MSK -II Module

3rd Year MBBS

 Table of Contents
Khyber Medical University (KMU) Vision: ................................................................. 4
Khyber Medical University (KMU) Mission: ................................................................ 4
Institute of Health Professions Education & Research (IHPER) Mission: ............................. 4
Teaching Hours Allocations.................................................................................... 5
Themes ........................................................................................................... 6
Learning Objectives ............................................................................................ 7
Knowledge ..................................................................................................... 7
Reinforcement ............................................................................................. 7
Pathology ................................................................................................... 7
Pharmacology .............................................................................................. 7
Community medicine ...................................................................................... 7
Forensic medicine ......................................................................................... 7
Medicine ..................................................................................................... 7
Orthopedic .................................................................................................. 8
Dermatology ................................................................................................ 8
Radiology .................................................................................................... 8
Paeds ........................................................................................................ 8
Eye ........................................................................................................... 8
ENT ........................................................................................................... 8
Prime: ....................................................................................................... 8
Skills: ........................................................................................................... 8
Special Pathology .......................................................................................... 8
Pharmacology .............................................................................................. 8
Forensic Medicine .......................................................................................... 8
Orthopedic/Medicine ...................................................................................... 9
Attitude: ....................................................................................................... 9
Theme I: Aching Bones ................................................................................... 10
Theme II: Joint Stiffness .................................................................................. 14
Theme III: Muscle weakness and Trauma ............................................................... 17
Theme IV: Skin Rash and Itching ......................................................................... 20
Pathology Practicals ....................................................................................... 24
Pharmacology Practicals .................................................................................. 24
Forensic Practicals ......................................................................................... 25
Learning Resources ........................................................................................... 25
KMU (IHPER)- Central Curriculum Committee 2
 List of reference books .................................................................................... 26
Assessment Plan – 3rd Year MBBS .......................................................................... 29
Assessment Blueprints ....................................................................................... 31

KMU (IHPER)- Central Curriculum Committee 3

Khyber Medical University (KMU) Vision:

Khyber Medical University will be the global leader in health sciences

academics and research for efficient and compassionate health care.

Khyber Medical University (KMU) Mission:

Khyber Medical University aims to promote professional competence
through learning and innovation for providing comprehensive quality
health care to the nation.

Institute of Health Professions Education & Research (IHPER) Mission:

To produce leaders, innovators and researchers in health professions
education who can apply global knowledge to resolve local issues.

KMU (IHPER)- Central Curriculum Committee 4

Teaching Hours Allocation
Table 1 Hours Allocation
S. No Subject Hours
1 Pathology 33
2 Pharmacology 18
3 Forensic medicine 22
4 Community medicine 4
5 Pediatrics 6
6 Medicine 5
7 Orthopedics 5
8 Radiology 1
9 Family medicine 1
10 Eye 1
11 ENT 1
12 PRIME/Research 1+1
Total 99

KMU (IHPER)- Central Curriculum Committee 5

 Themes
S.NO Themes Duration 4 weeks
1 Aching Bones 2 week (1st& 2nd Week)
2 Joint Stiffness 1 week (3rd Week)
3 Muscle weakness and Trauma 1 week (4th Week)
4 Skin Rash and Itching 1 week (5th Week)

KMU (IHPER)- Central Curriculum Committee 6

 Learning Objectives
At the end of this module, students will be able to

Knowledge
Reinforcement
• Explain important anatomical and physiological characteristics of musculoskeletal system

Pathology
• Explain essential pathological concepts of diseases involving
Ø Joints
Ø Bones
Ø Muscles
Ø Cartilages
Ø Soft tissues
Ø Skin
Pharmacology
• Describe the clinical applications of NSAIDs in the treatment of musculoskeletal disorders
• Describe the basic and clinical pharmacology of drugs affecting bone and Mineral
Homeostasis
• Describe the basic and clinical pharmacology of drugs used to treat Gout and Rheumatoid
Arthritis
• Describe the basic and clinical pharmacology of skeletal muscles relaxants
• Describe the drugs used for dermatological disorders.

