LIAQUAT NATIONAL MEDICAL COLLEGE 1 YEAR … .pdf · liaquat national medical college st1 year mbbs, ... professor amir ali ... liaquat national medical college st1 year mbbs, semester

2015

LIAQUAT NATIONAL MEDICAL COLLEGE 1ST YEAR MBBS, SEMESTER 2 LOCOMOTOR MODULE

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STUDY GUIDE FOR LOCOMOTOR SYSTEM

S.No CONTENTS: Page No

1 Overview 03

2 Introduction to Study Guide 04

3 Learning Methodologies 05 4 Assessment Methods 06

5 Semester Examination Rules And Regulations of JSMU 08

6 Module 1: Locomotor System

6.1 Importance of Locomotor System 11 6.2 Objectives and strategies 11

6.2.1 Anatomy 11

6.2.2 Biochemistry 17 6.2.3 Community Medicine 18

6.2.4 Neurology 19 6.2.5 Orthopedics 19

6.2.6 Pathology 19

6.2.7 Pharmacology 20 6.2.8 Physiology 22

6.2.9 Physiotherapy 23 6.2.10 Research & Skill Lab 24

6.2.11 Rheumatology 24 6.3 Skills &Practicals 25

7 Learning Resources 26

8 Modular Examination Rules And Regulations (LNMC) 27 9 Schedule 28


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Module name: Locomotor System

Semester: Two Year: One Duration: 6 weeks

Timetable hours: Lectures, Case-Based Learning (CBL), Self-Study, Practical, Skills,

Demonstrations, First Aid, Visit to Wards

Credit hours:6 credit hours in theory and 3 credit hours in practical

MODULE INTEGRATED COMMITTEE

DEPARTMENTS’& RESOURCE PERSONS’ FACILITATING LEARNING

BASIC HEALTH SCIENCES CLINICAL AND ANCILLARY DEPARTMENTS

ANATOMY

Professor Zia-ul-Islam

Professor Faiz Muhammad

NEUROLOGY

Dr Naveeduddin Ahmed

Dr. Hazim Brohi

BIOCHEMISTRY

Professor Jawed Altaf Baig

ORTHOPEDICS

Professor Shahid Noor

Dr.Zaki Idrees

COMMUNITY MEDICINE

Professor Rafiq Soomro

PHYSIOTHERAPY

Mr. Hassan Abbas

PATHOLOGY

Professor Naveen Faridi

RADIOLOGY

Dr Muhammad Ayub Mansoor

PHARMACOLOGY

Professor Nazir Ahmad Solangi

RESEARCH AND SKILLS DEVELOPMENT CENTER

Dr Kahkashan Tahir

Dr Sara

PHYSIOLOGY

Professor Syed Hafeezul Hassan

RHEUMATOLOGY

Dr Tahira Perveen

Dr Lubna Nazir

DEPARTMENT of HEALTHCARE EDUCATION

Professor Nighat Huda Dr. Mirza Aroosa Beg

LNH&MC MANAGEMENT

Professor Amir Ali Shoro, Dean & Principal, Director FHS LNH&MC

Dr. Shaheena Akbani, Controller A.A & R.T LNH&MC

STUDY GUIDE COMPILED BY: Department of Health Care Education

Dr. Muhammad Suleman Sadiq

Dr. Rabia Mahmood

MODULE COORDINATOR: Professor Zia-ul-Islam CO-COORDINATOR: Professor Nighat Huda


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INTRODUCTION

WHAT IS A STUDY GUIDE?

It is an aid to:

Inform students how student learning program of the semester-wise module has been

organized

Help students organize and manage their studies throughout the module

Guide students on assessment methods, rules and regulations

THE STUDY GUIDE:

Communicates information on organization and management of the module.

This will help the student to contact the right person in case of any difficulty.

Defines the objectives which are expected to be achieved at the end of the module.

Identifies the learning strategies such as lectures, small group teachings, clinical skills,

demonstration, tutorial and case based learning that will be implemented to achieve the

module objectives.

Provides a list of learning resources such as books; computer assisted learning program, web-

links, journals, for students to consult in order to maximize their learning.

Highlights information on the contribution of continuous and semester examinations on the

student’s overall performance.

Includes information on the assessment methods that will be held to determine every student’s

achievement of objectives.

Focuses on information pertaining to examination policy, rules and regulations.

CURRICULUM FRAMEWORK

Students will experience integrated curriculum similar to previous modules of the first semester.

INTEGRATEDCURRICULUM comprises of system-based modules such as locomotor system, respiratory,

cardiovascular, endocrine which links basic science knowledge to clinical problems. Integrated teaching

means that subjects are presented as a meaningful whole. Students will be able to have better

understanding of basic sciences when they repeatedly learn in relation to clinical examples.

