Multan Medical & Dental College

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Multan Medical & Dental College

3rd

YEAR MBBS CURRICULUM 2020- 2021

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PATRON:

Mr. Imran Rasool Chief Operating Officer

Multan Medical and Dental College

CURRICULUM COMMIITTEE:

Dr. Tanveer Jahan

(Professor Obs & Gynae) Chairman

Dr. M. Awais Khan

(Assistant Professor DME) Secretary

MEMBERS:

Dr. Kamran Ameer (Associate Professor)

Dr. Sakina Joiya (Demonstrator)

EDITED AND COMPILED BY:

Dr. Sakina Muhammad Joiya

ASSISTANCE:

Dr. Mirza M. Hassan

Dr. Aman Fatima

Dr. Asad Ali

Multan Medical & Dental College

MBBS CURRICULUM 2021- 2022

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Prof. Dr. Shabbir Ahmad Nasir

Chief Executive & Principal Multan Medical

& Dental College

Avicenna once said ―The extraordinary faith put in oneself &

in one’s creator, as one takes the very first step for a new

journey, shall mark itself as a milestone to one’s eternal

glory‖. This was my vision and that of my team to provide

quality medical education to the students at Multan Medical

& Dental College, when we laid the foundation stone of this

nascent Alma Mata, seven years ago. This college has come

of a small age in terms of years but we feel a genuine pride

to see that it is fledgling with powerful wings to embark towards its destination of eternal glory in the

field of quality medical education. A journey, which apparently seemed to be less promising at the

beginning, has now turned into a story of achievements at every front. It is indeed a matter of immense

pleasure to welcome applications for the Seven batch at Multan Medical & Dental College with a mission

to impart profound quality medical education.

In consonance with the vision of the Government to extend healthcare to all segments of society and

groom the best quality medical professionals, Multan Medical & Dental College has responded positively

well to this national cause. We have taken the pledge to keep serving this noble mission and prove our

credentials as a beacon so that our nation reposes its full confidence in our commitment to excellence.

Besides providing quality education, based on modern teaching techniques, I am sure the college shall

also develop a strong spectrum of research-oriented activities. Owing to a top-class faculty, supported by

a 600-bedded modern hospital, Ibn-e-Siena Hospital & Research Institute, I am confident that its

graduates shall emerge as doctors upholding the highest intellectual, professional & social values.

Institutions are developed through professional acumen and commitment to the cause. My advice to the

students & faculty alike is to leave no stone unturned to keep on bringing laurels to themselves and this

institution as they have done it in their initial trials. In their endeavors, they shall always find me at their

back to provide them a genuine direction and elan to help channel their energies into a glorious outcome.

I wish the best of luck to all those who are associated with this project for the fulfillment of this already

being realized dream.

MESSAGE FROM PRINCIPAL

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MULTAN MEDICAL & DENTAL COLLEGE

MISSION STATEMENT

To Produce Professionally Competent, Research Oriented Health Care Providers, Through

Modern Medical Education, Meeting the Local And Global Needs And Committed To Serve

Humanity

VISION

Working in Consonance with the vision of UHS, the Federal and provincial Health Authorities to

groom best quality Medical Professionals by providing the best quality Education based on

Modern Teaching Techniques. Also, committed to develop a strong spectrum of research-

oriented activities.

Envisaging an example in eliminating Health disparities faced by the different strata of the

society by finding their solution through research and execution of Public Health Programs.

OUTCOMES

By the end of (MBBS/BDS) program the graduates of MM&DC will be able to:

1. Perform various basic Medical/Surgical and Dental procedures independently.

2. Demonstrate Knowledge and comprehension of common Medical/Surgical and Dental

procedures.

3. Assist in management of Critically ill patient.

4. Manage common non critical conditions Independently.

5. Demonstrate professional, ethical and culturally appropriate behavior.

6. Advocate health promotion and disease prevention.

7. Involve in research programs.

8. Quality Outcomes:

Develop a habit of reflection, critical thinking and applying the knowledge to reach the level of

Creativity.

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Multan Medical and Dental College is grateful to its faculty

for their contribution in the

preparation of the Curriculum.

&

The College is also thankful to

faculty and students for their

feedback and suggestions.

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Contents MESSAGE FROM PRINCIPAL .......................................................................................................................... 3

CURRICULUM COMMIITTEE .......................................................................................................................... 8

DEFINITIONS AND ABBREVIATIONS ............................................................................................................ 10

ASSESSMENT POLICIES ................................................................................................................................ 11

PROMOTION POLICIES ................................................................................................................................ 14

YEARLY DISTRIBUTION OF SUBJECTS .......................................................................................................... 15

SUBJECT ....................................................................................................................................................... 16

ORGANOGRAM ........................................................................................................................................... 17

INTRODUCTION .................................................................................................................................. 18

TEACHING STRATAGIES ............................................................................................................................... 19

TEACHING ENVIRONMENT .......................................................................................................................... 20

SUBJECT OUTCOMES ................................................................................................................................... 21

SYLLABUS .................................................................................................................................................... 23

SCHEME OF STUDIES ................................................................................................................................... 35

TABLE OF SPECIFICATIONS .......................................................................................................................... 36

LEARNING OBJECTIVES ................................................................................................................................ 37

TEACHING AND ASSESSMENT STRATAGIES ................................................................................................ 37

The Cell as a Unit of Health and disease ................................................................................................ 37

Cellular Responses to Stress and Toxic Insults: Adaptation, Injury, and Death ..................................... 38

Inflammation and Repair ........................................................................................................................ 39

Tissue Repair .......................................................................................................................................... 40

Hemodynamic disorders Thromboembolic Disease and shock .............................................................. 41

Genetics .................................................................................................................................................. 42

Neoplasia ................................................................................................................................................ 43

General Bacteriology .............................................................................................................................. 44

General virology ..................................................................................................................................... 45

Special virology ...................................................................................................................................... 46

DNA Non-enveloped virus ..................................................................................................................... 46

RNA enveloped virus .............................................................................................................................. 46

Hepatitis virus ......................................................................................................................................... 46

Arbovirus ................................................................................................................................................ 47

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Mycology ................................................................................................................................................ 47

Parasitology............................................................................................................................................. 47

Immunology ............................................................................................................................................ 48

Special bacteriology ................................................................................................................................ 49

Practical Work ........................................................................................................................................ 51

TIMETABLE .................................................................................................................................................. 52

ASSESSMENT SCHEDULE ............................................................................................................................. 52

BATCHES ALLOCATIONS .............................................................................................................................. 52

WARD PRE-REQUISITES ............................................................................................................................... 52

LEARNING RESOURCES ................................................................................................................................ 52

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The Curriculum Committee for session 2020-21 is hereby notified as under:

Curriculum Committee

Sr. # Name Designation Department

1. Dr. Tanveer Jahan

(Professor Obs & Gynae) Chairman Clinical Sciences

2. Dr. M. Awais Khan

(Assistant Professor) Secretary Medical Education

3. Dr. Sakina Joiya Member Medical Education

4. Dr. Kamran Ameer

(Associate Professor of Anatomy) Member Basic Sciences

5. Dr. Khalid

(Professor) Member Community Medicine

6. Dr. Asif Mughal

(Assistant Professor) Member Behavioral Sciences

7. Waleed Ahmad Member Student Representative

8. Muhammad Bilal Member Student Representative

9. Hasnat Sahu Member Student Representative

CURRICULUM COMMIITTEE

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The following faculty members were involved

in the process of documentation of curriculum

at various stages

1. Prof. Dr. Muhammad Ijaz Alam

2. Dr. Nudrat Fayyaz

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DEFINITIONS Definitions of the following terms used in the Curriculum Document have been

taken from HEC Guidelines.

CREDIT HOURS:

1. A credit hour means teaching a theory course of 50 minutes each week throughout the year

(1 lecture of 50 minutes = 1 credit hour).

2. One credit hour in laboratory or practical work / project would require lab contact of two

hours per

week throughout the year

Credit Hours:

15 MIN OF INFORMATION TRANSFER/ LEARNING=0.25 HRS

30 MIN OF INFORMATION TRANSFER/ LEARNING =0.5 HRS

45 MIN OF INFORMATION TRANSFER/ LEARNING =0.75 HRS

60 MIN OF INFORMATION TRANSFER/ LEARNING =1 HR

ABBREVIATIONS

KEY: SEQ:

SAQ:

MCQ:

SGD:

PBL:

CBL:

SBL:

OSPE:

OSCE:

HEC:

PMC:

DME:

SC:

Short Essay Questions

Short Answer Questions

Multiple Choice Questions

Small Group Discussion

Problem Based Learning

Case Based Learning

Scenario Based Learning

Objective structured Practical Evaluation

Objective structured Clinical Evaluation

Higher Education Commission

Pakistan Medical Commission

Department Of Medical Education

Short Cases

DEFINITIONS AND ABBREVIATIONS

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Examinations are of two kinds:

I) Internal Examinations

II) University Examinations

I) Internal Examinations

Send Up examinations shall be compulsory for students of all classes. Students who do not

appear or fail in the examination will be regarded as students whose courses of instructions

are incomplete and unsatisfactory and will not be allowed to appear in the university

professional examination for promotion to the next higher class and may also loose the

scholarship, if any, granted to them.

