1st YEAR MBBS Study Guide

Prepared by:

                           Zuha Iftikhar (G-14)

Compiled by:

                           Jawad Ashraf (G-14)

Reference Books:

• Medical Histology by Laiq Hussain Revised 7^th Edition (Chapter numbers are mentioned according to this edition)
• DiFiore’s Atlas of Histology
• Manual of Histology (your practical notebook)

CIRCULATORY SYSTEM

(Module No 4)

Chapter 13:

(CV-A-011 – CV-A-017).

• Endocardium, Myocardium & Epicardium (Just Remember the Layers, can be asked in MCQs)
• SA node & AV node (Go through it Conceptually can be Asked in SEQ)
• Endothelium & its Functions IMP
• Layers of blood vessels i.e tunica intima, media & adventitia (Basic Go through) & then you must Know Which arteries Lack which Layer, distinctive Features of arteries, veins and Capillaries from each other is very Important
• The Difference between Different Arteries, Different Veins & Capillaries can be done from your Histo Practical Notebook or You can do it Thoroughly by understanding Diagrams Along with their histological Features (Very Important to Do)
• All green Boxes Diseases are a Must Do thing, never skip these i.e Thrombosis & Embolism, lymphedema, Blood pressure Diseases Arteriosclerosis, Atherosclerosis Important
• Pericytes Important
• Difference between capillaries types, their Examples (Important Often Asked in OSPE and Written)
• Vein Types, must do their Difference
• About T tubules and Intercalated discs (Proff 2023 Question) You have done it in Block-2
• Lymphatic system is not That Important, just go through once for MCQs & basic general Concept (in case it comes)

Note: Basically, Diagrams Are More Important of these Chapters and are often Asked in     Written and OSPE both

RESPIRATORY SYSTEM

(Module No 5)

Chapter 17:

(Re-A-020 – Re-A-025)

• Proximal / Distal Respiratory Tract Important Question Asked
• Respiratory epithelium Complete, Cell Names and Description Important
• Olfactory epithelium, Cell Names and Description Important
• About the whole tract from start till alveoli u must know about changes in epithelium glands and cartilage (Question Often Asked to tell the Epithelium from start to end of Respiratory System)
• Paranasal sinuses, Nasopharynx, Larynx Do Their Layers
• Trachea Important Diagram and Layers Both ( Proff 2024 and Block-3 Internal Repeatedly Asked Question )
• Difference b/w intra and extra pulmonary bronchi Important
• Terminal Bronchioles & Clara cells (Club cells) Very Important  
• Diff between type 1 and 2 Pneumocytes (Question Asked in Proff OSPE stations)
• Pulmonary Surfactant, Dust cells and Blood Air Barrier Very Important
• Epithelium of Bronchioles to Alveolar sacs is Repeatedly Asked. Must remember it
• All green boxes are Important to Do

Don’t Skip Diagrams, those are Very Important to Do.

Prepared by:

                            Hanzala Masood (G-14)

Compiled by:

                           Jawad Ashraf (G-14)

Reference Books:

• Snell’s Clinical Anatomy by Regions 10th edition
• BD Chaurasia Human Anatomy 8th edition

THORAX

Important Note:

•  This part of Anatomy is easy when done in a proper way.
•  First of all use Snell as main book for thorax. However there are several points and LOs in the curriculum which are not in Snell or not properly written in Snell. For them go for BD
•  In Snell there are 2 chapters of Thorax (Chp 4&5)
•  For clinicals use TH Clinicals but must give a good read to clinicals from Snell as many lines of Snell were asked as it is in our proff
• For practice use BRS gross anatomy (scenario mcqs) & past papers
•  Proff Qs
• Nerve supply of diaphragm, structures passing through diaphragm, bronchopulmonary segment, root of lung(draw), mediastinal syndrome it’s symptoms and effects (clinical v.v.imp). Guidelines are mentioned according to your LOs

CARDIOVASCULAR SYSTEM

(Module No 4)

CV-A-001

• Mediastinum (boundaries & contents) v.v.imp rom BD chp 17 complete
• Superior vena cava (imp) from BD chp 19 
• Aorta (imp) complete from Snell chp 5
  • Must Do relations of Aortic arch from BD chp 19 (also try to do of ascending and descending aorta but arch is most imp)
• Azygous+Hemizygous+Accessory Hemizygous veins (extremely imp) from BD chp 14
  • do it completely as they are frequently asked in exams (skip relations)
• Nerve Supply of Heart from Snell chp 5 (under the topic extrinsic nerve supply)

CV-A-002

• Pericardium (v.imp )  from Snell +
  • nerve supply from Snell
  • Blood supply: Internal Thoracic + Musculophrenic + Descending Aorta
• Pericardial sinuses transverse and oblique (v.v.imp ) complete from BD + their Boundaries (college block 3 seq ) 