Community medicine
• Classify accidents and injuries, burden of RTAs, prevention and control strategies of RTAs
• Define poliomyelitis and discuss the epidemiology, prevention, and control of poliomyelitis
• Define Ergonomics, Principles of Ergonomics, Epidemiology of MSK disorders and their
prevention
• Discuss burden and prevention of Osteoporosis, Osteomalacia and Rickets

Forensic medicine
• Define and classify wounds
• Describe types of hurt according to Qisas and Diyat Act
• Describe firearm and explosives injuries
• Describe RTAs, Railway and Aircraft injuries
• Describe the Medico legal aspects of wounds

Medicine
• Describe Osteoporosis and Osteomalacia and develop its management plan
• Discuss Rheumatoid Arthritis and Ankylosing Spondylitis
• Discuss Myopathies
KMU (IHPER)- Central Curriculum Committee 7
Orthopedic
• Describe types of fracture and explain the open fractures
• Explain the emergency treatment of an injured limb.
• Identify and describe common benign and malignant bone tumours.
• Describe common ligamentous, tendon injuries and common spinal fractures
Dermatology
• Describe the pathological lesions of skin and their clinical presentation with differential
diagnosis.

Radiology
• Interpret normal X-Rays and X-Rays showing structural deformities

Paeds
• Explain bone pains and aches in children
• Discuss Congenital/Hereditary Myopathies

Eye
• Describe the basic Anatomy of Eye

ENT
• Discuss anatomy of Ear, Nose, Para nasal Sinuses and Oral Cavity

Prime:

Communication Skills
• Dealing with patients
Behavioral Sciences / Professionalism
• Attributes of Professionalism
Research
• Study Designs
• Research question

Skills:
Special Pathology
• Identify morphological features of Basal cell carcinoma and Squamous cell carcinoma
• Identify morphological features of Tuberculous osteomyelitis

Pharmacology
• Writing a prescription for a patient with Rheumatoid arthritis
• Writing a prescription for a patient with Gout

Forensic Medicine
• Identify types of mechanical wound
• Identify the causative weapon
• Identify the manner of wound causation
• Issue a medico legal certificate for the given wound
KMU (IHPER)- Central Curriculum Committee 8
Orthopedic/Medicine
• Acquire a thorough history in relevance to MSK and take focused general examination of
musculoskeletal system.
• Identify, evaluate and interpret the X-ray to diagnose fractures/musculoskeletal conditions
• Discuss the radiological characteristics of fractures and radiological characteristics of
dislocations

Attitude:
While not necessarily taught explicitly, students are expected to develop following attitudes
throughout the course:

1. Demonstrate teamwork, leadership, punctuality and good manners

2. Demonstrate humbleness and use socially acceptable language during academic and social
interactions with colleagues and teachers.
3. Make ethically competent decisions when confronted with an ethical, social or moral
problem related to MSK in professional or personal life
4. Discuss ethical issues, social and preventive aspect of health care in the context of MSK
system.

KMU (IHPER)- Central Curriculum Committee 9

Theme I: Aching Bones

Subject Topic Learning Outcome Hrs

Anatomy Important Anatomical Discuss important anatomical 1

Characteristics of MSK characteristics of musculoskeletal
system
Physiology Important Physiological Discuss important Physiological 1
Characteristics of MSK characteristics of musculoskeletal
system
Pathology Metabolic diseases of Describe the following metabolic 1
bone diseases of bone from pathological
point of view:
• Osteopenia and Osteoporosis
• Paget Disease (Osteitis
Deformans)
• Osteomalacia and Rickets
Fracture and Classify fractures and describe 1
Osteonecrosis healing process in fractures
Enlist aetiologies of osteonecrosis
(Avascular Necrosis)
Describe clinical features and
morphological findings in
osteonecrosis
Osteomyelitis Classify osteomyelitis and delineate 1
its etiology, pathogenesis, common
clinical features, morphological
findings, and complications related
to osteomyelitis
Bone Tumors Classify bone tumors 1

Describe the frequency of different

bone tumors in general population
Enlist common clinical features
found in common types of bone
tumors.
Enlist key morphological features of
Osteosarcoma, Osteoid osteoma and
Osteoblastoma
Cartilage-Forming Discuss the frequency of different 1
Tumors cartilaginous tumors in general
population

