3rd YEAR MBBS Study Guide

UHS 8^th Block

  (Module No 16)

Prepared by:    

                          Zernaab Jodat (G11)

                          Shahr Bano Sayal (G12)

                          Chaman Zulfiqar (G12)

Compiled by:

                    Talha Saleem (G12)

COMMUNITY MEDICINE

Recommended Book:

• Excel 14th edition. (No need to do K-park for this topic)

(N-CM-001)

Chapter 7:

• Definition of screening (just add word of cancer in this to convert it into def of Cancer screening)

Importance of Cancer Screening

You can do this topic from here:

1. Early Detection:

• Screening can catch cancer before symptoms appear, increasing the chances of successful treatment.

2. Better Treatment Outcomes:

• Cancers found early are usually smaller and haven’t spread, so they are easier to treat and more likely to be cured.

3. Increased Survival Rates:

• Early diagnosis through screening often leads to a higher survival rate and better quality of life.

4. Cancer Prevention:

• Some screenings (like Pap smears and colonoscopies) can detect and remove precancerous lesions before they turn into cancer.

5. Reduces Cancer-related Deaths:

• Screening programs have been proven to lower death rates from cancers like breast, cervical, and colorectal cancer.

6. Cost-effective:

• Treating early-stage cancer is usually less expensive and less intense than treating advanced cancer.

7. Peace of Mind:

• Regular screening gives reassurance if results are normal and allows timely action if anything abnormal is found.

Imp point, never ever confuse methods of screening with types of screening.

Types of Screening:

1. Mass screening
2. High risk screening
3. Multi phase screening

Methods of Screening

Methods of Cancar screening are not mentioned in book so you can do it from here:

1. Mammography (Breast Cancer):

• X-ray of the breasts to detect lumps or tumors early.

2. Pap Smear (Cervical Cancer):

• Collects cervical cells to check for precancerous or cancerous changes.

3. HPV DNA Test (Cervical Cancer):

• Detects high-risk types of human papillomavirus that cause cervical cancer.

4. Colonoscopy (Colorectal Cancer):

• A flexible camera examines the colon and rectum for polyps or tumors.

5. FOBT / FIT (Colorectal Cancer):

• Tests stool samples for hidden blood, a sign of polyps or cancer.

6. Sigmoidoscopy (Colorectal Cancer):

• Examines the lower part of the colon with a flexible tube for polyps or tumors.

7. PSA Test (Prostate Cancer):

• Measures prostate-specific antigen in blood; high levels may suggest cancer.

8. Digital Rectal Exam – DRE (Prostate Cancer):

• Finger exam of the rectum to feel for prostate abnormalities.

9. Low-dose CT (Lung Cancer):

• CT scan of the chest with low radiation to detect early lung nodules in high-risk individuals (e.g., heavy smokers).

10. Oral Exam (Oral Cancer):

• Visual and physical inspection of the mouth for sores, lumps, or color changes.

11. Skin Exam (Skin Cancer):

• Full-body check for unusual moles or skin changes by self or clinician.

12. TVUS – Transvaginal Ultrasound (Ovarian Cancer):

• A probe inserted into the vagina to image the ovaries and uterus.

13. CA-125 Test (Ovarian Cancer):

• Blood test measuring cancer antigen-125, elevated in ovarian cancer.

14. Ultrasound (Liver Cancer):

• Imaging of the liver to detect abnormal masses.

15. AFP Blood Test (Liver Cancer):

• Measures alpha-fetoprotein, often elevated in liver cancer.

16. Endoscopy (Esophageal/Stomach Cancer):

• A flexible tube with a camera is inserted through the mouth to view the esophagus and stomach lumen.

Preventive and Control Measures

Preventive and control measures, you can write yourself if you’ve covered levels of prevention in chap 1 of excel, I’m giving below these points too:

Primordial Prevention (Avoid emergence of risk factors in the population)

• Health promotion from early life
• Anti-tobacco and anti-alcohol campaigns
• Public policies to reduce environmental carcinogens
• Promotion of healthy lifestyle in schools and media
• Banning junk food and tobacco ads

Primary Prevention (Prevent onset of disease by controlling risk factors)

