4th YEAR MBBS Study Guide

Prepared by:

                  Soila Ansar (G12)

Compiled by:

                  Hafiz Muhammad Umair Noor (G12)

Reference Books:

• Medium Robbins Latest Edition (Chapter numbers are mentioned according to this edition)
• Pathoma Fundamentals of Pathology

Note:

• The sequence of the approach is the same as I’ve explained in the previous block guidelines that first you take Pathoma lectures and give a read to its notes and then move towards Medium Robbins. Therefore, I’ll guide you from Robbins only in the section below.

GLOMERULAR DISEASES

Note: If you want to have a better understanding of this section, read these topics from Robbins before doing specific diseases; Mechanisms of glomerular diseases.

001: Nephrotic Syndrome

• Table: etiological factors of nephrotic syndrome (1° and 2°)
• Pathogenesis: definition of nephrotic syndrome+ hallmarks and their pathogenesis (given in the start of chapter)
• Gross and microscopic features in glomeruli will be explained in subsequent sections where each disease will be discussed in detail.
• Diagnosis: it is the same as the hallmarks of disease like edema+ protein and lipids in urine (urine analysis), increase lipid in serum, coagulopathy, dec serum albumin, etc. Also, gross and microscopic features of glomeruli on biopsy specimens.

002: Podocytopathies

• Podocyte injury (given in the mechanism of glomerular diseases)
• Minimal Change Disease (pathogenesis+ morphology)
• Focal segmental glomerulosclerosis (pathogenesis+ morphology)

003: Membranous Nephropathy

• ​primary and secondary etiologies
• ​pathogenesis+ morphology

004: Nephritic syndrome (it is the inflammatory process therefore every glomerulonephritis is the cause of this syndrome)

• ​Definition and hallmarks and their pathogenesis (given in start of chapter)
• ​Etiologies (MPGN, PSGN, RPGN, IgA nephropathy- most common glomerulonephritis, Alport syndrome)
• ​Lab findings, management and complications are according to the type of etiological disease.

005: PSGN

• ​Etiological infections, immunopathogenesis, morphology

006: Ig A nephropathy

• Etiology and risk factors (like viral infections of URT etc.
• ​pathogenesis
• ​morphology
• clinical features (like episodes of microscopic and gross hematuria )
• Prognosis depends upon findings of renal biopsy(4 features)
• ​Difference from Henoch schnolein purpura( it’s a systemic disease inv other systems as well)
• ​Management and diagnosis ( google it)

007: RPGN (it’s not a specific type of primary glomerular disease but it’s a sequelae of any severe rapidly progressing glomerulonephritis)

• ​immunological types( best given in pathoma) also do it from pathogenesis
• ​morphology

TUBULOINTERSTITIAL DISORDERS

008: Acute tubular necrosis

• ​Definition, types/etiologies (ischemic and nephrotoxic) , pathogenesis, morphologies, clinical features, management ( not given in book).

009: Tubulointerstitial nephritis (aka pyelonephritis)

• ​acute pyelonephritis: pathogenesis is very imp- hematological and ascending infections) , risk factors ( catheterization, female gender, etc.) morphology- papillary necrosis ( also in diabatic nephropathy and SCD) , clinical features
• ​Chronic pyelonephritis: 3 types , morphology-thyroidization, clinical features.
• ​Drug induced nephritis ( complete)

010: PKD

• ​Genetic factors( autosomal dominant + recessive)
• ​pathogenesis: cyst formation
• ​morphology
• ​clinical features and management ( google)

RENAL FAILURE

• Chronic Kidney disease ( pathogenesis , clinical features)

OBSTRUCTIVE & INFECTIVE UROPATHIES

• Urolithiasis: types of stones and pathogenesis , clinical features
• ​Hydronephrosis- congenital and acquired , pathogenesis clinical features
• ​Prostatitis (male genital system; ch 18) , its categories and clinical features
• ​Cystitis ( ch 18 ) different forms and their pathogenesis+ features

MALE GENITOURINARY TRACT

• ​Pathogenesis, Etiology, and clinical features of BPH and prostate cancer( ch 18)

RENAL & TESTICULAR TUMORS

• Renal cell carcinoma
• benign tumors( oncocytoma)
• Malignant – RCC ( risk factors, types, type specific etiologies including genetics morphologies, clinical features )
• Wilms Tumor ( given in the chapter of childhood tumors )
• ​Testicular tumors: summary table , morphology, risk factors, clinical features

Prepared by:

                 Shahr Bano Sayal (G12)

Compiled by:

                  Hafiz Muhammad Umair Noor (G12)

Reference Books:

• Davidson’s Principles and Practice of Medicine 25^th Edition (Chapter numbers are mentioned according to this edition)

Note: This guideline is made according to your selective LOs

Chapter 28

• Epilepsy
  • Definition
  • Pathophysiology
  • Types
  • Tables of causes of seizures
  • Investigations
  • Managements of epilepsy
  • Guidelines of drug therapy
• Neuroinflammatory disease
  • multiple sclerosis
  • Criteria for diagnosis (table 28.45)
  • clinical features (table 28.46)
  • Investigation and management
• Neurodegenerative disease
  • Parkinson disease
  • Causes of Parkinsonism
  • Investigation and management
• Infections of nervous system
  • Meningitis
  • Viral meningitis
  • Bacterial meningitis
  • Tuberculous meningitis
  • Fungal meningitis
• Parenchymal viral infection
  • Viral encephalitis
  • Prion disease
• Brain tumors
  • Table 28.75(primary brain tumors)
  • Management
• Para neoplastic neurological disease
  • Hydrocephalus
• Diseases of peripheral nerves
  • Guillian Barre syndrome
• Muscular dystrophies
  • Inherited and acquired myopathies

