STUDENT STUDY GUIDE

Integrated Modular System

1st Professional MBBS Liaquat Institute
of Medical and Health
Academic Year_________ Sciences, Thatta1

Liaquat Institute of Medical and Health Sciences, Thatta

 TABLE OF CONTENTS
1 Foundation Module-1 ......................................................................................................................11
Introduction .....................................................................................................................................11
Duration ...........................................................................................................................................11
Learning Outcomes.........................................................................................................................11
Themes ...........................................................................................................................................12
Topics with specific learning objectives and teaching strategies ..................................................12
Blueprint of Assessment .................................................................................................................24
2 Haematology Module-1 ...................................................................................................................25
Introduction: ....................................................................................................................................25
Duration: ..........................................................................................................................................25
Learning outcomes .........................................................................................................................25
Themes ...........................................................................................................................................26
Topics with specific learning objectives and teaching strategies ..................................................26
Blueprint of Assessment .................................................................................................................31
3 Musculoskeletal Module - 1.............................................................................................................32
Introduction .....................................................................................................................................32
Duration ...........................................................................................................................................32
Learning Outcomes.........................................................................................................................32
Themes ...........................................................................................................................................33
Topics with specific learning objectives and teaching strategies ..................................................33
Blueprint of Assessment .................................................................................................................47
Introduction .....................................................................................................................................48
4 Cardiovascular Module-1 ................................................................................................................48
Duration ...........................................................................................................................................48
Learning Outcomes.........................................................................................................................48
Themes ...........................................................................................................................................49
Topics with specific learning objectives and teaching strategies ..................................................50
Blue print of assessment ................................................................................................................57
Introduction .....................................................................................................................................58
5 Respiratory Module 1 ......................................................................................................................58
Duration ...........................................................................................................................................58
Learning Outcomes:........................................................................................................................58
Themes ...........................................................................................................................................59
Topics with specific learning objectives and teaching strategies ..................................................59
Blueprint of Assessment .................................................................................................................67
6 examination assessement...............................................................................................................68
7 learning resources ...........................................................................................................................68

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Liaquat Institute of Medical and Health Sciences, Thatta
 PREFACE
The MBBS curriculum is designed to prepare the medical student to assume the role of the principal
caregiver for patients. The majority of instruction in the various basic and clinical science disciplines
is focused on attaining this objective. The amount of material and specificity that the student must
acquire in order to complete the MBBS programme as a whole is substantial. Subject-based
instruction affords students the chance to develop comprehensive and profound understanding of
each respective subject. However, this instructional framework might result in the student failing to
recognize the interconnectedness of knowledge across different disciplines, their interrelation, and
most significantly, their significance in the context of patient care.
Over the years, numerous inventive approaches have been devised to tackle these obstacles. One
such approach is the integration of instruction at multiple levels, which eliminates and reduces
boundaries within subjects, both vertically and horizontally, across phases. LIMHS, while
acknowledging the merits of these methodologies, has endeavored to seize the opportunity to
comprehend the interdependencies and minimize duplication in the subjects being instructed through
the implementation of an integrated modular approach.
The cardiovascular system, musculoskeletal system, and respiratory system are few examples of
system-based modules in an integrated modular curriculum that connects basic scientific knowledge
to clinical problems. By means of integrated instruction, subjects are presented as a unified whole.
Students can enhance their comprehension of basic scientific principles through consistent
application of clinical examples in their learning. A skills lab provides early exposure to the acquisition
of skills, case-based discussions, and self-directed learning are all elements of an integrated teaching
programme.

LEARNING STRATEGIES
The following instructional and learning strategies are implemented to foster greater comprehension:
❖ Interactive Lectures
❖ Small group sessions
❖ Case-Based Learning (CBL),
❖ Self-Study,
❖ Practical,
❖ Skills lab sessions,
❖ Demonstrations
❖ Field visits

INTERACTIVE LECTURES
In large group, the lecturer actively involves the students by introducing the topic or common clinical
conditions and explains the underlying phenomena by questions, pictures, videos of patients’
interviews, exercises, etc. in order to enhance their learning process.

SMALL GROUP TEACHING (SGT):

This strategy is helpful for the students to make their concepts clear, and s acquiring skills or
attitudes. These sessions are organized with the help of specific tasks such as patient case,
interviews or discussion topics. Students are than encouraged to exchange their ideas and apply
knowledge gained from lectures, tutorials and self-study. The facilitator employs probing
questioning, summarization, or rephrasing techniques to enhance the understanding of concepts.

CASE- BASED LEARNING:

A format of small group discussion that centres on a sequence of questions derived from a clinical
scenario, with the aim of facilitating learning. Students engage in discussions and provide answers
by applying pertinent knowledge acquired in clinical and basic health sciences throughout the
curriculum.
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Liaquat Institute of Medical and Health Sciences, Thatta
PRACTICAL:
Basic science practical related to anatomy, biochemistry, pathology, pharmacology and physiology
are scheduled to promote student learning by application.

SKILLS LAB SESSION:

Skills relevant to respective module are observed and practiced where applicable in skills laboratory.

SELF DIRECTED LEARNING:

Students take on the responsibility of their own learning by engaging in independent study,
collaborating and talking with classmates, accessing knowledge from the Learning Resources
available, teachers, and other experts. Students can make use of the designated self-study hours
provided by the college.

DEMONSTRATIONS:
During Anatomy teaching hour students in small groups are encouraged to utilize their knowledge
in demonstrating different morphological features of various organs of the body with the help of their
facilitator and discuss with their peers. This would help in enhancing their learning as well as
motivate them in team based learning environment.

FIELD VISITS:
Students visit community health areas to understand the common diseases and their preventive
measures.

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Liaquat Institute of Medical and Health Sciences, Thatta
 STUDY GUIDE
A study guide is a strategic and effective approach to

❖ Provide students a detailed framework of the modules organization

❖ Support students in organising and managing their studies throughout academic year.
❖ Provide students information on assessment methods and the rules and regulations that
apply.

• It outlines the outcomes which are expected to be achieved at the end of each module.
• Ascertains the education strategies such as lectures, small group teachings,
demonstration, tutorial and case based learning that will be implemented to achieve the
module objectives.
• Provides a list of learning resources for students in order to increase their learning.
• Emphasizes information on the contribution of attendance, end module tests, block
examinations and annual examinations on the student’s overall performance.
• Includes information on the assessment methods that will be held to determine every
student’s achievement of objectives.

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 ABBREVIATIONS

FOUNDATION Fnd
HAEMATOLOGY Hem
RESPIRATORY RESP
CARDIOVASCULAR CVS
MUSCULOSKELETAL MSK
PATHOLOGY Path
PHARMACOLOGY Pharm
MEDICINE Med
SURGERY Surg
PAEDIATRICS Paeds
COMMUNITY MEDICINE CM
GYNAECOLOGY & OBSTETRICS Gynae & Obs
CARDIOLOGY Cardio
SPIRAL S

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 CONTIBUTIONS
Faculty

Department Of Anatomy
S# Teaching Faculty
Chairperson And Professor
1. Prof. Dr. Ghulam Sarwar Qureshi
2. Prof. Dr. Surriya Sarwat
Associate Professor
3. Dr. Zafar Haleem Baloch
4. Dr. Ashok Kumar
5. Dr. Farhana Rajpar
Assistant Professors
6. Dr. Gul
7. Dr. Priya
Lecturers
8. Dr. Nirmal Zareen
9. Dr. Hifsa
10. Dr. Iqra Khalid
11. Dr. Kahaf Naz
12. Dr. Anum Pario

DEPARTMENT OF BIOCHEMISTRY
S# TEACHING FACULTY
CHAIRPERSON AND PROFESSOR:
1. Prof. Dr. Fauzia Imtiaz
ASSOCIATE PROFESSORS
2. Dr. Fatima
ASSISTANT PROFESSORS
3. Dr. Maria
4. Dr. Sofia
LECTURERS
5. Dr. Sadia Ashraf
6. Dr. Sana Zameer
7. Dr. Sana Zameer
8. Dr. Kiran Waheed
9. Dr. Erum Memon

DEPARTMENT OF PHYSIOLOGY LIMHS

S# TEACHING FACULTY
CHAIRMAN AND PROFESSOR
1. Prof. Dr. Israr Ahmed Akhund
2. Prof. Dr. Wali Muhammad
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 ASSOCIATE PROFESSOR
3. Dr. Hanozia
ASSISTANT PROFESSOR
4. Dr. Arsalan Ahmed Uqaili
5. Dr. Rubina Zareen
LECTURER
6. Dr. Jehanzeb
7. Dr. Sana Jawad
8. Dr. Anees Ahmed
9. Dr. Nisha Alam
10. Dr. Sabahat Samiullah
11. Dr. Muhammad Zaid

DEPARTMENT OF PATHALOGY
S# TEACHING FACULTY
CHAIRMAN AND PROFESSOR
1. Prof. Dr. Farzana Memon
ASSOCIATE PROFESSOR
2. Dr. Umair Ali Soomro
3. Dr. Shomail Saeed Siddiqui
4. Dr. Dr. Agha Nazeer Pathan
5. Dr. Dr. Muhammad Naved uz Zafar
ASSISTANT PROFESSORS
6. Dr. Zahid Ali
7. Dr. Fida Hussain
8. Dr. Sadia Akber
LECTURERS
9. Dr. Naureen Jalbani
10. Dr. Syeda Ghazia Nazim
11. Dr. Mehwish Imam khushk
12. Dr. Rehan Akhtar
13. Dr. Shanzeb
14. Dr. Rab Nawaz

DEPARTMENT OF PHARMACOLOGY
S# TEACHING FACULTY
CHAIRMAN AND PROFESSOR
1. Prof. Dr. Nasir Ali Afsar
ASSOCIATE PROFESSOR
2. Dr. Raj Kumar Chohan
ASSISTANT PROFESSOR
3. Dr. Munza Dar
LECTURERS
4. Dr. Soobia

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 5. Dr. Mudasir Hussain
6. Dr. Ayesha Ramzan
7. Dr. Sumeira Naeem Khan
8. Dr. Sawaira

DEPARTMENT OF COMMUNITY MEDICINE

S# TEACHING FACULTY
PROFESSORS
1. Prof. Dr. Najeeb Memon
ASSOCIATE PROFESSOR
2. Dr. Ambreen Sahto
ASSISTANT PROFESSORS
3. Dr. Rafaina Shah
4. Dr. Sindhu Almas
LECTURERS
5. Dr. Kenjhar
6. Dr. Fozia
7. Dr. Samreen
8. Dr. Hasan Shami
9. Dr. Rai Chand
10. Dr. Shahzad Ali

Checked and verified by:

Dr. Hudebia Allah Buksh

HOD
DME

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Liaquat Institute of Medical and Health Sciences, Thatta
 1 FOUNDATION MODULE-1
Introduction
Welcome to the foundation module. This exciting module will serve as building block and is very essential to
your future work as doctors. This module is designed to make your learning both interesting and productive
by including several interactive activities.
During this module, students will be encouraged to learn basic organization of human body in terms of
structure, function and Biochemical properties in an integrated manner i.e. Basic subjects including Anatomy,
Physiology, Biochemistry, Pharmacology and Pathology will be learned and assessed together. You will also
learn to integrate basic knowledge with clinical relevance. By adopting this approach, you will be prepared
for your future work as doctor, where patients will come to you with problems that are not categorized by
discipline name.
In order to help you learn in an integrated manner, we have updated the learning of basic sciences around a
few key health-related situations (real life situations), which you are likely to encounter as house officers. You
will be expected to think about the scenarios and participate in case-based learning sessions for clearing your
concepts and better learning. It will also help you focus your attention on what you need to achieve from the
Interactive Lectures, practical and tutorials that have been scheduled during this module.

Rational
Orientation of medical sciences in respect to health and disease is the fundamental requirement of every
medical student. Therefore, this module is designed to provide the integration of core concepts that underlie
the foundation of basic sciences and their correlation and application in clinical sciences. Students also learn
clinical skills such as how to communicate effectively with patients and their relatives with compassion and
understanding their issues/problems and how to resolve in coming years. Working in groups will enhance
students’ team working skills and capacity and management skills. Along with LGT/Interactive Lectures,
practical and demonstrations; through supplemented case-based learning they develop problem solving skills
to apply their basic medical knowledge and skills to practical situations under supervision and subsequently
in real life practice.

Duration
8 weeks

Learning Outcomes
By the end of this foundation module, the students should be able to:

Knowledge
• Describe the cell division, its types and genetic material along with its clinical correlation.
• Describe the basic organization of the human body.
• Describe the basic tissues of the human body
• Explain the maintenance of homeostatic mechanism.
• Describe the various malformations.
• Describe the Biochemistry of carbohydrates, nucleic acids and enzymes
• Describe various cellular adaptations during cell growth, differentiation and cell injury
• Describe the basic concepts of medical ethics, professionalism, clinical research, behavioral
sciences, communication skills, information technology skills

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 Skills
• Demonstrate the use of microscope
• Identify basic tissues under the microscope
• Perform biochemical analysis of carbohydrates
• Prepare different solutions used in laboratory for tests

Attitude
• Professionally participate in class and practical work
• Effectively communicate in a team with peers, staff and teachers
• Demonstrate ethical values in dealing with cadavers, peers, staff and teachers.
• Demonstrate professionalism in dealing with cadavers, peers, staff and teachers.
• Demonstrate the ability to reflect on the performance.

