Kasturba Medical College

Manipal and Mangalore

A constituent institutions of Manipal University

Syllabus for II MBBS programme

TABLE OF CONTENTS

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1. Syllabus Pathology Pharmacology Microbiology Forensic Medicine 1 27 28 52 53 84 85 97

2. Rules regarding Attendance and Internal Assessment

98 - 99

3. Question paper pattern

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PATHOLOGY

i)

GOAL The broad goal of the teaching of undergraduate student in Pathology is to provide the students with a comprehensive knowledge of the mechanisms and causes of diseases, in order to enable him/her to achieve complete understanding of the natural history, morphology and clinical manifestations of diseases.

ii) a)

OBJECTIVES Knowledge At the end of the course, the student should be able to: (1) Describe the structure and ultra structure of a sick cell, mechanisms of cell injury, cell death and repair and be able to correlate structural and functional alterations. Explain the pathophysiological processes which govern the maintenance of homeostasis, mechanisms of their disturbance and the morphological and clinical manifestations associated with it. Describe the mechanisms and patterns of tissue response to injury such that she/he can appreciate the pathophysiology of disease processes and their clinical manifestations. Correlate the normal and altered morphology (gross and microscopic) of different organ systems in common diseases to the extent needed for understanding of disease processes and their clinical significance.

(2)

(3)

(4)

b)

Skills At the end of the course, the student should be able to: 1. Describe the rationale and principles of technical procedures of the diagnostic laboratory tests and interpretation of the results. Perform the simple bed-side tests on blood, urine and other biological fluid samples. Draw a rational scheme of investigations aimed at diagnosing and managing the cases of common disorders. Understand biochemical/physiological disturbances that occur as a result of disease in collaboration with pre clinical departments.

2. 3.

4.

c)

Integration At the end of training he/she should be able to integrate the causes of disease and relationship of different etiological factors (social, economic and environmental) that contribute to the natural history of diseases most prevalent in India.

GENERAL PATHOLOGY
CELLULER RESPONSES TO STRESS AND TOXIC INSULTS (8 hours)

Learning outcomes: The students should be able to Define Hypertrophy, Hyperplasia, Atrophy, Metaplasia Describe the mechanisms of physiological and pathological adaptations with examples Explain cell injury and cell death List the Causes of cell injury with examples Describe Morphologic alterations in Reversible & irreversible cell injury, Describe Cell death-types-necrosis versus apoptosis Define Necrosis. Describe the morphology of different patterns of necrosis (coagulative, liquefactive, gangrenous, caseous, fat, fibrinoid), with examples. Explain the Mechanisms of cell injury. Examples of clinically significant cell injury and necrosisIschemic and hypoxic injury, Ischemia reperfusion injury, Chemical toxic injury Define Apoptosis and Describe the Physiological & Pathological causes of apoptosis with examples Describe the Morphological and Biochemical changes in apoptosis and Discuss the Mechanisms of apoptosis Explain the Mechanisms of intracellular accumulation with examples-Lipids, Proteins, Glycogen, Hyaline change Describe the Mechanism and morphology of different Pigment deposition -Exogenous, Endogenous Define Pathologic calcification and describe morphology of different types with examples, Dystrophic versus metastatic. Explain mechanism of Cellular aging by Telomere shortening

Lectures content and Learning process: 1. 2. Introduction to Pathology Adaptation of cellular growth and differentiation- Hypertrophy, Hyperplasia, Atrophy, MetaplasiaDefinition, Mechanisms, Physiological with examples, Pathological with examples Reversible & Irreversible injury Causes & mechanisms Necrosis Definition, patterns and morphology with examples Apoptosis- Definition, Causes-Physiological & Pathological with examples, Morphological Biochemical changes in apoptosis, Mechanisms - Intrinsic and extrinsic pathways Intra cellular accumulations,-Lipid-causes, mechanisms Hyaline change Pigments-Exogenous & Endogenous Pathologic calcification-Definition, Types with examples , morphology, Cellular aging and

3. 4. 5.

6.

& morphology, Proteins, Glycogen,

7. 8.

Practicals: 1. Specimens Gangrene-foot Gangrene-intestine Slides Tuberculous(TB) lymph node with caseous necrosis Fatty Liver Malignant Melanoma 2. Amyloidosis (demonstration)

ACUTE AND CHRONIC INFLAMMATION (7 hours)

Learning outcomes: The students should be able to

Define inflammation Explain characteristics of inflammation described by Celsus. i.e. the 5 cardinal signs Describe reaction of blood vessels in acute Inflammation- Changes in vascular flow, caliber, permeability, response of lymphatic vessels Explain patterns of responses, like immediate transient response Describe reaction of leucocytes in acute inflammation including margination, leucocyte adhesion, transmigration, chemotaxis and phagocytosis Enumerate the chemical mediators of inflammation and explain their modes of action- Both cell derived and plasma protein derived mediators Explain the role of adhesion molecules in inflammation Describe the morphologic patterns of acute inflammation Describe disorders of defect in leukocyte function Explain the concept of chronic inflammation Describe the function of cells involved in chronic inflammation Enumerate the causes of chronic inflammation Describe the morphologic features of chronic inflammation Define granulomatous inflammation and explain the pathogenesis of granuloma formation Enumerate the causes of granulomas Describe different types of granulomas, immune and foreign body type Explain the systemic effects of inflammation

Lecture content and Learning process: 1. Acute inflammation Introduction, definition, cardinal signs & vascular changes 2. Cellular events- Leucocyte adhesion, migration, chemotaxis 3. Cellular events Phagocytosis- Recognition, attachment, engulfment, killing and degradation 4. Chemical mediators - Cell derived- Vasoactive amines , Arachidonic acid metabolites, PAF, Reactive oxygen species, NO, Cytokines and Chemokines 5. Chemical mediators - Plasma protein derived-Complements, Coagulation and Kinin systems 6. Outcome of Acute inflammation, morphological features, and systemic effects 7. Chronic inflammation- Causes, cells involved, morphology, granuloma-Types and causes

Practicals: 1. Specimens Acute appendicitis, Pneumonia TB Lymph node, Madura foot Slides Acute appendicitis, Pneumonia TB Lymph node, Leprosy including AFB (demonstration)

TISSUE RENEWAL, REPAIR AND REGENERATION (2 hours)

Learning outcomes: The students should be able to Define Labile tissues, Quiescent tissues and Permanent tissues, with examples for each Define Stem Cells, Embryonic Stem cells, Adult (somatic) stem cells Describe Healing by Repair, scar formation and fibrosis Explain basic concept of Angiogenesis Describe cutaneous wound healing -Healing by first intention, Healing by second intention and wound strength Describe local and systemic factors that influence wound healing Describe pathological aspects, complications of repair Lecture content and Learning process: 1. Introduction to wound healing, Stem cells, Type of cells, Cell cycle 2. Healing by Primary and Secondary intention Mechanism with sequence of events, Local and Systemic factors that influence wound healing and Complications

Practicals: Slides Granulation tissue

HEMODYNAMIC DISORDERS (8 hours)

Learning outcomes: The students should be able to Define edema, and Describe factors influencing fluid transit across capillary walls List differences between transudate and exudate Describe the pathophysiological categories of edema and mechanisms Explain the clinical consequences of edema Define hyperemia and congestion, Eumerate differences between hyperemia and chronic venous congestion (CVC) Describe mechanism and morphology of liver, spleen and lung in CVC Define a) Hematoma, b) Petechiae, c) Ecchymoses, d) Purpura, Explain sequence of events in hemostasis at the site of vascular injury, Role of endothelium in injury , Antithrombotic properties, Prothrombotic properties Explain role of platelets in injury including platelet endothelial cell interactions

Describe coagulation cascade: Clotting and Fibrinolytic pathway Explain Virchows triad, Antiphospholipid syndrome briefly Describe Morphology of thrombus Describe differences between arterial and venous thrombus List and explain Fate of the thrombus Describe clinical consequences of venous, arterial and cardiac thrombi Describe differences between ante mortem and post mortem clot Define embolism Explain pathophysiology and examples of pulmonary, systemic, fat and marrow, air and amniotic fluid embolism Describe Caisson disease Define Infarction Describe the types of Infarcts - red and white infarcts with examples, septic and bland with examples Describe the characteristics of infarctions- ischemic coagulative necrosis Explain factors influencing development of an infarct Define Shock and describe causes of shock, Explain pathogenesis of Septic shock, Describe stages of shock, with morphology of end organs and clinical consequences

Lecture content and Learning process: 1. Oedema Definition, Differences between transudate and exudate, Pathophysiological categories of edema and mechanisms, Clinical consequences of edema. 2. Hyperemia, Congestion Causes and morphology of CVC liver, lung, spleen, Hemorrhage 3. Thrombosis-Normal hemostasis and causes (Virchows triad) 4. Thrombosis- Morphology of different types, fate of thrombus 5. Definition , Pathophysiology and examples of Pulmonary & Systemic embolism 6. Embolism: fat and marrow, air and amniotic fluid embolism, Caisson disease 7. Infarction : Definition, Classification, Morphology and examples, Factors influencing the development of an infarct 8. Shock Definition, Causes of shock, Pathogenesis of septic shock, Stages of shock, Morphology of end organs in shock, Clinical consequences of shock. Practicals: 1. Specimens CVC Liver & Lung Myocardial infarction with thrombus Splenic infarct Slides CVC Liver & Lung

GENETICS (3 hours)
Learning outcomes: The students should be able to Explain broad categories of human genetic disorders Define a) mutations (including various types), b) Karyotyping: Ploidy, mosaicism, deletion, translocation Describe features of autosomal dominant and recessive disorders, with examples Describe characteristic clinical and cytogenetic features of the following syndromes: a) Trisomy 21, b) Klinefelter syndrome, c) Turner syndrome Describe enzyme deficiency, Clinical features and Morphology of the following Lysosomal storage diseases: a) Niemann-Pick disease: Types A & B, b) Gaucher disease Lecture content and Learning process: 1. Introduction and basics of genetics 2. Mendelian Disorders (AD, AR, X-linked), Normal Karyotyping 3. Down, Kilnefelter and Turner syndromes, Gaucher and Niemann Pick disease Practicals: NIL

NEOPLASIA (12 hours)

Learning outcomes: The students should be able to Define Neoplasia Explain nomenclature of tumors Describe differences between benign and malignant tumors Explain molecular basis of cancer including Normal cell cycle, Self sufficiency in growth Protooncogenes, Oncogenes, RAS, MYC, oncoproteins, Tumor suppressor genes, RB, p53, APC, Microsatellite instability, DNA repair defects Describe invasion and metastasis , metastatic cascade and pathways of spread Describe molecular basis of multistep carcinogenesis, Ca colon, Explain Carcinogenesis Chemical, Radiation, Microbial Explain effects of tumor on host Define and describe the different types of Paraneoplastic syndromes Explain grading and staging of tumor Describe Laboratory diagnosis of cancer Lecture content and Learning process: 1. Definition & Nomenclature of benign & malignant tumors 2. Differences between benign and malignant tumor 3. Molecular basis of cancer , Cell cycle 4. Proto oncogenes, Oncogenes (RAS, MYC)

5. Tumor suppressor genes (RB, p53, APC) 6. Metastasis, pathways of spread and metastatic cascade 7. Chemical carcinogenesis 8. Radiation carcinogenesis 9. Microbial carcinogenesis 10. 11. 12. Paraneoplastic syndromes Grading and staging of tumors Laboratory diagnosis of cancer

Practicals: 1. Specimens Lipoma,Leiomyoma, Squamous papilloma, Fibroadenoma, Pleomorphic adenoma, Adenocarcinoma, Squamous cell Ca, Basal Cell Carcinoma, Malignant melanoma, Metastasis to Lymph nodes Slides Lipoma, Leiomyoma, Squamous papilloma, Cavernous & capillary hemangioma, Fibroadenoma, Pleomorphic adenoma, Squamous cell Carcinoma, Adenocarcinoma, Malignant melanoma, Basal cell carcinoma Metastasis-Lymph node

DISEASES OF THE IMMUNE SYSTEM (6 hours)

Learning outcomes: The students should be able to Describe Innate and adaptive immunity Describe cells of immune system Explain role of MHC in adaptive immunity Describe mechanisms of 4 types of hypersensitivity reactions with examples Explain the concept of autoimmune diseases Describe the etiology, pathogenesis and antibody spectrum of Systemic lupus erythematosus (SLE) Describe the Morphology and Clinical features of SLE Describe Structure and Life cycle of HIV Explain pathogenesis and mechanism of immunodeficiency Enumerate AIDS defining opportunistic infections and neoplasms Explain the basics and mechanism of recognition and rejection of allografts Define Amyloidosis and explain physical and chemical nature of amyloid Describe classification and morphology of various organs in amyloidosis Enumerate the special stains used to demonstrate amyloid

Lecture content and Learning process: 1. Mechanisms of Hypersensitivity reactions with examples (type I to IV) 2. Introduction to autoimmune diseases, Autoimmune diseases including SLE- Etiology and Pathogenesis 3. SLE Antibody spectrum , Morphology, Clinical features 4. Amyloidosis: Physical and chemical nature, Classification and morphology in various organs, Special stains 5. Basics of Transplant pathology, Mechanism, recognition, and rejection of allograft 6. HIV: Structure: a) Pathogenesis- life cycle, b) Mechanism of T-cell immunodeficiency c)Enumerate AIDS defining opportunistic infections and neoplasms Practicals: Amyloid kidney slide/amyloid in medullary carcinoma thyroid

INFECTIOUS DISEASES (5 hours)

Learning outcomes: The students should be able to Describe the Epidemiology, Causative organism and Transmission of TB Explain tuberculin test Exlpain the pathogenesis of TB Describe Natural history and clinical features of TB Describe the morphology of organ/s in different types of Tuberculosis Primary TB, Ghon Focus, Ghon complex, Progressive primary TB, Secondary TB, Miliary TB, Isolated Organ TB, Intestinal TB Describe the Methods of Diagnosis of TB Describe the Incidence, Mode of Transmission and Causative Organism of Leprosy Describe Pathogenesis, Classification and Stains used in Leprosy Describe the Clinical Features and Morphology of lesions in individual types of Leprosy Describe Lepromin test, Leprosy reactions Explain differences between TT & LL Leprosy Describe briefly the causative organism, morphology, lesions, stains and pathogenesis of following fungal Infections: Candidiasis, Cryptococcosis, Aspergillosis, (Aspergilloma, Invasive aspergillosis), Mucormycosis Describe causative organisms, types , symptoms, morphology of Actinomycosis Describe causative organism, forms of disease, morphology of Rhinosporidiosis Lecture content and Learning process: 1. The Causative organism, Incidence, Mode of Transmission, Pathogenesis, Classification, Stains, Clinical features and Morphology of lesions in individual types of leprosy, 2. The Reactions in Leprosy, Lepromin test and the differences between TT & LL Leprosy. 3. Epidemiology, causative organism, Transmission, Tuberculin test, Pathogenesis, Natural history, Clinical Features, Complications and Course of Primary & Secondary TB, 4. The morphology in organs in primary and secondary Tuberculosis and diagnosis. 5. Fungal Infections: Candidiasis: Causative organism, morphology of lesions Cryptococcosis: Causative organism, lesions, stains Aspergillosis: causative organism, pathogenesis, lesions Mucormycosis: Pathogenesis, morphology, Actinomycosis Organisms, types, symptoms, morphology, Rhinosporidiosis Organism, forms of disease, morphology. Opportunistic fungal infections in HIV

Practicals: Specimen TB Lymph node, lung, intestine, kidney Mycetoma Slides Actinomycosis, Rhinosporidiosis TB enteritis Leprosy

METABOLIC DISEASES (2 hours)

Learning outcomes: Define and classify diabetes mellitus (DM) Discuss the diagnosis of DM Describe pathogenesis of each subtype Describe the pathogenesis of complications Describe the morphology of DM and its complications Discuss the clinical features of DM Lecture content and Learning process: 1. 2. Definition, classification and diagnosis, pathogenesis of DM Morphology, complications and its pathogenesis, and clinical features

HEMATOLOGY
RBC DISORDERS & BLEEDING DISORDERS (11 hours) Learning outcomes: The students should be able to RBC DISORDERS Describe normal maturation of RBC precursors in bone marrow and normal morphology of RBCs in peripheral blood Define and classify (Morphologic & Etiologic) Anemias Describe the mechanism of normal Iron metabolism, Desribe the etiology, clinical features and laboratory diagnosis of Iron deficiency anemia. Desribe the mechanism of absorption and metabolism of Vit. B12 and folic acid, Desrcibe causes , clinical features, lab diagnosis of Megaloblastic anemia. Explain the classification of Hemolytic anemias, Describe the pathogenesis, clinical features and lab diagnosis of Hereditary Spherocytosis, Thalassemia & Sickle cell anemia. Describe the etiology, clinical features and lab diagnosis of Aplastic Anemia. BLOOD TRANSFUSION Describe different Blood group systems Explain Transfusion reactions Describe Coombs test Describe Hemolytic disease of new born

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BLEEDING DISORDERS Describe etiopathogenesis, clinical Features and lab Diagnosis of ITP Describe clinical Features and lab Diagnosis of Hemophilia and vWD Describe etiopathogenesis, clinical features and lab Diagnosis of DIC Lecture content and Learning process: 1. Introduction, Normal maturation of RBCs precursors in BM, Normal morphology of RBCs in peripheral blood 2. Anemia Definition. Morphologic & Etiologic classification 3. Iron deficiency anemia - Iron metabolism, Etiology, Clinical features, Lab. Diagnosis 4. Megaloblastic anemia - Causes, Absorption and Metabolism of Vit B12 and folic acid, Clinical features, Lab diagnosis 5. Haemolytic anemia Classification, Hereditary spherocytosis- Pathogenesis, Clinical features, Lab diagnosis 6. Thalassemia- Pathogenesis, Clinical features, Lab diagnosis 7. Sickle cell anemia- Pathogenesis, Clinical features, Lab diagnosis 8. Aplastic anemia Etiology, Clinical features, Lab. Diagnosis, and PNH briefly 9. Blood groups , Transfusion reactions, Coombs test, Hemolytic disease of the new born 10. Bleeding disorders: ITP, von Willebrand disease Etiopathogenesis, Clinical Features, Lab Diagnosis Hemophilia and DIC - Etiopathogenesis, Clinical features, Lab Diagnosis

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Practicals: Staining of peripheral blood smear & reporting Hemoglobin estimation Determination of blood group Interpretation hematology charts Interpretation of Iron deficiency anemia, Megaloblastic anemia, Malaria, Microfilaria - peripheral blood smears. Bone Marrow slides of Megaloblastic Anemia and ITP Instruments: Wintrobes tube, Westegrens tube, Sahlis hemoglobinometer, RBC pipette, Neubauers chamber, Bone marrow needle Group discussion with charts: Iron deficiency anemia, Megaloblastic anemia, Sickle cell anemia, Thalassemia, MalariaFalciparum &vivax

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DISEASES OF WBC DISORDERS & LYMPH NODES (6 + 4 hours)

Learning outcomes: The students should be able to Define and enumerate causes of Leukocytosis, Leucopenia, Agranulocytosis Describe WHO classification of Acute Myeloid and Lymphoid Leukemia Describe morphology, clinical features and laboratory diagnosis of AML, ALL, CML and CLL Define and enumerate causes of Leukemoid reactions & Leukoerythroblastic blood picture and describe the differences between the two. Describe classification of Myeloproliferative neoplasm and MDS Describe morphology, clinical features and laboratory diagnosis of Myeloma Describe clinical features and laboratory diagnosis of Polycythemia vera Describe WHO classification of Lymphoid neoplasms Describe clinical features & classification of Hodgkin Lymphoma (HL), Reed Sternberg cell and its variants Describe morphology of Nodular sclerosis and Mixed cellularity HL Mention the current classification of non Hodgkin lymphoma (NHL) Explain clinical staging of HL and NHL Describe morphology, clinical features and immunophenotype of Burkitt Lymphoma Lecture content and Learning process: 1. Introduction: Definition and causes of Leucocytosis , Leucopenia, Agranulocytosis 2. Leukemia -classification, ALL- Morphology, clinical features and laboratory diagnosis, Diagnostic criteria 3. AML- WHO classification- Morphology, clinical features and laboratory diagnosis 4. CLL, CML- Morphology, clinical features, laboratory diagnosis and Prognosis 5. Classification of myeloproliferative Leukoerythroblastic reaction neoplasm, MDS, Polycythemia, Leukemoid &

6. Myeloma - Clinical features and Laboratory diagnosis 7. Lymph Nodes - Introduction & WHO classification of Lymphomas 8. HL - Classification, Reed Sternberg cell and variants, Morphology of Nodular sclerosis and Mixed cellularity HL, Clinical features, Clinical staging 9. NHL Classification and differences between HL and NHL, Clinical staging 10. Morphology, Clinical features and Immunophenotype of Burkitt Lymphoma

Practicals: 1. Interpretation of charts Interpretation of Neutrophilia, Eosinophilia, ALL, CML, AML, CLL peripheral blood smears and Myeloma marrow slides Instruments-WBC Pipette, Neubauer Chamber Specimen of Lymphoma Group discussion with charts 1. AML, ALL, CML. CLL, Myeloma

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SYSTEMIC PATHOLOGY
BLOOD VESSELS (4 hours) Learning outcomes: The students should be able to Define atherosclerosis, arteriosclerosis, and arteriolosclerosis, Explain the constitutional and modifiable risk factors, additional risk factors for Atherosclerosis (AS), Describe the pathogenesis of AS Response to injury hypothesis (mainly) and others, Describe the blood vessels commonly involved in descending order, Describe the gross and microscopy with evolution of atheromatous lesions Define vulnerable plaque and stable plaque, Mention the clinical consequences Myocardial infarction, Cerebral infarction, Aneurysm and Peripheral vascular disease. Define true and pseudo aneurysms, and arterial dissection, Classify aneurysms based on shape, size, and etiology, Describe the Pathogenesis in general of true aneurysms Explain in detail about Aortic aneurysms, Berry aneurysms, and aortic dissection pathogenesis, pathology and complications. Define Vasculitis, Classify based on size of the blood vessels involved and presumptive etiologies, Describe the pathogenesis, pathology and clinical features of three different types Giant cell arteritis, Polyarteritis nodosa and Wegener arteritis, Briefly explain Takayasu arteritis and Kawasaki disease. Lecture content and Learning process: 1. AS Definition, Risk factors, Pathogenesis, Distribution, 2. AS - Gross and microscopy, Complicated plaque and Clinical consequences 3. Aneurysms- Definition, Types, Pathogenesis and Pathology of each type. 4. Vasculitis Definition, Classification, Etiopathogenesis, Pathology and Clinical features Practicals Specimens Aortic atherosclerosis Slides Aortic/coronary atherosclerosis Capillary hemangioma Cavernous hemangioma