Case based discussions, computer-based assignments, early exposure to clinics, wards, and skills

acquisition in skills lab, Physiotherapy department are characteristics of integrated teaching program.


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LEARNING METHODOLOGIES

The following teaching / learning methods are used to promote better understanding:

Interactive Lectures

Hospital / Clinic visits

Small Group Discussion

Case- Based Learning

Practicals

Skills session

Self-Directed Study

INTERACTIVE LECTURES

In large group, the lecturer introduces a topic or common clinical conditions and explains the underlying

phenomena through questions, pictures, videos of patients’ interviews, exercises, etc. Students are

actively involved in the learning process.

HOSPITAL VISITS: In small groups, students observe patients with signs and symptoms in hospital or

clinical settings. This helps students to relate knowledge of basic and clinical sciences of the relevant

module.


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SMALL GROUP SESSION: This format helps students to clarify concepts acquire skills or attitudes.

Sessions are structured with the help of specific exercises such as patient case, interviews or discussion

topics. Students exchange opinions and apply knowledge gained from lectures, tutorials and self study.

The facilitator role is to ask probing questions, summarize, or rephrase to help clarify concepts.

CASE- BASED LEARNING: A small group discussion format where learning is focused around a series of

questions based on a clinical scenario. Students’ discuss and answer the questions applying relevant

knowledge gained in clinical and basic health sciences during the module.

PRACTICAL: Basic science practicals related to anatomy, biochemistry, pathology, pharmacology and

physiology are schedule for student learning.

SKILLS SESSION: Skills relevant to respective module are observed and practiced where applicable in

skills laboratory or Department of Physiotherapy.

SELF-DIRECTED STUDY: Students’ assume responsibilities of their own learning through individual study,

sharing and discussing with peers, seeking information from Learning Resource Center, teachers and

resource persons within and outside the college. Students can utilize the time within the college

scheduled hours of self-study.

ASSESSMENT METHODS:

Theory: Best Choice Questions (BCQs)also known as MCQs (Multiple Choice Questions) is used to asses

objectives covered in each module.

A BCQ has a statement or clinical scenario followed by four to five options (likely answer).

Students after reading the statement/scenario are supposed to select ONE, the most

appropriate response from the given list of options.

Correct answer carries one mark, and incorrect ‘zero mark’

Students mark their responses on specified computer-based sheet designed for LNHMC.

OSPE: Objective Structured Practical Examination

The content may assess application of knowledge, or practical skills.

A structured examination that will have observed, unobserved, interactive and rest stations.

Observed and interactive stations will be assessed by internal or external examiners.


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Unobserved will be static stations in which students will have to answer the question on the

provided response sheet.

Rest station is a station where there is no task given and in this time student can organize

his/her thoughts.

Internal Evaluation

During the module, students will be assessed to determine achievement of module objectives.

Module Examination: will be scheduled on completion of each module. The method of

examination comprises theory exam which includes BCQs, and practical (Objective Structured

Practical Examination).

20% marks of internal evaluation will be added in theory of semester exam. That 20% will

include class attendance, class tests and the modular exam which all have specific marks

allocation.

Formative Assessment

Individual department may hold quiz or short answer questions to help students assess their

own learning. The marks obtained are not included in the internal evaluation

Example : Number of Marks allocated for Semester Theory and Internal Evaluation

Semester

Semester Examination Theory Marks

Internal Evaluation (Class test + Attendance +

Modular Exam) Total (Theory)

80% 20% 100%

More than 75% attendance is needed

to sit for the modular and semester

examinations


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SEMESTER EXAMINATION RULES & REGULATIONS OF JINNAH SINDH MEDICAL UNIVERSITY

(JSMU)

In one academic year there will be two semesters. The semester duration is approximately sixteen weeks.

Each semester may have two to three modules from two to eight weeks duration.

JSMU EXAMINATIONS:

JSMU will schedule and hold Semester Examinations on completion of each semester.

In one academic year, there will be two semester examinations and one Retake Examination.

MBBS first year:

Semester I examination is scheduled on completion of Foundation Module and Blood Module

Semester II Examination is scheduled on completion of Locomotor Module, Respiratory and

Cardiovascular Modules.

Examination Protocols:

In each semester, there will be ONE Theory paper comprising MCQs and practical OSPE

(Objective Structured Practical Examination).

1. Theory

Theory paper will comprise of 100 one best type MCQs.

Time duration for theory paper will be 120 minutes.

Students will mark their responses on JSMU specified response sheets assessed by computer software.

It will carry out 80% contribution in theory results of the Semester.

2. OSPE:

It is to be held at the respective college unless specified by JSMU.