Pass percentage for Send up examinations is 50%.

i) First Year M.B.B.S. There will be send up examination in the subjects of Anatomy,

Physiology and Biochemistry. Students will not be allowed to sit in the University

Examination if they fail in any of the subjects in the send up examination.

ii) Second Year M.B.B.S. There will be send up examination in the subjects of Anatomy,

Physiology and Biochemistry. Failed Students will not be allowed to sit in the University

Examination if they fail in any of the subjects in the send up examination.

iii) Third Year M.B.B.S. There will be one send up examination. The subjects will be: -

1. Pharmacology and Therapeutics

2. Forensic Medicine and Toxicology

3. General Pathology/Microbiology and Parasitology

4. Behavioural Sciences

5. Clinical Methods in Surgery

6. Clinical Methods in Medicine

All subjects will be compulsory for the purpose of examination but only those students will

be detained from appearing in the University Examination who fail in any of the first four

subjects.

iv) Fourth Year M.B.B.S. There will be send up examination in the following subjects: -

1. Special Pathology/Systemic Pathology

2. Community Medicine

3. Ophthalmology

4. Otorhinolaryngology

5. Medicine

6. Surgery

7. Obstetrics &Gynecology

The students will be allowed to sit the University Examination only if they clear at least the

first four subjects.

ASSESSMENT POLICIES

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v) Final Year M.B.B.S. The send up examination will be conducted in the following

subjects:

1. Medicine & Allied Specialties including Psychiatry and Dermatology

2. Surgery & Allied Specialties including Orthopedics and Anesthesia etc.

3. Obstetrics &Gynecology

4. Pediatrics

The students will be allowed to appear in the University Examination only if they pass in all

subjects.

NOTE:

1. During the clinical years, the progress of the students will be judged from the remarks of

the respective Professor on the Clinical Record Cards. Those students, whose cards show

unsatisfactory work during any of their clinical assignments, will be detained from appearing

in the final professional examination of the university.

2. A duplicate record of Clinical Card of each student will be kept in the office of the

concerned Professor.

3. Ten percent (10%) of marks of university examinations are based on internal assessment.

4. Remanded students will not be detained from the University examination if they have

fulfilled the required percentage of attendance and have satisfactory report from the

respective professor for their work during the terms, in question.

5. Certificate of Honor is awarded by the college to the student who obtains 75% or more

marks in a subject of Send Up examination of the year provided he/she does not get less than

50 percent marks in other subjects of the same examination.

Regulations for Internal Assessment

(i) The weightage of internal assessment shall be 10% in all subjects. 5% internal assessment

marks shall be added to the aggregate score of Theory and 5% internal assessment marks to

aggregate score of Oral and Practical Examination and not to an individual component like

MCQs, SEQs Paper or Oral /

Practical / Clinical Examination.

(ii) Continuous internal assessment shall consist of evaluation at the end of each assignment,

e.g. stages/sub-stages, class tests etc., attitudinal assessment from educational and or clinical

supervisors, clinical skill assessment from clinical supervisors, and Year’s work books.

(iii) Assessment of Knowledge, Skills and Attitude shall contribute towards internal

assessment. Methods used to assess these domains shall include Multiple Choice Questions,

Short essay questions, Oral/Viva, and Practical Clinical examinations.

(iv) The score of internal assessment shall contribute 10% to final examination and final

university examination of each subject shall contribute 90% to total score, and the candidate

shall pass in aggregate.

(v) Awards of internal assessment in all the subjects of all the candidates shall be submitted

to the Controller of Examinations along with Admission Forms for the annual examination.

Internal assessment received after commencement of the final examination shall not be

accepted.

(vi) The marks of internal assessment shall be submitted only once a year prior to annual

examination and the same shall be counted both for annual and supplementary examinations.

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It is further emphasized that fresh assessment or a revision of assessment for supplementary

examination shall not be permissible.

(vii) Proper record of continuous internal assessment shall be maintained by respective

departments of the medical/dental colleges.

(viii) Internal assessment awarded in particular year may not be decreased subsequently

detrimental to the candidate.

II) University Examinations

University Examinations are strictly governed by the statutes and regulations of the

University

A) MBBS

i) First Professional M.B.B.S Examination will be held at the end of first academic year.

NOTE: Any student who fails to clear the 1st Professional M.B.B.S. examination in four

chances, availed or un-availed, after becoming eligible for each examination and has been

expelled on that account shall not be eligible for continuation of medical and dental studies

of MBBS and BDS in subsequent professional examinations.

ii) Second Professional M.B.B.S Examination held at the end of second academic year.

iii) Third Professional M.B.B.S Examination will be held at the end of third academic year.

iv) Fourth Professional M.B.B.S Examination will be held at the end of fourth academic year.

v) Final Professional M.B.B.S. Examination will be held at the end of fifth academic year.

NOTE: Any student who fails to clear the 1st Professional M.B.B.S. examination in four

chances, availed or un-availed, after becoming eligible for each examination and has

been expelled on that account shall not be eligible for continuation of medical and

dental studies of MBBS and BDS in subsequent professional examinations.

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1. Minimum attendance and satisfactory completion of the log book is required for a

student to be eligible for Certifying Examination(s).

2. Formative and Summative Assessment: The same tools may be used for formative or

summative assessment. Formative Assessments will be used only for feedback to

develop the learners, while Summative Assessments will be used to make pass/fail or

progress decisions). Any assessment where the results contribute to a final score,

which leads to a decision of

the progress of the student, must be considered summative.

3. Summative Assessment consists of the sum of the Continuous Assessment score

(Internal assessment based on assessment of student performance during the module

or clerkship) and end of year University Examination.

4. University Examinations will be held at the end of each

academic year

PROMOTION POLICIES

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YEAR WISE DISTRIBUTION OF SUBJECTS:

1ST YEAR 2ND YEAR 3RD YEAR 4TH YEAR 5TH

YEAR

General

Anatomy

Histology

and

Embryology

General

Anatomy

Histology and

Embryology

Pharmacology

and therapeutics

ENT Gynecology

Physiology Physiology Forensic

Medicine and

Toxicology

Ophthalmology Pediatrics

Bio-

Chemistry

Bio-Chemistry General

Pathology

Special Pathology Surgery

Pak Studies

and

Islamiyat /

Ethics

Behavioural

Sciences

Community

Medicine

Medicine

YEARLY DISTRIBUTION OF SUBJECTS

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General Pathology

Immunology

Parasitology

SUBJECT

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Head of Department Prof. Dr. Muhammad Ijaz Alam

Professor Dr. Iqbal Hussan Malik

Dr. Riaz Hussain Malik

Dr. Ayaz Saleem Ghauri

Associate Professor Dr. Naeem Gogi

Dr. Afra Samad

Assistant Professor Dr. Naseem Akhtar

Dr. Nudrat Fayyaz

Senior Registrar

Admin Registrar

Demonstrators Ms.Aqs

a

Dr.

Safia

Dr.

Zara

Dr.

Sahar

Dr.

Rizwan

Dr.

Bashir

Dr.

Ifrah

Ms.Maria Dr. Amber

Paramedical Staff

ORGANOGRAM

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INTRODUCTION

Pathology is a medical specialty that determines the cause and nature of diseases by examining and

testing body tissues (from biopsies and pap smears, for example) and body fluids (from samples including

csf, blood and urine). The results from these pathology tests help doctors diagnose and treat patients

correctly.

From the birth we rely on pathology tests such as on blood tests, biopsies and a multitude of other

pathology tests to prevent, diagnose and treat infections, allergies, chronic diseases, cancers and countless

other medical conditions. Read more about the most common pathology tests.

As a matter of fact, pathology serves as a backbone to the knowledge of medicine.

Course intended learning outcomes

This subject also contributes specifically to the development of following course intended

learning outcomes: An understanding of the nature, practice and application of the chosen

science discipline. Encompasses problem solving, critical thinking and analysis attributes and an

understanding of the scientific method for knowledge acquisition. The ability to acquire,

develop, employ and integrate a range of technical, practical and professional skills, appropriate

and ethical ways within a professional context, autonomously and collaboratively and across a

range of disciplinary and professional areas, e.g. time management skills, personal organization

skills, teamwork skills, computing skills, laboratory skills, data handling, quantitative and

graphical literacy skills. An awareness of the role of science within a global culture and

willingness to contribute actively to the shaping of community views on complex issues where

the methods and findings of science are relevant. An understanding of the different forms of

communications, writing, reading, speaking & listening - including visual and graphical, within

science and beyond and the ability to apply these appropriately and effectively for different

audiences.

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The educational strategies in this curriculum are multiple and aligned with domain of learning

and according to the desired outcome

Interactive lectures

One-third of the curriculum will be delivered in a traditional didactic format including

PowerPoint presentations and case discussions. Didactic education is considered to be a one-way

transmission of material from teacher to learner, we cannot overlook the possibility of

meaningful interaction between experts and learners during live lectures. This type of interaction,

which allows for immediate clarification of concepts and extension of knowledge, may be

particularly important for novice learners who have relatively little exposure to the subject

matter, such as our study population.

Small Group Discussion

Small group discussion provides a unique environment to achieve high standards in medical

education. Activation of prior knowledge, exchange of ideas, and engagement at a higher

cognitive level are assumed to result in deeper learning and better academic achievements by

students.