THE HEART (6 hours)

Learning outcomes: The students should be able to Classify Congenital heart disease cyanotic vs acyanotic with examples, Describe the etiopathogenesis in brief Discuss Tetralogy of Fallot with reference to the four cardinal features, morphology and clinical features Define Ischemic heart disease (IHD) and discuss the associated clinical syndromes - Myocardial Infarction (MI), Angina pectoris, Chronic ischemic heart disease, Sudden cardiac death. Discuss the pathogenesis and consequences of myocardial ischemia, Coronary artery occlusion Stable plaque, Acute plaque change, Importance of timely Reperfusion to salvage the reversibly damaged myocardium, Reperfusion injury

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 Define MI and describe the pathogenesis, myocardial response, differentiate Transmural vs subendocardial infarction, Describe the Morphology, Clinical features, Laboratory diagnosis and Complications of MI Define Rheumatic fever, describe the pathogenesis (molecular mimicry), morphology of heart in acute rheumatic carditis, Clinical features with Jones criteria and relevant laboratory evaluation for diagnosis, Describe the Morphology of heart in chronic Rheumatic Heart Disease (RHD), Long term prognosis and complications. Define Infective Endocarditis (IE), Discuss the types, Etiopathogenesis, Morphology, Clinical features, Lab diagnosis and Complications of IE, Discuss the causes and differences between infective and noninfective vegetations on the heart valves with examples, Lecture content and Learning process: 1. Congenital heart disease - Classification with examples, Etiopathogenesis in general, Features of Tetralogy of Fallot 2. IHD - Definition, Associated clinical syndromes, Epidemiology, Pathogenesis, Consequence of myocardial ischemia , 3. MI - Coronary artery occlusion and myocardial response, Evolution of morphologic changes in MI, Laboratory diagnosis and Complications of MI. 4. Rheumatic fever - Definition, Jones criteria for diagnosis, Pathogenesis, Morphology of acute carditis and laboratory diagnosis, 5. Morphology of Chronic RHD and clinical consequences. 6. IE - Definition, Classification, Etiopathogenesis, Morphology, Lab diagnosis, and Complications, Different types of vegetative endocarditis. Practicals: Specimens Myocardial infarction (MI) MI with thrombus MI with aneurysm Fibrinous pericarditis Mitral Stenosis Infective endocarditis Calcific Aortic stenosis Slides: NIL Group discussion: 1. Lab Diagnosis of MI. 2. Pathology of RHD

THE LUNG (7 hours)

Learning outcomes: The students should be able to Define Pneumonia. Explain the etiopathogenesis and pneumonia syndromes, Describe the morphological types, clinical course and complications of pneumonia. Define Bronchiectasis, Describe the associated conditions, Explain its etiology, and pathogenesis, Describe the morphology and clinical course. Define Lung abscess,

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 Explain the etiology, and pathogenesis, Describe its morphology, and clinical course Define Emphysema, Explain its pathogenesis & the different types of emphysema, Describe the morphology, clinical course and other forms of emphysema. Define Chronic Bronchitis, Briefly describe its Pathogenesis, Morphology, Clinical course. Define Pneumoconiosis. Mention the lung diseases caused by air pollutants Discuss the pathogenesis of coal workers pneumoconiosis (CWP), Silicosis and Asbestos - related diseases, including the types of silica and asbestos and their fibrogenic nature Describe the morphology and clinical course of CWP, Silicosis, Asbestos-related diseases. Mention the classification of malignant epithelial lung tumors as per the WHO system, Discuss the etiopathogenesis, morphology, staging and clinical course of lung carcinomas, Mention the diagnostic methods and paraneoplastic syndromes associated with lung carcinoma. Lecture content and Learning process: 1. Pneumonia - Definition, local defense mechanisms, etiology (pneumonia syndromes), Morphology, Clinical course, Complications, differences between lobar and bronchopneumonia. 2. Bronchiectasis - Definition, association with other conditions, Etiology, Pathogenesis, Morphology, and Clinical course. Lung abscess - Definition, Etiopathogenesis, Morphology, Clinical course. 3. Emphysema - Definition, associated factors, Pathogenesis, Types and morphology, Clinical course, and other forms of emphysema Bronchitis - Definition, Pathogenesis, Morphology , Differentiation from asthma and Clinical course 4. Pneumoconiosis - Definition, pathogenesis in general. CWP - Pathogenesis, Morphology and Clinical course. 5. Silicosis Pathogenesis , Morphology and Clinical course, and associated susceptibility to tuberculosis Asbestos-related disease - List of related diseases, forms of asbestos, their pathogenecity, Morphology of asbestosis, Role in development of mesothelioma and lung cancer, Clinical course. 6. Lung cancer - WHO classification, Epidemiology, Incidence, Etiopathogenesis, Molecular genetics, Morphology of each subtype of carcinoma 7. Diagnostic methods, Sputum cytology : Collection, microscopy for malignant cells, Cytology of bronchoscopic materials, FNAC and other ancillary investigations, Paraneoplastic syndromes Practicals: Specimens Lobar Pneumonia Ghon Lesion Fibrocaseous/ cavitary TB Miliary TB Lung Bronchiectasis Carcinoma lung Secondaries in lung Slides Bronchiectasis TB lung Lobar pneumonia Bronchogenic carcinoma Group discussion: Carcinoma Lung Classification, Clinical features, Lab diagnosis

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ORAL CAVITY AND THE GASTROINTESTINAL TRACT (11 hours)

Learning outcomes: The students should be able to List and Describe the premalignant lesions of oral cavity - leukoplakia, erythroplakia, submucosal fibrosis, Enumerate the etiological factors and discuss the pathogenesis of Squamous cell carcinoma (SCC) Mention the favored location, Morphology & prognosis of SCC of the oral cavity. Mention the WHO Classification of Tumors of salivary gland. Discuss the clinical features and morphology of Pleomorphic adenoma, Warthin tumor, Mucoepidermoid carcinoma, Adenoid cystic carcinoma. Define and Discuss briefly the morphology and clinical features of Reflux esophagitis & Barretts esophagus. Describe the pathogenesis and morphology of Squamous cell carcinoma and adenocarcinoma Describe the indigenous mechanisms of protection against gastric injury, Mention the Classification of Gastritis, Describe the etiopathogenesis of Chronic gastritis H pylori and atrophic gastritis, Discuss the morphology, clinical features and diagnostic tests for H.pylori gastritis, Discuss briefly about autoimmune gastritis, Discuss the pathogenesis, morphology, clinical features and complications of Peptic ulcer disease. Mention the classification of gastric carcinoma, Discuss the epidemiology, pathogenesis, morphology, clinical features and prognosis of early and advanced gastric adenocarcinoma, Enlist the differences between benign and malignant gastric ulcers. List the causes for small and large intestinal ulcers Define Inflammatory bowel disease (IBD), mention the types, epidemiology, pathogenesis of IBD. Discuss the morphology, clinical features, extra intestinal manifestations and risk of associated neoplasia of Ulcerative colitis (UC) and Crohn Disease(CD). Mention the differences between UC and CD. Mention the differences between CD and TB Classify Polyps of intestine Briefly describe Inflammatory, Hyperplastic, Hamartomatous, Neoplastic Discuss briefly the Polyposis Syndromes (FAP and HNPCC) Describe the epidemiology, etiopathogenesis of Carcinoma Colon Discuss the molecular changes in adenoma-carcinoma sequence Describe the Morphology, Differences between right and left colonic tumors, clinical features, modes of metastasis and prognosis of carcinoma colon Define Carcinoid tumor Location, Morphology, Secretory products, Carcinoid syndrome, Clinical features and Behavior. Briefly describe Pseudomyxoma peritonei (PMP) and Gastrointestinal stromal tumor (GIST) Lecture content and Learning process: 1. Oral cavity Premalignant lesions, Squamous cell carcinoma Etiopathogenesis, Favoured locations, Morphology& Metastasis, 2. Tumors of salivary gland, Classification , Clinical features and Morphology of Pleomorphic adenoma, Warthin tumor, Mucoepidermoid carcinoma, Adenoid cystic carcinoma 3. Esophagus Reflux esophagitis, Barretts esophagus, Etiopathogenesis of carcinoma, Morphology and Prognosis 4. Gastritis Mechanisms of gastric injury and protection. Role of H-Pylori and other etiologies, Atrophic gastritis and Peptic ulcer disease - etiopathogenesis, morphology & complications 5. Gastric cancer Early and Advanced gastric cancer, Etiopathogenesis, Morphology, Classification, and Metastasis. 6. Intestine - Differentiating features of various intestinal ulcers

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7. Inflammatory Bowel Disease - Definition, Epidemiology, Etiopathogenesis and Pathology of Ulcerative colitis (UC)and 8. Crohn disease(CD) 9. Polyps of the GI T- Classification and morphology, 10. Carcinoma Colon Epidemiology, Etiopathogenesis including molecular pathogenesis, Morphology, Clinical features and Prognosis. 11. Carcinoid tumor, PMP , GIST Practicals: Specimens Chronic gastric ulcer Carcinoma stomach, ulcerative Linitis plastica TB intestine Typhoid ulcer Bacillary dysentry Amoebic ulcers Intussusception Intestinal polyp Ulcerative colitis Colonic Carcinoma Slides Pleomoprhic adenoma of salivary gland. Adenocarcinoma stomach TB intestine Adenocarcinoma colon Seminar by students Peptic ulcer Gastric carcinoma Colonic adenocarcinoma

LIVER AND BILIARY TRACT (10 hours)

Learning outcomes: The students should be able to Describe the Normal structure , Function and Hepatic microarchitecture, Discuss the patterns of hepatic injury, Pathophysiology of jaundice & Interpretation of Liver function tests. Mention the hepatotropic viruses, Describe the type of virus, route of transmission, incubation period, frequency of chronic liver disease, and diagnosis of Viral hepatitis with sequence of serologic markers, List and describe the clinicopathologic syndromes of viral hepatitis. Describe the morphology of acute and chronic hepatitis (viral & other etiologies) Describe fulminant heptic failure and its morphology. Describe the Pathogenesis, Clinical features and Morphology of Alcoholic liver disease. Define & classify cirrhosis (morphologic and etiologic), Discuss the Pathogenesis, Morphology and Complications of cirrhosis with emphasis on portal hypertension. Classify Hepatic tumors. Describe the Epidemiology, Etiopathogenesis, Morphology, Clinical features of Hepatocellular carcinoma. Mention the types of gall stones, Discuss the Etiopathogenesis, Morphology, Clinical features, Complications of cholelithiasis, Describe the morphological features of Cholecystitis.

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Lecture content and Learning process: 1. Introduction to structure of liver and LFT Microarchitecture, Patterns of hepatic injury degeneration, intracellular accumulation, inflammation, necrosis, regeneration, fibrosis 2. Bilirubin metabolism and Jaundice 3. Acute Viral Hepatitis Hepatotropic viruses A & E, Clinical features, morphology, & Lab diagnosis 4. Acute Viral Hepatitis Hepatotropic viruses B,C & D, Clinical features, Morphology, & Lab diagnosis 5. Chronic hepatitis Definition, Clinical features, Etiology viral and others, Morphology, & Lab diagnosis 6. Alcoholic liver disease Forms of diseases, Pathogenesis and Morphology of fatty liver and alcoholic hepatitis. Briefly about nonalcoholic fatty liver disease. 7. Definition of Cirrhosis, Classification and Morphology, Lab diagnosis, Clinical consequences 8. Classification of hepatic tumors - Hepatocellular carcinoma Etiopathogenesis, Morphology, Clinical features and Diagnosis. Briefly about fibrolamellar carcinoma 9. Cholelithiasis Definition, Types, Etiopathogenesis 10. Practicals: Specimens Cirrhosis Nutmeg Liver Fatty liver Hepatocellular carcinoma Secondaries in liver Hydatid cyst Amoebic liver abscess Gall stones Slides Hepatocellular carcinoma Cirrhosis Nutmeg Liver Fatty liver LFT Charts: Acute Hepatitis, Chronic Liver Disease, Obstructive Jaundice Group discussion: Liver function test Objective structured questions 1. GIT, Liver, Gall bladder Morphology of acute and chronic cholecystitis, Clinical features and Complications.

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THE PANCREAS (2 hours)

Learning outcomes: The students should be able to Describe the Etiologic factors, Morphology, Pathogenesis, Clinical features and Laboratory findings of acute pancreatitis Briefly explain Hereditary pancreatitis Discuss the Etiologic factors, Pathogenesis, Morphology, Clinical features, of chronic pancreatitis. Describe the precursors, molecular carcinogenesis, etiopathogenesis, clinical features and morphology of pancreatic carcinoma. Lectures content and learning process: 1. Acute and chronic pancreatitis- Etiology, Pathogenesis, Morphology, Clinical features, Long term outcome 2. Pancreatic carcinoma Pathogenesis, Clinical features and Morphology Practicals: NIL

THE KIDNEY (14 hours)

Learning outcomes: The students should be able to Describe the normal gross and microscopic features of the kidney, Describe the various clinical presentations of renal diseases. Definition & state the differences between nephritic & nephrotic syndrome, List the causes for nephritic and nephritic syndrome. Mention the classification of Glomerular diseases with examples of primary glomerulopathies, systemic & hereditary diseases with glomerular involvement. Discuss the role of light microscopy, immunoflouresence& electron microscopy in the diagnosis of glomerular diseases, Explain various pathogenetic immune mechanisms involved in glomerular injury, Describe various mediators of immune injury, Describe mechanisms of progression of glomerular diseases. Describe the etiology, pathogenesis, and morphology on light microscopy, immunoflourescence & electron microscopy of Acute post streptococcal glomerulonephritis and Rapidly progressive glomerulonephritis with clinical course. Describe the etiology, pathogenesis, morphology on light microscopy, Immunoflourescence , electron microscopy and Clinical course of Minimal change disease & Focal segmental glomerulosclerosis, Membranous glomerulopathy, Membranoproliferative glomerulonephritis. Discuss the causes & morphology of Granular contracted kidney and stages of chronic renal failure with the relevant laboratory investigations. Describe the pathogenesis and morphology of Diabetic nephropathy. Describe the morphology & various types of lupus nephritis according to the WHO classification. Mention the role of the serology Discuss the etiology, pathogenesis (pathway of renal infection), morphology, clinical features, complications of acute and chronic pyelonephritis. Mention the causes, pathogenesis and morphology of Acute tubular necrosis. Discuss the role of the kidney and morphological changes in the kidney in hypertension. Mention the types of renal calculi. Describe the Cause, Pathogenesis, Morphology, Clinical features and Complications of Renal stones. List the causes of hydronephrosis. Discuss obstructive uropathy. Mention the classification of Renal Tumors & Renal cell carcinoma (RCC) Discuss the Epidemiology, Classification, Cytogenetics and Genetics, Morphology, Clinical course and Paraneoplastic syndromes associated with RCC.

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 Describe the pathogenesis & genetics, morphology and clinical features of Wilms tumor. Describe the Etiopathogenesis ,Classification, Sites, Morphology and Clinical course of transitional cell carcinoma (TCC) of the urinary tract. Lecture content and Learning process: 1. Introduction-The normal structure and function of kidney, Clinical manifestation of renal diseases,Laboratory tests to detect renal disease. 2. Pathogenesis of glomerular injury. Classification of glomerular diseases. Histologic alterations in glomerulonephritis. 3. Nephritic Syndrome Definition, and Etiopathogenesis, Morphology, Clinical features & Lab diagnosis and Clinical course Post streptococcal GN and RPGN . 4. Nephrotic syndrome - Definition, and Etiopathogenesis, Morphology, Clinical features, Lab diagnosis and Clinical course of Minimal change disease , Focal Segmental Glomerulosclerosis. 5. Etiopathogenesis, Morphology, Clinical features, Lab diagnosis and Clinical course of Membranoproliferative glomerulonephritis, and Membranous Nephropathy. 6. Granular contracted Kidney- Causes, Gross and Microscopy, and chronic renal failure. 7. Morphology of kidney in systemic diseases like Diabetes &SLE and acute tubular necrosis 8. Hypertension, pathogenic mechanisms and morphology of the kidney 9. Acute & Chronic pyelonephritis- Causes, Clinical features, Morphology & Complications 10. Renal stones - Types, Cause and Pathogenesis, Morphology and Clinical features 11. Hydronephrosis - Obstructive lesions of the urinary tract , Definition, Morphology and Clinical features 12. Classification of Renal Tumors and RCC. Cytogenetics and genetics, Morphology, and Clinical features of Renal Cell Carcinoma. 13. Wilm Tumor-Risk factors, Genetics, Morphology, and Clinical Presentation. 14. Transitional Cell Carcinoma Etiopathogenesis, Classification, Sites, Morphology and Clinical course Practicals: Specimens Granular contracted kidney Hydronephrosis Polycystic kidney Horse Shoe Kidney Amyloid Kidney TB kidney Wilms tumor Renal cell carcinoma Slides Renal Cell Carcinoma TB Kidney Charts- Nephritic syndrome, Nephrotic syndrome, Chronic renal failure Group discussion: Nephritic and Nephrotic syndrome Definition, Causes, Interpretation of charts and Diagnosis

MALE GENITAL SYSTEM (4 hours)

Learning outcomes: The students should be able to Discuss the common causes of urinary tract infections and retention of urine in males. Describe the pathogenesis, clinical features and morphology of nodular prostatic hyperplasia. Explain the etiopathogenesis, morphology and clinical course of carcinoma prostate, PIN. Briefly mention grading and staging of carcinoma prostate and significance of PSA, Classify testicular tumors and mention its pathogenesis. Describe the types of Seminoma and their morphology.

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 Brief understanding of the morphology of other testicular tumors Describe the Etiopathogenesis, morphology and clinical features of squamous cell carcinoma of the penis Lecture content and Learning process: 1. Nodular Prostatic Hyperplasia- Incidence, Etiology, Pathogenesis and morphology. 2. Adenocarcinoma prostate- Etiopathogenesis, Morphology, grading, staging, diagnosis and clinical course. 3. Testicular tumors- Classification, morphology with special reference to Seminoma 4. Brief mention of other testicular tumors, Tumor markers, carcinoma penis Practicals: Specimens Benign hyperplasia prostate with hydronephrosis Seminoma testis Teratoma testis Squamous cell carcinoma penis Slides Nodular hyperplasia prostate Seminoma testis Teratoma testis Squamous cell carcinoma penis Seminar/case study: 1. Male genital system

THE FEMALE GENITAL TRACT (8 hours)

Learning outcomes: The students should be able to Classify Premalignant lesions of the cervix, mention the role of Pap smear (Screening and prevention) the technique, staining. Mention the natural history of CIN/SIL, Discuss the Epidemiology, Etiopathogenesis, Classification, Morphology, Staging, Clinical features of Carcinoma Cervix. Define Endometrial hyperplasia. Classify and mention the salient morphological features. Classify Uterine tumors, Describe the morphology and clinical features of Leiomyoma, Discuss the epidemiology, Molecular pathogenesis, Subclassification (Type I & II), Morphology, and Clinical course of Endometrial carcinoma. Classify and explain the histogenesis of Ovarian tumors, Discuss the molecular pathogenesis, Morphology and Biologic behavior of Surface epithelial tumors with special reference to Serous and mucinous tumors. Discuss morphology of Germ Cell Tumors with special reference to teratoma and Dysgerminoma. Briefly describe the morphology of Sex cord stromal tumors with special reference to granulosa theca cell tumors and fibroma thecoma. Discuss the morphology of Krukenberg tumor. Mention the primary malignancies that give rise to this tumor. Define and Classify Gestational trophoblastic diseases, Discuss the Origin, Morphology, Clinical features, HCG as a prognostic marker and Clinical course of complete and partial mole, and choriocarcinoma. Lecture content and Learning process: 1. Premalignant lesions of cervix Classification, Risk factors, Pathogenesis and Morphology of Cervical Intraepithelail Neoplasia and role of Pap smear 2. Carcinoma cervix- Morphology, Staging and Clinical features. 3. Classification of uterine tumors. Morphology and clinical features of Leiomyoma.

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4. Endometrial hyperplasia classification and morphology. Endometrial Carcinoma-Clinical presentation, Classification, Morphology and Grading, Factors influencing outcome. 5. Ovarian tumors-Classification and histogenesis. Morphology and clinical features of Serous and mucinous tumors. Brief mention of other surface epithelial tumors. 6. Germ Cell tumors - Morphology and clinical features of teratoma and Dysgerminoma 7. Primary tumor sites and morphology of Krukenberg tumor. 8. Gestational trophoblastic disease - Classification, Origin of complete and partial mole, Morphology and diagnosis of Hydatidiform mole, Invasive mole and Choriocarcinoma. Practicals: Specimens Carcinoma cervix Leiomyoma uterus Vesicular mole Papillary cystadenoma ovary Mucinous cystadenoma ovary Dermoid cyst ovary Dysgerminoma Slides Proliferative endometrium Secretory endometrium Simple hyperplasia Adenocarcinoma uterus Leiomyoma Vesicular mole Papillary cystadenoma ovary Mucinous cystadenoma ovary Seminar/Case Study: 1. Female genital tract BREAST (4 hours) Learning outcomes: The students should be able to.. Describe the clinical presentation of breast diseases. Classify benign epithelial lesions. Describe the morphology nonproliferative and proliferative breast disease (without and with atypia) with the risk of developing breast carcinoma Describe the methods for diagnosis of breast lesions- Role of clinical examination, FNAC, Core biopsy, Mammogram and Ultrasound. Discuss the Incidence, Epidemiology, Pathogenesis of Carcinoma breast. Mention the Classification (Morphologic and Molecular) of breast cancer. Understand the difference between in situ and invasive carcinoma. Describe the Etiopathogenesis, Morphology, Clinical features and Prognostic predictive factors of Infiltrating ductal carcinoma (NST), Medullary carcinoma and Paget disease. Describe the morphology, clinical features and behavior of Fibroadenoma, Phyllodes tumor. Lecture content and Learning process: 1. Clinical presentation and diagnosis of breast diseases. Benign Epithelial Lesions- Fibrocystic change, Proliferative breast disease without and with atypia. 2. Carcinoma Breast Classification, Incidence, Epidemiology, Morphology, Prognostic and Predictive factors, 3. Morphology and clinical course of Medullary carcinoma, Pagets disease. 4. Age group, Morphology, Clinical features and Behavior of Fibroadenoma and Phyllodes Tumor.