Chapter 29

• Stroke
  • Cerebral infarction
  • Intracranial hemorrhage
  • Table 29.2, 29.3, 29.4
  • Investigation
  • Subarachnoid hemorrhage

Prepared by:

                  Soila Ansar (G12)

Compiled by:

                  Hafiz Muhammad Umair Noor (G12)

Reference Books:

• Dhingra ENT 8^th Edition (Chapter numbers are mentioned according to this edition)

Overview:

• As it’s a clinical subject so first you need to understand the basics of preparing such subjects,  like you will be focusing on the clinical workup of every disease which includes:
• Differential Diagnosis: patient’s complaints or symptoms, points to be noted in history and signs on inspection and examination.
• Confirmation of Diagnosis: examination points and investigations to rule out other DDS, investigations to confirm a certain diagnosis and investigations to monitor the response of treatment on follow up.
• Management:
  • Conservative: lifestyle changes , any special advice.
  • Medical : drugs etc.
  • Surgical: minimal invasive to radical procedure.
• Always try to segregate emergency situations from non-emergency cases as in ER case, you will skip conservative step and provide immediate resuscitation ( almost similar steps to follow in most of the cases like, admission, IV lines for fluid and antibiotics if infective cause, oxygen therapy if spO2 indicates the need, definitive airway, monitoring) to stabilize the patient. We usually avoid surgical procedures as they further deteriorate the patient’s physiological reserve but indicated only if it’s necessary to save the life of the patient.
• One other important thing I want to mention beforehand, as in the modular system you’re provided with LOs and our books are not written according to these LOs therefore it’s not always possible to find the answer in your books. I’ll try to cover max points from the book but It’ll be better if you people take help from AI sources.

NOSE

(ENT2-Nose-001)

Chapter 23:

• External nose – bony part, cartilaginous part,
• internal nose- choana, vestibule , nasal valve, nasal valve area,
• Lateral nasal wall:  inferior turbinate( opening of NLD, hasner’s valve) middle turbinate ( attachments, basal lamella, openings of sinuses,) middle meatus( uncinate , hiatus semilunaris, infundibulum, bulla ethmoidalis, atrium , agger nasi cells, concha bullosa, haller cells,) superior turbinate( onodi cells related to optic nerve, sphenoethmoídal recess), supreme turbinate.
• Medical wall: bones forming it
• Linings of vestibule, olfactory region, respiratory region and their differences
• Nerve: olfactory nerve injury–> CSF rhinorroea
• autonomic nerve: vidian nerve — > neurectomy in vasomotor
• lymphatics: communication with CSF space
• Blood : ICA + ECA 

Chapter 35:

• Openings of ant and post groups of sinuses
• Maxillary sinus: shape, floor related to roots of 2nd premolar + 1st molar teeth , oroantral fistula, Roof–> infraorbital nerve+ vessles
• Frontal Sinus:  locations, drainage of sinus,
• Ethmoidal Sinus: openings, lamina papyracea
• Anterior group cells and thier locationsn,
• Posterior group cels( onodi cells relation of optic nerve)
• Sphenoid sinus: relations in diagram
• mucus membrane’s difference
• Ventilation of sinuses: paradoxical
• Mucociliary clearance: all sinuses+ diagrams
• Development of sinuse: table –> status at birth and first radiological evidence

(ENT2-Nose-002)

Chapter 25:

• Cellulitis
• Fruncle / Boil : staph aureus, etiology, danger area of nose, Management, complications (CST, cellulitis, septal abscess)
• Vestibulitis: staph aureus, acute & chronic forms, management.
• Remember these points( in case)
  • Saddle nose ( augmentation rhinoplasty)
  • Hump nose( reduction rhinoplasty)
  • Encephalocele( cough impulse)
  • Rhinophyma( potato tumor, hypertrophy of sebaceous glands on nose tip)
  • BCC( rodent ulcer, rolled edges, no mets,)
  • SCC( rolled out edges )

Chapter 29:  

• Foreign body nose (presentation, investigation: radiograph, 5 causes of unilateral nasal discharge, treatment: eustachian catheter, complications)
• Rhinolith (etiology, C/F , stony hard, irregular mass, txt)
• Nasal myiasis (Chrysomyia, underlying cases, C/ F with timeline, complications, txt, advice)

(ENT2-Nose-003)

Chapter 55:

• Definition of snoring+ its mechanism and etiology
• Definition of sleep apnoea+ types+ pathophysiology+ table of consequences of OSA
• Clinical workup: History+ physical examination+ Treatment options( conservative than surgical)

(ENT2-Nose-004)

Chapter 26 & 88:

• Entire chapters are very important. 

(ENT2-Nose-005)

Chapter 27:

• Acute rhinitis types, viral rhinitis complete
• Chronic rhinitis types
• hypertrophic rhinitis
• Atrophic rhinitis is very important
• rhinitis sicca and caseosa 

Chapter 30:

• Allergic rhinitis( etiology, phases, C/F , ARIA classification, investigations, complicated, treatment options , immunotherapy

Chapter 31:

• Vasomotor rhinitis
• Rhinitis medicamentosa

(ENT2-Nose-006)

Chapter 36:  

• definition, classification, symptoms, Acute maxillary, frontal, ethmoidal and sphenoid sinusitis

Chapter 37:

• CRS with and w/o polyposis and their treatment options
• surgical techniques old(3) and new(FESS)
• Fungal sinusitis

Chapter 38:  

• complications ( local, orbital, cranial) entire chapter

(ENT2-Nose-007)

Chapter 32:  

• entire chapter is important.