KMU (IHPER)- Central Curriculum Committee 10

 Enlist common clinical features of
common cartilaginous tumors
Describe etiology, pathogenesis, 1
Tumors of Unknown and key clinico-morphological
Origin features of Ewing’s Sarcoma and
Giant Cell Tumor
Lesions Simulating Describe key clinico-morphological 1
Primary Neoplasms features and essential points in the
pathogenesis of Fibroma
Pharmacology NSAIDs Describe the clinical applications of 1
NSAIDs in the treatment of
musculoskeletal disorders
Drug affecting Bone & Classify drugs used in metabolic 2
Mineral Homeostasis bone disorders
Enlist calcium preparations
Describe clinical uses of calcium
salts
Enlist vitamin D preparations

Describe actions of vitamin D on

intestine, Kidney and Bone
Describe clinical uses of vitamin D

Describe the mechanism of action,

clinical uses and adverse effects of
Bisphosphonates
Describe the mechanism of action,
clinical uses and adverse effects of
calcitonin
Classify drugs used to treat
osteoporosis
Explain the mechanism of action of
SERM (Raloxifene) and RANK ligand
(Denosumab)
Forensic Mechanism of Define and classify wound 1
Medicine production of wound
Describe mechanism of action of
wound production associated
factors, appearance and
complications.
Abrasion Define and classify abrasion

Explain types of abrasion and

mechanism of wound production
associated factors, appearance, and
complication.
Differentiate between antemortem
& postmortem abrasion.

KMU (IHPER)- Central Curriculum Committee 11

 Describe the medico legal aspects
of abrasion
Bruise Define and classify bruise 1

Describe types of bruise and

mechanism of wound production
associated factors, appearance, and
complication.
Differentiate between ante mortem
& postmortem Bruise.
Describe the medico legal aspects
of Bruise
Lacerated wound Define and Classify lacerated wound 1
Describe types of lacerated wound
and Mechanism of wound
production associated factors,
appearance and complication.
Difference between ante mortem &
postmortem Laceration.
Describe the medico legal aspects
of Lacerated wound
Incised Wound Define and classify incised wound 1

Describe types of incised wound and

mechanism of wound production
associated factors, appearance, and
complication.

Difference between ante mortem &

postmortem Incised Wound

Differentiate between incised &

lacerated wound.
Describe the medico legal aspects
of Incised wound
Stab wounds Define and classify Stab wound
Describe types of Stab wound and
mechanism of wound production
associated factors, appearance, and
complication.
Difference between ante mortem &
postmortem stab wound
Describe the medico legal aspects
of stab wound
Battered baby Explain the salient features of 1
syndrome diagnosing Battered baby syndrome
Community Ergonomics Describe Ergonomics 1
Medicine
Describe the principles &
importance of Ergonomics at work
place
KMU (IHPER)- Central Curriculum Committee 12
 Explain the epidemiology of
musculoskeletal disorders
Discuss prevention and control
strategies for Musculoskeletal
disorders
Public health aspects • Explain the types of 1
of disability rehabilitation and public
limitations: health issues faced by the
(Osteoporosis, disabled person, and
Osteomalacia and measures to be taken for
Rickets) rehabilitation
• Discuss epidemiology and
prevention of Osteoporosis,
Osteomalacia and Rickets

Medicine Osteoporosis and Describe Osteoporosis and 1

Osteomalacia Osteomalacia
List common causes and risk factors
of Osteoporosis and Osteomalacia
Discuss clinical features ,
differential diagnosis of
Osteoporosis and Osteomalacia
Enlist the Investigations for patient
presenting with Osteoporosis and
Osteomalacia
Orthopedics Fractures Describe and illustrate types of 1
fracture, fracture patterns,
displacement and angulation of
fractures in children and adults.
Explain open fractures
Discuss the basic principles of
wound debridement.
Bone Tumours To recognize, investigate and 1
describe the radiological features of
common benign and malignant Bone
Tumours.
Radiology X-Ray Interpretation Identify and interpret different 1
types of fractures
Eye Anatomy of Eye Describe anatomy of Orbit 1
Describe anatomy of Eye Ball
ENT 1
Ear Explain anatomy of ear
Paeds Bone pains and aches Common causes of bones aches and 1
in children pains including Growing pains in
children