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Practicals: Specimens Fibroadenoma Carcinoma Breast(IDC - NST) Slides Fibroadenoma Carcinoma Breast (IDC - NST) Seminar/case study/group discussion/problem based learning: 1. Carcinoma Breast

THE ENDOCRINE SYSTEM (5 hours)

Learning outcomes: The students should be able to Define and describe Diffuse( simple) and Multinodular goiter. Discuss the Etiopathogenesis, Morphology, Clinical course of MNG and thyroid function tests. Define and classify Thyroiditis. Discuss the Pathogenesis, Morphology, Clinical course, Thyroid function test and Antithyroid Antibodies in Hashimoto Thyroiditis. Discuss the Pathogenesis, Morphology, Clinical course, Thyroid function test in Graves Disease. Classify Thyroid tumors. Describe the Pathogenesis of carcinomas. Describe the Morphology and Clinical course of Papillary carcinoma, Follicular adenoma and follicular carcinoma, Medullary and Anaplastic carcinoma. Define Pheochromocytoma. Explain the Rule of 10s and genetic basis. Describe the morphology, Clinical course and Laboratory diagnosis. Define Neuroblastoma. Mention the sites, Age group, Morphology, Stage, Prognostic factors, Clinical course and Laboratory diagnosis of neuroblastoma. Lecture content and Learning process: 1. Thyroid Gland- Multinodular goiter- Etiopathogenesis, Morphology and Clinical course. 2. Hashimoto thyroiditis and Graves disease- Pathogenesis, Morphology and clinical course. 3. Thyroid tumors- Classification, Carcinomas- Papillary, follicular Pathogenesis, Morphology and Clinical Course. 4. Anaplastic, and Medullary carcinoma Pathogenesis, Morphology and Clinical Course. 5. Adrenal Gland-Pheochromocytoma- Rule of 10s, Genetic basis, Morphology and Clinical Course, and Neuroblastoma- Sites, Age group, morphology, clinical course and prognostic features. Practicals: Specimens MNG, Follicular Adenoma Papillary Thyroid Carcinoma Slides MNG Papillary Thyroid Carcinoma

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SKIN (2 hours)
Learning outcomes: The students should be able to Describe the pathogenesis, premalignant lesions and risk factors of Squamous cell carcinoma (SCC) of skin, Describe the sites, morphology and clinical course of SCC. Describe the pathogenesis, morphology and clinical course of Basal cell carcinoma. Describe the clinical features, morphology, prognostic factors and pathogenesis of Malignant melanoma. Lecture content and Learning process: 1. Pathogenesis, Premalignant lesions, morphology, prognostic factors and clinical course of Squamous Cell Carcinoma and Basal Cell Carcinoma. 2. Pathogenesis, Premalignant lesions, morphology, prognostic factors and clinical course of Malignant Melanoma Practicals: Specimens Squamous Cell Carcinoma Foot Basal Cell Carcinoma Malignant Melanoma with lymph node metastasis Slides Squamous Cell Carcinoma Basal Cell Carcinoma Malignant Melanoma Seminar/case study discussion: Malignant Melanoma

BONES, JOINTS AND SOFT-TISSUE TUMORS (5 hours)

Learning outcomes: The students should be able to Define and Mention the types of Osteomyelitis . Describe the Etiopathogenesis, Morphology, Clinical features, Complications of pyogenic osteomyelitis. Describe the Etiopathogenesis, Morphology, Clinical features, Complications of Tuberculous osteomyelitis. Define Rheumatoid arthritis. Discuss the pathogenesis, morphology and clinical course of Rheumatoid arthritis. Define and Mention the types of Fractures. Describe the process of fracture healing. List the factors influencing fracture healing. Define Tophi and Gout. Know the Normal uric acid level, Describe the Pathogenesis, Morphology and Clinical course of gouty arthritis. Classification of Bone tumors. Describe the Pathogenesis, Morphology, Radiological features, Clinical course and Prognosis of Osteosarcoma. Describe the Morphology, Radiological features, Clinical course and Prognosis of chondrosarcoma, giant cell tumor (osteoclastoma), and Ewing sarcoma.

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Lecture content and Learning process: 1. Osteomyelitis - Definition, Types, Etiopathogenesis, Morphology, Clinical features, Complications of pyogenic osteomyelitis and tuberculous. 2. Arthritis - Definition, Etiopathogenesis, Morphology, Diagnosis of Rheumatoid and Gouty arthritis. 3. Fractures Types, Process of healing and influencing factors. 4. Bone tumors-Introduction, Classification, Clinical features and Morphology of Osteochondroma, Giant cell tumor and Ewing sarcoma. 5. Osteosarcoma, Chondrosarcoma- Pathogenesis, Morphology, Clinical features, Prognosis. Practicals: Specimens Osteomyelitis - Sequestrum Osteosarcoma Osteoclastoma Slides Osteosarcoma Osteoclastoma Seminar/case study/ group discussion: Osteosarcoma

THE CENTRAL NERVOUS SYSTEM (3 hours)

Learning outcomes: The students should be able to Mention the causes of Intracranial hemorrhage, Discuss the differences between Extradural, Subdural , Sub-arachnoid and intracerebral hemorrhage. Explain the Indications, contraindications, sample collection and sample division for different Biochemical, Cell count and Microbiological studies on CSF samples collected, Discuss the difference between CSF findings in Bacterial, Viral and Tuberculous meningitis. Mention the classification of Brain tumors as per the WHO classification and based on age, cell of origin and location, Discuss the clinical features of Brain tumors, Descibe the morphology of Astrocytoma, Glioblastoma, Oligodendroglioma, Ependymoma, Meningioma and Medulloblastoma. Lecture content and Learning process: 1. Intracerebral Hemorrhage-Definition of Cerebrovascular accident, Intracerebral hemorrhage, Causes- Hypertension, Aneurysms and Vascular Malformation, Clinical features. Intracranial haemorrhage-Common sites of aneurysm, Location and causes of Extradural, Subdural and Sub-arachnoid hemorrhage. 2. CSF analysis, Definition of Meningitis, causes and broad sub-types: Bacterial, Viral and Tuberculous with CSF findings.

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3. Brain tumors- Classification based on cell of origin, Location of different classes of brain tumours and clinical features, Classification of Gliomas and grading with brief morphology of Astrocytoma, Glioblastoma, Meningiomas, Oligodendroglioma, Ependymoma, and Medulloblastoma

Practicals: Specimens Brain Abscess Astrocytoma Meningioma Cerebral Hemorrhage Slides : Meningioma C.S.F.Charts Pyogenic Meningitis Tuberculous Meningitis Viral meningitis

Learning outcomes of Practicals Diagnose the given set of slides, describe the morphology and draw a neat labeled diagram Diagnose the given set of specimen and describe the morphology Stain and report a peripheral smear Perform Haemoglobin estimation by Sahlis method Determine the blood group of a given sample ABO & Rh Perform complete urine examination-Physical examination including specific gravity, Chemical examination- sugar, protein, ketone bodies, bile salts, bile pigments, blood Identify the set of instruments , write the identification points and uses Interpret the given charts and answer the relevant questions related to the charts Interpret the specimen, slides & charts at the OSPE stations and answer the relevant questions

SPECIFICATION TABLE Instructions: 1. Each paper is of 100 marks. 2. In each Paper there shall be 1 essay question and one clinical oriented question of 10 marks each and 15 short notes of 4 marks each and an MCQ paper of 20 marks with 20 MCQs.

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SPECIFICATION TABLE FOR PAPER I & II

GENERAL PATHOLOGY-100 marks

Marks Allotted

ESSAY TYPE 10 10 10

SHORT NOTES/MCQ 15 20 15

Inflammation, Hemodynamic changes Hematology and lymphoma Neoplasia, Immunology, and metabolic diseases Cell Injury, Genetics, and diseases Infectious

25 30 25

20

10

10

SYSTEMIC PATHOLOGY-100 marks

Marks Allotted

ESSAY TYPE 10 10 10 10 10

SHORT NOTES/MCQ 12 12 12 7 7

Blood vessels and Heart, Endocrines Male & female genital tract, Breast GIT, Liver, Gall bladder, and Pancreas Respiratory System, Skin, and Bone Kidney, CNS

22 22 22 17 17

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PHARMACOLOGY

 (i) Goal

PHARMACOLOGY

The broad goal of teaching undergraduate students in Pharmacology is to inculcate a rational and scientific basis of therapeutics.

(ii) Objectives (a) Knowledge At the end of the course, the student shall be able to: 1. Describe the pharmacokinetics and pharmacodynamics of essential and commonly used drugs. 2. List the indications, contraindications, interactions and adverse reactions of commonly used drugs. 3. Indicate the use of appropriate drug in a particular disease with consideration of its cost, efficacy and safety for (i) individual needs (ii) mass therapy under national health programmes.

4. List the drugs of addiction and recommend the management. 5. Classify environmental and occupational pollutants and state the management issues. 6. Integrate the concept of rational drug therapy in clinical pharmacology. 7. State the principles underlying the concept of Essential Drugs. 8. Evaluate the ethics and modalities involved in the development and introduction of new drugs. (b) Skills At the end of the course, the student shall be able to: 1. Prescribe drugs for common ailments. 2. Demonstrate techniques of drug administration 3. Recognize adverse reactions and interactions of commonly used drugs. 4. Observe experiments designed for study of effects of drugs and interpretation of the experimental data. 5. Scan information on common pharmaceutical preparations and critically evaluate drug formulations. (c) Integration Practical knowledge of use of drugs in clinical practice will be acquired through integrated teaching with clinical departments and preclinical departments.

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III SEMESTER
GENERAL PHARMACOLOGICAL PRINCIPLES (Classes: 16) Topic Introduction, Routes of Drug Administration No. of hours: 3

Learning outcomes: At the end of the class, students should be able to Define various terms used in Pharmacology. Describe the routes of drug administration with their advantages and disadvantages and new drug delivery systems. Lecture 1: Introduction to pharmacology; drug nomenclature, pharmacopoeia, nature and sources of drugs. Lectures 2 & 3: Routes of drug administration and new drug delivery systems. Practicals: Introduction to pharmacy, prescription writing and sources of drug information, Pharmaceutical preparations, Parenteral drug administration, Drug delivery systems. Topic Pharmacokinetics No. of hours: 5

Learning outcomes: At the end of the class, students should be able to Explain drug transport mechanisms. Explain various pharmacokinetic parameters & factors affecting them. Lecture 4: Absorption Drug passage across cell membranes, Factors modifying absorption and bioavailability. Lecture 5: Drug distribution Volume of distribution, Plasma protein and tissue binding and its clinical implications. Lectures 6 & 7: Biotransformation Sites; Phases, examples, Factors modifying it and its consequences, Enzyme induction and inhibition and their clinical importance. Lecture 8: Drug Elimination channels of drug excretion and Factors modifying it. Kinetics of elimination. Topic Pharmacodynamics No. of hours: 5

Learning outcomes: At the end of the class, students should be able to Explain the mechanism of drug action. Describe dose response relationships; explain factors modifying drug action. Describe adverse drug reactions. Explain rational drug use and essential medicines. Define bioassay, biostandardisation and bioequivalence. Lectures 9 &10: Mechanism of drug action, Receptor and non-receptor mediated drug actions. Lectures 11 &12: Factors modifying drug action. Lecture 13: Adverse drug reactions, Pharmacovigilance. Practicals Dose response curves, Potentiation and antagonism, calculation of drug dosage and percentage solution. Rational use of medicines, ADR Reporting, Pharmacoeconomics, critical analysis of drug promotional literature. 30

Topic

Clinical Pharmacology

No. of hours: 3

Learning outcomes: At the end of the class, students should be able to Explain various pharmacokinetic parameters and factors affecting them. Explain pre-clinical and clinical phases of drug development. List drugs of addiction and explain management of drug dependence. List environmental and occupational pollutants and their management. Lecture 14: Pharmacokinetic parameters with their clinical implications. Therapeutic drug monitoring. Therapeutic considerations in geriatrics, pediatrics and pregnancy. Lecture 15: Drug Addiction with its management. Lecture 16: New drug discovery and development. Environmental and occupational pollutants management issues. DRUGS AFFECTING BLOOD AND BLOOD FORMATION (Classes: 5) Topic Haematinics No. of hours: 2 Learning outcomes: At the end of the class, students should be able to Describe the physiological role, pharmacokinetics, adverse effects, uses, drug interactions of iron, folic acid and vitamin B12. Outline the physiological role and preparations of various growth factors. Lecture 1: Haematinics Iron: sources, metabolism, preparations, indications and adverse effects; Management of iron overdosage. Lecture 2: Vitamin B12 and Folic acid sources, requirements, physiological role, deficiency states and management. Growth factors (in brief). Topic Drugs affecting coagulation, bleeding and thrombosis No. of hours: 3

Learning outcomes: At the end of the class, students should be able to List systemic and local haemostatics with their salient features. Classify and explain the mechanism of action, kinetics, adverse effects, uses, drug interactions of anticoagulants. Explain the mechanism of action, uses and adverse effects of antiplatelet agents, fibrinolytics and antifibrinolytics. List the plasma expanders with their salient features; outline the pharmacotherapy of shock. Lecture3: Physiology of coagulation. Coagulants vitamin K, other systemic and local haemostatics examples and uses. Anticoagulants classification; mechanism of action, kinetics, adverse effects, uses and drug interactions, management of overdosage, specific antidotes and contraindications of heparin. Low molecular weight heparin, fondaparinux and heparinoids. Lecture 4: Mechanism of action, kinetics, adverse effects, uses and drug interactions, management of overdose and contraindications of warfarin. Examples, uses and adverse effects of fibrinolytics and antifibrinolytics. Lecture 5: Antiplatelet drugs examples, mechanism of action, uses and adverse effects of aspirin, ticlopidine, clopidogrel, abciximab, tirofiban and eptifibotide. Newer drugs. Examples, uses and contraindications of plasma expanders. Pharmacotherapy of shock. Practicals: PSE: 23; Prescription: 12, 13; Emergency Management: 4. 31

HORMONES AND HORMONE ANTAGONISTS (Classes: 13) Topic Anterior Pituitary Hormones No. of hours: 1

Learning outcomes: At the end of the class, the students should be able to List the hypothalamic factors and anterior pituitary hormones with their functions, analogues and uses. Lecture 1: Anterior pituitary hormones: actions, regulation, preparations/analogues, uses; hypothalamic factors, analogues. Topic Thyroid Hormones and Antithyroid Drugs No. of hours: 2

Learning outcomes: At the end of the class, students should be able to List the steps in the synthesis of thyroid hormones. Describe the actions, therapeutic uses and adverse effects of thyroid hormones. Classify and explain the pharmacological actions, pharmacokinetics, uses, adverse effects, contraindications and interactions of of antithyroid drugs. Outline the management of myxoedema coma and thyroid storm. Lecture 2: Biosynthesis, storage and release, actions, preparations, uses and interactions; Comparison T3 and T4. Lecture 3: Antithyroid drugs: classification, mechanism of action, indications and adverse effects, precautions and limitations. Management of myxedema coma and thyroid storm. Practicals : PSE: 37, Prescription: 34, Emergency management: 9. Topic Antidiabetic Drugs No. of hours: 3

Learning outcomes: At the end of the class, students should be able to Outline the physiological effects of insulin and pathophysiology of diabetes mellitus. Describe sources and preparations, classification, uses and adverse effects of insulin. List insulin delivery devices. List various groups of oral antidiabetics with examples; explain their uses, adverse effects, contraindications and interactions. List the actions and uses of glucagon and newer antidiabetics in brief. Lecture 4: Insulin Physiological role, secretion, regulation, actions. Different preparations of insulin with their duration of action, adverse effects, insulin resistance. Purified insulins merits over older insulin. Lecture 5: Oral Antidiabetic Agents Classification with examples Mechanism of action. Pharmacokinetics, adverse effects, limitations of oral hypoglycemic agents. Newer antidiabetics. Lecture 6: Management of diabetes mellitus Non-insulin dependent diabetes mellitus (NIDDM), Insulin dependent diabetes mellitus (IDDM). Management of diabetic ketoacidosis. Other drugs which alter blood glucose; Glucagon. Practicals: PSE: 38; Prescription: 32, 33; Emergency management: 8.

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Topic

Corticosteroids

No. of hours: 2 actions, indications,

Learning outcome: At the end of the class, student should be able to List the corticosteroids; classify glucocorticoids; describe the contraindications and adverse effects of corticosteroids.

Lectures 7 & 8: Naturally occurring and synthetic glucocorticoids classification, mechanism of action, pharmacological actions, uses, adverse reactions, precautions. Mineralocorticoids and corticosteroid antagonists (in brief). Practicals: PSE: 25, 39, 40, 41. Topic Sex Steroids and Anabolic Steroids No. of hours: 3

Learning outcome: At the end of the class, student should be able to List the sex hormones; explain their physiological role, pharmacological effects, clinical uses and toxicities Describe hormonal contraception List the sex hormone antagonists and anabolic steroids with their uses and adverse effects. Lectures 9 & 10: Estrogens and progestins Actions, uses and adverse reactions of commonly used preparations; hormonal contraceptives; antiprogestins, antiestrogens, SERMs. Lecture 11: Androgens: role, actions, preparations, indications, adverse effects. Antiandrogens (brief). Anabolic steroids definition and examples, pharmacological actions, therapeutic uses and abuse. Practicals: PSE: 42. Topic Calcium Metabolism No. of hours: 1

Learning outcome: At the end of the class, student should be able to Outline the role of calcium; list preparations of calcium with their uses. List the drugs affecting calcium balance and explain their clinical relevance Lecture 12: Calcium and vitamin D metabolism, physiological role, preparations, uses, adverse effects; parathormone and calcitonin actions, uses, preparations. Bisphosphonates: examples, mechanism of action, uses and adverse effects. Treatment of hypocalcemia and hypercalcemia. Topic Drugs acting on Uterus No. of hours: 1

Learning outcome: At the end of the class, student should be able to List oxytocics and tocolytics explain their actions, uses, adverse effects Lecture 13: Oxytocics: Examples, mechanism and pharmacological actions, pharmacokinetics, adverse effects, uses, contraindications and drug interactions. Tocolytics Examples, mechanism of action, indications, route of administration Abortifacients. Practicals: PSE: 43; Prescription: 35. 33

AUTONOMIC NERVOUS SYSTEM (Classes: 7) Topic Introduction to Autonomic Nervous System No. of hours: 1

Learning Outcomes : At the end of the class, students should be able to Outline the anatomical organization of the ANS and physiology of neurotransmission. Explain the physiological responses of end organs produced by activation of the parasympathetic and sympathetic nervous systems. Lecture 1: Anatomy of ANS; steps in neurotransmission; effects of sympathetic and parasympathetic stimulation. Topic Cholinergic System No. of hours: 5

Learning Outcomes : At the end of the class, students should be able to List the cholinergic receptors; describe the actions, adverse effects and uses of cholinergic agonists. Classify anticholinergics; describe their actions, uses and adverse effects. Lectures 2 & 3 : Acetylcholine synthesis, storage, release, inactivation and actions. Cholinomimetics definition, classification; Esters of choline and cholinomimetic alkaloids pharmacokinetics, actions, uses, adverse effects, contraindications; Mushroom poisoning and treatment in brief. Lecture 4: Anticholinesterases: Classification, actions, pharmacokinetics, uses, adverse effects. Organophosphorus poisoning management. Lectures 5 & 6: Antimuscarinic agents: classification; Atropine as prototype: actions, pharmaco- kinetics, uses, adverse effects, contraindications, drug interactions. Treatment of Belladonna poisoning Atropine substitutes; Ganglion blocking drugs in brief.

Topic

Skeletal Muscle Relaxants

No. of hours: 1

Learning Outcomes : At the end of the class, students should be able to Classify skeletal muscle relaxants explain their uses and adverse effects. Lecture 7: Skeletal muscle relaxants: Classification; Mechanism of action, pharmacological actions, pharmacokinetics, adverse effects, uses, contraindications and drug interactions of d-tubocurarine and succinylcholine as prototype drugs; salient features of others. Centrally acting skeletal muscle relaxants (in brief).