Each OSPE examination will be in two shifts at 4/5 tracks (depending on number of candidates).

It may comprise between 12- 25 stations. Each station will carry 10 marks.

All students begin and end at the same time.

The content assessed is the same for all students

The time allocated for each station is the same.


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3. JSMU Grading System

It will be based on GPA – 4 system

Marks obtained in Percentage range

Numerical Grade Alphabetical Grade

80-100 4.0 A+

75-79 4.0 A

70-74 3.7 A-

67-69 3.3 B+

63-66 3.0 B

60-62 2.7 B-

56-59 2.3 C+

50-55 2.0 C

<50 Un-grade-able 0 U

A candidate obtaining GPA less than 2.00 (50%) is declared un-graded (fail).

Cumulative transcript is issued at the end of clearance of all modules.

4. Retake Examination

The failures are to re-appear in subsequent examinations.

It is held once a year that is after the even number semesters. For example at the end of second, fourth, sixth, eighth or tenth semester.

Retake examinations are for those students who fail in semester examinations, and who wish to improve grades (GPA) secured in semester examinations.

The candidate who has passed the semester examinations with GPA less than 3.0 GPA may re-appear in respective retake examination to improve grades.

MBBS first year Candidates failing in retake examinations may re-appear in semesters’ examinations of the following year. The format is exactly the same as in semester examinations.

EXAMPLE OF PROMOTION RULES:

A student who fails in Semester One Examination and passes Semester Two, s/he will take Retake for

Semester One Examination. S/he passes Semester Two and is promoted to 2nd year. If that student

FAILS in Retake, s/he will be promoted to 2nd year BUT will have to Pass Semester One examination in

Second year along with Semester Three and Four examinations for promotion to third year.


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Never regard study as a duty, but

as the enviable opportunity to

learn to know the liberating

influence of beauty in the realm of

the spirit of your own personal joy

and to the profit of the community

to which your later work belongs.

(Albert Einstein)

5. Promotion to next class

Students who pass both semester examinations are promoted from first year to second year.

Students who fail the MBBS first year semester retake examination will be promoted to second year.

Students will be promoted from second year to third year and onward only if they have passed the semester examinations of that year.

Clearance of all modules and their components of semester one to four are mandatory for promotion from second year to third year (as per PMDC rules).

As per PMDC rules any candidate failing to clear a module or its component in four (1+3) attempts is not allowed to carry out further medical education.

Clearance of all modules and their components of semester/s are mandatory for promotion from third year onward.


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MODULE 1 : LOCOMOTOR SYSTEM

IMPORTANCE OF LOCOMOTOR SYSTEM

It is likely that everyone will, at some time, suffer from a problem related to the musculoskeletal system,

ranging from a very common problem such as osteoarthritis or back pain to severely disabling limb

trauma or rheumatoid arthritis. Many musculoskeletal problems are chronic conditions. The most

common symptoms are pain and disability, with an impact not only on individuals’ quality of life but

also, importantly, on people’s ability to earn a living and be independent. It has been estimated that one

in four consultations in primary care is caused by problems of the musculoskeletal system. Healthy

lifestyle such as exercise and diet can help one maintain good health.

COURSE OBJECTIVES AND STRATEGIES

ANATOMY

At the end of the module the students will be able to:

Objectives of upper limb Strategy

Describe the Osteology and muscular attachment of clavicle and scapula

Demonstration

Identify microscopic features of bone and cartilage

Lecture\ skills

Identify break in weight transmission from upper limb to axial skeleton due to fractures of bones of pectoral girdle and resulting disabilities

Small Group Discussion\CBL

Identify the importance of mesoderm in embryological basis of diseases

Lecture

Describe the normal structure and development of mammary gland. Correlate the involvement of upper limb in carcinoma breast

Lecture

Describe the Osteology and muscular attachments on bones of Humerus

Demonstration

Describe the shoulder joint and anastomosis around it

Demonstration

Correlate the clinical manifestation of shoulder region (winging of scapula and drooping of shoulder by relating the muscle, ligaments and neurovascular bundle of scapula region)

Small Group Discussion\CBL

Identify the congenital anomalies of cartilage by discussing its structure and chemistry

Lecture


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Identify the boundaries and content of axilla and pectoral region

Demonstration

Describe the histological features of muscle

Lecture\Skills

Identify the lesions and dermatological distribution of brachial plexus, with knowledge of its structure and formation


Recognize the congenital anomalies of upper and lower limbs by knowing their development with special emphasis on the following: a)Polydactyly b)Meromelia c)Coxavara d) CoxaValga e)Talipesequino varies

f) Talipesequino valgus

Lecture

Describe the course, branches and applied anatomy of: Vessels: Axillary and brachial artery and vein Nerves: Axillary, musculocutaneous, ulnar, radial and median nerve