Themes
Theme 1: Cell structure, Chemistry and Function
Theme 2: Cellular interactions, Cell injuries, Cellular responses and Adaptations
Theme 3: Body fluids: Composition, Function & Homeostasis
Theme 4: Macromolecules: Fundamental tissues/systems of the human body
Theme 5: Fundamental tissues/systems of the human body
Theme 6: Development, Differentiation and Growth
Theme 7: Genetics and Developmental anomalies

TOPICS WITH SPECIFIC LEARNING OBJECTIVES AND TEACHING

STRATEGIES
INTRODUCTORY WEEK
TEACHING
S# LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
State the history of the subject
Anatomy including its various Fnd-S1-Ana-G1
branches and practical Introduction to the
1
applications of Anatomy as a subject of Anatomy
foundation in different fields of and its subdivisions
medicine
Comprehend the exact location of Fnd-S1-Ana-G2
dissected/prosecuted part /organ Anatomical position,
2 of human body with respect to Interactive
various terms of positions, Anatomical planes & SBAs & OSPE
direction, and body planes terms of position Lecture
Interpret the movements of
different parts of human body the Fnd-S1-Ana-G3
3
knowledge of various terms of Terms of movements
movement.
Fnd-S1-Ana-G4
Explain the appendicular and axial Introduction to the
4
skeleton parts of axial and
appendicular skeleton
Physiology
Fnd-S1-Phy-1
Define Physiology and Enumerate Interactive
5 Introduction to SBAs & OSPE
the branches of Physiology Physiology Lecture
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 Biochemistry
Fnd-S1-Bio-1
Define Biochemistry &
Discuss the role of Biochemistry in Introduction to Interactive
6 SBAs &OSPE
medicine Biochemistry and its Lecture
implication in medicine
Describe the significance of
Fnd-S1-Bio-2
Protection protocols to keep
7 Laboratory Hazards &
yourself safe during Biochemistry
Protection Protocols
laboratory work.
Demonstrate importance of
Fnd-S1-Bio-3
chemicals and reagents in the
8 Chemicals and Practical OSPE & OSCE
different reactions of
reagents
Biomolecules
Illustrate techniques of using Fnd-S1-Bio-4
glassware and handling of Use of glassware &
9
Biochemical instruments during Instruments for
laboratory work. laboratory work
Pathology
Define the pathology
Enumerate the different branches Fnd-S1-Path-1
Interactive
10 of pathology Introduction to SBAs & OSPE
Lecture
Describe the terminologies used Pathology
in Pathology
Pharmacology
Define the Pharmacology and role Fnd-S1-Pharm-1
of Pharmacology in medicine Introduction to Interactive
11 Discuss Pharmaco-dynamics and Pharmacology and its SBAs & OSPE
Lecture
Pharmacokinetics
implication in Medicine
Community Medicine
Define different definition of public
health/Community Medicine
Discuss basic functions of Public
health/community Medicine Fnd-S1-CM-1
Define the difference between Introduction to Interactive
12 SBAs & OSPE
clinical and community medicine Community Medicine & Lecture
Discuss Non-Governmental Public Health
organizations, International
agencies and National Programs
of Pakistan
Forensic Medicine
Define Forensic Medicine,
Forensic Pathology and state
Medicine
Know the branches and the
history of Forensic Medicine
briefly Fnd-S1-FM-1
Introduction to forensic Interactive
13 Discuss the scope of Forensic Medicine and SBAs & OSPE
Lecture
Medicine in practice Toxicology
Identify the essential facilities for
medico legal investigation.
Define medical jurisprudence and
differentiate it from Forensic
medicine
Medical Education

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 Describe the curriculum and
modules under implementation Fnd-S1-ME-1
Describe the use of study guides Curriculum structure
14
(not to be assessed) teaching learning Interactive
SBAs & OSPE
Differentiate between various strategies Lecture
teaching & learning strategies
Describe various study skills Fnd-S1-ME-2
15
strategies Study skills strategies
Information Technology
Define IT and its importance in Fnd-S1-IT-1 Interactive
16 SBAs & OSPE
Medicine Importance of IT skills Lecture
Library Sciences
Fnd-S1-LIB-1
Interactive
17 Learn literature search skills Literature search and SBAs & OSPE
Lecture
library resources
Behavioral Sciences
Learn the significance of Fnd-S1-BS-1
Interactive
18 communication skills in Medical Introduction to SBAs & OSPE
behavioral Sciences Lecture
Sciences
Communication Skills
Learn the significance of Fnd-S1-CS-1
Interactive
19 communication skills in Medical Introduction to SBAs & OSPE
communication skills Lecture
Sciences
Biomedical Ethics
Fnd-S1-BE-1
Learn the significance of ethics in Interactive
20 Introduction to Bio SBAs & OSPE
Medical Sciences Medical Ethics Lecture
Research Methodology
Fnd-S1-RM-1
Learn the significance of ethics in Introduction to research Interactive
21 SBAs & OSPE
Medical Sciences methodology Lecture

Theme 1: Cell Structure, Chemistry & Functions

TEACHING
S# LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
Fnd-S1-Ana-H1
Describe the basic structure and
Cell structure and
functions of cell membrane. Interactive
22 function SBAs & OSPE
Describe the basic structure and Lecture
(Membrane structure
functions of the Nucleus.
and the Nucleus)
Describe the structural Organization
of different organelles of a cell.
(Endoplasmic Reticulum, Golgi Fnd-S1-Ana-H2
23
Apparatus, Ribosomes, Centrioles, Cell Organelles
Mitochondria, Lysosomes,
Peroxisomes)
Operate the different parts of the
Fnd-S1-Ana-H3
light microscope.
24 Parts of Light Practical OSPE & OSCE
Explain how to use the light
microscope
microscope to visualize a slide.
Physiology

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 Fnd-S1-Phy-2
Describe the Functional
Functional
arrangement of different level of
arrangement of
organization and General structure, Interactive
25 different levels of SBAs& OSPE
Physiology and composition of cell, Lecture
organization and
tissues, organs, organ systems,
General structure and
cell nutrition, capillary and venules.
composition of Cell.
Fnd-S1-Phy-3
Define the Functional organization
Cell organelles-I
of different components of a cell
(Lysosomes,
and its organelles, Describe the
26 Peroxisomes,
functions of lysosomes &
Endoplasmic
peroxisomes, Endoplasmic
Reticulum, Golgi
Reticulum.
complex)
Fnd-S1-Phy-4
Describe the functions of
Cell organelles-II
mitochondria, its special features &
Mitochondria,
its role in generation of ATP
27 Microtubules &
Describe the functions of ER, Golgi
Microfilaments,
apparatus, Ribosomes, and
Ribosomes Vaults
cytoskeleton.
Centromere.
Fnd-S1-Phy-5
Recognize the structure &
28 Nucleus & its
functions of Nucleus
functions
Fnd-S1-Phy-6
Show the Parts And Functions of
29 Introduction to Practical OSPE & OSCE
the Microscope
Microscope
Biochemistry
Describe the chemical structure and Fnd-S1-Bio-5
significance of mitochondria, Mitochondria:
functions and location of enzymes Structure, functions Interactive
30 SBAs & OSPE
for metabolic pathways & chemical & location of Lecture
reactions that occur in enzymes for
mitochondria. metabolic pathways
Fnd-S1-Bio-6
Solutions,
Prepare all types of solutions and
concentration
31 their quantities in different Practical OSPE & OSCE
expression (Percent
chemicals reaction.
solutions, Molarity,
Molality, Normality)
Pathology
Define Hypertrophy, Hyperplasia,
Atrophy and Metaplasia.
Fnd-S1-Path-2 Interactive
32 Enlist Physiological and SBAs & OSPE
Cellular adaptations Lecture
pathological mechanisms of
cellular adaptation

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Theme 2: Cellular Interactions, Cell Injuries, Cellular Responses and
Adaptations
TEACHING
S# LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
Fnd-S1-Ana-H-4
Describe components of cell
Cell surface
33 surface modifications and junction
modifications and
complex
cell Junctions Interactive
SBAs & OSPE
Fnd-S1-Ana-E-1 Lecture
Differentiate between normal and
Cell cycle: Mitosis
34 abnormal cell division and their
and Meiosis cell
consequences
divisions
Enlist steps of tissue processing.
Fnd-S1-Ana-H-5
Define the artifacts. Know the
35 Slide preparation and Practical OSPE & OCPE
basic histological stains. Define
the H&E Staining
H&E Staining.
Physiology
Explain composition and basic Fnd-S1-Phy-7
structure of cell membrane, its Plasma membrane &
36
functional importance and its structure and
adaptation function
Describe types and process of Fnd-S1-Phy-8
37 transport across the membrane Types of transport,
and their effects. Simple Diffusion
Fnd-S1-Phy-9
Describe the Transport across cell
Protein mediated
membrane via protein mediated
38 transport
method.
Facilitated diffusion,
Describe the process of osmosis
Osmosis
Fnd-S1-Phy-10
Active transport, Interactive
Explain the Physiological SBAs & OSPE
Primary active Lecture
39 mechanism and types of transport.
transport, Secondary
(Passive & Active)
active transport
Bulk transport
Describe the membrane potential
Fnd-S1-Phy-11
its development & maintenance of
Resting membrane
resting membrane potential.
Potential
40 Explain Permeability of cell
Graded potential,
membrane
Factors affecting
Explain the Propagation of action
membrane potential
potential and its ionic basis
Discuss action potential
Fnd-S1-Phy-12
41 Give mechanism of propagation of
Action potential
action potential & its ionic changes
Employ types and methods of Fnd-S1-Phy-13
42 Practical OSPE & OSCE
sterilization Sterilization
Pathology
Demonstrate gross and
Fnd-S1-Path-3 Interactive
43 microscopic features of cellular SBAs & OSPE
Cell Pathology Lecture
adaptations and Necrosis
Pharmacology

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 Enlist different routes of drug
Fnd-S1-Pharm-2
administration
Routes of drug
44 Describe the merits & demerits of
administration (Entral,
the different routes of drug
Parentral) drugs
administration Interactive
SBAs & OSPE
Fnd-S1-Pharm-3 Lecture
Describe drug absorption & factors Absorption: Process of
45 affecting rate and extent of drug absorption & Factors
absorption modifying drug
absorption

Theme 3: Body Fluids: Composition, Function & Homeostasis

TEACHING
S# LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Physiology
Describe the divisions of body
Fnd-S1-Phy-14
46 fluids into intracellular, extracellular
Body fluids
and intravascular compartments.
Recognize the Physiological
aspects for the maintenance of
Fnd-S1-Phy-15
47 homeostasis, ECF, Internal
Homeostasis
environment and role of various Interactive
body systems in homeostasis. SBAs& OSPE
Lecture
Explain the concepts of
homeostasis and its regulation
through feedback mechanism. Fnd-S1-Phy-16
48
Negative feedback, Positive Mechanisms of Homeostasis
Feedback, Feed-forward Stress
& disease
Pharmacology
Explain Bioavailability & describe Fnd-S1-Pharm-4
49 Bioavailability +half-
factors affecting Bioavailability life + 1st Pass Effect
Interactive
Describe the distribution of a drug SBAs & OSPE
Fnd-S1-Pharm-5 Lecture
through various body
50 Drug Distribution &
compartments
Reservoir
Explain clinical significance of Vd
Pathology
Define cell aging Fnd-S1-Path-4 Interactive
51 SBAs & OSPE
Discuss events in Cellular Aging Cell Aging Lecture

Theme 4: Macromolecules/ Fundamental tissues/systems of the

Human Body
TEACHING
S# LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
Define the divisions & functions
of skeletal system. Fnd-S1-Ana-G5
Classify bones on the basis of The skeletal system SBAs,
52 Demonstration
shape, development, region, (classification of OSPE & OSCE
structure and microscopic bones.)
features, gross structure of adult

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 long bone and parts of young
long bone.
Fnd-S1-Ana-G6
Describe general concepts of
Bone development
53 development, ossification and
(ossification), Blood
blood supply of bones
supply of long bones
Define the joints. Classify joints
on the basis of structure, Fnd-S1-Ana-G7
regions and functions The joints and its Interactive
54 SBAs & OSPE
Discuss the characteristics of types. Lecture
synovial joints and classify on The synovial joints.
basis of structure & movement
Clinical
Define dislocation, sprain and Fnd-S1-Orth-1
55 Interactive SBAs & OSPE
inflammation of joints Fractures
Lecture
Describe the microscopic features
of epithelial tissues
Fnd-S1-Ana-H-06
56 Explain their functional The Epithelium
importance and their surface
modifications
Discuss gross and microscopic Fnd-S1-Ana-H-07
57
features of exocrine glands Exocrine glands
Define the composition of the Interactive
SBAs & OSPE
connective tissue. Lecture
Fnd-S1-Ana-H-08
58 Describe and differentiate the
Histology of
microscopic features of the
Connective tissue
different types of the connective
tissues
Demonstrate histological features Fnd-S1-Ana-H-09
59 of cartilage. The cartilage and its
Describe the types of the cartilage. types
Identify different types of the
Fnd-S1-Ana-H-10
60 epithelia on the light microscope Practical OSPE & OSCE
Epithelium
Physiology
Explain Physiology experiments Fnd-S1-Phy-17
61
and introduction to power-lab. Power lab
Identify the indications of hand
washing Practical OSPE & OSCE
Fnd-S1-Phy-18
62 Demonstrate the protocols and
Hand washing
steps of hand washing insequential
manner
Biochemistry
Fnd-S1-Bio-07
carbohydrates:
Apply the basic knowledge of
introduction,
63 carbohydrates in chemistry for
classification and its
health
Biochemical
significance Interactive
SBAs& OSPE
Fnd-S1-Bio-08 Lecture
Describe the Biochemical structure
Monosaccharides:
44 of polysaccharides with its clinical
Classification,
importance
Structure, Functions
Discuss functions of carbohydrates Fnd-S1-Bio-09
65
in cell membrane, energy provision Chemical Properties &

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 and nutrition supply to different Derivatives of
parts of body Monosaccharides &
their Biochemical
significance in
Biological systems.
Fnd-S1-Bio-10
Isomerism: Structural
Describe different isomers of
& Optical Isomerism in
66 monosaccharides e.g. Glactose,
carbohydrates & their
Mannose, Fructose, Dextrose.
Biochemical
significance.
Fnd-S1-Bio-11
Glycosidic Linkage,
Explain Structure of disaccharides Biologically important
67
and oligosaccharides disaccharides and
oligosaccharides

Fnd-S1-Bio-12
Polysaccharides:
Describe classification of
Classification,
68 polysaccharides and their
Structure & Functions
functions.
of
Homopolysaccharides
Perform Molisch’s Test, Iodine
Fnd-S1-Bio-13
Test, Benedict’s Test to identify an
69 Molisch’s Test, Iodine
unknown carbohydrate in a given
Test, Benedict’s Test
fluid
Practical OSPE & OSCE
Fnd-S1-Bio-14
Detect carbohydrates by different Selivanoff’s Test,
70
tests Barfoed’s Test,
Osazone Test
Fnd-S1-Bio-15
Classification of Amino
Classify amino acids on the basis of
Acids on the basis of
71 their polarity, charge & nutritional
structure, Properties,
significance.
Nutrition & their role in
human metabolism
Describe Physio-chemical Fnd-S1-Bio-16
classification of proteins. Classification of Interactive
SBAs & OSPE
Enumerate functional classification Proteins on the basis Lecture
72
of proteins. of their structures,
Classify proteins on the basis of functions & chemical
their axial ratio. reactions.
Fnd-S1-Bio-17
Describe the structural levels of
73 Structural
proteins and their important
Organization of
Biochemical features.
Proteins
Fnd-S1-Bio-18
Able to detect unknown amino General Tests for
74 Practical OSPE & OSCE
acid/protein in a given fluid Proteins & Amino
acids
Fnd-S1-Bio-22
Discuss the significance of Lipids Lipids: Classification & Interactive
75 SBAs & OSPE
for a balanced diet and Health Biochemical Lecture
significance.
Able to detect proteins by colour Fnd-S1-Bio-19 OSPE & OSCE
76 Practical
reaction tests Colour Reaction Tests