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IV semester
AUTONOMIC NERVOUS SYSTEM (Classes: 7) Topic Adrenergic System No. of hours : 7

Learning Outcomes : At the end of the class, student should be able to Outline the biosynthesis and regulation of catecholamines; list the adrenergic receptors. Classify adrenergic agonists; explain their actions, uses, adverse effects and contraindications Classify Alpha blockers and Beta blockers; describe their actions, uses, adverse effects and contraindications. Lecture 1: Adrenergic transmission; adrenergic receptors. Classification of sympathomimetics: based on therapeutic use, mode of action, chemical structure, receptor selectivity. Lectures 2 & 3: Pharmacology of catecholamines. Pharmacokinetics, pharmacodynamics, indications, contraindications and current status of adrenaline, dopamine, dobutamine, noradrenaline and isoprenaline. Lecture 4: Non-Catecholamines: Pharmacological actions, uses and adverse effects of ephedrine, amphetamines, phenylephrine, nasal decongestants, vasopressors, selective beta 2 agonists. Adrenergic Neuron Blockers: Salient features, reserpine, guanethidine, bretylium, metyrosine. Lecture 5: Alpha Adrenergic Receptor Blockers: classification. Non-selective and selective blockers: actions, therapeutic uses, adverse effects and contraindications. Lecture 6: Beta Adrenergic Receptor Blockers: classification. Prototype Propranolol: actions, pharmacokinetics, adverse effects, therapeutic uses and contraindications, drug interactions; salient features of other commonly used beta blockers. Alpha and Beta Adrenergic Blockers: Labetalol and Carvedilol. Lecture 7: Drugs used in Glaucoma Practicals : PSE: 1, 2, 3, 11; Emergency management: 1, 2. Topic Diuretics and Antidiuretics (Classes: 3) No. of hours: 3

Learning Outcomes: At the end of the class, students should be able to Outline renal physiology Classify diuretics; list the sites of action, explain mechanism of action, uses, adverse effects, interactions and contraindications of the different classes of diuretics. List actions of ADH; list vasopressin analogues - their actions and uses with clinical basis. Lecture 1: Physiology of urine formation, diuretics definition, classification. Lecture 2: Examples of diuretics. Mechanism of action, uses, adverse effects, interactions and contraindications: Loop diuretics, thiazides, potassium sparing diuretics, osmotic diuretics, carbonic anhydrase inhibitors. Lecture 3: Drugs used in Diabetes insipidus; mechanism of action, adverse effects, uses, drug interactions. 35

CARDIOVASCULAR SYSTEM (Classes: 10) Topic Antihypertensives No. of hours: 3

Learning outcomes: At the end of the class, the students should be able to List factors responsible for maintenance of blood pressure Explain the role of renin angiotensin aldosterone system Explain the role of drug therapy in the management of hypertension Classify antihypertensive drugs Describe pharmacological actions, pharmacokinetics, uses, adverse effects, contraindications and group interactions of clinically relevant drugs Explain treatment of hypertension including hypertensive emergency and hypertension in pregnancy Lecture 1: Introduction; Classification, Central sympatholytics Methyldopa & clonidine in detail; Diuretics, alpha blockers, beta blockers, alpha + beta blockers. Lecture 2: Angiotensin converting enzyme inhibitors (ACEIs): Role of renin-angiotensin system with special reference to cardiovascular system. Commonly used ACEIs; Actions, pharmacokinetics, adverse effects, contraindications and interactions of prototype ACE inhibitor captopril; Other ACE inhibitors in comparison with prototype. Angiotensin receptor blockers Examples, actions, uses, adverse effects Calcium channel blockers: Types of calcium channels, physio-pharmacological importance Classification; Prototype: Nifedipine/Verapamil: Actions, kinetics, adverse effects, therapeutic uses, contraindications, drug interactions; Salient features: Diltiazem, amlodipine, nimodipine. Lecture 3: Vasodilators : hydralazine, minoxidil, diazoxide, sodium nitroprusside (in brief) Newer drugs. Management of hypertension, hypertensive emergencies, hypertension in pregnancy. Practicals: PSE: 4, 5, 6, 7, 8; Prescription: 2; Emergency management: 3

Topic

Drugs in Congestive Heart Failure (CHF)

No. of hours: 2

Learning outcomes: At the end of the class, the students should be able to Outline the pathophysiology of congestive heart failure and cardiac performance List the main approaches to treatment of heart failure Classify drugs used in congestive heart failure Describe the pharmacological actions, pharmacokinetics, uses, adverse effects, contraindications and interactions of clinically relevant drugs Lecture 4: Pathophysiology of congestive heart failure and cardiac performance. Rationale of using diuretics, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, aldosterone antagonist in CHF. Lecture 5: Rationale of using vasodilators, beta blockers in CHF; Cardiac glycosides in detail, Other positive inotropic drugs and newer drugs (in brief). Practicals: Cardiac stimulants and depressants; PSE: 10; Prescription: 4. 36

Topic

Antianginal Drugs

No. of hours: 2

Learning outcomes: At the end of the class, the student should be able to Outline the pathophysiology of angina pectoris Classify antianginal drugs. Describe the actions, important pharmacokinetic features, uses, adverse effects, drug interactions and contraindications of the clinically relevant drugs. Explain treatment of acute attack of angina and prophylaxis of angina. Lecture 6: Pathophysiology of angina pectoris, classification of antianginal drugs. Nitrates: mechanism of action, pharmacological actions, important pharmacokinetic features, adverse effects, uses and drug interactions. Lecture 7: Calcium channel blockers: Classification; Prototype Nifedipine / Verapamil: actions, pharmacokinetics, adverse effects, contraindications, drug interactions. Salient features - diltiazem, amlodipine, nimodipine. Beta blockers, potassium channel openers, other newer drugs: Basis for use, contraindications, drug interactions. Treatment of myocardial infarction. Practicals: PSE: 8, 9; Prescription: 3 Topic Antiarrhythmic Drugs No. of hours: 2

Learning outcomes: At the end of the class, the student should be able to Explain the generation of normal cardiac potential, mechanism of arrhythmias and disorders of cardiac rhythm. Classify antiarrhythmic drugs. Describe the actions, important pharmacokinetic features, uses, adverse effects, drug interactions and contraindications of the clinically relevant antiarrhythmic drugs. Lecture 8: Electrophysiology of the heart, mechanism of arrhythmias, disorders of cardiac rhythm; Classification of antiarrhythmic drugs; mechanism of action, actions, important pharmacokinetic features, adverse effects, uses, drug interactions and contraindications of the prototype Class I drugs quinidine, lignocaine, propafenone. Lecture 9: Mechanism of action, actions, important pharmacokinetic features, adverse effects, uses, drug interactions and contraindications of the prototype drugs propranolol (Class II), amiodarone (Class III) and verapamil (Class IV). Salient features procainamide, disopyramide, mexilitene, esmolol, sotalol, dofetilide, diltiazem, adenosine, digitalis, atropine, isoprenaline and other newer drugs. Topic Hypolipidemic Drugs No. of hours: 1

Learning outcome: At the end of the class, the student should be able to List the types of hyperlipoproteinemias. Classify drugs used for their treatment. Describe the actions, important pharmacokinetic features, uses, adverse effects, drug interactions and contraindications of the clinically relevant drugs. Lecture 10: Hyperlipoproteinemias; types and role of plasma lipoproteins. Mechanism of action, uses, adverse effects, drug interactions and contraindications of statins, fibrates, nicotinic acid, bile acid sequestrants, ezetimibe, omega-3 fatty acids and newer drugs.

37

CHEMOTHERAPY (Classes: 26) Topic General Principles of Chemotherapy No. of hours: 2

Learning outcome: At the end of the class, the student should be able to Classify antimicrobial agents based on chemical structure, mechanism of action and spectrum of activity. Describe the selection and judicious use of antimicrobial agents. Explain the mechanism and pattern of resistance to antimicrobial agents. Define superinfection; list the causes and drugs used for its treatment. Define chemoprophylaxis with examples. Lecture 1: Historical aspects; Definition chemotherapy, antibiotic. Classification and mechanism of action; Antimicrobial spectrum; factors that determine the susceptibility/resistance of micro-organisms to antimicrobial agents. Lecture 2: Choice of antimicrobials as monotherapy, combination with its advantages and disadvantages; superinfection; chemoprophylaxis; misuse of antibiotics. Topic Sulfonamides and Cotrimoxazole No. of hours: 1

Learning outcome: At the end of the class, student should be able to Describe the antibacterial spectrum, pharmacokinetics, clinical uses and toxicities of sulfonamides and trimethoprim - singly and in combination (cotrimoxazole). Lecture 3: Introduction, classification of sulfonamides. Mechanism of action, important pharmaco- kinetic features, uses, adverse effects, drug interactions and contraindications of sulfonamides, trimethoprim, cotrimoxazole. Topic Beta Lactams No. of hours: 4

Learning outcome: At the end of the class, student should be able to Describe mechanism of action, important pharmacokinetic features, uses, adverse effects, interactions and contraindications of Beta lactam antibiotics. List Beta lactamase inhibitors with their uses. Lectures 4 & 5: Penicillins: brief introduction, classification, penicillin units and formulations; Antibacterial spectrum, mechanism of action, resistance, pharmacokinetics, therapeutic uses, adverse reactions, interactions. Beta lactamase inhibitors. Lecture 6: Cephalosporins: generations with examples; antibacterial spectrum, mechanism of action, resistance, pharmacokinetics, therapeutic uses, adverse reactions, interactions of prototype in each generation and salient features of others. Lecture 7: Carbapenems and monobactams: examples and salient features.

38

Topic

Quinolones, Fluoroquinolones, Urinary Antiseptics

No. of hours: 1

Learning outcome: At the end of the class, student should be able to List quinolones with their salient features. List fluoroquinolones; describe their antibacterial spectrum, mechanism of action, pharmacokinetics, therapeutic uses, adverse reactions, contraindications and interactions. List urinary antiseptics with their actions and uses. Lecture 8: Quinolones: examples and salient features; Fluoroquinolones: classification, antibacterial spectrum, mechanism of action, resistance, pharmacokinetics, therapeutic uses, adverse reactions, interactions of prototype ciprofloxacin. Salient features of norfloxacin, ofloxacin, pefloxacin, lomefloxacin, levofloxacin, moxifloxacin. Urinary antiseptics examples, mechanism of action, uses. Practicals: Prescription: 17, 19, 20. Topic Broad Spectrum Antibiotics, Macrolides and Miscellaneous Antibiotics No. of hours: 3

Learning outcome: At the end of the class, student should be able to Describe the antibacterial spectrum, mechanism of action, resistance, pharmacokinetics, therapeutic uses, adverse reactions, special precautions, contraindications and interactions of tetracyclines, chloramphenicol, macrolides and miscellaneous antibiotics. Lectures 9 & 10: Tetracyclines classification, antibacterial spectrum, mechanism of action, resistance, kinetics, uses, adverse reactions, contraindications and interactions. Salient features and advantages of long acting tetracyclines. Chloramphenicol: antibacterial spectrum, mechanism of action, resistance, pharmacokinetics, therapeutic uses, adverse reactions, contraindications and drug interactions. Lecture 11: Macrolides and Miscellaneous antibiotics: classification, antibacterial spectrum, mechanism of action, resistance, kinetics, uses, adverse reactions, contraindications and interactions of erythromycin. Salient features of roxithromycin, clarithromycin and azithromycin. Salient features of miscellaneous antibiotics. Practicals: PSE: 26, 27, 28, 29; Prescription: 14, 15, 16. Topic Aminoglycosides No. of hours: 1 of action,

Learning outcomes: At the end of the class, students should be able to List aminoglycosides; describe their antibacterial spectrum, mechanism pharmacokinetics, major clinical uses, toxicities and contraindications.

Lecture 12: Introduction; general properties of aminoglycosides, antibacterial spectrum, mechanism of action, pharmacokinetics, resistance, major clinical uses, toxicities and contraindications, drug interactions - streptomycin, gentamicin, amikacin. Salient features of kanamycin, neomycin, netilmicin, tobramycin, sisomycin and framycetin. Practicals: Prescription: 18; PSE: 30.

39

Topic

Chemotherapy of Tuberculosis

No. of hours : 2

Learning outcomes: At the end of the class, students should be able to Classify the drugs used in tuberculosis; describe their mechanism of action, relevant pharmacokinetics, adverse effects, interactions of antitubercular drugs. Outline treatment regimens DOTS, RNTCP guidelines; role of corticosteroids in the treatment of tuberculosis. Lecture 13: Introduction, classification of drugs; First line drugs (detail) Second line agents (brief); resistance; Rationale of multidrug therapy in tuberculosis and General management of tuberculosis. Lecture 14: Regimens recommended by RNTCP for treatment of tuberculosis; treatment of tuberculosis in special groups; role of corticosteroids; chemoprophylaxis. Practicals : PSE: 31; Prescription: 21. Topic Chemotherapy of Leprosy No. of hours : 1

Learning outcomes : At the end of the class, students should be able to Classify drugs used in leprosy; describe their mechanism of action, adverse effects, interactions; list various regimens used in the treatment of leprosy. Outline lepra reactions and their treatment. Lecture 15: Introduction; Classification; Individual agents: mechanism of action and adverse effects. Drug treatment of different types of leprosy, pathogenesis and treatment of lepra reaction. Topic Chemotherapy of Malaria No of hours : 2

Learning outcomes: At the end of the class, the students should be able to Classify antimalarial drugs on the basis of their effects on different stages of plasmodium life cycle. Describe the mechanism of action of individual agents, pharmacokinetic features, their indications for use, adverse effects ,drug interactions. Describe the treatment of different types of malaria Lecture 16: Introduction including types of malaria; life cycle of malarial parasite. Classification of drugs; Individual agents: mechanism of action, pharmacokinetics, adverse effects, therapeutic uses. Lecture 17: Regimens for treatment of malaria - uncomplicated, severe and drug resistant malaria; chemoprophylaxis. Practicals: PSE: 32; Prescription: 22, 23, 24; Emergency management: 7. Topic Antifungal Drugs No. of hours: 2

Learning outcomes: At the end of the class, students should be able to Classify antifungal drugs; describe the mechanism of action, pharmacokinetics, adverse effects, important interactions, formulations and therapeutic indications for major antifungal agents. List drugs for superficial and deep fungal infections. Lectures 18 & 19: Classification; Individual agents: mechanism of action, adverse effects, formulations, pharmacokinetics, therapeutic uses and drug interactions. Practicals: Prescription: 25, 26. 40

Topic

Antiviral Drugs

No. of hours: 2

Learning outcomes: At the end of the class, the students should be able to Classify antiviral drugs; describe their mechanism of action, pharmacokinetics, adverse effects and major therapeutic indications of major antiviral including antiretroviral drugs. Outline the treatment and prophylaxis in HIV infection and opportunistic infections associated with AIDS. Lectures 20 & 21: Classification; individual agents mechanism of action, adverse effects, pharmacokinetics, interactions, uses. Newer developments in anti-viral therapy Practicals: PSE: 33, 34, 35; Prescription: 27. Topic Chemotherapy of Amoebiasis No. of hours: 1

Learning outcomes: At the end of the class, students should be able to Classify drugs used in amebiasis explain their mechanism of action, therapeutic indications, relevant interaction and major toxicities. Lecture 22: Introduction including life cycle of Entamoeba histolytica; classification of drugs. Individual agents mechanism of action, pharmacokinetics, adverse effects, therapeutic uses and drug interactions. Management of other protozoal infections (in brief). Practicals: PSE: 36, Prescription: 28, 29. Topic Chemotherapy of Helmintic Infestations No. of hours: 1

Learning outcomes: At the end of the class, students should be able to List the drugs used in helminthic infestations. Describe the mechanism of action, adverse effects, route(s) of administration, regimens, clinical uses, relevant interaction and contraindications of various antihelminthic drugs. Lecture 23: Classification; individual agents mechanism of action, adverse effects, formulations, therapeutic uses and drug interactions. Practicals: Prescription: 30, 31. Topic Chemotherapy of Neoplastic Diseases No. of hours: 3

Learning outcomes: At the end of the class, students should be able to Explain cell cycle kinetics. List major classes of anticancer drugs describe the mechanism of action of the main drugs in each class, uses, adverse effects. Lectures 24 & 25: General principles in cancer chemotherapy; classification of drugs; Major classes of anticancer drugs mechanism of action of the main drugs in each class, uses, adverse effects, mechanism of action, specific toxicities, indications, and drug interactions. Lecture 26: Immunomodulators. Practicals: Miscellaneous drugs acting on skin and mucous membrane, antiseptics, ectoparasiticides, vitamins and vaccines (Spotters). 41

V semester
CENTRAL NERVOUS SYSTEM (CNS) (Classes: 22) Topic Introduction to central nervous system No. of hours: 1

Learning outcomes: At the end of the class, students should be able to List various neurotransmitters in CNS and explain briefly their role. List the types of drug action on the CNS. Lecture 1: Types of drug action CNS depressants/stimulants; Non-specific/specific; Neurotransmitters and neuromodulators Topic Sedatives and Hypnotics No. of hours: 2

Learning outcomes: At the end of the class, students should be able to Describe the pharmacological actions, relevant pharmacokinetics, uses, adverse effects, contraindications and interactions of sedative - hypnotics. Outline the treatment of benzodiazepine and barbiturate overdose. Lecture 2: Physiology of sleep; classification of sedatives-hypnotics. Pharmacological actions, pharmacokinetics, adverse effects, uses benzodiazepines. Treatment of benzodiazepine overdose. and interactions of

Lecture 3: Salient features of non-benzodiazepines; Pharmacological actions, pharmacokinetics, adverse effects, uses and interactions of barbiturates. Treatment of barbiturate overdose. Topic Alcohol No. of hours: 1

Learning outcomes: At the end of the class, students should be able to Describe the actions, pharmacokinetics, interactions and uses of ethyl alcohol. Describe the management of acute alcohol intoxication and chronic alcoholism. Describe the management of methanol poisoning. Lecture 4: Actions, pharmacokinetics, interactions and uses of ethyl alcohol. Management of acute alcohol intoxication; role of disulfiram and other measures in alcohol deaddiction. Methanol poisoning and its treatment. Topic General Anaesthetics No. of hours: 2

Learning outcomes: At the end of the class, students should be able to Outline the mechanism of general anaesthesia. Classify and list important pharmacokinetic features, adverse effects and salient features of Inhalational and Intravenous anaesthetics. Explain preanaesthetic medication. Lectures 5 & 6: Introduction, stages and classification of general anaesthetics. Advantages and disadvantages of nitrous oxide, ether, fluorinated anaesthetics and intravenous anaesthetics. Preanaesthetic medication and conscious sedation (in brief). Complications of GA and drug interactions of anaesthetics.

42

Topic

Local Anaesthetics

No. of hours: 2

Learning outcomes: At the end of the class, students should be able to Classify local anesthetics; explain their mechanism of action; list important pharmacokinetic features, adverse effects and uses of local anaesthetics. Describe the techniques of local anaesthesia. Lectures 7 & 8: Classification, mechanism of action and salient features of individual agents. Uses and techniques of local anaesthesia (in brief).

Topic

Antiepileptics

No. of hours: 2

Learning outcomes: At the end of the class, students should be able to Classify antiepileptic drugs based on seizure type. Describe the mechanism of action, pharmacokinetics, adverse effects, indications and clinically relevant drug interactions of antiepileptics. Describe the management of status epilepticus. Lecture 9: Types of epilepsy. Classification of antiepileptics: Chemical and clinical; Mechanism of action, pharmacokinetics, adverse effects, drug interactions and therapeutic uses of Phenytoin sodium, phenobarbitone, carbamazepine, ethosuximide, valproic acid and benzodiazepines. Lecture 10: Other newer antiepileptics. Treatment of epilepsy ; management of status epilepticus. Practicals: PSE: 14, 15; Prescription: 5, 6. Topic Nonsteroidal Antiinflammatory Drugs (NSAIDs) No. of hours: 3

Learning outcomes: At the end of the class, students should be able to Explain the significance of cyclo-oxygenase enzyme system in prostaglandin synthesis and its role in pain, inflammation and fever. Classify NSAIDs. Describe the pharmacological actions, uses, adverse effects, drug interactions of clinically significant NSAIDs. Lecture 11: Introduction; Pathophysiology of pain, inflammation and fever. Classification of NSAIDs; Aspirin as prototype Mechanism of action, pharmacodynamics and kinetics, adverse effects and therapeutic uses. Lecture 12: Aspirin Contraindications, Drug interactions, Other NSAIDs Salient features. Lecture 13: Differences between paracetamol and other NSAIDs and management of paracetamol poisoning. Practicals: PSE: 16; Prescription: 7, 8.

43

Topic

Drugs for Rheumatoid Arthritis and Gout

No. of hours: 1

Learning outcomes: At the end of the class, students should be able to Outline the pathogenesis of rheumatoid arthritis. List the general approaches in the management of rheumatoid arthritis and gout. List the drugs used in the treatment of rheumatoid arthritis and gout. Explain the pharmacological actions, pharmacokinetics, uses, adverse effects, contraindications and interactions of clinically relevant drugs. Lecture 14: Rheumatoid arthritis pathophysiology; NSAIDs role in RA. Disease modifying anti-rheumatic drugs (DMARDs) therapeutic uses, adverse effects, other drugs. Gout Pathophysiology; Drugs used in acute and chronic gout, basis for use, adverse effects and interactions. Role of NSAIDs, steroids, colchicine, uricosuric agents, uric acid synthesis inhibitors and newer drugs in gout. Practicals: PSE: 17,18. Topic Parkinsonism and other Neurodegenerative Disorders No. of hours: 1

Learning outcomes: At the end of the class, students should be able to Classify drugs used for the treatment of Parkinsonism. Describe the mechanism of action, relevant pharmacokinetics, adverse effects and interactions of drugs used in parkinsonism. Explain the mechanism of iatrogenic parkinsonism and its management. List the drugs used in other neurodegenerative disorders; various CNS stimulants and cognitive enhancers. Lecture 15: Parkinsonism pathophysiology; Classification of drugs, mechanism of action, adverse effects, clinical uses and drug interactions of drugs used in parkinsonism, Drugs for other neurodegenerative disorders, CNS stimulants and cognition enhancers. Topic Opioid Analgesics No. of hours: 3

Learning outcomes: At the end of the class, students should be able to List opioid receptor subtypes. Classify and describe pharmacological actions, pharmacokinetics, uses, adverse effects, contraindications and interactions of opioid agonists with morphine as prototype. List salient features of opioid antagonists; describe treatment of opioid overdose and dependence. Explain the choice of opioids in various clinical conditions. Lecture 16: Definition, introduction to nociception, Classification Opioids and non-opioids. Opioid Analgesic; Classification, pure agonists, pharmacological actions of opioids with morphine as prototype, source and chemistry. Lecture 17: Opioid receptors and peptides, pharmacodynamics and kinetics, adverse effects, therapeutic uses and contraindications of Acute morphine poisoning Management. Lecture 18: Drug interactions of opioids, salient features and examples of mixed opioid agonists/ antagonists and opioid antagonists. Practicals: Prescription: 7.