• Health education about diet, physical activity, avoiding tobacco/alcohol
• Vaccination:
• HPV vaccine → Cervical cancer
• HBV vaccine → Hepatocellular carcinoma
• Occupational safety: Protect workers from carcinogens (asbestos, chemicals)
• Dietary modifications: High-fiber, low-fat, antioxidant-rich foods
• Sun protection to reduce skin cancers

Secondary Prevention (Early detection and prompt treatment to stop progression)

• Cancer screening programs:
• Pap smear – Cervical cancer
• Mammography – Breast cancer
• Colonoscopy / FOBT – Colorectal cancer
• Low-dose CT scan – Lung cancer (in smokers)
• PSA test / DRE – Prostate cancer
• Oral cavity visual inspection – Oral cancer (esp. in tobacco users)
• Community-based screening camps
• Early referral and diagnosis

Tertiary Prevention (Reduce complications, disability, and recurrence after diagnosis)

• Treatment: Surgery, chemotherapy, radiotherapy
• Rehabilitation: Physical, psychological, occupationa
• Palliative care: Pain management, end-of-life care
• Follow-up and surveillance for recurrence
• Support groups and counseling for cancer patients and families
• Cancer registries for data tracking and planning

BEHAVIOURAL SCIENCES

N-BhS-001

• Do this from Section E (Psychosocial issues in hospital settings)
• For any disease steps are same as psychosocial assessment just give a read to this topic, not imp for seq pov)
• Topic oncology (page #167)

UHS 8^th Block

(Module No 17)

COMMUNITY MEDICINE

Recommended Book:

• Excel 14th Edition (Chapter numbers are mentioned according to this edition)

ID-CM-001:

• Chap 4 excel, Pg 93, read whole topic it’s extremely high yield topic as this disease is very common in PAK, focus mainly on its prevention and control measures and epidemiology

ID-CM-002:

• Excel chap 4, Pg 105, read whole topic with special focus on epidemiology and its prevention and control

ID-CM-003:

• Excel chap 4, Pg 81 read whole topic, with special focus on epidemiology and its prevention and control

ID-CM-004:

• Excel chap 4, Pg 88 (rubella), Pg 76 (mumps), Pg 74 (measles), read whole topics, but epidemiology and prevention should be at your finger tips.
• Must remember name of vaccine for each disease and time at which vaccine is given

ID-CM-005:

• Excel chap 6, Pg 134, Objectives of EPI, implementation strategy,
• Page 135 General hazards of immunization, adverse effects following immunization,
• Page 137, causes of failure of OPV,
• Table of EPI on Pg 140 (VVV imp table),
• Common barriers to immunization in PAK are not covered properly in book, do this topic from google/ ChatGPT

ID-CM-006:

• Excel chap 4, Pg 65, diphtheria VVV imp topic, pay special focus to epidemiology + prevention and control

ID-CM-007:

• Excel, chap 4, Pg 90, tetanus, again a really imp topic from clinical point of view, read the whole topic particularly focusing on epidemiology and prevention and control

GYNAECOLOGY

ID-GO-001, ID-GO-002

• All the mentioned topics from Chater 9 of Ten Teachers

PAEDIATRICS

ID-Pe-001 to ID-Pe-003

• Book: Paediatrics Ahmed Hassan
• CNS → pyogenic and tuberculous meningitis
• GIT → chronic diarrhea
• Respiratory disorders

Prepared by:

                           Christopher Stephen (G12)

Compiled by:

                     Hafiz Muhammad Umair Noor (G12)

Reference Books:

• Pathoma Fundamentals of Pathology
• Medium Robbins Latest Edition
• Essentials of Special Pathology by MBBS Cafeteria

Chapter 10:

Rheumatoid Arthritis:

• Mechanism(HLA association)
• Clinical features especially morning stiffness that improves with activity(often scenario is presented this way) and age (60+)
• Morphology from cafeteria book, in purple box
• Lab findings like antibodies and markers etc
• Treatment

Osteoarthritis:

• Mechanism (wear and tear)
• Presentation: age, stiffness that worsens during the day
• Morphology from cafeteria book
• Clinical features like osteophytes and nodes
• Treatment

Gout:

• Mechanism overproduction/underexcretion
• Types 1⁰ or 2⁰
• Clinical presentation
• Causes
• Lab findings (negative birefringence vvvvimp)
• Differentiate it from pseudogout (crystal shape and +ve birefringence)

Tumors:

• Scenario is asked, giant cell tumor and ewing sarcoma, osteosarcoma are more imp
• Focus on location, age bracket, any special finding(like soap bubble in giant cell), associations
• Tumor morphology from cafeteria book (super high yield)
• Soft tumors like lipoma etc

Note: You can use Robbins for morphologies if cafeteria  is not suitable.

