnostic
approaches for tryptophan metabolism disorders (Hartnup disease,
pellagra, and serotonin syndrome)
Describe the role of quinolinic acid in neurological disorders and the
clinical implications of an imbalanced kynurenine pathway
Explain the diagnostic methods to assess disorders of tryptophan
metabolism
Amino Acid Metabolism: Specific Amino Acids (Methionine):
Upon completion of this unit, the students should be able to:
Outline the structural features of methionine
List the dietary sources of methionine and its daily requirement in human
nutrition
Discuss the physiological roles of methionine
Outline the metabolic fates of methionine and the metabolic/clinical
significance of various intermediates and products
Outline the regulation of methionine metabolism, and discuss the
influence of dietary methionine, folate, and vitamin B12 on the metabolic
pathways of methionine
Describe the pathophysiology, clinical features, and biochemical basis of
disorders related to methionine metabolism (homocystinuria,
hyperhomocysteinemia)
Explain the role of methionine metabolism in the development of neural
tube defects due to impaired folate or vitamin B12 metabolism
Discuss the diagnostic methods to assess disorders related to methionine
metabolism and outline the therapeutic strategies for managing
methionine metabolism disorders
Inborn Errors of Metabolism: Basics:
Upon completion of this unit, the students should be able to:
Define and classify inborn errors of metabolism
Discuss the historical significance of Archibald Garrod’s work in relation
to inborn error of metabolism
Outline the general principles of metabolic block, substrate accumulation,
and product deficiency in inborn errors of metabolism and discuss the
general biochemical consequences of enzyme defects
Correlate the clinical manifestations of inborn errors of metabolism with
the underlying metabolic derangements
Identify the general clinical features of inborn errors of metabolism and
discuss the significance of early identification of ‘red flag signs’ for inborn
errors of metabolism in neonates and infants
Outline the general diagnostic approach to inborn errors of metabolism
Discuss the role of newborn screening programs in the early detection of
common inborn errors of metabolism and describe the significance of
genetic testing in confirming the diagnosis of inborn errors of metabolism
Outline the general principles of managing inborn errors of metabolism
and discuss the role of enzyme replacement therapy and gene therapy in
specific inborn errors of metabolism
Explain the importance of genetic counseling for families affected by
inborn errors of metabolism
Discuss the role of population-wide newborn screening programs in
reducing morbidity and mortality from inborn errors of metabolism
Inborn Errors of Metabolism: Phenylketonuria:
Upon completion of this unit, the students should be able to:
Define phenylketonuria (PKU)
Explain the pathophysiology of PKU and discuss the inheritance pattern
of PKU
Outline the normal metabolism of phenylalanine and its conversion to
tyrosine
Explain the biochemical consequences of the deficiency of phenylalanine
hydroxylase in PKU
Identify the biochemical markers of PKU in the blood and urine
Outline the clinical manifestations of PKU and correlate them with the
metabolic defects and biochemical findings
Describe the diagnostic approach for PKU, and discuss the importance of
newborn screening and its role in the early diagnosis of PKU
Discuss the dietary management of PKU
Outline emerging treatment options for PKU, including gene therapy and
enzyme replacement therapy
Describe the importance of genetic counseling for families with a history
of PKU
Inborn Errors of Metabolism: Alkaptonuria:
Upon completion of this unit, the students should be able to:
Define alkaptonuria
Describe the pathophysiology of alkaptonuria and discuss the inheritance
pattern of alkaptonuria
Outline the normal metabolic pathway of phenylalanine and tyrosine,
emphasizing the conversion of tyrosine to homogentisic acid
Identify the biochemical markers of alkaptonuria
Outline the common clinical manifestations of alkaptonuria and correlate
them with the metabolic defects
Explain the diagnostic approaches for alkaptonuria, and discuss the
importance of newborn screening and its role in the early diagnosis of
alkaptonuria
Outline the management strategies for alkaptonuria
Describe the importance of genetic counseling for families with a history
of alkaptonuria
Inborn Errors of Metabolism: Cystinuria:
Upon completion of this unit, the students should be able to:
Define cystinuria
Outline the pathophysiology of cystinuria and discuss its inheritance
pattern
Describe the normal transport mechanism of amino acids in the renal
tubules and their defective reabsorption in cystinuria
Outline the common clinical manifestations of cystinuria and correlate
them with the metabolic defects
Explain the diagnostic approach for cystinuria, and discuss the
importance of newborn screening and its role in the early diagnosis of
cystinuria
Outline the general management strategies for cystinuria and discuss the
long-term management of this condition
Describe the importance of genetic counseling for families with a history
of cystinuria
Inborn Errors of Metabolism: Homocystinuria:
Upon completion of this unit, the students should be able to:
Define homocystinuria
Outline the pathophysiology of homocystinuria and identify its
inheritance pattern
Outline the normal metabolism of homocysteine and its conversion to
cysteine and to methionine
Outline the common clinical manifestations of homocystinuria and
correlate them with the metabolic defects
Explain the diagnostic approach for homocystinuria, and discuss the
importance of newborn screening and its role in the early diagnosis of
homocystinuria
Outline the general management strategies for homocystinuria and
discuss the management of thromboembolic events in homocystinuria
Describe the importance of genetic counseling for families with a history
of homocystinuria
Inborn Errors of Metabolism: Maple Syrup Urine Disease:
Upon completion of this unit, the students should be able to:
Define maple syrup urine disease (MSUD)
Outline the pathophysiology of MSUD and identify its inheritance pattern
Outline the normal catabolic pathway of branched-chain amino acids
Outline the common clinical manifestations of MSUD and correlate them
with the metabolic defects
Explain the diagnostic approach for MSUD, and discuss the importance
of newborn screening and its role in the early diagnosis of MSUD
Describe the general management strategies for MSUD and outline its
long-term management
Describe the importance of genetic counseling for families with a history
of MSUD
Inborn Errors of Metabolism: Methylmalonic Aciduria:
Upon completion of this unit, the students should be able to:
Define methylmalonic aciduria
Outline the pathophysiology of methylmalonic aciduria and identify its
inheritance pattern
Outline the conversion of methylmalonyl-CoA to succinyl-CoA (as a part
of the pathway of oxidation of odd chain fatty acids) and role of vitamin
B12
Outline the common clinical manifestations of methylmalonic aciduria
and correlate them with the metabolic defects
Describe the diagnostic approach for methylmalonic aciduria, and discuss
the importance of newborn screening and its role in the early diagnosis of
methylmalonic aciduria
Describe the management strategies for methylmalonic aciduria and
outline the emergency management of metabolic crises
Describe the importance of genetic counseling for families with a history
of methylmalonic aciduria
Inborn Errors of Metabolism: Tyrosinosis:
Upon completion of this unit, the students should be able to:
Define and classify tyrosinosis
Outline the pathophysiology of different types of tyrosinosis and identify
their inheritance patterns
Explain the normal metabolism of tyrosine, including the enzymatic steps
involved in its breakdown to acetoacetate and fumarate
Outline the common clinical manifestations of tyrosinosis and correlate
them with the metabolic defects
Explain the diagnostic approach for different types of tyrosinosis, and
discuss the importance of newborn screening and its role in the early
diagnosis of this disorder
Describe the management strategies for different types of tyrosinosis
Discuss the role of genetic counseling in families with a history of
tyrosinosis
Inborn Errors of Metabolism: Hartnup Disease:
Upon completion of this unit, the students should be able to:
Define hartnup disease
Outline the pathophysiology of hartnup disease and identify its
inheritance pattern
Explain the normal transport mechanism of neutral amino acids,
including tryptophan, phenylalanine, and other essential amino acids,
across intestinal and renal cells
Outline the common clinical manifestations of hartnup disease and
correlate them with the metabolic defects
Describe the diagnostic approach for hartnup disease, and discuss the
importance of newborn screening and its role in the early diagnosis of this
disorder
Describe the general management strategies for hartnup disease
Discuss the role of genetic counseling in families with a history of hartnup
disease

MICROBIOLOGY
Introduction to STDs And STIs

Gonococcal And Non-Gonococcal Urethritis

Syphilis

Chancroid, Lymphogranuloma venerum, Granuloma Inguinale,

Genital Herpes

HIV/AIDS

Vaginitis And Vaginosis

Genital Warts and Genital Herpes

Vertically Transmitted Infections (TORCH)

CONTENTS:

Introduction to Sexually transmitted infections: normal flora of vagina

and their roles, define STI, causative agents, terminology used in STI,
mode of transmission and approach to laboratory diagnosis.

Nesisseria gonorrhoeae [Morphology, Virulence Factors, Pathogenecity,

Clinical Presentations, Laboratory Diagnosis, Complications]

Treponema palladium- I: Morphology, antigens, mode of transmission,

pathogenesis

Treponema palladium-II: Clinical manifestations and laboratory

diagnosis

Chlamydial Infections [ Agents, Morphology, Pathogenecity, Clinical

Presentation, Laboratory Diagnosis, Complication]
Non gonococcal urethritis: Causative agents, Morphology, antigens, mode
of transmission, pathogenesis, clinical manifestations and laboratory
diagnosis

Klebsiella granulomatous and Haemophilus ducreyi: Morphology,

antigens, mode of transmission, pathogenesis, clinical manifestations and
laboratory diagnosis.

Vaginitis And Vaginosis- Trichomonas vaginalis, bacterial vaginosis-

Agents, Pathogenecity, Clinical Presentations, Laboratory Diagnosis,
Complications]

Candidiasis [Agents, Morphology, Pathogenecity, Clinical Presentation,

Laboratory Diagnosis]

Herpes Simplex [Agents, Pathogenecity, Clinical Presentation, Laboratory

Diagnosis, Complications]

HIV virus – I [Introduction, History, Morphology, Genes And Antigens,

Pathogenecity]

HIV Virus- II [Clinical Presentations, Opportunistic Infections,

Complications Laboratory Diagnosis, Prophylaxis]

Genital warts- Papilloma virus And Molluscum Contagiosum [Agents,

Pathogenecity, Clinical Presentations, Laboratory Diagnosis,
Complications]

Congenital Infections (Torch)- Toxoplasma, Rubella, CMV, HSV-

Morphology, mode of transmission, clinical manifestations

PATHOLOGY
Male genital tract: Prostate, Testes, Penis
Female genital tract: Vulva, vagina, cervix, uterus, ovary, fallopian tubes,
gestational trophoblastic diseases
Breast: Abscess, fibrocystic diseases, tumors, gynecomastia
Contents:

Male genital tract:

Prostate:
Benign prostatic hyperplasia: aetiology, pathogenesis, gross and
microscopic features
Carcinoma: aetiology, pathogenesis, gross and microscopic features
Testes:
Congenital anomalies: Cryptorchidism
Inflammation and infection: Epididymitis, orchitis
Vascular disorders
Spermatic cord and paratesticular tumors
Tumors: Classification, gross and microscopic features

Penis:
Congenital anomalies: Epispadias, hypospadias, phimosis
Premalignant lesions of penis
Malignant Lesions of Penis: Carcinoma penis, aetiology, gross and
microscopic features

Female Genital Tract:

Vulva, Vagina:
Infection: Pelvic inflammatory disease, Herpes simplex virus
Condyloma acuminatum
Premalignant lesions: Vulvar intraepithelial neoplasia, vaginal
intraepithelial neoplasia
Malignant lesions: Squamous cell carcinoma, Extramammary Paget
disease

Cervix:
Cervicitis: Aetiology and morphology
Endocervical polyp
Cervical intra-epithelial neoplasia: Classification
Carcinoma Cervix: Aetiology, risk factors and pathogenesis
Squamous cell carcinoma: Gross and microscopic features and staging
Cervical cancer screening and prevention

Uterus:
Endometrial histology in the menstrual cycle
Dysfunctional uterine bleeding
 Inflammatory disorders: endometritis
Simple and complex (cytoglandular and adenomatous) hyperplasia:
Aetiology and morphology
Endometriosis: Definition, sites and pathogenesis
Adenomyosis and its complications
Leiomyoma, Leiomyosarcoma: Aetiology, gross and microscopic
features, complications
Carcinoma Endometrium: Classification, aetiopathogenesis, gross and
microscopic features

Ovary:
Polycystic ovarian syndrome
Tumors of Ovary: Classification
Surface epithelial tumors, germ cell tumors: Aetiopathogenesis, gross
and microscopic features

Fallopian tube:Inflammation, tumors and cysts

Gestational Trophoblastic diseases: Hydatidiform mole,

choriocarcinoma, placental site trophoblastic tumors – aetipathogenesis,
gross and microscopic features

Breast: Clinical presentation of Breast disease

Inflammatory disorders:
Acute mastitis, duct ectasia, granulomatous mastitis: Aetiology, gross
and microscopic features
Benign epithelial lesions: Fibrocystic changes, Gynaecomastia

Tumors of Breast:
Classification.
Carcinoma breast: Risk factors, pathogenesis, classification, gross and
microscopic features
Fibroadenoma, phyllodes tumor: Clinical features, gross and
microscopic features
Paget’s disease of Breast: Definition, gross and microscopic features
Differential diagnosis of lump in the breast

PHARMACOLOGY
Uterine stimulants and Tocolytic agents: Overview, classification,
indication, mechanism of action, adverse effects and contraindications.
Drugs used for pregnancy and lactation: List the drugs that can be used
safely during pregnancy and lactation.
Drugs used for management of STIs: Introduction to sexually transmitted
infections, describe in brief about drugs used for sexually transmitted
infections
Antivirals: Introduction, classification of antiviral agents, mechanism of
action, indication and adverse effects of antiviral agents. Describe
treatment regimens for HIV infections.Discuss about the national
programme for HIV control
Estrogen and progesterone: Overview, types, mechanism of action,
indication, adverse effects
Hormonal contraceptives: Overview of hormonal contraceptives,
mechanism of action, types, indications and adverse effects of hormonal
contraceptives
Anabolic steroids: Introduction, classification, indications and misuses of
anabolic steroids
CENTRAL NERVOUS SYSTEM AND SPECIAL SENSE