Demonstration

Describe the Osteology and muscular attachments on bones of upper limb(radius and ulna)

Demonstration

Describe the development of muscles

Lecture

Describe the elbow joint and anastomosis around it


Describe the actions of the muscles and neurovasculature of Compartments of forearm

Demonstration

Describe the osteology, actions of the muscles and neurovasculature of hand

Demonstration

Identify the boundaries and contents of cubital fossa, and anatomical snuff box and palmer spaces

Demonstration

Describe the wrist and hand joint

Demonstration\Skills

Describe the lymphatic drainage of upper limb

Lecture

Mark the following structures/areas on a simulator Arteries: axillary, brachial, ulnar, radial, superficial and deep palmar arches Nerves: axillary, musculocutaneous, ulnar, radial and median Retinacula: Flexor and Extensor Retinacula Area for intramuscular injection in upper limb Area for venepuncturein upper limb Dermatomes

Skills\Practical


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Explain the anatomical basis of: a) Common dislocation of shoulder joint b) Painful arc of shoulder joint c) Tennis elbow d) Students elbow e) Pulled elbow / slipped elbow f) Posterior dislocation of elbow joint g) Wrist drop h) Wrist fracture (Colle’s and smith fracture) i) Boxer and Bennett’s fracture j) Saturday night palsy k) Dupuytren’s contracture l) Volksman contracture m) Klumkey’s and Erb’s palsy n) Winged scapule o) Claw hand p) Cricket finger q) Carpel tunnel syndrome r) Ape like han


Differentiate between the normal and abnormal radiographs of upper limb

Lecture\Demonstration

Recognize the importance of venous system of upper limb with localization of antecubital vein for drawing blood

Lecture

Enumerate the muscles and joints of upper limb involved in daily life activities

Demonstration

Mark the surface anatomy of major nerves and vessels of upper limb

Skills

At the end of the module, students will be able to:

Objectives of Lower Limb Strategy Describe the gross structure and muscular attachment of hip bone and

femur

Demonstration

Identify the effect of break in weight transmission from axial skeleton to lower limb

CBL

Describe the group actions and clinical relevance of the muscles of following regions / compartments: a) Gluteal region b) Anterior, posterior and medial compartments of leg

Demonstration


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Describe the boundaries and contents of : a)Femoral triangle b)Femoral sheath c)Adductor canal d)Saphenous opening

Demonstration

Describe formation, branches, lesions and dermatological distribution of the following nerves/plexus a) Lumbar plexus b) Sacral plexus c) Femoral &Obturator nerve d) Sciatic nerve

Demonstration

Identify the clinical effects of lumbosacral root and nerve compression

CBL

Identify the injuries as a result of stab wound on the front of thigh

CBL

Describe the deep fascia of thigh its modification, inguinal ligament

Lecture

Differentiate femoral from inguinal hernia

Lecture

Describe the gross structure, anastomosis and applied anatomy of hip joint

Lecture\Demonstration

Indicate the features of avascular necrosis of hip joint

Lecture

Describe the course, branches and clinical significance of femoral and popliteal artery

Demonstration

Describe the osteology and muscular attachment of tibia and fibula

Demonstration

Describe the boundaries and contents of popliteal fossa

Demonstration

Describe the group actions and clinical relevance of the muscles of anterior, posterior and lateral compartments of leg

Demonstration

Describe the gross structure, possible movements and applied anatomy of knee joint

Demonstration

Differentiate between normal and abnormal knee joint

Demonstration

Describe formation, branches, lesions and dermatological distribution of the following nerves/plexus. a) Tibial nerve. b) Common peroneal nerve

Demonstration

Describe the course, branches and clinical significance of anterior and posterior tibial artery.

Demonstration


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Describe the gross structure of bones of foot with their muscular attachment.

Demonstration

Describe the gross structure, possible movements and applied anatomy of the following joints:- a) Ankle joint b) Superior and inferior tibiofibular joint c) Subtalar joint

Demonstration

Describe the group actions and clinical relevance of the muscles of sole of foot


Describe formation, branches, lesions and dermatological distribution of common perennial nerve


Describe the course, branches and clinical significance of dorsalispedis artery

Demonstration

Describe the attachment and structure passing beneath extensor and flexor retinaculum

Demonstration

Describe the venous and lymphatic drainage of lower limb

Lecture

Identify and mark the anatomical points used for surface marking of: a) Femoral, popliteal, anterior and posterior tibial and dorsalispedis arteries. b) Great saphenous, small saphenous and femoral vein c) Sciatic, tibial, common peroneal, superficial and deep peroneal nerves