CV-A-003

• External features of heart + openings in heart (just give a good read to this topic from Snell chp 5) They are mainly asked in Ospe and viva especially on model. So try to do it on heart model and study all landmarks written in text
  • Moderator Band imp for written
• Arterial supply: Coronary arteries (v.v.imp) complete from Snell chp 5
• Left and Right coronary artery branches + variations in coronary arteries+ anastomosis + table 5.3 all from Snell chp 5
• Venous drainage of heart from Snell chp 5
• Cardiac Plexus from BD chp 18 imp
• Fibrous Skeleton of heart + valves from Snell chp 5 (imp)

RESPIRATORY SYSTEM

(Module No 5)

Re-A-001

• This portion has to be covered from Snell chp 12 (Head and Neck portion)
• For Nasal cavity, Pharynx & Larynx give a read to their Anatomical features
• Prepare Neurovascular supplies and Lymph drainage of all these (imp)
• If you’ve time just give read to clinicals of Larynx (Laryngeal nerve lesions & piriform fossa)
• NOTE: Only 2-3 mcqs were asked from these topics

Re-A-002

• Trachea complete with relations from Snell chp 5

Re-A-003

• Superior thoracic aperture from BD
• Inferior thoracic aperture or DIAPHRAGM
  • NOTE: Inferior thoracic aperture is nothing but diaphragm. You’ve to do from Snell from chp 4 pg 202-204 (don’t skip any point and also do clinicals)
  • V.V.IMP: Just do a table of openings and structures passing through these openings of diaphragm from BD chp 12 table 12.1 memorise it completely as it is always asked either in written or in Viva
• Thoracic outlet syndrome v.v.imp

Re-A-(004 + 006 + 007)

• Diff b/w typical + atypical rib (extremely imp)
• Rib viva me sunate hue lazmi lazmi pta hona chahye whether it’s typical / atypical
• Typical rib (complete)
• 1st rib (complete)
• 2nd rib (complete)
• Sternum (easiest bone of thorax). Do it complete
• Diff b/w typical + atypical vertebrae (vv imp)
• Viva me vertebrae differentiate krna ana chahye
• Thoracic vertebrae ka diff sunte h viva me baqi vertebrae se (vv imp)
• Vertebrae ke just bony feature krne h. Buht easy h. Abhi ache se kr le ge to 2nd Year me easy lge ga
• Respiratory movments (pg 234) vvv imp seq. Do it complete till pg 236. Buht se viva ques bhi ha is me
• Must remember classification of ribs (vertebrochondral vertebrosternal etc. and also that which Rib number belongs to which category)
• Joints of Thorax from BD chp 13
  • For ligaments just do their names
• All clinicals
•  Kyphosis, Scoliosis, Sternal biopsy, Sternotomy, Sternal fractures all clinicals imp.

Re-A-005

• Thoracotomy (imp clinical)
• Intercostal muscles (imp)
  • Do intercostal muscles from Snell chp 4 pg 200-202 complete
  • Completely cover the headings of intercostal muscles + their actions+ nerve supply (main things asked are their actions NV supply and also their difference like direction of fibers etc) All this will be covered from Snell pg 200- 202
• Intercostal space form Snell chp 4
  • In the topic of I.C space, 7 layers are written memories these 7 layers and make mnemonic (v.v.imp)
  • Question is usually asked that IF WE HAVE TO PERFORM LUNG BIOPSY, WHICH LAYERS WILL BE PIERCED the answer is these 7 layers (V.imp asked in both clg block 3 and PROFF viva)
  • Contents of IC space: Intercostal (Vein+ Artery+ Nerve) Mnemonic: VAN (imp)

Re-A-008

• Endothoracic Fascia Snell chp 4
• Suprapleural membrane or Sibson’s Fascia + attachments (imp) from Snell chp 4

Re-A-009

• Joints of Thorax from BD chp 13
  • For ligaments just do their names
• Mechanics of Respiration (v.v.imp topic) you can cover it from BD but more preferred is that take a good lecture and then cover it from Snell )
  • Vertical Diameter (Piston Pump Mechanism) From Picture

• Ant.Post diameter (pump handle mechanism) from topic
  • Transverse diameter (bucket handle mechanism) from Topic
  • Muscles involved in respiratory movements (from picture)

Re-A-010

• Intercostal arteries
  • Posterior intercostal arteries from BD chp chp 14 complete
  • Anterior intercostal arteries from BD chp 14 complete
  • Intercostal veins from BD chp 14 complete (must do table 14.2 from BD)
  • Intercostal nerves from Snell chp 4 pg 204-5
• Alternate routes v.imp (will be covered from TH clinicals)