(ENT2-Nose-008)

Chapter 33:

• Little’s area, retrcolumellar vein, woodruffs plexus
• Causes of epistaxis
• classification+ difference
• Management (follow this sequence of steps : First aid, general measures, cauterization, anterior packing/ posterior packing, then delayed management which includes endoscopic cauterization, elevation of SMR flap, ligation of vessels(do it in detail like which vessel is ligated in which bleeed and how), TeSpal, embolization.
• Osler Weber rendu syndrome (hereditary heamorrhagic telemgiectasia )

(ENT2-Nose-009)

Chapter 34:

• general management
• Fracture of nasal bone and septum ( most common fracture, types, C/F, diagnosis, best time of reduction, closed and open reduction)
• Fracture of zygoma (2nd most common)
• Fracture of orbital floor ( blow out fravtire, tennis ball, blunt trauma, tear drop sign)
• Fractures of maxilla( Le fort types, fracture lines, features, Dx, Mx,type ll and lll can have CSF rhinorroea)
• Fracture of mandible( common sites, features, Dx, treatment)

Chapter 29:

• CSF rhinorroea complete

(ENT2-Nose-010)

Chapter 28:

• Tuberculosis, lupus vulgaris
• Leprosy
• Aspergillosis , Mucormycosis ( also see Ch 37 )
• Wegeners granulomatosis
• Sarcoidosis

(ENT2-Nose-011)

Chapter 39:

• Inverted papilloma complete
• squamous cell CA

Chapter 40:

• etiological factors in malignant tumors ( nickel- SCC , furniture- ethmoidal adeniCA )
• Maxillary sinus CA( features and spread, diagnosis,ohngren  classification, treatment, weber furgusson incision)

Prepared by:

                 Shahr Bano Sayal (G12)

Compiled by:

                  Talha Saleem (G12)

                  Hafiz Muhammad Umair Noor (G12)

Reference Books:

• Clinical Ophthalmology by Shafi M. Jatoi 7^th Edition (Chapter numbers are mentioned according to this edition)

UVEAL TRACT

Note: selective topics with sign and symptoms, investigation and treatment are vvvvv imp

Chapter 12

• Give a read to anatomy and physiology
• Definition of uveitis, anatomical, clinical, histological classification**
• Acute /chronic Anterior uveitis
  • Definition
  • Sign n symptoms in sequence
  • Investigation
  • Treatment**
• Intermediate uveitis
  • Clinical features
  • Complications
  • Treatment**
• Posterior uveitis
• Tuberculosis uveitis (give a read)
• Endophthalmitis **
  • Each and every line of this topic is imp.
• Panophthalmitis (vv imp.)
• Sympathetic ophthalmitis**

PUPIL

Note: You will do these topics in your ward rotation

Chapter 17

• Light reflex
  • Afferent and efferent pathway
• pupillary reflexes
• Relative Afferent pupillary defect **
• Absolute afferent pupillary defect***
• Argyll Robertson pupil
• Adie tonic pupil
• Horner syndrome
  • Pharmacological tests**

LENS

Chapter 10

• Anatomy and physiology is vvv imp **
•  Cataract definition and classification
• Congenital cataract**
• Aetiology***
• Differential diagnosis***
•  Investigation and treatment***
• Acquired Cataract
  • Definition
  • Types
  • Senile cataract with stages**
  • Fate of mature cataract***
  • Diagnosis
  • Complications***
  • Treatment
• Types of cataract extraction (vvv imp)*
• Pre operative evaluation
• Extracapsular cataract extraction
  • Each method**
• Complications of cataract extraction (Each n every line is McQ)**
• Aphakia
  • Definition
  • Signs***
• Ectopia lentis
• Definition**
• Causes (each cause has different site for dislocation)
• Indication of surgery and complications

GLAUCOMA

Note: This chapter is vvv imp you have to do while chapter

Chapter 11

• Give a read to physiology
• Anterior chamber angle
• Aqueous dynamics and drainage
• Aiural variation
• Glaucoma definition
  • Normal tension glaucoma
  • Hypertension glaucoma
  • Classification
  • Theories (just read)
  •  Diagnosis of glaucoma
  • Gonioscopy with angles***
  • Glaucomatous visual field defects (names)*
• Primary open angle glaucoma
• Each and every line is McQ***
• Primary angle closure glaucoma
• Each and every line is McQ***
• Secondary glaucoma (make sure to know which type of glaucoma occurs in each cause..)
• Congenital glaucoma (whole topic)***
• Surgical procedures (just names)

VITREOUS BODY

Chapter 14

• Posterior vitreous detachment
• Types of opacities in each cause
• Vitreous hemorrhage***
• Vitrectomy

RETINA

Note: This chapter is vvvv imp in whole ophthalmology and you should do this chapter on first priority

Chapter 15

• Retinal gross anatomy
• Retinal physiology
• Microscopic structure
• Diabetic retinopathy (Vvvvv imp do whole topic**)
• Hypertension retinopathy
• Pathogenesis
• S/S
• Both classifications**
• Retinal vein occlusion
• Core of retinal disorders (do each and every line***)
• Retinal artery occlusion
• Central artery occlusion ( Aetiology, signs, investigation ,treatment)
• Branch retinal artery occlusion
• Retinopathy of prematurity (Whole topic *)
• Age related macular degeneration (Whole topic***)
• Retinal detachment (Whole topic, each and every line***)
• Retinitis pigmentosa
  • Definition
  • Aetiology
  • Signs and symptoms**
  • Diagnosis and treatment*
• Retinoblastoma (Whole topic****)