Self- directed learning

Students' take 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 or afterwards for self-study.

Power Point Presentations

Power point Presentations on various topics are assigned to the students which will increase their

knowledge and build their confidence.

CBL

Using a case-based approach engages students in discussion of specific scenarios that resemble

or typically are real-world examples. This method is learner-centered with intense interaction

between participants as they build their knowledge and work together as a group to examine the

case.

Assignments

TEACHING STRATAGIES

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Students are given written formative assignments on designated topics. Revision of the topics

already covered by anatomy and physiology departments are given to students as oral

presentations.

Tutorials/Demonstrations

A tutorial, in education, is a method of transferring knowledge and may be used as a part of a

learning process. More interactive and specific than a book or a lecture, a tutorial seeks to teach

by example and supply the information to complete a certain task.

Lecture Halls

Pathology Museum

Pathology Laboratory

TEACHING ENVIRONMENT

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Goals The board goal of the teaching of undergraduate student in pathology is to provide the

students with a comprehensive knowledge of the mechanisms and causes of disease, in

order to enable him/her to achieve complete understanding of the natural history and

clinical manifestations of disease. The aim 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.

Outcomes At the end of this curriculum the student should be able to:

KNOWLEDGE:

1. Describe the structure and ultrastructure of an abnormal cell, mechanisms of cell

degeneration, cell death and repair.

2. Correlate structural and functional alterations in abnormal cell.

3. Explain the pathophysiology processes which govern the maintenance of

hemostasis, mechanisms of their disturbance and the morphology and clinical

manifestations associated with it.

4. 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.

5. Correlate 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.

SKILL:

1. Describe the rationale and principles of technical procedures of the

diagnostic laboratory tests and interpretation of the results.

2. Understand biochemical/physiological disturbances that occur as a result of

disease in collaboration with pre-clinical departments.

3. Identify the common infectious agents with the help of laboratory procedures

and use antimicrobial sensitivity tests to select antimicrobial agents.

4. Perform tests for detection of infectious agents such as blood film for

malaria, gram staining and AFB staining and stool sample for OVA cyst.

ATTITUTE:

Demonstrate ability to give and receive feedback, respect for self and peers.

Demonstrate empathy and care to patients while collecting samples

Develop respect for the individuality and values of others - (including having

respect for oneself) patients, colleagues and other health professionals

Organize& distribute tasks

Exchange opinion & knowledge

Develop communication skills and etiquette with sense of responsibility

SUBJECT OUTCOMES

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Demonstrate professional and ethical behavior by honestly completing course

examinations without attempting to seek an advantage by unfair means; and by

reporting any unethical behavior of peers to the course administration.

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CELL INJURY

1. Necrosis, Ischemia, Hypoxia, Infarction and Gangrene Oncosis and Autolysis.

2. Sequence of the ultrastructural and biochemical changes which occur in the cell in response to

the following:

Ischemia

Immunological injury, e.g., Asthma / SLE / Anaphylactic reaction

Physical agents, e.g., Radiation

Genetic defects, e.g., Thalassemia / Hemophilia

Nutritional deficiency, e.g., Kwashiorkor

Infectious agents

Viruses, e.g., Hepatitis

Bacteria, e.g., Staphylococcus aureus

Fungi, e.g., Candida

Parasites, e.g., Malaria

Nutritional deficiency

3. Irreversible and reversible injury

4. Apoptosis and its significance.

5. Necrosis and its types

6. Exogenous and endogenous pigmentation.

7. Dystrophic and metastatic calcification along with clinical significance.

8. Metabolic disorders

• Lipid disorders, Steatosis of liver, Hyperlipidemia

• Protein disorders

• Carbohydrate disorders

9. Cellular Adoptations

SYLLABUS

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INFLAMMATION, MEDIATORS OF INFLAMMATION

1. Role of inflammation in the defense mechanisms of the body.

2. Vascular changes of acute inflammation and their relation to morphological and tissue

effects.

3. Molecular basis of cellular events.

4. Process of Chemotaxis, Opsonization and Phagocytosis.

5. Role of cellular components in inflammatory exudate.

6. Exudates and transudate.

7. Important chemical mediators of inflammation.

8. Pathway of Arachidonic Acid metabolism.

9. Systemic effects of inflammation of possible outcomes.

10. Role of products of Arachidonic acid metabolism in inflammation.

11. Mechanism for development of fever, with reference to exogenous and endogenous

pyrogens.

12. Morphologic patterns in inflammation

13. Chronic inflammation including Granulomas.

14. Granuloma and its types along with causes.

15. Systemic effects of acute and chronic inflammation and their possible outcomes.

16. Significance of ESR.

17. Induced hypothermia in medicine.

WOUND HEALING

1. Repair and regeneration.

2. Wound healing by first and second intention.

3. Factors that influence the inflammatory reparative response.

4. Wound contraction and cicatrisation.

5. Formation of granulation tissue.

6. Complications of wound healing.

7. Healing in specialized tissue.

DISORDERS OF CIRCULATION

a. Thrombo-embolic disorders and their modalities

1. Etiology and pathogenesis of thrombosis.

2. Possible consequences of thrombosis

3. Difference between thrombi and clots

4. Classification of emboli according to their composition.

5. Difference between arterial and venous emboli.

b. Hemorrhage, Hyperemia and Congestion

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1. Definitions of common types of Hemorrhage

2. Types of hyperemia

3. Difference between hyperemia and congestion

c. Infarction

1. Types of infarction

2. Difference between anemic and hemorrhagic infarct

3. Morphological picture of infraction in different organ systems

d. Disorders of the circulation and shock

1. Edema, ascites, hydrothorax and anasarca.

2. Pathophysiology of edema with special emphasis on CHF.

3. Pathogenesis of four major types of shock (Hypovolemic, cardiogenic, vasovagal &

septic) and their causes.

4. Compensatory mechanisms involved in shock.

MICROBIOLOGY

1. Defense mechanisms of the body.

2. Microbial mechanisms of invasion and virulence.

3. Difference between sterilization and disinfection.

4. Methods of disinfection and sterilization of the following:

a. Facility where the doctor practices,

b. Examination table,

c. Any spillage e.g. sputum, vomitus, stool, urine, blood,

d. Examination tools, e.g., thermometer, nasal and ear specula and spatula,

5. Principles of aseptic techniques such as Venepuncture, urinary

catheterization, bandaging, suturing and lumber puncture.

6. Universal precautions for infection control.

7. General principles of the following serological tests:

a. ELISA – Hepatitis (A,B,C,D,E,G) Rubella, CMV and HIV

b. PCR

c. Haemagglutination – TPHA

d. Western Blot –HIV

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e. Malaria.

8. Interpretation of :

a. Culture reports

b. Serological reports and

c. Microscopic reports of gram stain and ZN stain.

9. Principles of proper collection and submission of specimens for laboratory investigations

10. General characteristics and taxonomy of Bacteria, Rickettsia, Chlamydia, Viruses and Fungi.

11. Communicable, Endemic, Epidemic, and Pandemic Diseases, Carriers Pathogens,

Opportunists, Commensals and Colonizers.

12. Microorganisms responsible for infection of the following organ systems:

• Central Nervous System

• Respiratory System

• Gastrointestinal System

• Genital System

• Urinary System

• Infections of Bones and Joints

• Zoonosis

• Infection of the Skin

• Hepatic Infections

13 Pathogenesis, Treatment, Epidemiology, Prevention and Control of the following organisms:

(i) Bacteria

• Staphylococcus aureus

• Streptococcus pneumoniae

• Beta hemolytic streptococcus group a & b

• Diphtheria sp.

• Bordetella sp.

• Bacillus anthracis

• Clostridium perfrignes

• Clostridium botulinum,

• Clostridium difficile

• Clostridium tetani

• Actinomycies israelli

• Nocardia asteroides

• Neisseria meningitis

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• Neisseria gonorrhoeae

• Gardenella vaginalis

• Haemophilus influenzae

• Mycobacterium tuberculosis

• Mycobacterium leprae

• E.coli

• Klebsiella

• Proteus

• Salmonella

• Shigella

• Yersinia pestis

• Pseudomonas

• Vibrio cholera

• Vibrio parahemolyticus

• Campylobacter jejuni

• Helicobacter pylori

• Legionella

• Mycoplasma pneumoniae

• Chlamydia

• Treponema pallidium

• Leptospira

• Rickettsia sp.

(ii) Viruses

• Mumps

• Herpes

• Measles

• Influenza,

• Para influenza

• RSV

• Hepatitis A, B, C, D, E

• Rota

• CMV

• EBV

• Rubella

• Chicken Pox

• HIV

• Rabies

(iii) Fungus

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• Cryptococcus neoformans

• Candida albicans

• Tinea species

(iv) Protozoa

• Plasmodium species

• Giardia lamblia

• Entamoeba histolytica

• Cryptosporidium

• Leishmania species

• Trichomonas vaginalis

• Toxoplasma gondii

• Pneumocyctis carinii

(v) Helminths

• Ascaris lumbricoides

• Ancylostoma duodenale

• Trichuris trichuria

• Enterobius vermicularis

• Filaria species

• Strongyloides stercoralis

• Schistosoma species

• Echinococcus species

• Taenia solium

• Taenia saginata

• Hymenolepis nana

• Drancanculus medinences

PRINCIPLES OF ANTI MICROBIAL ACTION.