44

Topic

Psychopharmacology

No. of hours: 4

Learning Outcomes: At the end of the class, students should be able to Classify and explain the mechanism of action, uses, adverse effects and interactions of drugs useful in schizophrenia, depression, bipolar disorder, obsessive compulsive disorder and anxiety. Lecture 19: Antipsychotics Description of dopamine, serotonin and glutamate hypothesis of schizophrenia. Classification of antipsychotic drugs; mechanism of action, pharmacodynamics, kinetics, uses, adverse effects and interactions of prototype drug chlorpromazine. Salient features of other conventional antipsychotics ; Atypical antipsychotics. Practicals: PSE: 20. Lecture 20: Mechanism of action, uses, adverse effects and drug interactions of lithium. Other drugs used in bipolar disorder (in brief). Practicals: PSE: 19. Lecture 21: Antidepressants classification; mechanism of action, pharmacokinetics, uses, toxicities and drug interactions of prototype imipramine; other tricyclic antidepressants (in brief) Salient features of other drugs. Lecture 22: Antianxiety drugs Serotonin hypothesis of anxiety; classification of antianxiety drugs; benzodiazepines and other antianxiety drugs (in brief). GASTROINTESTINAL TRACT (Classes: 4) Topic Peptic Ulcer No. of hours: 1 Learning Outcomes: At the end of the class, student should be able to Outline the physiology, regulation and factors altering gastric acid secretion. Classify and explain the mechanism of action, kinetics, adverse effects, uses, drug interactions of drugs used in peptic ulcer. Explain the treatment of peptic ulcer, gastroesophageal reflux disease and H. pylori infection. Lecture 1: Physiology and regulation of gastric acid secretion. Classification, mechanism of action, uses, adverse effects and drug interactions of the various classes of drugs used in treatment of peptic ulcer; Treatment of H. pylori infection. Antifoaming agent, carminatives (in brief). Practicals: PSE: 22; Prescription: 9. Topic Emetics and Antiemetics No. of hours: 1

Learning Outcomes: At the end of the class, student should be able to Outline the physiology of vomiting. List the types of emesis; list emetics with their uses and contraindications. Classify antiemetics; describe their mechanism of action, kinetics, adverse effects, uses, drug interactions; explain treatment of various types of vomiting. List the appetite stimulants and suppressants with their mechanism of action, uses, adverse effects/contraindications. Lecture 2: Physiology of vomiting; emetics (in brief); Classification of antiemetics: mechanism of action, adverse effects, uses. Appetite stimulants and appetite suppressants (in brief); gallstone dissolving drugs (in brief). Practicals: Prescription: 10; PSE: 21. 45

Topic

Laxatives/Purgatives

No. of hours: 1

Learning Outcomes: At the end of the class, student should be able to Classify drugs used in the management of constipation; explain their mechanism of action, adverse effects and uses. Lecture 3: Pathophysiology of constipation; mechanism of action, pharmacokinetics, adverse effects and uses of purgatives. Topic Anti-diarrhoeals and Drugs for Inflammatory Bowel Disease No. of hours: 1

Learning Outcomes: At the end of the class, student should be able to List the drugs used in the treatment of diarrhea with their salient features. Explain rehydration therapy. Classify drugs used for inflammatory bowel disease with their salient features. Lecture 4: Pathophysiology of diarrhea; Rehydration therapy; antidiarrhoeals (in brief). Drugs for inflammatory bowel disease (in brief). Practicals: Oral rehydration solution.

RESPIRATORY SYSTEM (Classes: 3) Topic Pharmacotherapy of Cough No. of hours: 1

Learning Outcomes: At the end of the class, student should be able to Classify the drugs used in cough with their salient features. Lecture 1: Pathophysiology of cough; Classification of drugs used in cough; demulcents, expectorants, antitussives mechanism of action with indications. Topic Pharmacotherapy of Bronchial Asthma No. of hours: 2

Learning Outcomes: At the end of the class, student should be able to Classify drugs used in bronchial asthma; explain their mechanism of action, adverse effects, indications, drug interactions. Describe the treatment and prophylaxis of bronchial asthma. Lecture 2: Pathophysiology of bronchial asthma; types of asthma; Drugs used in bronchial asthma; mechanism of action, adverse effects, indications, drug interactions of bronchodilators. Lecture 3: Mechanism of action, adverse effects, indications, drug interactions of mast cell stabilizers, leukotriene receptor antagonists, corticosteroids and newer drugs. Treatment and prophylaxis of bronchial asthma. Practicals: Prescription: 11; Emergency management: 6.

46

CHELATING AGENTS (Class: 1) Learning Outcomes: At the end of the class, student should be able to Define a chelating agent; list various chelating agents with their clinical uses and adverse effects. Topic Chelating agents No. of hours: 1

Lecture 1: Definition, examples, mechanism of action, uses and adverse effects of clinically relevant chelating agents. BIOGENIC AMINES AND POLYPEPTIDES (Classes: 3) Topic Autacoids No. of hours - 3

Learning outcomes: At the end of the class, student should be able to Describe the mechanism of action, adverse effects and uses of histamine. List H1 receptor antagonists; describe their mechanism of action, adverse effects and uses. List serotonin agonists and antagonists; explain their clinical uses, adverse effects and contraindications. Explain the therapeutic indications of eicosanoids and their antagonists. Outline the role of kinins and platelet activating factors and list the drugs (antagonists) affecting them. Lecture 1: Autacoid: definition; difference between hormone and autacoids. Histamine distribution, biosynthesis, physiological role with relevant pharmacological actions, Receptors types, location, role; histamine releasers. H1 receptor antagonists classification, examples, mechanism of action, pharmacological actions, adverse effects and uses. Lecture 2: Distribution, synthesis and pathophysiological role of serotonin, types and location of 5HT Receptors; Serotonin agonists, antagonists and their clinical uses; drugs used for acute attack and prophylaxis of migraine. Bradykinin: Synthesis, degradation pathophysiological role, receptors, uses of antagonists. Platelet activating factor: Sources, pathophysiological role, uses of antagonists. Lecture 3: Prostaglandins and leukotrienes; biosynthesis and pathophysiological role; therapeutic indications of eicosanoids and its antagonists. Practicals: PSE: 24.

47

PHARMACOLOGY PRACTICALS (Total 100 Classes, 200 Hours) Introduction to Pharmacy, prescription writing and sources of drug information Pharmaceutical preparations Parenteral drug administration and Drug delivery system Effect of drugs on eye (miotics, mydriatics, local anesthetics) Drug interaction on an in vitro preparation Cardiac stimulants and depressants Oral rehydration solution Calculation of drug dosage and percentage solution Adverse drug reaction reporting Pharmacoeconomic exercises and critical analysis of drug promotional literature Prescriptions Problem Solving Exercises Graphs Emergency management Spotters and Emergency tray Tutorials/Discussion No. of Classes 2 1 1 2 2 2 1 1 1

1 17 30 3 5 1 30

48

Text Books Recommended Essentials of Medical Pharmacology by K D Tripathi 6th Edition Books for Reference 1. Pharmacology and Pharmacotherapeutics by Satoskar & Bhandarkar 21st Edition 2. Basic & Clinical Pharmacology by Bertram C Katzung 11th Edition 3. Clinical Pharmacology by P N Bennett & Brown 10th Edition 4. Principles of Pharmacology by H L Sharma & K K Sharma 1st Edition 5. Goodman & Gilman The Pharmacological Basis of Therapeutics 12th Edition 6. Pharmacology by H P Rang & M M Dale 7th Edition 7. Averys Drug Treatment 4th Edition

49

PATTERN FOR SESSIONAL EXAMINATION There will be three Sessional Examinations at the end of 3rd, 4th & 5th Semester ALL THREE SESSIONAL EXAMINATIONS ARE COMPULSORY Theory = 100 Duration = 3 hrs. 1. Twenty multiple choice questions (1 mark each) (with negative marks) 2. Two essay questions (10 marks each) 3. Fifteen short answer questions (4 marks each) Viva voce Practicals (Max marks = 60) Objective Structured Practical Examination (OSPE) Record OSPE MARKS DISTRIBUTION 10 stations S1 Problem Solving Exercise S2 Prescription Writing S3 Spotters S4 Dose Calculation S5 ADR S6 Formulations, ORS, Emergency trays, Solutions (5% dextrose, DNS, NaHCO3, Ringer lactate, Normal Saline, Metronidazole, Mannitol etc.) [Interaction] S7 Graphs S8 Skills (IM, IV, SC, Intradermal, Eye drops/ointment, Ear drops, Nasal drops, MDI) [Observation] S9 FDC, PSE on drug interaction, Emergency Management S10 Pharmacoeconomic exercise, Critical analysis of promotional literature INTERNAL ASSESSMENT The marks obtained in sessional examination would be equated to a maximum of 15 marks each in theory and practical. Time: 5 Minutes for each = 4 marks = 4 marks = 4 marks = 4 marks = 5 marks = 50 marks = 10 marks = 20 marks = 20 marks = 60 marks = 20 marks

= 9 marks = 5 marks

= 5 marks = 5 marks = 5 marks

50

PATTERN FOR UNIVERSITY THEORY EXAMINATION Theory = 100 Duration = 3 hrs. 1. Twenty multiple choice questions (1 mark each) (with negative marks) 2. Two essay questions (10 marks each) 3. Fifteen short answer questions (4 marks each) Viva voce = 20 marks = 20 marks = 60 marks = 15 marks

UNIVERSITY PRACTICAL EXAMINATION Objective Structured Practical Examination (OSPE) OSPE MARKS DISTRIBUTION = 25 marks

10 stations S1 Problem Solving Exercise S2 Prescription writing S3 Spotters S4 Dose Calculation S5 ADR

Time: 5 Minutes for each = 2 marks = 2 marks = 2 marks = 2 marks = 2.5 marks

S6 Formulations, ORS, Emergency trays, Solutions (5% dextrose, DNS, NaHCO3 , Ringer lactate, Normal Saline, Metronidazole, Mannitol etc.) [Interaction] = 4.5 marks = 2.5 marks [Observation] = 2.5 marks = 2.5 marks = 2.5 marks S7 Graphs S8 Skills (IM, IV, SC, Intradermal, Eye drops/ointment, Ear drops, Nasal drops, MDI) S9 FDC, PSE on drug interaction, Emergency Management S10 Pharmacoeconomic exercise, Critical analysis of promotional literature

51

SPECIFICATION TABLE FOR II MBBS PHARMACOLOGY UNIVERSITY EXAMINATION There will 2 papers of 100 marks each PAPER I Paper I General Pharmacology & Clinical Pharmacology ANS CVS Diuretics Respiratory system Blood GIT Autacoids Chelating agents Total PAPER II Paper II Chemotherapy Hormones + drugs Acting on uterus CNS Total No. of classes 26 13 22 61 Distribution of Marks Short essay 30 20 30 80 MCQ 8 4 8 20 Total Marks 38 24 38 100 No. of classes 16 14 10 3 3 5 4 3 1 59 8 80 1 20 9 100 16 8 8 8 4 1 2 2 20 9 10 10 Distribution of Marks Short essay 16 16 MCQ 5 5 Total Marks 21 21

52

MICROBIOLOGY

LESSON PLAN FOR MBBS

i) GOAL

The broad goal of the teaching of undergraduate students in Microbiology is to provide an understanding of the natural history of infectious disease in order to deal with the etiology, pathogenesis, laboratory diagnosis, treatment and control of infections in the community. ii) OBJECTIVES a. KNOWLEDGE At the end of the course, the student should be able to: 1. 2. 3. 4. 5. State the infective micro-organisms of the human body and describe the host parasite relationship. List pathogenic micro-organisms (bacteria, viruses, parasites, fungi) and describe the pathogenesis of the diseases produced by them. State or indicate the modes of transmission of pathogenic and opportunistic organisms and their sources, including insect vectors responsible for transmission of infection. Describe the mechanisms of immunity to infections. Acquire knowledge on suitable antimicrobial agents for treatment of infections and scope of immunotherapy and different vaccines available for prevention of communicable diseases. Apply methods of disinfection and sterilization to control and prevent hospital and community acquired infections. Recommend laboratory investigations regarding bacteriological examination of food, water, milk and air.

6. 7.

b.

SKILLS At the end of the course, the student should be able to: 1. 2. 3. Plan and interpret laboratory investigations for the diagnosis of infectious diseases and to correlate the clinical manifestations with the etiological agent. Identify the common infectious agents with the help of laboratory procedures and use antimicrobial sensitivity tests to select suitable antimicrobial agents. Perform commonly employed bed-side tests for detection of infectious agents such as blood film for malaria, filaria, gram staining and AFB staining and stool sample for ova cyst. Use the correct method of collection, storage and transport of clinical material for microbiological investigations.

4.

c.

INTEGRATION The student should understand infectious diseases of national importance in relation to the clinical, therapeutic and preventive aspects.

54

General Bacteriology and Immunology

1. 2.

Name of the chapter Learning outcomes 1 Course content Lectures Lecture 1

1.

Historical Introduction

At the end of the chapter the student should be able to Learn about major scientists of Microbiology of the past and their discoveries

Introduction to Microbiology, Antony Van Leuwenhoek discovery of bacteria-, Theory of spontaneous generation, contributions of Louis Pasteur, Discovery of vaccines, solid media, Contributions of Robert Koch, Kochs postulates, and its short comings, KochsMolecular postulates, Discovery of disinfectant father of antiseptic surgery Lord Lister Not Applicable 2. Morphology of bacterial cell At the completion of the Chapter, the student should be able To learn the differences between Prokaryotes and Eukaryotes To learn to classify the bacteria according to the shapes To learn about the principles, working and applications of the different types of microscopes To learn about the different stains and staining methods to demonstrate bacteria To learn about Grams staining method in detail To learn about Gabbets staining method in detail To learn about Alberts staining method in detail

Practicals 1 2. Name of the chapter Learning outcomes 1 2 3 4 5 6 7 Course content Lectures Lecture 1

Differences between Prokaryotes and Eukaryotes discussed with examples, Classification of microorganisms systematic classification, Classification of bacteria different methods, Classification according to the shape and grams staining in detail with diagrams. Demonstration class on Microscopy: The student learns about the different types of microscopes and their uses, Principle, working and applications of Fluorescent microscope, Dark ground microscope, electron microscope explained. Demonstration of how to focus under low power objective, high power objective and oil immersion objective, parts of light microscope are demonstrated and wet mounts and stained slides are focused for observation by students Demonstration class on Staining methods: The different types of stains with examples, Different types of staining methods with 55 principle and applications, Smears stained by Methylene blue, Grams stain, Alberts stain, Gabbets stain and Negative staining methods focused.

Practicals Practical 1

Practical 2

Practical 3

Practical Exercise on Grams staining: A brief about the Grams Staining along with theories of Grams stain and examples is given to students. Heat fixed smears provided and the students individually stain their slides 3. Bacterial cell structure At the completion of the Chapter, the student should be able To understand about the bacterial cell structure To understand about the role of endospores in disease

1. 2.

Name of the chapter Learning outcomes 1 2 3 Course content Lectures Lecture 1

Lecture -2

Cell wall, cytoplasmic membrane, cytoplasm Structure, functions , methods of demonstration of cell wall Differences between gram positive and gram negative cell wall with neat labeled diagrams. L- forms and the clinical significance, structure and functions of cytoplasmic membrane, demonstration of Nucleoid, ribosomes, intra cytoplasmic inclusions Extracellular structures Definition, functions, method of demonstration of Capsule with examples of bacteria bearing capsule, microcapsule, slime and glycocalyx, Flagella with examples of bacteria bearing , definition, functions of different types of pili. Endospores Definition, structure with diagram, arrangement of endospores with examples of bacteria bearing endospores, Methods of demonstration of endospores and the clinical significance Not applicable 4. Growth and multiplication of bacteria At the completion of the Chapter, the student should be able To know growth requirements of bacteria To learn in detail about the growth curve

Lecture 3

Practicals 1. 2. Name of the chapter Learning outcomes 1 2 Course content Lectures Lecture 1

Growth requirements and growth curve Binary fission, generation time and growth requirements of bacteria, Classification of bacteria according to oxygen requirements, temperature and pH requirement, definitions of auxotrophs, chemotrophs, Capnophilic, Halophilic and Bacterial growth curve in detail with diagram Not applicable

Practicals

56

Systematic Bacteriology
1 2. Name of the chapter Learning outcomes 1 2 3 4 5 3 Course content Lectures Lecture 1 1. Staphylococcus At the completion of the chapter, the student should be able to List the general properties and classification of Genus Staphylococcus. Describe the pathogenicity, pathogenesis, clinical symptoms of infections caused by S. aureus Describe the Lab. Diagnosis of S. aureusinfections Describe the prevention, drug resistance and treatment of S. aureusinfections. Describe the properties and clinical significance of Coagulase negative staphylococci and MRSA

Lecture -2

General properties and classification of Genus Staphylococcus. Virulence factors produced by S. aureus.Pathogenesis and clinical symptoms of diseases caused by S. aureus. Lab. Diagnosis and prevention of infections caused by S. aureus, treatment with a note on drug resistance and MRSA. Coagulase negative staphylococci Properties and clinical significance of S. epidermidisand S. saprophyticus

Lecture 3 Practicals Practical 1 Practical 2

Spotter Gram stain of pus smear with staphylococci.Students should identify the spotter and answer the questions. Applied microbiology Chart: on Surgical Wound Infection caused by S. aureus. A case of Surgical Wound Infection is described. Results of microbiological investigations related to the case are demonstrated (for eg., Grams smear is focused along with Culture plates and biochemical reactions). At the end of the class the student should be able to make a correct diagnosis and answer questions related to the case. 2. Streptococcus At the completion of the chapter, the student should be able to Describe the general properties and classification of Genus Streptococcus List the general properties of Group A Streptococcus, Group B Streptococcus, Viridans Streptococci S. pneumonia and Enterococci Describe the pathogenesis, clinical symptoms of infections caused by various streptococci and poststreptococcal diseases. Describe the Lab. Diagnosis of infections caused by various streptococci Describe the prevention and treatment of streptococcal infections.

1. 2.

Name of the chapter Learning outcomes 1 2 3 4 5

Course content Lectures Lecture 1

Lecture -2

General properties and classification of Genus Streptococcus. Group A Streptococcus Antigenic structure, pathogenicity, pathogenesis, clinical symptoms of pyogenic infections and poststreptococcal diseases. Lab. Diagnosis of diseases caused by Group A Streptococcus Prevention and treatment of diseases caused by Group A Streptococcus. Group B Streptococcus properties, pathogenesis and clinical symptoms of infections caused by Group B Streptococcus. Lab. Diagnosis, prevention and treatment.

57

Lecture 3 Practicals Practical 1

Properties, pathogenesis, clinical symptoms, lab. Diagnosis, treatment of infections caused by Enterococci, Viridans streptococci and S. pneumonia Spotter Gram stain streptococcus in pus.Students should identify the spotter and answer the questions. 3. Neisseria At the completion of the Chapter, the student should be able to Describe the general properties and Classification of Genus Neisseria Understand pathogenesis and laboratory diagnosis of N.meningitidis and N. gonorrhoeae Understand the epidemiology, etiology, pathogenesis and lab diagnosis, treatment and prevention of gonorrhea and Meningitis. Prevention and control of gonorrheaand Meningitis

1 2.

Name of the chapter Learning outcomes 1 2 3 4

Course content Lectures Lecture 1 Lecture -2

Practicals 1 2. Name of the chapter Learning outcomes 1 2 Course content Lectures Lecture 1 Lecture -2 Practicals Practical 1 Practical 2 Practical 3 1 2. Name of the chapter Learning outcomes 1 2 3 Course content Lectures Lecture 1

Properties of genus Neisseria, Classification and Pathogenesis of N. gonorrhoeae Laboratory diagnosis of N. gonorrhea. Virulence factors, Pathogenesis, lab diagnosis and treatment of Meningococcal meningitis. A note on non gonococcal urethritis None 4. Corynebacterium At the completion of the Chapter, the student should be able to Describe the epidemiology, etiology, pathogenesis, lab diagnosis, treatment and prevention of diphtheria Understand the clinical significance of diphtheroids

Properties and classification of Corynebacterium, C. diphtheriae properties, diphtheria toxin and pathogenesis Lab diagnosis of diphtheria, Prevention and treatment of diphtheria, a note on diphtheroids Albert staining Student is taught how to perform, screen and report the stained smearand his/ her staining skill is evaluated. Spotter TelluriteBlood agar.Students should identify the spotter and answer the questions.

5. Genus Bacillus At the completion of the Chapter, the student should be able to Describe the characters of Genus Bacillus Describe the pathogenesis and laboratory diagnosis of Anthrax Understand the clinical significance of B. cereus and food poisoning

Properties, classification of Bacillus, Bacillus anthracis pathogenesis, laboratory diagnosis, treatment. A note on B.cereus

58

Practicals

None

1 2.

Name of the chapter Learning outcomes 1

6. Clostridium At the completion of the chapter the student should be able to Enumerate the different species of Clostridia and briefly explain the morphological differences between the different species of Clostridia (Shape & location of spores) Describe the pathogenesis, clinical features and Laboratory diagnosis of tetanus and gas gangrene. Describe the prophylaxis of tetanus and gas gangrene Briefly explain the pathogenesis, Lab diagnosis, treatment and prophylaxis of C botulinumand C difficile

2 3 4 3 Course content Lectures Lecture 1

Lecture -2 Lecture 3 Lecture -4 Practicals 1 2. Name of the chapter Learning outcomes 1 2

Morphological features, Properties and classification of Clostridium species; Introduction to Clostridium tetani with properties, Properties and mechanism of action of Tetanus toxin. Pathogenesis of tetanus. Clinical features and lab diagnosis of Tetanus, Treatment and prophylaxis of tetanus.Properties and virulence factors of Clostridium perfringens Gas gangrene: pathogenesis, clinical features, treatment and prophylaxis of gas gangrene. Clostridium botulinumand Clostridium difficle None 7. Non-sporing anaerobes At the completion of the Chapter, the student should be able To classify and describe the propertiesof nonsporing anaerobes To enumerate and briefly explain the types of infections,pathogenesis, laboratory diagnosis and treatment of infections caused by nonsporing anaerobes

Course content Lectures Lecture 1

Classification, and properties of nonsporing anaerobes. Pathogenesis, clinical findings, Lab diagnosis, treatment and prevention of infections caused by nonsporing anaerobes. None 8. Enterobacteriaciae After the completion of this chapter, the student should be able to Classify and enumerate the important members of the Enterobacteriacae family. Describe the Pathogenesis and lab diagnosis of infections caused by E coli Describe the Pathogenesis, lab diagnosis, prevention and treatment of Enteric fever Describe Non typhoidal salmonellosis Describe the Pathogenesis, lab diagnosis and prevention of Bacillary dysentery Briefly explain the infections caused by Klebsiella, Proteus- ProvidenciaMorganella group and other members of the Family Enterobactericiae

Practicals 1 2. Name of the chapter Learning outcomes 1 2 3 4 5 6

59

Course content Lectures Lecture 1 Lecture -2 Lecture 3 Lecture -4 Lecture 5

Properties and classification of Enterobactericiae, Clinical significance and pathogenesis of infection with E.coli Lab diagnosis of Infections with E coli. Note on Diarrheagenic E.coli. Properties, virulence factors of Salmonella spps, Pathogenesis, Clinical features of Enteric fever Lab diagnosis of Enteric fever Treatment ( to include drug resistant Salmonella), Prevention ( to include typhoid vaccine), Non typhoidal Salmonellosis Properties, and Virulence factors of Shigellasppsand Pathogenesis, Clinical features and Lab diagnosis of Bacillary dysentery. Difference between Amoebic and Bacillary dysentery. Properties and clinical significance of other important members of enterobactericiaeKlebsiellaspps, ProteusProvidencia- Morganella group Applied microbiology Chart: on Blood Culture. A brief class on Blood Culture is taken (indications, method of blood collection and culture, isolation and identification of blood borne bacterial pathogens is described). Results of microbiological investigations related to the case are demonstrated (for eg.Grams smear is focused along with Culture plates and biochemical reactions). At the end of the class the student should be able to make a correct diagnosis and answer questions related to that particular case. Applied microbiology Chart: on Widal test. A case of Enteric Fever is described; followed by demonstration of results of Widal test. At the end of the class the student should be able to make a correct diagnosis and answer questions related to that particular case. Applied microbiology Chart: on Bacillary dysentery. A case of Bacillary dysentery is described; At the end of the class the student should be able to make a correct diagnosis and answer questions related to that particular case Applied microbiology Chart: Urinary Tract Infection. A brief Class on UTI is taken. A case of UTI is described; followed by the results of microbiological investigations (for eg., Grams smear is kept focused & along with Culture plates and biochemical reactions). At the end of the class the student should be able to make a correct diagnosis and answer questions related to that particular case. 9. Vibrio At the completion of the chapter, the student should be able to Explain the importance of cholera, its history and current status Understand the pathogenesis, lab diagnosis, treatment and preventin of Cholera. Enumerate halophillicvibrios and briefly explain their clinical significance.