KMU (IHPER)- Central Curriculum Committee 13

 Discuss nutritional Rickets
causation, clinical presentation,
Lab and Radiological findings and
prevention
Skeletal dysplasia’s Discuss clinical feature and 1
differential diagnosis of the
following
• Achondroplasia
• Osteopetrosis
• Osteogenesis Imperfecta
PRIME/Research Proposal writing Write a proposal for research 3
project using KMU or CPSP
guidelines or any other standard
guidelines
PRIME/MEDICAL Attributes of Discriminate empathy and 1
EDUCATION professionalism- sympathy
Empathy Demonstrate empathy in patient-
health professional interaction

Theme II: Joint Stiffness

Subjects Topics Hours
Los
Pathology Osteoarthritis Describe aetiology and pathogenesis 1
of osteoarthritis
Discuss clinical and morphological
features of osteoarthritis
Enumerate complications of
osteoarthritis
Rheumatoid Arthritis Describe aetiology and pathogenesis 1
of Rheumatoid Arthritis
Discuss clinical and morphological
features of Rheumatoid Arthritis
Enumerate complications of
Rheumatoid Arthritis
Seronegative Classify and explain 1
Spondyloarthropathies Spondyloarthropathies
Discuss pathogenesis and clinical
features of Ankylosing Spondylitis
Discuss pathogenesis and clinical
features of Reactive Arthritis
Discuss pathogenesis and clinical
features of Psoriatic Arthritis
Infectious Arthritis Describe etiology and pathogenesis 1
of Suppurative Arthritis
Discuss clinical featuresand
morphological features of
Suppurative arthritis.
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 Enumerate complications of
Suppurative arthritis
Describe etiology and pathogenesis
of Mycobacterial Arthritis
Discuss clinical features and
morphological features of
Mycobacterial Arthritis
Enumerate complications of
Mycobacterial Arthritis
Rheumatic Fever Describe key structural features, 1
virulence factors, modes of
pathogenesis and diagnosis of
Streptococcus pyogenes
Explain etiology, pathogenesis,
clinical features, diagnosis, and
complications of Rheumatic Fever.
Crystal-Induced Arthritis Enlist different types of crystal- 1
Induced arthritis
Describe key points of aetiology,
pathogenesis, clinical features,
morphological features, and
complications of:
• Gout
• Calcium Pyrophosphate Crystal
deposition Disease (Pseudo-
Gout)
Pharmacology Pharmacotherapy of 2
Classify drugs used to treat gout
Gout
Describe the role of NSAIDs in the
treatment of gout
Describe the role of Glucocorticoids
in the treatment of gout
Describe the mechanism of action of
various drugs (Colchicine,
Probenecid, Allopurinol,
Febuxostat) used in the treatment of
Gout
Discuss the adverse effects of anti-
gout drugs
Describe the drug interactions of
Allopurinol and Probenecid
Enlist the drugs causing
hyperuricemia
Discuss the mechanism by which
drugs causes hyperuricemia
Pharmacotherapy of Classify drugs used in Rheumatoid 3
Rheumatoid Arthritis arthritis
Discuss the role of NSAIDs in
Rheumatoid Arthritis
KMU (IHPER)- Central Curriculum Committee 15
 Discuss the role of Glucocorticoids in
Rheumatoid Arthritis
Define and classify DMARDs
Enlist biological and non-biological
agents used to treat rheumatoid
arthritis
Describe pharmacokinetics
mechanism of action, clinical uses
and adverse effects of
methotrexate.
Enlist adverse effects and
therapeutic uses of DMARDs
Forensic Age of Wound & Describe events associated with 1
Medicine Complication wound healing
Differentiate between old and fresh
wound
Describe injury zone on the basis of
histo-chemical changes and
Biochemical events taking place.
Qisas & Diyat 1
Define hurt, Wound & injury
Classify hurt according to
International law
Types of hurt according to Qisas &
Diyat Act
Explain Punishments (tazir),
compensation and Fine (Diyat)
Injured person medical Describe the salient features of 1
aid act injured person medical aid act
Work-men compensation Describe the salient features of
laws Work-men compensation laws
Medicine Rheumatoid Arthritis Describe Rheumatoid Arthritis with 1
its clinical presentation and
differential diagnosis.
Ankylosing Spondylitis Describe Ankylosing Spondylitis with
its clinical presentation and
differential diagnosis.
Orthopedics Bone and Joint Descirbe the aetiology, pathology, 1
Infections clinical presentation and
investigations of Bone and Joint
infections
Nose, Para Nasal Sinuses Discuss anatomy of Nose, Para nasal 1
ENT
& Oral Cavity sinuses & oral cavity
Discuss criteria for classification of 1
Juvenile Idiopathic JIA
Paeds
arthritis (JIA) Discuss its clinical features and
differential diagnosis.