1. Antibiotics, selective toxicity, bacteriostatic and bactericidal.

2. Host determinants in relation to selection of an antimicrobial drug for therapy.

3. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC)

4. Bacterial resistance and the mechanisms involved in acquiring bacterial resistance

5. Mechanisms involved in transfer of drug resistance to bacterial resistance.

6. Mode of action of various antimicrobial drug groups.

7. Superinfection and cross sensitivity.

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LIST OF COMMON ORGANISMS CAUSING ORGAN SYSTEM EFFECTS

a. Common organisms causing CNS Infections

(i) Bacteria

• Steptococcus pneumoniae

• Beta hemolyticus streptococcus group b

• Neisseria meningitidis

• Haemophilis influenzae

• Mycobacterium tuberculosis.

• E.coli

• Listeria monocytogenes

(ii) viruses

• Enterovirus

• Mumps

• Herpes

• Adenovirus

• Fungus

• Cryptococcus neoformis

(iv) protozoa

• Malaria

• Toxoplasma

B. Common organisms causing respiratory tract infection

(i) bacteria:

• Steptococcus pneumoniae

• Beta hemolyticus streptococcus group b

• Diptheria sp.

• Bordetella sp.

• Hemophilus influenzae

• Mycobacteriurn tuberculosis

• Klebsiella

• Legionella

• Mycoplasma pneumoniae

(ii) viruses

• Herpes

30

• Adeno virus

• Measles

• Influenza

• Para influenza

• Rhinovirus

• RSV

(iii) protozoa

• Pneumocystic carinii

C. Organisms causing gastrointestinal tract infection / infestation

(i) Bacteria

• Clostridium difficile


• Salmonella

• Shigella

• Vibrio cholera

• Vibrio parahemolyticus

• Campylobacter jejuni

• Helicobacter pylori

(ii) Viruses

• Hepatitis A

• Rota

• Astro

(iii) Fungus

• Cryptococcus neoformis

(vi) Protozoa

• Giardia lamblia

• Entameba histolytica

• Cryptosporidium

D. Common organisms causing hepatic infections

(i) Bacteria

• Streptococcus species

31

• Coliforms

• Anaerobes

(ii) Viruses

• Herpes

• Hepatitis A, B, C, D, E

• CMV

• EBV

(iii) Protozoa

• Entameba histolytica

• Tape worms

• Echinococcus granulosus

E. Common organisms causing skin infection

(i) bacteria

• Staphylococcus aureus

• Streptococcus pyogenes

• Actinomyces israelli

• Nocardia asteroides


• Mycobacterium leprae

• Corynebacterium diphtheriae

(ii) viruses

• Herpes

• Measles

• Rubella,

• Chicken pox

• Moluscum contagiosum

(iii) fungus

• Candida albicans

• Tinea species

(iv) arthropodes

32

• Sarcoptes scabiei

• Pediculus species

• Cinex lectularius

(v) helminths

• Filaria species

• Strongyloides stercoralis

• Schistosoma sp.

(vi) protozoa:

• Leishmania species.

• Common organisms causing bone and joint infection

• Bacteria: Staph aureus, Streptococcus pyogenes, Haemophilus

• influenzae, Neisseria gonorrhoeae, Brucella melitenesis, Salmonella

• typhi, Strep. pneumonae, Pseudomonas sp. and Mycobacterium

• tuberculosis.

g. Common organisms causing genital infection

(i) Bacteria: Mycoplasma urealyticum

(ii) Viruses: Pox, Herpes, Hepatitis B, HIV

(iii) Fungus: Candida albicans

(iv) Arthropodes: Sarcoptes scabiei

(v) Protozoa: Tricomonas vaginalis

h. Common organisms causing zoonosis

(i) Viruses: Rabies,

(ii) Protozoa: Toxoplasma gondii, Leishmania sp.

(iii) Helmenthics: Echinococcus sp.

GENETICS

1. Common sex linked, autosomal recessive and autosomal dominant disorders.

2. Common genetic mutations.

33

3. Diseases associated with consanguineous marriages.

4. Molecular biology techniques.

GROWTH DISORERS/NEOPLASIA

1. Atrophy and Hypertrophy, Agenesis, Dysgensis, Aplasia, Hypoplasia, Hyperplasia,

Metaplasia, Dysplasia, Neoplasia, Anaplasia,

2. Cell cycle and cell types (stable, labile, permanent)

3. Mechanisms controlling cell growth

4. Classification systems of tumors.

5. Characteristics of benign and malignant tumors

6. Difference between Carcinoma and Sarcoma.

7. Grading and staging system of tumors.

8. Biology of tumor growth

9. Process of carcinogenesis

10. Host defense against tumors.

11. Mechanism of local and distant spread.

12. Local and systemic effects of tumors.

13. Tumor markers used in the diagnosis and management of cancers.

14. Common chemical, physical agents and viruses related to human cancer.

15. Epidemiology of common cancers in Pakistan.

16. Radiation and its effects on tissues.

17. Cancer screening.

IMMUNOLOGY

1. Antigen, antibody, epitope, hapten and adhesion molecules.

2. Difference between innate and acquired immunity.

3. Structure and function of major histocompatibility complex (MHC).

34

4. Cytokines.

5. Mechanism of humoral and cell medicated immunity.

6. Hypersensitivity reactions, Type I, Type II, Type III and Type IV.

7. Autograft, homograft, allograft and xenograft.

8. Immunotolerance and immunoparalysis.

9. Mechanism involved in allograft rejection and steps that can be taken

to combat rejection.

10. Classification of Immunodeficiency disorders

11. Basis of autoimmunity.

12. Tissue transplantation.

13. Pathology and pathogenesis of AIDS.

14. Lab diagnosis of immunological diseases.

35

Subject 3rd

Year MBBS PMC Requirement Total Hours Achieved

MM&DC

Pharmacology

Test-----------27 Hours

Lecture-------180 Hours

SGD ----------45 Hours

Practical ---- 36 Hours

Tutorial------ 36 Hours

300 Hours 324 Hours

Pathology

Test-----------27 Hours

Lecture------180 Hours

SGD —----- 45 Hours


250 Hours 288 Hours

Forensic Medicine

Test-----------27 Hours




100 Hours 180 Hours

Behavioral Sciences

Test-----------27 Hours



150 Hours 144 Hours

Community Medicine Lecture ------36 Hours ------------ 36 Hours

Surgery

Clinical

Lecture ------18 Hours

Skill Lab ----18 Hours

------------ 36 Hours

Medicine

Clinical

Lecture ------18 Hours

Skill Lab ----18 Hours

------------ 36 Hours

SDL SDL---------- 72 Hours 25 Hours 72 Hours

SCHEME OF STUDIES

36

Sr# Course Content MCQs

1. Cell Injury 04

2. Inflammation and Mediators of Inflammation 06

3. Healing and Repair 02

4. Disorders of Circulation 04

5. Parasitology 05

6. Virology 06

7. General Bacteriology 04

8. Special Bacteriology 14

9. Mycology (Fungi) 04

10. Genetics 02

11. Disorders of Growth 09

12. Immunology 05

Total 65

Sr# Course Content SEQs

1. Acute and Chronic inflammation 01

2. Cellular Adaptations, cell injury and cell death 01

3. Inflammation and Repair 01

4. Disorders of Circulation 01

5. Genetic Disorders 01

6. Neoplasia 01

7. Immunology 01

8. Bacteriology 01

9. Bacteriology (Mycobacterium) 01

10. Parasitology 01

11. Virology 01

12. Mycology 01

13. Disorders of Circulation

Total SEQs 14 SEQs

TABLE OF SPECIFICATIONS

37

TOPIC LEARNING OBJECTIVES Interactiv

e Lectu

re

SG

D

SD

L

CB

L

Bed

side

Skills L

ab

SE

Qs

MC

Qs

Viv

a

At the end of each session, student will be able to:

Knowledge Skill/Attitude Teaching Strategies Assessment

The Cell as a Unit of Health and disease 1.

Introduction to

Pathology

-Define pathology

-Describe the four aspects of

pathology

1. Etiology

2.Pathogenesis

3.Morphology

4. Clinical manifestations

* * * * * *

2.

Cellular

Housekeeping

-Describe the structure of

Plasma Membrane

-Describe the components of

Cytoskeleton along with Cell

Interactions

-Describe the Biosynthetic

Machinery of cell

(Endoplasmic Reticulum and

Golgi )

-Describe the structure and

fucntion of Lysosomes and

Proteasomes

-Describe the Cellular

Metabolism along with

mitochondrial function

* * * * * *

3.

Cellular Activation

-Describe Cell Signaling and

its mechanism

-Describe various types of

Signal Transduction Pathways

-Enlist various types Growth

Factors and Receptors with

their function

-Describe the Interaction of

intracellular and the

Extracellular Matrix

* * * * * *

4.

Maintaining Cell

Populations

-Explain the Proliferation and

the Cell Cycle along with

role of inhibitors and inducers

-Describe the role of Stem

Cells in recent medicine

* * * * * *

LEARNING OBJECTIVES

TEACHING AND ASSESSMENT STRATAGIES

38

Cellular Responses to Stress and Toxic Insults: Adaptation, Injury, and Death 5.