Demonstration

Identify and mark the anatomical points used for: a) Femoral artery catheterization b) Venous cut down


Identify the above-mentioned blood vessels and nerves on dissected limb, models & photographs

Demonstration

Describe the layers of sole of foot

Lecture

Describe arches of foot and the role of foot as a weight bearer and a lever

Lecture

Recognize the importance of varicose veins of lower limb

Lecture

Identify the applied anatomy of foot drop


Recognize the importance of soleal pump in relation to deep vein thrombosis



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Recognize the effects of ischemia and neuropathy of foot


Identify “flat foot” and its mechanical effects


Enumerate the muscles, joint and nerves of lower limb involved in daily life activities


Mark the surface anatomy of major nerves and vessels of lower limb

Demonstration

Differentiate between the normal and abnormal radiographs of lower limb

Demonstration


Objectives of Back Strategy

Describe the main distinguishing characteristic of vertebrae in different regions of vertebral column

Demonstration

Describe the atlanto-occipital and atlanto-axial joints

Lecture

Describe the muscles, ligaments of back and intervertebral joints

Lecture

Describe the structure of intervertebral disc and mechanism of its prolapsed


List common sites of disc prolapsed


Describe the reason for more common rupture of intervertebral disc in the lumber region.


Deduce the nerve root compressed and identify the appropriate herniated disc on a given scenario or MRI.

Demonstration

Describe the normal primary and secondary curves of the spine

Lecture

Describe the important pathological curves of the spine

Lecture

Describe posture and its maintenance.

Lecture

Identify different component of vertebral column on a given radiograph and MRI

Demonstration

Identify the muscles/group of muscles on model or photograph

Demonstration


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BIOCHEMISTRY

By the end of this module students will be able to:

OBJECTIVES LEARNING STRATEGY

BIOCHEMISTRY OF CONNECTIVE TISSUES (GLYCOSAMINOGLYCAN)

Describe the chemical composition of connective tissue

Explain the composition of ground substance

Explain the functions of Glycosaminoglycans

Lecture

CONNECTIVE TISSUES (ECM) COLLAGEN & ELASTIN

Describe the chemistry of collagens

Classify collagen and identify its uses

Explain the chemical composition of elastin

Explain the functions of elastin

Lecture

COLORIMETRY

Understand the functions of colorimeter in Lab Practical

HORMONAL REGULATION OF CALCIUM AND PHOSPHATE, HYPER AND HYPOCALCEMIA.

Relate mineral metabolism, role of hormones and Vitamin D in connection with bones

Describe Ca, PO4, metabolism

Explain the synthesis, regulation, functions, sources and deficiency of Vitamin D

Give an over view of regulation and release of PTH

Explain the regulation and release of Calcitonin

Recall normal values of calcium and phosphate in serum

Relate hypocalcaemia and hypercalcemia and its consequences

Describe hypophosphatemia & Hyperphosphatemia

Lecture

Explain the major components of cartilage

Explain the structure and chemical composition of myelin sheath

Describe the types of lipids present in the myelin sheath, their structure, functions & biomedical importance

Describe types of proteins present in myelin sheath, their structure, function & biomedical importance

Explain the biochemical role of vitamin B12 in the synthesis of fatty acids in the myelin sheath

Explain the significance of enzymes present in myelin sheath

Discuss the metabolic Changes in muscles during and after exercise and their effects

Lecture

Estimate serum Ca level in blood/serum

Practical

Estimate serum PO4 level in blood/serum Practical


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Describe the composition of nucleotides and nucleoside

Explain digestion of nucleic acids

Explain Biosynthesis of purine nucleotide

Describe degradation of purine nucleotides

Lecture

ESTIMATION OF SERUM ALKALINE PHOSPHATASE IN SERUM

Estimate and interpret enzyme Alkaline Phosphatase in serum

Practical

COMMUNITY MEDICINE

By the end of this module the students will be able to:

OBJECTIVES STRATEGY OCCUPATIONAL HEALTH

Explain promotion and maintenance of the physical, mental and social well- being of workers in all occupations

Categorize occupational diseases, their prevention and treatment

Describe the placement of worker in an occupational environment suitable for physiological and psychological needs

Lectures

HEALTH EDUCATION

Relate principles of health education in individuals, family and community to develop health consciousness

Relate various stages of health education to bring positive behavioral changes in individuals and community

Use different methods of health education to educate, instruct and influence the communities

Lectures

INTRODUCTION TO BIOSTATISTICS

Describe briefly biostatics, vital statistics, vital index etc and main types of biostatistics

Identify the role of biostatistics in the field of Public Health, Medicine and Research