REFRACTIVE ERRORS

Chapter 20

• Emmetropia
• Ametropia with types
• Hypermetropia (Whole topic***)
• Myopia (Whole topic***)
• Astigmatism
  • Definition
  • Types
  • Clinical features
  • Treatment

Prepared by:

                 Shahr Bano Sayal (G12)

Compiled by:

                  Talha Saleem (G12)

                  Hafiz Muhammad Umair Noor (G12)

Reference Books:

• Handbook of Behavioural Sciences by Mowadat H Rana 3^rd Edition (Chapter numbers are mentioned according to this edition)
• Friends Behavioral Sciences 3^rd Edition

Note:

• This module is very haphazard, you can use both books either Mowadat Rana or friends but I prepared your guidelines from Mowadat Rana .
• Some topics according to your LOs are not mentioned in Mowadat Rana and friends , you have to prepare those topics from internet

Section A

Chapter 1

• Definition of holistic and allopathic medicine
• Bio psycho social model and it’s clinical application

Section B

• Doctor patient relationship
• Rights and responsibilities of patients and doctor
• psychological reactions of doctor patient relationship

Section C

• Memory
• Stages and types of memory
• Methods to improve memory
• Perception and abnormal perception
• Decision making and creative thinking
• Steps and barrier of creative thinking
• Emotions definition and types
• Motivation definition and types
• Definitions of intelligence
• Emotional intelligence
• Difference table of IQ and EQ
• Personality development
• Piaget theory of personality development
• Freud’s theory
• Erikson theory
• personality types
• Personality clusters
• Personality disorders (from friends)
• Sleep
• Stages of sleep
• Sleep disorders
• Sleep hygiene

Section D

• Child rearing practices
• Stigma
• Sick role
• Impact of social factors on treatment adherence
• Definition of culture, subcultures, beliefs, norms, values, folkways, mores, laws
• Culture sensitive clinical assessment

Section E

Chapter 1

• Defence mechanisms
• Table of defense mechanism
• Psychological reactions to hospitalizations and illness
• Stress due to illness
• Stress due to hospitalization
• Patient reaction to hospitalizations

Chapter 2

• Psychosocial assessment
• Mental state examination
• Psychosocial management

Chapter 6

• Mixed anxiety and depression disorder
• Panic disorder
• Drug abuse, alcohol and tobacco use with table of effects
• Suicide and deliberate self- harm definitions
• Protective effects and risk factors of suicide
• Delirium

Chapter 7

• Sexual disorders
• Sexual dysfunction
• Sexual behavior (neurotransmitters)
• Disorder of sexual preference/paraphilia
• Gender dysphoria

Chapter 8

• Psychological aspects of pain
• Factors influence
• Acute pain
• Chronic pain
• Psychological symptoms
• Psychogenic pain disorder
• Pian behaviour
• Management of psychological pain **

Chapter 13

• Stress definition
• Response to stress
• Management of stress

Prepared by:

                 Zernab Jodat (G12)

Compiled by:

                 Hafiz Muhammad Umair Noor (G12)

Reference Books:

• Book for Medicine:  Davidson Principle and Practice of Medicine 24th Edition
• Book for Surgery:  Bailey & Love’s Short Practice of Surgery 28 Edition
• Book for Pediatric Surgery: Bailey & Love’s Short Practice of Surgery 28 Edition
• Book for Pediatric Medicine: Basis of Pediatrics by Pervez Akbar Khan

UHS 10^th Block

  (Module No 24)

CMFH2-FM-001

Chapter: Neurology

CMFH2-FM-002

Chapter: Infectious Diseases

• Topic Fever (complete)

CMFH2-FM-003

Chapter 9: Neonatology

• Importance of resuscitation
• Care of newborn infant

CMFH2-FM-004

Chapter 31:

• Medical psychiatry
• Refer to the related topics only as mentioned in the syllabus

CMFH2-FM-005

Chapter 22: Undernutrition

CMFH2-FM-006

Chapter: Nephrology

• Do the concerned topics as mentioned in the guidelines

CMFH2-FM-007

Chapter 27: Dermatology

• Specific diseases and their primary management i.e.
• Fungal infections
• Scabies
• Pediculosis
• Cellulitis
• Folliculitis
• Dermatitis
• Eczema
• Warts
• Herpes simplex
• Acne

CMFH2-FM-008

Chapter 34: Aging and disease

• From investigation and management complete chapter

UHS 10^th Block

  (Module No 25)

1. ESOPHAGUS

GIT2-GE 012 to 016

Chapter 23: Gastroenterology

• Dysphagia
• GERD
• Achalasia
• Carcinoma
• Candidiasis

GIT2-GE 023 to 027

Chapter 23: Gastroenterology

• Vomiting
• Haematemesis
• Peptic ulcer disease
• Abdominal pain
• Gastric cancer
• All of these topics are very very important

GIT2-S-028

Chapter: Stomach and Duodenum

• Duodenal obstruction causes
• Duodenal carcinoma and management

GIT2-S-029

Chapter: Bariatric and Metabolic Surgery

• Just do the mentioned context

2. SMALL AND LARGE INTESTINE

GIT2-GE-041

Chapter 23: Gastroenterology

• Gastroenteritis
• Diarrhoea

GIT2-GE-042

Chapter 23: Gastroenterology

• Miscellaneous disorders of small intestine
• Gastroenteritis

GIT2-GE-043 to 047

Chapter 23: Gastroenterology

• All respective topics in this chapter

GIT2-PS-051a to 051d

Chapter: Principles Of Paediatric Surgery

• Intussusception
• Appendicitis
• Hernia
• Phimosis
• Paraphimosis
• Bladder and cloacal exstrophy