Overview: Cellular

Responses to Stress

and Noxious

Stimuli

-Enlist the Stages of the

cellular response to stress and

injurious stimuli.

-Describe the Stages of the

cellular response to stress and

injurious stimuli

* * * * * *

6. Adaptations of

Cellular Growth

And differentiation

-Enlist the types of cellular

adaptations

-Describe the mechanism of

hypertrophy with examples


hyperplasia with examples


atrophy with examples


metaplasia with examples

* * * * * *

7.

Overview of Cell

Injury and Cell

death

-Enlist various Causes of Cell

Injury


Reversible Injury

-Define Necrosis

-Describe various Patterns of

Tissue Necrosis

* * * * * *

8.

Mechanisms of

Cell Injury


Oxidative Stress in the cell

and the injury caused by it

-Describe the defects in

membrane permeability

-Describe the damage to DNA

and proteins

* * * * * *

9.

Clinicopathologic

Correlations


Ischemic and Hypoxic Injury

-Describe the mechanisms of

ischemic cell injury

-Describe the Ischemia-

Reperfusion Injury

-Describe the Chemical

(Toxic) Injury to cell

* * * * * *

10. Apoptosis -Define Apoptosis

* * * * * *

11.

Causes of

Apoptosis

-Describe the process of

apoptosis in physiologic

situations

-Describe the apoptosis in

pathologic conditions

* * * * * *

12.

Morphologic and

Biochemical

Changes in

Apoptosis

Describe

1.The Intrinsic

(Mitochondrial) Pathway of

Apoptosis

2. The Extrinsic (Death

Receptor-Initiated) Pathway

of Apoptosis

-Describe the the execution

phase of apoptosis


removal of dead cells

* * * * * *

39

13. Clinicopathologic

Correlations:

Apoptosis in

Health and Disease

-Describe the examples of

apoptosis

-Describe the disorders

associated with dysregulated

apoptosis


heterophagy and autophagy


Necroptosis with examples

* * * * * *

14.

Intracellular

Accumulations

-Describe the pathogenesis

and morphology of following

intracellular accumulations

1. Lipids Steatosis (Fatty

Change)

2. Cholesterol and Cholesterol

Esters

3. Proteins

4. Hyaline Change

5. Glycogen

* * * * * *

15.

Pigments

-Enlist the types of exogenous

pigments and endogenous

pigments

-Describe the morphological

features of various types of

pigments

* * * * * *

16.

Pathologic

Calcification

-Describe the pathogenesis,

and morphology of

Dystrophic Calcification

-Describe the pathogenesis,

and morphology of Metastatic

Calcification

-Describe the etiology of

Cellular Aging and cellular

senescence

Demonstrate the working of

microscope

* * * * * *

Inflammation and Repair 17.

Overview of

Inflammation:

Definitions and

General Features

-Enlist and briefly describe

Causes of Inflammation

-Explain and Illustrate the

Recognition of Microbes and

Damaged Cells

* * * * * *

18.

Acute

Inflammation

-Describe the reactions of

blood vessels in acute

inflammation

-Describe the changes in

vascular flow and caliber

-Explain mechanism of

increased vascular

permeability

(Vascular Leakage)

-Describe the responses of

lymphatic vessels and lymph

nodes

* * * * * *

19.

Leukocyte

Recruitment to

Sites of

Inflammation


leukocyte adhesion to

endothelium


leukocyte migration through

endothelium


chemotaxis of leukocytes

* * * * * *

20. Phagocytosis and -Describe the mechanism of * * * * * *

40

Clearance of the

Offending Agent

Phagocytosis

-Describe the role of

Intracellular destruction of

microbes and debris

-Define Neutrophil

Extracellular Traps

-Describe the Leukocyte-

mediated tissue injury and

associated defects 21. Termination of the

Acute

Inflammatory

Response

Describe the termination of

the response

* * * * * *

22.

Mediators of

Inflammation

-Describe the role and source

of mediators;

1. Vasoactive Amines:

Histamine and Serotonin

2. Arachidonic Acid

Metabolites

3. Cytokines and Chemokines

4. Complement System

* * * * * *

23.

Morphologic

Patterns of Acute

Inflammation

-Explain the morphological

pattern and example of Serous

Inflammation


pattern and example of

Fibrinous Inflammation



Purulent (Suppurative)

Inflammation, Abscess



Abscess and ulcer

* * * * * *

24. Outcomes of

Acute

Inflammation

-Summarize the events of

Acute Inflammation

* * * * * *

25.

Chronic

Inflammation

-Enlist the Causes of Chronic

Inflammation

-Describe the morphologic

features of chronic

inflammation

* * * * * *

26.

Cells and

Mediators of

Chronic

Inflammation

-Explain the role of

macrophages in chronic

inflammation

-Explain the role of Role of

Lymphocytes

-Enumerate the other cells in

chronic inflammation

* * * * * *

27. Granulomatous

Inflammation

-Describe the etiology,

pathogenesis and morphology

of granuloma

* * * * * *

28. Systemic Effects

of Inflammation

-Enumerate the systemic

effects of inflammation

* * * * * *

Tissue Repair 29.

Overview of Tissue

Repair

-Describe the control

mechanisms in cell

proliferation

-Describe the Mechanisms of

Tissue Regeneration

* * * * * *

30. Repair by -Enumerate the Steps in Scar * * * * * *

41

Connective

Tissue Deposition

Formation


angiogenesis

-Explain the Deposition of

Connective Tissue in tissue

remodeling

-Explain the mechanism of

Remodeling of Connective

Tissue 31. Factors That

Influence Tissue

Repair

-Enumerate alllocaland

systemic factors for tissue

repair

* * * * * *

32.

Selected Clinical

Examples of Tissue

Repair and fibrosis

-Describe Healing of Skin

Wounds both primary and

secondary

-Explain mechanism of

Fibrosis in Parenchymal

Organs

* * * * * *

33.

Abnormalities in

Tissue Repair

-Describe the formation of

keloid ad hypertrophic scar

-Describe the formation of

exuberant formation and

desmoids

* * * * * *

Hemodynamic disorders Thromboembolic Disease and shock 34.

Edema and

Effusions

-Discuss the causes of

increased hydrostatic

pressures -Discuss the causes of

reduced plasma osmotic

pressures Discuss the causes

of sodium and water retention

-Discuss the causes of

lymphatic obstruction

Identify pathophysiological

categories of Edema

-Explain the morphology and

clinical features of Edema

* * * * * *

35. Hyperemia and

Congestion

-Explain the differences of the

terms hyperemia and

congestion morphologically

* * * * * *

36.

Hemostasis,

Hemorrhagic

disorders and thrombosis

-Define the term Hemostasis

and explain the sequence of

events leading to hemostasis

Relate the role of platelets in

maintaining hemostasis

-Revise the coagulation

cascade

-Discuss in detail the

significance of Endothelium

in

maintaining Hemostasis

-Explain the etiology,


of thrombosis

-Discuss the effects of

endothelial injury

-Describe in detail the effects

of alternations in normal

blood flow

-Associate hypercoagulability

with thrombus formation

* * * * * *

42

-Discuss in detail the fate of

thrombus

37.

Embolism

-Discuss the etiology,


of

pulmonary embolism



of

systemic thromboembolism



of fat

and marrow embolism



of air

embolism



of

amniotic fluid embolism

* * * * * *

38.

DIC

Infarction

-Explain the mechanism of

infarction

-Discuss the factors that lead

to development of infarct and

its morphology

Explain the process of

Disseminated intravascular

coagulation

-Discuss the pathophysiology

and morphology of DIC

* * * * * *

39.

Shock

-Discuss the pathogenesis of

septic shock

-Describe all stages of shock,

morphology and clinical

Consequences

* * * * * *

Genetics 40. Genes and human

diseases

-Discuss in detail mutations

-Define Mendelian disorders

* * * * * *

41.

Single gene

disorders

-Discuss the transmission

patterns of autosomal

dominant disorders


patterns of autosomal

recessive disorders


patterns of X-linked disorders

* * * * * *

42.

Biochemical and

molecular

-Discuss the enzyme defects

and their consequences with

example (lysosomal and

glycogen storage diseases)

-Discuss the disorders of

structural proteins (Marfan

Syndrome, EDS)

* * * * * *

43.

basis of single gene

disorders

-Discuss the defects in

receptors and transport system

with example (familial

hypercholesterolemia)

-Review of alteration in

* * * * * *

43

structure, function or quantity

of nonenzymic proteins

-Review of genetically

determined adverse reaction

to drugs 44.

Chromosomal

Disorders

-Discuss cytogenic disorders

involving sex

chromosomes (Klinefelter

Syndrome, Turner syndrome)

-Define the terms

hermaphroditism and

pseudo hermaphroditism

* * * * * *

45. Single gene

disorders with nonclassical

inheritance

-Define the diseases

associated with single gene

mutations

* * * * * *

46.

Molecular Genetics

Diagnosis

-Explain the diagnostic

methods (PCR, FISH, MLPA)

-Discuss polymorphic

markers and molecular

diagnosis, RNA Analysis

* * * * * *

Neoplasia 47.

Nomenclature

-Explain the terms

differentiation and anaplasia

-Explain the terms local

invasion and metastasis

-Explain pathways of spread

of tumors

-Discuss features of benign

and malignant neoplasms

-Differences of benign and

malignant neoplasms

* * * * * *

48.