Lecture

INTRODUCTION TO EPIDEMIOLOGY I

Define epidemiology and enumerate its uses

Classify the types of epidemiology and its importance in Public Health, Clinical medicine and Research

Lecture

DEMOGRAPHY

Define demography

Describe sources of demographic data and measures of fertility

Lectures


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Explain the stages of Demographic Transition Cycle and relate it with Pakistan scenario

Describe and compare Population Pyramid and Age-sex composition of a population

NEUROLOGY


OBJECTIVES STRATEGY MYOPATHIES

Explain Myopathies, its types, causes and its signs & symptoms

CBL

ORTHOPAEDICS


OBJECTIVES STRATEGY Discuss the various types of limb trauma and its clinical implications

Identify the various types of limb fractures /dislocations and there clinical presentations

CBL

PATHOLOGY


OBJECTIVES STRATEGY OSTEOPOROSIS

Define Osteoporosis

Discuss the different types of osteoporosis

Differentiate the histological features of an osteoporotic bone with normal bone

Discuss sequence of pathological events leading to osteoporosis

Lecture

Explain the histopathology of Osteomalacia, Osteomyelitis and Rickets

CBL

FRACTURE REPAIR

Define bone fracture

Describe the stages of bone repair (internal, intermediate and external callus formation)

Lecture


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Outline the role of the periosteum and endosteum in repair

List common factors affecting repair of bone and their resulting pathology BONE TUMORS

Classify soft tissue and bone tumors

Correlate the pathology with the clinical presentation, behavior and spread

Describe giant cell tumor of bone and Ewing sarcoma regarding common sites, age, prognosis and morphology

BREAST TUMORS

Classify breast tumors

Differentiate the histopathological features of different types of breast tumor

Lecture

Explain breast abscess formation and common breast tumors

CBL

PHARMACOLOGY


OBJECTIVES STRATEGY NSAIDs & OPIOID Analgesics ASPRIN:

Explain its mechanism of action

Discuss its therapeutic effects and clinical uses

Explain its adverse effects

Enlist its contraindications

Explain drug interactions

Explain symptoms and treatment salicylate overdose

Lecture

ACETAMINOPHEN & OTHERS:

Compare Acetaminophen with Aspirin

Explain the symptoms and treatment of Acetaminophen overdose

Compare Indomethacin with Aspirin

Discuss the advantages and disadvantages of COX2

Compare Brufen with Aspirin

Discuss the uses and adverse effects of Diclofenac

Lecture

OPIOIDS:

Explain Opioid receptors and mechanism of action of drug

Discuss the systemic side effects of Morphine

Enlist uses of Morphine

Enlist adverse effects of Morphine

Discuss contraindications of Morphine

Lecture


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Discuss treatment of Morphine dependence

Discuss symptoms and treatment of acute Morphine overdose

Enlist Morphine antagonists

Compare Pethidine with Morphine

MUSCLE RELAXANTS

NEUROMUSCULAR BLOCKING DRUGS:

Classify the neuromuscular blocking drugs

Explain mechanism of action of depolarizing and non-depolarizing NMBDs

Discuss adverse effects of depolarizing and non-depolarizing NMBDs

Explain the indications for use of NMBDs

Enlist drug interactions of NMBDs

Lecture

CENTRALLY ACTING MUSCLE RELAXANTS

Discuss the mechanism of action of centrally acting muscle relaxants

Explain the uses of centrally acting muscle relaxants

Lecture

TREATMENT OF MUSCULOSKELETAL DISORDERS

GOUT

Discuss the treatment of acute gout attack

Explain mechanism of action and adverse effects of Colchicine

Discuss Allopurinol as treatment of chronic gout

Identify uricosuric drug

Lecture

OSTEOPOROSIS

Explain the mechanism of action of Bisphosphonates

Explain Pharmacokinetics of Bisphosphonates

Explain adverse effects of Bisphosphonates

Discuss the indications for the use of Selective Estrogen Receptor Modulators

Discuss the indications for the use of Calcitonin

Discuss the indications for the use of Teriparatide

Lecture& CBL

RHEUMATOID ARTHRITIS

Explain mechanism of action of Methotrexate

Discuss adverse effects of Methotrexate

Explain mechanism of action of Leflunomide

Discuss adverse effects of Leflunomide

Discuss the drugs used in combination with Methotrexate

Discuss the contra-indications of D-Penicillamine

Discuss the adverse effects of gold salts

Explain the therapeutic indications of Etanercept& Infliximab apart from Rheumatoid Arthritis

Explain the mechanism of action of Etanercept& Infliximab

Discuss the adverse effects of Infliximab

Explain the mechanism of action of Adalimumab

Discuss the therapeutic indications of Adalimumab

Lecture&CBL


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PHYSIOLOGY


OBJECTIVES STRATEGY ELECTRICAL PROPERTIES OF NEURONS

Describe the introduction to nerve and muscle physiology

Explain the types of Glial cells

Describe the structure, function and types of Neuron

Define and discuss Resting Membrane Potential

Lecture

INTRODUCTION TO POWER LAB

Identify the different parts and function of Power Lab.