Prepared by:    

Zernaab Jodat (G11)

Compiled by:

                     Hafiz Muhammad Umair Noor (G12)

UHS 8^th Block

(Module No 16)

PRINCIPLES OF ONCOLOGIC SURGERY

(N-S-001)

Recomended Book:

• Dogar General Surgery 4th Edition

Chapter 20:

• Screening
• Tumor markers
• Principles of cancer surgery
• Principles of chemotherapy and radiotherapy (vvimp)
• Principles of immunotherapy
• Tumor board (TEAM)

UHS 8^th Block

(Module No 17)

GASTROINTESTINAL TRACT

N-S-001(b)

Recomended Book:

• Irfan Masood Surgery

Chapter 2:

• Difference between hydatid cyst and amebic liver abscess:
• Signs
• Symptoms
• Management

SKIN

ID-S-001(a)

• Management of gas gangrene, carbuncle and necrotising fascitis:
• Introduction of these diseases from Microbiology
• For treatment and management consult chapter 29 (plastic and reconstructive surgery) from Bailey & Love’s Short Practice of Surgery.

UHS 8^th Block

(Module No 18)

ORTHOPEDICS

Recomended Book:

• Dogar Systemic Surgery

MS2-Orth-001

• Definition of orthopedics and its significance → From Google

Chapter 1:

MS2-Orth-002

• Principles of fracture healing
• Difference between complete and incomplete fractures

MS2-Orth-003(a)

• Salter- Harris classification

Chapter 4:

MS2-Orth-003(b)

• Management of paediatric fractures

Recomended Book:

• Bailey & Love’s Short Practice of Surgery

Chapter 28:

MS2-Orth-004

• What are osteoporotic fractures, sites and risk factors

MS2-Orth-005

• Pathologic fractures, difference from traumatic and their management

Chapter 32:

MS2-Orth-006

• Sports injuries in upper and lower limbs:
• Management
• Prevention
• Rehabilitation
• Assistive devices
• Surgical intervention
• Nutritional role

Chapter 39:

MS2-Orth-007

• Achondroplasia and marfans syndrome → features, management, counselling of marfans

MS2-Orth-008(a)

• Osteogenesis imperfecta → features, management, counselling of patients

Chapter 33:

MS2-Orth-008(b)

• Scoliosis → types, management, rehabilitation

SURGICAL TRAUMATOLOGY

Recomended Book:

• Dogar General Surgery 4th Edition

Chapter 9:

• ATLS → ABCDE and trauma management
• All the traumatic injuries and their ATLS interventions are (v imp)
• Causes and features of traumatic injuries
• Primary survey
• Traumatic Brain Injury

Recomended Book:

• Tintinallis Emergency Medicine Manual 9th Edition

MS2-Orth-012

• Do topic of Shock from chapter 5

MS2-Orth-014

• Do topic of Neck and Spine Trauma from chapter 161 and 163

MS2-Orth-015

• Do topic of Maxillofacial Trauma from chapter 162

MS2-Orth-012

• Do topic of Extremities Trauma from chapter 168

Prepared by:    

Zernaab Jodat (G11)

Compiled by:

                     Hafiz Muhammad Umair Noor (G12)

UHS 8^th Block

  (Module No 16)

RADIOLOGY

Recomended Book:

• Kelleys Essential Of Internal Medicine

Chapter 248:

N-M-001

• Imagine techniques types

N-Ra-001 to N-Ra-003

• Imaging in cancer staging
• Treatment planning of cancer patients

N-Ra-004

• Specific modalities

Note: Also practice various radiographic images on the internet.

ONCOLOGY

Recomended Book:

• Davidsons Principles and Practice of Medicine

Chapter 33:

N-M-002

• Presenting problem of cancer patients

N-M-003

• Risk factors

N-M-004

• Investigations
• Examination
• Determinants

N-M-005(a)

• Emergency complications

N-M-006

• Therapy strategy

Recomended Book:

• Kelleys Essential Of Internal Medicine

Chapter 247:

N-M-005(b)

• Paraneoplastic syndromes and oncological emergencies….what are those?