Practicals Practical 1

Practical 2

Practical 3

Practical 4

1 2.

Name of the chapter Learning outcomes 1 2 4 Course content Lectures Lecture 1 Lecture -2 Lecture 3 Lecture -4 Practicals Practical 1

Properties and classification of Vibrios with introduction to Vibrio cholerae Cholera toxin and other virulence factors; Cholera- source, transmission, pathogenesis, clinical findings Laboratory diagnosis of cholera and prevention; El Tor vibrio and Classical Vibrios Halophilicvibrios- Definition, examples and clinical significance Spotter: TCBS agar. The student has to identify the culture medium, and intended use

60

Practical 2

Applied exercise chart on Cholera. A case of Cholera is described; followed by the results of microbiological investigations. The student has to arrive at the correct diagnosis and answer the questions given at the end, related to that particular case. 10. Campylobacter and Helicobacter At the completion of the Chapter, the student should be able to Describe the morphology and properties of the genera Campylobacter & Helicobacter. Describe the pathogenesis, Lab diagnosis, treatment and prevention of diseases caused by Campylobacter and Helicobacter

1 2.

Name of the chapter Learning outcomes 1

Course content Lectures Lecture 1

Practicals Name of the chapter 2. Learning outcomes 1 2 3 Course content Lectures Lecture 1 Practicals

Campylobacter: Morphology, important species, pathogenesis and lab diagnosis of infection caused by C. jejuni Helicobacter: Morphology, pathogenesis, clinical featuresl,laboratory diagnosis, treatment and prevention of H. pylori infection. None 11. Pseudomonasand Acinetobacter At the completion of the Chapter, the student should be able to Understand the properties,pathogenesis and the diagnosis of infection caused by Pseudomonas spps, and Acinetobacterspps Briefly explain the significance of Pseudomonas spps&Acinetobactersppsas nosocomial pathogens

Properties, classification, clinical significance, lab diagnosis &Treatment of infections caused by Pseudomonas spps&Acinetobacterspps Applied Microbiology Chart: Burn wound infection: A case of Burn wound infection is described; followed by the results of microbiological investigations. At the end of the class the student should be able to make a correct diagnosis and answer questions related to that particular case. 12. Yersinia At the completion of the chapter, the student should be able to Describe the classification and properties of Genus Yersinia Describe the pathogenesis and clinical symptoms of plague Describe the lab. Diagnosis, prevention and treatment of plague Give a note on Y enterocolytica

1 2.

Name of the chapter Learning outcomes 1 2 3 4 Lectures Lecture 1

Practicals

Properties and classification of Genus Yersinia. Morphology and properties of Yersinia pestis.Pathogenesis and clinical symptoms of bubonic, pneumonic and septicaemic plague. Laboratory diagnosis of plague,epidemiology, prevention and treatment of plague Spotter on Rat flea: Students should identify the spotter and answer the questions. 13. Pasteurella and Francisella At the completion of the Chapter, the student should be able to Describe the clinical significance and laboratory diagnosis of diseases caused byPasteurella and Francisella

1 2.

Name of the chapter Learning outcomes 1

61

Course content Lectures Lecture 1 Practicals

Properties, clinical significanceand lab diagnosis of diseases caused byPasteurella and Francisella None 14. Haemophilus At the completion of the Chapter, the student should be able to Describe the properties and growth factor requirements of organisms belonging to the genus Haemophilus. List the important species of Haemophilus with diseases caused. Describe the clinical features, lab diagnosis, treatment and prophylaxis of H. influenza Give a brief note on H ducreyi

1 2.

Name of the chapter Learning outcomes 1

Course content Lectures Lecture 1

Practicals 1 2. Name of the chapter Learning outcomes 1

Properties, classification, virulence factors, pathogenesis, clinical findings, lab. Diagnosis, treatment and prevention of infections caused byH. influenza. Note on Chancroid None 15. Bordetella pertussis At the completion of the Chapter, the student should be able to Describe the pathogenesis, clinical features, laboratorydiagnosis, treatment and prevention of infections caused by Bordetella pertussis

Course content Lectures Lecture 1 Practicals

Properties, pathogenesis, clinical findings, lab. Diagnosis, treatment and prevention of pertussis. None 16. Brucella At the completion of the Chapter, the student should be able to Define and list the etiological agents of Zoonoses Describe the pathogenesis of Brucellosis Describe the Laboratory diagnosis and prevention of Brucellosis Describe the etiology and investigation procedure for pyrexia of unknown origin

1 2.

Name of the chapter Learning outcomes 1 2 3 4 Course content Lectures Lecture 1

Properties and classification of Brucella.Pathogenesis, clinical features, lab. Diagnosis, treatment and prevention of brucellosis None 17. Mycobacteria At the completion of the chapter student should be able to ClassifyMycobacteria and list the properties of organisms belonging to the Genus Mycobacteria

Practicals 1 2. Name of the chapter Learning outcomes 1

62

2 3 4 3 Course content Lectures Lecture - 1 Lecture - 2 Lecture - 3

Describe the pathogenesis, laboratory diagnosis, prophylaxis of tuberculosis Define and ClassifyAtypical Mycobacteria. Briefly explain the properties and infections caused by each class of Atypical Mycobacteria. Describe the pathogenesis, laboratory diagnosis, treatment, prophylaxis and epidemiology of leprosy.

Lecture - 4

General properties of Genus Mycobacteria, Classification, Pathogenesis of tuberculosis (primary, post primary, and extra pulmonary). Laboratory diagnosis of pulmonary and extra pulmonary TB. Prophylaxis of tuberculosis including BCG vaccine, RNTCP programme, epidemiology of tuberculosis. Classification and properties of atypical Mycobacteria. Pathogenesis and laboratory diagnosis of atypical mycobacterial infections Leprosy: pathogenesis, Ridley &Joplingsclassification, laboratory diagnosis, treatment, prophylaxis and epidemiology of leprosy.

Practicals Practical 1

Practical 2 Practical 3

Gabbets staining for acid fast bacilli in sputum smears. Student is taught how to perform acid fast staining on sputum smears, and screen the stained smear; and his/ her skill is evaluated. Spotter: Lowenstein-Jensen medium with colonies: the student has to identify the culture medium, and state its composition and intended use. Applied microbiology Chart: on Pulmonary tuberculosis. A case of pulmonary tuberculosis is described. Results of microbiological investigations are demonstrated (for e.g., acid fast smear is focused & culture bottle of LJ medium with buff colored colonies is kept). At the end of the class the student should be able to make a correct diagnosis and answer questions related to that particular case.

1 2.

Name of the chapter Learning outcomes 1 2 3

18. Spirochaetes At the end of the chapter students should be able to Classify and list the general characteristics of Spirochaetes Describe the pathogenesis,clinical features of the diseases produced by spirochaetes Understand the laboratory diagnosis of the diseases produced by Spirochaetes including collection of specimen and various diagnostic methods .To understand about prevention of these diseases

Course content Lectures Lecture 1 Lecture -2 Lecture 3 Lecture--4

Classification and general characteristics of Spirochaetes. Pathogenesis, clinical stages, clinical features syphilis. Laboratory diagnosis, treatment and prevention of syphilis. Pathogenesis and laboratory diagnosis of leptospirosis Pathogenesis and laboratory diagnosis of relapsing fever and Lyme disease

Practicals Practical 1

Applied Microbiology chart on syphilis: A case of syphilis is discussed. Results of microbiological investigations related to the case are demonstrated. At the end of the class the student should be able to make a correct diagnosis and answer questions related to that particular case. Students should identify the spotter and answer the questions.

63

Practical 2

SpotterVDRL plate. Students should identify the spotter and answer the questions.

1 2.

Name of the chapter Learning outcomes 1 2 3 4 Course content Lectures Lecture 1

19. Mycoplasma At the end of the chapter students should be able to Describe the general properties of Mycoplasmas. List the important genera under this family Describe the diseases caused by genus Mycoplasma and Genus Ureaplasma Briefly outline the laboratory diagnosis of the diseases.

4 1 2.

Practical Name of the chapter Learning outcomes 1 2 Course content Lectures Lecture 1 Practical

General properties of Mycoplasmas, important genera and species.Diseases caused by Mycoplasma pneumoniae, M. hominis and Ureaplasmaurealyticum, outline of laboratory diagnosis. None 20. Actinomyces On completion of the chapter students should be able to Describe the characteristic properties of Actinomyces. Describe the pathogenesis and lab diagnosis of diseases caused by Actinomyces.

Characteristic features and classification of actinomyces. Pathogenesis and laboratory diagnosis of actinomycotic and nocardial infection. None

1 2.

Name of the chapter Learning outcomes 1 2

21. Miscellaneous Bacteria At the end of the Chapter, the student should be able to List and describe the characteristic features of these bacteria Briefly explain the pathogenesis and laboratory diagnosis of the diseases caused by these bacteria. Give a note on HACEK group of organisms

Course content Lectures Lecture 1

Practicals 1 2 Name of the chapter Learning outcomes 1

The pathogenesis and laboratory diagnosis of Listeria monocytogens, Erysipelothrixrhusiopathiae, Spirillum minus, Streptobacillusmoniliformis, Morexellacatarrhalis and Legionella pneumophila. Mention about HACEK group of organisms and their clinical significance. None 22. Rickettsiae At the end of the chapter students should able to Describe the general characteristics,classificationof Rickettsiae.Briefly explain the pathogenesis and laboratory diagnosis of diseases caused by members of Rickettsiae.

64

Course content Lectures Lecture 1

Practical

Introduction and classification of Rickettsiae. Pathogenesis, clinical features and laboratory diagnosis of Rickettsial diseases. Brief note on Weil- Felix reaction. None

1. 2.

Chapter Learning Outcome 1. 2.

23. Chlamydia At the end of the Chapter, the student should be able to Describe the general properties and classification of Chlamydiae Describe the pathogenesis and laboratory diagnosis of infections caused by Chlamydia trachomatis List and give the clinical significance of other members of Chlamydia. General properties and Classification of Chlamydia, Pathogenesis and Lab diagnosis of trachoma and Inclusion conjunctivitis (TRIC agents) Pathogenesis and Lab diagnosis of LGV, Psittacosis and infection caused by Chlamydia pneumoniae None

Course Content Lecture 1 Lecture 2

Practicals

65

Mycology
1 2. Name of the chapter Learning outcomes 1 2 Course content Lectures Chapter 1: Introduction to Mycology At the completion of the Chapter, the student should be able To compare fungi and bacteria and to classify fungal infections To elaborate on the General Characters and Lab diagnosis of fungi

Lecture-1

Practicals

Introduction, Differentiation of fungi and bacteria, Classification of fungi based on Morphology & Sporulation, Clinical and Systematic infection. Reproduction and Sporulation - Different types of spores; Sexual & Asexual, Lab diagnosis of fungal infection : Specimen Collection, Direct Microscopy, Culture and Detection of antigen Not applicable

1 2.

Name of the chapter Learning outcomes 1

Chapter 2: Superficial mycoses & Cutaneous mycoses At the completion of the chapter, the student should be able to Familiarise with Cutaneous and subcutaneous fungal infection along with their Salient clinical features and labdiagnosis

Course content Lectures Lecture-1 Lecture-2

Practicals

Superficial infections: Tineaversicolor, Tineanigra, Piedra Cutaneous Infection: Dermatophytes: Definition & Source, Classification, Morphology, Pathogenesis of dermatophytoses, Clinical symptoms, Lab diagnosis, Treatment Spotter for Dermatophyte Applied Microbiology chart on Fungal Skin infection: A case of Fungal Skin infection is described alongwith the relevant investigations. Student has to arrive at the correct diagnosis and answer the questions given at the end related to that particular case.

1 2.

Name of the chapter Learning outcomes

Chapter 3: Subcutaneous mycoses At the completion of the chapter, the student should be able to Understand the epidemiology, etiology, clinical features, pathogenesis and labdiagnosis of Myctetoma, Chromomycoses, Sportotrichosis and Rhinosporidiosis

1 3 Course content Lectures

Lecture-1

Definition, Epidemiology, Classification, Etiology, Pathogenesis & Clinical features of Mycetoma, Lab diagnosis, Differentiation from Actinomycetoma Definition & General features Etiology and Morphology of different fungi, Pathogenesis & Clinical features, Lab diagnosis of Chromomycosis: Sporotrichosis: Definition, Aetiology & Morphology, Rhinosporidiosis:Definition & Epidemiology, Aetiology and Morphology, Pathogenesis & Clinical manifestation, Lab diagnosis Not applicable

Lecture-2 Practicals

66

1 2.

Name of the chapter Learning outcomes

Chapter 4: Systemic mycoses At the completion of the chapter, the student should be able to Define dimorphic fungi and Dimorphic fungal infections , causative agents, morphology, source, mode of transmission, Pathogenesis & Clinical features and labdiagnosis of Histoplasmosis, Blastomycoses, Parcoccidiodomycoses, Coccidiodomycoses

1 3 Course content Lectures Lecture-1 Lecture-2

Practicals 1 2. Name of the chapter Learning outcomes 1 3 Course content Lectures

Histoplasmosis: Causative agent, Morphology, Source, Mode of transmission, Pathogenesis & Clinical features, Lab diagnosis Blastomycoses: Causative agent, Morphology, Source, Mode of transmission, Pathogenesis & Clinical features, Lab diagnosis Paracoccidiodomycoses: Causative agent, Morphology, Source, Mode of transmission, Pathogenesis & Clinical features, Lab diagnosis Coccidiodomycoses: Causative agent, Morphology, Source, Mode of transmission, Pathogenesis & Clinical features, Lab diagnosis Not applicable Chapter 5: Opportunistic mycoses At the completion of the chapter, the student should be able to Describe the epidemiology, etiology, clincal features, pathogenesis and labdiagnosis of Crptococcosis, Candiasis, Aspergillosis, zygomycosis, penicillosis and Pneumocystis jiroveci

Lecture-1

Lecture-2

Practicals

Cryptococcosis: Causative agent and epidemiology, Morphology, Source, Mode of infection, Pathogenesis & Clinical features, Lab diagnosis Candidiasis: Morphology and Important species, Pathogenesis, Clinical features, Lab diagnostic. Aspergillosis: Important species, Morphology, Pre-disposing factors, Pathogenesis, Clinical manifestations, Lab diagnosis Zygomycosis: Important Species, Morphology, Pre-disposing factors, Pathogenesis, Clinical manifestations, Labdiagnosis Penicilliosis: Important species, Morphology, Clinical manifestations, Lab diagnosis Pneumocytisjiroveci: Morphology, Life Cycle, Pathogenesis, Lab diagnosis & Treatment Spotter for Candida, Mucor and Aspergillus Spotter slide of Cryptococcus: Identify the slide with two points and mention its clinical significance Spotter slide of Candida: Identify the slide with two points and mention its clinical significance Spotter slide of Aspergillus: Identify the slide with two points and mention its clinical significance Spotter slide of Mucor: Identify the slide with two points and mention its clinical significance Clinical cases for Candida infection and Aspergillus infection: Applied Microbiology chart on Candidiasis and Aspergillosis: A case of Candidiasis and aspergillosis is described alongwith the relevant investigations. Student has to arrive at the correct diagnosis and answer the questions given at the end related to that particular case.

Practical 2

67

Practical 3

Applied Microbiology chart on Chronic meningitis-Cryptococcosis: A case of Cryptococcal meningitis is described alongwith the relevant investigations. Student has to arrive at the correct diagnosis and answer the questions given at the end related to that particular case

1 2.

Name of the chapter Learning outcomes 1

Chapter 6: Lab contaminating fungi & Miscellaneous At the completion of the chapter, the student should be able to Define and state the etiolgical agents of Otomycosis, Keratomycosis (Mycotic Keratitis), Mycotoxicoses&Mycetismus

Course content Lectures Otomycosis:Definition, Causative agents, Clinical features, Lab diagnosis Keratomycosis (Mycotic Keratitis): Definition, Causative agents, Clinical features, Lab diagnosis Mycotoxicosis: Definition, Different Mycotoxins Mycetism: Definition, Different fungi causing mycetism Not applicable

Lecture-1

Practicals

68

Parasitology
1 2. Name of the chapter Learning outcomes 1 2 3 4 3 Course content Lectures Lecture-1 Defintions of terms used in parasitology, types of parasites, Types of hosts, sources of infection and mode of transmission, life cycle, Lab diagnosis and prophylaxis. Classification of parasites. Not applicable 2. Entamoebahistolytica,Entamoeba coliand free living amoebae At the completion of the Chapter, the student should be able to Classify Protozoa and Describe the morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prophylaxis of pathogenic, Nonpathogenic amoebae and free living amoebae Understand Intestinal and extraintestinalamoebiasis 1. Introduction to Parasitology At the completion of the Chapter, the student should be able to Define and enumerate types of parasites and classify parasites Describe types of Hosts and Host-parasite relationships Describe sources of infection, Portal of entry, Life cycle of human parasites Describe pathogenicity , Immunity in parasitic infections, and Laboratory diagnosis of parasites

Practicals 1 2. Name of the chapter Learning outcomes 1 2 3 Course content Lectures Lecture-1 Lecture -2

1 2.

Practicals Name of the chapter Learning outcomes

Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prophylaxis. Intestinal and extraintestinalamoebiasis Entamoeba coli- Morphology, life cycle, pathogenesis, clinical features and laboratory diagnosis Naegleriafowleri- Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis and treatment Acanthamoeba species- Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis and treatment Not applicable 3. Intestinal, Genitourinary and Haemoflagellates At the completion of the Chapter, the student should be able to Classify Flagellates, Describe morphology, life cycle, pathogenesis, laboratory diagnosis and treatment of Giardia lamblia, Trichomonasvaginalis, Leishmaniadonovani, Trypanosomes brucei and T.cruzei Describe about Post kalaazar dermal leishmaniasis

1 2 Course content Lectures Lecture-1 Lecture -2

Classification of intestinal and genitourinary flagellates, Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis and treatment of Giardia lamblia, Trichomonasvaginalis Classification of haemoflagellates

69

Lecture -3

Lecture -4

Leishmaniadonovani - Morphology, life cycle, pathogenesis, clinical features and laboratory diagnosis Post kalaazar dermal leishmaniasis- Causes, clinical features, diagnosis and treatment Leishmaniatropica and Leishmaniabraziliensis in brief Trypanosomabrucei and T.cruzei- Morphology, life cycle, pathogenesis, clinical features , laboratory diagnosis and treatment Not applicable 4. Sporozoa At the completion of the Chapter, the student should be able to Classify blood and intestinal sporozoa and the various species of plasmodium Differentiate between P.vivax and P.falciparum Describe life cycle, pathogenesis, laboratory diagnosis, clinical features, complications, treatment and prevention of Plasmodium falciparum Describe the morphology, life cycle, pathogenesis, laboratory diagnosis, treatment and prevention of Toxoplasma gondii Describe the morphology, life cycle, pathogenesis, laboratory diagnosis, treatment of opportunistic Intestinal sporozoa

Practicals 1 2. Name of the chapter Learning outcomes 1 2 3 4 5 3 Course content Lectures Lecture-1 Lecture -2 Lecture -3 Lecture -4 Lecture -5

Classification of blood and intestinal sporozoa Various species of plasmodium Differences between P.vivax and P.falciparum Plasmodium falciparum- life cycle, pathogenesis, laboratory diagnosis, clinical features, complications, treatment and prevention Toxoplasma gondii- Morphology, life cycle, pathogenesis, laboratory diagnosis, treatment and prevention Morphology, life cycle, pathogenesis, laboratory diagnosis, treatment of Isospora belli, Cyclosporacayetanensis,Cryptosporidium parvum , Microsporidia and Balantidium coli

Practicals

1 2.

Name of the chapter Learning outcomes 1

Applied Microbiology chart on Malaria, cryptosporidiosis, and toxoplasmosis: A case of Malaria, cryptosporidiosis, and toxoplasmosis is described alongwith the relevant investigations. Student has to arrive at the correct diagnosis and answer the questions given at the end related to that particular case 5. Helminths At the completion of the Chapter, the student should be able to Classify helminthes, differentiate between Cestodes, Trematodes and Nematodes Classify Cestodes and Describe the morphology, life cycle, pathogenesis, laboratory diagnosis, treatment and prevention of Diphyllobothriumlatum Describe in brief about sparganosis and its prevention

2. 3. Course content Lectures Lecture-1

Classification of helminthes General characteristics of Cestodes, Trematodes and Nematodes Classification of Cestodes-Pseudophyllidean tapeworms and

70

Cyclophyllidean tapeworms Diphyllobothriumlatum-Morphology, life cycle, pathogenesis, laboratory diagnosis, treatment and prevention Sparganosis Practicals Stool examination Practical: Students are given a brief description of various types of parasitic eggs seen in stool. Students are given samples of stool. They are required to individually do the wet mount of stool, observe and demonstrate atleast two types of parasitic eggs and enter the findings in their record. 6. Cyclophyllidean tapeworms At the completion of the Chapter, the student should be able to Describe the morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prevention of Taeniasaginata Describe the morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prevention of Taeniasolium Differentiate between T.solium and T.saginata and understand about Cysticercosis-larval form of T.solium Describe the morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prevention of Echinococcusgranulosus and Hymenolepis nana Hydatid disease-clinical features, Laboratory diagnosis and treatment

1 2.