Practical

ACTION POTENTIAL GENERATION AND PROPAGATION

Define and discuss Membrane potential

Define Nernst Potential and explain the equation

Describe the Goldman Hodgin Katz equation

Define and Discuss nerve action potential and its stages

Explain the initial & propagation of Action potential

Describe the Plateau in some action potential

Define and discuss mono phase and bi phase action potential

Lecture

Explain Action Potential of Skeletal Muscle


EMG

Demonstrate the Electromyography (EMG) with the help of Power Lab

Practical

FUNCTIONAL CLASSIFICATION OF NERVE FIBERS

Describe the types and function of Nerve fibers

Lecture

NCV

Demonstrate the Nerve Conduction Velocity (NCV) with the help of Power Lab

Practical

SKELETAL MUSCLE CONTRACTION MECHANISM

Describe the structure and characteristics of Skeletal muscles

Enlist the contractile filaments and their molecular characteristics

Describe the Sliding mechanism and Walk Along theory

Differentiate between slow and fast muscle fibers

Define Motor Unit, Muscle tone, Muscle fatigue, Muscle Hypertrophy, and Atrophy, effects of Muscle Denervation, Rigor Mortis

Lecture

Explain skeletal muscle structure &contraction

Presentation

Discuss structure of skeletal muscle and theories of muscle contraction Small Group Discussion


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SUMMATION & TETANIZATION

Illustrate the summation and tantalization through Kymograph

Practical

NMJ/TRANSMISSION

Define and explain the structure and function of Neuromuscular Junction

Lecture

Discuss neuro-muscular Junction


DISORDERS OF NEUROMUSCULAR TRANSMISSION I

Describe Myasthenia Gravis and Lambert-Eaton syndrome

Lecture

Discuss Rigor Mortis

CBL

DISORDERS OF NEUROMUSCULAR TRANSMISSION II

Explain the excitation-contraction coupling

Describe the drugs that effect nerve transmission at NMJ

Lecture

MUSCLE ADAPTATION TO EXERCISE/MUSCLE METABOLISM

Describe the muscle adaptation to exercise

Lecture

MUSCLE BULK POWER AND TONE OF MUSCLE

Measure the muscle bulk power and tone of muscle on the Human Subject

Practical

SUPERFICIAL & DEEP TENDON REFLEXES

Demonstrate the superficial and deep tendon reflexes

Practical

PHYSIOTHERAPY


OBJECTIVES STRATEGY CORRELATE THE CLINICAL MANIFESTATION OF SHOULDER REGION

Explain functions of important muscles, ligaments and nerves supply of upper limb

Identify different structures responsible for any shoulder problem e.g. winging of scapula, dropping of shoulder

Discuss different structures, which can lead to shoulder problems

Discuss the benefits of Exercises in the management of shoulder problems

Small Group Teaching

DIFFERENTIATE BETWEEN NORMAL AND ABNORMAL KNEE JOINT

Discuss important functions of different muscles, ligaments and nerves for knee stability and its dynamic function

Explain most commonly knee problem that can limit the daily life activities

Clinically differentiate between normal and abnormal knee

Discuss the benefits of Exercises in the management of knee problems



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ENUMERATE THE MUSCLES AND JOINTS OF UPPER LIMB INVOLVED IN DAILY LIFE ACTIVITIES

Explain the role of important muscles of upper limb that primarily participate in performing functions of daily activities

Explain the role of major joints in upper limb that provide support to muscles

Discuss the benefits of Exercises in the management of impaired muscle function involved in activities of daily living


RESEARCH & SKILLS DEVELOPMENT


OBJECTIVES STRATEGY LOCALIZATION OF UPPER LIMB VEINS FOR DRAWING BLOOD

Know the different indications of I/V Cannulation

Select the appropriate size of cannula for effective use

Demonstrate technique of venous engorgement (via use of venous tourniquets, dependent positioning, “pumping” via muscle contraction) for localization of vessels

Demonstrate proper technique of I/V Cannulation to minimize damage to layers of vessel walls and reduce the risk of PHELIBITIS


