General Medicine Syllabus, Notes & PYQ for GGSIPU Bachelor of Medicine and Bachelor of Surgery Phase 3

Universities GGSIPU Bachelor of Medicine and Bachelor of SurgeryPhase 3General Medicine

Bachelor of Medicine and Bachelor of Surgery

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General Medicine

IM1.1 — Describe and discuss the epidemiology, pathogenesis clinical evolution and course of common causes of heart disease including: rheumatic/ valvular, ischemic, hypertrophic inflammatory

IM1.2 — Describe and discuss the genetic basis of some forms of heart failure

IM1.3 — Describe and discuss the aetiology microbiology pathogenesis and clinical evolution of rheumatic fever, criteria, degree of rheumatic activity and rheumatic valvular heart disease and its complications including infective endocarditis

IM1.4 — Stage heart failure

IM1.5 — Describe, discuss and differentiate the processes involved in R Vs L heart failure, systolic vs diastolic failure

IM1.6 — Describe and discuss the compensatory mechanisms involved in heart failure including cardiac remodelling and neurohormonal adaptations

IM1.7 — Enumerate, describe and discuss the factors that exacerbate heart failure including ischemia, arrhythmias, anemia, thyrotoxicosis, dietary factors drugs etc.

IM1.8 — Describe and discuss the pathogenesis and development of common arrhythmias involved in heart failure particularly atrial fibrillation

IM1.9 — Describe and discuss the clinical presentation and features, diagnosis, recognition and management of acute rheumatic fever

IM1.10 — Elicit document and present an appropriate history that will establish the diagnosis, cause and severity of heart failure including: presenting complaints, precipitating and exacerbating factors, risk factors exercise tolerance, changes in sleep patterns, features suggestive of infective endocarditis

IM1.11 — Perform and demonstrate a systematic examination based on the history that will help establish the diagnosis and estimate its severity including: measurement of pulse, blood pressure and respiratory rate, jugular venous forms and pulses, peripheral pulses, conjunctiva and fundus, lung, cardiac examination including palpation and auscultation with identification of heart sounds and murmurs, abdominal distension and splenic palpation

IM1.12 — Demonstrate peripheral pulse, volume, character, quality and variation in various causes of heart failure

IM1.13 — Measure the blood pressure accurately, recognise and discuss alterations in blood pressure in valvular heart disease and other causes of heart failure and cardiac tamponade

IM1.14 — Demonstrate and measure jugular venous distension

IM1.15 — Identify and describe the timing, pitch quality conduction and significance of precordial murmurs and their variations

IM1.16 — Generate a differential diagnosis based on the clinical presentation and prioritise it based on the most likely diagnosis

IM1.17 — Order and interpret diagnostic testing based on the clinical diagnosis including 12 lead ECG, Chest radiograph, blood cultures

IM1.18 — Perform and interpret a 12 lead ECG

IM1.19 — Enumerate the indications for and describe the findings of heart failure with the following conditions including: 2D echocardiography, brain natriuretic peptide, exercise testing, nuclear medicine testing and coronary angiogram

IM1.20 — Determine the severity of valvular heart disease based on the clinical and laboratory and imaging features and determine the level of intervention required including surgery

IM1.21 — Describe and discuss and identify the clinical features of acute and subacute endocarditis, echocardiographic findings, blood culture and sensitivity and therapy

IM1.22 — Assist and demonstrate the proper technique in collecting specimen for blood culture

IM1.23 — Describe, prescribe and communicate non pharmacologic management of heart failure including sodium restriction, physical activity and limitations

IM1.24 — Describe and discuss the pharmacology of drugs including indications, contraindications in the management of heart failure including diuretics, ACE inhibitors, Beta blockers, aldosterone antagonists and cardiac glycosides

IM1.25 — Enumerate the indications for valvuloplasty, valvotomy, coronary revascularization and cardiac transplantation

IM1.26 — Develop document and present a management plan for patients with heart failure based on type of failure, underlying aetiology

IM1.27 — Describe and discuss the role of penicillin prophylaxis in the prevention of rheumatic heart disease

IM1.28 — Enumerate the causes of adult presentations of congenital heart disease and describe the distinguishing features between cyanotic and acyanotic heart disease