Re-A-011

• Dermatomes not v.imp
• Rest will be covered in clinicals

Re-A-012

• This LO is about Diaphragm (for this see previous points above under Re-A-003)

Re-A-013

• Complete Topic of PLEURA from Snell chp 5 (Layers + recesses + divisions + Nerve supply) all very very imp
  • Blood supply and lymph drainage (picture)

• Diff b/w parietal and visceral pleura from BD chp 15 table 15.1
  • All clinicals v.v.imp

Re-A-014

• Anatomical features of lungs from Snell chp 5
• Diff bw features of Right and Left Lungs from BD chp 16.2
• Pulmonary Ligament (covered in topic of Pleura)
• Root of lung (v.imp) from BD chp 16
  • In root of lung cover following headings from BD: Contents+ arrangement of structures in root+ Relations of root (pg 267)
• Lobes and Fissures from Snell chp 5 pg 232 + table 5.1 v.imp.
• Bronchopulmonary segments complete (extremely imp) from Snell chp 5 pg 233-234 (don’t skip anything)
  • Also know how to draw (diagram in BD) plus you can watch any video for their diagram as diagram is sometimes asked in exams.
• Blood supply, Nerve Supply, and Lymph drainage from Snell chp 5
• All clinicals (bronchoscopy, thoracentesis imp) are imp.

Note: Apparently guidelines seem scattered and keep on switching between Snell and BD — but it is to cover every topic in a proper and in an understandable way. So, when you study thorax, study Snell and BD side by side according to guidelines.

Thorax MCQs

Thorax Clinical Scenario MCQs

ALL Clinicals of Thorax

T.H.Clinicals of Thorax

Prepared by:

                           Zuha Iftikhar (G-14)

Compiled by:

                           Jawad Ashraf (G-14)

Reference Books:

• Langman Medical Embryology 14^th Edition

Note:

• Do both CVS and Respiratory System from Langman.
• Make flow charts for all developments.
• Don’t stick to every single line.

AXIAL SKELETON

Chapter 10:

(Re-A-015 – Re-A-016)

• Do Vertebrae and Vertebral Column (Very Important SEQ), Must do Its Diagram Along as well.
• Anomalies mentioned of Vertebral defects (Do Complete)
• Do Ribs and Sternum (Important SEQ as well) Along with their Anomalies
• For axial Skeleton overview: From sthe start of chapter, Just Go through once as it is not linked to Your Syllabus but mentioned in LOs, you just have to know basic overview of Axial skeleton and factors contributing.
• Regarding anomalies of Axial Skeleton, you have to do those, as they were asked from us in Proff 2024, you can’t skip Anomalies.

Chapter 7:

(Re-A-017)

• Diaphragm and thoracic cavity (Do it completely till the End of Chapter)
• Sources of Diaphragm is a repeatedly asked question. Do it Conceptually and Thoroughly. (Proff 2023 Question)
• Must do Anomalies of Diaphragm Like Diaphragmatic Hernia etc (Important)

CARDIOVASCULAR SYSTEM

Chapter 13:

(CV-A-004 – CV-A-010)

This chapter is tricky to Understand, for this firstly take Ninja Nerd Lecture to Grasp the Concept properly and then readout the textbook thoroughly. Otherwise, you will not be able to retain it.

• Do all the developments from establishment and patterning of primary heart field semilunar valves. These are often asked in SEQ and OSVE as well. Must Do all these through lectures (Otherwise it will be difficult to Understand)
• Most Important Among these are:
  • Cardiac Loop formation
  • Septum formation in the common atrium (Proff Viva Question)
  • Formation of left atrium and pulmonary Vein
  • Septum formation in the atrioventricular Canal
  • Septum formation in the truncus arteriosus and Conus Cordis (Proff Question)
• You must have to do all as well, anyone of them might come.
• Must do All the clinicals In between. (Important as well)
• Formation of Conducting system of heart, Do it thoroughly
• Table 13.1 Not important (Just Go through for MCQs, to remember event Duration)
• Must do derivatives of aortic arches only table 13.2 (Important to Do)
• Vascular System: Arterial System (Changes that occur with alteration in aortic arch system) Very Important SEQ.
• Course of Recurrent Laryngeal Nerve is an important SEQ
• Rest of arteries: vitelline, Umbilical Coronary Do Understand it atleast, They are often asked at VIVA stations and MCQs
• Clinicals of arterial System are very Important
• Venous System: Do Understand Coronary, Vitelline, umblical and Cardinal Veins for Viva and MCQs.
• Development of IVC Important SEQ
• Clinicals of venous system Must to do
• The rest of the Chapter is not Important. Regarding the Lymphatic system. It never Came till now. But to be on the safe side. At least, you must have a concept of it.