UHS 8^th Block

(Module No 17)

INTERNAL MEDICINE

Recomended Book:

• Step Up Medicine 2025-26 Edition

Chapter 10:

ID-Pa-009

• Pyrexia of unknown origin…stepup page 407

ID-Ph-011(a)

• Pneumonia

ID-Pa-013

• Meningitis
• Encephalitis

Recomended Book:

• Irfan Masood Medicine 3^rd Edition

Chapter 6:

ID-Ph-011(b)

• Do tuberculosis from page 250.

UHS 8^th Block

(Module No 18)

RHEUMATOLOGY

Recomended Book:

• Irfan Masood Medicine 3^rd Edition

Chapter 12:

MS2-Rh-001 to MS2-Rh-006

• Introduction and scope from Google
• Rheumatoid arthritis, gout, osteoarthritis, systemic inflammatory vasculitis, other rheumatic diseases, do their definitions and management
• Pathophysiology of all and differences

Prepared by:

                           Chaman Zulfiqar (G12)

Compiled by:

                     Hafiz Muhammad Umair Noor (G12)

Reference Books:

• NRA Forensic Medicine 2^nd Edition
• Shahbaz Forensic Medicine 6^th Edition

For2-Tr-001:

• Chapter 5, def of injury, wound, hurt with their section number
• Def must be learnt word to word as it is
• Page 109 Injuries classification on basis of causative agent complete topic
• Table 4.2 NRA complete as it is vvv imp

For2-Tr-002:

• Chapter 5 SHAHBAZ, pg 107, mech of wound production complete

For2-Tr-003:

• Chapter 5 SHAHBAZ , pg 113 to 114 complete topic of abrasion

For2-Tr-004:

• Chapter 5 SHAHBAZ pg 110 to 112, bruise, complete topic along with tables + table 6.3  from NRA vvv imp table

For2-Tr-005:

• Chapter 5 SHAHBAZ, pg 115 to 116 Laceration complete topic + table of diff b/w laceration, incised wound and stab wound on SHAHBAZ pg 123 sendup question

For2-Tr-006:

• Not given in book, you’ll have to do it from google or chat/gpt

For2-Tr-007:

• SHAHBAZ chap 5 pg 116 to 121,  incised and stab wounds complete

For2-Tr-008:

• Mainly related to pathology

For2-Tr-009:

• SHAHBAZ chap 5, pg 125 age of wound, complete topic till next page

For2-Tr-010:

• Ewings postulate, from NRA (given at end of traumatology chap)

For2-Tr-011:

• Chapter 15 SHAHBAZ, pg 322 battered baby syndrome, comp topic

For2-Tr-012  For2-Tr-013

• These topics will be covered in your lab and wards

For2-Tr-014:

• Chap 6 SHAHBAZ, def of firearm pg, 127
• Firearm components + def of ballistics, pg 129

For2-Tr-015:

• Chapter 6 SHAHBAZ, pg 133, exterior ballistics ke last pr 2 points h air resistance aur gravity wale ye topic krna ha

For2-Tr-016:

• Chapter 6 SHAHBAZ, firearm wound complex + pg 145 determination of dist of fire + pg 142, table of diff b/w entry and exit wound

For2-Tr-017:

• Chapter 6 SHAHBAZ, pg 132 gun powder types and composition

For2-Tr-018:

• Complete topic of explosions from SHAHBAZ, pg 33, not much imp

For2-Tr-019 and For2-Tr-020

• complete topic of pedestriam injuries from SHAHBAZ pg 326 to 322

For2-Tr-021:

• Chapter 7 SHAHBAZ Thermal injury complete topic till pg 162

For2-Tr-022:

• Chapter 7 SHAHBAZ, pg 164 till end complete topic of electrocution and lightening

For2-Tr-023:

• SHAHBAZ pg 348, complete topic of heat (mcqs ae the hme is topic se test me, so don’t ignore it)

For2-Tr-024:

• Covered in topic of burns

For2-Tr-025:

• SHAHBAZ Chapter 8, pg 188, complete topic of drowning

For2-Se-001:

• SHAHBAZ Chapter 9 pg 195, all def + causes of impotence from next pg along with medicolegal imp from pg 197

For2-Se-002:

• SHAHBAZ Chapter 10, signs of viriginity, complete topic + medicolegal imp from pg 207

For2-Se-003:

• Chapter 10 SHAHBAZ, signs of pregnancy, complete topic, pg 207

For2-Se-004:

• Chapter 10, Signs of delivery, complete topic

For2-Se-005:

• Chapter 10 SHAHBAZ, pg 217 abortion complete topic (criminal abortion is extremely imp)

For2-Se-006:

• SHAHBAZ Chapter 11, def of sexual offences,  classificatio, legal consideration, examination of case of rape (it’s written very lengthy here, do it from NRA) extremely imp topic (ques of our prof exam)

For2-Se-007:

• SHAHBAZ Chapter 15, Def of infanticide + summary of factors indicative of live birth from pg 318, 
• Definition of live born, still born, dead born, and table differentiating b/w ante-natal and intra-natal deaths, from pg 312
• Their autopsy findings are not mentioned here properly. You can do it from google

Prepared by:                                                                                          

                           Christopher Stephen (G12)                            

Compiled by:

                     Hafiz Muhammad Umair Noor (G12)

Recomended Books:

• Mini Katzung Pharmacology Edition 2024-25
• Classification from Ali Raza Notes  

(MS2-Ph-001)

DMARDS

Chapter 36:

• Classification of DMARDS
• MOA
• Effects + clinical uses
• Adverse Effects

CORTICOSTEROIDS

Chapter 39:

• Role in autoimmune diseases(like rheumatoid arthritis
• MOA
• Adverse Effects

BISPHOSPHONATES

Chapter 42:

• Names
• MOA
• Adverse Effects (esophagitis so maintain upright position for half an hour)

NSAIDs

Chapter 36:

• MOA
• Indication in different diseases
• Adverse Effects specially those of nsaids and aspirin

OPIOIDS

Chapter 31:

• MOA
• Indication in different diseases
• Adverse Effects

Prepared by:

                           Shahr Bano Sayal (G12)

Compiled by:

                     Hafiz Muhammad Umair Noor (G12)

Reference Books:

• Mini Katzung Pharmacology Edition 2024-25
• Kaplan USMLE Step 1 Pharmacology Lecture Notes

• Ali Raza Chaudhary Notes

CHEMOTHERAPEUTICS

Note:

One of the lengthy but selective topics, do this topic according to guidelines otherwise it’ll give you headache, Kuch chapters ap ny Kaplan Sy krny Hain  aur Kuch katzung Sy. I’ll mention accordingly.

• Saab Sy phly classification krni ha ap ny hr topic ki (Three times a day😅)
• Do complete chapter from mentioned book
• Preferred to do Ayesha batool shortlist on your book (it’ll help a lot for SEQ)
• If you want, give a read to topic from Lippincott (it’s optional, If you find something imp note it on your main book)
• I’ll mention chapters numbers from Katzung.

Chapter 43: (Beta Lactam Antibiotics)

• Classification from ARC notes
• Complete chapter from Kaplan

Chapter 44 +45: (Aminoglycosides and Tetracyclines)

• Classification from ARC notes
• Comp chapter from Kaplan (v imp)

Chapter 46:

• Classification from ARC notes
• Complete chapter from Katzung (v imp)

Chapter 47

• Classification from ARC notes
• Complete chapter from Katzung (v imp)

Chapter 48

• Classification from ARC notes
• Complete chapter from Katzung (v imp)

Chapter 49

• Antiviral from Kaplan (one of the imp topics)
• Table 49.2 (imp) (from Katzung)

Chapter 50 +51

• No need to do it.

 Chapter 52:

• Antiprotozoal [just do classification from ARC notes and give a read to summary table from Katzung(imp)]
• Chloroquine, primaquine , sodium sitabogluconate from summary table

Chapter 53:

• Just classification from ARC notes
• Summary table from Katzung

Prepared by:

                         Kisa e Zahra (G12)

Compiled by:

                   Hafiz Muhammad Umair Noor (G12)

Reference Books:

• Anwar Microbiology 2^nd Edition
• Sketchy Microbiology

Note:

• Sketchy + Anwar (this is the best combo for micro and you have to prepared everything in this) 
• You can also use Levinson as it is standard book for your better understanding.