IM1.29 — Elicit document and present an appropriate history, demonstrate correctly general examination, relevant clinical findings and formulate document and present a management plan for an adult patient presenting with a common form of congenital heart disease

IM1.30 — Administer an intramuscular injection with an appropriate explanation to the patient

IM2.1 — Discuss and describe the epidemiology, antecedents and risk factors for atherosclerosis and ischemic heart disease

IM2.2 — Discuss the aetiology of risk factors both modifiable and non modifiable of atherosclerosis and IHD

IM2.3 — Discuss and describe the lipid cycle and the role of dyslipidemia in the pathogenesis of atherosclerosis

IM2.4 — Discuss and describe the pathogenesis natural history, evolution and complications of atherosclerosis and IHD

IM2.5 — Define the various acute coronary syndromes and describe their evolution, natural history and outcomes

IM2.6 — Elicit document and present an appropriate history that includes onset evolution, presentation risk factors, family history, comorbid conditions, complications, medication, history of atherosclerosis, IHD and coronary syndromes

IM2.7 — Perform, demonstrate and document a physical examination including a vascular and cardiac examination that is appropriate for the clinical presentation

IM2.8 — Generate document and present a differential diagnosis based on the clinical presentation and prioritise based on “cannot miss”, most likely diagnosis and severity

IM2.9 — Distinguish and differentiate between stable and unstable angina and AMI based on the clinical presentation

IM2.10 — Order, perform and interpret an ECG

IM2.11 — Order and interpret a Chest X-ray and markers of acute myocardial infarction

IM2.12 — Choose and interpret a lipid profile and identify the desirable lipid profile in the clinical context

IM2.13 — Discuss and enumerate the indications for and findings on echocardiogram, stress testing and coronary angiogram

IM2.14 — Discuss and describe the indications for admission to a coronary care unit and supportive therapy for a patient with acute coronary syndrome

IM2.15 — Discuss and describe the medications used in patients with an acute coronary syndrome based on the clinical presentation

IM2.16 — Discuss and describe the indications for acute thrombolysis, PTCA and CABG

IM2.17 — Discuss and describe the indications and methods of cardiac rehabilitation

IM2.18 — Discuss and describe the indications, formulations, doses, side effects and monitoring for drugs used in the management of dyslipidemia

IM2.19 — Discuss and describe the pathogenesis, recognition and management of complications of acute coronary syndromes including arrhythmias, shock, LV dysfunction, papillary muscle rupture and pericarditis

IM2.20 — Discuss and describe the assessment and relief of pain in acute coronary syndromes

IM2.21 — Observe and participate in a controlled environment an ACLS program

IM2.22 — Perform and demonstrate in a mannequin BLS

IM2.23 — Describe and discuss the indications for nitrates, anti platelet agents, gpIIb IIIa inhibitors, beta blockers, ACE inhibitors etc in the management of coronary syndromes

IM2.24 — Counsel and communicate to patients with empathy lifestyle changes in atherosclerosis / post coronary syndromes

IM3.1 — Define, discuss, describe and distinguish community acquired pneumonia, nosocomial pneumonia and aspiration pneumonia

IM3.2 — Discuss and describe the aetiologies of various kinds of pneumonia and their microbiology depending on the setting and immune status of the host

IM3.3 — Discuss and describe the pathogenesis, presentation, natural history and complications of pneumonia

IM3.4 — Elicit document and present an appropriate history including the evolution, risk factors including immune status and occupational risk

IM3.5 — Perform, document and demonstrate a physical examination including general examination and appropriate examination of the lungs that establishes the diagnosis, complications and severity of disease

IM3.6 — Generate document and present a differential diagnosis based on the clinical features, and prioritise the diagnosis based on the presentation

IM3.7 — Order and interpret diagnostic tests based on the clinical presentation including: CBC, Chest X ray PA view, Mantoux, sputum gram stain, sputum culture and sensitivity, pleural fluid examination and culture, HIV testing and ABG

IM3.8 — Demonstrate in a mannequin and interpret results of an arterial blood gas examination

IM3.9 — Demonstrate in a mannequin and interpret results of a pleural fluid aspiration

IM3.10 — Demonstrate the correct technique in a mannequin and interpret results of a blood culture

IM3.11 — Describe and enumerate the indications for further testing including HRCT, Viral cultures, PCR and specialised testing

IM3.12 — Select, describe and prescribe based on the most likely aetiology, an appropriate empirical antimicrobial based on the pharmacology and antimicrobial spectrum

IM3.13 — Select, describe and prescribe based on culture and sensitivity appropriate empirical antimicrobial based on the pharmacology and antimicrobial spectrum.