Name of the chapter Learning outcomes 1 2 3 4

Course content Lectures Lecture-1 Lecture -2 Lecture -3

Lecture -4

Practicals

Taeniasaginata- Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prevention Taeniasolium- Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prevention Differences between T.solium and T.saginata Cysticercosis. Echinococcusgranulosus- Morphology, life cycle, pathogenesis, clinical features Hydatid disease-clinical features, Laboratory diagnosis and treatment and prevention Hymenolepis nana- clinical features, Laboratory diagnosis and treatment Applied Microbiology chart onHydatid cyst disease: A case of Hydatid cyst disease is described alongwith the relevant investigations. Student has to arrive at the correct diagnosis and answer the questions given at the end related to that particular case. 7. Trematodes At the completion of the Chapter, the student should be able to Describe the general characteristics of Trematodes Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prophylaxis of Schistosomes or blood trematodes Describe the morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prophylaxis of Hepatic trematodes or liver fluke Describe the morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prevention of lung fluke and Intestinal trematodes

1 2.

Name of the chapter Learning outcomes 1

71

Course content Lectures Lecture-1

Lecture -2

Lecture -3

Practicals 1 2. Name of the chapter Learning outcomes 1 2 3 Course content Lectures Lecture-1

General characteristics of Trematodes Schistosomes or blood trematodes - Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prophylaxis Fasciola hepatica- Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prevention Clonorchissinensis- Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prevention Fasciolopsisbuski- Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prevention Paragonimuswestermani- Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prevention Not applicable 8. Nematodes, and Trichinellaspiralis At the completion of the Chapter, the student should be able to Describe the Classification and general characteristics of Nematodes Describe the morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prophylaxis of Trichinellaspiralis

Practicals 1 2. Name of the chapter Learning outcomes 1 3 Course content Lectures Lecture-1 Practical 1

General characteristics and classification of Nematodes Trichinellaspiralis- Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prophylaxis Not applicable 9. Ascarislumbricoides At the completion of the Chapter, the student should be able to Describe morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prophylaxis of Ascarislumbricoides

Ascarislumbricoides- Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prophylaxis Spotter of Ascarislumbricoides: Identify the preserved specimen with two points and mention its clinical significance Stool examination practical 10. Hookworm At the completion of the Chapter, the student should be able to Describe of morphology, Life Cycle, Pathogenesis, Clinical Features, Laboratory Diagnosis, Treatment And Prophylaxis of Ancylostomaduodenale And Necatoramericanus

1 2.

Practical 2 Name of the chapter Learning outcomes 1

Course content Lectures Lecture-1

Practicals

Hookworms(Ancylostomaduodenale&Necatoramaricanus) - Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prophylaxis Stool examination practical

72

1 2.

Name of the chapter Learning outcomes 1

11. Strongyloides At the completion of the Chapter, the student should be able to Describe the morphology, Life Cycle, Pathogenesis, Clinical Features, Laboratory Diagnosis, Treatment of Strongloidesstercoralis Define and expalin Larva migrans

2 Course content Lectures Lecture-1

Practicals 1 2. Name of the chapter Learning outcomes 1

Strongyloidesstercoralis- Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prophylaxis Larva migrans: definition and types Not applicable 12. Enterobiusvermicularis At the completion of the Chapter, the student should be able to Describe the morphology, Life Cycle, Pathogenesis, Clinical Features, Laboratory Diagnosis, Treatment And Prophylaxis of Enterobiusvermicularis

Course content Lectures Lecture-1

Practicals 1 2. Name of the chapter Learning outcomes 1 3 Course content Lectures Lecture-1 Practicals 1 2. Name of the chapter Learning outcomes 1

Enterobiusvermicularis- Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prophylaxis. Note on NIH swab Not applicable 13. Trichuristrichiura

Morphology, Life Cycle, Pathogenesis, Clinical Features, Laboratory Diagnosis, Treatment And Prophylaxis of Trichuristrichiura

Trichuristrichiura- Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prophylaxis Stool examination practical 14. Tissue Nematodes At the completion of the Chapter, the student should be able to Describe the morphology, Life Cycle, Pathogenesis, Clinical Features, Laboratory Diagnosis, Treatment And Prophylaxis of Wuchereriabancrofti and Brugiamalayi Describe the morphology, and Morphology, life cycle, pathogenesis, laboratory diagnosis and treatment of Loa loa and Onchocerca volvulus

2 3 3 Course content Lectures Lecture-1 Lecture-2

Wuchereriabancrofti - Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prophylaxis. Note onBrugiamalayi and Microfilariat

73

Lecture-3

Loa loa- Morphology, clinical features, laboratory diagnosis and treatment Onchocerca volvulus- Morphology, clinical features, laboratory diagnosis and treatment

Practicals

Applied Microbiology chart on Lymphatic Filariasis: A case of Lymphatic Filariasis is described alongwith the relevant investigations. Student has to arrive at the correct diagnosis and answer the questions given at the end related to that particular case. 15. Dracunculusmedinensis At the completion of the Chapter, the student should be able to Describe the morphology, Life Cycle, Pathogenesis, Clinical Features, Laboratory Diagnosis, Treatment And Prophylaxis of Dracunculusmedinensis

1 2.

Name of the chapter Learning outcomes 1

Course content Lectures Lecture-1 Practicals

Dracunculusmedinensis- Morphology, life cycle, pathogenesis, clinical features, laboratory diagnosis, treatment and prophylaxis Not applicable

74

Virology
1 2. Name of the chapter Learning outcomes General Properties of viruses At the completion of the Chapter, the student should be able to Know the differences between bacteria and viruses, relevant historical interests Know about the morphology, classification, chemical properties, resistance and replication of viruses Understand the various methods of cultivation of viruses including methods of detection of virus growth in cell cultures and other methods of Lab diagnosis of viruses. Know about Inclusion bodies, viral vaccines, antiviral agents and interferons.

3 3 Course content Lectures Lecture 1 Lecture 2 Lecture 3 Lecture 4 Practicals

Differences between bacteria and viruses, relevant historical interests Morphology, chemical properties, resistance and replication of viruses Cultivation of viruses including methods of detection of virus growth in cell cultures Classifications of viruses Laboratory diagnosis of viral infections Inclusion bodies viral vaccines, antiviral agents and interferons Spotter on Syncitia formation: A slide on synticia formation is focused. Student should identify and mention its significance Spotter on embryonated eggs: Student should identify and mention uses in Virology. Bacteriophage and Adenovirus At the completion of the Chapter, the student should be able to Define and understand the morphology, types of life cycle , uses and significance of bacteriophages Understand the properties, classification, pathogenesis and clinical features and laboratory diagnosis of adenoviral infections

1 2.

Name of the chapter Learning outcomes 1

2 3 Course content Lectures

Lecture-1

1 2.

Practicals Name of the chapter Learning outcomes 1 2 3

Definition and significance of bacteriophages Morphology and types of life cycle of bacteriophages Uses of bacteriophages Properties, classification, pathogenesis and clinical features of adenoviral infections Laboratory diagnosis of adenoviral infections Not applicable Pox viruses At the completion of the Chapter, the student should be able to Know about the morphology, properties and classification of pox viruses Describe the clinical features, lab diagnosis, prevention and global eradication of variola virus Briefly describe the morphology and infections caused by Molluscumcontagiosum

75

Course content Lectures Lecture-1 Practicals Name of the chapter Learning outcomes 1 2 Pox viruses-Morphology, properties and classification Variola virus- Clinical features, lab diagnosis, prevention and its Global eradication Note on Molluscumcontagiosum Not applicable Herpes viruses At the completion of the Chapter, the student should be able to Know the morphology, classification, properties and unique features of herpes viruses Know in detail about Herpes simplex virus, Varicella zoster virus, Cytomegalovirus and Epstein Barr virus with respect to pathogenesis, clinical symptoms, laboratory diagnosis, treatment and prophylaxis Know in brief about infections caused by Human Herpes viruses 6, 7 and 8

1 2.

Course content Lectures Lecture-1 Lecture -2 Lecture -3

Classification and Morphology of herpes viruses, properties and unique features Human Herpes viruses 6, 7 and 8 Herpes simplex virus, Varicella zoster virus, Cytomegalovirus and Epstein Barr virus with respect to pathogenesis, clinical symptoms, laboratory diagnosis, treatment and prophylaxis Applied exercise Chart-A case of Herpes simplex with photograph of Giemsa stained smear from base of the vesicles. The student should arrive at the diagnosis and answer questions given at the end, related to that particular case Picorna viruses At the completion of the Chapter, the student should be able to Classify and describe the properties of picorna virus Classify, and describe the properties, pathogenesis, clinical symptoms, laboratory diagnosis and Prophylaxis (salk and sabin vaccines) of polio virus including global eradication of poliomyelitis with special emphasis on pulse polio programme Familiarize with the coxsackie viruses with respect to classification, clinical significance and laboratory diagnosis Familiarize with the clinical significance, pathogenesis and lab diagnosis of Echoviruses, Enteroviruses, and Rhinovirus

Practicals

1 2.

Name of the chapter Learning outcomes 1 2

3 4

Course content Lectures Lecture 1

Classification and properties of picorna virus Polio virus - Classification, properties, pathogenesis, clinical symptoms, laboratory diagnosis Salk and sabin vaccines, global eradication of poliomyelitis with special emphasis on pulse polio programme

76

Lecture 2

Practicals

Coxsackie viruses- classification,clinical significance and laboratory diagnosis Note on Echoviruses and Enterovirusesand Rhino viruses Applied exercise chart -A case of flaccid paralysis due to polio virus. A brief Case history is provided along with the laboratory investigations.The student has to arrive at the correct diagnosis and answer the questions given at the end .

1 2.

Name of the chapter Learning outcomes 1

Orthomyxoviruses At the completion of the Chapter, the student should be able to Know the properties, classification and differences between Ortho and Paramyxoviruses Understand about the morphology, antigenic structure, antigenic variations, epidemiology, pathogenesis, laboratory diagnosis, prophylaxis and treatment of Influenza virus Familiarize with Swine flu and bird flu as a threat of a global pandemic

3 Course content Lectures Lecture-1

Lecture -2 Practicals Name of the chapter Learning outcomes 1 2

1 2.

Description, Properties, classification and differences between Ortho and Paramyxoviruses Influenza viruses: properties and pathogenesis of influenza Laboratory diagnosis and prevention of Influenza. Note on Swine flu and bird flu as a threat of a global pandemic Not applicable Paramyxoviruses At the completion of the Chapter, the student should be able to Know the classification, properties, pathogenesis and lab diagnosis of Parainfluenza viruses Understand the pathogenesis, complications, lab diagnosis and prophylaxis of Mumps viruses, Respiratory syncytial viruses and Measles viruses

Course content Lectures Lecture-1 Lecture -2

1 2.

Practicals Name of the chapter Learning outcomes 1 2

Parainfluenza viruses:Pathogenesis, lab diagnosis and prophylaxis Mumps viruses-Pathogenesis, lab diagnosis and prophylaxis Measles viruses -pathogenesis, complications, lab diagnosis and prophylaxis Mumps virus--pathogenesis, complications, lab diagnosis and prophylaxis Note on MMR Respiratory syncytial viruses-pathogenesis, clinical features and lab diagnosis Not applicable Arboviruses At the completion of the Chapter, the student should be able to Describe the properties and classifyarboviruses, understand the Epidemiology and pathogenesis of arboviral infections Enumerate various arboviral infections seen in India with special emphasis on Dengue viruses, Chikungunya, Japanese B encephalitis and KFD

77

transmission, clinical presentation and prophylaxis Yellow fever virus 3 Course content Lectures Lecture 1 Lecture 2 Practicals Name of the chapter Learning outcomes 1 2

Arboviruses-Epidemiology, classification, Properties and pathogensis. Note on Dengue viruses, and Chikungunya Note on Japanese B encephalitis and KyassanurForest Diseaseand Yellow fever virus Rhabdoviruses At the completion of the Chapter, the student should be able to Classify and understand the properties of Rhabdoviruses Describe Rabies virus with respect to morphology, transmission, pathogenesis, clinical features, laboratory diagnosis and prophylaxis of rabies in humans

1 2.

Course content Lectures Lecture-1 Lecture 2 Lecture 3 Practicals

Rhabdoviruses-Classification and properties Rabies virus- Morphology, transmission, pathogenesis, clinical features Laboratory diagnosis and prophylaxis of rabies Applied exercise chart-A case of Rabies virus is discussed with relevant questions.The student should arrive at the diagnosis and answer questions given at the end, related to that particular case Hepatitis viruses At the completion of the Chapter, the student should be able to Classify hepatitis viruses and understand the pathogenesis, clinical features, laboratory diagnosis and prophylaxis of Hepatitis A virus, Hepatitis B virus, Hepatitis C and Hepatitis D and E viruses

1 2.

Name of the chapter Learning outcomes 1

Course content Lectures Lecture-1 Lecture-2 Lecture-3 Practicals

Classification of hepatitis viruses, Hepatitis A virus Hepatitis B virus Hepatitis C virus, In brief of Hepatitis D and E viruses Applied Exercise Chart -A case of Hepatitis virus with ELISA test demonstration interpretation of various serological markers. The chart is discussed in so that the student is familiarized with the association of various serological markers and their usefulness is assessing the stage of the disease in the patient and manage accordingly Retroviruses At the completion of the Chapter, the student should be able to Know the definition, classification and properties of retroviruses with special emphasis on Human Immunodeficiency virus (HIV) with respect to morphology, types and subtypes, natural history, pathogenesis, clinical features, laboratory diagnosis, treatment and prevention measures Understand brief the various opportunistic infections seen in AIDS and laboratory monitoring of HIV infection In brief on laboratory monitoring of HIV infection

1 2.

Name of the chapter Learning outcomes 1

78

Course content Lectures Lecture-1

Lecture-2

Lecture 3 Practicals

Definition, classification and properties of retroviruses Morhology, pathogenesis and clinical stages of Human Immunodeficiency virus (HIV) infection Opportunistic infections seen in AIDS Laboratory diagnosis and monitoring of HIV infection, prevention and control of HIV infection . Applied Exercise Chart-A case of HIV with ELISA test demonstration and Rapid test . The student is familiarized with the common antigens and antibodies of HIV ,interpretation of the laboratory tests and about the NACO testing strategy. The student studentbe able to answer questions given at the end, related to that particular case.

1 2.

Name of the chapter Learning outcomes 1

Oncogenic viruses At the completion of the Chapter, the student should be able to Define and , list oncogenic viruses, and understand the mechanisms of viral oncogenesis.

1 2.

Course content Lectures Lecture-1 Practicals Name of the chapter Learning outcomes 1

Oncoviruses: Definition and mechanism of viral oncogenesis Not applicable Miscellaneous viruses At the completion of the Chapter, the student should be able to Describe the morphology, pathogenesis, lab diagnosis and prophylaxis of Rubella virus, papilloma viruses,Polyoma viruses, Reoviruses, and Parvovirus B 19 Define and enumerate Teratogenic viruses Know the etiology of Aseptic meningitis with respect to causes, , CSF findings, differentiating features from acute pyogenic meningitis and treatment

2 3

Course content Lectures Lecture-1 Lecture-2 Practicals

1 2.

Name of the chapter Learning outcomes 1

Rubella virus, of Papilloma viruses, Polyoma viruses, Reoviruses, : Morphology, pathogenesis, lab diagnosis and prophylaxis. Note on Parvovirus B 19, Teratogenic viruses,Aspectic Meningitis Applied Exercise-A case of Rota virus with demonstration of electron photo micrograph. The importance of the viral gastroenteritis in children and the management is stressed upon in this exercise. Slow viral diseases At the completion of the Chapter, the student should be able to Define and enumerate the causative agents of slow viral diseases Know in brief about Progressive multifocal leukoencephalopathy, SSPE Know in brief about Prions with respect to properties, diseases caused, methods to destroy prions

79

Know in brief of Kuru, CJD, Variant CJD, BSE 3 Course content Lectures Lecture-1 Practicals

Slow viral diseases: definition, types, pathogenesis Prions: Properties and note on Prion diseases. Not applicable

80

Applied Microbiology
1 2. Name of the chapter Learning outcomes 1 2 3 Course content Lectures Lecture-1 Lecture-2 Practicals Applied microbiology Chart: on Blood Culture. A brief class on Blood Culture is taken (indications, method of blood collection and culture, isolation and identification of blood borne bacterial pathogens is discussed). A case of Enteric Fever is described; followed by the results of microbiological investigations (for eg., Grams smear is kept focused & Blood culture bottle is kept, along with Culture plates and biochemical reactions). The student has to arrive at the correct diagnosis and answer the questions given at the end, related to that particular 1 2 Name of the chapter Learning outcomes 1. 2. 3 Course content Lectures Lecture-1 Practical Name of the Chapter Learning outcomes 1 2 Course content Lectures Lecture-1 1 2. Name of the chapter Learning outcomes 1 Define PUO, enumerate the etiology of PUO. Enumerate the various laboratory investigations required for the diagnosis of PUO Applied exercise on Enteric fever Urinary Tract Infection At the completion of the chapter, the student should be able to Define and enumerate the causative agents of UTI Know the Predisposing factors, clinical features and lab diagnosis of UTI. PUO At the completion of the chapter, the student should be able to Define and enumerate the etiology of PUO Describe in brief the approach to the diagnosis of a patient with PUO Indications, procedure, processing and interpretation of Blood culture. Note on Automated Blood culture systems Blood culture At the completion of the chapter, the student should be able to Know the indications of blood culture Know how to collect blood sample (quantity, and number of sets required) and procedure and interpretation of Blood culture

2.

Definition, causative agents, predisposing factors, clinical presentation and in detail about collection, processing and interpretation of urine cultures. Zoonoses At the completion of the chapter, the student should be able to Know the definition, etiological agents, modes of transmission of Zoonotic diseases

81

2 3 3 Course content Lectures Lecture-1 Practicals

Important zoonotic diseases including laboratory diagnosis Know the definition, types of infections, etiological agents, predisposing factors and prevention of Nosocomial infections

Brief description of Zoonotic diseases including their laboratory diagnosis. Nosocomial infections types, importance and prevention of such infections Applied Microbiology Chart: Burn wound infection: A case of Burn wound infection is described; followed by the results of microbiological investigations. The student has to arrive at the correct diagnosis and answer the questions given at the end, related to that particular case. Bacterial Meningitis At the completion of the chapter, the student should be able to Various aetiological agents of Bacterial Meningitis Pathogenesis Laboratory diagnosis Differentiate between bacterial, aseptic and tubercular meningitis based on CSF findings

1 2.

Name of the chapter Learning outcomes 1 2 3 4

Course content Lectures Lecture-1 Definition, causative agents, Pathogenesis and in detail laboratory diagnosis of bacterial meningitis. CSF findings of bacterial, aseptic and tubercular meningitis : Applied Microbiology Chart on pneumococcal meningitis: A case of pneumococcal meningitis is described; followed by the results of microbiological investigations. The student has to arrive at the correct diagnosis and answer the questions given at the end, related to that particular case. Food Poisoning At the completion of the chapter, the student should be able to Enumerate the causative agents & Classification based on incubation period Know the pathogenesis, Laboratory diagnosis & Prevention

Practicals

1 2.

Name of the chapter Learning outcomes 1 2 Course content Lectures Lecture-1 Practicals

Brief description of definition, classification, pathogenesis, laboratory diagnosis and prevention of food poisoning Not applicable Diarrheal diseases

Name of the chapter

2.

Learning outcomes 1 2 3 4

At the completion of the chapter, the student should be able to Various aetiological agents and classification based on mechanisms Pathogenesis and clinical symptoms Laboratory diagnosis Preventive measures

82

Course content Lectures Lecture-1 Practicals

Definition, classification, causative agents, Pathogenesis and in detail laboratory diagnosis of diarrhoeal diseases. Applied microbiology Chart: on Bacillary dysentery. A case of Bacillary dysentery is described; The student has to arrive at the correct diagnosis and answer the questions given at the end, related to that particular case. Applied exercise on Cholera. A case of Cholera is described; followed by the results of microbiological investigations. The student has to arrive at the correct diagnosis and answer the questions given at the end, related to that particular case. Sexually transmitted diseases At the completion of the chapter, the student should be able to Enumerate the causative agents of STD

1 2.

Name of the chapter Learning outcomes 1 2 3 4 Course content Lectures Lecture-1 Practicals

Know the clinical presentation and Laboratory diagnosis of STDs

Brief description of definition, causative agents, classification, pathogenesis and laboratory diagnosis of STDs SpotterVDRL plate .The student has to identify the spotter and explain about non treponemal test for syphilis Applied microbiology Chart: on Sexually Transmitted disease. A case of Syphillisis described; The student has to arrive at the correct diagnosis and answer the questions given at the end, related to that particular case. Sexually transmitted disease Gonorrhoea Applied exercise Biomedical waste management At the completion of the chapter, the student should be able to Define biomedical waste Understand types of waste generated at various points in hospital and laboratories Understand hazards of improper waste management. Understand waste segregation, decontamination and safe disposal

1 2

Name of the chapter Learning outcomes 1 2 3 4

Course content Lectures Lecture 1

Practicals

Definition of BMW, various types of waste generated and hazards involved in improper management, Segregation of waste at point of generation using color coded disposal units, rendering waste safe for handling, proper disposal methods. Applied microbiology. Various types of waste and the different color coded containers / bags are demonstrated. Students are made to segregate the items in appropriate containers. At the end questionnaire is provided to assess the understanding about the topic

83

1 2

Name of the chapter Learning outcomes 1 2 3

Nosocomial Infection and Infection control At the completion of the chapter, the student should be able to Understand the burden of health care associated infections Have a better understanding of the basic principles of infectioncontrol and be able to apply standard precautions in relation to infection control Be aware of the importance of infection prevention and control in providing a safe environment for patients, staff and visitors Be aware of healthcare-associated infection Explain surveillance and other assessment monitoring activities including the role of the infection control team. Outline an understanding of the key concepts underpinning the control of infections relating to MRSA, MDR Gram negatives, Blood borne viruses with emphasis on HIV and HBV. Understand their own role in the prevention of the spread of infection.