19
Liaquat Institute of Medical and Health Sciences, Thatta
 of Proteins
Able to detect proteins by Fnd-S1-Bio-20
77
Separation tests Separation Tests
Able to detect proteins by Fnd-S1-Bio-21
78
precipitation tests Precipitation Tests
Able to detect solubility, oily nature, Fnd-S1-Bio-23
79
emulsification, saponification tests Tests for Lipids
Pharmacology
Explain Biotransformation & enlist Fnd-S1-Phrm-6
80 phase I and phase II Drug
Biotransformation
Biotransformation reactions Phase-I Reactions Interactive
Fnd-S1-Phrm-7 SBAs & OSPE
Explain Biotransformation Lecture
Drug
81 Enlist phase I and phase II
Biotransformation
Biotransformation reactions
Phase-II reactions

Theme 5: Fundamental Tissues/Systems of the Human Body

TEACHING
S# LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
Define the parts of the skin
Define the appendages of the Fnd-S1-Ana-G-08
skin. Introduction to
82
Recognize the role of Component Integumentary system
tissues of Skin and fascia in (Skin and fascia)
Support and Protection
Explain the types and functions of
Fnd-S1-Ana-G-09
83 blood vessels. (Arteries, veins,
Blood vascular system
capillaries and Anastomosis)
Integrate the function of Defense Fnd-S1-Ana-G-10
84 with the structureof lymph nodes Introduction to
andlymphatic’s lymphatic system
Define the types of muscles
Describe the internal structure of Fnd-S1-Ana-G-11
muscle action, nerve supply and Definition and
85
naming of skeletal muscles classification of
Define smooth and cardiac muscles Interactive
SBAs & OSPE
muscles. Lecture
Describe the Nervous system and
Fnd-S1-Ana-G-12
classification of NS
86 Introduction to
Define the central and peripheral
Nervous System
nervous system
Fnd-S1-Ana-G-13
Describe the structure and the Formation and
87
structure of the typical spinal nerve. structure of Typical
Spinal Nerve
Define the autonomic nervous
Fnd-S1-Ana-G-14
system.
General Concepts of
88 Describe the types and functions of
Autonomic nervous
Autonomic Nervous System.
system
Describe the process of Fnd-S1-Ana-E-2
89
Gametogenesis Gametogenesis
90 Discuss ovulation and phases Fnd-S1-Ana-E-3
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Liaquat Institute of Medical and Health Sciences, Thatta
 and outcomes of fertilization Ovulation Fertilization
Enumerate the events of first week
Fnd-S1-Ana-E-4
of development (cleavage and
91 The First week of
blastocyst formation and
development
implantation)
Enumerate the events of Second
week of development (Formation Fnd-S1-Ana-E-5
of amniotic cavity, amnion,
92
bilaminar embryonic disc, yolk sac, The second week of
chorionic sac and primary development
chorionic villi)
Recognize male & female Fnd-S1-Cli-G&O-1
genitalia. Fertilization (The
93
Describe the process of fertilization conception)
(conception).
Physiology
Describe the Physiological
Concepts and organization of Fnd-S1-Phy-19
nervous system. Introduction
94
State general physiological Organization of the
concepts and organization of Nervous system
Autonomic Nervous System
Interactive
Describe the basic Structure and Fnd-S1-Phy-20 SBAs & OSPE
Lecture
function of neuron & neuroglia Neuron and
95
Describe the Excitable cells and neuroglia synaptic
their types(Synapse) transmission
Definition, structure, functions and Fnd-S1-Phy-21
96 types of synapse, Properties of Synapses and neural
synapse integration
Pharmacology
Describe drug excretion & enlist Fnd-S1-Pharm-8 Interactive
97 SBAs & OSPE
routes of drug excretion Drug Excretion Lecture

Theme 6: Development, Differentiation and Growth

TEACHING
S# LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
Explain the main events of third Fnd-S1-Ana-E-6
week of development Third week of
98
State formation of the primitive development
streak, Gastrulation and notochord (Trilaminar germ disc)
Explain formation of neural tube Fnd-S1-Ana-E-7
and somites Third week to eighth
99
Recognize external appearance of week of development
embryo during second month (Embryonic period)
Enlist the derivatives of Ectoderm Fnd-S1-Ana-E-08 Interactive
SBAs & OSPE
and neural crest cells Derivatives of Lecture
100 ectodermal germ layer
and neural crest cells
Enlist the derivatives of Fnd-S1-Ana-E-09
mesodermal and endodermal germ Derivatives of
101 layers mesodermal and
endodermal germ
layers
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Liaquat Institute of Medical and Health Sciences, Thatta
 Describe the development of fetus Fnd-S1-Ana-E-10
102 & parturition 3rd month to birth
(Fetal Period)
Explain the interchange of Fnd-S1-Ana-E-11
substances between maternal and Placenta and fetal
fetal blood by applying the membranes
103
knowledge of structure and
functions of placenta and fetal
Membranes & clinicals
Describe the Ectopic pregnancy & Fnd-S1-CL-O&G-2
104
its consequences. Ectopic pregnancy

Theme 7: Genetics and Developmental Anomalies

TEACHING
S# LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
Define teratogenesis and the basic Fnd-S1-Ana-E-12
principles of teratogenesis. Teratogenesis
105
Categorize the common
teratogens
Explain the types of twin/ multiple Fnd-S1-Ana-E-13 Interactive
106 pregnancies and clinical Twin pregnancy SBAs & OSPE
significance Lecture
Calculate the expected date of Fnd-S1-Gyn &Obs-3
delivery (EDD) The Fetal wellbeing &
107
Describe various methods used to EDD
assess fetal wellbeing
Biochemistry
Enlist different types of nucleotides Fnd-S1-Bio-24 Interactive
108 and their basis in genetics. Structure and types of SBAs & OSPE
nucleotides. Lecture
Enlist different types of nucleotides Fnd-S1-Bio-25 Interactive
109 and their basis in genetics Structure of DNA & SBAs & OSPE
Lecture
RNA
Physiology
Fnd-S1-Phy-22
DNA, Gene,
Genetic code
Describe Physiological basis of RNA,Types, codan , Interactive
110 gene and functions of DNA and anti codan SBAs & OSPE
Lecture
RNA Fnd-S1-Phy-23
Control of gene
functions
Pharmacology
Fnd-S1-Pharm-09
Introduction to
Dynamics Drug
Explain the term Receptors A. Relation
Pharmacodynamics between drug Interactive
111 concentration & SBAs & OSPE
Explain the terms affinity, efficacy, Lecture
response & signaling
intrinsic activity & potency Mechanism
Fnd-S1-Pharm-10
Drug Receptors
B. Second
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 messengers &
receptor regulation
Fnd-S1-Pharm-11
112 Describe the general mechanisms Factors Modifying drug
by which drugs act action &Therapeutics
Index
Fnd-S1-Pharm-12
Correlate the principles of general Adverse drug reaction
113 Pharmacology for the appropriate (ADR)
therapy of disorders / diseases Fnd-S1-Pharm-13
Teratogenic drugs
Pathology
Define Mutation and its types. Fnd-S1-Path-5
114 Classification of genetic disorders Introduction to genetic
Define Mendelian Disorders disorder
Describe the normal Karyotype Fnd-S1-Path-6
115 Discuss various numerical and Chromosomal Interactive
structural abnormalities of aberration. SBAs & OSPE
Lecture
chromosomes
Describe causes and pathogenesis Fnd-S1-Path-7
116 of congenital fetal abnormalities Congenital fetal
abnormalities

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Liaquat Institute of Medical and Health Sciences, Thatta
 Blueprint of Assessment
Purpose of Assessment: Summative Assessment First Professional MBBS
Curriculum: Integrated Modular Curriculum
Module: Foundation Module I
Weeks Week Week Week Week Week Week Week Week Total Weigh Rounde Total
1 2 3 4 5 6 7 8 hrs tage % d off number of
Weight Qs
age %
Teaching hours

Gross Anatomy 02 01 02 02 01 01 01 ---- 10 9.6 10 10

Histology 01 01 01 01 --- 01 -- -- 05 4.8 05 05

Embryology 01 01 ---- ----- ----- ----- ----- ----- 13 12.5 12 12

Physiology 03 03 03 03 03 03 03 02 23 22.11 22 22

Biochemistry 01 01 02 01 01 01 02 01 25 25.03 25 25

Pathology --- 1 --- 1 1 1 1 2 07 6.7 07 07

Pharmacology 01 02 02 01 02 02 02 01 13 12.5 12 12

Parallel subjects 01 01 01 01 01 01 01 01 08 7.6 07 07

(CM, IT, BS, Res,
BME)
Total 104 100% 100

Subject in Proportion
Module of subjects Weightage Test Instrument/tool/method Explanation
in module
What to assess? How to assess?
MCQs (SBAs) OSPE OSCE Any Proportion of test
Level 1 & 2 stations Level 3 Other instruments to be
Level 1 used:
&2 Theory
Gross 10 10 MCQs (SBAs)= 100 %;
Anatomy Practical
Embryology 05 05 OSPE=80%
Histology 12 12 OSCE= 20%
Physiology 22 22 Competency level &
Biochemistry 25 25 Learning Domain at
Pathology 07 07 Miller’s Pyramid:
Pharmacology 12 12 Cognition:
Parallel 07 07 Know (Level-1) & How to
subjects (CM, know (Level-2)
IT, BS, Res, Skills & Attitude:
BME) Show (Level-3) & Does
(Level-4)
100% 100 80% 20%

24
Liaquat Institute of Medical and Health Sciences, Thatta
 2 HAEMATOLOGY MODULE-1
Introduction
Welcome to the Hematology module. This module aims to provide the basic understanding of
hematopoiesis and hemostasis at the molecular level. This module is designed to learn and integrate basic
knowledge of blood cells, with clinical relevance. This module is designed to make your learnin g both
interesting and productive by including more practical activities. It will deal with the basic Patho-Physiological
and Pharmacological aspects of infections and chemo therapeutic agents and integrate it with clinical
sciences.
The module will give the 1 st year medical students, an opportunity to know the presentations and principles
of management of common hematological, immunological, inflammatory and neoplastic disorders. You will
be expected to think about the scenarios and participate in case-based learning sessions for clearing your
concepts and better learning. It will also help you focus your attention on what you need to achieve from the
Interactive Lectures, practical and tutorials that have been scheduled in this module.

Duration:
8 weeks

Learning outcomes

COGNITIVE DOMAIN:
By the end of this module, first year MBBS students shall be able to:
• Identify & describe the various cellular and non-cellular components of blood in relation to its
Anatomy, Physiology &Biochemistry
• Describe structure, synthesis and degradation of Hemoglobin
• Describe the regulatory mechanisms of normal hemostasis and coagulation
• Describe the conditions associated with dysfunction of cellular and non-cellular components of
blood
• Describe the basic characteristics of immune system.
• Discuss the structure, functions and Biochemical aspects of the Lympho-reticular system.
• Explain the principles and clinical significance of ABO/RH blood grouping system
• Explain the Patho-Physiology of various bleeding disorders
• Identify the role of Pharmacology in inflammation, anemia and bleeding disorders.

PSYCHOMOTOR DOMAIN
Description of the psychomotor skills to be developed and the level of performance required:

By the end of this Module, the student should be able to:

• Perform bleeding time and clotting time and to know normal values and its diagnostic
importance in relation to bleeding disorders.
• Perform Blood groups typing and Rh factor.
• Perform ESR and to know its normal value and prognostic importance.
• Perform WBC counting accurately using a counting chamber.
• Identify platelets accurately in blood smears under the microscope.

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Liaquat Institute of Medical and Health Sciences, Thatta
 • Determine platelet counts using appropriate methods.

ATTITUDE AND BEHAVIOUR:`

By the end of Module, the student shall gain the ability and carry responsibility to:

• Demonstrate sympathy and care to patients.

• Demostrate communication skills with sense of responsibility.
• Demonstrate good laboratory practices

Laboratory Skills (Physiology & Pathology):

By the end of Module, the students should be able to:

• Describe types & methods of sterilization

• Collect blood sample by various methods i.e. pricking method &venipuncture on dummies
• Prepare blood film & Identify and quantify different types of white blood cells on blood film
• Identify different blood groups
• Antigen-Antibody reactions in the Laboratory
• Determine hemoglobin concentration (Sahli’s method)
• Laboratory diagnosis of Anemias
• Estimate bleeding time, clotting time (BT & CT)
• Laboratory diagnosis of Bleeding Disorders
• Estimate erythrocyte sedimentation rate (ESR by wester green method)
• Non. Neoplastic WBC Disorders
• Acute Inflammation/ Chronic inflammation
• Repair: Wound Healing
• Isolation of micro-organism/Lab diagnosis of infectious disease
• Culture Media-I & Culture Media-II

Clinical Skills:

By the end of Module, the students should be able to:

1. Practice history taking: patients with anemia and bleeding disorders

2. Define and classify polycythemia
3. Define and describe the different types of anemia
4. Describe various types of blood indices

Themes
Theme 1: Red cell disorders (Anemia, Polycythemia)
Theme 2: Infections & Inflammation
Theme 3: Bleeding & thromboembolic disorders
Theme 4: ABO & Rh-Incompatibility
Theme 5: Immunological disorders

TOPICS WITH SPECIFIC LEARNING OBJECTIVES AND TEACHING

STRATEGIES

Theme 1: Red cell disorders (Anemia, Polycythemia)