ANATOMY
Head and Neck

Scalp
Describe the layers of scalp, its blood supply, its nerve supply and
surgical importance
Describe emissary veins with its role in spread of infection from
extracranial route to intracranial venous sinuses
Face & parotid region
Describe & demonstrate muscles of facial expression and their
nerve supply
Describe sensory innervation of face
Describe & demonstrate origin /formation, course, branches
/tributaries of facial vessels
Describe & demonstrate branches of facial nerve with
distribution
Describe cervical lymph nodes and lymphatic drainage of head,
face and neck
Identify superficial muscles of face, their nerve supply and
actions
Explain the anatomical basis of facial nerve palsy
Explain surgical importance of deep facial vein
Describe & demonstrate the parts, borders, surfaces, contents,
relations and nerve supply of parotid gland with course of its
duct and surgical importance

Anterior Triangle of neck

Describe boundaries and subdivisions of anterior triangle
Describe & demonstrate boundaries and contents of muscular,
carotid, digastric and submental triangles

Posterior triangle of neck

Describe & demonstrate attachments, nerve supply, relations
and actions of sternocleidomastoid
Explain anatomical basis of wry neck
Temporal and Infratemporal regions
Describe & demonstrate extent, boundaries and contents of
temporal and infratemporal fossae
Describe & demonstrate attachments, direction of fibres, nerve
supply and actions of muscles of mastication
Describe & demonstrate articulating surface, type & movements
of temporomandibular joint
Explain the clinical significance of pterygoid venous plexus
Describe the features of dislocation of temporomandibular joint

Submandibular region
Describe and demonstrate the superficial and deep structures,
muscles, nerves, vessels, and glands in the submandibular
region.
Describe & demonstrate the morphology, relations and nerve
supply of submandibular salivary gland & submandibular
ganglion
Describe the basis of formation of submandibular stones
Deep structures in the neck
Describe the parts, extent, attachments and modifications of
deep cervical fascia
Describe the fascial spaces of neck
Describe and demonstrate extent, drainage & applied anatomy
of cervical lymph nodes
Demonstrate & describe the origin, parts, course & branches
subclavian artery
Describe & demonstrate origin, course, relations, tributaries and
termination of internal jugular & brachiocephalic veins

Head & neck Joints

Describe & demonstrate the movements with muscles producing
the movements of atlantooccipital joint & atlantoaxial joint
Describe the development and congenital anomalies of face,
palate, branchial apparatus
Radiology
Identify the anatomical structures in 1) Plain x-ray skull, 2) AP
view and Lateral view 3) Plain x-ray cervical spine-AP and lateral
view 4) Plain x-ray of paranasal sinuses

Describe the anatomical route used for carotid angiogram and

vertebral Angiogram, Identify anatomical structures in carotid
angiogram and vertebral Angiogram

Vertebral column
Describe the curvatures of the vertebral column
Describe & demonstrate the type, articular ends, ligaments and
movements of intervertebral joints, Sacroiliac joints & Pubic
symphysis
Describe lumbar puncture (site, direction of the needle,
structures pierced during the lumbar puncture)
Explain the anatomical basis of Scoliosis, Lordosis, Prolapsed
disc, Spondylolisthesis & Spina bifida
Describe the contents of the vertebral canal
Introduction to the nervous system
Describe general plan of nervous system with components of
central, peripheral & autonomic nervous systems
List components of nervous tissue and their functions
Describe parts of a neuron and classify them based on number of
neurites, size & function
Describe structure of a typical spinal nerve
Describe principles of sensory and motor innervation of muscles
Describe concept of loss of innervation of a muscle with its
applied Anatomy
Describe various type of synapse
Describe differences between sympathetic and spinal ganglia
Spinal Cord
Describe the external features of spinal cord
Describe extent of spinal cord in child & adult with its clinical
implication
Draw & label transverse section of spinal cord at mid-cervical &
midthoracic level
Enumerate ascending & descending tracts at mid thoracic level
of spinal cord
Describe anatomical basis of syringomyelia
Describe & identify various layers of meninges with its extent &
modifications
Describe circulation of CSF with its applied anatomy
Skull osteology
Demonstrate anatomical position of skull, Identify and locate
individual skull bones in skull
Describe the features of Norma frontalis, verticalis, occipitalis,
and lateralis and basalis
Describe cranial cavity, its subdivisions, foramina and structures
passing through them
Describe morphological features of mandible
Describe features of typical and atypical cervical vertebrae (atlas
and axis)
Explain the concept of bones that ossify in membrane
Cranial cavity
Describe the cranial fossae & identify related structures
Describe & identify major foramina with structures passing
through them
Describe & identify dural folds & dural venous sinuses
Describe clinical importance of dural venous sinuses
Orbit
Describe & identify extra ocular muscles of eyeball
Describe & demonstrate nerves and vessels in the orbit
Describe anatomical basis of Horner’s syndrome
Enumerate components of lacrimal apparatus
Organs of hearing and equilibrium
Describe & identify the parts, blood supply and nerve supply of
external ear
Describe & demonstrate the boundaries, contents, relations and
functional anatomy of middle ear and auditory tube
Describe the features of internal ear
Explain anatomical basis of otitis externa and otitis media
Explain anatomical basis of myringotomy
Eyeball
Describe & demonstrate parts and layers of eyeball
Describe the anatomical aspects of cataract, glaucoma & central
retinal artery occlusion
Describe the position, nerve supply and actions of intraocular
muscles

Medulla Oblongata
Identify external features of medulla oblongata
Describe transverse section of medulla oblongata at the level of
1) pyramidal decussation, 2) sensory decussation 3) ION
Enumerate cranial nerve nuclei in medulla oblongata with their
functional group
Describe anatomical basis & effects of medial & lateral medullary
syndrome

Pons
Identify external features of pons
Draw & label transverse section of pons at the upper and lower
level
Enumerate cranial nerve nuclei in pons with their functional
group
Cerebellum
Describe & demonstrate external & internal features of
cerebellum
Describe connections of cerebellar cortex and intracerebellar
nuclei
Describe anatomical basis of cerebellar dysfunction

Midbrain
Identify external & internal features of midbrain
Describe internal features of midbrain at the level of superior &
inferior colliculus
Describe anatomical basis & effects of Benedikt’s and Weber’s
syndrome

Cranial nerve nuclei & Cerebral hemispheres

Enumerate cranial nerve nuclei with its functional component
Describe & demonstrate surfaces, sulci, gyri, poles, & functional
areas of cerebral hemisphere.
Describe the white matter of cerebrum.
Enumerate parts & major connections of basal ganglia & limbic
lobe
Describe boundaries, parts, gross relations, major nuclei and
connections of dorsal thalamus, hypothalamus, epithalamus,
metathalamus and subthalamus
Describe & identify formation, branches & major areas of
distribution of circle of Willis
Ventricular System
Describe & demonstrate parts, boundaries & features of IIIrd,
IVth & lateral ventricle
Describe anatomical basis of congenital hydrocephalus
Embryology/histology
Describe & identify the microanatomical features of Spinal cord,
Cerebellum & Cerebrum
Describe the development of neural tube, spinal cord, medulla
oblongata, pons, midbrain, cerebral hemisphere & cerebellum
Describe various types of open neural tube defects with its
embryological basis

CONTENTS:

HEAD AND NECK:

Pharyngeal arches Development of: face & eye
Bones: Gross and Special Features of Bones Maxilla, zygomatic bone
Cranial bones- frontal, parietal, temporal, sphenoid Foetal skull.
Names of skull bones in adult
Cranial fossae with structures passing through major foramina
Cervical vertebrae: general and special features
Mandible: attachments of muscles and ligaments, differences in mandible
at different ages
Face: muscles of facial expression, nerves & vessels
Scalp: layers, blood-supply, and nerve-supply
Joints: Atlanto-occipital & Atlanto-axial-type, subtype, ligaments,
movements, applied aspects
Temporomandibular joint –type, movements and applied aspects,
including the muscles involved in producing movements
Deep fascia of neck- distribution & clinical important
Triangles of neck: Boundaries, contents and applied aspects
Infratemporal fossa: boundaries, contents and applied aspects
Pterygopalatine fossa: boundaries, contents and applied aspects
Parotid and submandibular regions:
Muscles: Names and nerve-supply of muscles of facial expressions
Attachments, nerve-supply, and actions of following muscles:
Sternocleidomastoid, Muscles of mastication, Orbicularis oculi,
Buccinator

Blood vessels: origin, course, termination, and branches/tributaries of:

Common carotid artery
External carotid artery Internal carotid artery
Subclavian arteries (right and left)
Maxillary artery
Internal jugular vein

Cervical lymph nodes: subgroups, drainage areas, applied aspects

Radiological anatomy: X-rays of skull A.P & lateral views

.
Surface anatomy:
External carotid artery, Internal carotid artery, Subclavian arteries (right
and left) & Internal jugular vein

CENTRAL NERVOUS SYSTEM:

Development of nervous system

Brain and its Meninges: Parts of Brain

Cerebral Hemispheres- Sulci and Gyri, Functional areas, fibers (white
matter), Blood supply, microscopic structure of cerebral cortex,

Internal capsule: parts, fibers, blood supply and applied aspects

Diencephalon:
Thalamus and Hypothalamus- Parts, Connections, Blood supply.
Epithalamus and Metathalamus - Parts and their functions
Basal Nuclei- Parts, Blood supply Major connections of corpus striatum
Limbic system: parts, connections & functions
Dural venous sinuses: Description and clinical importance
Ventricular System and Cerebrospinal Fluid (CSF)
Cerebellum- Gross Features, Connections, Blood supply, microscopic
structure of cerebellar cortex
Brainstem (Midbrain, Pons, and Medulla oblongata)- External features,
Blood supply, Cross-sections at different labels of each brainstem
Cranial nerves: origins, course, distributions & applied aspects
Vertebral canal
Spinal Cord: Extent, gross features, meninges, and blood supply
Transverse sections at cervical, thoracic, lumbar & sacral regions showing
positions of major tracts
Origin, course termination and applied aspects of the following tracts:
Corticospinal Spinothalamic Spinocerebellar,and Posterior column tracts

SPECIAL SENSES

Eye ball (Development, and associated anomalies),Tunics of eyeball and

their blood supply
Microscopic structure of cornea and retina
Chambers of the eyeball, and circulation of aqueous humor
Extraocular muscles (attachments, nerve supply and actions)
Ear and its parts: External ear (gross features, blood supply, and nerve
supply)
Middle ear (tympanic cavity): parts, boundaries, and contents; pharyngo-
tympanic (Eustachian) tube
Internal ear: names of its parts only
Taste buds and olfactory epithelium: location and microscopic structure
Radiological anatomy
PHYSIOLOGY
Introduction to Nervous System: Organization of the nervous system. The
structural and functional unit of nervous system. Neurons: types,
morphology, functions, functional components, classification of nerves,
neuroglia.
Signal transmission: Graded potential: definition, characteristic,
physiological significance. Resting membrane potential – ionic basis.
Action potential – definition. Ionic basis for electrical, chemical,
excitability changes. Propagation: mechanism, factors influencing.
Response of neurons and nerve fibers to injury: Types of injuries. Types
of changes: Wallerian degeneration, regeneration, factors influencing
regeneration.
Microenvironment of the neuron: Blood brain barrier, importance.
Synapses – Ultra structure, properties, synaptic plasticity,
neurotransmitters and mode of transmission. Definition, types, structure
and mechanism of transmission. Neurotransmitters and
neuromodulators and their properties.
Sensory receptors: Definition, classification, properties.
Reflexes: Definition, classification, Reflex arc and stretch reflex.
Properties of reflexes, their clinical significance.
Somato-sensory system: Sensory tracts, Sensory cortex, Dermatome, Bell-
Megendie’s law. Sensory pathways and regulation at the higher level.
Classification of pain, Pathways of pain, Theory of pain: Gate control
theory of pain, referred pain, Endogenous pain relief system
Control of posture and movement: General principles of organisation of
motor control. Upper and lower motor neuron lesions. Effects of complete
transection and hemisection of spinal cord.
Descending pathways involved in motor control. Pyramidal
(corticospinal) and extrapyramidal system (vestibulospinal,
reticulospinal, tectospinal and rubrospinal).
Motor cortical areas, basal ganglia – Connections, Neurotransmitter,
Functions and disorders. Cerebellum – functional anatomy, connections,
functions and disorders. Vestibular apparatus in control of -motor
movements, and their disorders.
Reticular formation: Definition, connections, functions.
Physiological basis of consciousness and sleep.
EEG: Evoked potentials, their clinical significance.
Hypothalamus: Components, connections, functions.
Thalamus: Components, connections, functions. Thalamic syndrome.
Limbic system: Components, connections, functions.
Prefrontal lobe: Components, connections, functions. Effects of lesions.
Higher cortical functions: Learning, memory, judgment, language,
speech.
Visual System: Structure of eye, overview of functions. Structure and
function of cornea. Aqueous humor: formation, circulation, drainage.
Intraocular pressure, functions. Optics of vision-image forming
mechanism. Pupil, its functions. Light reflex, accommodation. Binocular
and monocular vision. Common errors of refraction. Visual acuity and
visual fields-clinical importance. Ophthalmoscopy, and perimetry. Photo
receptors - distribution, visual pigments mechanism of excitation and
their functions. Light and dark adaptation, photopic and scotopic vision.
Visual pathway-transduction, transmission. Synaptic modulation and
visual cortex. Effects of transection of visual pathway at various levels. Eye
movements. Neurophysiological basis of fixation of gaze and conjugate
movements, squint. Physiology of colour vision- theories and
electrophysiological aspects. Colour blindness: classification, tests.
Auditory Systems: Functional anatomy of ear and general properties of
sound. External ear: functions. Middle ear: functions of tympanic
membrane and ossicles, mechanism of sound transmission, impedance
matching, function of eustachian tube. Internal ear: structure and
function of cochlea, pitch and intensity discrimination. Auditory pathway:
receptive fields and tonotopic maps, binaural interactions, nerve pathway
from the cochlea to the auditory cortex. Organization of auditory cortex,
functions, sound localization. Deafness: Types. Tests to diagnose
deafness. Audiometry, its clinical applications.
Vestibular System: Structure of labyrinth. Vestibular transduction -
response to rotational and linear acceleration. Central vestibular pathway.
Vestibulo-ocular reflex, its clinical importance. Clinical tests for vestibular
integrity, disorders of labyrinth
Olfactory System: Location of receptors, mechanism of stimulation and
pathways. Disorders of olfactory sensation.
Gustatory System: Location of receptors, mechanism of stimulation and
pathways. Disorders of gustatory sensation.