4 5 6

7 3 Course content Lectures Lecture 1

Lecture 2

Ways of transmission of microorganisms, chain of infection, direct contact and indirect contact, potential sources of infection, patient susceptibility with special emphasis on high risk areas like ICUs, NICUs etc, eradication of micro-organisms from the environment, antimicrobial resistance and appropriate usage. Nosocomial infections types, risk factors, common organisms and their diagnosis and management, prevention, outbreak investigation outline, concept of audit Standard precautions and transmission based precautions, concepts of antiseptic hand hygiene, surgical hand hygiene, use of PPE, reiterate concepts of cleaning, disinfection and sterilization, blood and body fluid safety, safe waste disposal measures Demonstration of hand wash techniques, antiseptic hand rubs.

Lecture 3.

Practicals

1 2

Name of the chapter Learning outcomes 1 2 3

Specimen collection and transportation for diagnosis of common infection syndromes Students should Understand the importance of appropriate specimen collection in diagnosing infections Methods of specimen collection in common infection syndromes Methods of transportation of specimen and use of appropriate transport media

Course content Lectures Lecture 1

Practicals

Common organisms encountered in various infection syndromes, Choice of specimen to be collected and methods of collection in suspected infection, transportation methods. Video demonstration of specimen collection like blood, wound specimen, throat swabs. Charts containing a brief clinical history of UTI, genital discharge, pharyngitis will be shown to students. They are expected to write the appropriate methods of specimen collection and transportation to the laboratory

84

FORENSIC MEDICINE

FORENSIC MEDICINE INCLUDING TOXICOLOGY

GOAL The broad goal of the teaching of undergraduate students in Forensic Medicine is to produce a physician who is well informed about medico-legal responsibilities in practice of medicine. He / She will also be capable of making observations and inferring conclusions by logical deductions to set enquiries on the right track in criminal matters and connected medico-legal problems. He / She acquire knowledge of law in relation to medical practice, medical negligence and respect for codes of medical ethics. OBJECTIVES a. KNOWLEDGE At the end of the course, the student should be able to: 1. Identify the basic medico-legal aspects of hospital and general practice. 2. Define the medico-legal responsibilities of a general physician while rendering community service either in a rural primary health center or an urban health center. 3. Appreciate the physician's responsibilities in criminal matters and respect for the codes of medical ethics. 4. Diagnose, manage and identify also legal aspects of common acute and chronic poisonings. 5. Describe the medico-legal aspects and findings of post-mortem examination in case of death due to common unnatural conditions & poisonings. 6. Detect occupational and environmental poisoning, prevention and epidemiology of common poisoning and their legal aspects particularly pertaining to Workmen's Compensation Act. 7. Describe the general principles of analytical toxicology. b. SKILLS At the end of the course, the student should be able to: 1. Make observations and logical inferences in order to initiate enquiries in criminal matters and medico-legal problems. 2. Diagnose and treat common emergencies in poisoning and manage chronic toxicity. 3. Make observations and interpret findings at postmortem examination. 4. Observe the principles of medical ethics in the practice of his profession. c. INTEGRATION Department shall provide an integrated approach towards allied disciplines like Pathology, Radiology, Forensic Sciences, Hospital Administration etc. To impart training regarding Medico-legal responsibilities of physicians at all levels of health care. Integration with relevant disciplines will provide scientific basis of clinical toxicology e.g. Medicine, pharmacology, etc.

86

Legal Procedure (4 hrs.)

Learning outcomes:
The students should be able to Enumerate the different Criminal Courts and their powers in India. Describe the different types of inquests held in India and abroad. Describe the procedure of recording of evidence in a Court. Enumerate/describe the different types of evidence, and describe the procedure of recording dying declaration and dying deposition Explain the different types of witnesses and enumerate the conduct of a doctor in the witness box. Salient features of Juvenile Justice (Care & Protection of Children) Act 2000

Course content and Learning process:

Lectures: 1. 2. 3. 4. Introduction to Legal Procedure, Inquest and types of Inquest Evidence, Types of evidence, dying declaration, dying deposition, different types of witness Procedure of recording of evidence in a court of law, hostile witness, perjury Criminal courts of India and their powers, Conduct of a doctor in the witness box Juvenile Justice (Care & Protection of Children) Act 2000

Practicals: NIL

Identification (14 hrs.)

Learning outcomes:
The students should be able to Enumerate the standard procedures for establishing the identity in living and dead individual in relation to age, sex, and their medico-legal importance. Explain / list the methods of determining the race & stature and their medico-legal importance. Explain the following terms and their significance in medico-legal practice: Dactylography, Cheiloscopy, Rugoscopy, Poroscopy, Hairs, Scars, Tattoos & Superimposition. DNA Profiling: Collection & Preservation of biological materials and its medico-legal applications. PCR in DNA profiling.

Course content and Learning process:

Lectures: 1. 2. 3. 4. 5. 6. Introduction to identity, Corpus delicti, Determination of Race. Estimation of Age and medico-legal importance of age. Determination of sex & stature and their medico-legal importance. Dactylography, Poroscopy, Cheiloscopy and Rugoscopy. Hairs, Scars, Tattoos & Superimposition. DNA Profiling: Collection & Preservation of biological materials and its medico-legal applications. PCR in DNA profiling. 87

Practicals: 1. 2. 3. 4. 5. 6. 7. 8. Determine of sex from Skull, Mandible Determine of sex from Femur, Hip bone and Sacrum Estimate the age from the X-rays of the following joints: Shoulder and elbow Estimate the age from the X-rays of the following joints: wrist and ankle Estimate the age from the X-rays of the following joints: hip and knee Estimate the age by dental examination dental formula 1 Estimate the age by dental examination dental formula 2 Documentation of identification mark on the body

Medico-legal Autopsy (26 hrs.)

Learning outcomes:
The students should be able to Explain the objectives and the rules and regulations governing the performance of medico-legal autopsy. Describe the routine procedures for performing medico-legal autopsy and be able to differentiate the artifacts encountered at autopsy. Describe the procedure of preservation and dispatch of viscera in a suspected case of poisoning. Interpret the findings of skeletal remains. Describe the legal requirements and procedure governing exhumation. Describe the negative and obscure autopsy. Describe the Autopsy guidelines in custodial deaths as per the National Human Rights Commission.

Course content and Learning process:

Lectures: 1. Objectives and the rules and regulations governing the performance of medico-legal autopsy, Various incisions at autopsy. 2. Procedures for performing medico-legal autopsy 3. Procedure of preservation and dispatch of viscera in a suspected case of poisoning, Interpret the findings of skeletal remains. 4. Exhumation, negative and obscure autopsy, Autopsy guidelines in custodial deaths Practicals: 1. Viscera packing 2. Postmortem instruments 3. Describe and interpret the autopsy findings (witnessing 10 autopsies)

88

Thanatology (14 hrs.)

Learning outcomes:
The students should be able to Define and explain death, types of death, suspended animation and their medico-legal significance. Describe modes, cause, manner of death, and sudden death. Explain the term Brain Stem Death, its significance and the tests to ascertain brain stem death. Describe the various postmortem changes, (immediate, early and late), and their medico-legal significance. Explain euthanasia and its implications in medical practice. Explain the rules and regulations governing Transplantation of Human Organs Act, 1994.

Course content and Learning process:

Lectures: 1. 2. 3. 4. 5. 6. 7. 8. Definition of death, types of death, suspended animation Modes, cause, manner of death, and sudden death. Brain Stem Death, its significance and the tests to ascertain brain stem death. Immediate postmortem changes, Algor mortis Livor mortis, Rigor mortis, Decomposition Modification of putrefaction, Euthanasia and its implications in medical practice. Transplantation of Human Organs Act, 1994.

Practicals: 1. Mounted specimens related to postmortem changes 2. Medical Certification of Cause of Death 3. Photographs of postmortem changes Integration: 1. Integrated teaching with department of neurology 3 hours

Medical Ethics and Law (14 hrs.)

Learning outcomes:
The students should be able to Explain the functions of Indian Medical Council & State Medical Council Explain Hippocratic oath, Geneva Convention Explain the Duties and the Rights of a Registered Medical Practitioner. Define and explain with examples the term Professional Misconduct and the disciplinary action and the procedure for appeal when punished. Explain Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002. Define Professional Negligence; explain the ingredients of negligence and its defenses. 89

Define/explain Consent, types of consent and their relevance in Medical practice. Informed refusal and consent & medical battery. Explain Duties and rights of a patient. Explain the different consumer forums and their powers. Describe Salient features of Medical Indemnity Insurance

Course content and Learning process: Lectures: 1. 2. 3. 4. 5. 6. 7. 8. Hippocratic oath, Geneva Convention, Indian Medical Council & State Medical Council Duties and the Rights of a Registered Medical Practitioner Professional Misconduct and the disciplinary action and the procedure for appeal Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002. Define Professional Negligence; Explain the ingredients of negligence Defenses against negligence Define/explain Consent, types of consent and their relevance in Medical practice. Informed refusal and consent & medical battery. Duties and rights of a patient, consumer redressal forums, Medical Indemnity Insurance

Practicals: 1. 2. 3. 4. 5. 6. Birth Intimation letter Death intimation Letter Police intimation letter Sick Leave Certificate Fitness Certificate after Sick Leave Consent Form

Injuries / Trauma (25 hrs.)

Learning outcomes: The students should be able to Define and classify Injuries Describe the different types of weapons used for causing injuries. Describe abrasions, contusions, lacerations, incised wounds, stab wounds, chop wounds and their medico-legal significance. Classify firearms, ammunitions and describe firearm wounds with reference to the probable weapon and range causing it, and their medico-legal significance. Describe the regional injuries to head (scalp, skull, meninges and brain), spinal column, neck, thorax and abdomen, and extremities. Describe the complications and causes of death from injuries. Describe the injuries sustained by the driver, occupants and pedestrian in a Road Traffic Accident Describe the legal aspects of wounds (Section 44, 319, 320, 324, 326, 304(A),304(B),498, 299, 300 IPC) Describe thermal injuries (burns, scalds, injuries due to cold), electricity, lightning, Explosion injuries, and their medico-legal significance Explain Workmans Compensation Act.

90

Course content and Learning process: Lectures: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Definition and classification of Injuries, different types of weapons Abrasions Contusions Lacerations Incised wounds, Stab wounds, Chop wounds Scalp and skull injuries Intra cranial hemorrhages Injuries to brain, spinal column, neck, thorax and abdomen, and extremities Classify firearms and ammunitions Wounds caused by rifled firearm Wounds caused by shotguns Peculiar ammunitions and firearm injuries, investigations in firearm injuries, Explosion injuries Complications and causes of death from injuries Injuries sustained by the driver, occupants and pedestrian in a Road Traffic Accident Legal aspects of wounds (Section 44, 319, 320, 324, 326, 304(A),304(B),498, 299, 300 IPC), Workmans Compensation Act 16. Burns 17. Scalds, Injuries due to cold 18. Electricity, Lightning

Practicals: 1. 2. 3. 4. 5. 6. 7. Weapons examination Mounted specimens related to injuries Photographs of injuries Postmortem summary 1 Postmortem summary 2 Postmortem summary 3 Postmortem summary 4

Asphyxial Deaths (12 hrs.)

Learning outcomes: The students should be able to Define and classify Asphyxial deaths. Describe the patho-physiology, signs and symptoms of Asphyxial deaths. Describe the different types of hanging, strangulation, suffocation and drowning, sexual & postural asphyxia & their postmortem findings.

Course content and Learning process: Lectures: 1. Definition and classification of Asphyxial deaths, patho-physiology, signs and symptoms of Asphyxial deaths 2. Hanging 3. Strangulation 91

4. Suffocation, sexual & postural asphyxia 5. Drowning definition, types, signs, patho-physiology of drowning 6. Features of Salt and fresh water drowning, investigations in drowning deaths. Practicals: 1. 2. 3. 4. 5. 6. Mounted specimens related to asphyxia Photographs related to asphyxia Postmortem summary 1 Postmortem summary 2 Postmortem summary 3 Postmortem summary 4

Sexual Jurisprudence (10 hrs.)

Learning outcomes: The students should be able to Describe the signs of virginity, pregnancy, delivery and their medico-legal significance. List the causes of Impotency & sterility and their medico-legal importance. Explain assisted reproduction and its medico-legal implications. Describe MTP Act, The signs of legal & criminal abortion, and its medico-legal significance. Classify sexual offences. Define Rape and describe the findings on a victim /accused in a case of rape. Describe the findings on a victim / accused of sodomy Describe Paraphilias and their medico-legal relevance

Course content and Learning process: Lectures: 1. 2. 3. 4. 5. 6. Virginity, Pregnancy, Delivery Impotency, Sterility, Assisted reproduction Abortion, MTP Act Classification of sexual offences, Rape Sodomy, Bestiality, Incest Sexual Paraphilias

Practicals: 1. Examination of victim of Rape 2 hours 2. Examination of accused of Rape/Potency Certificate 2 hours

Infanticide (4 hrs.)
Learning outcomes: The students should be able to Explain the methods adopted to commit infanticide and autopsy procedure in a case of infanticide. 92

Explain/ describe the terms viability, stillbirth, dead born, live born. Describe Battered baby syndrome, Sudden infant death syndrome and their medico-legal importance. Explain Female feticide and Pre-conception and Pre-natal Diagnostic Techniques (PCPNDT) Act 1994.

Course content and Learning process: Lectures: 1. Infanticide, Fetal autopsy 2. Viability, Stillbirth, Dead born, Live born, Battered baby syndrome, Sudden infant death syndrome 3. Pre-natal Diagnostic Techniques (PCPNDT) Act 1994. Practicals: 1. Postmortem summary 1

Forensic Psychiatry (6 hrs.)

Learning outcomes: The students should be able to Define/ explain Delusion, Hallucination, Mental sub normality, Illusion, Impulse, Obsession and their medico-legal significance. Explain the Mental Health Act Explain the different types of restraint of a mentally ill person Describe feigned insanity and differentiate it from true insanity. Describe the civil and criminal responsibilities of a mentally ill person. Mc Naughtens rule and section 84 IPC. Course content and Learning process: Lectures: 1. DSM IV Classification, Delusion, Hallucination, illusion, Impulse, Obsession, Phobia 2. Mental Health Act-1987 3. Criminal responsibilities of a mentally ill, Mc Naughtens rule, section 84 IPC, feigned insanity, true insanity. 4. Civil responsibilities of a mentally ill Practicals: NIL Integration: 1. Integrated teaching with the department of psychiatry 2 hours

Forensic Science Laboratory (3 hrs.)

Learning outcomes: The students should be able to Explain the Collection & Preservation of evidentiary materials for dispatch to F.S.L List / describe the tests for detecting biological stains like blood, semen and saliva. 93

Explain the Principle & application of latest analytical / investigation techniques, Brain Mapping, Narco analysis & Polygraph

Course content and Learning process: Lectures: 1. Collection, Preservation, Dispatch of viscera and other material to FSL 2. Blood and seminal stains 3. Brain Mapping, Narcoanalysis, Polygraph, Chromatography

Practicals: NIL

Toxicology (40 hrs.)

A. General Principles

Learning outcomes: The students should be able to Define and Classify poisons. Describe the factors modifying the actions of poisons. Enumerate / describe the duties of a doctor in case of suspected poisoning (legal and medical).

Course content and Learning process: Lectures: 1. Definition and classification of poisons 2. Factors modifying the actions of poisons, Clinical features, Management, Antidotes 3. Duties of Doctor -legal and medical. Practicals: 1. Appliances used in emergency service

B.

Corrosives

Learning outcomes: The students should be able to Classify corrosive poisons Explain the diagnostic features and the management of acute /chronic poisoning by corrosives acids, alkalis and salts

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Course content and Learning process: Lectures: 1. Acids- Sulphuric acid / Nitric acid, Hydrochloric acid, Formic acid 2. Phenol, Oxalic acid, Alkalis Practicals: 1. Sulphuric acid / Nitric acid, Phenol

C.

Irritants

Learning outcomes: The students should be able to Classify Irritant poisons Explain the diagnostic features and the management of acute /chronic poisoning by irritants of plant and animal origin, metallic and nonmetallic and mechanical irritants

Course content and Learning process: Lectures: 1. 2. 3. 4. 5. Inorganic Irritants- Metallic Inorganic Irritants- Non Metallic Organic Irritants Plant origin Organic Irritants Animal origin Mechanical Irritants

Practicals: 1. Inorganic Irritants Metallic & Non Metallic 2. Organic Irritants Plant origin 3. Organic Irritants Animal origin

D.

Insecticides

Learning outcomes: The students should be able to Classify Insecticides Explain the diagnostic features and the management of acute /chronic poisoning by Organophosphate, Carbamates, Organochlorates, Aluminum Phosphide, Zinc Phosphide, Paraquat, pyrethrins.

Course content and Learning process: Lectures: 1. Organophosphates 2. Carbamates, organochlorates, Aluminum Phosphide, Zinc Phosphide, Paraquat, pyrethrins. 95

Practicals: 1. Postmortem summary

E.

Neurotics

Learning outcomes: The students should be able to Classify Neurotics Explain the diagnostic features and the management of acute /chronic poisoning by opium, barbiturates, Psychotropics drugs, Datura, cannabis, cocaine, Ethyl and methyl alcohol.

Course content and Learning process: Lectures: 1. 2. 3. 4. 5. 6. Somniferous-Opium Inebriants Ethyl Alcohol Inebriants Methyl Alcohol, Chloral Hydrate Delirients- Datura Delirients- Cannabis, Cocaine Psychotropics

Practicals: 1. Neurotoxic poisons 2. Drunkenness Certificate 3. Postmortem summary

F.

Cardiac and Spinal Poisons

Learning outcomes: The students should be able to Classify cardiac and spinal poisons Explain the diagnostic features and the management of acute /chronic poisoning by Cardiac Poisons-Aconite, Tobacco, Digitalis, Nerium odorum, Cerbera odollum, Cerbera thevitia Explain the diagnostic features and the management of acute /chronic poisoning by Spinal poisons-Strychnine, Curare Course content and Learning process: Lectures: 1. Cardiac Poisons - Aconite, Tobacco, Digitalis, 2. Cardiac Poisons - Nerium odorum, Cerbera odollum, Cerbera thevitia 3. Spinal poisons - Strychnine, gelsemium, Curare Practicals: 1. Cardiac Poisons 2. Spinal poisons 96

G.

Respiratory Poisons

Learning outcomes: The students should be able to Classify respiratory poisons Explain the diagnostic features and the management of acute /chronic poisoning by Carbon dioxide, carbon monoxide, Cyanides, War gases

Course content and Learning process: Lectures: 1. Carbon dioxide, carbon monoxide 2. Cyanides, War gases

Practicals: 1. Post mortem summary

H.

Food Poisoning and Drug Abuse

Learning outcomes: The students should be able to Classify Food Poisoning and Drug Abuse Explain the diagnostic features and the management of acute /chronic Food poisoning, Poisonous food ingestion Explain the diagnostic features and the management of acute /chronic Drug addiction, Drug dependency, Solvent abuse, Body packer syndrome

Course content and Learning process: Lectures: 1. Food poisoning, Poisonous food 2. Drug addiction, Drug dependent, Solvent abuse, Body packer syndrome Practicals: Integration: 1. Integrated teaching with the department of pharmacology and internal medicine 3 hours NIL

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Attendance and Internal Assessment (IA)

1. As per the existing regulations of the Medical Council of India a student must attend at least 75% of lectures and 75% of practicals / clinical to be eligible to appear for the University examination. Students who are not permitted to appear for University examination due to shortage of attendance will have to make up the attendance along with the junior batch by paying the fee specified by the University. A student must secure a minimum of 35% marks in the Internal Assessment in each of the subjects theory and practical / clinical separately, failing which he/she will not be permitted to appear for the University examination in that particular subject (s). To become eligible to appear for the next University examination a student is required to improve his/her internal assessment marks by appearing in the sessional examinations for which a prescribed amount of fee is to be paid. To be declared as pass in the University Examination in a subject, a candidate must obtain 50% in aggregate with a minimum of 50% in Theory including viva-voce and minimum of 50% in Practicals. There shall be three Sessional examinations (both theory and practical). Viva-voce marks are added to the theory marks in each subject.

2.

3.

4.

5.

It is mandatory that a student shall appear for all the three examinations.

Calculation of Internal Assessment Marks

Regular Students: Marks are calculated for theory (including viva-voce) & practical examinations separately. Students having attendance of more than 90% in a given subject, the average of the best two (of the three) sessional examination marks will form the internal assessment mark (theory + viva & practical examinations separately) in a given subject. This facility is only for those who appeared all the 3 sessional examinations Students with attendance of less than 90% in a given subject, the average of all three sessional examination marks will figure as the internal assessment mark (theory + viva & practical examinations separately) in a given subject.

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If a student is unable to appear for any of the three examinations, the reason for not appearing is to be submitted to the Dean, either prior to the commencement or within 24 hours of commencement of the said examination, (written/viva-voce or practical/clinical) examination The validity of a reason for not appearing for an examination shall be decided by the committee appointed by the Dean. The decision of the committee is binding. a. If the committee considers the reason for absence as valid: The IA will be calculated by dividing the marks obtained in two sessional examinations by 2 b. and if the absence is considered as invalid: The IA will be calculated by dividing the marks obtained in two sessional examinations by 3.

Syllabus
Theory: The syllabus covered during a given semester will be considered as the content for each Sessional examination. Practicals: The practicals conducted during a semester will be evaluated for that semester during 3rd and 4th semester examinations. However for the third practical examination conducted at the end of 5 semester the department will decide the syllabus for the practical examination and will communicate to the students well in advance.
th

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Kasturba Medical College, Manipal and Mangalore

MBBS Programme Scheme for University Examination Question Papers

SI# Nature of Questions Duration of Paper : 3 hours, (Max. marks - 100) No. of Marks/question questions 2 10 15 4 20 1 Total

1 2 3

Essay Short answer MCQ

Total marks 20 60 20 100

SI#

Nature of Questions

1 2 3

Essay Short answer MCQ

Duration of Paper : 1 hours, (Maximum marks - 50) No. of Marks questions /question 1 8 8 4 10 1 Total

Total marks 8 32 10 50

100