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Liaquat Institute of Medical and Health Sciences, Thatta
 TEACHING
S# LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
Illustrate the organization of
hematopoietic tissue Hem-S1-E1-Ana-
Interactive
1 Enlist the sites and source of Development of SBAs & OSPE
Lecture
hematopoiesis before and after the blood
birth.
Examine structure of RBC, WBC &
Hem-S1-H1-Ana- Interactive SBAs &OSPE &
platelets.
2 Morphology of blood Lecture/
Illustrate methods use to study OSPE
cells Practical
blood and bone marrow cells.
Physiology
Discuss the cellular components of Hem-S1-Phy-1
blood Composition of
3
Define hematocrit, normal values & blood & its cellular
factors affecting hematocrit components
Discuss the various stages of
RBC’S formation. Interactive
SBAs & OSPE
Discuss various sites of Hem-S1-Phy-2 Lecture
erythropoiesis Development of
4
Enlist the factors necessary for RBCs
erythropoiesis. (Erythropoiesis)
Discuss the significance of
Reticulocyte count
Hem-S1-Phy-3
Examine hemoglobin concentration hemoglobin
5
by Sahli’s method concentration
(Sahli’s method)
Hem-S1-Phy-4
Practical OSPE & OSCE
Estimation of
Estimate erythrocyte sedimentation erythrocyte
6
rate (ESR by wester green method) sedimentation rate
(ESR by wester
green method)
Biochemistry
Hem-S1-Bio-1
Explain Biochemical basis for the
Composition of
difference in plasma & serum.
blood & plasma
7 Describe composition of blood &
proteins
plasma protein.
(Specialized body
fluid)
Describe Chemistry& synthesis of
Heme Hem-S1-Bio-2
8
Explain structure, types & forms of Normal Hemoglobin
Hb. Interactive
SBAs & OSPE
Hem-S1-Bio-3 Lecture
Identify abnormalities of Heme
9 Abnormal Heme
synthesis (PorPhyrias & its types).
Hem-S1-Bio-4
Explain the Biochemical aspects ofAbnormal
10 Hemoglobinpathies. (Thalassemia, Hemoglobin
sickle cell anemia) (Hemoglobinopathie
s)
Describe degradation of heme. Hem-S1-Bio-5
11
Explain bile pigments, formation, Degradation of
27
Liaquat Institute of Medical and Health Sciences, Thatta
 types, transport & Excretion of bile. Heme
Discuss Iron Metabolism & identify HemM-S1-Bio-6
12
its abnormalities. Iron Metabolism
Explain the Biochemical importance Hem-S1-Bio-7
13 of Vitamin B12 & Folic acid & their Vitamin B12 & Folic
associated diseases. acid
Describe importance of Vitamin K &
Hem-S1-Bio-8
14 E & their associated diseases.
Vitamin K & E

Pathology
Describe classification ofAnemia
Hem-S1-Path-1
Differentiate the different types of
15 Introduction of
anemias on the basis of Morphology
Anaemia
& Patho-Physiology.
Identify the types of nutritional
Anemias Hem-S1-Path-2
16 Enlist causes of iron deficiency, Iron deficiency Interactive
SBAs & OSPE
Anemia & clinical features and Anemia Lecture
Laboratory diagnosis
Enlist causes of vitamin D-12 and
folate deficiency Hem-S1-Path-3
17 Explain the Patho-Physiology, Megaloblastic
clinical features and laboratory Anemia
diagnosis.
Pharmacology
Describe role of oral & injectable
18 Hem1-S1-Pharm-1
iron in iron deficiency anemia Interactive
SBAs & OSPE
Describe role of Vit. B12 & Folic acid Lecture
19 Hem1-S1-Pharm-2
in Macrocytic anemia

Theme 2: Infections & Inflammation

TEACHING
S# LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
Hem-S1-E2-Ana-
Discuss the embryological source Interactive
21 Development of SBAs & OSPE
of lymphoid organs Lecture
lymphoid organs
Discuss the components, location
Hem-S1-G1-Ana- SBAs, OSPE &
& structure of lymphoid issue.
22 Gross features of Demonstration
Describe parts, surfaces and OSCE
lymphoid organs
relations of Lymphoid organs
Hem-S1-H3-Ana
Discuss the histological
Microscopic Interactive
23 classification & microscopic SBAs & OSPE
anatomy of lymphoid Lecture
features of lymphoid organs.
organs
Hem-S1-H4-Ana-
Define histological features of
24 Spleen & Lymph
spleen & lymph node.
node Practical OSPE & OSCE
Define histological features of Hem-S1-H5-Ana-
25
Thymus gland & Tonsil. Thymus & Tonsil
Physiology
Describe the process of leukocyte Hem-S1-Phy-5 Interactive SBAs,
26 genesis, enlist various types of Genesis and general Lectures/ OSPE & OSCE

28
Liaquat Institute of Medical and Health Sciences, Thatta
 granulocytes and agranulocytes, characteristics, and Small Group
their functions & normal values functions of white Discussion
Explain the significance of blood cells
Reticuloendothelial system
Discuss the functions of T and B
lymphocytes.
Pathology
Define acute inflammation. Hem-S1-Path-4
Describe the changes systemic Overview of acute
27
effects & occurring in acute and chronic
Interactive
inflammation. inflammation SBAs & OSPE
Lecture
Describe causes of Neutrophilia Hem-S1-Path-5
28 and Neutropenia, Eosinophilia, Non Neoplastic
Lymphocytosis, Monocytosis WBC Disorders

Theme 3: Bleeding & thromboembolic disorders

TEACHING
S# LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Physiology
Describe the four-basic mechanism Hem-S1-Phy-6
of Hemostasis, Hemostasis & role of
42
Explain the mechanism of Thrombocytes
formation of platelet plug. Interactive
Explain steps involved in intrinsic Hem-S1-Phy-7 Lectures/Small SBAs, OSPE &
and extrinsic pathway for Clotting cascade & Group OSCE
coagulation, bleeding disorders Discussion
43
Enlist the clotting factors, to
describe the role of clotting factors
in coagulation.
Biochemistry
Describe importance of Vitamin K & Hem-S1-Bio-9 Interactive
44 SBAs & OSPE
E & their associated diseases. Vitamin K & E Lecture
Pathology
Discuss the different types of
bleeding disorders.
Discuss Quantitative & Qualitative Hem-S1-Path-6
45 platelets disorders Platelet and
Describe classification& Lab. Bleeding disorder
diagnosis of haemophilia and Von Interactive
SBAs & OSPE
Willebrand disease. Lecture
Discuss thrombosis, pathogenesis, Hem-S1-Path-7
46
types and fate of thrombosis. Thrombosis
Define embolism, its types and
Hem-S1-Path-8
47 morphological features of
Embolism
embolism.
Pharmacology
Discuss the role of commonly used Interactive
48 Hem-S1-Pharm-3 SBAs & OSPE
coagulants & anticoagulants Lecture
Theme 4: ABO & Rh-Incompatibility

TEACHING
S# LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Physiology

29
Liaquat Institute of Medical and Health Sciences, Thatta
 Describe the antigens & antibodies Hem-S1-Phy-8
for A,B,AB & O blood groups Blood groups
Define Agglutinogen, agglutinin, ABO/RH system
and agglutination & what takes
Interactive
place when incompatible blood
Lectures/Small SBAs, OSPE &
types are mixed.
49 Group
Identify universal donor & recipient OSCE
Discussion/
& explain why?
Practical
Enlist various Rh antigens & Rh
immune response.
What is erythroblastosis fetalis &
how it can be prevented
Pathology
Recognize different types of blood Hem-S1-Path-9 Interactive
50 SBAs & OSPE
transfusion reaction. Blood Transfusion Lecture

Theme 5: Immunological Disorders

TEACHING
S# LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Physiology
Discuss overall organization of Hem-S1-Phy-9
immune system Immunity.
Interactive
Differentiate between innate & SBAs, OSPE &
Lectures/
51 acquired immunity,
Small Group OSCE
Discuss cell mediated immunity
Discussion
and humoral immunity, active and
passive immunity.
Biochemistry
Define Immunoglobins.
Hem-S1-Bio-10 Interactive
52 Describe chemistry, structure & SBAs & OSPE
Immunoglobins Lecture
their classification.
Pathology
Define hypersensitivity
Hem-S1-Path-10
Describe Pathogenesis of Type-I &
55 Hypersensitivity
II hypersensitivity reactions with
reaction Type I & II
examples SBAs & OSPE
Describe type III & IV Hem-S1-Path-11
Interactive
56 hypersensitivity reactions with Hypersensitivity
Lecture
examples. reaction Type III & IV
Discuss primary immunodeficiency
and its causes Hem-S1-Path-12
58
Discuss secondary Immunodeficiency
immunodeficiency and its causes
Pharmacology
Associate role immunomodulating Interactive
59 Hem-S1-Pharm-4 SBAs & OSPE
drugs in autoimmune disorders Lecture

30
Liaquat Institute of Medical and Health Sciences, Thatta
 Blueprint of Assessment
Purpose of Assessment: Summative Assessment First Professional MBBS
Curriculum: Integrated Modular Curriculum
Module: Haematology Module -1

Weeks Week Week Week Week Week Week Week Week Total Weigh Rounde Total
1 2 3 4 5 6 7 8 hrs tage % d off number
Weight of Qs
age %
Teaching
hours
Gross Ana ---- 01 ---- ----- ------ ----- ----- ---- 01 1.01 01 01

Histology 01 01 01 01 --- 01 -- -- 05 9.2 09 09

Embryolog 01 01 ---- ----- ----- ----- ----- ----- 02 3.7 04 04

y
Physiology 01 02 01 01 01 01 01 01 10 18.5 19 19

Biochemist 01 01 02 01 01 01 02 01 10 18.5 19 19
ry
Pathology 2 2 2 2 2 1 1 -- 12 22.2 22 22

Micbio --- --- --- --- ---- ---- ----- ----- 00 00 00 00

Pharmacol ___ 01 ---- 01 ------ 01 ------- 01 04 7.4 07 07

ogy
Parallel 01 01 01 01 01 01 01 10 18.5 19 19
subjects
(CM, BS,
IT, Mres,
Prof,
clinical)
Total 54 100% 100

Subject in Proportion
Module of subjects Weightage Test Instrument/tool/method Explanation
in module
What to assess? How to assess?
MCQs (SBAs) OSPE OSCE Any Proportion of test
Level 1 & 2 stations Level 3 Other instruments to be
Level 1 used:
&2 Theory
Gross 01 01 MCQs (SBAs)= 100 %;
Anatomy Practical
Embryology 09 09 OSPE=80%
Histology 04 04 OSCE= 20%
Physiology 19 19 Competency level &
Biochemistry 19 19 Learning Domain at
Pathology 22 22 Miller’s Pyramid:
Pharmacology 00 00 Cognition:
Parallel 07 07 Know (Level-1) & How to
subjects (CM, know (Level-2)
IT, BS, Res, Skills & Attitude:
BME) Show (Level-3) & Does
(Level-4)
100% 100% 80% 20%

31
Liaquat Institute of Medical and Health Sciences, Thatta
 3 MUSCULOSKELETAL MODULE - 1
INTRODUCTION
This exciting module will serve as building block and is very essential to your future work as
doctors. This module is designed to make your learning both interesting and productive by
including several interactive activities.
Motility is the most important feature of life. Every living being shows locomotion in one or other
form. Human locomotor system is very beautiful and well organized. Man is the only mammal
that walks on two feet. So, our musculoskeletal system is well oriented to counter the effect of
gravity. God Himself has said in Holly Quran that He has made man in the best of its form.
Cerebral cortex, the highest center of brain causes controls various body movements by
coordination of the muscles, bones, & joints.

Rationale
This module is designed to build a solid foundation regarding knowledge of the structure and
function of various muscles, bones and joints. This also provides information regarding its clinical
applications. It has been estimated that one in four consultations in primary care is caused by
problems of the musculoskeletal system.
It is likely that individuals at some time suffer from a problem related to the musculoskeletal
system, ranging from a very common problem such as osteoarthritis or back pain to severely
disabling limb trauma or rheumatoid arthritis. Many musculoskeletal problems are chronic
conditions as well. The most common symptoms are pain and disability, with an impact not only
on individuals’ quality of life but also, importantly, on people’s ability to earn a living and be
independent.
Throughout this module, students will have the opportunity to link basic science knowledge to
clinical problems. Teaching relevant basic sciences with clinical examples will help you make
connections among concepts and retain the information for later clinical education.

Duration
10 weeks

Learning Outcomes
By the end of this module, the students should be able to describe, demonstrate & explain
Knowledge
• Identify and describe the anatomical structures of the upper limb and lower limb.
• Understand the relationships between muscles, bones, joints, and neurovascular structures.
• Recognize common clinical implications related to upper and limb anatomy, such as nerve
compression syndromes or vascular injuries.
• Identify and describe the microscopic structures of muscles, bones, cartilages, and skin.
• Correlate microscopic features with macroscopic anatomy and clinical relevance.
• Identify common collagen disorders and their underlying pathophysiology.

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Liaquat Institute of Medical and Health Sciences, Thatta
 • Discuss diagnostic approaches and therapeutic interventions for collagen-related disorders.
• Understand the embryological development of muscles and bones.
• Identify factors influencing fracture healing and complications.
• Understand the pathophysiology, risk factors, and management of osteoporosis.
• Explain the process of muscle contraction at the molecular level.
• Identify key proteins involved in muscle contraction and their functions.
• Understand the regulatory mechanisms controlling muscle contraction and relaxation.

Skills
• Identify different types of cartilage microscopically.
• Perform experiments to observe and measure muscle twitch and summation.
• Perform experiments to study the relationship between stimulus intensity and muscle recruitment.
• Interpret EMG data to analyze muscle function and activity patterns.
• Perform experiments to estimate calcium levels using appropriate techniques.
• Perform experiments to estimate phosphorus levels using suitable techniques.

Attitude
Follow the basic laboratory protocols

• Professionally participate in class and practical work

• Effectively communicate in a team with pears, staff and teachers
• Effectively Communicate in a team with pears and teachers.