3. HEPATOBILIARY SYSTEM

GIT2-GE-059 to 064

Chapter: Hepatology

• Jaundice
• Viral hepatitis
• NAFLD
• Carcinoma
• CLD genetic disorders

GIT2-S-065 to 066

Chapter: Gallbladder and Bile Ducts

• Cholecystectomy

Chapter: The Pancreas

• Pancreatitis

GIT2-PS-067

Chapter: Principles Of Paediatric Surgery

Or

Chapter: Peritoneum, Omentum, Mesentery, Retroperitoneal Space

•  Acute Peritonitis

4.SPLEEN

GIT2-PS-068

Chapter: Spleen

• Splenectomy

5. HEALTH AND NUTRITION

GIT2-S-075

Chapter: Nutrition and Fluid Therapy

• Perioperative nutritional management
• Assessment, fluid electrolytes, requirements
• Artificial nutritional support

Prepared by:

                 Sadaid ul Hassan (G12)

Compiled by:

                  Talha Saleem (G12)

                  Hafiz Muhammad Umair Noor (G12)

Reference Books:

• Dhingra ENT 8^th Edition (Chapter numbers are mentioned according to this edition)

Overview:

• ENT is one of the most interesting subjects of fourth year, yes interesting, if you approach it in the right way. 
• ENT has three sections Ear Nose Throat
• Each section has about 15-18 chapter, but dw choty choy chapters and each section has 4-5 imp chapters.

How to approach?

• First of all, tu ap ko basic anatomy Ani chahiya especially EAR ki NOSE n THRAOT ki basic c anatomy ha. 
• MUST DO Anatomy of each part cuz it will be very easy to get the disease process later on.

Lectures:

• Without lec ENT nhi Hoti
• If at the end of year b krni ho tu taking lecs is the best way.
• Ma na PREPLADDER k lec leya thy and believe me BEST, BESTEST and detailed lec hain 
• Sara lecture DHINGRA sy hi hota ha
• PREPLADDER k lec lengthy hain magar ap ny Ghabrana nhi ha
• Indian teacher ha, same accent ha aur easily 2x pr (even 3x pr b airbuds k Sath) lec ly skty hain
• 2x pr 20-25 mins ma Sara chapter A to Z clear how jata ha, ap ENT specialist ban jaty ho itny achy lec hain
• Aik dafa lec try zaroor kro sab log.  ENT will be your favorite subject
• Chapter 1-2-3 these are basic chapter, mainly MCQs aty
• Ye chap aty ho tu ENT easy ho jati

Most Important Chapters:

• Chapter 8, 10, 11, 12, 13,15,18

HEARING LOSS

Chapter 5:

This chapter will cover 4 topics of your syllabus

1. Hearing Loss and Types

2. Ototoxic drugs:

• Figure out Type of hearing Loss,
• Reversible/irreversible Mechanism (2-3 ma yaad krna lena)

3- Noise Induced Hearing loss:

• A less imp topic, occasionally exam ma a b jata
• Take PREPLADDER lec of this topic easy ho ja a gah
• Fig 5.7 imp.

4- Presbycusis:

• A very imp topic Sara krna ha
• Almost Sara chap krna ha upto Presbycusis

• Skip
• Non organic Hearing loss
• Social legal aspects

Chapter 20:

• For hearing implants
• A general topic
• Do remember Indications and limitation of each implant

DISEASES OF EXTERNAL EAR

Chapter 8:

(Half of Chapter Important ha, rest read only for MCQs)

• Most Important Topics:
  • Hematoma of auricle (cauliflower ear)
  • Perichondritis
  • Otitis externa hemorrhagica
  • Herpes zoster oticus
  • Furuncle
  • Diffuse otitis externa(complete)
  • Malignant otitis externa
  • Otomycosis
  • Keratosis obturans
• Less Important Topics:
  • Preauricular sinus
  • Frostbite
  • Foreign bodies of Ear (read, so that have basic idea)
• Read rest of chapter for MCQs

DISEASES OF MIDDLE EAR

Chapter 10:

(This is one of the most imp chap of EAR section)

• Most Important Topics: (complete krny hain)
  • Acute Suppurative Otitis media
  • Acute necrotizing otitis media
  • Otitis media with effusion
• Treatments k mainly names aty ho aur basic idea ho
• Table 10.1 skip b kr skty hain 
• Read rest of chapter

Chapter 11:

• Chronic Otitis Media is most imp topic of Ear

Chapter 12:  

• Important Topics:
  • Classification
  • Acute Mastoiditis (complete)
  • Accesses in relation to Mastoid infection
  • Gardengio syndrome (Under topic – Petositis)
  • Labyrinthitis (complete)
  • Meningitis
  • Clinical features of Lateral sinus thrombosis
• Give a read to rest of chap

Chapter 81:  

• Do complete chapter

OTOSCLEROSIS

Chapter 13:

• Most imp and easy chap
• Read anatomy of labyrinth
• Rest of chap comp krna ha

DISEASES OF INNER EAR

Chapter 7:  

• This will cover your 2 topics
• Benign paroxysmal positional Vertigo (Imp topic Sara krna ha)
• Vestibular Neuronitis (ye chota sy likha howa ha. Use chatgpt if detail ma krna ha)
• Table 7.1 imp.