BIOCHEMISTRY
Introduction & biochemical basis of neuronal function
Blood brain barrier
Cerebrospinal fluid biochemistry
Central nervous system metabolism

CONTENTS:

Introduction & Biochemical Basis of Neuronal Function:

Upon completion of this unit, the students should be able to:
Outline the structural and functional components of the central nervous
system
Describe the functional aspects of the central nervous system in
maintaining homeostasis and interacting with the peripheral nervous
system
Outline the basic biochemistry involved in neurotransmission
Outline the role of ions in the generation and propagation of action
potentials
Enumerate the major neurotransmitters involved in CNS function
Outline the synthesis and biochemical roles of major neurotransmitters
involved in CNS function
Blood Brain Barrier:
Upon completion of this unit, the students should be able to:
Define the blood-brain barrier
Outline the structural features of the blood brain barrier
Explain the importance of blood brain barrier emphasizing on the roles of
endothelial cells, tight junctions, basement membrane and astrocytic end-
feet
Classify transport mechanisms across the blood brain barrier (passive
transport, active transport, receptor-mediate transcytosis, and efflux
transport systems)
Discuss the role of specific transporters as the glucose and amino acid
transporters in supporting neuronal metabolism
Outline the factors affecting the permeability of the blood brain barrier
and discuss their clinical significance
Outline the development of the blood brain barrier during fetal and
neonatal life and discuss its implications for drug and toxin exposure in
infants
List the conditions that likely compromise the integrity of the blood brain
barrier and discuss the biochemical mechanisms underlying such
disruptions
Explain how dysfunction of the blood brain barrier contributes to the
pathogenesis of neurodegenerative diseases
List the biomarkers associated with the dysfunction of the blood brain
barrier
Discuss how inborn errors of metabolism, such as phenylketonuria, may
affect BBB function and CNS outcomes
Cerebrospinal Fluid Biochemistry:
Upon completion of this unit, the students should be able to:
Define cerebrospinal fluid (CSF)
Outline the importance of CSF in maintaining CNS function
Outline the anatomy of CSF production
List the normal volume, composition, and flow dynamics of CSF in adults
and children
Explain the key functions of CSF
Enumerate the major components of normal CSF (electrolytes, proteins,
glucose, lactate, cells)
Compare the composition of CSF with plasma and explain the differences
List the parameters analyzed in routine CSF biochemistry and their
clinical significance
Describe the biochemical changes in CSF associated with infections,
subarachnoid hemorrhage, demyelinating disorders, CNS tumors,
hydrocephalus and other CSF flow abnormalities
Explain the diagnostic role of CSF biomarkers in neurodegenerative
diseases
Describe the procedure for CSF collection and discuss the principles of
laboratory analysis for CSF
Discuss the proper handling and storage of CSF samples for accurate
biochemical and microbiological analysis
Differentiate between the CSF biochemical patterns seen in bacterial, viral,
and tubercular meningitis
Central Nervous System Metabolism:
Upon completion of this unit, the students should be able to:
Outline the metabolic adaptations of carbohydrate, lipids and amino acid
metabolism in the neuronal tissues in physiological variations and various
pathological conditions
Define cerebral metabolic rate and discuss how it is regulated and plays a
role in maintaining normal brain function
Illustrate glutamine-glutamate cycle discuss its importance
Explain the role of phospholipids and sphingolipids in maintaining the
integrity of neuronal membranes and myelin sheaths
Discuss the impact of various metabolic diseases on CNS function,
particularly in childhood development and mental function
Outline the biochemical processes involved in traumatic brain injury
Explain the biochemical basis of cerebral edema and the
pathophysiological mechanisms underlying increased intracranial
pressure
Discuss the biochemical aspects of brain repair mechanisms
Explain the biochemical changes associated with aging of the CNS,
Describe the role of oxidative stress, inflammation, and mitochondrial
dysfunction in age-related neurodegenerative diseases
Outline the biochemical biomarkers for early diagnosis and monitoring of
CNS disorders
SPECIAL SENSE
Vitamin A & vision
Biochemistry of taste
Biochemistry of smell
Biochemistry of pain
CONTENTS:

Vitamin A & Vision:

Upon completion of this unit, the students should be able to:
Identify the chemical forms of vitamin A and outline their structural
features
List the dietary sources of vitamin A
Describe the absorption, transport, and storage of vitamin A in the body
Enumerate the key biological functions of vitamin A
Explain the role of vitamin A in the visual cycle, and discuss the signal
transduction cascade involved in it
List the causes of vitamin A deficiency
Explain the clinical consequences of vitamin A deficiency on vision
Describe the consequences of hypervitaminosis A
Interpret laboratory investigations used to assess vitamin A status and
correlate vitamin A status with clinical findings in related pathological
conditions
Discuss the therapeutic uses of vitamin A in managing vision-related
disorders
Explain the role of vitamin A supplementation programs in preventing
blindness and other health complications in children
Describe the significance of biofortification and dietary diversification in
addressing vitamin A deficiency
Biochemistry of Taste:
Upon completion of this unit, the students should be able to:
Define taste as a sensory function
List the five basic taste modalities (sweet, sour, salty, bitter, and umami)
Outline the structure and function of taste buds and taste papillae and the
distribution of taste buds on the tongue and their association with specific
taste modalities
Identify the cranial nerves involved in taste perception outline and their
roles in transmitting taste signals to the brain
Explain the molecular mechanisms of taste perception (G-protein coupled
receptors, ion channels) and outline the roles of taste receptor genes
Outline the signal transduction pathways for different taste modalities
List factors that influence taste perception
Discuss the biochemical basis of taste disorders, such as ageusia
Explain the relationship between taste perception and dietary choices
Describe the role of taste receptors in the gut and their involvement in
nutrient sensing and metabolism
Discuss the biochemical mechanisms of taste dysfunction in diseases such
as zinc deficiency, diabetes mellitus, and neurological disorders affecting
cranial nerves;
Describe diagnostic approaches for evaluating taste function, such as taste
tests and electrogustometry
Biochemistry of Smell:
Upon completion of this unit, the students should be able to:
Define the sense of smell (olfaction)
Outline the anatomical structure of the olfactory system
Explain the molecular basis of odor detection, emphasizing the role of
olfactory receptor proteins
Describe the genetic basis of olfactory receptors, including the diversity of
the olfactory receptor gene family
Explain how specific odor molecules bind to olfactory receptors and
initiate signal transduction
Outline the signal transduction mechanisms in olfactory receptor neurons
List the factors influencing olfactory sensitivity and perception
Explain the biochemical and physiological basis of conditions affecting the
sense of smell
Discuss the biochemical and pathological mechanisms of olfactory
dysfunction in diseases like COVID-19, neurodegenerative diseases, head
trauma and sinus infections
Explain the significance of olfactory testing in diagnosing neurological
and systemic conditions
Biochemistry of Pain:
Upon completion of this unit, the students should be able to:
Define and classify pain (acute, chronic, nociceptive, neuropathic, and
psychogenic)
Outline the physiological and biochemical basis of nociception (pain
perception) and differentiate between nociception and the subjective
experience of pain
Describe the biochemical basis of signal transduction in nociceptors
Explain the biochemical mediators of pain
Outline the biochemical events in pain signal transmission
Explain the role of neurotransmitters in transmitting pain signals at
synapses
Describe the biochemical pathways involved in pain modulation,
including the role of endorphins, enkephalins, and the descending
inhibitory pathways
Explain the biochemical basic of inflammatory pain, neuropathic pain and
chronic
Describe the biochemical basis of conditions associated with abnormal
pain perception
List the biomarkers of pain and their potential role in personalized pain
management

MICROBIOLOGY
Introduction to CNS Infections

Meningitis

Encephalitis

Tetanus

Botulism

Rabies

Poliomyelitis

Parasitic Infection of CNS

CONTENTS:

Introduction To CNS Infections: Definitions, Etiological Agents,

Principle Of Laboratory Diagnosis]

Bacterial Meningitis [Agents, Pathogenecity, Clinical Presentations,

Laboratory Diagnosis, Complications]

Nesisseria meningitides [Morphology, virulence Factors, mode of

transmission, pathogenesis, clinical manifestations and laboratory
diagnosis]
 Fungal meningitis: causative agents, mode of transmission, route of
infection pathogenesis, clinical manifestations and laboratory
diagnosis.

Encephalitis: [Definition and causative agents and laboratory

diagnosis.]

Tetanus [Agents, Pathogenecity, Clinical Presentations, Laboratory

Diagnosis, Complications]

Botulism [Agents, Pathogenecity, Clinical Presentations, Laboratory

Diagnosis, Complications]

Poliomyelitis [Agents, Pathogenecity, Clinical Presentations,

Laboratory Diagnosis]

Japanese B encephalitis virus: Morphology, mode of transmission,

pathogenesis, clinical manifestations, laboratory diagnosis and
immunization.

Slow Viruses, Prion Diseases And Miscellaneous Viruses [Agents,

Morphology, Pathogenesis, Clinical Manifestations, Laboratory
Diagnosis]

Rabies [Causative Agents, Morphology, Pathogenesis, Clinical

Manifestations, Laboratory Diagnosis, Prophylaxis]

Parasitic infections in CNS: causative agents, mode of transmission,

pathogenesis, clinical manifestations and laboratory diagnosis.

PATHOLOGY
Cellular pathology of central nervous system

Cerebral edema, hydrocephalus

Malformations and developmental disorders

 Trauma

Cerebrovascular diseases
Infections
Demyelinating diseases
Neurodegenerative diseases
Metabolic diseases
Tumors
Eye: Trachoma, Retinoblastoma

Contents:

Cellular pathology of central nervous system: Reactions of glial

cells to injury
Cerebral edema, hydrocephalus: Definition, types, morphology,
clinical features, complications

Malformations and developmental disorders: Neural tube defects,

forebrain and posterior fossa anomalies
Trauma: Skull fractures, parenchymal injuries, traumatic vascular injury
Cerebrovascular diseases: Definition, types, clinical features,
complications

Infections:
Meningitis: Aetiopathogenesis, classification
Bacterial meningitis, viral meningitis, tubercular meningitis: gross and
microscopic features
CSF examination as a tool in differential diagnosis of different
meningitis
Brain abscess: Aetiopathogenesis, morphology, diagnosis
Viral meningoencephalitis: Aetiology, pathogenesis, morphology

Demyelinating diseases: Types, Multiple sclerosis: Gross and

microscopic features

Neurodegenerative Diseases: Types, Prion disease, Alzheimer’s

disease, Parkinson’s disease: aetiopathogenesis, gross and microscopic
features, Huntington disease, spinocerebellar degenerations: brief
introduction

Metabolic diseases:
Genetic: leukodystrophies
Toxic and acquired: Vitamin deficiencies, neurologic sequelae of
metabolic disturbances

Tumors:
Classification
Astrocytoma, oligodendroglioma, ependymoma, glioblastoma: Gross
and microscopic features
Meningioma: Classification, gross and microscopic features
Embryonal neoplasm: medulloblastoma
Metastatic tumors
Paraneoplastic syndromes

Eye:
Conjunctiva: Pingecula, pterygium, neoplasm
Cornea: Keratitis and ulcers
Uvea: Uveitis, uveal nevi and melanoma
Trachoma: Etiology, Clinical features, Prevention

Retina and vitreous:

Retinal vascular disease: Hypertension, diabetes mellitus
Age related macular degeneration
Retinoblastoma: Aetiopathogenesis, clinical features, gross and
microscopic features

PHARMACOLOGY
General consideration of CNS, Neurotransmitters, Drug acting on CNS
and basis of centrally acting drugs
Alcohol: Overview of alcohol, Management of alcohol poisoning,
General anaesthesia: Definition, classification, Stages of anesthesia
Mechanism of action, pre-anaesthetic medication in brief, Basal
anaesthesia, Method of administration.
Local anesthesia: Classification, mechanism of action, adverse effects,
precautions and interactions, indications and technique of local
anesthesia.
Sleep physiology:
Hypnotics and sedatives: Classification, mechanism of action, indication,
adverse effects.
Benzodiazepines: Classification, mechanism of action, indication, adverse
effects.
Therapy for epilepsy: Introduction of Epilepsy, seizure, classification
of anti-epileptic drugs, Treatment of different types of epilepsy, Novel
treatment approach of epilepsy
CNS stimulants: Describe in brief about CNS stimulants
Classification of mental disease, different theories &
classification of drugs:
Psychopharmacology: Antipsychotic agents, classification, mention of
action, indications and adverse effects of antipsychotics
Anti-anxiety drugs: Classification, mechanism of action, indication,
adverse effects.
Antidepressants: Classification, mechanism of action, indication, adverse
effects
Mood Stabilizing agents (Antimanics): Classification, mechanism of
action, indication, adverse effects
Anti-parkinsonian drugs: Overview, Classification, mechanism of action,
indication, adverse effects.
Anti-Alzheimer’s drugs: List the drugs used in Alzheimer’ disease.
Describe briefly about the novel treatment modalities.
Special senses:
Drugs used for treatment of ear infections
Drugs used for diseases of eye: Bacterial conjunctivitis, Glaucoma
 PRACTICALS

ANATOMY
Gross Anatomy Practicals
Basic concepts:

 Study of body parts and regions.

 Study of models of spermatozoa, ova, spermatogenesis & oogenesis.
 Study of models of fertilization, implantation, blastocyst, early development of
embryo.
 Study of models of placenta & umbilical cord.

Lymphoid organs:
 Gross anatomy of spleen, lymph nodes and thymus
 Gross anatomy of tonsils

Histology practical on Basic concepts

 Histological structure of simple epithelium.