KMU (IHPER)- Central Curriculum Committee 16

 Explain importance of answering 1
PRIME/MEDICAL Communication Skills:
questions and giving explanation
EDUCATION Dealing with Patients
and/or instructions

Theme III: Muscle weakness and Trauma

Subjects Topics Los Hours

Pathology Tumors of adipose tissue Classify soft tissue tumors and 1
provide a brief description of their
salient clinical features
Enlist key morphological features of
lipoma and liposarcoma
Fibrous Tumors Describe important clinico- 1
pathological and morphological
features of:
• Nodular Fasciitis
• Fibromatoses
Muscle tumors Classify muscle tumors 1
Describe etiology, clinico-
morphological features, and
complications of
Rhabdomyosarcoma
Describe etiology, clinico-
morphological features, and
complications of Leiomyoma
Describe etiology, clinico-
morphological features, and
complications of Leiomyosarcoma
Describe etiology, clinico-
morphological features, and
complications of Fibrosarcoma
Skeletal muscle atrophy 1
Describe pathological features of
and myopathies
Skeletal Muscle Atrophy
Describe pathological features of
Neurogenic and Myopathic changes
in Skeletal Muscle
Describe pathological features of
Inflammatory Myopathies

Describe pathological features of

Dermatomyositis

Describe pathological features of

Polymyositis
Describe pathological features of
Inclusion Body Myositis
KMU (IHPER)- Central Curriculum Committee 17
 Describe pathological features of
Toxic Myopathies
Inherited Diseases of Describe genetic abnormality, 1
Skeletal Muscle morphology and clinical features of
Muscular Dystrophies
Pharmacology Skeletal muscle 3
Classify skeletal muscle relaxants.
relaxants
Describe the mechanism of action
of Non-depolarizing and
depolarizing neuromuscular
blockers.
Discuss the differences between
depolarizing and non-depolarizing
skeletal muscle relaxants
Describe the therapeutic uses and
adverse effects of skeletal muscle
relaxants
Describe centrally acting skeletal
muscle relaxants (Spasmolytics)
Name drugs causing malignant
hyperthermia
Discuss the rationale for use of
Dantrolene in the treatment of
malignant hyperthermia
Discuss succinylcholine apnea and
its management
Forensic Transportation Discuss injuries to the driver & 2
Medicine Accidents front seat occupant and rare seat
occupant.
Discuss spinal injuries including
Whiplash injury and railway spine
Explain Railway injuries with
medico legal significance
Discuss Air crash accidents.
Firearm Injuries Describe wound ballistics and its 3
types.
Describe terms /Definition used in
firearm injuries, types of bullets.
Explain basic mechanism of firearm.
Explain ranges of fire in firearm
injuries, beveling phenomenon,
wound production mechanism.
Identify types of gun powders and
ammunition used.
Interpret findings of injuries
produced by different weapons.
Explain pattern of identification of
entry and exit wound.
KMU (IHPER)- Central Curriculum Committee 18
 Explain information inferred from
examination of firearm entry
wound.
Injuries By Explosives Describe mechanism of production 1
of injuries by bomb blast.
Explain different causes of death in
blast injuries.
Interpret Autopsy findings in
explosion fatalities.
Thermal Injuries Describe Thermal Injuries 1

Describe their classifications

Describe Burns and Scalds
Electrical Injuries Explain electrocution 1

Types of electrical injuries

Describe PM findings

Explain Lightning
Community Rehabilitation of Define disabilities and its types, and 1
Medicine disabilities: concepts, and distinguish between
Poliomyelitis impairment, disability and
handicapped, and significance of
DALYs and QALYs.
Describe the Epidemiology,
determinants & distribution of
poliomyelitis
Describe the prevention and control
measures and rehabilitation of
Poliomyelitis
Accidents and its Describe of types of accidents and
prevention their mechanisms and their
prevention (Haddon`s model)
Describe Road Traffic Accidents 1

Classify different types of road

traffic accidents and injuries?
Describe and compare the burden
of road traffic accidents in a
developed country with a
developing country like Pakistan
List and Explain the risk factors of
road traffic accidents
Explain effective public health
strategies used at individual and
national level to prevent for road
traffic accidents
Medicine Myopathies Define Myopathy 1