IM3.14 — Perform and interpret a sputum gram stain and AFB

IM3.15 — Describe and enumerate the indications for hospitalisation in patients with pneumonia

IM3.16 — Describe and enumerate the indications for isolation and barrier nursing in patients with pneumonia

IM3.17 — Describe and discuss the supportive therapy in patients with pneumonia including oxygen use and indications for ventilation

IM3.18 — Communicate and counsel patient on family on the diagnosis and therapy of pneumonia

IM3.19 — Discuss, describe, enumerate the indications and communicate to patients on pneumococcal and influenza vaccines

IM4.1 — Describe and discuss the febrile response and the influence of host immune status, risk factors and comorbidities on the febrile response

IM4.2 — Describe and discuss the influence of special populations on the febrile response including: the elderly, immune suppression, malignancy and neutropenia, HIV and travel

IM4.3 — Discuss and describe the common causes, pathophysiology and manifestations of fever in various regions in India including bacterial, parasitic and viral causes (e.g.Dengue, Chikungunya, Typhus)

IM4.4 — Describe and discuss the pathophysiology and manifestations of inflammatory causes of fever

IM4.5 — Describe and discuss the pathophysiology and manifestations of malignant causes of fever including hematologic and lymph node malignancies

IM4.6 — Discuss and describe the pathophysiology and manifestations of malaria

IM4.7 — Discuss and describe the pathophysiology and manifestations of the sepsis syndrome

IM4.8 — Discuss and describe the pathophysiology, aetiology and clinical manifestations of fever of unknown origin (FUO) including in a normal host, neutropenic host, nosocomial host and a host with HIV disease

IM4.9 — Elicit document and present a medical history that helps delineate the aetiology of fever that includes the evolution and pattern of fever, associated symptoms, immune status, comorbidities, risk factors, exposure through occupation, travel and environment and medication use

IM4.10 — Perform a systematic examination that establishes the diagnosis and severity of presentation that includes: general skin mucosal and lymph node examination, chest and abdominal examination (including examination of the liver and spleen)

IM4.11 — Generate a differential diagnosis and prioritise based on clinical features that help distinguish between infective, inflammatory, malignant and rheumatologic causes

IM4.12 — Order and interpret diagnostic tests based on the differential diagnosis including: CBC with differential, peripheral smear, urinary analysis with sediment, Chest X ray, blood and urine cultures, sputum gram stain and cultures, sputum AFB and cultures, CSF analysis, pleural and body fluid analysis, stool routine and culture and QBC

IM4.13 — Perform and interpret a sputum gram stain

IM4.14 — Perform and interpret a sputum AFB

IM4.15 — Perform and interpret a malarial smear

IM4.16 — Enumerate the indications and describe the findings in tests of inflammation and specific rheumatologic tests, serologic testing for pathogens including HIV, bone marrow aspiration and biopsy

IM4.17 — Observe and assist in the performance of a bone marrow aspiration and biopsy in a simulated environment

IM4.18 — Enumerate the indications for use of imaging in the diagnosis of febrile syndromes

IM4.19 — Assist in the collection of blood and wound cultures

IM4.20 — Interpret a PPD (Mantoux)

IM4.21 — Develop and present an appropriate diagnostic plan based on the clinical presentation, most likely diagnosis in a prioritised and cost effective manner

IM4.22 — Describe and discuss the pharmacology, indications, adverse reactions, interactions of antimalarial drugs and basis of resistance

IM4.23 — Prescribe drugs for malaria based on the species identified, prevalence of drug resistance and national programs

IM4.24 — Develop an appropriate empiric treatment plan based on the patient’s clinical and immune status pending definitive diagnosis

IM4.25 — Communicate to the patient and family the diagnosis and treatment

IM4.26 — Counsel the patient on malarial prevention

IM5.1 — Describe and discuss the physiologic and biochemical basis of hyperbilirubinemia

IM5.2 — Describe and discuss the aetiology and pathophysiology of liver injury

IM5.3 — Describe and discuss the pathologic changes in various forms of liver disease