 Histological structure of compound epithelium.
 Histological structure of bone (T.S & L.S.).
 Histological structure of different types of cartilages.
 Histological structure of different types of muscles.
 Histological structure of nerve & ganglion - spinal and sympathetic

Lymphoid organs:
Histological structure of lymph node, spleen, tonsil and thymus
Histology Practical of Integumentary System – thick and thin skin.
Gross Anatomy Practicals of Upper Limbs:
 Demonstration of bones of upper limbs
 Dissection & Demonstration of pectoral region.
 Dissection of axilla, axillary artery and brachial plexus.
 Dissection & Demonstration of scapular muscles and muscles of back.
 Dissection & Demonstration of upper arm – front and back.
 Dissection of cubital fossa and front of forearm.
 Dissection & Demonstration of back of forearm.
 Dissection & Demonstration of palm and back of hand.
 Radiological anatomy of upper limb.
 Surface anatomy of upper limb

Gross Anatomy Practicals of Lower Limbs:

 Demonstration of bones of lower limbs
 Dissection of femoral triangle and front of thigh.
 Dissection of anterior and medial compartments of thigh.
 Dissection & Demonstration of gluteal region.
 Dissection of muscles of back of thigh.
 Dissection & Demonstration of popliteal fossa.
 Dissection of anterior, lateral and posterior compartments of leg.
 Radiological anatomy of lower limb.
 Surface anatomy of lower limb.

Gross Practical of Cardio-Vascular System:

 Demonstration of pericardium – fibrous and serous pericardium.
 Demonstration of external features of heart and its surface markings.
 Demonstration of blood supply of the heart.
 Demonstration of right atrium and right ventricle.
 Demonstration of left atrium and left ventricle.
 Demonstration of aorta, pulmonary trunk and pulmonary veins.
 Radiological and Surface anatomy of cardiovascular system.

Histology Practical of Cardiovascular System:

 Histological structure of cardiac muscle.

 Histological structure of artery and vein.
Gross Practical of Respiratory System:

 Identify and describe the salient features of sternum, typical rib, IST rib and typical
thoracic vertebra.
 Identify & describe the features of 2nd, 11th and 12th ribs, 1st, 11th and 12th thoracic
vertebrae.
 Demonstration of nasal cavity n a s a l septum a n d paranasal sinuses.
 Demonstration of thoracic wall and thoracic diaphragm.
 Demonstration of different parts of pleura & pleural recesses
 Gross anatomy of right lung and relations of its mediastinal surface.
 Gross anatomy of left lung and relations of its mediastinal surface.
 Demonstration of structures in mediastinum.
 Radiological anatomy of respiratory system.
 Surface anatomy of respiratory system.

Histology Practical of Respiratory System:

 Histological structure of epiglottis, trachea & lung

 PHYSIOLOGY

FIRST YEAR

Haemopoietic system:
Study of the compound microscope.
Preparation and examination of peripheral blood smear and determination of
differential leucocyte count
Determination of total red blood cell count
Determination of total leucocyte count
Determination of platelet count
Determination of reticulocyte count
Determination of eosinophil count
Determination of osmotic fragility of erythrocytes
Determination of erythrocyte sedimentation rate, packed cell volume and calculation
of the absolute values
Determination of hemoglobin concentration of blood
Determination of ABO and Rh blood groups
Determination of bleeding time, clotting time
Respiratory System:
Spirometry: Determination of various lung volumes and lung capacities
Examination of human respiratory system.

Cardiovascular System:
Clinical Examination of CVS.
Measurement of arterial pulse and systemic arterial blood pressure.
Determination of the effect of posture and exercise on blood pressure.
Cardiopulmonary resuscitation.
Demonstrations:
Electrocardiogram.
Methods of artificial respiration.
SECOND YEAR

Gastrointestinal System:
Clinical examination of the abdomen.
Renal and electrolyte system/ endocrine; reproductive system :
To show the prepared charts and diagrams, figures to explain applied aspects of renal
and electrolyte system/ endocrine and reproduction.
CNS and Special senses :
Physiological examination of sensory system.
Physiological examination of motor system.
Physiological examination of reflexes.
Examination of cranial nerves.
Visual activity, field of vision, colour vision.
Tests for hearing: Rinne’s test, Weber’s test.
Tests for taste and smell.
Examination of cerebellar functions
 BIOCHEMISTRY
Basic laboratory skills & safety
Carbohydrate analysis
Protein analysis
Laboratory equipment & instruments
Specimen collection & handling
Advanced analytical techniques
Biochemical estimations
Basic Laboratory Skills and Safety
Upon completion of this unit, the students should be able to:
Familiarize themselves with laboratory facilities, equipment, and reagents used in
clinical biochemistry
Demonstrate proper handling of equipments used in biochemistry laboratory
List common laboratory hazards and outline the appropriate preventive measures and
safety protocols
Carbohydrate Analysis
Upon completion of this unit, the students should be able to:
Perform qualitative tests for carbohydrates on given samples and interpret the results
Protein Analysis
Upon completion of this unit, the students should be able to:
Perform qualitative tests for proteins on given samples and interpret the results
Laboratory Equipment and Instruments
Upon completion of this unit, the students should be able to:
Describe the principles of operation of all the necessary equipment and instruments
used in the biochemistry laboratory and identify their clinical applications
Specimen Collection and Handling
Upon completion of this unit, the students should be able to:
Identify the different types of biological samples that are analyzed in the biochemistry
laboratory
Understand the protocols for blood-specimen collection, preservation, and
transportation in a hospital laboratory setting
Outline the appropriate methods for handling other different types of biological
samples
Advanced Analytical Techniques
Upon completion of this unit, the students should be able to:
Observe the processes of electrophoresis and chromatography and interpret the
obtained results
Biochemical Estimations
Upon completion of this unit, the students should be able to:
Describe the principle of colorimetry and demonstrate the operation of a colorimeter
and/or a spectrophotometer
Clinically interpret the serum total protein and albumin levels estimated in the clinical
laboratory by using standard laboratory method
(colorimeter/spectrophotometer/semi/fully automated analyzer)
Clinically interpret the serum uric acid levels estimated in the clinical laboratory by
using standard laboratory method (colorimeter/spectrophotometer/semi/fully
automated analyzer)
Clinically interpret the serum total and ionized calcium levels estimated in the clinical
laboratory by using standard laboratory method
(colorimeter/spectrophotometer/semi/fully automated analyzer)
Clinically interpret the serum total cholesterol levels estimated in the clinical
laboratory by using standard laboratory method
(colorimeter/spectrophotometer/semi/fully automated analyzer)
Clinically interpret the levels of different components of serum lipid profile estimated
in the clinical laboratory by using standard laboratory method
(colorimeter/spectrophotometer/semi/fully automated analyzer)
Clinically interpret the levels of different components of serum iron profile estimated
in the clinical laboratory by using standard laboratory method
(colorimeter/spectrophotometer/semi/fully automated analyzer)
 MICROBIOLOGY

FIRST YEAR

General Concept in Basic Medical Science:

Introduction of Universal Safety Precautions, Biosafety cabinets And Biosafety

Levels.

Handling Of Light Microscope, Principle of Other Microscopes, Morphology Of

Bacteria And Gram Staining.

Introduction to Different Instruments Used in Microbiology, Their Parts And

Functions (Autoclave, Hot air oven, anaerobic jar, candle jar, inoculating loop.
straight wire, sample container, cotton swab).

Introduction of different types of culture media (Basal, enriched, enrichment,

selective, differential, transport, anaerobic) and demonstrate colony
characteristics.

Visit to CSSD, Hospital Waste Management, Visit to Clinical Microbiology

Laboratory At Hospital

Smear Preparation And Study of Morphology And Classification of

Microorganisms by Gram’s stain, Motility by Hanging Drop Preparation And
Agar Inoculation

Study Of Various Biochemical Tests [Catalase, Coagulase, Oxidase, Citrate, SIM,

TSI, Urease]

Study Of Antibiotic Susceptibility Tests by Stokes Method And Kirby Bauer

Method

Immune System And Immunology:

Antigen- Antibody Reactions (Serological Tests- Agglutination, Precipitation)
Integumentary System:

Leprosy And Pyogenic Skin Infections- Demonstration Of Lepra bacilli,

Staphlyococcus, Streptococcus, and their specimen Collection, Transport,
Handling, Stain used for Diagnosis, Media Used For Inoculation]
Fungal Infections Of The Skin- Specimen Collection, Transport, Handling, Media
Used, Skin Scraping, KOH
Fungal Infections of The Skin- Stain Used- LPCB Mount, Growth Characters in
Media, Candida, Germ Tube Tests, Growth on BA, SDA

Haemopoietic System:
Blood Culture for bacterial isolation- Sample collection techniques, Media Used for
blood culture, Standard Precaution.

Preparation of thick and thin smear and rapid diagnostic tests for identification
of malarial Parasites.
Peripheral Blood Smear And Demonstration Of Blood Parasites: Kala-Azar, Filaria
And Their Laboratory Diagnosis

Cardiovascular System:

Diagnosis Of Rheumatic Fever/RHD, Infective Endocarditis- Sample collection

and demonstration of blood culture for diagnosis of infective Endocarditis.

Respiratory System:

Collection And Processing Of Clinical Specimen For Respiratory Tract Infections

[Throat Swab, Sputum]

Laboratory Diagnosis Of Upper Respiratory Tract Infections: Streptococcal

Pharyngitis And Diphtheria

Laboratory Diagnosis Of Lower Respiratory Infections: Staphylococcus aureus,

Streptococcus Pneumoniae, Klebsiella Pneumoniae

Laboratory identification of capsulated fungi using India Ink preparation.

Laboratory diagnosis of fungal infections (sample collection, cultural
characteristics, staining and biochemical tests).
SECOND YEAR
Gastrointestinal System:
Laboratory Diagnosis of Enteric Pathogenic Bacteria: Specimen collection, hanging
drop preparation or wet mount preparation Colony characteristics in culture
media, Different Biochemical Reactions; Oxidase, TSI, Urea, SIM, Citrate and
Other tests.

Diagnosis of Enteric Fever- Specimen Collection, Demonstration of Salmonella on

selective media, enrichment media, biochemical reactions, Widal test.

Laboratory Diagnosis Of Intestinal Protozoal/Parasitic Infections- Demonstration

of Ova/ Cyst/ adult parasites

Hepatobiliary System:

Serological diagnosis of hepatitis B and C viruses.

Wet mount and iodine preparation of hepatobiliary parasites

Renal and Electrolyte System:

Laboratory diagnosis of urinary tract infection with E. coli, Klebsiella, Proteus

etc.: specimen collection, Culture methods, Growth Interpretation And
Biochemical Tests
Laboratory diagnosis of urinary tract infection with E. coli, Klebsiella, and
Proteus etc.: Rapid test and Antibiotic sensitivity test.
Laboratory diagnosis of renal tuberculosis: Ziehl Neelsen and other rapid
diagnostic methods.

Reproductive System:

Laboratory diagnosis of urethral discharge & Bacterial Vaginosis: specimen

collection, gram stain, culture, biochemical tests and antibiotic sensitivity test.

Laboratory diagnosis of syphilis: VDRL, RPR, TPHA (principle, procedure and

interpretation of result.
 Trichomonas vaginalis: Wet mount preparation.

Candida Infections- Colony Characteristics of Candida in Blood Agar and SDA,

Gram staining reaction, Germ Tube Test.

Laboratory Diagnosis Of HIV: Serological Tests HIV1 & HIV 2, ELISA, Western
Blot Demonstration

Central Nervous System:

Laboratory diagnosis of bacterial meningitis: specimen collection, concentration

techniques, gram stain, culture, biochemical tests and antibiotic sensitivity test.

Laboratory diagnosis of fungal meningitis: specimen collection, India ink

preparation and serological tests.

Spore staining by malachite green.

Special Senses:

Laboratory diagnosis of conjunctivitis/ or chronic suppurative otitis media:

specimen collection, gram stain, culture, biochemical tests and antibiotic
sensitivity test.
 PATHOLOGY

FIRST YEAR
Orientation to the Pathology Laboratories, knowing equipment and
instruments:
Microscope, RBC pipette, WBC pipette, Westergreen's tube with stand, Wintrobe tube,
Bone marrow aspiration and biopsy needle, Glass slides
Hematology:
Staining of peripheral blood smears;
Identification of cells in Romanowsky-stain stained blood film: Study of morphology
of RBC, platelets; total leukocyte count, differential leukocyte count
Perform investigations: Haemoglobin estimation by Sahli’s hemoglobinometer
Blood grouping – ABO and Rh grouping
Gross and microscopic changes in diseases. (On materials available,
specimens, slides, photographs, cards):
The study of microscope
Acute and chronic inflammation slide study
The study of granulation tissue/ calcification/ thrombus
Chronic venous congestion of liver/spleen
Amylodosis
Tuberculosis
Hemangioma (capillary/cavernous)
Benign and malignant tumor (eg. Lipoma /Fibrosarcoma/Squamous cell
carcinoma/Adenocarcinoma
Skin – Leprosy/ SCC/ Basal cell carcinoma/ Melanoma
Osteomyelitis/ Giant cell tumor/ Osteosarcoma
Neurofibroma/Schwannoma
Reactive lymphocytes/ Lymphadenitis/ Lymphoma
IDA/ Megaloblastic anemia
AML/ALL
CLL/CML
Atheroma
Myocardial infarction/ Brief introduction to myxoma
Pneumonia/Pulmonary Tb
Bronchiectasis
Carcinoma of lung (Squamous cell/ Bronchogenic)
Procedures: PBS staining, Sahli’s Hb estimation, ABO Blood grouping, instruments
Second Year
Equipment and instruments:
Cassettes, Paraffin block, Microtome blade
Urine examination: physical, chemical, microscopic.
Protein: Heat acetic acid test
Ketone: Rothera's test
Reducing sugar: Benedict's test
Gross and microscopic changes in diseases (on materials available,
specimens, Photographs, cards):
Squamous cell carcinoma of oral cavity/ Nasal Polyp / Rhinosporidiosis
Leukoplakia/Pleomorphic Adenoma/ Warthin tumor
SCC esophagus
Peptic ulcer/ Duodenal ulcer
Carcinoma of stomach ( intestinal/diffuse)
Tb intestine/ Polyp (Juvenile rectal polyp)
Carcinoma of colon (proximal / distal)
Fatty liver
Cholelithiasis
Cirrhosis/ Hepatocellular carcinoma/ Metastatic carcinoma to liver
Pyelonephritis (Acute/Chronic)
Tuberculous pyelonephritis
Hydronephrosis
Renal cell carcinoma/ Transitional cell carcinoma/ Nephroblastoma
Goitre (Colloid/Multinodular)/ Hashimoto's thyroiditis
Thyroid carcinoma (Papillary/Follicular)
Ectopic pregnancy/ Molar pregnancy
Endocervical polyp/ Cervical carcinoma
Proliferative and secretory endometrium
Endometrial hyperplasia
Ovary tumor (Serous/Mucinous), Teratoma
Leiomyoma/Adenomyoma
Fibroadenoma/Phyllodes tumor
Breast carcinoma (Invasive Ductal carcoma/Lobular carcinoma)
Seminoma
Benign Prostate Hyperplasia
Meningioma
CNS tumor (Glioblastoma/Oligodendroglioma/Astrocytoma/Ependymoma)
Retinoblastoma
 PHARMACOLOGY