(ID-Pa-001)

For clinical bacteriology basic steps are always on your fingertips like staining, morphology, virulence factors, special disease by microbe etc

Gram +ve Microbes

Anwar Chapter # 12, 14

Levinson Chapter # 15, 17 (All tables are imp)

IMPORTANT POINTS FOR BACTERIA

• Staph aureus ( all diseases caused by this(Kawasaki disease and other), its cell wall components and pathogenisis
• For strep know about it’s hemolysis classification and strep pyogenese is imp one
• Clostridium classification+imp diseases caused by them
• Bacillus (imp) caused by reheated rice
• Corynebacterium pathogenisis and diseases imp
• Read of listeria and gardenella

Gram -ve Cocci

Anwar  Chapter # 13

Levinson Chapter # 16

• Neisseria species are imp (specially their pathogenesis and lab diagnosis)

Gram -ve Rods:

Lab diagnosis are important that will differ microbes like MacCkoney’s agar, urease test, TSI test colour.

Anwar Chapter #15

Levinson Chapter # 18+19

• E.coli (most imp) it’s pathogenesis, it’s ETEC and EHEC form and lab diagnosis
• Salmonella (imp pathogenesis, rose spots, lab diagnosis)
• Shigella (pathogenesis)
• Vibrio (imp pathogenesis+ rice watery stools + lab diagnosis)
• Proteus (pathogenesis+ urease positive + staghorn canaliculi)
• Pseudomonas (imp pigments + diseases + patho)
• H.pylori and camplylobacter (read+ sketchy)
• Actinomyces (only sketchy)

Spirochetes:

Anwar Chapter # 21

Levinson Chapter # 24

• Traponema (imp one it’s types, patho, lab diagnosis)
• Borrelia and leptospira (read)

Mycobacterium:

Anwar Chapter # 18

Levinson Chapter # 21

• Mycobacterium Tuberculosis is most imp . Should done everything ( pathogenesis, diseases, lab diagnosis imp)
• Laprae( imp and it’s two types difference)

Rickettsia and Chlymadia:

Anwar Chapter # 22, 23

• Just do sketchy and anwar

(D-Pa-002)

• For parasites most imp are life cycles and the most of transmission
• Sketchy and Anwar are best for context and do life cycles from Levinson

Anwar Chapter # 44, 45, 46, 47, 48

Levinson Chapter # 51, 52, 54, 55, 56

IMPORTANT PARASITES

• Entamoeba
• Plasmodium (very imp)
• Echinococcus(life cycle imp)
• Shictosoma
• Entrobius
• Ascaris
• Necator
• Ancylostoma

(Note:  do each and everything of above mention parasites)

(ID-Pa-003)

For fungi (Anwar + sketchy is enough)

Anwar Chapter # 40, 41, 42

IMPORTANT FUNGI

• Dermatophytes (type+ lab diagnosis)
• Histoplasma imp (morphology+ pathogenesis)
• Candida (most imp) (patho+ clinical findings+ lab diagnosis)
• Cryptococcus (patho+ lab diagnosis)
• Aspergillus (imp patho+ it’s forms + lab diagnosis)

(ID-Pa-004)

• Virology is tough from others microbes just do imp viruses
• Sketchy and Anwar is more than enough
• Always remember imp points that will help in diagnosis

Anwar Chapter # 31

• Herpes+ varicella + cytomegalovirus are imp one
• Others just read

Anwar Chapter # 32

• Influenza (important it’s types+ antigenic drift and shift and pathogenisis factors
• Measles mumps (sketchy is enough and read from Anwar)
• Rabies most imp) (it’s pathogenesis and incubation period and vaccine)
• Rubella (read)

Anwar Chapter # 33

• Corona virus (important it’s pathogenesis)

Anwar Chapter # 34

• Polio virus (imp) (it’s mode of transmission + pathogenesis + it’s vaccine types)
• Reovirus (read)

Anwar Chapter # 35

• Hepatitis B is most imp among them
• Serological findings
• Clinical features
• Pathogenesis
• Window period
• Read other hepatitis types

Anwar Chapter # 36

• Dengue virus (very imp)
• Dengue hemorrhagic fever hypothesis
• Lab diagnosis

Anwar Chapter # 37

• Just do table

Anwar Chapter # 38

• HIV (most imp)
• Pathogenesis
• Cycle
• Stages of AIDS
• Lab diagnosis

(Note: Do sktechy must for microbiology)

(ID-Pa-005)

Microbes Causing CNS Infections

For meningitis this will help:

1. Less than 2 Months (Neonates and Young Infants)

1. Streptococcus Agalactiae (Group B Streptococcus
2. Escherichia Coli (E. coli)
3. Listeria Monocytogenes
4. More than 2 Months (Infants and Young Children)

1. Streptococcus Pneumoniae (Pneumococcus)
2. Neisseria Meningitidis (Meningococcus)
   • Important Note: If a child is unvaccinated then Haemophilus influenzae becomes a very significant, often the number 1 cause of bacterial meningitis in this age group.
3. 2-18 Years (Children and Adolescents)
4. Neisseria Meningitidis (Meningococcus)
5. More than 18 Years (Adults)
6. Streptococcus Pneumoniae (Pneumococcus
7. Immunocompromised Individuals (e.g. HIV positive, Drug Users)
8. Listeria Monocytogenes

(Note: Correlate above knowledge)

(ID-Pa-006)

• GIT problems
• Correlate above knowledge
• Hepatitis guidelines mention in virology part
• Entamoeba in parasitic part

(ID-Pa-007)

• GIT infections
• Correlate from above knowledge

(ID-Pa-008)

• Rickettsia and leptospira mention in above bacteriology guidelines
• Anthrax, plague,francisella, bartonella and Brucella (do table from Anwar chapter17 and sketchy)

Prepared by:

                           Chaman Zulfiqar (G12)                           

Compiled by:

                     Hafiz Muhammad Umair Noor (G12)

NEOPLASIA

Recommemded Book:

• Medium Robbins Latest Edition

Note:

• Anwar General Pathology (for revision of theory in block/prof.)
• Must do flow charts, tables and diagrams from robbins as it is

N-pa-001:

• Definition of neoplasia (vvv imp def, asked in seq as well as in viva)

Neoplasia is an abnormal, uncontrolled, and autonomous proliferation of cells that persists even after the removal of the initial stimulus.

• Nomenclature from robbins chap 6 (2nd pg) + table 6.1
• Difference between benign and malignant tumor from google
• Epidemiology of cancer from robbins chap 6 pg 196 to 199

N-pa-002:

• Robbins chap 6, pg 200 from cancer genes to Carcinogenesis on pg 204 complete
• Page 221 fig 6.27 (vvv imp, ques of our class test + proff)
• Topic of sustained angiogenesis from robbins chap 6 pg 219
• Evasion of cell death with fig 6.25 complete on pg 217
• Fig 6.20 + 6.21 
• Definitions from topic of benign tumors + malignant tumors in robbins chap 6, just next to topic of nomenclature:

• Adenoma
• Chondroma
• Sarcoma
• Melanoma
• Seminoma
• Hamartoma
• Choristoma
• Teratoma

N-pa-003:

• Carcinogenic agents on pg 228 complete topic upto pg 235
• H.pylori with table 6.5 and fig 6.32

N-pa-004:

• Lab diagnosis of Cancer on pg 237, complete till end of chapter extremely imp from mcqs and point of view

N-pa-005:

• Grading and staging of cancer on pg 236 vvv imp seq, question of our class test and sendup 
• Fig 6.31 + tumor markers table from Big Robbins or you can google it as it’s not mentioned in medium robbins vvv imp table, question of our class test + proff

N-pa-006:

• Already covered in above topics + hall marks of cancer, just names of points from robbins chap 6 pg 205

N-pa-007:

• Table 6.6 (vvv imp from seq, mcqs, even viva point of view)

Prepared by:

                           Chaman Zulfiqar (G12)

Compiled by:

                     Hafiz Muhammad Umair Noor (G12)

Reference Books:

• Mini Katzung Pharmacology Edition 2024-25

(N-Ph-001)

Chapter 54:

• Cell cycle kinetics
• The log kill hypthesis
• Fig 54.1

(N-Ph-002)

Chapter 54:

• Page 457, from alkylating agents to page 461, upto mitomycin.
• This topic is quite lengthy, so for quick revision go for drug summary table given at end of chapter.