IM5.4 — Describe and discuss the epidemiology, microbiology, immunology and clinical evolution of infective (viral) hepatitis

IM5.5 — Describe and discuss the pathophysiology and clinical evolution of alcoholic liver disease

IM5.6 — Describe and discuss the pathophysiology, clinical evolution and complications of cirrhosis and portal hypertension including ascites, spontaneous bacterial peritonitis, hepatorenal syndrome and hepatic encephalopathy

IM5.7 — Enumerate and describe the causes and pathophysiology of drug induced liver injury

IM5.8 — Describe and discuss the pathophysiology, clinical evolution and complications cholelithiasis and cholecystitis

IM5.9 — Elicit document and present a medical history that helps delineate the aetiology of the current presentation and includes clinical presentation, risk factors, drug use, sexual history, vaccination history and family history

IM5.10 — Perform a systematic examination that establishes the diagnosis and severity that includes nutritional status, mental status, jaundice, abdominal distension ascites, features of portosystemic hypertension and hepatic encephalopathy

IM5.11 — Generate a differential diagnosis and prioritise based on clinical features that suggest a specific aetiology for the presenting symptom

IM5.12 — Choose and interpret appropriate diagnostic tests including: CBC, bilirubin, function tests, Hepatitis serology and ascitic fluid examination in patient with liver diseases.

IM5.13 — Enumerate the indications for ultrasound and other imaging studies including MRCP and ERCP and describe the findings in liver disease

IM5.14 — Outline a diagnostic approach to liver disease based on hyperbilirubinemia, liver function changes and hepatitis serology

IM5.15 — Assist in the performance and interpret the findings of an ascitic fluid analysis

IM5.16 — Describe and discuss the management of hepatitis, cirrhosis, portal hypertension, ascites, spontaneous bacterial peritonitis and hepatic encephalopathy

IM5.17 — Enumerate the indications, precautions and counsel patients on vaccination for hepatitis

IM5.18 — Enumerate the indications for hepatic transplantation

IM6.1 — Describe and discuss the symptoms and signs of acute HIV seroconversion

IM6.2 — Define and classify HIV AIDS based on the CDC criteria

IM6.3 — Describe and discuss the relationship between CD4 count and the risk of opportunistic infections

IM6.4 — Describe and discuss the pathogenesis, evolution and clinical features of common HIV related opportunistic infections

IM6.5 — Describe and discuss the pathogenesis, evolution and clinical features of common HIV related malignancies

IM6.6 — Describe and discuss the pathogenesis, evolution and clinical features of common HIV related skin and oral lesions

IM6.7 — Elicit document and present a medical history that helps delineate the aetiology of the current presentation and includes risk factors for HIV, mode of infection, other sexually transmitted diseases, risks for opportunistic infections and nutritional status

IM6.8 — Generate a differential diagnosis and prioritise based on clinical features that suggest a specific aetiology for the presenting symptom

IM6.9 — Choose and interpret appropriate diagnostic tests to diagnose and classify the severity of HIV-AIDS including specific tests of HIV, CD4

IM6.10 — Choose and interpret appropriate diagnostic tests to diagnose opportunistic infections including CBC, sputum examination and cultures, blood cultures, stool analysis, CSF analysis and Chest radiographs

IM6.11 — Enumerate the indications and describe the findings for CT of the chest and brain and MRI

IM6.12 — Enumerate the indications for and interpret the results of: pulse oximetry, ABG, Chest Radiograph

IM6.13 — Describe and enumerate the indications and side effects of drugs for bacterial, viral and other types of diarrhea

IM6.14 — Perform and interpret AFB sputum

IM6.15 — Demonstrate in a model the correct technique to perform a lumbar puncture

IM6.16 — Discuss and describe the principles of HAART, the classes of antiretrovirals used, adverse reactions and interactions

IM6.17 — Discuss and describe the principles and regimens used in post exposure prophylaxis

IM6.18 — Enumerate the indications and discuss prophylactic drugs used to prevent HIV related opportunistic infections

IM6.19 — Counsel patients on prevention of HIV transmission

IM6.20 — Communicate diagnosis, treatment plan and subsequent follow up plan to patients

IM6.21 — Communicate with patients on the importance of medication adherence

IM6.22 — Demonstrate understanding of ethical and legal issues regarding patient confidentiality and disclosure in patients with HIV