FIRST YEAR
Basic concepts:
Experimental Pharmacology
Introduction to experimental pharmacology
Dose response curve
Therapeutic Index
Study of action of drugs on the rabbit’s eye
Effect of drugs on dog’s blood pressure- CAL
Charts and Graphs
Demonstration of Instruments
Clinical Pharmacology:
Introduction to clinical pharmacology
Pharmacokinetic parameters
Time plasma concentration curve
Therapeutic drug monitoring
RUD, EML, STG & Sources of drug information
P-drug concept & pharmacoeconomics
General principles of anti-microbial use
Drug interaction & Fixed dose drug combination
Critical appraisal of drugs advertisements
Dosage forms of Drugs
Autonomic Nervous System:
Prescription writing on cases related to ANS
Clinical cases
P drug selection
Drug formulary

Musculoskeletal System and Integumentary System:

Prescription writing
Clinical cases
P drug selection
Drug formulary
Haemopoetic System:
Prescription writing
Clinical cases
P drug selection
Drug formulary

Cardiovascular System:
Prescription writing
Clinical cases
P drug selection
Drug formulary

Respiratory System:
Prescription writing
Clinical cases
P drug selection
Drug formulary

Second Year
Gastrointestinal and Hepatobiliary System:
Prescription writing
Clinical cases
P drug selection
Drug formulary

Renal System:
Prescription writing
Clinical cases
P drug selection
Drug formulary

Endocrine System:
Prescription writing
Clinical cases
P drug selection
Drug formulary

Reproductive System:
Prescription writing
Clinical cases
P drug selection
Drug formulary

Central Nervous System:

 Prescription writing
Clinical cases
P drug selection
Drug formulary

Special Sense:
Prescription writing
P drug selection
INTRODUCTION TO CLINICAL MEDICINE(ICM)

MBBS FIRST YEAR

Medical Ethics
Art of History Taking
Clinical Examination

At the end of Semester-I the learner should be able to:

realise the roles and responsibilities of a basic medical doctor.
Familiarise with the societal expectations of medical profession.
understand the functions of Nepal Medical Council.
perceive medical ethics as an essential of medical profession
and;cultivate and exhibit an attitude of compassion and respect to
patient as a fellow-human being.
develop preparedness and readiness to provide medical care with
dedication, acting in the best
interest of the patient.
uphold confidentiality of patient related information.
be truthful and honest with colleagues and others in the medical
profession.
refrain from causing any form of harm to the patient.
be well aware of the Law of the Land and strive to uphold the Law of the
Land.
know the professional norms and imbibe - exhibit the behavior expected
of a doctor.
appraise with the components of communications skills.
state the importance and the need for history taking.
develop skill of taking history
comprehend the socio-cultural habits of ethnic groups.
recognise the geographical variations in the prevalence of different types
of diseases.
demonstrate on peers the techniques of systematic general physical
examination procedures.
make observation of: first aid, dressings, injection procedures,
venesection, blood transfusion in
emergency room / hospital wards.
Musculo-skeletal System:
appraise the common problems related to Musculo-skeletal System.
take relevant history on Musculo-Skeletal System.
correlate anatomical structures and Pathophysiology involved in giving
rise to different clinical
sign in relation to Musculo-Skeletal System.
identify laboratory and radiological investigations required in making
diagnosis.
list steps of testing patients clinically in relation to motor, reflexes, ,
sensory, gait and coordination.
Instructional Method:
Lectures in class-room, practical demonstrations, practice on
peers and on patients, supplementary
video

Examination of Respiratory System Examination of Cardiovascular

System

At the end of Semester II, the undergraduate medical students should be

able to:
recall the structures of respiratory and cardiovascular systems.
correlate anatomical locations of organs and describe steps of clinical
examinations.
demonstrate locations of important structures related to respiratory and
cardiovascular over the chest, neck and limbs.
integrate basic sciences with clinical problems related to respiratory
system and cardiovascular system.
take good history related to respiratory and cardiovascular system.
practice on peers the method of clinical examination of respiratory system
and cardiovascular system, as appropriate.
Familiarise with X-ray chest, ECG, sputum, blood and other investigations
in relation to respiratory system and cardiovascular system.
identify normal structures in diagrams, angiograms, echocardiograms.
mention the steps followed in performing cardiopulmonary resuscitation.

Instructional Methods:
Lectures in class room, practical demonstrations, practice on Peers, and
on patients and supplementary video.

MBBS SECOND YEAR

list common problems related to Gastrointestinal, Hepatobiliary, Renal,

Metabolism and Endocrine Systems.
perform on peers clinical examination procedures related to
Gastrointestinal, Hepatobiliary and Renal System.
correlate anatomical structures of different systems while performing
clinical examinations on peers.
Familiarise with routine blood, urine, stool examination and with upper
and lower endoscopic examination and other examinations in relation to
Gastrointestinal, Hepatobiliary, Renal and Endocrine Systems.
demonstrate Heimlich maneuver.
Instructional Methods:
Lectures in class-room, practical demonstrations, practice on
peers and on patients, supplementary
video.
appraise the common problems related to Reproductive system, Central
Nervous System and Special Senses..
take relevant history on Reproductive system, Central Nervous System
and Special Senses.
correlate anatomical structures and Pathophysiology involved in giving
rise to different clinical signs in relation to Reproductive system, Central
Nervous System and Special Senses.
identify laboratory and radiological investigations required in making
diagnosis.
list steps of testing patients clinically in relation to higher functions,
motor, reflexes, cranial nerves, sensory, gait and coordination.
Instructional Method:
Lectures in classroom, practical demonstrations, practice on peers and
on patients, supplementary video displays.
 COMMUNITY MEDICINE
Table: Overview of Community Medicine
Year Community Included Subspecialty Marks
Medicine
First Community A. Theory: Theory=80
Year Medicine-I 1. Basic Epidemiology 40 Internal
2. Biostatistics and Health Research 25 Assessment=20
3. Demography 15 Total=100
B. Practical:
a. Epidemiology and biostatistics calculation and
computer lab
Community A. Theory: Theory=80
Medicine-II 1. Human and Medicine 5 Internal
2. Health Promotion and Education 25 Assessment=20
3. Environmental and Occupational Health 30 Total=100
4. Medical Entomology and Rodontology 10
5. Medical Sociology and Anthropology 10
B. Practicum:
a. Field: Health education in school
b. Observations: Solid waste disposal, water
purification, industries
c. Lab: Entomology and Rodontology
Secon Community A. Theory: Theory=80
d Medicine-III 1. Applied Epidemiology 35 Internal
Year 2. Human Nutrition 30 Assessment=20
3. School Health Program 15 Total=100
B. Practical:
a. Field: Health facilities, nutritional home visits,
school health program
b. Lab: Nutrition
Community A. Theory: Theory=20
Medicine-IV 1. Community Health Diagnosis 20 Field
B. Practicum: Practicum=80
a. Community Health Diagnosis Residential Field 80 Total=100
Third Community A. Theory: Theory=80
Year Medicine-V 1. Family Health 45 Internal
2. Rehabilitation 10 Assessment=20
3. Disaster Management 10 Total=100
4. Primary Health Care, MDGs, SDGs 15
B. Practicum: Total=50
a. Family Health Exercise (Concurrent Field
Practicum) 50
C. Practical:
a. Observation visit: Rehabilitation centers, PHC
b. Simulation exercise: Disaster management
Fourt Community A. Theory: Theory=20
h Medicine-VI 1. Health Management and Health System of Nepal 20 Field
Year B. Practicum: Practicum=80
a. Comprehensive Provincial/ District/ Local 80 Total=100
Health Service Management Field
Total 650
First Year: Community Medicine I
Basic Epidemiology
Unit 1: General Concept of Epidemiology

 Describe the concept of epidemiology and historical development of

epidemiology

 Define health and disease, natural history of disease and models of

disease occurrence and causation (epidemiological triad, wheel, web of
causation and pie).

 Explain the need and principles of classifying diseases

 Describe different sources of epidemiological data, their types, uses,

reliability and weakness, and appraise the data critically

 Define infections, communicable/non-communicable diseases, case,

host (primary and intermediate), agent, environment, carriers,
parasites, vectors, reservoir, incubation period, latency, persistency,
infectivity, antigenicity, virulence, pathogenicity, saprophytes, eco-
health

 Explain various terminologies used in the epidemiologic description of

communicable and non-communicable diseases including type of
epidemics (common source, propagated and cyclical), endemicity,
sporadic, pandemic, epizootic, enzootic etc.

Unit 2: Mechanism of transmission of Infection

 Explain mechanism of transmission of infection in terms of

 Describing the processes of transmission of communicable diseases

 Explaining host, parasite and the environment relationship

 Ways of breaking the transmission cycle

 Describe levels of prevention and discuss control and prevention of

communicable diseases
Unit 3: Immunity

 Explain immunity and the body defense mechanisms in relation to:

antigen and antibody, basic immuno-biology, active and passive,
natural and artificial immunity, herd immunity

 Mechanism of immuno-compromised conditions

Unit 4: Immunization:

 Define immunization, types of immunization, contraindication of

immunization,

 Immunization schedule of Nepal

Unit 5: Epidemiological Investigation

 Method of control carry out epidemiological investigations of

infectious and non-infectious diseases and describe general principles
of investigation of an epidemic with examples

Unit 6: Measurement of disease

 Frequency measures (rate, ratio, proportion,

 Prevalence, incidence and other epidemiological indices,

 Measures of association

Unit 6: Characteristics disease/health status in terms of

persons, place and time

 Importance and need for collecting information on the people/person

affected with a disease,

 Role of intrinsic and extrinsic factors associated with person/s

including ethnicity in disease distribution

 Intrinsic and extrinsic conditions of place and migration

 Role of place in disease occurrence

 Geographical distribution of diseases and comparison of disease
occurrence at international, regional and local levels;

 Describing seasonal clustering of disease

 Describing clustering and cyclic fluctuations of disease

 Describing secular trends of the disease

Recommended textbooks

1. Bonita and Beaglehole. Basic Epidemiology. WHO Publications

2. Park JE, Park K. Textbook of Social and Preventive Medicine

3. Lilienfied & Lilienfield Fundamentals of Epidemiology

4. Robert H Fletcher, Suzanne W Fletcher and Edward H Wagner.

Clinical Epidemiology, Second Edition, Williams and Wilkins 1988

Biostatistics and Research

 Define statistics and explain its scope, functions, limitations and

usefulness

 State and explain the role of Biostatistics in the community medicine

and health sciences;

 Explain the significance and use of different branches of statistics in

the investigation of community health and biomedical problems in
public health and medical research;

 Collect and record statistical information on medical and related fields

from primary and secondary sources viz census, vital registration, ad-
hoc surveys, population registers, hospitals records, medical journals
and bulletins;

 Process data including the determination of frequency distribution,

presentation of statistical data diagrammatic and graphic forms as
 simple, multiple, subdivided bar diagrams, pie diagram, cartograms,
pictogram, histogram frequency curve, frequency polygon, cumulative
frequency curve, scattered diagram and give an elementary
interpretation of the data including simple analyses of tables, charts
and graphs;

 Compute different rates and ratios of mortality, morbidity and fertility

measures

 State and compute different measures of central tendencies — mean,

mode, median and identify the requisites of an ideal average and its
merits and demerits;

 State and compute different measures of location — quartiles, deciles

and percentiles

 State and compute different measures of dispersions like range,

standard deviation, variance, co-efficient of variation and identify the
requisites of an ideal dispersions

 Explain the concept of probability and chance in regard to biomedical

applications such as diagnosis of cases, recovery from diseases (
efficacy of treatments): enunciate the simple additive and
multiplicative laws of probability;

 Define and state the properties ‘of Binomial, Poisson and Normal
probability distributions and identify the parameters of these
distribution and solve numerical examples;

 Define concept of correlation and state the properties of correlation

coefficients and compute the Pearson correlation coefficient and
Spearman rank correlation coefficient and explain its meaning and
solve numerical examples

 Explain concept of regression analysis for two variables and compute

the regression coefficients for simple linear regression equations and
explain the cause and effect relationship between two variables;

 Describe hypothesis and perform tests of significance in terms of

defining hypothesis
  Formulating a statistical hypothesis,

 Differentiating null hypothesis from alternative hypothesis,

 Defining Type I and Type II errors in testing of hypothesis/level of

significance

 Conducting statistical tests of significance, Z-tests and t-test for one

sample and two

 Explain samples, chi square — test for proportion, goodness fit and
independence or association, test of correlation coefficient and draw
inferences and solve numerical examples;

 Explain sampling theory under the following:

 Defining population, sample, sampling unit, sampling frame

 Describing sample survey and census, and state the relative merits and
demerits of sample versus census,

 Explain the criteria for selecting appropriate sampling design

 Differentiating between probability and non-probabiiity sampling

 Describing accidental sampling or convenience sampling, purposive

sampling or judgmental

 Sampling quota sampling and snow balling sampling as non-

probabiiity sampling

 Describing simple random sampling, stratified random sampling,

systematic sampling,

 Cluster sampling and multi-stage sample as probability sampling

 Explaining the meaning of sampling errors and the sample size

 Describing non-sampling errors that may occur in observational

data

 Describe research and its use in medicine

  Types of research

 Describing the steps necessary for conducting a research

 Writing a research protocol

 Framing research tools — questionnaire, checklist, guideline

 Conducting a simple scientific research

 Interpretation of results

 Familiar with bioinformatics in terms of

 writing and presenting reports using MS Office

 retrieving subject matter from CD Rom, internet, websites

 applying computer skills in data processing and analysis : EPI- INFO

and SPSS

Recommended Reference Books:

1. Hill AB. Principles of Medical Statistics, Bl Publications, New Delhi

2. Mahajan BK. Methods in Biostatistics for medical students and

research workers: Jaypee Brothers, New Delhi

Demography
Unit 1: Sources of demographic data

 Identify different sources of demographic data on population

structure, composition and distribution of the community;

 Describe method, strength and weaknesses of these sources;

 Use these sources for the collection of demographic data.