KMU (IHPER)- Central Curriculum Committee 19

 Enlist Myopathies (Hereditary &
Acquired Myopathies)
Describe the etiology and clinical
features of Myopathies
Plan investigations for Myopathies
Orthopedic Application of Cast Explain the emergency treatment of 1
an injured limb.
Explain emergency immobilization
techniques of the Neck, Spinal
column and limbs.
Describe and discuss the basic
principles pertaining to application
of a cast, the complications of cast
application.
Discuss the principles of a three-
point pressure system in a cast.
Soft Tissue Injuries, Describe the common ligamentous 1
Spinal Injuries and tendon injuries and advise
appropriate management
Recognize common Spinal
fractures, and provide
appropriate initial management
Paeds Congenital/Hereditary Discuss common congenital and 1
Myopathies hereditary myopathies, their
genetics, causation, clinical
presentation, diagnosis.
Duchene Muscular Describe DMD, its clinical 1
dystrophy (DMD) presentation and differential
diagnosis.

Theme IV: Skin Rash and Itching

Subjects Topics Los Hours

Pathology Important pathological Define the following skin lesions 1
terms and describe these with respect to
their etiologies and gross
morphological features.
• Macule
• Papule
• Nodule
• Plaque
• Vesicle
• Bulla
• Blister
• Pustule
• Scale
• Lichenification
• Excoriation
KMU (IHPER)- Central Curriculum Committee 20
 • Hyperkeratosis
• Parakeratosis
• Acanthosis
• Dyskeratosis
• Acantholysis
• Papillomatosis
• Lentiginousspongiosis
• Urticaria
• Pemphigus
• Bullous pemphigoid
• Warts
Eczematous dermatitis 1
Classify eczematous dermatitis
Describe the morphological and
clinical features of acute
eczematous dermatitis
Describe the etiology and
pathogenesis of
• Contact dermatitis
• Atopic dermatitis
• Drug related eczematous
dermatitis
• Photoeczematus eruption
• Primary irritant dermatitis
Erythema multiforme List the conditions which are 1
associated with erythema
multiforme and describe its clinical
features
Psoriasis Describe the etiopathogenesis, 1
morphological and clinical features
of psoriasis
Pre-malignant epithelial List the pre-malignant epithelial 1
lesions lesions (Epidermal)
• List the predisposing factors for
squamous cell carcinoma of skin
• Differentiate squamous cell
carcinoma from basal cell
carcinoma on the basis of
morphology and clinical features
Nevocellular Nevi and List types of Nevocellular Nevi 1
Malignant Melanoma (Congenital Nevus, blue nevus,
Spitz’s Nevus, halo nevus dysplastic
nevus) along with their clinical
significance. (Dermal)
• Describe the clinical and
morphological features of
dysplastic nevi
• Describe malignant melanoma
with respect to frequent site of

KMU (IHPER)- Central Curriculum Committee 21

 origin, clinical and morphological
features.
Viral skin infections Describe the following viral skin 1
infections in context of
etiopathogenesis:
• Herpes simplex virus
• Herpes zoster virus
Fungal skin infections Classify and describe the following 1
fungal skin infections in context of
etiopathogenesis:
• Tinea
• Candida
Skin and soft tissue Describe the following skin lesions 1
infections in context of ethiopathogenesis and
diagnosis
• Impetigo
• Cellulitis / Erysipelas
• Folliculitis
• Skin Abscess (Furuncle &
Carbuncle)
• Necrotizing Soft Tissue Infections
Pharmacology Drugs used for 2
Classify dermatological preparations
dermatological disorders
Enlist topical antibacterial,
antifungal
&antiviral preparations.
Describe clinical uses and adverse
effects of topical antibacterial,
antifungal and antiviral drugs.
Discuss oral treatment of
candidiasis
dermatophytosis and
onychomychosis.
Describe various acne preparations
and antibiotics used to treat acne.
Enlist clinical uses of
immunomodulators
(Imiquimod, Tacrolimus) related to
skin diseases.
Enlist ectoparasiticides
Enlist clinical uses and adverse
effects of Permethen.
Discuss drug treatment of Scabies &
Pediculosis.
Describe the mechanism of action
and
adverse effects of various agents
used for pigmentation disorders