Themes
Theme 1: Theme 1: Pectoral region and Breast
Theme 2: Back, Axilla and Shoulder joint
Theme 3: Brachial Plexus and Arm
Theme 4: Forearm, hand and carpal tunnel syndrome
Theme 5: Anterior thigh and femoral hernia
Theme 6: Gluteal region, hip joint and Sciatic nerve
Theme 7: Anterior compartment of leg and compartment syndrome
Theme 8: Posterior compartment of leg and foot

TOPICS WITH SPECIFIC LEARNING OBJECTIVES AND TEACHING

STRATEGIES
Theme 1: Pectoral region and Breast

33
Liaquat Institute of Medical and Health Sciences, Thatta
 TEACHING
S# LEANING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
• Define different regions of the
upper limb
• Identify various compartments of MSK-S1-Ana-G-1
arm, forearm & hand. Introduction to locomotor
1
• Define the axial and system & Organization of
appendicular skeleton and upper limb
define the girdle bones. SBAs,
• Identify joints of the upper limb. Demonstration OSPE & OSCE
• Define the pectoral region.
• Describe its muscles. MSK-S1-Ana-G-2
• Identify the general features and
2 different land marks for side Pectoral region& the
determination and the
clavicle
attachments of various muscles
on clavicle.
• Discuss development of Bone
• Describe Intramembranous
ossification
• Describe endochondral
ossification MSK-S1-Ana-E-1
Interactive
3 • Describe ossification of the limb Development of skeletal SBAs & OSCE
system Lecture
bones
• Describe development of the
joints
• Describe development of the
cartilage
• Identify general features and
different land marks for side
determination and the MSK-S1-Ana-G-3
attachments of various muscles Scapular region (scapula SBAs,
4 on the Scapula. bone, muscles & Demonstration OSPE & OSCE
• Define arrangement, neurovascularBundle of
attachments,neurova-scular back)
bundle and actions of muscles of
back
Identify the bony components, type
MSK-S1-Ana-G-4
& variety & movements of
5 Sternoclavicular
sternoclavicular, acromioclavicular
acromioclavicularJoints
joints
• Define the extent and quadrants
of the breast
• Describe the blood supply and MSK-Ana-G-5 Interactive
6 SBAs & OSPE
lymphatic drainage of breast in Anatomy of the breast Lecture
the female with its clinical
significance.
• Identify histology of mammary
gland in non-lactating, lactating
& during pregnancy under MSK-S1-Ana-H-1
7 Practical OSPE & OSCE
microscope. Histology of breast
• Identify and describe histological
features of nipple and areola.
Physiology
8 • Describe thePhysiology of MSK-S1-Phy-1 SBAs & OSPE
34
Liaquat Institute of Medical and Health Sciences, Thatta
 Mammarygland. Physiology of breast and
• Describe the Hormone lactation
responsible for milk production &
ejection.
• Describe the let-down reflex
(milk ejection reflex)
Interactive
• Discuss the basic relationship
Lecture
between vitamin D, PTH,
calcium and Phosphate in MSK-S1-Phy-2
9 relation to bone formation Hormones regulating
• Describe the various cells of the calcium homeostasis
bones and their function in
Cahomeostasis
• Identify and name various parts
MSK-S1-Phy-P1
of power lab OSPE & OSCE
10 Introduction to Power Practical
• Illustrate functions of various
Lab
parts of the powerlab
Biochemistry
Enlist classification, functions and MSK-S1-Bio-01
Biochemical significance of Role
11
Heteropolysaccharides in formation ofHeteropolysaccharides
of Extracellular Matrix. (Glycosaminoglycans)
Explain Mucopolysacharridoses: Interactive
MSK-S1-Bio-02 SBAs & OSPE
12 Classification, Deficient Lecture
Mucopolysaccharidoses
EnzymesClinical Manifestation
Discuss general introduction and MSK-S1-Bio-03
13 Classification of
classification of Minerals.
Minerals
Clinical Interactive Lecture
• Define bone density and factors
which are responsible to
maintain bone density
• Define Pathogenesis and clinical MSK-S1-Gyn &Obs-1
14 course of change in bone density Changes in bone density
and conditions associated with with lactation
lactation.
• Discuss its complications and Interactive SBAs & OSPE
management. Lecture
• Describe the Patho-Physiology
of mammary gland disorders
• Describe the lactation reflex MSK-S1-Paeds-1
15 • Describe weaning Breast feeding guide for
• Describe the hormonal effect medical profession
• Student guide for complete
protocol of lactation and weaning

Theme 2: Back, Axilla and Shoulder joint

TEACHING
S. # LEANING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy

35
Liaquat Institute of Medical and Health Sciences, Thatta
 • Describe the attachments, nerve
supply and the actions of the
MSK-S1-Ana-G-6
16 muscles of the back.
Muscles of back
• Define the effects of paralysis of
these muscles SBAs, OSPE &
Demonstration
MSK-S1-Ana-G-7 OSPE
Discuss the arterial anastomosis
Anastomosis around
around the scapula.
17 scapula &
Explain the neurovascular bundle
Neurovascular bundle of
of scapula.
scapula
• Enumerate bony components,
type & variety, attachment of
capsule and ligaments of this
joint. MSK-S1-Ana-G-8
18
• Demonstrate various muscles & The Shoulder Joint Interactive
SBAs & OSPE
movements at the joint. Lecture
• Identify the factors stabilizing or
weakening the shoulder joint.
Discuss the developmental stages MSK-S1-Ana-E-2
19
of skull and its clinicals Development of skull
• Define the shape, location,
boundaries and contents of
Axilla.
MSK-S1-Ana-G-9
• Discuss the formation, course SBAs, OSPE &
20 Axilla: Boundaries & Demonstration
and relations of axillary vessels OSCE
Contents
• Describe arrangement of axillary
lymph nodes and their area of
drainage.
• Describe and draw formation of
the brachial plexus.
• Mention different parts of
brachial plexus and their
MSK-S1-Ana-G-10 Interactive
21 location. SBAs & OSPE
Brachial Plexus Lecture
• Identify different nerves with their
root values.
• Discuss the effects of injury to
different sites of brachial plexus.
• Identify the skeletal muscle
under light microscope
• Describe the structural basis of
MSK-S1-Ana-H-2
muscle striations. OSPE & OSCE
22 Histology of skeletal Practical
• Recognize the structural muscle
elements that produces muscle
contraction and brings the
movement of a body part.
PhysiologC
• Describe the distribution of
calcium in thebones.
MSK-S1-Phy-3
23 • Describe the mechanism by
Role of Calium in bones
which Ca is released inblood
Interactive
from Bone SBAs & OSPE
Lecture
• Describe and classify properties MSK-S1-PHY-4
of various types of muscle. Properties of muscles &
24
• Describe the structure, functions structure of skeletal
and arrangements of Myosin, muscles.

36
Liaquat Institute of Medical and Health Sciences, Thatta
 Actin, Troponin & Tropomyosin
filaments
Biochemistry
Describe sources, RDA,
MSK-S1-Bio-4
25 Absorption, transport, Functions,
Calcium metabolism.
Clinical Aspects
Describe sources, RDA, MSK-S1-Bio-5
26 Absorption, transport, Functions, Magnesium &
Clinical Aspects Phosphorus Metabolism
Describe sources, RDA,
MSK-S1-Bio-6
27 Absorption, transport, Functions,
Vitamin D metabolism. Interactive
Clinical Aspects SBAs & OSPE
Describe miscellaneous minerals: Lecture
MSK-S1-Bio-7
28 Iodine, Floride, Selenium, Cobalt,
Miscellaneous Minerals
Zinc, Copper
MSK-S1-Bio-8
Discuss role of Parathyroid,
29 Regulation of Calcium &
Calcitonin & Vitamin D
PO4 Metabolism
Discuss chemical composition of MSK-S1-Bio-9
30 bone, remodeling and normal Chemical composition of
composition of synovial fluid. bone
Demonstrate importance of calcium
as macro-mineral.RDA, Absorption, MSK-S1-Bio-10
31 factors influencing Estimation of serum Practical OSPE & OSCE
absorption.clinical manifestation of calcium
excess and deficiency states.
Pathology
• Define Vitamin D
• Explain significance of vitamin D
in the body
MSK-S1-Path-1 Interactive
32 • Describe the different deficiency SBAs & OSPE
Vitamin D deficiency Lecture
states related with vitamin D
• Discuss the prevention of
Vitamin D Deficiency
Pharmacology
• Enlist various drugs used in
MSK-S1-Pharm-1
hypocalcemia Interactive
33 Drugs used in SBAs & OSPE
• Discuss their clinical uses Lecture
Hypocalcemia
• Explain their adverse effects

Theme 3: Brachial Plexus and Arm

TEACHING
S. # LEANING OBJECTIVES TOPIC ASSESSEMNT
STRATEGY
Anatomy
• Explain the arrangement of
different functional groups of
muscles in the ant compartment
MSK-S1-Ana-G-11
of arm & their attachment SBAs, OSPE &
Humerus bone
• Demonstrate the actions of Demonstration
34 Anterior compartment OSCE
above muscles
of arm
• Describe the neurovascular
structures and their important
relations
37
Liaquat Institute of Medical and Health Sciences, Thatta
 • Define cubital fossa.
MSK-S1-Ana-G-12 Interactive
35 • Discuss its boundaries SBAs & OSPE
Cubital fossa Lecture
• Clinical correlates
• Explain arrangement of different
functional groups of muscles in
the post compartment arm & their
MSK-S1-Ana-G-13 SBAs, OSPE &
attachment
36 Posterior compartment Demonstration
• Demonstrate actions of muscles OSCE
of arm & Elbow joint
• Describe neurovascular
structures and their important
relations
• Identify general features of
theradius & ulna. MSK-S1-Ana-G-14
37 • Discuss attachments of various Radius & Ulna
muscles on the radius & ulna. (radioulnar joints)
• Discuss the radioulnar joints.
• Explain arrangement of different
functional groups of muscles in
anterior compartment of fore-arm MSK-S1-Ana-G-15
38 & their attachment. Anterior compartment SBAs, OSPE &
• Describe neurovascular of forearm
Demonstration OSCE
structures and their important
relations
• Explain arrangement of different
functional groups of muscles in
the posterior compartment of MSK-S1-ANA-G-16
39 forearm & their attachment. Posterior compartment
• Describe neurovascular of forearm
structures and their important
relations
MSK-S1-Ana-E-3
• Describe ossification of vertebra Development of Interactive
40 SBAs & OSPE
ribs &sternum and its clinicals vertebra, ribs, & Lecture
sternum .
• Identify smooth and cardiac
muscles under light microscope
• Describe structural basis of
MSK-S1-Ana-H-3
muscle striations & differentiate
41 Histology of smooth Practical OSPE & OSCE
the two muscles.
and cardiac muscles
• Recognize function and
organization of the connective
tissue in muscle.
Physiology
• Describe general mechanism of
skeletal muscle contraction.
• Describe molecular mechanism MSK-S1-Phy-5
(sliding filament theory) of skeletal Mechanism & different
42 muscle contraction. theories of muscle
• Describe walk along theory– contraction Types of
Interactive
power stroke. muscle contraction SBAs & OSPE
Lecture
• Define motor unit, isotonic &
isometric contraction
• Define neuromuscular junction MSK-S1-Phy-6
(NMJ) & list the components of Neuromuscular
43
NMJ Junction &
• Explain sequence of events of transmission
38
Liaquat Institute of Medical and Health Sciences, Thatta
 neuromuscular transmission
• Define end plate potential
MSK-S1-Phy-7
• Describe excitation contraction
44 Excitation contraction
coupling
coupling
• Explain myasthenia gravis
• Demonstrate Nerve conduction
velocity
MSK-S1-Phy-P2
45 • Explain how electrical Practical OSPE & OSCE
Action potential
eventsare converted to
mechanical events
Biochemistry
Demonstrate sources, daily
MSK-S1-Bio-11
requirements, intestinal absorption,
46 Estimation of Serum Practical OSPE & OSCE
transport and Biochemical role
Vit.D3
andregulation of Vit-D3
Pharmacology
• Enlist various drugs used in
MSK-S1-Pharm-2
hypercalcemia Interactive
47 Drugs used in SBAs & OSPE
• Discuss their clinical uses Lecture
Hypercalcemia
• Explain their adverse effects
Clinical Interactive Lecture
• Enlist disorders of skeletal muscle
disorders and factors which are
responsible to it
MSK-S1-Ortho-1
• Define Pathogenesis and clinical Interactive
48 Disorders of voluntary SBAs & OSPE
course of conditions associated Lecture
muscles
with skeletal muscle disorders
• Discuss it’s complications and
management

Theme 4: Forearm, Hand and Carpal Tunnel Syndrome

TEACHING
S# LEANING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
• Describe the location, destination,
course & relations of arteries &
their branches in upper limb.
MSK-S1-Ana-G-17
• Identify and discuss the deep SBAs, OSPE &
53 Neuromuscular bundle Demonstration
veins of upper limb. OSCE
of the upper limb
• Describe the location, destination,
course & relations of nerves &
their branches in upper limb.
• Describe the type, variety,
attachment of capsule and
ligaments of this joint.
• demonstrate various movements MSK-S1-Ana-G-18
Interactive
54 at this joint. Wrist joint SBAs & OSPE
Lecture
• Describe the structural
organization of the Flexor &
Extensor Retinaculum.
• Discuss carpal tunnel syndrome.

39
Liaquat Institute of Medical and Health Sciences, Thatta
 MSK-S1-Ana-G-19
• Describe the bony arrangement of
Osteology of the hand
55 the hand.
and the joints of the
• Describe the joints of the hand. hand.
• Discuss the cutaneous supply,
arteries & veins of palm of hand.
SBAs, OSPE &
• define fibrous flexor sheath. MSK-S1-Ana-G-20 Demonstration
56 OSCE
• Define the palmer aponeurosis, Palm of the hand
facial spaces.
• Describe small muscles of hand.
• Discuss the dorsal venous arch.
MSK-S1-Ana-G-21
57 • Describe insertion of the long Dorsum of the hand
extensors tendons.
• Describe different regions of lower
limb.
• Identify the various bones forming
skeleton of lower limb.
MSK-S1-Ana-G-22
• Describe general arrangement of Interactive
Introduction to lower SBAs & OSPE
58 superficial & deep fasciae of Lecture
limb / Organization of
lower limb
skeleton of lower limb
• Demonstrate the bones of pelvic
girdle.
• Identify different landmarks in
different regions of lower limb
• Identify the superficial arteries of
lower limb
• Name and discuss superficial
MSK-S1-Ana-G-23
veins of lower limb
Superficial veins,
• Highlight the course of great and SBAs, OSPE &
59 arteries , lymph nodes Demonstration
small saphenous vein OSCE
& cutaneous supply of
• Describe the superficial lymphatic the lower limbs
vessels & lymph nodes of lower
limb
• Discuss clinical correlates.
• Describe the development of
skeletal muscle.
MSK-S1-ANA-E-4
• Discuss the development of Interactive
60 Development of SBAs & OSPE
Myotomes Lecture
skeletal muscles
• List derivatives of Ebaxial and
Primaxial divisions of myotomes
• Classify bone on developmental
and structural basis.
• Differentiate between woven bone
and lamellar bone under MSK-S1-Ana-H-4
Practical OSPE & OSCE
61 microscope. Histology of bones
• Differentiate between compact
bone and spongy bone under
microscope.
Physiology
• Demonstrate SMT on power lab MSK-S1-Phy-P3
• What are the different periods of Muscular twitch
62 SMT & their duration? response Practical OSPE & OSCE
• Demonstrate the phenomenon of
fatigue & Tetanus
63 • Describe types of muscle fibers MSK-S1-Phy-8 SBAs & OSPE