Unit 2: Population structure and characteristics

 Analyze the composition of population, construct Population Pyramid,

develop concept of Young and old population;

 Identify the problems due to ageing of population;

 Describe and calculate Dependency Ratio; Masculinity Ratio, Sex

Ratio,

Unit 3: Fertility and its measurement

 Identify the factors that influence the size and composition of

population,

 Explain the simple measures of fertility such as: Crude Birth Rate,
General Fertility Rate, Age Specific Fertility Rate, Total Fertility Rate,
Child Women Ratio, Describe concept of Baby Boom Syndrome, Baby
Bust Syndrome,

 Identify the determinants of fertility,

 Describe the process of standardization of birth rates

Unit 4: Reproduction and its measurement

 Explain the concept of Reproduction rates, Replacement level fertility,

Population Momentum and Contraceptive prevalence rate.

Unit 5: Mortality and its measurement

 Describe the simple measures of mortality such as: Crude Death Rate,
Age Specific Death Rate, Infant Mortality Rate, Neo-natal Mortality
Rate, Maternal Mortality Ratio

 Identify the determinants of fertility

 Describe the process of Standardization of Death Rates and the concept
of Life expectancy.

Unit 6: Migration and its measurement

 Explain the common terminology of migration,

 Describe the simple measures of migration such as: In migration rate,

Out migration rate, Gross migration rate and Net migration rate,

 Identify the determinants of migration

Unit 7: Population Projection

 Describe the concept of Balancing Equation Method, and project the

population by Mathematical Methods (Arithmetic Growth Model,
Geometric Growth Model, Exponential Growth Model),

 Identify the demerits of one method over the other,

 Explain the concept of Population Doubling Time

Unit 8: Population Theories

 Critically analyze the Malthusian Population Theory and the

Demographic Transition theory

Unit 9: Population policy

 Describe the purpose of population theory,

 Identify the main content of population theory,

 Critically analyze the recent population of Nepal as compared with

world population policy.
Unit 10: Concept of Human Development Index

 Explain the concept of Human Development Index, understand and

interpret it

Recommended Books

1. Bhende, AA and Kanitar T. Principles of population studies. Himalaya

Publishing House, Bombay

2. Misra BD. An introduction to the study of population” South Asian

Publishers Pvt. Ltd, New Delhi

3. Mahajan BK. Method in Biostatistics. Jaypee Publishers, New Delhi

4. Shryock, HS; Siegel JS; and Associate. The methods and materials of
Demography. US Bureau of Census, Washington DC.

5. Cox RC. Demography. Cambridge University Press.

First Year: Community Medicine II

Human and Medicine

 Medicine in antiquity (Primitive Medicine, Indian Medicine,

Chinese Medicine,
 Egyptian Medicine, Greek Medicine, Roman Medicine)
 Dawn of Scientific Medicine Modern Medicine
 Medical Revolution Health Care Revolution
 Socio-Cultural aspects of Health in Nepal Eugenics
 Alternative medicine Medical Ethics
 History of human and medicine and its developments

Health Promotion and Education

Unit 1: Introduction

 Describe the meaning of health promotion with due focus to Ottawa

charter and

 Jakarta declaration as applied to health promoting hospitals/ Medical

care settings.

 Describe aim, objective and principles of health education by analyzing

various definitions of health education, particularly those propounded
by G. W. Stewart, Dorothy Nyswander, WHO scientific group and
SOPHE_AAPHER

 Explain the concept, principle and practice of patient health education

and counseling for compiiance and patient satisfaction

 Describe the place and opportunities of health education in health and

medical services;

 Describe scope of health education in:

 schools
  work sites

 family

 community

 Health and medical care settings, such as hospitals, health centers,

nursing homes, private clinics, and health care projects.

Unit 2: Health education in health and medical care settings

(HMCS)

 Explain the concept of facilitation of health education in health and

medical care settings (HMCS);

 Describe the role and functions of health and medical care providers
(HMCP) for facilitation of patient health education as a planner,
counselor, a facilitator or a monitor;

 List and explain the following functions of health and medical care
providers (HMCP):

 Risk assessment and identification of patient’s needs/problems;

 Health education planning and facilitating functions;

 Health education counseling function

 Health education monitoring functions.

Unit 3: Patient health education counseling (PHEC), planning

and facilitating

 Identify health promotion and education need in the medical care

settings through qualitative approaches — Participatory appraisal such
as Participatory Learning Actions and Focus Group Discussions

 Explain the concept of patient counseling (PC) as one of the strategy

for behaviour change;
 List and explain the essential traits required among HMCPs to carry
out patient education;

 Demonstrate the process of planning, implementing patient

education/counseling in HMCS;

 Describe the need of assessing the effectiveness of health

education/counseling activities in the HMCS.

Unit 4: Methods and media of health education/counseling in

medical care setting

 List the patient education/counseling methods appropriate for use in

HMCS;

 Appreciates the role of group dynamics and group process for

conducting effective group discussions

 Describe the nature, process and limitations of interview, counseling

and group discussion methods;

 Explain the selection criteria for interview, counseling demonstration

and group discussion methods of health education;

 Demonstrate the process of patient education/counseling methods;

 List the health education materials and equipment appropriate for

health education in HMCS.

Unit 5: Communication in patient education process

 Explain effective interpersonal and group communication with patient

and patient parties;

 Define communication, its elements and principles for effective

communication;
 Describe interpersonal and group communication barriers and the
ways to overcome the barriers in terms of :Inadequate and misleading
perception of patient’s own problems, Offensive behavior, Message
distortion, communication noises, Cultural difference between
providers and patient/patient parties, and Concept of activated patient
and compliance tendency.

Unit 6: Practice of health promotion and education in a hospital

setting

 Assess the existing situation and prepares an annual plan of action for
health promotion education with the medical team from patient and
providers perspective with due provision of regular review monitoring
in a hospital setting.

 Conduct participatory learning action (PLA) process in the medical

care setting; Conducts successful group discussions and patient
counseling

 Prepare and demonstrate proper use of some of the selected health

education materials such as pamphlet, Flash cards, display board and
electronic media.

Recommended textbooks

1. Pradhan, Hari Bhakta, Textbook of Health Education, Educational

Publishing House, Kathmandu.

2. Ramchandra L, Dharmalingam T. A Textbook of Health Education,

Vikas Publishing, New Delhi.

3. Lawrence Green et al. Health Education a diagnostic and planning

approach — PRECEDE and PROCEED Framework.

4. Ottawa Charter and Jakarta Declaration of 1986 and 1997.

5. Bedworth David & Bedworth A. Health Education: A process of human

effectiveness, Harper and Row, New York, 1978.
6. Guilbert, J J, Educational Handbook for Health Professional, Geneva:
WHO, 1977.

Environment and Occupational Health

Unit 1: Environmental Health

 Explain the concept and relevance of environmental health and

environmental sanitation

 Describe the key environmental issues.

Unit 2: Water

 Describe the sources of water.

 Analyze the relevancy of water quality and quantity

 Explain the concept of safe water, water quality standard/ water

quantity guideline

 Explain water quality indicator parameters

 Explain the implication of water quality map in the community

 Explain the concept of water purification and its types and implication

 Describe water related diseases and its prevention

Unit 3: Waste

 Describe the types of wastes and classify the wastes.

Unit 4: Solid waste

 Describe the types of solid wastes

 Explain the waste management practices existing in Nepal

 Analyze the waste types and their impact on health

Unit 5: Liquid Waste

 Describe the types of liquid waste

 Explain the liquid waste management practices existing in Nepal

 Explain the liquid waste quality and its impact on health

Unit 6: Air Pollution

 Describe the air pollution

 Explain the sources of air pollution

 Explain the types of air pollution

 Describe air pollutants and its impact on health

 Explain air pollution mitigation measures

Unit 7: Housing/ Settlement

 Define housing

 Describe the effect of poor housing

 Explain standard of housing

 Explain the concept of settlement

 Explain the rural settlements/ urban settlements

 Explain urban development and its consequences

 Explain noise pollution and its health impact

Unit 8: Ecology

 Explain the concept of ecology, ecosystem, biosphere, energy cycle,

interdependence of environment, plant, animal and human health.

 Describe the people’s participation in ecological preservation.

 Explain the management of environmental health

 Describe the role of governmental and non-governmental agencies and

communities in environmental preservation and promotion of
environmental health.

Unit 9: Occupational Health

 Define occupational health and safety, historical development,

principles, concept and scope of occupational health

 Enumerate and discuss occupational health hazards in agriculture:

1. Zoonotic and insect-borne diseases (Tetany, Bovine TB, Anthrax,

Plague, Rabies)

2. Physical health hazards (Heat, cold, light, moisture, noise, vibration)

3. Chemical hazards (Acid, Alkali, Pesticides)

4. Biological hazards (Bacteria, Virus, Clamidia, fungus, parasites,

insects)

5. Mechanical hazards (machineries, trauma)

 Discuss industrial occupational hazards such as:

1. Dermatological health problems (Primary, Secondary, Primary with

systemic illness, Carcinogenic
2. Respiratory health problems (Coalmiac pneumoconiosis, Asbestosis,
Silicosis, Cold and cough, Bassynosis, Baggasosis, Bird fancier’s lungs,
Farmer’s lung)

3. Cardiovascular problems (Cor pulmonale)

4. Problems of nervous system (peripheral, central)

5. Occupational liver disease (Cirrhosis, Hepatitis, Hydelidosis,

Carcinoma)

6. Renal disease (Carcinoma)

 Carry out occupational health risk assessment and its management

(man and environment, man and machine, man and man, principles
and procedures of management)

 Explain ergonomic hazards and their control (Musculoskeletal

hazards, relationship between biological and mechanical strength,
Engineering and administrative control of ergonomic hazards)

 Explain regulations regarding the occupational hazards:

1. Workers compensation, (general concepts, procedure, requirement,

types of compensation,

2. Labour Act of Nepal (Principles, procedure, labour right,

compensation)

Reference

1. Abbasi, SA. Environmental Pollution and its Control. India. Cogent

International, 1998.

2. Bryan, FL. Hazard Analysis Critical Control Point Evaluations. Geneva.

WHO, 1992
3. Gleeson C and Gray. The Coliform Index and waterborne Disease,
Problem of microbial drinking water assessment. London. E & F. N.
Spon, 1997.

4. Chapman D. Water Quality Assessment. London, Chapman and Hall,

1992.

5. Cheesbrough M. Medical Laboratory Manual for Tropical Countries.

Vol. I and II. ELBS Publication, 1993

6. Cooper P F et al. Reed Beds and constructed Wetlands for

WastewaterTreatment. Swindon: WRc pic, 1996.

7. Lucas, AO and Gills HM. Preventive Medicine for the Tropics. London:
Edward Arnold, 1990.

8. MOPE/ICIMOD/UNEP. Nepal: Status of Environment Report 2001.

Kathmandu.

9. Park, K. Preventive and Social Medicine. India: Banarsidas Bhanot,

1997

10. Peavy HS, Rowe DR and Tchobanoglous G. Environmental

Engineering. McGraw-Hill International Editions, 1985.

11. Pradhan, PK. (2003), Manual for Urban Rural Linkage and Rural
Development Analysis. Kathamndu: New Hira Book Enterprises.

12.Santra, SC. Environmental Science. India: New Central Book Agency,

2001

13. Tebbutt, THY. Principle of Water Quality Control. Pergaman Press,

1992.

14.WHO/WMO/UNEP (1996), Climate Change and Human Health.

Geneva: WHO

15. Hunter D. Diseases of Occupation

16.Jeyaratnam J. (ed). Occupational Health in Developing Countries

17. WHO. Early Detection of Occupational Diseases

18.Labour Act and Regulations of Nepal

Medical Entomology and Rodontology

Unit 1: Medical Entomology

 Define medical entomology

 Explain the nature of important insects and arthropods as vector

agents in relation to health

 Explain the mode of disease transmission, preventive methods and

medical importance of the following insects: Bed-bugs, Cockroach,
mosquitoes, fleas, sand-flies, domestic flies, ticks and mite.

Unit 2: Medical Rodontology

 Define medical rodontology

 Explain the nature of important and harmful effect relation to health.

 Explain the mode of disease transmission, preventive methods and

medical importance of the following rodents: mouse, rats, guinea pig,
squirrel.

Medical Sociology and Anthropology

Unit 1: Basic Concepts

 Explain the basic concepts of Sociology and Anthropology and

appreciate its application in medical field

 Explain the terminology used in Sociology and Anthropology (for

example social status, role, social stratification, cultural relativism,
 social process, ethnocentrism, norms, values, customs, belief systems,
cultural- lag, ethno-medicine, self- medication, ethno psychiatry) and
apply them in medical practice

 Define and explain: nature, scope, and development of Medical

Sociology and Medical Anthropology and its application in medical
sector.

 Trace the genesis, development and contemporary status of society and

health issues.

Unit 2: Culture and Health

 Explain the meaning, definition and characteristics of culture applied

to medical practice.

 Identify the Personalistic and Naturalistic medical system

 Appreciate the value of Self-medication/alternative medication and

other prevailing health care practices and its importance.

 Appreciate and apply social importance of indigenous health care

system and health care provider.

 Analyze Cross-cultural examples including gender differences in these

cultures on the concept of illness and healing practices in Nepal.

Unit 3: Doctor-Patient Relationship

 Describe the meaning and interpretation of doctor-patient relationship

 Explain reciprocal roles of doctor-patient.