Most Important Clinicals:

• Dextrocardia
• Tetralogy of Fallot
• Patent ductus arteriosus
• Unequal division of arterial trunks
• Transposition of great
• Vessels and Valvular stenosis
• Coarctation of aorta

Note: These are most important clinicals but you have to do all the clinicals because mostly SEQs are asked from clinicals.

RESPIRATORY SYSTEM

Chapter 14:

(Re-A-018 – 019)

Note: Do watch Ninja Nerd Lecture for it as well before Reading. It is a very Easy Chapter.

• Formation of lung bud
• Larynx, Trachea, bronchi & Lungs (Do All by Ninja Nerd Lecture)
• Maturation of lungs make a flow chart (not as such important)
• Table 14.1 maturation of lungs, must do week duration as well, You have to write it properly (Proff 2024 Question + Block 3 Internal Question)

Clinicals:

• Esophageal atresia (Repeatedly Asked SEQ, Viva Question)
• VECTERL (Do Read it Out for MCQs)
• Respiratory distress syndrome (v.v imp)

Note: As I Always Mention, After Doing Any Chapter of Embryology, Do Go through the Question written at the End of Each chapter. In Proff Exams, Exact These statements are Asked in SEQ Questions, you can check out Proff Question paper of 2023. Repeatedly asked in Blocks. So, you must have to go Through these Questions at the End. Answer key of these Questions is given at the End of Book Langman.
Best wishes ~ Zuha Iftikhar

Prepared by:

                            Ahsan Ali (G-14)

Compiled by:

                           Jawad Ashraf (G-14)

Reference Books:

• Lippincott Illustrated Reviews: Biochemistry 8^th Edition (Chapter numbers are mentioned according to this edition)
• Satya narayana Biochemistry 6^th Edition
• Harper’s illustrated Biochemistry 30^th edition

CARDIOVASCULAR SYSTEM

(Module No 04)

CV-B-001

• Classification of lipids (Satya chap 3)
• You must know one example
• Every classification

CV-B-002

• Biomedical importance & functions of lipids(imp) (Satya chap 3)

CV-B-003

• Fatty acids (Satya chap 3)
• Nomenclature of fatty acids + how to number carbon atoms (when starting from COOH     group, numbering is 1,2,3… when starting from terminal CH3 group, numbering is w1, w2, w3….) 
• Saturated and unsaturated fatty acids with examples (v.imp) w3, w6 and w9 fatty acids (also harper table 21.2) and also their functions (vv.imp)
• Essential fatty acids (functions, toad skin)
• Examples of hydroxy fatty acids + cyclic fatty acids(read)
• Trans fatty acids (adverse effects) (v.v.v.v.v.imp)
• Below topics are not your LO’s but still we got questions from them in block and prof!!!
• Functions of triacylglycerol (v.v.v.imp)
• Saponification (imp)
• Rancidity (imp) antioxidants examples (v.imp)
• Iodine number (v.imp)
• RM number 
• Saponification number (imp)
• Acid number
• Glycolipids (cerebrosides & gangliosides) (v.v.imp)
• Phospholipid classification with functions (v.imp)
• Structure of Phosphatidylcholine or Lecithin (v.imp)
• Functions of plasmalogens and Cardiolipin (v.v.v.imp)
• As a whole functions of phospholipids (v. imp)
• Lecithin-Sphingomyelin ratio = 2:1 after 30th week —-> Lung maturity Infant respiratory distress syndrome (v.v.v.imp)
• Amphipathic lipids
• Emulsion (read)liposome

CV-B-004

• Lipid peroxidation from the pics shared

CV-B-005

• Eicosanoids (Lippincott chap 17 Fig 17.23 only (v.v imp)
•  https://youtube/-JOn8g8LvwE?si=NvXQb_oGw1yhKp9w

CV-B-006

• Lipoprotein metabolism & disorders (Lippincott chap 18 pg # 252 to pg # 262+ fig imp)
• Regulations of cholesterol (fig 18.21) imp
• Foam cells (imp) HDL role (imp)

CV-B-007/CV-B-008

• Hyperlipidemias from pics & PDF shared

CV-B-009/CV-B-010

• Vitamins (Lippincott chap 28 complete)
• All vitamins are (v.v.v.v.v. imp)
• Vit.B9 and Vit.B12, folate trap, B12 absorption, VitA and VitD are much imp their clinical (deficiency and excess) also.