MENIERE’S DISEASE

Chapter 15:

• Most Imp chapters
• Sara chapter krna ha

GLOMUS TUMOR

Chapter 17:  

• Glomus Tumor (Whole topic is imp)
• DDs k name yaad krna Lena (and also how to differentiate)
• Diagnosis and treatment
• Names with overall idea

FACIAL NERVE PALSY

Chapter 14:  

(Imp chap ha but Sara nhi krna)

• Read first 2-3 pages (aik dafa lec ly Lena Sara clear ho jae ga)
• Surgical land marks, Variations and anomalies (For mcq)
• Diagnostic test, may be viva ma poch ly unexpectedly, give it a read
• Causes of facial palsy (Complete)
• Table 14.1 imp.
• Diagnosis, treatment, management Sara Karna
• Melkersson Syndrome (imp)
• Ramsey Hunt syndrome (imp)
• Read traumatic causes, Table 14.2 dekh Lena once
• Localization of Facial nerve (read)
• Diagnostic test, (read)
• Complications, (imp), mainly names yaad ho tu idea ho jata ha
• Surgery of facial nerve, names only with a basic idea
• For Temporal bone trauma do Fig 14.10, Table 14.2

SURGICAL PROCEDURES

• This is somewhat boring topics (for me)
• SEQ b a jata aur Viva ma b HOD poch lety
• PREPLADDER ya YouTube sy koi Video dekh Lena for each procedure
• Mainly ap ko Indications. Post op care and complications Ani chahiya
• Steps of operation k names yaad kr lena, aur aik overall idea ho operation ka step by step
• Video dekh k clear ho jata

Prepared by:

                Soila Ansar (G12)

                Shahr Bano Sayal (G12)

Compiled by:

                  Talha Saleem (G12)

Reference Books:

• Medium Robbins Latest Edition (Chapter numbers are mentioned according to this edition)
• Pathoma Fundamentals of Pathology
• Essentials of Special Pathology by MBBS Cafeteria

Overview:

• The most important subject in the entire MBBS is pathology so prepare it thoroughly and don’t go after short cuts for this subject. It is always the best way to prepare not from a single book or source and try to give at least a read to more than one source.
• Sources for pathology which I used were; Medium Robbins, pathoma notes and its lectures, Dr Najeeb’s lectures, MBBS cafeteria book.

Medium Robbins: It should be your main book if you want to have a clear and detailed understanding of things. The problem with this book is that it looks exhausting and boring so to overcome this you first need to tell yourself that it’s not difficult and you can easily do it for enough times to kick off the fear of this book then for the first time, don’t try to remember each line of it instead just try to understand what it’s saying and flow of information like try to remember that which aspects have been discussed. And the imp thing is to highlight or underline the imp 2 or 3 lines of each paragraph. For the second time, again read the entire text and then after that you’ll just need to read the highlighted ones. And one other thing, whenever you read this book, always do histology diagrams and foot notes, I said always, it will help you a lot in remembering morphologies.

Pathoma: When you decide to prepare for a certain topic, first take its lectures. It will provide you an overview of the topic. Further, many MCQ points are typical of this book which can’t be solved even after learning Robbins. This book doesn’t give a comprehensive concept but a short note of every related and less imp thing, so in this way you’d be able to have heard unimportant things which rarely come in exams.

Dr Najeeb’s lectures: I personally like the way of teaching of this man but if you don’t find it suitable according to your mood then it’s fine. You can take any other lectures or no lectures at all, whatever you like. But, after taking his lectures, I always felt that it makes you stand out among others when it comes to having a deep concept of things.

MBBS Cafeteria: As far as this book is concerned, it has no value at all once you have prepared a topic from pathoma and robbins. You can use this book in an emergency situation (except PROFF) when you don’t have time to prepare from a good source and you have no other option.

GASTROINTESTINAL TRACT

Chapter 15:

It’s the most important topic of pathology. First take pathoma lectures, then do the following topics from medium Robbins:

Oral Cavity:

• Aphthous ulcers, oral candidiasis (only read)
• Leukoplakia and Erythroplakia (imp)
• Squamous cell CA (v.imp) risk factors, pathogenesis, morphology
• Salivary gland neoplasms (imp) classification, morphologies

Esophagus:

• Atresia, fistula, stenosis, ectopia (only read)
• Achalasia* (imp) triad, 1° & 2°, causes
• Esophageal varices (imp)
• Esophagitis (v.imp) Mallory Weiss tears, Boerhaave syn, chemical, infectious
• Reflux esophagitis (imp)
• Eosinophilic esophagitis (read)
• Barret esophagus (imp) morphology
• Esophageal CA (v.imp) adenocarcinoma (RF, morphology) SCC (RF, pathogenesis, morphology)

Stomach:

• Gastropathy vs gastritis, pathogenesis, curling, Cushing and stress ulcers
• Chronic gastritis (v.imp) 3 main causes, H. pylori (pathogenesis, morphology), autoimmune (CF, pathogenesis, morphology), difference table
• PUD (v.imp) pathogenesis, morphology, CF
• Dysplasia, gastric polyps (read)
• Gastric adenocarcinoma (v.imp) pathogenesis, morphology, CF 
• Lymphoma
• Carcinoid tumor(imp) pathogenesis, morphology, CF
• GIST (read) gene, morphology

Small & Large Intestine:

• Intestinal obstruction (4 causes)
• Intussusception, Hirschsprung disease (v.imp)
• Hernia, Ischemic bowel disease (pathogenesis, CF), hemorrhoids (read)
• Diarrhea (SOME 4 categories), malabsorptive (4 types+ table), cystic fibrosis
• Celiac disease (v.imp) pathogenesis, fig, morphology, CF
• Lactase def, abetalipoproteinemia(read)
• Microscopic colitis(imp)
• Infectious enterocolitis (table+summary)

HEPATOBILIARY SYSTEM

• Do this topic from medium robbins with Ayesha Batool’s shortlist (because it’s very important topic) and morphology from MBBS Cafeteria
• Or if you have no time then use MBBS Cafeteria bcz morphology is mentioned in cafeteria book.