 Apply Parson’s sick role model and Szaaz and Hollender’s basic model
of Doctor- Patient relationship

 Identify barriers and possible remedies in effective Doctor-Patient

relationship
Unit 4: Health Politics

 Explain the concept and interpretation of health politics.

 Describe Comprehensive and Selective Primary Health Care and

political Camps.

 Analyze the Impact of politics on health scenario.

 Identify the legal provisions of health in Nepal

Reference Books:

1. Dixit, Hemang. Nepal’s Quest for Health, Educational Publishing

House, Kathmandu.

2. Foster, George M., and Anderson, Barbora, G. Medical Anthropology

3. Freeman, E. Howard, Levine, Sol, and Reeder G. Leo (edited(1979)):

Handbook of Medical Sociology; Third Edition, Prentice-Hall, Inc.
Englewood Cliffs, New Jersey

4. Gartoulla, Ritu Prasad. An introduction to Medical Sociology and

Medical Anthropology, RECID/N, Kathmandu.

5. Gartoulla, Ritu Prasad. Therapy Pattern of Conventional Medicine,

RECID/N, Kathmandu.

6. Mechanic, D. Medical Sociology: A selective view, New York, The Free

Press.

7. Werner, D. and Bower W. Helping Health Workers Learn. Palo Alto,

CA, Hesperian Foundation.
Second Year: Community Medicine III

Applied Epidemiology

Unit 1: Epidemiology of infectious diseases

 Identify the infectious disease, and its causative agent by clinical as

well as laboratory methods

 Describe the magnitude of health problem

 Discuss the route, mode and factors responsible for the transmission

 Institute immediate management of the case and effective control

measures of:
A. Bacterial infections
Sub group I: Cholera, enteric fever (Typhoid and paratyphoid fevers),
brucellosis staphylococcal infections, meningococcal meningitis,
streptococcal infections, tuberculosis, sexually transmitted diseases and
HIV/AIDS

Sub group II: Plague, tularaemia, anthrax, relapsing fevers (tick-borne and
louse-borne relapsing fevers), leptospirosis, typhus fever, and
lymphogranuloma venereum.

B. Viral infections

Sub group I — Chicken pox, herpes zoster, herpes simplex, measles

(rubella), influenza, common cold, viral pneumonia, viral meningitis,
poliomyelitis, rabies, mumps, viral gastroenteritis, general introduction of
arboviral diseases, Japanese Encephalitis, dengue and viral Hepatitis A, B,
C, D, E.

Sub group II — Small pox (history only), foot and mouth disease,
encephalitis

C. Protozoal infections

Sub group I — Malaria, visceral leishmaniasis, amoebiasis, giardiasis,

trichomoniasis; Use of insecticide for the control of vector borne diseases

Sub group II — Coccidiosis, balantidiasis, toxoplasmosis.

D. Helminthiasis

Sub group I — Taeniasis (Taenia saginata, T. solium), Hydatid infections,

falariasis, trichuriasis, strongyloidiasis, ancylostomiasis, ascariasis
(Nematodes).

Sub group II — intestinal flukes, lung fluke, liver fluke, schistosomiasis,

draconculosis, toxocariasis, trichiniasis, capillariasis, tropical pulmonary
eosinophila.

Unit 2: Epidemiology of non-infectious and chronic diseases

 Describe epidemiology

 Analyse information in order to identify the determinants

 Discuss the impact on population of non-communicable diseases such
as accidents (road traffic accident), injuries, violence, industrial
hazards Chronic Obstructive Pulmonary Disease (COPD), bronchial
asthma, alcoholism and drug addiction, cancer, peptic ulcer,
myocardial insufficiencies, cerebro-vascular disease and nutritional
deficiency diseases (anemia, iodine deficiency disorders and vitamin A
deficiency, arsenicosis.

Unit 3: Health services for communicable and non-communicable

diseases

 Describe the operations of the following programmes: National

Tuberculosis Center, TB Control Projects, Nepal TB Association- its
hospital and community programs, Leprosy Control Project and
Khokana Leprosarium; Sukraraj Infectious Diseases Hospital, Teku,
Epidemiology and Disease Control Division, National Health
Laboratory, Department of Health Services and other health
institutions and disease control programs.

Recommended textbooks

1. Park JE and Park K. A Textbook of Preventive and Social Medicine

2. Davidson’s Principles and Practice of Medicine

3. Mohamed Illiyas, Community Medicine and Public Health, Medical

Division Karachi Pakistan.

4. Control of Communicable Diseases. American Public Health

Association
Human Nutrition

Unit 1: Introduction to Human Nutrition

 describe nutrition and importance of food and nutrition

 explain the metabolism of nutrients, carbohydrates, proteins, fat,

minerals and vitamins

 analyze the nutritional value of locally available food, cereals, pulses,

fruits, vegetables, meat, fish, egg, milk and dairy products

 discuss the food hygiene and effect of unhygienic food

 describe the food processing, its effects on nutrients of food processing

and storage

 describe the food adulteration and health hazards

 discuss mycotoxin and nutrition

Unit 2: Nutritional requirement at different stages of life

 identify balanced diet and its importance for different age, sex,
occupational groups

 analyze and describe nutritional needs during different stages of life:

infancy, adolescence, pregnancy, lactation and old age

Unit 3: Breast feeding

 describe the physiology of breast milk production

 discuss the advantages of breast-feeding

 explain artificial feeding and its impact on health

 analyze breast-feeding in different health conditions including HIV/
AIDS

Unit 4: Supplementary feeding

 describe the types and approaches and importance of supplementary

feeding

Unit 5: Problems related to nutrition and health

 describe the malnutrition, its types, magnitude and management

 analyze the poverty, infection and malnutrition

Unit 6: Anthropometric measurement

 identify the indicators of nutritional status

 describe and apply the measurement technique: weight for age, height-
for age, weight for height and mid arm circumference

 interpret the anthropometric findings

Unit 7: Nutrition plans, policies and program in Nepal

 describe the national policy and strategies in nutrition

 analyse nutritional programs conducted by GO, NGO/ INGO

 describe and analyse food supplementation programs

 discuss the legislative issues and quality control regarding food

production, transportation, marketing and consumption
Unit 8: Nutritional survey

 identify the nutritional survey in Nepal

 analyze the nutritional status of Nepalese people and current

nutritional studies and research

Unit 9: Food

 explain the concept of food security

 explain food adulteration and food storage

 explain principals of food handling and food supply

 explain about the mycotoxin in food: Aflotoxin; Fusarium derived

toxin and its prevention; Zeralenon etc.

 describe about food law in relation to food hygiene

Reference books

1. Adhikari RK, and Krantz ME. Child Nutrition and Health. Health
Learning Material Center, TU, lOM

2. King FS and Burgess A. Nutrition for Developing Publication

Countries. Oxford Medical Publication

3. The Health Aspect of Food and Nutrition, WHO

4. Vidhybhushan. Fundamentals of Sociology

5. Nepal Demographic and Health Survey, 2006

School Health Program

 Introduction and history of School Health Program

 Components of School Health Service
 Mid-day Meal
 National Response to School Health and Nutrition
2nd Year: Community Medicine IV

Community Health Diagnosis (Theory)

 describe concept of Community Medicine.

 describe concept and objectives of Community Health Diagnosis

 describe differences and similarities between Community Health

Diagnosis and clinical diagnosis

 discuss the importance and relevance of Community Health Diagnosis

for physicians

 explain different components of Community Health Diagnosis

 describe different approaches to Community Health Diagnosis

 Describe different method/techniques (observation, interviews, focus

group discussion, participatory appraisal, etc.) and tools (observation
checklist, questionnaire, discussion guideline, etc.) used in Community
Health Diagnosis.

 Explain necessity and ways of prioritization of the problems in the

community.

 Describe concept of micro health project in relation to Community

Health Diagnosis

Community Health Medicine (Integrated Practical)

 develop different tools of data collection (questionnaire, observation

checklist, focus group discussion guidelines, interview guidelines, etc.)

 apply method/techniques of data collection (interview, focus group

discussion, observation, participatory appraisal)

 estimate/calculate different health indicators and epidemiological

measurements.
 assess nutritional status of children under five by anthropometric
measurements (height for age, weight age, weight for height, and
MUAC)

 prepare weaning foods including Sarbottam Pitho

 assess dehydration and prepare ORS and other food base rehydration
solutions

 acquire basic skills on environmental health

 demonstrate basic skills on communication and health education

 Calculate/estimate basic indicators on population studies.

Community Health Diagnosis (Residential field)

 Communicate with the people in relation to the health problems in the

community in socio-cultural context of the community

 Apply different methods to collect data required for community

diagnosis.

 Use different tools of data collection that is required for community

diagnosis

 Analyze and interpret the data to identify the problems and ways of
their solutions in the community

 Prioritize the problems based on observed and felt needs and available
resources.

 Dissemination of the findings of community diagnosis process by

presentation to the community and in the campus.

 Identify the community resources to address the problems

 Plan and implement a micro-health project based on prioritization of

needs with the participation of the community.
 Write a report of community diagnosis.

Methods

Teaching learning methods of this course include theory lectures,

laboratory (practical) and field works in the community.

Laboratory works — Students will be divided in to several groups. Each of

the groups will be given assignments and guided by the teachers to assist
and monitor the performances of the students. The students will maintain
individual note on the practical works performed.

Community Medicine Diagnosis (Field) — include the following processes:

1. Selection of the field

Orientation to the students

Orientation about the community they will be posted

Orientation about process of field work

Development of the specific objectives by each group Development and

pretest of specific tools for data collection, Development of work plan in
the community

Organize logistics

1. In the community — rapport building, meeting with the people, data

collection, preliminary analysis, community presentation,
prioritization of the problem, implementation of micro health project

2. Presentation in the campus

3. Submission of the report to the Department of Community Medicine
and Family Health.

Reference books

1. Hale C. Shrestha IB and Bhattacharya A. Community Diagnosis

Manual, HLMC Institute of Medicine, 1996

2. Field Training Manual. FESU, Institute of Medicine, 1995

3. Bennette FJ. Community Diagnosis and Health Action; A manual for

tropical and rural areas, Churchill Livingstone 1979.
Third Year: Community Medicine V

Family Health

Unit 1: Concept of Family Health

 explain concept on family health

 describe holistic — biomedical and bio-psycho-social model of family

health

 describe functions of family and its relation to health care utilization

(for example, sickness role, interactions among family members in
health disease, counselling and rehabilitation)

 describe determinants of family health (Living and working

conditions; physical

 environment, personal health practices, etc.)

 explain the concept and social construct of gender, interpret gender as

determinant of health.

 describe the problems faced by the family and their impacts on family
health, for example, Teenage marriage and its consequences; Broken
and dysfunctional families; Disability and rehabilitation; Substance
abuse; Gender based violence including girl trafficking

 identify the role of medical professional in addressing these family

health problems

Unit 2: Family Health in Life Cycle perspective

2.1. Child health

 analyze the child health situation of the region and Nepal

 describe the causes and childhood morbidity and mortality — neonatal,
infancy and under five year old children.

 explain the mother’s health and its relation with child health

 describe the child survival strategies historical perspective and the

current approaches

 identify the social problems in children (child abuse, abandoned or

street children, child labour, conflict and refugee situation and its
impact on child health)

 describe importance and methods of child health surveillance

 analyze the importance of child rights and protection in child

development aspect

2.2. Adolescent Health

 identify the adolescent health needs for growth and development.

 analyze adolescent’s problems in Nepal, including teenage pregnancy,

STDs, drug abuse, alcoholism, smoking, accidents, violence, crime etc.

 describe approaches to address the adolescent health problems, life

skill education and national adolescent health strategy

2.3. Reproductive Health

 describe the evolution of the concept of reproductive health, its

components and relevance.

 Explain the major problems related to reproductive health (STD

including HIV/AIDS)

 describe the approaches to address the reproductive health problems

2.4. Maternal Health
 describe maternal health situation (morbidity and mortality)
 identify the approaches to address the maternal health problems

2.5. Aging and Health

 identify the issues of healthy aging
 identify the major health problems and their magnitude
 describe approaches to address the health of elderly people

2.6 Family Planning and Contraceptive Use

 Describe types and recent trends in contraception, their mode of
action, efficacy, indications and contraindications. Importance of
counselling and follow-up; calculation of indicators that are commonly
used.
 analyse the importance of FP program in health (social, economic,
environment, quality of life etc)
 discuss factors associated with use and non use of contraceptives,
benefit, side effects, and contraindication of contraceptive devices
 explain approaches in Family Planning program: Right-based,
Responsible parenthood
Rehabilitation
 Meaning, Definition, Principles of Rehabilitation
 Types of Rehabilitation
 Role on Rehabilitation
 Based on the treatment types

Disaster Management

 Definition, Classification, Disaster management cycle

 Morbidity, effect of disaster
 The problem statement: World-wise, Nepal
 TRIAGE of Disaster Management
 Role of Government of Nepal for Disaster Management
Primary Health Care
 describe the historical background of Primary Health Care.
 explain the principles of Primary Health Care according to Alma-Ata
Declaration.
 Principles, ELEMENTS of PHC
 Discuss health as the right and responsibility of all irrespective of
gender, ethnicity, religion, and ideological and other beliefs.
 explain the process of marginalization.
 describe the equity and social justice in health, priorities for the poor,
deprived, underprivileged, and underserved.
 describe implementation of Primary Health Care in Nepal.
 explain the concept and relevance of primary health care

SDGs
 Introduction of SDGs
 Goals of SDGs

MDGs
 Introduction of MDGs
 Goals of MDGs
 Health related goals of MDGs

Family Health Exercise Field Practical

Students will be able to:

 describe the need to follow up of a patient at home or community, and

plan and implement appropriate follow up system;

 describe social-psychological and economic pressure of the family,

community and environment where he/she lives in;

 identify various interactions between the patients and healers, family

members and community;

 identify knowledge, attitude, and practices of the patients towards

his/her own illness and control of the disease;

 identify knowledge, attitude, and practice of family members and

community towards the patient and his/her illness;

 describe different consequences of disease in family;

 obtain necessary information and cooperation from patients and
his/her family members;

 counsel the patients and family members and encourage them for
change, if necessary:

 refer to appropriate centres.