CV-B-011

• Minerals (Lippincott chap 29) https://youtube.com/playlist=PLk1F96oveZLGGviPzLJDxPCf1FURMT_NY&si=QTY3yYFHA3ldV7v6Zinc (imp)
• Magnesium, Sodium(imp), Potassium(imp), Calcium(v.v.imp), Iodide, Copper(v.imp). Phosphorus, Selenium(imp) & Sulphur
• Menkes syndrome+ Wilson disease (v.v imp)

RESPIRATORY SYSTEM

(Module No 05)

Re-B-001

• Single gene disorders (cystic fibrosis & emphysema) from PowerPoint slides shared
• Emphysema (lippon chp 4. Last 2page elastin and emphysema+ fig 4.14)

Re-B-002

• Diseases from your class lectures

Re-B-003

• Acid Base Balance (Satya chap 21 pg # 475 to pg # 485)
• This chapter is important for clinicals point of view
• 3 lines of defense (Blood buffer, Respiratory buffer, Renal buffer mechanisms) (imp)
• Metabolic acidosis, Respiratory acidosis, Metabolic alkalosis, Respiratory alkalosis their causes and compensatory mechanisms (v.v.v.v.v. imp)
• Tables 21.4 & 21.7 (v.v. imp)
• Anion gap + it’s significance (v.v.v.v.v.imp)
• Mixed acid base disorder (v.v.v.imp)

Prepared by:

                           Mahnoor (G-14)

Compiled by:

                            Jawad Ashraf (G-14)

Recommended Book:

• Guyton and Hall Textbook of Medical Physiology 14^th Edition (Chapter numbers are mentioned according to this edition)

RESPIRATION

Note:

• Watch medical gateway lectures and try to give read to guyton once to grasp concept

Chapter 38:

(Re-P-001 – 004)

• Muscles involved in normal and laboured breathing (viva)
• Pressure that causes movement of air in and out Fig 38.2 vv imp (viva /qs)
• Compliance of lungs with fig 38.3 and 38.4 and factors (v.imp qs / viva)
• Work of breathing (blue box)
• Pulmonary volumes and capacities with fig 38.6(whole topic v.v.v imp)
• FEV1/FVC ratio clinical importance in obstructive and restrictive lung disease (v.v.v.imp viva/qs)
• Minute respiratory volume and alveolar ventilation and rate of ventilation (Viva)
• Dead space and its types (v.v Imp viva)
• Cough reflex / Sneez reflex (blue box)

Chapter 39:

(Re-P005 -006)

• Pressures in pulmonary system (read +mcqs)
• Blood volume of lungs (mcqs)
• Blood flow through lungs and its distribution (read)
• Three zones of blood flow (pg505-507) imp
• Capillary dynamics (understand this topic for concept)
• ⁠Pulmonary edema (v.v.v.v.imp viva/proff qs)
• Fluid in pleural cavity (read)
• Pleural Effusion and causes (viva)

Chapter 40:

(Re-P 007)

• (Skip from the start until 515)
• Diffusion of gases through resp membrane (pg 515-517)

(Re-P 011)

• V/Q ratio blue box at the end of ch 40 (vvimp)
• Abnormalities of V/Q ratio (proff qs)

Chapter 41:

(Re-P008-010)

• Transport of Oxygen (read)
• Bohr Effect with fig 41.10 and factors (proff qs)
• Transport of oxygen in dissolved state blue box(mcq)
• CO poisoning blue box with fig 41.12(viva)
• Transport of CO2 with Fig 41.13 imp
• Cl Shift/Hamburger phenomenon (vvimp)
• Haldane effect with Fig 41.15(imp)
• Respiratory Exchange Ratio (Viva)

Chapter 42:

(Re-P016-018)

• ⁠Respiratory Centers (viva)
• Inspiratory Ramp signal (proff qs)
• Hering-Brerer reflex (viva/ seq)
• Chemical control (pg 533-536) imp
• Regulation of Respiration in exercise (imp)
• Periodic breathing and Chenye stroke Breathing (blue box)
• Sleep apnea

Chapter 43: (Most Important)

(Re-P019-030)

Note: Scenario type questions can be asked so do the diseases carefully.

• Pathophysiology of following diseases (Risk factors, causes, management)
• Pneumonia
• Tuberculosis
• RDS
• Asthma
• Cyanosis and its types
• Dyspnea
• Pneumothorax
• Pleuritis
• Bronchitis
• Respiratory failure
• Hypoxia and its types

(Hypoxia inducible factors do this topic from ch 44 pg 555)

Chapter 44:

(Re-P-013 – 014)

• Acclimatization
• Acute mountain sickness
• Chronic mountain sickness
• Decompression sickness from ch 44

These terms are frequently asked in viva so do them properly

Prepared by:

                            Ibtihal Iftikhar (G-14)

                            Ahsan Ali (G-14)

Compiled by:

                           Jawad Ashraf(G-14)

Recommended Book:

• Guyton and Hall Textbook of Medical Physiology 14^th Edition (Chapter numbers are mentioned according to this edition)

Reference Books:

• Jaypee Essentials of Medical Physiology 6^th Edition

CARDIOVASCULAR SYSTEM

Chapter 9:

(CV-P-001 and 002)