IM6.23 — Demonstrate a non-judgemental attitude to patients with HIV and to their lifestyles

IM7.1 — Describe the pathophysiology of autoimmune disease

IM7.2 — Describe the genetic basis of autoimmune disease

IM7.3 — Classify cause of joint pain based on the pathophysiology

IM7.4 — Develop a systematic clinical approach to joint pain based on the pathophysiology

IM7.5 — Describe and discriminate acute, subacute and chronic causes of joint pain

IM7.6 — Discriminate, describe and discuss arthralgia from arthritis and mechanical from inflammatory causes of joint pain

IM7.7 — Discriminate, describe and discuss distinguishing articular from periarticular complaints

IM7.8 — Determine the potential causes of joint pain based on the presenting features of joint involvement

IM7.9 — Describe the common signs and symptoms of articular and periarticular diseases

IM7.10 — Describe the systemic manifestations of rheumatologic disease

IM7.11 — Elicit document and present a medical history that will differentiate the aetiologies of disease

IM7.12 — Perform a systematic examination of all joints, muscle and skin that will establish the diagnosis and severity of disease

IM7.13 — Generate a differential diagnosis and prioritise based on clinical features that suggest a specific aetiology

IM7.14 — Describe the appropriate diagnostic work up based on the presumed aetiology

IM7.15 — Enumerate the indications for and interpret the results of : CBC, anti-CCP, RA, ANA, DNA and other tests of autoimmunity

IM7.16 — Enumerate the indications for arthrocentesis

IM7.17 — Enumerate the indications and interpret plain radiographs of joints

IM7.18 — Communicate diagnosis, treatment plan and subsequent follow up plan to patients

IM7.19 — Develop an appropriate treatment plan for patients with rheumatologic diseases

IM7.20 — Select, prescribe and communicate appropriate medications for relief of joint pain

IM7.21 — Select, prescribe and communicate preventive therapy for crystalline arthropathies

IM7.22 — Select, prescribe and communicate treatment option for systemic rheumatologic conditions

IM7.23 — Describe the basis for biologic and disease modifying therapy in rheumatologic diseases

IM7.24 — Communicate and incorporate patient preferences in the choice of therapy

IM7.25 — Develop and communicate appropriate follow up and monitoring plans for patients with rheumatologic conditions

IM7.26 — Demonstrate an understanding of the impact of rheumatologic conditions on quality of life, well being, work and family

IM7.27 — Determine the need for specialist consultation

IM8.1 — Describe and discuss the epidemiology, aetiology and the prevalence of primary and secondary hypertension

IM8.2 — Describe and discuss the pathophysiology of hypertension

IM8.3 — Describe and discuss the genetic basis of hypertension

IM8.4 — Define and classify hypertension

IM8.5 — Describe and discuss the differences between primary and secondary hypertension

IM8.6 — Define, describe and discuss and recognise hypertensive urgency and emergency

IM8.7 — Describe and discuss the clinical manifestations of the various aetiologies of secondary causes of hypertension

IM8.8 — Describe, discuss and identify target organ damage due to hypertension

IM8.9 — Elicit document and present a medical history that includes: duration and levels, symptoms, comorbidities, lifestyle, risk factors, family history, psychosocial and environmental factors, dietary assessment, previous and concomitant therapy

IM8.10 — Perform a systematic examination that includes : an accurate measurement of blood pressure, fundus examination, examination of vasculature and heart

IM8.11 — Generate a differential diagnosis and prioritise based on clinical features that suggest a specific aetiology

IM8.12 — Describe the appropriate diagnostic work up based on the presumed aetiology

IM8.13 — Enumerate the indications for and interpret the results of : CBC, Urine routine, BUN, Cr, Electrolytes, Uric acid, ECG

IM8.14 — Develop an appropriate treatment plan for essential hypertension

IM8.15 — Recognise, prioritise and manage hypertensive emergencies

IM8.16 — Develop and communicate to the patient lifestyle modification including weight reduction, moderation of alcohol intake, physical activity and sodium intake

IM8.17 — Perform and interpret a 12 lead ECG

IM8.18 — Incorporate patient preferences in the management of HTN

IM8.19 — Demonstrate understanding of the impact of Hypertension on quality of life, well being, work and family

IM8.20 — Determine the need for specialist consultation

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