Epidemiology of

cancer

-Discuss the global impact of

cancer

-Discuss the role of

environmental factors in

development of cancer

-Discuss in detail age,

acquired predisposing

conditions

-Explain the genetic

predisposition and interaction

between

inherited and environmental

factors

* * * * * *

49.

Molecular basis

of cancer

-Discuss role of genetic and

epigenetic alterations

-Describe cellular and

molecular hallmarks of cancer

-Explain the self-sufficiency

in growth signals

-Describe the terms,

ONCOGENES,

PROTOONCOGENES,

ONCOPROTEINS

-Explain the insensitivity to

growth inhibition

-Explain the growth

promoting metabolic

alterations

-Explain warburg effect

* * * * * *

44

-Discuss in detail the evasion

of programmed cell

death (APOPOTOSIS)

Associate limitless replicative

potential with tumor growth

-Explain the role of

angiogenesis, invasion and

metastasis in

development of tumor

-Discuss the evasion of host

defense, genomic instability

Illustrate with examples

cancer enabling inflammation

-Discuss dysregulation of

cancer associated

gene (chromosomal changes,

epigenetic changes and

noncoding RNA's) 50.

Carcinogenic Agents

Role of chemical

carcinogenesis and

steps involved in

development of

cancer

-Describe direct acting

carcinogens

-Describe indirect acting

carcinogens

-Explain the role of radiation

carcinogenesis (uv RAYS,

IONIZING RADIATION)

-Discuss the microbial

carcinogenesis

* * * * * *

51.

Clinical Aspects

of Neoplasia

-Explain the grading and

staging of tumors

--Discuss laboratory diagnosis

of cancer

Explain the tumor markers in

detail

* * * * * *

General Bacteriology 52.

Introduction

-Recall bacteria

-Discuss important features of

microbes

-Describe characteristics of

prokaryotic and eukaryotic

cells

* * * * * *

53.

Structure of

bacteria

-Discuss shape and size of

bacteria

-Discuss cell wall and its

components

-Compare cell wall of gram

positive and gram negative

-Describe bacterial spores and

their importance

-Discuss cytoplasmic

structure and its components

* * * * * *

54.

Growth

-Define Binary fission

-Discuss growth cycle and

curve and its phases

-Discuss aerobic and

anaerobic growth

-Discuss fermentation and

iron metabolism

* * * * * *

55.

Genetics

-Define genetics

-Discuss mutation and its

types

-Discuss transfer of DNA

* * * * * *

45

within bacterial cell

-Discuss transfer of DNA

between bacterial cell

-Discuss recombination and

its types 56.

Classification of

important

bacteria

-Discuss principles of

classification

-Classify bacteria on different

basis

* * * * * *

57.

Normal flora

-Define normal flora

Enlist normal flora with their

anatomical sites

-Discuss medical importance

of normal flora

-Define commensals, carrier

state, colonization and

resistance

* * * * * *

58.

Pathogenesis

-Define pathogen, virulence,

infectious dose, parasite and

types

-Describe types of bacterial

infections

-Enlist stages of bacterial

infection

-Discuss determinants of

bacteria

-Enumerate different strains

of bacteria causing disease

* * * * * *

59.

Host Defense

-Define innate and acquired

immunity

-Describe host defenses

against bacteria

-Describe components of

acquired and innate immunity

* * * * * *

60.

Laboratory

diagnosis of bacteria

-Discuss approach to

laboratory work

-Discuss approach to

serological testing

-Describe specimen taking for

different cultures

-Discuss commonly used

bacterial agars

-Discuss different methods of

diagnosis based on nucleic

acid analysis

* * * * * *

61.

Bacterial vaccine

-Enlist general principles of

bacterial vaccines

-Describe active and passive

immunity

-Enlist common bacterial

vaccine

* * * * * *

62.

Sterilization and

Disinfection

-Define sterilization and

disinfection

-Discuss methods of

sterilization and disinfection

-Identify instruments

/agents/machine used in

sterilization

* * * * * *

General virology 63.

Introduction -Recall virus

-Discuss important properties

* * * * * *

46

-Enlist comparison of viruses

and cell 64.

Structure of virus

-Discuss shape and size of

virus

-Discuss different component

of virus

* * * * * *

65.

Classification of

virus

-Discuss principle of

classification

-Enumerate classification of

virus

* * * * * *

Special virology 66. Herpesvirus

-Discuss features,

transmission, pathogenesis,

diagnosis, prevention

* * * * * *

67. Herpes simplex

virus

* * * * * *

68. Varicella-Zoster

virus

* * * * * *

69. Cytomegalovirus * * * * * *

70. Epstein-barr virus * * * * * *

71. Human

herpesvirus 8

* * * * * *

72. Smallpox * * * * * *

DNA Non-enveloped virus 73. Adenovirus -Discuss features,



* * * * * *

74. Papillomavirus * * * * * *

75. Parvovirus -Recall orthomyxoviruses * * * * * *

RNA enveloped virus 76.

Orthomyxoviruses

-Discuss features,



* * * * * *

77. Influenza virus -Define paramyxoviruses * * * * * *

78. Paramyxoviruses

-Discuss features,



* * * * * *

79. Measles virus * * * * * *

80. Mumps virus * * * * * *

81. Respiratory

syncytial virus

* * * * * *

82. Parainfluenza

virus

* * * * * *

83. Togavirus * * * * * *

84. Rubella virus * * * * * *

85. Rhabdovirus * * * * * *

86. Rabies virus * * * * * *

87. Retrovirus * * * * * *

88. Human T-cell

Lymphotropic

virus

* * * * * *

89. Filoviruses * * * * * *

90. Ebola virus * * * * * *

Hepatitis virus 91. Hepatitis A

-Discuss features,



* * * * * *

92. Hepatitis B * * * * * *

93. Hepatitis C * * * * * *

94. Hepatitis D * * * * * *

47

95. Hepatitis E * * * * * *

96. Hepatitis G * * * * * *

Arbovirus 97. Yellow fever -Discuss

features, transmission,

pathogenesis, diagnosis,

prevention

* * * * * *

98. Dengue virus * * * * * *

99. Chikungunya virus * * * * * *

100.

HIV

-Discuss

features, transmission,

pathogenesis, diagnosis,

prevention

* * * * * *

Mycology 101.

Introduction

-Define mycology

-Discuss structure of fungi

Compare of Fungai and

bacteria

-Discuss pathogenesis

* * * * * *

102. Cutaneous and

subcutaneous

mycoses

-Enlist cutaneous and

subcutaneous mycoses

* * * * * *

103. Dermatophytosis

, tinea nigra -Discuss features,



* * * * * *

104. Tinea versicolor * * * * * *

105. Sporotrichosis,

chromomycosis

* * * * * *

106. Mycetoma * * * * * *

107. Systemic mycoses -Enlist systemic mycoses * * * * * *

108. Coccidioides,

Histoplasma -Discuss features,



* * * * * *

109. Blastomyces,

Paracoccidioides

* * * * * *

110. Opportunistic

mycoses -Enlist opportunistic mycoses

* * * * * *

111. Candida,

Cryptococcus,

Aspergillus, mucor

& rhizopus -Discuss features,



* * * * * *

112. Pnuemocystis,pe

Nicllium marneffei,

* * * * * *

113. Fusarium solani,

pseudallescheriabo

ydii

* * * * * *

Parasitology 114. Intestinal parasite -Enlist intestinal parasite * * * * * *

115. Entamoeba,

Giardia,

cryptosporidium

-Discuss features,



* * * * * *

116. Urogenital parasite -Enlist urogenital parasite * * * * * *

117. Blood and tissue

parasite

-Enlist blood and tissue

parasite

* * * * * *

118. Plasmodium,

toxoplasm -Discuss features,



* * * * * *

119. leishmania * * * * * *

120. Cestodes * * * * * *

121. Trematodes -Define trematodes * * * * * *

122. Schistosoma, -Discuss features, * * * * * *

48

Clonorchis,

paragonimus


diagnosis, prevention 123. Fasciola,

Fasciolosis,

Heterophytes

* * * * * *

124. Nematodes -Define nematodes * * * * * *

125. Enterobius,

trichuris,ascaris,an

cyo

Stoma & nectar

-Discuss features,



* * * * * *

126. Strongyloides,tric

hinella

* * * * * *

127. Wucheria,onchoc

erca,loa,dracuncul

us

* * * * * *

128. toxocara,ancylost

oma,angiostrongyl

us,anisakia

* * * * * *

Immunology

129.

Introduction and

cells of immune

system

-Define immunology

-Enumerate cell of immune

system

-Difference between innate

and adaptive immune system

* * * * * *

130.

Cell mediated

immunity

-Describe cell mediated

immunity

-Discuss Maturation and

education of T and B cells

-Enumerate their functions

* * * * * *

131.

Humoral immunity

-Define and describe humoral

immunity

-Enlist Different types of

antibodies and discuss

-Functions of humoral

immunity

* * * * * *

132.

Cells and cytokines

-Enlist cell involved in innate

and adaptive immune system

-Briefly describe role of

different cytokines in

immunology

* * * * * *

133.

Hypersensitivity

Reactions

-Define hypersensitivity

reaction

-Enlist Different types of

hypersensitivity reactions

-Discuss Differentiation

between different reactions

-Briefly discuss Laboratory

diagnosis

* * * * * *

134.