II. Methods

Students will be given 30 hours orientation comprising theoretical

concepts and practical guidelines to implementation of the exercise.
During the orientation, students will be divided into small groups
comprising 5–6 students; each group will develop the action plan of the
exercise.

Each group will be assigned 5 cases for family visits and follow ups. The
cases will be:

1. One case of infectious disease e.g., leprosy, tuberculosis, malaria, STI,

common surgical/medical, Gynae/Obs, Eye/ENT and paediatric
problems;

2. One case of non-infectious disease, e.g., COPD, bronchial asthma,

congenital abnormalities etc.;

3. One case of physical handicap requiring rehabilitation;

4. One case of mental handicap or mental or psychosomatic disorder;

5. One case to be selected by the students themselves.

The cases will be selected from the outdoor or indoor patients after
discharge from respective hospitals. The group will visit each case at least
for three times in the family to collect the relevant information from the
patients and family members and to observe the dynamics of the disease.
During the visits, students will also provide counselling to the patients and
the family members, encourage compliance, and facilitate them to seek the
appropriate services.

The students will be supervised by the faculty periodically during the visits.

After completion of the visits, students will present the findings and their
learning reflections in the campus.

Finally, each group of the students will submit the report of the family
health exercise.

Requirements of the Report:

1. The case history including clinical and laboratory findings and diagnosis

2. Habits, culture and customs which may influence the disease

3. Care pattern of healer (medical personnel or traditional healer or other)

4. Care and support system by the community and family members

5. Social, psychological, gender and economical aspects of the disease in

the family

6. Development of disease process and treatment

7. Alternatives for the care and rehabilitation

8. Gender analysis with specific tools to understand the gender issues

9. Learning reflection
III. Course contents of Orientation sessions

1. Introduction to Family Health Exercise field program

2. Concept of family medicine

3. Health care seeking behaviours and its dimensions

4. Psychological counseling

5. Coping mechanisms and adapting mechanisms

6. Family health exercise: Approaches and process

Fourth Year: Community Medicine VI

Health Management and Health System of Nepal

Management Theory

 Explain the concept and purpose of management, relevance and

importance og management in health services delivery
 Describe principal management theories, management styles and
different components of management
a. Human resource, management (need assessment, training,
retaining, personal evaluation, supervision, motivation)
b. Final management (concepts and importance)
c. Logistic management (concepts and importance)
d. Information management (concept, importance, methods)
 Explain planning cycle and planning process (eg need assessments,
target setting, resource allocation, priority setting, evaluation)
 Describe general principles of budgeting
 Describe organization theories, leadership in organization
 Explain the concept and process of supervision, evaluation and
monitoring
 Describe the ethical aspects of management (eg proper and improper
use of authority, concept of corruptions, responsibilities and
accountability of managers towards employers, superiors, juniors,
consumers and nation, social responsibility of manager)

Health Care System in Nepal

 Describe the main features of National Health Policy; characterize

the nature of health care system in Nepal
 Describe the health service delivery mechanisms in Nepal
a. Public sector
b. Private sector for profit and for non profit
c. Information sector like traditional, indigenous, self care
  Describe organizational structure of health sector in Nepal (MOHP,
Departments, Divisions etc)
 Describe hierarchical of health sector (central, regional, district,
village and community level), functions and facilities at each level.
Role and responsibilities of health service providers at different
levels, particularly, role the district health officer
 Describe the concept of Local Self Governance Act (LSGA)
 Describe targets of health sectors
a. Five year plan
b. Second long term health plan
c. Millennium Development Goals
d. Sustainable Development Goals
 Describe different strategies to achieve the targets/goals
a. Maternal and Neonatal Health (MNH) strategy
b. Reproductive Health (RH) strategy
c. Safe motherhood strategy
d. Disease Control strategy (TB, STD/AIDS, Malaria etc
e. Population policy
f. Other relevant policy and strategy
g. Community Drug Programme (CDP)
 Describe the major partners in health sectors and critical analyze
their role in health development in Nepal (NGO/INGO, donors,
multilateral agencies)
Describe rule and regulations related to health in Nepal:
Drug Regulation Act
Food safety Act
Consumers Act
Abortion Act
Ethical guidelines of Nepal Medical Council and NHRC
Other relevant Acts, Regulations
Field Placement: Comprehensive Health Service Management Field
Comprehensive Provincial/ Districts/ Local Health Service
Management Field Practice:
Collect the relevant information from different sources, analyze and
interpret them, communicate with the people, appreciate and work in
the team
Describe the health service delivery mechanism at the regional, district
and community level
Describe the health service management, administration and planning
process at the district level, role of differ partners (for example, DDC,
VDC, NGO, INGO, privet sector. Traditional service providers etc) in
providing health service in district, relationship of health office to these
partners
Prepare the district health profile including organization structure,
health work force, health programmes, health problems and issues etc
Analyze prevalence and epidemiological trend of health problems in the
district
Critically analyze the health service management in the district and
produce alternative solutions
Prepare a five year plan to address a particular problem or issue in the
district based on the local situation
To disseminate the information and effectively advocated for issues at
the different levels
 Overview of the subjects, subject-wise breakdown of hours and the exam
patterns in the first year MBBS
MBBS I-01 Theory
Systems
1. General Concepts in Basic Medical Science
2. Molecular and Cytogenetics
3. Immunology
Course Duration
1. Total Theory: 138 hours
2. Total Practical: 85 hours
Marks Distribution
1. Full Marks: 100, Pass Marks: 50
2. Internal Assessment: Full Marks: 20, Pass Marks: 10
3. Final Examination: Full Marks: 80, Pass Marks: 40
Question Patterns
1. Multiple Choice Questions: 20%
2. Short Answer Questions: 60%
3. Problem Based Questions: 20%

MBBS I-02 Theory

Systems
1. Autonomic Nervous System
2. Musculoskeletal System
3. Integumentary System
Course Duration
1. Total Theory: 138 hours
2. Total Practical: 85 hours
Marks Distribution
1. Full Marks: 100, Pass Marks: 50
2. Internal Assessment: Full Marks: 20, Pass Marks: 10
3. Final Examination: Full Marks: 80, Pass Marks: 40
Question Patterns
1. Multiple Choice Questions: 20%
2. Short Answer Questions: 60%
3. Problem Based Questions: 20%

MBBS I-03 Theory

Systems
1. Hemopoietic System
2. Cardiovascular System
Course Duration
1. Total Theory: 138 hours
2. Total Practical: 85 hours
Marks Distribution
1. Full Marks: 100, Pass Marks: 50
2. Internal Assessment: Full Marks: 20, Pass Marks: 10
3. Final Examination: Full Marks: 80, Pass Marks: 40
Question Patterns
1. Multiple Choice Questions: 20%
2. Short Answer Questions: 60%
3. Problem Based Questions: 20%

MBBS I-04 Theory

Systems
1. Respiratory System
Course Duration
1. Total Theory: 138 hours
2. Total Practical: 85 hours
Marks Distribution
1. Full Marks: 100, Pass Marks: 50
2. Internal Assessment: Full Marks: 20, Pass Marks: 10
3. Final Examination: Full Marks: 80, Pass Marks: 40
Question Patterns
1. Multiple Choice Questions: 20%
2. Short Answer Questions: 60%
3. Problem Based Questions: 20%

MBBS-I-05 Theory
Subject: Community Medicine
Course Duration
1. Total Theory: 300 hours
2. Total Practical: 60 hours
Marks Distribution
1. Full Marks: 100, Pass Marks: 50
2. Internal Assessment: Full Marks: 20, Pass Marks: 10
3. Final Examination: Full Marks: 80, Pass Marks: 40
Question Patterns
1. Multiple Choice Questions: 20%
2. Short Answer Questions: 60%
3. Problem Based Questions: 20%

MBBS-I-06 Theory
Subject: Introduction to Clinical Medicine
Course Duration
1. Total Theory+Practical: 60 Hours
Marks Distribution
1. Full Marks: 100, Pass Marks: 50
2. Internal Assessment: Full Marks: 20, Pass Marks: 10
3. Final Examination: Full Marks: 80, Pass Marks: 40
Question Patterns
1. Multiple Choice Questions: 20%
2. Short Answer Questions: 60%
3. Problem Based Questions: 20%
MBBS I-07 Practicum
Subjects: Practicals of all the subjects taught in the first year)
1. Anatomy (Code: Anatomy Practicum)
2. Physiology (Code: Physiology Practicum)
3. Biochemistry (Code: Biochemistry Practicum)
4. Microbiology (Code: Microbiology Practicum)
5. Pathology (Code: Pathology Practicum)
6. Pharmacology (Code: Pharmacology Practicum)
7. Community Medicine (Code: Community Medicine Practicum)
8. Introduction to Clinical Medicine (Code: Introduction to Clinical Medicine
Practicum)
Marks Distribution
1. Full Marks: 100, Pass Marks: 50
2. Internal Assessment: Full Marks: 20, Pass Marks: 10
3. Final Examination: Full Marks: 80, Pass Marks: 40
 Overview of the subjects, subject-wise breakdown of hours and the
exam patterns in the second year MBBS
MBBS II-08 Theory
Systems
1. Gastrointestinal System
2. Hepatobiliary System
Course Duration
2. Total Theory: 150 hours
3. Total Practical: 85 hours
Marks Distribution
1. Full Marks: 100, Pass Marks: 50
2. Internal Assessment: Full Marks: 20, Pass Marks: 10
3. Final Examination: Full Marks: 80, Pass Marks: 40
Question Patterns
1. Multiple Choice Questions: 20%
2. Short Answer Questions: 60%
3. Problem Based Questions: 20%

MBBS II-09 Theory

Systems
1. Renal and Electrolyte System
2. Endocrine System
Course Duration
4. Total Theory: 150 hours
5. Total Practical: 85 hours
Marks Distribution
1. Full Marks: 100, Pass Marks: 50
2. Internal Assessment: Full Marks: 20, Pass Marks: 10
3. Final Examination: Full Marks: 80, Pass Marks: 40
Question Patterns
1. Multiple Choice Questions: 20%
2. Short Answer Questions: 60%
3. Problem Based Questions: 20%

MBBS II-10 Theory

Systems
1. Reproductive System
Course Duration
6. Total Theory: 150 hours
7. Total Practical: 85 hours
Marks Distribution
1. Full Marks: 100, Pass Marks: 50
2. Internal Assessment: Full Marks: 20, Pass Marks: 10
3. Final Examination: Full Marks: 80, Pass Marks: 40
Question Patterns
1. Multiple Choice Questions: 20%
2. Short Answer Questions: 60%
3. Problem Based Questions: 20%
MBBS II-11 Theory
Systems
1. Central Nervous System
2. Special Senses
Course Duration
8. Total Theory: 150 hours
9. Total Practical: 85 hours
Marks Distribution
1. Full Marks: 100, Pass Marks: 50
2. Internal Assessment: Full Marks: 20, Pass Marks: 10
3. Final Examination: Full Marks: 80, Pass Marks: 40
Question Patterns
1. Multiple Choice Questions: 20%
2. Short Answer Questions: 60%
3. Problem Based Questions: 20%

MBBS II-12 Theory

Subject: Community Medicine
Course Duration
1. Total Theory: 300 hours
2. Total Practical: 60 hours
Marks Distribution
1. Full Marks: 100, Pass Marks: 50
2. Internal Assessment: Full Marks: 20, Pass Marks: 10
3. Final Examination: Full Marks: 80, Pass Marks: 40
Question Patterns
1. Multiple Choice Questions: 20%
2. Short Answer Questions: 60%
3. Problem Based Questions: 20%

MBBS II-13 Theory

Subject: Introduction to Clinical Medicine
Course Duration
1. Total Theory+Practical: 60 Hours
Marks Distribution
1. Full Marks: 100, Pass Marks: 50
2. Internal Assessment: Full Marks: 20, Pass Marks: 10
3. Final Examination: Full Marks: 80, Pass Marks: 40
Question Patterns
1. Multiple Choice Questions: 20%
2. Short Answer Questions: 60%
3. Problem Based Questions: 20%

MBBS I-14 Practicum

Subjects: Practicals of all the subjects taught in the first year)
1. Anatomy (Code: Anatomy Practicum)
2. Physiology (Code: Physiology Practicum)
3. Biochemistry (Code: Biochemistry Practicum)
4. Microbiology (Code: Microbiology Practicum)
5. Pathology (Code: Pathology Practicum)
 6. Pharmacology (Code: Pharmacology Practicum)
7. Community Medicine (Code: Community Medicine Practicum)
8. Introduction to Clinical Medicine (Code: Introduction to Clinical Medicine
Practicum)
Marks Distribution
1. Full Marks: 100, Pass Marks: 50
2. Internal Assessment: Full Marks: 20, Pass Marks: 10
3. Final Examination: Full Marks: 80, Pass Marks: 40

List of Contributors for the development of MBBS Curriculum:

SN Name of the Designation Department Organization
Contributors
1. Dr. Niraj Pandey Professor Anatomy RAHS
Dr. Bishal Pokhrel Professor Community RAHS
Medicine
2. Dr.Kushal Associate Biochemistry RAHS
Bhattarai Professor
3. Dr.Nilu Associate Physiology RAHS
Manandhar Professor
4. Dr.Binaya Associate Pharmacology RAHS
Shrestha Professor
5. Dr. Utshav Assistant Pharmacology RAHS
Chapagain Professor
6. Dr.Sulav Regmi Lecturer Community RAHS
Medicine
7. Mr.Subash Lecturer Community
Poudel Medicine (Biostat.)
8. Dr. Subrata Lecturer Microbiology RAHS
Pokhrel
9. Dr.Jenice Lecturer Pathology RAHS
Chhatkuli
10. Dr. Nabindra Lecturer Anatomy RAHS
Phuyal
11. Dr. Anup Pandey Lecturer Anatomy RAHS
12. Mr.Khirendra Lecturer Physiology RAHS
Chaudhary
13. Mr.Deepak Lecturer Biochemistry RAHS
Neupane
14. Mr.Damodar Lecturer Microbiology RAHS
sharma