Chapter 16:

• Table 16.1 (vvv imp)
• General features of liver disease (hepatocyte injury, confluent necrosis and bridging necrosis)
• Liver failure types (imp)
• Acute liver failure (flow chart bna lein) morphology from cafeteria
• chronic liver failure causes and complications (v imp) (morphology from cafeteria)
• Acute on chronic causes (v imp)
• Summary of liver failure (v imp)
• Viral hepatitis table 16.2 (v imp)
• Figure 16.2(seq) (imp)
• Figure 16.9 (v imp)
• Figure 16.10 (v imp)
• Figure 16.12 (v imp)
• Clinicopathologic syndromes (read it)
• Acute asymptomatic
• Acute symptomatic
• Fulminant failure (v imp)
• Morphology from cafeteria
• Figure 16.13 (v imp)
• Autoimmune hepatitis with morphology (v imp)
• Table 16.3 (read it)
• Alcoholic liver failure (imp most) with morphology
• Non-Alcoholic liver disease with morphology (v imp)
• Fig 16.19
• Wilson disease (imp)
• Alpha-1 antitrypsin deficiency (v imp)
• Table 16.4 (vv imp)
• Autoimmune cholangiopathies (v imp) (Both types are most important)
• Table 16.5 (imp)
• Hepatocellular carcinoma (v imp)
• With morphology
• Gallstones, types, features (v imp)
• Table 16.6 (vv imp)
• Cholecystitis
• Acute calculous cholecystitis (imp)
• Acute Acalculous cholecystitis (imp)

Chapter 17:

• Annular pancreas
• Acute pancreatitis (imp) with morphology
• Table 17.1 (imp)
• Figure 17.1 (v imp)
• Chronic pancreatitis with morphology (imp)
• Pancreatic carcinoma (read it)

Prepared by:

                 Shahr Bano Sayal (G12)

Compiled by:

                  Talha Saleem (G12)

Reference Books:

• Clinical Ophthalmology by Shafi M. Jatoi 7^th Edition (Chapter numbers are mentioned according to this edition)

Overview:

• This book is more than enough for your eye exams and for ospe + viva
• Make sure to note down Dr Irfan’s lecture points (Sir Jo baatein apko lecture me btatay hain wo note krty jao…ospe aur mcqs wohi sy aty..exact sir wli lines)
• Important point…you don’t need to learn whole book (just do mentioned topics and give a read to remaining part for McQ)

How to study ophthalmology?

• First read a topic signs and symptoms and investigation treatment.
• Then use Past papers either chapter 4 or Gyan to see how questions are asked in exams, it will guide you to make diagnosis on basis of Signs and Symptoms mentioned in questions
• Important most in eye and ENT is investigations and treatment (Jis ki nhi likhi hui…. Google kr k likh lo)
• Must do picture for OSPE of mentioned important topics

ORBIT

(Eye 1-001)

Chapter 8:

(You don’t have to do whole chapter, just go to the point mentioned topics)

• Orbit anatomy+walls+ contents of fissures
• Orbital spaces (ospe, viva, seq Saab a skta)
• proptosis (whole topic is hell important) (imp)
• Preseptal cellulitis (definition (imp), extension, investigation and treatment)
• Orbital cellulitis (each and every point of this topic is important most) (imp)
• Difference between Preseptal and orbital cellulitis (UQ)
• Thyroid eye disease (most imp topic, each and every line is McQ and seq)

EYELIDS

(Eye 1-002)

Chapter 5:

• Eyelid anatomy, nerve supply, blood supply and functions of eyelid
• Chalazion (important topic for exams and clinical point of view) (imp)
• Hordeolum (externum and Internum both)
• Difference between stye and chalazion (favorite topic of Sir Irfan)
• Blepharitis (types, signs n symptoms with treatment)
• Trichiasis (important to rule out causes and types)
• Entropion (types and causes of each type and treatment of each type will be asked separately) (imp)
• Ectropion (do whole topic) (imp)
• Ptosis (favorite topic of UHS, types, causes of each type …. investigation is most important and treatment is imp SEQs) (v imp)
• Benign tumors (names and just xanthelasma)
• Malignant (Basal cell carcinoma most important)
• Give a read to rest of tumors with ospe picture

LACRIMAL SYSTEM 

(Eye 1-003)

Chapter 6:

• Anatomy of lacrimal system
• Excretory system
• Tears with functions and layers
• Congenital nasolacrimal duct obstruction (v imp) (signs, investigation, treatment)
• Acquired Nasolacrimal duct obstruction and types of DCR
• Acute dacryocystitis
• Chronic dacryocystitis
• Signs of dacryoadenitis
• Keratoconjunctivitis Sicca (imp most) (imp)
• Treatment of keratoconjunctivitis Sicca (v imp)
• Lacrimation and euphoria difference
• Tests for euphoria (read it)

CONJUNCTIVA

(Eye 1-004)

Chapter 7:

• Conjunctiva definition, parts, nerve supply and functions
• Bacterial conjunctivitis all types (signs and symptoms, investigation and treatment)
• Viral conjunctivitis (adenovirus conjunctivitis with both types) (v imp)
• Chlamydial conjunctivitis (Trichoma) (v imp)
• Stages of Trichoma (imp), WHO classification (imp)
• Treatment (whole topic is very imp)
• Neonatal conjunctivitis with all types and treatment of each type (imp)
• Vernal keratoconjunctivitis (important most)
• Steven Johansen syndrome (read)
• Pterygium (fav topic of examiners) (vv imp)
• Pseudo pterygium and difference with pterygium
• Pinguicula (read)
• Xerophthalmia (most important)
• WHO classification (v imp)
• Treatment (v imp)