COMPLEMENT

SYSTEM

-Define is complement system

-Discuss Different pathways

of complement system

-Describe Functions of

complement system

-Briefly review Clinical

implications of complement

system

* * * * * *

135. Immune tolerance

& Autoimmunity

-Define immune tolerance

-Enlist diff. Mechanisms

involved in immune tolerance

-Discuss Pathophysiology of

* * * * * *

49

autoimmunity

-Enumerate Different

autoimmune diseases

-Discuss Diagnosis of

autoimmune diseases 136. Major

Histocompatibility

Complex

-Describe MHC

-Enumerate Different types

and structure

-Briefly classes Role of MHC

* * * * * *

137.

Antigen and

Antibody Reaction

-Give brief Introduction &

Salient Features of Antigen –

Antibody Reaction.

-Discuss Strength of Antigen

– Antibody Reaction.

-Properties of Antigen –

Antibody Reaction.

-Different Types of Antigen –

Antibody Reaction.

-Briefly review Application of

Antigen – Antibody Reaction.

-Discuss Conclusion.

* * * * * *

138.

Immunodeficiency

disorders

-Define immunodeficiency

disorders

-Classify immunodeficiency

disease

-Discuss Manifestations

Etiology &

AIDS

* * * * * *

139.

Transplantation &

graft rejection.

-Discuss different types of

grafts.

-Briefly discuss pathogenesis

of different types of graft

rejection

-Discuss the measures to

prevent graft rejection

* * * * * *

Special bacteriology 140. Gram positive

cocci

-Enlist types of gram-positive

cocci

* * * * * *

141. Staphylococcus

-Discuss features,



* * * * * *

142. Staphylococcus

aureus,epidermid

is,saprophyticus

* * * * * *

143. Streptococcus * * * * * *

144. Streptococcus Pneumoniae

* * * * * *

145. Gram negative

cocci

-Enlist types of gram-negative

cocci

* * * * * *

146. Nesseris

Meningitidis,

N.gonorrhea

-Discuss features,



* * * * * *

147. Gram positive rods

-Define gram positive rods

Classify gram positive rods

* * * * * *

148. Spore-forming

gram-positive rods

-Discuss features,



* * * * * *

149. Spore-forming

gram positive rods

* * * * * *

150. Bacillus anthracis,

cereus

* * * * * *

151. Clostridium * * * * * *

50

tetani, botulinum,

perfringens,

difficile 152. Non-spore forming

gram positive rods

* * * * * *

153. Cornybacterium

diphtheriae

* * * * * *

154. Listeria

monocytogenes

* * * * * *

155. Gardnerella

vaginalis

* * * * * *

156. Gram negative

rods related to

enteric tract

Introduction of

Enterobacteriaceae

-Discuss Enterobacteriaceae

and related organism

* * * * * *

157. Pathogen both

inside and outside

enteric

Tract

-Enlist pathogens both inside

and outside enteric tract

* * * * * *

158. E.coli,Salmonella

-Discuss features,



* * * * * *

159. Pathogens within

the enteric tract

* * * * * *

160. Shigella,compyloba

cer, helicobacter

* * * * * *

161. Vibrio cholera,

parahae molyticus,

vulnificus

* * * * * *

162. Pathogens outside

the enteric tract

* * * * * *

163. Klebsillaenterobact

erserratia group

* * * * * *

164. Proteusprovidencia

morganella group

* * * * * *

165. pseudomonas,

bacteroides &

prevotella

* * * * * *

166. Gram negative

rods related to

respiratory tract

-Recall and classify gram

negative rods related to

respiratory tract

* * * * * *

167. Haemophilus,

Boedetella,Legionel

la, Acinetobacter

-Discuss features,



* * * * * *

168. Gram negative

rods related to

animal source

-Discuss gram negative rods

related to animal source

* * * * * *

169. Brucella,

Francisella,

Pasteurella,Barton

ella

-Discuss features,



* * * * * *

170. Mycobacterium

-Discuss types of

mycobacterium

* * * * * *

171. Mycobacterium

tuberculosis -Discuss features,



* * * * * *

172. Atypical

mycobacteria,

Mycobacterium

leprae

* * * * * *

173. Actinomycetes -Define actinomycetes * * * * * *

174. Actinomyces -Discuss features, * * * * * *

51

israelii,Nocardia

Asteroides,


diagnosis, prevention 175. Mycoplasma -Recall Mycoplasma * * * * * *

176. Mycoplasma

Pneumonia

-Discuss features,



* * * * * *

177. Spirochetes -Recall spirochetes * * * * * *

178. Treponema,Leptos

pir

-Discuss features,



* * * * * *

179. Borrelia

burgdorferi,

recurrentis,hermsii

,

miyamotoi

* * * * * *

180. Chlamydiae --Recall chlamydiae * * * * * *

181. Chlaymydia

trachnomatis,pne

umoniae,psittaci

Discuss features,



* * * * * *

182. Rickettsiae -Recall rickettsiae * * * * * *

183. Rickettsia

rickettsii,prowazek

ii -Discuss features,



* * * * * *

184. Coxiella burnetii,

anaplasma

phagocytophilum

* * * * * *

Practical Work 185.

Study of

Microscope

Identify and understand

principal components of light

microscope

Demonstrate how to set up

and use light microscope.

* * * * * *

186.

Urine Sample

Enumerate microscopic

findings in urine.

Distinguish different casts &

crystals

* * * * * *

187.

Stool sample

Explain macroscopic and

microscopic examination of

stool.

* * * * * *

188.

Gram staining

Differentiate two major

categories of bacteria

Explain how gram stain

affects bacteria based on

structural differences in their

cell wall

* * * * * *

189.

ZN Staining

Differentiate bacteria between

acid fast group and non-acid

fast group

Explain how ZN stain and its

acid alcohol deodorizer

affects bacteria.

* * * * * *

190.

Chronic venous

congestion

Define the disorder

Explain the causes of disorder

Understand outcome

Demonstrate gross and

microscopic features

* * * * * *

191.

Features of

malignant tumor

Differentiate between benign

and malignant tumor

Understand the term anaplasia

Explain rate of growth

Explain metastasis

* * * * * *

52

192.

Lipoma

Define the term

Enlist type of tumor

Describe formation

Enlist sites of types

Discuss gross or microscopic

picture

* * * * * *

193.

Leiomyoma

Define the term

Classify types of tumor

occurrence to learn size of

tumor

Interpret clinical features

gross and microscopic

picture

* * * * * *

194.

Hemangioma

Distinguish between benign

and malignant tumors

Enlist the types

Explain gross or microscope

picture

* * * * * *

195.

Squamous cell

carcinoma

State the type of carcinoma

Recognize its site

State its incidence

Enumerate its Predisposing

factors

Observe and describe the

gross and microscopic

picture

* * * * * *

196.

Basal cell

carcinoma

Identify the type of carcinoma

Memorize the site of tumor

Enlist predisposing factors

Recall growth pattern.

Observe gross and

microscopic picture

* * * * * *

197.

Fatty change liver

Define and explain liver

steatosis

Enumerate its causes

Describe its pathophysiology

Enlist its types

Explain gross and

microscopic features on slide

* * * * * *

198. Hyperplasia

Define hyperplasia

Distinguish its gross and


* * * * * *

199. Metaplasia

Define metaplasia



* * * * * *

200. Atrophy

Define Atrophy



* * * * * *

201.

Necrosis

Define necrosis?

Enlist the important features

of necrosis

Elaborate its types

Elaborate features of

necrosis on slide during

microscopy

* * * * * *

202. Pathological

calcification

Define calcification

State pathological

calcification

Elaborate its pathophysiology

Enumerate its types with

explanation and examples

Elaborate the features of

pathological calcification on

slide during microscopy

* * * * * *

203. Pigmentation Define pigmentation

State its types

Define the nevus and classify

them

Describe features of nevus

on gross and microscopy

* * * * * *

204. Anthrocosis Define anthrocosis

Describe its pathophysiology

Classify anthrocosis

Enumerate the important

features of anthrocosis on

gross and microscope

* * * * * *

205. Infarction Recognize the disorders

Discuss the cause of

infarction

Identify the gross or

microscopic picture

* * * * * *

53

Identify the types of infarction

Recognize the severe outcome 206. Thrombosis Define thrombosis

Enumerate the causes

Describe the outcome

Explain the sites of formation

Identify gross or microscopic

picture

* * * * * *

207. Adenoma Identify the site of tumor

Describe predisposing factors

Enumerate gross and

microscopic picture

* * * * * *

208. Fibroadenoma Describe predisposing factors Enumerate gross and

microscopic picture

* * * * * *

209. Acute

inflammation

Define acute inflammation

Explain its components

Enumerate its types

* * * * * *

210. Chronic

inflammation

Define Chronic inflammation

Enumerate its causes and

types

Identify the chronic

inflammation on gross and

microscope picture

* * * * * *

211. Chronic

granulomatous

inflammation

Define granuloma?

Describe granulomatous

inflammation

Elaborate granulomatous

inflammation with types and

examples

Identify the granulomatous

inflammation on slide during

microscopy

* * * * * *

212. Malarial

Parasites

Differentiate between

different forms of malarial

parasite.