KMU (IHPER)- Central Curriculum Committee 22

 Describe the clinical uses and
adverse effects of drugs used for
the treatment of psoriasis.
Describe clinical uses and adverse
effects of topical corticosteroids
Enlist dermatological disorders
responsive to topical corticosteroids
ranked in order of sensitivity.
Discuss keratoytic agents,
antipruritic
agents, trichogenic and
antitrichogenic
agents and use of antineoplastic
agents in topical conditions
Medicine/Derma Important pathological Enlist and explain the clinical 1
tology terms with Clinical presentation of the following skin
presentations Lesions:
• Macule
• Papule
• Nodule
• Plaque
• Vesicle
• Bulla
• Blister
• Pustule
• Scale
• Lichenification
• Excoriation
• Hyperkeratosis
• Parakeratosis
• Acanthosis
• Dyskeratosis
• Acantholysis
• Papillomatosis
• Lentiginousspongiosis
• Urticaria
• Pemphigus
• Bullous pemphigoid
• Warts
Pre-malignant skin Enlist the pre-malignant skin 1
conditions conditions
Explain their differential diagnosis
on the basis of clinical
presentations
Enlist the relevant investigations
Malignant conditions of Enlist the malignant conditions of
skin skin (squamous and basal cell
carcinoma) Explain their
differential diagnosis on the basis of
clinical presentations

KMU (IHPER)- Central Curriculum Committee 23

 Enlist the relevant investigations

Nevocellular Nevi List the types of Nevocellular Nevi

and discuss their differential
diagnosis on the basis of their
clinical presentations.
Enlist the relevant investigations
Family medicine Leishmaniasis Explain the clinical features and
management of cutaneous
Leishmaniasis in primary healthcare
Paeds Juvenile 1
Dermatomyocytis (JDM) Discuss diagnostic criteria of JDM

Discuss its clinical features

differential diagnosis
PRIME/Research Qualitative and Write a proposal for research 7
quantitative study 3 project using KMU or CPSP
guidelines or any other standard
guidelines

Pathology Practicals
Week Topic Practical
Week 1 Tuberculous osteomyelitis Identify gross and microscopic
morphological features of
tuberculous osteomyelitis
Week 2 Osteogenic sarcoma, Identify gross and microscopic
Osteoclastoma and morphologic features of
chondrosarcoma osteogenic sarcoma,
osteoclastoma and
chondrosarcoma
Week 3 ASO (Anti Streptolysin O) Perform ASO (Anti Streptolysin
test O) test by latex agglutination
technique
Week 4 Tumors of Skin Identify gross and microscopic
features of
• Squamous cell carcinoma
• Basal cell carcinoma

Pharmacology Practicals
Week Topic Practical
Week 1 Gout Write prescription for Gout
Week 2 Rheumatoid Arthritis Write prescription for
Rheumatoid Arthritis
Week 4 Drugs used to treat Write down prescription for
Dermatological Disorders scabies.

KMU (IHPER)- Central Curriculum Committee 24

 Write down prescription for
Psoriasis

Forensic Practicals
Week Topic Practical
Week 1 Examination of wound and • Abrasion
weapon • Bruise
• Laceration
• Incised wound
• Qisas and Diyat models/
• Dura prints of injuries
Week 2 Examination of wound and • Stab wound
weapon • Fracture
• Displacement
• Qisas and Diyat models of
injuries/ multimedia slides
remaining
Week 3 Examination of wound and Firearm injuries / Weapons
weapon Identification of bullets
Week 4 Writing a medico legal Medicolegal report writing in
certificate case of firearm Injuries

KMU (IHPER)- Central Curriculum Committee 25

 Learning Resources
• Digital library
• Virtual Learning Environment (VLE)
• Ambulatory care settings which may be outside the hospital
• Accident and Emergency/Casualty departments
• Clinical Skills Laboratory
• Community Settings
• Electives in own and other Institutions
• Experimental Laboratories
• Hospital Wards
• Out Patient Departments
• Medical College setting

List of reference books

Recommended books

Pharmacology
Text Books

1. Basic and Clinical Pharmacology by Katzung BG, Masters SB, Trevor AJ, 14th Edition.
2. Lippincott’s Illustrated Reviews: Pharmacology, Clark MA, Finkel R, Rey JA, Whalen K, 7th
Edition.
Reference Books:

1. Goodman & Gilman’s The Pharmacological Basis of Therapeutics, Brunton LL 12th Edition.
Pathology
Text Books

1. Robbins Pathologic Basis of Disease

Reference Books:
1. Walter& Israel’s General Pathology"
2. Harsh Mohan's "Textbook of Pathology".
3. Pathology Illustrated
4. Stefan Silbernagl’s "Color Atlas of Pathophysiology"
5. Muir's Textbook of Pathology

Textbook for Microbiology

1. Jawetz, Melnick&Adelberg's "Medical Microbiology"

Reference Books:

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 1. Levinson's "Medical Microbiology & Immunology"
2. Sherris Medical Microbiology
3. Lippincott's Illustrated Reviews: Microbiology
Forensic Medicine
Textbooks:
1. CK Parikh new edition

Reference Books:
1. Nasib R Awan
2. KrishanVij
3. Smart series (SSS) Forensic MCQs with explanation
4. Gazette Pakistan Penal Code (PPC)
5. VV Pillay and Rajesh Bardale
Community Medicine
Textbooks:

1. Public Health & Community Medicine by Shah Ilyas Ansari; 8th Edition
2. Parks Textbook of Prevention & Social Medicine by K.Park; 24th Edition
Ophthalmology
Textbooks:

1. Parsons’ Disease of the EYE

Reference Books:

2. Short Kanski
3. Clinical Ophthalmology Shafi M Jatoi
Research and Biostatistics
1. A synopsis of epidemiology and basic statistics (Ali Muhammad Mir)
2. Statisstics at square one (TDVS winscow)
3. Essentials of research design and methodology. (GeoferryMarczyk)
4. The essentials of clinical epidemiology (Robert H)
Medicine & Allied
1. Kumar and Clark for Medicine 8th edition 2012
2. Davidson
Surgery & Allied
1. Bailey and Love. Short Practice of Surgery 25th edition 2008
2. Current Surgical Diagnosis and Treatment 13th edition 2009

Otorhinolaryngology
1. PL Dhingra 7th edition
2. Cuming standards, ENT
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Paediatric Medicine
1. Text book of paediatrics, Pakistan paediatrics association
2. Essentials of paediatrics, Nelson, Eight edition
3. Basis of paediatrics, Pervez akbar khan, Ninth edition

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 Assessment Plan – 3rd Year MBBS
The year-3 will be assessed in 3 blocks

1) Block-1 (Foundation 2 and Infection and Inflammation modules) will

be assessed in paper-G
2) Block-2 (Multisystem, blood and MSK modules) will be assessed in
paper-H
3) Block-3 (CVS and Respiratory module) will be assessed in paper-I
4) Each written paper consists of 120 MCQs and
5) Internal assessment will be added to final marks in KMU as shown in
below table.
In OSPE, each station will be allotted 6 marks, and a total of 120 (+10%
marks of internal assessment) marks are allocated for each OSPE/OSCE
examination

KMU (IHPER)- Central Curriculum Committee 29

 Year 3 Professional Exam in System-based Curriculum

Theory Modules Theory Internal OSPE/OSPE Internal TOTAL

paper marks assessment assessment MARKS
theory OSPE/OSPE
(10%) (10%)

Paper G Foundation-II 120 14 120 14 268

Inf.&Inflamm.
Paper H Multisystem 120 13 120 14 267
Blood
MSK-II
Paper I CVS-II 120 13 120 12 265
Respiratory-II
TOTAL 360 40 360 40 800
MARKS

*Research viva of 20 marks will be conducted in paper-L. However, the rest of 15 marks will be
decided by the concerned department internally for the contribution of the students in research
project/thesis.

KMU (IHPER)- Central Curriculum Committee 30

 Assessment Blueprints
Table 2 Paper-H (Multisystem, Blood and MSK)

Subjects Total MCQs

MSK 44
Multisystem I 41
Blood and Immunology 35
Total 120

Table 3 OSCEs

Subjects Total OSCEs

MSK 10
Multisystem I 0
Blood and Immunology 10
Total 20

A minimum of 20 stations will be used in final exams. Total marks will

be 120 (6 marks for each station).

KMU (IHPER)- Central Curriculum Committee 31