FIRST AID SKILLS

Know how to stop visible bleeding

Apply Bandaging skills

Use tourniquets

Take care of amputated digit

Provide First Aid Care in Head Neck and Spine Injuries

Apply Splints


RHEUMATOLOGY


OBJECTIVES STRATEGY ARTHRITIS

Identify the common musculoskeletal findings in arthritis

Lecture

GOUT

Identify clinical findings along with radiological and lad abnormalities

CBL


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PRACTICALS & SKILLS:

Microscopic Anatomy

1. Bone

2. Cartilage

3. Muscle

Surface anatomy of upper and lower limb

Movement of joint of upper and lower limb

Nerve lesions of brachial and lumbosacral plexus

Introduction to Power Lab

EMG

NCV

Summation &Tetanization

Superficial and deep reflexes

Measurement of Bulk, power and tone

Estimation of Ca in Serum

Estimation of PO4 in Serum

Role of colorimeter in Lab

Estimation of Alk.Po4 in Serum

Demonstrate first aid-skill in simulated environment


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LEARNING RESOURCES

SUBJECT RESOURCES

ANATOMY

A. GROSS ANATOMY 1. K.L. Moore, Clinically Oriented Anatomy 2. Neuro Anatomy by Richard Snell

B. HISTOLOGY 1. B. Young J. W. Health Wheather’s Functional Histology 2. Langman’s Medical Embryology

C. EMBRYOLOGY 1. Keith L. Moore. The Developing Human 2. Langman’s Medical Embryology

BIOCHEMISTRY

A. TEXTBOOKS 1. Harper’s Illustrated Biochemistry 2. Lehninger Principle of Biochemistry 3. Biochemistry, Devlin

COMMUNITY MEDICINE

A. TEXT BOOKS 1. Community Medicine Parikh 2. Community Medicine by M Illyas 3. Basic Statistics for the Health Sciences by Jan W Kuzma

PATHOLOGY/MICROBIOLOGY

A. TEXT BOOKS 1. Robbins & Cotran Pathologic Basis of Disease, 9th edition. 2. Rapid Review Pathology, 4th edition by Edward F. Goljan MD

1. http://library.med.utah.edu/WebPath/webpath.html 2. http://www.pathologyatlas.ro/

PHYSIOLOGY

A. TEXTBOOKS 1. Textbook Of Medical Physiology By Guyton And Hall 2. Ganong ‘ S Review Of Medical Physiology 3. Human Physiology By Lauralee Sherwood 4. Berne & Levy Physiology 5. Best & Taylor Physiological Basis Of Medical Practice

B. REFERENCE BOOKS 1. Guyton & Hall Physiological Review 2. Essentials Of Medical Physiology By Jaypee 3. Textbook Of Medical Physiology By InduKhurana 4. Short Textbook Of Physiology By Mrthur 5. NMS Physiology

CDs/DVDs

Internet Recourses

Skill Lab

Computer Lab

http://www.amazon.com/s/ref=dp_byline_sr_book_1?ie=UTF8&field-author=Edward+F.+Goljan+MD&search-alias=books&text=Edward+F.+Goljan+MD&sort=relevancerank


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MODULAR EXAMINATION RULES & REGULATIONS (LNH&MC)

Student must report to examination hall/venue, 30 minutes before the exam.

Exam will begin sharp at the given time.

No student will be allowed to enter the examination hall after 15 minutes of scheduled

examination time.

Students must sit according to their roll numbers mentioned on the seats.

Cell phones are strictly not allowed in examination hall.

If any student is found with cell phone in any mode (silent, switched off or on) he/she will be not

be allowed to continue their exam.

No students will be allowed to sit in exam without University Admit Card, LNMC College ID Card

and Lab Coat

Student must bring the following stationary items for the exam: Pen, Pencil, Eraser, and

Sharpener.

Indiscipline in the exam hall/venue is not acceptable. Students must not possess any written

material or communicate with their fellow students.


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SCHEDULE:

WEEKS 1ST YEAR SEMESTER 2 MONTH

WEEK 1

LOCOMOTOR MODULE

8th July 2015

WEEK 2

WEEK 3

WEEK 4

WEEK 5

WEEK 6

WEEK 7

WEEK 8

MODULAR EXAM Mid August 2015*

WEEK 1

RESPIRATORY MODULE

WEEK 2

WEEK 3

WEEK 4

WEEK 5

WEEK 6

MODULAR EXAM

WEEK 1

CVS MODULE

WEEK 2

WEEK 3

WEEK 4

WEEK 5

WEEK 6

MODULAR EXAM

PREPARATORY LEAVE

SEMESTER EXAM

RETAKE *Final dates will be announced later.

Documents

LIAQUAT NATIONAL MEDICAL COLLEGE 1 YEAR … .pdf · liaquat national medical college st1 year mbbs, ... professor amir ali ... liaquat national medical college st1 year mbbs, semester