• Complete
• Fig 9.5, 9.6, 9.7, 9.8(Most Imp)
• Should learn to draw cardiac action potential and fig 9.8
• Learn to draw fig 9.11, leave fig 9.10

Chapter 10:

(CV-P-001, 002 and 003, ectopic pacemaker)

• Complete
• Read the chapter thoroughly and mark the mcq points.
• Learn to draw fig 10.2 and 10.4

Chapter 11:

(CV-P-004)

• Normal ecg labelling, characteristics and time intervals vv imp.
• Rest read.
• Memorize name, placements and polarity of leads.
• Einthoven’s law (v imp)

Chapter 12:

(CV-P-004)

• Fig 12.2 and 12.3
• Mean electrical axis.
• All conditions of abnormalities.
• Current of injury (j point (imp)
• Coronary ischemia
• T wave abnormalities vv importan.
• Do the flowchart given below

Effect of electrolytes:

(CV-P-005)

Chapter 13:

(CV-P-006)

• Most important chapter.
• Complete except paroxysmal tachycardia
• AV block, ventricular fibrillation (v.v.imp)
• Should be able to recognise ECGs.

Chapter 14, 15, 16:

(CV-P-007 and 008)

• From Firdaus
• Starling forces and Reynold’s number are important

Chapter 17:

(CV-P-009)

• Complete (Guyton)

Chapter 18:

(CV-P-010 and 011)

• From Guyton (v.imp)
• Do all reflexes and make flow charts of them
• Figure 18.10 vv imp.

Chapter 19:

(CV-P-012)

• Full chapter is important so read carefully
• MEMORIZE three flowcharts: fig 19.6, fig 19.9, fig 19.12

Chapter 20:

• Normal values
• Cardiac index
• Hyper and hypo-effective heart
• Nervous control
• Pathologically high and low CO.
• Venous return (read and focus on headings)
• Only Ficks Oxygen method in measuring Cardiac Output

Chapter 21:

• Read and do important points
• onlyFocus on headings
• Can do from Firdaus

Chapter 23:

• Heart sounds (v.v.v.imp) Table Given
• Full chapter is v important
• Should be able to recognize phonocardiograms.

Chapter 24:

• Most important
• Scenario based SEQs
• Do it complete from Guyton

Note: Watch Dr. Najeeb ECG lectures for UNDERSTANDING, however nothing from them will be asked in exam, it is only to understand how characteristic ECG is produced

Chapter 12 Guyton

Prepared by:

                     Hassan e Muhammad (G14)

Compiled by:

                     Hafiz Muhammad Umair Noor (G12)

Recommended Book:

• Guyton and Hall Textbook of Medical Physiology 14^th Edition (Chapter numbers are mentioned according to this edition)

Reference Books:

• Jaypee Essentials of Medical Physiology 6^th Edition

MEMBRANE PHYSIOLOGY

Chapter 5:

MS-P-001:

• Membrane potentials across selectively permeable membrane pg 63  (read for Basic concept + mcqs)

MS-P-002:

• ⁠Normal distribution of Ca Cl Na and K across membrane from fig 4.1
• Membrane potential vs Nerst potential
• Nernst potential and it’s basis
• Nernst equation (calculate the nernst potential  for Na and K by putting values in the equation)

MS-P-003:

• Goldman Equation pg 64 imp(use to calculate diffusion potential & resting potential when membrane is permeable to several different ions)

MS-P-004:

• Resting membrane potential of neurons pg 65
• Table 5.1 (mcqs)
• Fig 5.5
• Origin of RMP (seq)  & physiological basis i.e factors contributing
• ⁠Hyperkalemia and Hypokalemia( imp)  ( pic is shared in the group)
• ⁠Membrane Stabilizers ( lidocaine, calcium, mexiletine, valproic acid)
• ⁠Inhibition of excitability stabilizers and local anesthetics pg 76 ( v imp) and their mechanism of action

MS-P-007:

• Neuron action potential pg 67 (definition+ all stages)
• Fig 5.6 imp ( also do it from the pic shared in the group )
• Voltage gated Na and K channels
• Na channels can be blocked by tetrodotoxin when applied outside the cell membrane (mcq)
• K channels can be blocked by tetraethylammonium ion when applied to interior of nerve fibre (mcq)
• Initiation of action potential pg 71( read)
• Propagation of action potential (read)
• All or nothing principle pg 72 (imp)
• Re establishing Na and K ionic gradients after action potential pg 72 (imp)
• Properties of action potential (pic is shared in the group)
• Monophasic action potential (pic is  shared in the group)
• Refractory period ( pic is shared in the group) relative v/s absolute

⁠ MS-P-008:

• Role of Other ions during action potential pg 70 blue box ( v imp + tetany is seq ) role of Ca+ in it
• Rheobase , chronaxie , utilization time ( vimp pic is shared in the group)