40
Liaquat Institute of Medical and Health Sciences, Thatta
 (type I and II) Muscle adaptation to
• Determine effect of exercise on exercise
muscle blood flow
• State effect of training, stamina
and resistance on muscle fibers
Interactive
• State Hypoxia, muscle Fatigue Lecture
during exercise and, its
Biochemical reasons.
Explain aerobic and anaerobic MSK-S1-Phy-9
64 exercise and effect of exercise on Role of muscle in
muscles. exercise
Biochemistry
Describe the Collagen Structure and MSK-S1-Bio-12
65 synthesis, Types, Role of vitamin C Collagen Structure and
in synthesis of Collagen synthesis Interactive
SBAs & OSPE
Brief overview of inherited Collagen MSK-S1-Bio-13 Lecture
66 Disorders and their clinical Overview of inherited
manifestation Collagen disorders
Estimation, RDA, Effects, regulation MSK-S1-Bio-14
67 and clinical manifestation of excess Estimation of serum Practical OSPE & OSCE
and deficiencies. phosphorus
Pharmacology
• List the drugs used in the
treatment of osteoporosis Explain MSK-S1-Pharm-3
68 their mode of action Drugs used in
• Explain their Pharmacokinetics Osteoporosis
• State the side effects of these drug Interactive
SBAs & OSPE
• Classify different muscle Lecture
relaxants. MSK-S1-Pharm-4
69 • Discuss mechanism of their action Drugs used as Skeletal
• Explain clinical uses and their muscle relaxant
adverse effects
Clinical Interactive Lecture
• Define of osteoporosis
• Describe generalized and
localized osteoporosis
• Enlist primary &secondary causes MSK-S1-Ortho-2
Interactive
70 of generalized osteoporosis Clinical manifestation SBAs & OSPE
Lecture
• Define Pathogenesis and clinical of Osteoporosis
course
• Discuss it’s complications and
management

Theme 5: Anterior thigh and femoral hernia

Theme 6: Gluteal region, hip joint and Sciatic nerve

TEACHING
S. # LEANING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
• Identify parts of the hip bone.
• Determine side of the bone. MSK-S1-Ana-G-24 SBAs, OSPE &
71 Demonstration
• Describe general features of each Hip bone + Femur OSCE
part of hip bone.
41
Liaquat Institute of Medical and Health Sciences, Thatta
 • Identify the bone.
• Determine the side of the bone.
• Describe the anatomical position of
the bone.
• Discuss division of the thigh into
compartments
• Enumerate muscles of the anterior
MSK-S1-Ana-G-25
compartment of thigh and their
72 Anterior compartment
respective actions.
of thigh
• Describe the innervation and blood
supply of muscles of anterior
compartment.
• Describe the Femoral triangle, its
boundaries and contents.
MSK-S1-Ana-G-26
73 • Discuss femoral sheath and its Femoral triangle
contents and the clinical conditions
associated.
Interactive
• Describe development of smooth SBAs & OSPE
Lecture
and cardiac muscle. MSK-S1-Ana-E-5
• Discuss development of Development of
74
Myotomes smooth & cardiac
• Enlist derivatives of epaxial and muscles
hypaxial divisions of myotomes
• Discuss muscles of medial
compartment of the thigh.
MSK-S1-Ana-G-27
• Discuss blood & nerve supply of SBAs, OSPE
75 Medial compartment of Demonstration
these muscles. & OSPE
thigh
• Describe actions of the muscles of
medial compartment of thigh.
• Describe location of gluteal region.
• Discuss about bones and
ligaments of gluteal region. SBAs, OSPE &
MSK-S1-Ana-G-28
76 • Discuss muscles of the gluteal Demonstration
The Gluteal region OSCE
region & their respective actions.
• Discuss nerves and blood vessels
of the gluteal region.
• Describe articular surfaces of the
hip joint along with capsular
attachment MSK-S1-Ana-G-29 Interactive
77 SBAs & OSPE
• Enumerate ligaments of the hip Hip joint Lecture
joint & describe their attachments.
• Discuss clinical correlates
• Identify different types of cartilage
MSK-S1-Ana-H-5
under light Microscope.
78 Histology of Hyaline Practical OSPE & OSCE
• Define distinctive microscopic Cartilage
features of each type.
Physiology
• Describe role of skin in
homeostasis
MSK-S1-Phy-12 Interactive
79 • Describe the function of skin SBAs & OSPE
Physiology of Skin Lecture
• Describe medico-legal importance
of the skin
Biochemistry

42
Liaquat Institute of Medical and Health Sciences, Thatta
 MSK-S1-Bio-15
Describe metabolic pathway for Metabolic pathway for
80
synthesis of purines and pyrimidines synthesis of purines
and pyrimidines
Interactive
SBAs & OSPE
Discuss in detail metabolic pathways MSK-S1-Bio-16 Lecture
for nucleic acids degradation. Metabolic pathways for
81 nucleic acids
Inherited associated disorders. Uric
degradation and
acid metabolic disorders. related disorders.
MSK-S1-Bio-17
Demonstrate the methods to estimate
82 Estimation of serum Practical OSPE & OSCE
the serum uric acid.
uric acid
Pharmacology
• Classify the drugs
MSK-S1-Pharm-5
• Describe their general properties. Interactive
83 Drugs used in SBAs & OSPE
• Explain mechanism of action. Lecture
Osteoporosis
• State their actions in general.
Pathology
• Mention types of arthritis
• Define Osteoarthritis& MSK-S1-Path-2 Interactive
84 Arthritis SBAs & OSPE
Rheumatoid arthritis Lecture
• Describe their clinical features
Clinical Interactive Lecture
MSK-S1-Ortho-3
Explain clinical manifestations of Interactive
85 Clinical manifestation SBAs & OSPE
arthritis Lecture
of Arthritis

Theme 7: Anterior Compartment of Leg and Compartment

Syndrome
TEACHING
S# LEANING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
• Describe muscles of posterior
compartment of thigh.
• Describe arterial supply of
MSK-S1-Ana-G-30
posterior compartment of thigh.
86 Post: compartment of
• Discuss trochanteric and cruciate thigh + popliteal fossa
anastomosis at back of thigh.
• Describe venous drainage of this
region. SBAs, OSPE &
Demonstration
• Describe anatomical position of OSCE
the bone.
• Identify the bone and its side
determination. MSK-S1-Ana-G-31
87
• Mark attachment of muscles and Tibia & fibula
ligaments.
• Describe the nerve injuries
related to it.
• Discuss site and time of
appearance of upper and lower MSK-S1-Ana-E-6
Interactive
88 limb buds. Development of Limbs SBAs & OSPE
Lecture
• Define source of mesoderm & its clinical 1
forming the limb muscles
43
Liaquat Institute of Medical and Health Sciences, Thatta
 • Discuss formation of different
compartments of leg.
• Explain arrangement of the
muscles in anterior compartments
of leg and their actions. MSK-S1-Ana-G-32
89 • Describe neurovasculature of Anterior compartment
these compartments of leg. of leg & dorsum of foot
• Identify bones forming the
architecture of foot. SBAs, OSPE &
Demonstration
• Discuss joints formed by these OSCE
bones.
• Explain arrangement of the
muscles in lateral compartments
MSK-S1-Ana-G-33
of leg and their actions.
Lateral compartment
90 • Describe the neurovasculature of
of leg & tibiofibular
these compartments of leg
joint
• Discuss clinical correlates like
compartment syndrome of leg.
• Describe articular surfaces of the
knee joint along with capsular
attachment.
• Describe ligaments & bursa of the
MSK-S1-Ana-G-34 Interactive
91 knee joint and discuss their SBAs & OSPE
Knee joint Lecture
attachments.
• Describe movements of the knee
joint. (locking & unlocking
mechanism)
• Identify different types of cartilage
MSK-S1-Histo-6
under light Microscope.
92 Histology of elastic Practical OSPE & OSCE
• Define distinctive microscopic
and fibrous cartilage
features of each type.
Biochemistry
• Demonstrate principals and types
of chromatography.
MSK-S1-Bio-18
• Interpretation of clinical Practical OSPE & OSCE
93 Chromatography
conditions and investigations
related to use in chromatography.
Pharmacology
• Classify the drugs
MSK-S1-Pharm-6
• Describe their general properties. Interactive
94 Drugs used in SBAs & OSPE
• Explain the mechanism of action. Rheumatoid Arthritis Lecture
• State their actions in general.
• Classify the drugs
• Describe their general properties. MSK-S1-Pharm-7 Interactive
95 SBAs & OSPE
• Explain the mechanism of action. Drugs used in Gout Lecture
• State their actions in general.

Theme 8: Posterior compartment of leg and foot

TEACHING
S# LEANING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
• Explain arrangement of the MSK-S1-Ana-G-35 SBAs,
96 muscles in posterior compartment Posterior compartment Demonstration
OSPE & OSCE
of leg. of leg
44
Liaquat Institute of Medical and Health Sciences, Thatta
 • Describe nerve supply of these
muscles.
• Explain actions of the muscles of
posterior compartment.
• Discuss clinical correlates.
• Describe the architecture of
arches of foot and the factors
responsible for their
MSK-S1-Ana-G-36
maintenance.
97 Skeleton of foot &
• Identify the bones forming these
arches of foot
arches.
• Describe the function of the
arches of foot.
• Discuss the hand plate and
formation of digital rays resulting
into digits MSK-S1-Ana-E-7
Interactive
98 • Describe the muscles involved in Development of Limbs SBAs & OSPE
Lecture
and process of rotation of limb & its clinical 2
• Explain the congenital anomalies
of the limbs
• Describe the Ankle Joint. MSK-S1-Ana-G-37
99 • Describe Superior and Inferior Ankle ,subtalar & small
Tibiofibular Joints. joints of foot
• Identify the bones forming
architecture of sole of foot.
• Discuss the joints formed by MSK-S1-Ana-G-38
100
these bones. Sole of foot
• Describe clinical correlates like
flat foot and club foot.
• Explain different nerve of lower SBAs, OSPE &
Demonstration
limb and their root value. OSCE
• Discuss causes of injuries. MSK-S1-Ana-G-39
101 • Enumerate common sites of Neurovascular bundle
these nerve injuries of lower limb
• Discuss symptoms caused by
these nerve injuries.
• Discuss the blood supply and
MSK-S1-Ana-G-40
nerve supply of sole of foot.
102 Neurovascular bundle
• Describe vascular and nervous of foot
supply of dorsum of foot.
• Describe development of
musculoskeletal system. MSK-S1-Ana-E-8
• Discuss development of Overview of
Myotomes Embryological
103
• List derivatives of epaxial and development of
hypaxial divisions of myotomes musculoskeletal Interactive
SBAs & OSPE
• Describe the development of system Lecture
bones, joints & cartilage
• Describe layers of the skin.
MSK-S1-Ana-H-7
• Discuss layers of the Epidermis.
104 Microscopic anatomy
• Describe appendages of skin.
of the Skin
• Discuss the functions of the skin.
• Identify three layers of skin under MSK-S1-Ana-H-8
105 Practical OSPE & OSCE
light microscope Histology of skin

45
Liaquat Institute of Medical and Health Sciences, Thatta
 • Describe structural basis &
elements of skin.
• Recognize function and
organization of connective tissue
in skin
• Identify three layers of skin under
light microscope
• Describe structural basis & MSK-S1-Ana-H-9
106 elements of skin. Histology of skin
• Recognize the function and appendages
organization of connective tissue
in skin
Pharmacology
• Classify different Nicotinic
blocking agents
MSK-S1-Pharm-8
• Discuss mechanism of their
107 Nicotinic receptor
action
agonists
• Explain clinical uses and adverse
effects Interactive
SBAs & OSPE
Lecture
• Classify different Nicotinic
blocking agents LMS-S1-Pharm-9
108 • Discuss mechanism of their action Nicotinic receptor
• Explain clinical uses and adverse antagonists
effects
Clinical Interactive Lecture
• Define terms related to fracture:
Stress Fracture, Incomplete
fracture,
• Closed (simple fracture), Open
(complicated) fracture, multi-
fragmented fractures, complex MSK-S1-Ortho-4 Interactive
109 SBAs & OSPE
fracture, Pathologic fractures Fractures/Dislocations Lecture
• Describe mechanism of bone
healing
• Enlist complications of fracture
• Describe etiology & Pathogenesis
of Pathologic fractures.
Pathology
• Classify different types of
osteomyelitis
MSK-S1-Path-3 Interactive
110 • List factors leading to their SBAs & OSPE
Osteomyelitis Lecture
etiology
• Explain its pathogenesis

46
Liaquat Institute of Medical and Health Sciences, Thatta
 Blueprint of Assessment
Purpose of Assessment: Summative Assessment First Professional MBBS
Curriculum: Integrated Modular Curriculum
Module: Musculoskeletal Module -1
Weeks Week Week Week Week Week Week Week Week Week Week10 Total Weigh Rounde Tota
1 2 3 4 5 6 7 8 9 hrs tage % d off l
Weight num
age % ber
of
Qs
Teaching
hours
Gross 04 04 04 04 04 04 04 04 04 04 40 35.39 35 35
Ana
Histology 01 01 01 01 01 01 01 01 01 00 09 7.96 8 8

Embryol 01 01 01 01 01 01 01 01 00 00 08 7.07 7 7
ogy
Physiolo 02 01 03 01 01 01 01 01 12 10.61 11 11
gy
Biochemi 02 02 02 02 02 01 02 02 02 01 18 15.92 16 16
stry
Patholog ----- 01 ----- 01 ---- 01 ---- --- 03 2.65 3 3
y
Pharmac ___ 01 01 02 01 02 01 01 09 7.96 8 8
ology
Parallel 01 01 01 01 01 01 01 14 12.38 12 12
subjects
(CM, BS,
IT, Mres,
Prof,
clinical)
Total 113 100% 100

Subject in Module Proportion Weightage Test Instrument/tool/method Explanation

of subjects
in module
What to assess? How to assess?
MCQs (SBAs) OSPE OSCE Any Proportion of test
Level 1 & 2 stations Level 3 Other instruments to be
Level 1 used:
&2 Theory
Gross Anatomy 35 35 01 MCQs (SBAs)= 100 %;
Embryology 8 8 01 Practical
Histology 7 7 01 OSPE=80%
Physiology 11 11 03 OSCE= 20%
Biochemistry 16 16 03
Pathology 3 3 01 Competency level &
Pharmacology 8 8 01 Learning Domain at
Parallel subjects 12 12 01 Miller’s Pyramid:
(CM, IT, BS, Res, Cognition:
BME) Know (Level-1) & How
to know (Level-2)
Skills & Attitude:
Show (Level-3) & Does
(Level-4)
100% 100% 80% 20%

47
Liaquat Institute of Medical and Health Sciences, Thatta
 4 CARDIOVASCULAR MODULE-1

Introduction
Welcometothecardiovascularabnormalities’module.Thisexcitingmodulewillbeverynecessaryto your future
work as doctors. This module is designed to make your learning both interesting and productive by including
interactive activities.
During this module, students will be encouraged to learn the structure and function of the cardiovascular
system in an integrated manner i.e. subjects such as Anatomy, Physiology and Biochemistry, will be learned
and assessed together (Horizontal Integration). We will also help you learn the basic sciences in a way that
is relevant to their clinical applications (Vertical Integration). By adopting this approach, we are preparing you
better for your future work as doctor, where patients will come to you with problems that are not categorized
by discipline name.
In order to help you learn in an integrated manner, we have updated the learning of basic sciences around a
few key health-related situations (real life situations), which you are likely to encounter as first year medical
students. You will be expected to think about the scenarios and participate in case based learning sessions
for clearing your concepts and better learning. It will also help you focus your attention on what you need to
achieve from the Interactive Lectures, practical and tutorials that have been scheduled during this module.