Anti-Tumor Drugs Associated with Rehabilitation

Anti-tumor drugs related to rehabilitation are given in a scattered way, I’m attaching  this topic below:

Drugs Causing Neuropathy (Physical Rehab needed)

1. Vincristine (Vinca alkaloid) – M-phase specific
2. Paclitaxel / Docetaxel (Taxanes) – M-phase specific

Rehab: Gait training, balance therapy, TENS, fine motor coordination

Drugs Causing Fatigue & Muscle Wasting

• Methotrexate (Antimetabolite – S-phase)
• 5-Fluorouracil (5-FU) – S-phase specific
• Cisplatin (Platinum compound – non-specific)

Rehab: Graded exercise therapy, energy conservation, physiotherapy

Drugs Causing Cardiotoxicity (Cardiac Rehab needed)

• Doxorubicin (Anthracycline – CCNS)
• Cyclophosphamide (Alkylating agent – CCNS)

Rehab: Cardiac monitoring, endurance training under supervision

Drugs Causing Cognitive Dysfunction (Chemo Brain)

• Cytarabine (S-phase)
• Ifosfamide

Rehab: Memory training, concentration techniques, mental exercises

Drugs Causing Bone/Muscle Issues (Orthopedic Rehab)

1. Anastrozole / Letrozole (Aromatase inhibitors – Hormonal therapy)

Rehab: Joint mobility exercises, bone-strengthening routines

Drugs Causing Psychological Disturbance

1. Tamoxifen (SERM – Hormonal therapy)

Rehab: Counseling, support groups, psychiatric intervention

Drugs for Tumor Lysis Syndrome (TLS)

Drugs for tumor lysis sundrome are also not given in summarized way, you can do this topic as given below:

1. Allopurinol – Prevents uric acid formation
2. Rasburicase – Rapidly lowers existing uric acid
3. IV Fluids – Flush out toxins, protect kidneys
4. Insulin + Glucose – Shifts potassium into cells (for hyperkalemia)
5. Calcium Gluconate – Stabilizes heart in severe hyperkalemia
6. Loop Diuretics (e.g. Furosemide) – Increases excretion of potassium/phosphate
7. Phosphate Binders (e.g. Sevelamer) – Treat hyperphosphatemia
8. Potassium Binders (e.g. Patiromer) – Lower high potassium
9. Dialysis – For severe cases or kidney failure

Drugs Used To Treat Complications Of Cancer

(Beside Surgical Resection)

1. Chemotherapy – Destroys cancer cells systemically

• Used for: Tumor shrinkage, metastasis, pain relief
• Examples: Cyclophosphamide, Doxorubicin, Methotrexate

2. Radiotherapy – Local tumor control, pain relief

• Used in: Brain mets, bone pain, spinal cord compression

3. Hormonal Therapy – Blocks hormones that fuel certain cancers

• Used in: Breast (Tamoxifen), Prostate (Leuprolide) cancers

4. Targeted Therapy – Blocks specific tumor growth pathways

• Examples: Imatinib (CML), Trastuzumab (HER2+ breast cancer)

5. Immunotherapy – Boosts immune response against cancer

• Examples: Pembrolizumab, Nivolumab

6. Bisphosphonates – Manage bone mets, reduce fractures

• Example: Zoledronic acid

7. Steroids – Reduce edema, especially in brain/spinal mets

• Example: Dexamethasone

8. Anti-emetics, painkillers, growth factors – Supportive care during treatment

Glucocorticoids In Anti-Cancer Drug Cocktails

Glucocorticoids (e.g., prednisone, dexamethasone) are steroid hormones used in many anti-cancer drug regimens, especially in hematological malignancies. Here’s how they help:

Mechanisms & Roles in Cancer Therapy

1. Cytotoxic to lymphoid cells

• Directly induce apoptosis in leukemias and lymphomas (esp. ALL, NHL).

2.Anti-inflammatory& Immunosuppressive

• Reduce tumor-associated inflammation.
• Prevent hypersensitivity or allergic reactions to other chemo drugs.

3. Part of Chemotherapy Regimens

• ALL (Acute Lymphoblastic Leukemia): Used in VDP or Hyper-CVAD protocols.
• NHL (Non-Hodgkin’s Lymphoma): In CHOP regimen:
• Cyclophosphamide, Hydroxydaunorubicin, Oncovin (vincristine), Prednisone.

4. Supportive Role

• Manage nausea/vomiting in chemotherapy.
• Reduce edema in brain tumors.
• Improve appetite and energy in terminal cases (palliative care)

Common Glucocorticoids Used

• Prednisone
• Dexamethasone
• Methylprednisolone

Side Effects (Long-Term Use)

• Immunosuppression
• Hyperglycemia
• Osteoporosis
• Mood swings
• Cushingoid features