CORNEA

(LOs 006)

Chapter 8:

(This is important topic of eye and must do it properly)

• Cornea definition, dimensions, thickness, curvature, refractive power, layers
• Blood supply, nerve supply, nutrition of cornea, definitions (imp)
• Bacterial corneal ulcer (v imp) (sign and symptoms, management, treatment) (v imp)
• Complications of bacterial corneal ulcers (v imp)
• Treatment of desmatoceole (imp)
• Perforated corneal ulcer management (imp)
• Fungal keratitis (v imp)
• Viral keratitis

Prepared by:

                 Shahr Bano Sayal (G12)

Compiled by:

                 Talha Saleem (G12)

Reference Books:

• Excel Community Medicine 14th edition (Chapter numbers are mentioned according to this edition)
• Park’s Textbook of Preventive and Social Medicine

Overview:

• You people are already familiar with this subject and may have idea how to study
• I would suggest to study it from excel and past papers
• I already shared pdfs with you for revision that will cover your deficits.
• And if you want you can study from K park (on your own risk)                     

BIOSTATISTICS

• Each and every word of this chapter is vvvv imp (just give a single read from K Park for this topic)

Chapter 8:

• Definition of biostatistics (imp)
• Vital statistics
• Functions of biostatistics (v imp)
• Terminology
• Data with types (imp)
• Census (imp) with types
• Methods for estimation of population (all formulas) (imp)
• System of collection of data (read it)
• Presentation of data (all tables & charts n diagrams (v imp)
• Measure of central tendency (v imp)
• Measure of dispersion (imp)
• Chi-square test (v imp)
• Student T test (imp)
• Z-test (v imp)
• Life table and advantages (v imp)
• Normal distribution curve (vv imp)
• Standard error (v imp)
• Hypothesis and types (vv imp)
• Table at end of chapter (v imp)

DEMOGRAPHY

• Important topic do it whole and formulas

Chapter 9:

• Definition
• Population dynamics (v imp)
• Population doubling time (imp)
• Growth rate (v imp)
• Crude birth and death rates
• Reasons for population change (v imp)
• Calculation of population (v imp)
• Components of population growth (v imp)
• How to control population explosion?
• Definition of literate person
• Fertility determinants (imp)
• Cause of higher fertility (imp) (SPED)
• High infant mortality affects fertility (v imp)
• Basic fertility measurements (most imp topic) (v imp) (do formulas from Park)
• Population pyramids (vv imp)
• Sex ratio (v imp)
• Demographic transition (v imp)
• Demographic cycle (most important) (cycle from Park)
• demographic trap (v imp)
• Population momentum formula (v imp)
• Implications of high population
• Demographic features (imp)
• Vital index (imp)
• Density of population (v imp)

PRIMARY HEALTHCARE

Chapter 10:

• PHC definition (imp)
• Elements of PHC (v imp)
• Principles of PHC (imp)
• Health for all (v imp)
• Global target for HFA
• Causes of failure of HFA
• Health planning cycle (vv imp)
• 7-star doctors
• Levels of health care
• Referral tier diagram (imp)
• BHU (v imp) (services, building duties of BHU)
• RHC (Facilities, services, duties) (imp)
• THQ
• DHQ
• Integrated rural health care definition
• LHV duties
• LHW duties
• Rural health problem
• Difference btw BHU &RHC

OCCUPATIONAL HEALTH

Chapter 13:

• Definition
• OCCUPATIONAL affairs
• Occupational health
• Ergonomics definition (imp)
• sickness absenteeism
• Occupational disease of different organs
• Pneumoconiosis definition and each type (v imp)
• Silicosis (important most, cause and X-rays pattern)
• Anthracosis (v imp)
• Asbestosis (causes and respiratory disorders) (imp)
• Byssinosis (imp)
• Bagassosis (imp)
• Pneumoconiosis preventions (medical, engineering measures, legislation) (imp)
• OCCUPATIONAL hazards (imp)
• Management plan to prevent
• Lead poisoning (vv imp)
• Table at end of chapter (vv imp)

NUTRITION

Chapter 16:

• Definition
• Classification of foods
• Nutrients Definition
• Balanced diet definition
• Basal metabolism (imp)
• Calories requirements of male, female, infants
• Factors affecting nutrition needs
• Proposed diets (v imp)
• Food fortification (imp)
• Adulteration of food (v imp)
• Theme and slogan of world health day (imp)
• Food borne diseases
• Food infection
• Preservation of food (v imp)
• Sources of Adulteration of milk (v imp)
• Methods of rendering milk safe (imp)
• Assessment of nutritional status (imp)
• Table of indicators of nutritional status (v imp)
• Anthropometric measurements (v imp)
• Forms of malnutrition (v imp)
• Protein-energy malnutrition (imp)
• Gomez classification (imp)Last table (vitamin A, Vit D, vit B1, B 12, calcium, iron)
• Table of trace minerals (Iodine)
• Differences btw marasmus& kwashiorkor (imp)
• Difference btw cholera & food Poisoning (v imp)
• Difference btw food fortification and Adulteration (v imp)

DISASTER MANAGEMENT

Chapter 20:

• Disaster definition (v imp)
• Hazard definition
• Types of disasters
• Morbidity resulting from disaster
• Phases of disaster (figure at end of chapter)
• Steps in disaster management (imp) (Shortlist and get idea)
• Triage (v imp)
• Post disaster management (v imp)
• Organization model
• The surveillance cycle (imp)
• Man made disaster (imp)
• Disaster in Pakistan (imp)
• Measures to be taken in specific disaster (imp)