MS-P-011:

• Special characteristics of signal transmission in nerve trunks (imp) pg 74
• saltatory conduction and its importance

Chapter 31: (Jaypee)

MS-P-009(a):

• Graded potential + table 31.1 basis& properties
• Graded vs Action Potential difference
• Compound Action Potential .. basis& properties

NERVE PHYSIOLOGY

Chapter 134:(Jaypee)

MS-P-005(a):

• Complete chapter till functionsof neurilemma
• Neuron anatomy
• Neuron classification
• Myelin sheath, neurilemma

Chapter 138: (Jaypee)

MS-P-005(b):

• Complete chapter 
• Neuroglial cells and their roles
• Myelination process
• Axonal transport ( pic is shared in the group)

Chapter 135: (Jaypee)

MS-P-006:

• Complete chapter
• Nerve fibers classification  table 135.1

Chapter 140: (Jaypee)

MS-P-009(b): Synapse

• Fig 140.4
• Fig 140.5

MS-P-010:

• Functional classification of synapse
• Fig 140.2 +140.3

Chapter 137: (Jaypee)

MS-P-012:

• Multiple Sclerosis
• GB syndrome (google)
• Causes, features and pathophysiology
• Degeneration of neuron two types
• Regeneration of neuron

MUSCLE PHYSIOLOGY

Chapter 6:

MS-P-013:

• Physiological anatomy of skeltal muscle
• Sarcomere
• Fig 6.3
• Jaypee Table 28.1 (Diference)

MS-P-014:

• ⁠ Charcteristics of muscle contraction
• Fig 6.12
• Also do examples Of Isotonic and isometric contraction
• Fast vs slow muscle fibres

MS-P-015:

• Motor unit
• Force summation
• Multiple summation
• Frequency summation and tetanization (imp)
• Treppe
• muscle fatigue
• Remodeling +Blue box

Chapter 7:

MS-P-016:

• Complete Chapter
• Anatomy, generation and conduction of impulse at NMJ
• Generation of endplate potential
• Excitation and contractions coupling (imp)
• Myasthenia Gravis (v.imp )
• NMJ enhancer and inhibitors

Chapter 8:

MS-P-017:

• Types of Smooth Muscle
• Physiologivcal basis Of Smooth Muscle contraction
• Smooth muscle contraction without Action Potential
• Hormones causing contractions without Action Potential
• Latch mechanism and importance
• Stress Relaxation
• Regulation By Calcium
• Nervous and hormonal Control (Complete till end)

Prepared by:

                     Mahnoor (G14)

Compiled by:

                     Hafiz Muhammad Umair Noor (G12)

Overview:

• If you do it in a right way, you can get all those easy marks.
• Give priority to notes shared in the group and give a read to book for mcqs

Things To Do In Histology:

• Diagrams are very important, 1st year diagrams are quite easy. Every diagram is important (frequently asked in exams)
• Histology’s trick is same as that of Gross anatomy (Visual memory), Visualize the Pictures and its features! Thats all they ask.

Reference Books:

• Medical Histology by Laiq Hussain Revised 7^th Edition (Chapter numbers are mentioned according to this edition)
• Difiore’s Atlas of Histology
• Mannual Of Histology (your practical notebook!)
• Shortlisted notes of histology are also shared in the group (By Zayn ul Hassan from G12)

Chapter 7: (Cartilage)

(MS-A-075, MS-A-076)

• Histo diagram of every type (vv imp)
• Diff b/w 3 types from your practical copy with examples (asked in viva)
• Microscopic features and function of perichondrium

Chapter 8: (Bone)

(MS-A-072, MS-A-073, MS-A-074)

• Organic and inorganic matrix for mcqs
• Metabolic role of bone
• Diff b/w types from your practical copy
• Haversian system (v imp)
• Compact and spongy bone diagram (vvv imp)
• Ossification types and features
• Zones of growth (mcqs)
• Bone repair recall it from GA /NOTES
• Clinicals (Osteoporosis, osteopenia, osteopetrosis, osteophytes)
• Appositional growth and Interstitial growth(our proff qs)

Chapter 10: (Muscular tissue)

(MS-A-070, MS-A-071)

• Diff b/w muscle types from practical copy
• Caveolae, dark, light, I and A band, sarcomere for mcqs
• Triad and diad present in which type
• Intercalated disc (imp proff qs)
• Hyperplasia and hypertrophy of muscle fibres
• Histopathology of Leiomyoma.