Examine different types of

malarial parasites in prepared

blood smears.

* * * * * *

213. Ascariasis Observe the different stages

of life cycle of Ascaris

Lumbricoides

* * * * * *

214. Amoebiasis Compare the different stages

of life cycle of Entamoeba

Histolytica

* * * * * *

215. Giardiasis Categorics the different stages

of life cycle of Giardia.

* * * * * *

216. Cestodes Analyze the stages of life

cycle of different Cestodes

* * * * * *

217. Opportunistic

Mycoses

Analyze different structures

of candida and other

opportunistic fungi under

microscope

* * * * * *

218. Culture Media Describe the nutritional

requirements of bacteria

Identify and describe culture

media used for growth of

bacteria including examples

of all purpose media,

enriched, differential Define

enrichment media.

Enlist growth phases of

microorganism and different

type of growth media

available to culture them

* * * * * *

219. Motility of bacteria Describe motility of living

bacteria

Summarize about different

methods of motility

determination

* * * * * *

220. Biochemical test. Reproduce different

biochemical reactions to

identify bacteria.

* * * * * *

54

221. Sterilization

technique

Discuss the rationale for


Select appropriate methods of


Implement appropriate quality

assurance measures.

* * * * * *

222. Collecting and

transporting

specimen

Analyze and compare

different techniques used for

the transportation of various

forms of specimen.

* * * * * *

223. Preparation of

blood film

Demonstrate different

techniques of blood film and

smear preparation

* * * * * *

224. Elisa Analyze different aspects of

the procedure

* * * * * *

225. Study of Various

pathology lab

instruments and

machines

Analyze different aspects of

Laboratory instruments

Demonstrate the proper use

Summarize the proper care.

* * * * * *

55

w.e.f. 29th

March, 2021 to 11th

December, 2021

Days 8:30-

09:20

09:20-

10:10 10:10–11-00

11:00–

11:50

11:50–

12:10 12:10–01:00 01:00–2:30

Monda

y

Test /

Discussio

n

Test /

Discussio

n

Lecture

Pharmacology

Lecture

Patholog

y Break

SGD

Batch A-

Forensic M

Batch B-

Pathology

Batch C-

Pharmacology

Batch D- B.S

Practical’s

Batch A-

Pharmacology

Batch B-

Forensic M

Batch C-

Pathology

Tuesda

y

Lecture

Patholog

y

Lecture

Pharmacol

ogy

Lecture

Forensic

Medicine

Lecture

Behavior

al

Sciences

Break Hospital Ward

Practical’s

Batch A-

Pathology

Batch B-

Pharmacology

Batch C-

Forensic M

Wedne

sday

Lecture

Behavior

al

Sciences

Lecture

Pathology

Lecture

Pharmacology SDL Break Hospital Ward

Practical’s

Batch A-

Forensic M

Batch B-

Pathology

Batch C-

Pharmacology

Thursd

ay

Test /

Discussio

n

Test /

Discussio

n

Lecture

Pharmacology

Lecture

Patholog

y Break Hospital Ward

SGD

Batch B-

Forensic M

Batch C-

Pathology

Batch D-

Pharmacology

Batch A- B.S

Friday

08:30-

9:30

09:30-

10:30

10:30-11:30

AM

11:30-

12:30

------------

----- ------------------ -------------------- Lecture

Forensic

Medicine

Tutorial

Pharmacol

ogy

SGD

Batch C-

Forensic M

Batch D-

Pathology

Batch A-

Pharmacology

Batch B- B.S

Skill Lab

Saturda

y

Lecture

Pharmaco

logy

SDL Lecture

Pathology

Lecture

Commun

ity

Medicine

Break

Lecture

Surgery/Medicin

e

SGD

Batch D-

Forensic M

Batch A-

Pathology

Batch B-

Pharmacology

Batch C- B.S

TIMETABLE

56

*Note: Self Directed Learning (Every Wednesday & Saturday) would be monitored by the Department, which will

be conducting test on Thursday & Monday, respectively.

Chief Operating Officer

Multan Medical & Dental College,

MULTAN

57

Sr# Date Subject Name of Facilitator Assessment

Tool

Topic

1 05-04-

2021

Pathology Dr. Afra + Dr. Nudrat MCQs +

SEQs

Hypermia & Congestion

Introduction of Neoplasia

2 19-04-

2021

Pathology

Dr. Naseem

MCQs +

SEQs Introduction to immunology

Cell mediated immunity

Humoral immunity

3 03-05-

2021

Pathology Dr. Afra + Dr. Nudrat

MCQs +

SEQs Hypermia, Congestion, Edema,

Hemorhagic, Introduction to

Neoplasia, Nomencloture.

4 17-05-

2021

Pathology Dr. Iqbal + Dr. Naseem

MCQs +

SEQs Immunology

Cell injury

5 31-05-

2021

Pathology Dr. Riaz Hussain Malik

MCQs +

SEQs General Bacteriology

6 14-06-

2021

Pathology Dr. Afra

MCQs +

SEQs Hemodynamic

7 28-06-

2021

Pathology Dr. Naseem Akhter

MCQs +

SEQs Immunology

8 12-07-

2021

Pathology

Dr. Nudrat

MCQs +

SEQs Nomenclature, Carcinogenic

agents

Anaplasia

Neoplasia

9 29-07-

2021

Pathology Dr. Iqbal Hussain Malik

MCQs +

SEQs Cell Injury: Adaptations,

Mechanism of cell injury

10 12-08-

2021

Pathology Dr. Afra

MCQs +

SEQs Genetics

11 30-08-

2021


MCQs +


12 13-09-

2021

Pathology Dr. Nudrat

MCQs +

SEQs Neoplasia

13 27-09-

2021

Pathology Dr. Ghauri

MCQs +

SEQs Special Bacteriology

14 11-10-

2021

Pathology Dr. Iqbal Hussain Malik

MCQs +

SEQs Cell Injury

15 25-10-

2021


MCQs +


ASSESSMENT SCHEDULE

58

16 08-11-

2021

Pathology Dr. Ghauri

MCQs +


17 22-11-

2021

Pathology Dr. Riaz Hussain Malik +

Dr. Naeem Gogi

MCQs +

SEQs Virology + Parasitology

18 06-12-

2021

Pathology Dr. Muhammad Ijaz

Alam

MCQs +

SEQs Inflammation and Repair

May Vary due to COVID-19 Outbreak

59

3

rd Year MBBS (Session 2020-2021)

PRACTICAL GROUPS

Sr.# Roll No. Batch

1 1-73 Batch-A

2 74-148 Batch-B

3 149-214 Batch-C

DEPARTMENTS

Sr.# Days Pharmacology Pathology Forensic Medicine

1 Monday Batch-A Batch-C Batch-B

2 Tuesday Batch-B Batch-A Batch-C

3 Wednesday Batch-C Batch-B Batch-A

SGD GROUPS

Sr.# Roll No. Batch

1 1-58 Batch-A

2 60-108 Batch-B

3 109-162 Batch-C

4 164-214 Batch-D

SGD’s

Sr.# Days Forensic Medicine Pathology Pharmacology Behavioral Sciences

1 Monday Batch-A Batch-B Batch-C Batch-D

2 Thursday Batch-B Batch-C Batch-D Batch-A

3 Friday Batch-C Batch-D Batch-A Batch-B

4 Saturday Batch-D Batch-A Batch-B Batch-C

BATCHES ALLOCATIONS

60

May Vary due to COVID-19 Outbreak

Sr.# Rotations Dates Batch Venue

1 29th March, 2021 to 13

th August, 2021 A 1-107

2 16th August, 2021 to 18

th December, 2021 B 108-214

Department of Surgery

Sr.# Rotations Dates Batch Venue

1 29th March, 2021 to 13

th August, 2021 B 108-214

2 16th August, 2021 to 18

th December, 2021 A 1-107

61

Rules and Regulations Laboratories:

Students must wear white overall in the Laboratory.

Students must wear face masks in the Laboratory.

Students must wear gloves before starting the practical and remove them after ending the

procedure.

Students must be trained about the usage of any instrument or machine before using it on

a patient.

Students must have their log books at the start of session and they must keep them safe

and maintain the record timely.

Students must submit their log books at the end of the session to the relevant Head of

Department.

Students should not use mobile phones in the Laboratory.

Students should never perform any procedure alone. The Demonstrators and the assistant

must be there with the student.

Always keep your hands at a safe distance from sharp instruments.

Unnecessary talking is not allowed in the Laboratory.

No student is allowed to leave the Laboratory without the permission of Supervisor.

No game of any sort is allowed to be played during the clinical/ward.

Any student breaking or damaging any property of the institution shall be required to pay

the cost of repair or replacement.

Students must demonstrate Professionalism and Medical Ethics.

WARD PRE-REQUISITES

62

BOOKS RECOMMENDED:

1. Pathological Basis of Disease by Kumar, Cortan and Robbins, 10th Ed.2020, W.B.

Saunders.

2. Medical Microbiology and Immunology by Levinson and Jawetz, 9th Ed., Mc Graw-Hill.

3. Medical Genetics by Jorde, 3rd Ed., Mosby.

4. Clinical Pathology Interpretations by A. H. Nagi

5. Robbins Basic Pathology 10th Ed. 2018

LEARNING RESOURCES

Multan Medical & Dental College

Documents

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