Rationale
An overall aim of this module is to help you form a cognitive base for understanding pathogenesis of
cardiovascular diseases as they are major cause of morbidity and mortality. (Cardiovascular diseases module
– Third-year) & practice of cardiovascular medicine (final-year clinical rotation). The module will prepare you
for your future work in the medical course that will include learning in relation to the assessment and
promotion of cardiovascular health and management of range of cardiovascular disease.

Duration
5 weeks

Learning Outcomes
By the end of this foundation module, the students should be able to:

Knowledge:
At the end of this module, the students will be able to:

• Describe the components of the cardiovascular system by learning and applying the relevant basic
sciences.
• Apply the knowledge to a few common real-life situations (Hypertension, Myocardial Infarction
and Shock) to explain how the anatomy, Physiology and Biochemistry are altered in the given
situation.
• Describe the anatomy of the different parts of the cardiovascular system in detail.
• Describe the development and anomalies of the cardiovascular system.
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Liaquat Institute of Medical and Health Sciences, Thatta
 • Define and identify the microscopic features of the cardiovascular system.
• Describe the functions of the cardiovascular system.
• Enlist pathologies involving cardiovascular system.

Clinical/ Practical skills

Measuring blood pressure using Sphygmomanometer with correct technique and interpretation of its
values and calculation of mean arterial pressure.
Identification of areas on the chest for auscultation of the heart sounds.
Placing electrodes and obtaining an electrocardiogram and interpretation of the basic ECG findings.
Identificationofcardiactissuesandbloodvesselsunderthemicroscopewithpointsof Identification.
(Students are required to draw and label microscopic sections of cardiovascular components in
histology journal. The journal will be assessed during end-module examination).

Attitude:
• Follow the basic laboratory protocols.
• Professionally participate in class and practical work
• Effectively communicate in a team with pears, staff and teachers
• Effectively Communicate in a team with pears and teachers.

Themes
Theme 1: Arrhythmias and Myocardial Infarction
Theme 2: Congenital anomalies of Cardiovascular System
Theme 3: Hypertension
Theme 4: Heart Failure

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Liaquat Institute of Medical and Health Sciences, Thatta
 TOPICS WITH SPECIFIC LEARNING OBJECTIVES AND TEACHING
STRATEGIES

Theme 1: Arrhythmias, Myocardial Infarction

TEACHING
S. # LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
• Define the middle mediastinum.
• Explain location and contents of the
middle mediastinum. CVS-S1-Ana-G-1
• Discuss fibrous and serous parts of the Middle Interactive
1 SBAs & OSPE
pericardium. Mediastinum and Lecture
• Define pericardial sinuses and nerve The Pericardium
supply of the pericardium.
• Discuss related clinical conditions.
• Define Anatomical position of the heart.
• Identify and name structures constituting CVS-S1-Ana-G-2
2 the borders and surfaces of the heart. Anatomy of the
Define the external features of the Heart-1
Chambers of the heart.
• Describe Internal features of each CVS-S1-Ana-G-3
3 chamber of heart. Anatomy of the SBAs, OSPE &
Demonstration
• Discuss the related clinical conditions. Heart-2 OSCE
CVS-S1-Ana-G-4
• Describe composition of the walls and the Structure of the
skeleton of the heart. heart and The
4
• Describe conducting system of the heart. Conducting
• Discuss related clinical conditions. system of the
Heart
Identify the histological features of heart; CVS-S1-Ana-H-1
5 endocardium, myocardium, epicardium on Histology of the Practical OSPE & OSCE
light microscope. Heart
Physiology
• Describe components/parts of CVS and
their functions
• Define systemic and pulmonary circulation
• Mention distribution of blood (in CVS-S1-Phy-1 Interactive
6 SBAs & OSPE
percentage of total blood) in different Overview of CVS Lecture
parts of the circulatory system
• Mention pressures in various portions
of the circulatory system
• Mention three major types of muscle
• Describe properties of cardiac muscle
(Functional syncytium, Automaticity,
CVS-S1-Phy-2
Rhythmicity, Conductivity, Long refractory Interactive
7 Properties of SBAs & OSPE
period) Lecture
cardiac muscle
• Describe cardiac muscle action potential
• Discuss mechanism of excitation
contraction coupling in cardiac muscle

50
Liaquat Institute of Medical and Health Sciences, Thatta
 • Describe various parts/components of
conducting system of the heart and their
functions
• Explain action potential and rhythmicity of
CVS-S1-Phy-3
sinus nodal fibers
Excitatory and
• Describe origin and spread of cardiac
08 Conducting
impulse
system of the
• Mention AV nodal delay and its heart
significance Interactive
SBAs & OSPE
• Describe the effect of ANS on the Lecture
functioning of conducting system of the
heart
• Define electrocardiogram and
electrocardiography
CVS-S1-Phy-4
• Describe the waves, intervals and
09 Electrocardiogram(
segments of a normal electrocardiogram
ECG)
(ECG)
• Mention the uses/indications of ECG
Biochemistry
CVS-S1-Bio-1
• Mention introduction of isoenzymes Diagnostic
significance of Interactive
10 • Discuss diagnostic significance of SBAs & OSPE
Isoenzymes in Lecture
isoenzymes
cardiovascular
disorders
Pathology
• Define ischemic heart diseases?
• Classify different types of ischemic heart CVS-S1-Path-1
Interactive
11 diseases. Ischemic heart SBAs & OSPE
Lecture
• Discuss causes and clinical manifestation disease
of ischemic heart diseases.
Medicine (Cardiology)
• Define Arrhythmias
• Recognize the commonabnormalities in
rate and rhythm of the heart (tachycardia,
bradycardia, flutter, fibrillations, heart
blocks and extrasystole) failure. CVS-S1-Cardio-1 Interactive
12 SBAs & OSPE
• Describe the hemodynamic, Arrhythmias Lecture
neuroendocrine and cellular changes that
occur in heart failure.
• Describe the Physiological basis of the
treatment principles in heart failure.
Theme 2: Congenital Anomalies of Cardiovascular System

TEACHING
S. # LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
• Describe development of cardiogenic field
and heart tube. CVS-S1-Ana-E-1
• Enumerate the derivatives of heart tube. Interactive
13 Development of SBAs & OSPE
• Define formation of cardiac looping and Lecture
dextrocardia and how sinus venous and the heart tube
cardiac septa formed.

51
Liaquat Institute of Medical and Health Sciences, Thatta
 • Explain atrial and interatrial septum
CVS-S1-Ana-E-2
development.
Development of
• Explain ventricles and Inter-ventricular
14 the heart
septum development.
chambers and
• Enlist common congenital anomalies of
their septa -1
heart chambers.
• Explain How atria and interatrial septum CVS-S1-Ana-E-3
develops? Development of
• How ventricles and Inter-ventricular
15 the heart
septum develops?
• What are the common congenital chambers and
anomalies of heart chambers? their septa -2
CVS-S1-Ana-E-4
• Describe septa formation in bulbus cordis Development of
and truncus arteriousis. septa in truncus
16
• Enlist congenital heart defects; arteriosus , valves
transposition of great vessels, PDA, PTA and conducting
system
• Describe the microscopic features of the CVS-S1-Ana-H-2
17 arteries Histology of the Practical OSPE & OSCE
• Identify the different types of arteries Arteries
Physiology
• Define cardiac cycle CVS-S1-Phy-5
• Mention duration of cardiac cycle and its Cardiac cycle and
relation with heart rate its mechanical
18 • Describe sequence of events of cardiac events-I
cycle
• Mention pressure changes that occur
during each cardiac cycle
• Describe the relationship of the CVS-S1-Phy-6
electrocardiogram to mechanical events Cardiac cycle and
of cardiac cycle its mechanical
• Mention pressure changes in atria events-II
• Define JVP and mention its clinical
19
importance
• Define EDV, ESV and Stroke volume
• Define ejection fraction and mention its
clinical importance Interactive
SBAs & OSPE
• Define preload and afterload Lecture
• Describe functions of heart valves
• Mention normal heart sounds and explain
their production
CVS-S1-Phy-7
• Define heart murmur
Heart valves,
20 • Mention the timing of the murmur heart sounds and
produced by valvular defects and murmurs
congenital heart diseases
• Explain the hemodynamic changes in
various valvular heart diseases
• Define Ohm’s law of circulation CVS-S1-Phy-8
• Describe main factors that determine Interrelationship
vascular resistance among blood flow,
21
• Define total peripheral vascular pressure and
resistance and total pulmonary vascular resistance
resistance

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Liaquat Institute of Medical and Health Sciences, Thatta
 • Mention Poiseuille’s law

Biochemistry
Describe different aspects related to fatty acids CVS-S1-Bio-2
Interactive
22 and their clinical significance in the CVS SBAs & OSPE
Fatty acids Lecture
diseases..
Pathology
CVS-S1-Path-2
Define aneurysm Classification of aneurysm Congenital
23 What are the true and false aneurysms with
their examples Pathogenesis of aneurysm anomalies of blood
Interactive
vessels SBAs & OSPE
Lecture
• Define congenital heart disease. CVS-S1-Path-3
24 • Describe etiopathogenesis. Congenital heart
• Discuss clinical features disease.
Paediatrics
Describe the Hemodynamic changes in CVS-S1-Paeds-I
various congenital heart diseases including; Interactive
25 Congenital heart SBAs & OSPE
Mitral Stenosis Mitral regurgitation Stenosis Lecture
Aortic regurgitation diseases

Theme 3: Hypertension
TEACHING
S# LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
• Describe the arterial supply and venous
drainage of heart. CVS-S1-Ana-G-5
• Describe the branches of major arteries Blood and nerve
26
and their distribution. Define the nerve supply of the
supply of the heart. Describe the cardiac Heart
plexus.
• Discuss development of arterial system;
CVS-S1-Ana-E-5 Interactive
aortic arches, umbilical, vitelline and SBAs & OSPE
Development of Lecture
27 coronary arteries
arterial system of
• Name the common congenital anomalies
heart
of arteries?
• Discuss development of venous system; CVS-S1-Ana-E-6
cardinal veins, umbilical and vitelline. Development of
28
• Name the common congenital anomalies venous system of
of venous system? heart
Describe the microscopic structure of the CVS-S1-Ana-H-3
29 Practical OSPE & OSCE
veins Histology of veins
Physiology
• Mention the specific needs of the tissues CVS-S1-Phy-9
for blood flow Control of local
• Define local blood flow blood flow
• Describe acute/short-term control of local
30 Practical OSPE & OSCE
blood flow
• Describe long-term control of local blood
flow
• Explain the auto-regulation of blood flow

53
Liaquat Institute of Medical and Health Sciences, Thatta
 • Describe structure of microcirculation and CVS-S1-Phy-10
capillary wall Capillary fluid
• Explain flow of blood in capillaries exchange
• Define vasomotion
• Define Starling forces and give their
approximate values
• Describe role of Starling forces in fluid
31
exchange across the capillary wall
• List the functions of lymphatics
• Define edema and explain the
pathoPhysiological basis for edema (i.e.
increased capillary hydrostatic pressure,
hypoalbuminemia, increased capillary
permeability and lymphatic obstruction)
• Describe vasomotor center, its important CVS-S1-Phy-11
areas and functions Nervous
• Define vasomotor tone regulation of
32 • Describe role of sympathetic nervous circulation
system in regulation of circulation
• Describe role of parasympathetic nervous
system in regulation of circulation
• Define systolic blood pressure, diastolic CVS-S1-Phy-12
blood pressure, pulse pressure and mean Blood pressure
arterial pressure and its
• Mention important factors on which blood Regulation-I
33 pressure depends (Baroreceptor
• List various mechanisms that reflex
regulate/control blood pressure mechanism)
• Describe role of baroreceptor reflex in
regulation of blood pressure
Biochemistry
Explain the metabolism and function of CVS-S1-Bio-3
34 cholesterol and its clinical significance in CVS
diseases Cholesterol
Interactive
CVS-S1-Bio-4 SBAs & OSPE
Lecture
Describe the prostaglandins & leukotriens,
35 Prostaglandins
their synthesis and general functions.
and Leukotriens
CVS-S1-Bio-P1
Demonstrate the estimation of the serum
36 Serum Cholesterol Practical OSPE & OSCE
cholesterol
estimation
Pharmacology
CVS-S1-Pharm-1
Introduction to
To describe the Physiological targets of drugs Interactive
37 targets of drugs SBAs & OSPE
used in systemic hypertension. Lecture
used in
hypertension
Medicine (Cardiology)
• Define hypertension. List the causes of
hypertension.
• Describe the pathogenesis of CVS-S1-Cardio-2 Interactive
38 SBAs & OSPE
hypertension. Hypertension Lecture
• Explain the compensatory measures that
maintain the blood pressure on rising

54
Liaquat Institute of Medical and Health Sciences, Thatta
 from supine positions.
• Explain the Physiological basis of the
treatment principles in hypertension