Prepared by:

                     Mahnoor (G14)

Compiled by:

                     Hafiz Muhammad Umair Noor (G12)

Reference Books:

• KLM Clinically Oriented Embryology 11^th Edition
• Langman Medical Emryology 14^th Edition

Note:

• Do all clinicals

Chapter 11: (Langman)

MS-A-065:

• Skip genetic and molecular factors
• Straited skeletal muscle development make flow chart
• Innervation Of Axial
• Skeletal Muscles + fig 11.4
• Origin of muscles from abaxial and primaxial precursor table 11.1 (vvvv imp)
• SMCs and Cardiac development just read it
• Clinicals
• Poland sequence
• Prune belly syndrome
• Muscle dystrophy

Chapter 12: (Langman)

MS-A-066:

• Limb development and growth. Shortlist it & Make a flow chart
• Topographic anatomy of UL and LL
• Fig 12.5(imp)
• All clinicals given in Langman (vvv imp)
• Amelia
• Meromelia
• Phocomelia
• Cleft Hand and Foot
• Polydactyly
• Brachydactyly
• Syndactyly
• Congenital club foot

Chapter 14: (KLM)

MS-A-069:

• Development of bone and cartilage only

Chapter 16: (KLM)

MS-A-067:

• Blood supply of limbs
• Cutaneous innervation of limbs

Prepared by:

                     Ibtihal Iftikhar (G14)

                     Muhammad Abdul Rehman Wazir (G14)

Compiled by:

                     Hafiz Muhammad Umair Noor (G12)

Reference Books:

• Lippincott Illustrated Reviews: Biochemistry 8^th Edition (Chapter numbers are mentioned according to this edition)
• Satyanarayana Biochemistry 6^th Edition
• Harper’s illustrated Biochemistry 30^th edition
• ABC of Clinical Genetics 3^rd edition
• Chatterjea Textbook of Medical Biochemistry 8^th edition
• Instant Biochemistry by Faiq Ahmed 3^rd edition

CARBOHYDRATES

Chapter 2: (From Satya)

MS-B-001:

• Classification of carbohydrates:
• General Classification pg # 9 & 10
• Monosaccharide Classification pg # 11 (Table 2.1 & 2.2)
• Oligosaccharide(disaccharide) Classification pg # 19 & 20
• Polysaccharide Classification pg # 20 to 25
• Biomedical importance of each class of carbs is given along with their classification

MS-B-002:

• Isomerism of carbohydrates pg # 10 to 15

MS-B-003 (a):

• Physical properties of carbohydrates
• Chemical properties of carbohydrates (Reactions of monosaccharides) pg # 15 to 18
• Difference between proteoglycans and glycoproteins is given in the pic shared below

Chapter 14:

MS-B-003 (b):

• Structure, function & clinical significance of Glycosaminoglycans (GAGs) pg # 173 to 175 (till before synthesis only) (Fig 14.4 vvvv.imp)

Chapter 8:  

MS-B-003 (d):

• Transport & uptake of glucose, pg # 105 to 107 (heading IV. Glucose transport into cells)
• Glycolysis reactions & regulation (heading V. Glycolysis reactions, heading VI. Hormonal regulation)

Chapter 9:  

MS-B-004:

• Full chapter in detail

PROTEINS

Chapter 4:

MS-B-003 (c):

• Structure & function of Fibrous proteins pg # 45 to 50 (Collagen) & pg # 52 (Elastin)
• Fig 4.7 is imp ( Rather than doing the whole text, you can do biosynthesis from this fig )
• Diseases associated with Fibrous proteins pg # 50 to 53 (Ehler-Danlos syndrome, Osteogenesis Imperfecta, Alport syndrome & Emphysema)
• Role of Vitamin C in collagen synthesis (Hydroxylation) pg # 49
• Duchene Muscular Dystrophy from the PDF with you.

Chapter 19:  

MS-B-005:

• Digestion & absorption of proteins, pg # 271 to 276

MS-B-006:

• Transamination from pg # 276 to 278
• Oxidative Deamination from pg # 278 to 279
• Do Deamidation, Decarboxylation & Transdeamination from PDF shared.

MS-B-007:

• Role of PLP covered in Transamination reaction ( Fig 19.9 )
• Role of Glutamate, Glutamine & Alanine (GLUCOSE-ALANINE CYCLE) pg # 279 (Topic : Ammonia transport to liver)
• For ammonia transport to liver, 2 pathways are mentioned, do both+ Fig 19.13 (vvv imp)

MS-B-008:

• Urea Cycle pg # 279 to 282

MS-B-009:

• Hyperammonemia pg # 282 till end of chapter

Chapter 20:  

MS-B-010:

• Metabolism of Amino Acids pg # 290 to 298

MS-B-011:

• Amino Acid Metabolism Disorders pg # 298 till end of chapter

VITAMINS

Chapter 28:  

MS-B-003 (c):

• Sources, functions, active form & deficiency of Vit C, pg 427 & 428

MS-B-007:

• Role of PLP, pg # 428

Amino Acid Metabolism Reactions by Medico Guides