Theme 4: Heart Attack

TEACHING
S. # LEARNINGOBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
CVS-S1-Ana-G-6
• Identify different chambers/structures of
39 Model study of
the heart.
heart SBAs &
Demonstration
CVS-S1-Ana-G-7 OSPE & OSCE
• Identify different chambers/structures of
40 Model study of
the heart.
heart
• Describe circulatory changes before and
CVS-S1-Ana-E-7
after birth. Interactive
41 Circulation before SBAs & OSPE
• Name the adult derivatives of embryonic Lecture
and after birth
structures?
CVS-S1-Ana-H-4
Identify the capillaries with the help of light
42 Histology of Practical OSPE & OSCE
microscope.
capillaries
Physiology
CVS-S1-Phy-13
• Explain renal-body fluid system and its Blood pressure
role in arterial pressure control and its regulation-II
43
• Describe Renin-Angiotensin system and (Role of kidneys in
its role in arterial pressure control long-term control
of blood pressure)
• Define cardiac output and mention its
relationship to stroke volume & heart rate
CVS-S1-Phy-14
• Describe factors regulating cardiac
44 Cardiac output and
output
venous return
• Describe Frank-Starling mechanism of
heart
• Mention some pathological conditions
that cause high cardiac output
• Mention some pathological conditions
that cause low cardiac output Interactive
CVS-S1-Phy-15 SBAs & OSPE
Lecture
• Mention methods of measurement of Cardiac output and
45
cardiac output venous return
• Define venous return and mention factors
that affect/regulate venous return
• Describe central venous pressure
• Define circulatory shock
• Describe causes and major types of
shock
46 CVS-S1-Phy-16
• Mention stages of shock
Circulatory shock
• Describe Physiology of non-progressive
and progressive hemorrhagic shock
• Mention compensatory mechanisms that
attempt to return cardiac output and CVS-S1-Phy-17
47
arterial pressure back to normal in a Circulatory shock
hemorrhagic shock (hypovolemic shock)

55
Liaquat Institute of Medical and Health Sciences, Thatta
 • Mention factors that lead to progression
of shock (i.e. factors worsening the
shock)
• Describe the Physiological basis of
treatment of circulatory shock
• To record pulse rate manually & on
CVS-S1-Phy-18
power lab
Pulse rate, blood
• To record blood pressure manually & on pressure, ECG
power lab
48 recording on power Practical OSPE & OSCE
• To record ECG on ECG machine & lab. and ECG
power lab machine
• To auscultate heart sounds

Biochemistry
Discuss lipoproteins’ metabolism and their CVS-S1-Bio-5 Interactive
49 SBAs & OSPE
clinical significance in CVS diseases Lipoproteins Lecture
CVS-S1-Bio-P2
50 Interpret lipid profile and its significance Practical OSPE & OSCE
Lipid Profile
Pathology
• Define shock
• Enlist types of shock CVS-S1-Path-4 Interactive
51 SBAs & OSPE
• Describe causes, patho-physiology, Shock Lecture
signs and symptoms of shock
Medicine (Cardiology)
• Define heart failure.
• Explain the Physiological basis of
common clinical manifestations of heart
failure.
• Describe different types of the heart CVS-S1-Cardio-3 Interactive
52 failure. SBAs & OSPE
Heart failure Lecture
• Describe hemodynamic, neuroendocrine
and cellular changes that occur in heart
failure.
• Describe Physiological basis of
treatment principles in heart failure.

56
Liaquat Institute of Medical and Health Sciences, Thatta
 Blueprint of Assessment
Purpose of Assessment: Summative Assessment First Professional MBBS
Curriculum: Integrated Modular Curriculum
Module: CVS Module -1

S. No Subject Week- Week- Week- Week- Week-5 Total Weightage Weightag Total
1 2 3 4 % e after Number of
Rounding Questions
(100)
Gross Anatomy 02 02 01 05 01 07 12.96 13 13

Embryo 01 02 02 01 01 07 12.96 13 13
Histo 01 01 01 01 00 04 7.40 07 07
Physiology 04 04 03 04 03 18 33.33 33 33
Biochemistry 01 01 01 02 02 07 12.96 13 13
Pharmacology 00 00 00 01 00 01 1.85 02 02
Pathology 01 01 00 01 01 04 7.40 07 07
Parallel subjects 02 02 02 02 01 06 11.11 11 11
(CM, IT, BS, Res,
BME)
TOTAL ------- ------- ------- 54 100% 100

Subject in Proportion Weightage Test Instrument/tool/method Explanation

Module of
subjects
in module
What to assess? How to assess?
MCQs (SBAs) OSPE OSCE Any Proportion of test
Level 1 & 2 stations Level 3 Other instruments to be
Level 1 used:
&2 Theory
Gross Anatomy 13 13 01 MCQs (SBAs)=
Embryology 13 13 01 100 %;
Practical
Histology 07 07 01 OSPE=80%
OSCE= 20%
Physiology 33 33 03
Biochemistry 13 13 03 Competency level &
Learning Domain at
Pathology 02 02 01 Miller’s Pyramid:
Cognition:
Pharmacology 07 07 01
Know (Level-1 &
Parallel subjects 11 11 01 How to know
(CM, IT, BS, (LevelC2)
Res, BME) Skills & Attitude:
Show (Level-3) &
Does (Level-4)
100% 100% 80% 20%

57
Liaquat Institute of Medical and Health Sciences, Thatta
 5 RESPIRATORY MODULE 1

Introduction
This exciting module will serve as building block and is very essential to your future work as doctors. This
module is designed to make your learning both interesting and productive by including several interactive
activities. An understanding of the structure of the chest wall and the diaphragm is essential if one has to
understand the normal movements of the chest wall. Contained within the protective thoracic cage are the
important life sustaining organs, such as lungs, Heart and the major blood vessels. Although the chest wall
is strong; blunt or penetrating wounds can injure the soft organs. Flail chest (stove-in chest) is an
extremely painful injury and impairs ventilation, thereby affecting oxygenation of the blood. This
module will explain the Patho-Physiology of all the related conditions.

Rationale
There is a high prevalence of respiratory diseases in our community which may leads to increased morbidity
and mortality. A practitioner can only be able to deal with the patients suffering from the respiratory diseases
when he/she has the basic concepts regarding the structural and functional knowledge of respiratory system.
Acute respiratory infections, like pneumonia are critical for children, older adults and people with immune
system disorders. For the management certain respiratory diseases, oxygen administration and artificial
ventilation are required, hence it is better to explain the students on these topics in earlier years. Smoking is
high risk factor for the development of COPD and lung cancer; therefore, its Patho-Physiology is important to
learn. Respiratory module is designed in such a way that a student can understand structure, functions,
pathogenesis, prescriptions including drug prescription and can educate the community regarding prevention
of diseases and promotion of health.

Duration
5 weeks

Learning Outcomes
Knowledge:
At the end of this module, the students will be able to:

• Describe the development and anomalies of the respiratory system.

• Define and identify the microscopic features of the respiratory system
• Describe the anatomy of the different parts of the respiratory system in detail
• Describe the functions of the respiratory system
• Interpret the Biochemical changes in the body related to the respiratory system
• Explain obstructive and restrictive pathologies involving respiratory system
• Describe the management of the respiratory diseases

Psychomotor Skills
• Microscopic identification of the different parts of the respiratory system.
• Perform the spirometry & plot a graph of lung volume
• Perform the cardiopulmonary resuscitation(CPR)
• Analysis of general properties of lipids

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Liaquat Institute of Medical and Health Sciences, Thatta
 • Application of pH meter
• Interpretation of ABGs, PFT
• Perform clinical examination of the respiratory system

Attitude

• Communicate effectively in a team with pears, staff and teachers

• Demonstrate professionalism and ethical values in dealing with patients, cadavers,
pears, staff and teachers.
• Communicate effectively in a team with pears and teachers.
• Demonstrate the ability to reflect on the performance.

Themes
Theme 1: The Chest / Thoracic wall and trauma
Theme 2: Airways and their conditions or diseases
Theme 3: Lung parenchyma & interstitium and the related diseases

TOPICS WITH SPECIFIC LEARNING OBJECTIVES AND TEACHING

STRATEGIES

Theme 1: The Chest/ Thoracic Wall and Trauma

TEACHING
S# LEARNING OBJECTIVES TOPIC Assessment
STRATEGY
Anatomy
• Define anatomical classification
of the respiratory system. RESP-S1-Ana-G-1
• Define structure of the thoracic General
cage & wall. introduction of the Interactive
1 SBAs & OSPE
• Define thoracic inlet & thoracic Respiratory system Lecture
outlet. and Anatomy of the
• Discuss thoracic outlet thorax
syndrome.
• Define general features of the
sternum.
• Define general features of the
RESP-S1-Ana-G-2
ribs.
Osteology of the
2 • Differentiate typical and atypical
Ribs and the
ribs.
Sternum
• Define costal cartilages.
SBAs, OSPE &
• Discuss attachment of various Demonstration
OSCE
muscles.
• Define general features of the
thoracic vertebra.
RESP-S1-Ana-G-3
• Differentiate typical and atypical
3 Osteology of the
thoracic vertebrae.
thoracic vertebrae
• Discuss joints of the thoracic
walls.

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Liaquat Institute of Medical and Health Sciences, Thatta
 • Define three morphological
layers of the muscles of the RESP-S1-Ana-G-4
thoracic wall. Muscles of the
4
• Define intercostal spaces. thoracic wall and
• Define endothoracic fascia. intercostal spaces
• Discuss suprapleural membrane.
• Define intraembryonic mesoderm
and its parts.
• Discuss divisions of lateral plate RESP-S1-Ana-E-1
mesoderm into visceral and Formation of the
parietal layers. intraembryonic
5
• Define extent of intraembryonic cavity , Serous
coelom and its divisions. membranes and
Interactive
• Discuss formation of the pleuro- thoracic cavity SBAs & OSPE
Lecture
pericardial and pleuro-peritoneal
membranes.
• Discuss steps of development of
diaphragm from its composite RESP-S1-Ana-E-2
6 embryonic derivatives. Development of the
• Discuss anomalies related with diaphragm
its development.
• Describe histological features of
different layers of Trachea.
• Identify tracheal epithelium and RESP-S1-Ana-H-1
other microscopic features of the
7 Histology of the Practical OSPE & OSCE
trachea with help of light Trachea
microscope.

Physiology
• Describe overview of respiration RESP-S1-Phy-1
• Describe parts and functions of Overview of
8 respiratory tract,
respiratory tract
• Define pulmonary ventilation functions
• Describe mechanics of RESP-S1-Phy-2
pulmonary ventilation and The mechanics of
muscles of respiration breathing
• Describe changes in the lung
volume, alveolar pressure,
9 pleural pressure &
Transpulmonary pressure & its
changes during respiration. Interactive
SBAs & OSPE
• Discuss alveolar ventilation & Lecture
dead space also describe cough
& sneezing reflexes
• Define lung compliance & list RESP-S1-Phy-3
factors affecting lung compliance Lung compliance &
• Describe composition & role of work of breathing
surfactant in maintaining the and surfactant
10 alveolar stability & infant
respiratory distress syndrome
• Differentiate compliance work,
tissue resistance work & airway
resistance work

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 • Define pulmonary volumes & RESP-S1-Phy-4
capacities with their normal Lung volumes &
values & significance in capacities
11
pulmonary function test.
• Discuss alveolar ventilation &
dead space
• Record effect of respiration
RESP-S1-Phy-5
during sitting & standing of young
Respiratory
adult on power lab & plot a graph.
adaptations during
12 • Record the effect of swallowing & Practical OSPE & OSCE
standing, sitting
deglutition on respiration in
and swallowing on
healthy adult on power lab & plot power lab
a graph
Biochemistry
RESP-S1-Bio-1
Concept of pH,
Concept of pH, Buffers & their
Buffers & their
13 mechanism of action, Types of
mechanism of
Buffers in humans
action, Types of
Buffers in humans
RESP-S1-Bio-2
• Describe the acid base balance.
Acid Base Balance/
• Explain the respiratory and Metabolic &
14 metabolic acidosis & alkalosis
Respiratory
with causes and compensatory Interactive
Acidosis & SBAs & OSPE
mechanisms. Lecture
Alkalosis
RESP-S1-Bio-3
Description & Biomedical Biomedical
15
significance of Compound Lipids significance of
Compound Lipids
RESP-S1-Bio-4
• Describe the Synthesis &
Synthesis of
Functions of Phospholipids.
16 Phospholipids &
• Discuss role of lecithin in
Role of Lecithin in
respiration Respiration
RESP-S1-Bio-5
Demonstrate the pH Meter, Introduction to pH
17 Practical OSPE & OSCE
Significance, interpretation Meter, Significance,
interpretation
Pathology
• Identify congenital anomalies of
lungs.
• Define acute lung injury RESP-S1-Patho-1
• Describe causes ARDS. Congenital
18 • Discuss characteristic features, anomalies, Practical OSPE & OSCE
morphology and pathogenesis of acute lung injury
ARDS. and ARDS
• Describe its consequences and
clinical course.
CLINICAL

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 • Define Chyne-stokes breathing
and effects on body.
• Define COPD and RLD.
• Differentiate between RLD &
RESP-S1-MED-1
COLD & effects on body
Obstructive and
(obstructive & restrictive lung Interactive
20 Restrictive Lung SBAs & OSPE
disease). Is COVID-19 RLD or Lecture
Diseases
COLD type of disease
• Define emphysema, chronic
bronchitis.
• Define Bronchiectasis.
• Define interstitial lung diseases

Theme 2: Airways and Their Conditions or Diseases

TEACHING
S# LEARNING OBJECTIVES TOPICS ASSESSMENT
STRATEGY
Anatomy
• Discuss attachments of the
diaphragm.
• Define blood and nerve supply of
the diaphragm. RESP-S1-Ana-G-5 SBAs, OSPE &
21 • Identify openings in the diaphragm The Diaphragm Demonstration
and its Openings OSCE
with levels.
• Define structures passing through
these openings.
• Define functions of the diaphragm.
• Describe mediastinum
• Describe boundaries and divisions RESP-S1-Ana-G-6
22
of mediastinum Mediastinum
Interactive
• Enumerate structures present in it SBAs & OSPE
Lecture
• Define anatomy of the trachea. RESP-S1-Ana-G-7
23 • Discuss clinical conditions related Anatomy of the
with trachea. trachea
• Define anatomy of the principal
RESP-S1-Ana-G-8
bronchi. SBAs, OSPE &
24 Anatomy of the Demonstration
• Discuss clinical conditions related OSCE
bronchi
with bronchi.
• Describe development of the RESP-S1-Ana-E-3
larynx, trachea and bronchi. Formation of the Interactive
25 SBAs & OSPE
• Discuss anomalies related with Larynx, Trachea Lecture
development of these structures. and Bronchi
• Describe microscopic features of
the bronchi. RESP-S1-Ana-H-2
• Differentiate primary bronchioles The Histology of
from the tertiary bronchioles. the Bronchi:
26 Practical OSPE & OSCE
• Identify general histological Primary and
features of bronchi and Tertiary
bronchioles with help of light Bronchioles
microscope.
Physiology
• Describe structure & functions of RESP-S1-Phy-6
Interactive
27 Respiratory membrane Diffusion of SBAs & OSPE
Lecture
Gasses

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 • Gasses exchange across the
respiratory membrane
• Factors affecting exchange
through membrane
• Describe transport of oxygen in the
RESP-S1-Phy-7
blood & discuss the oxygen Hb
28 Transport of
dissociation curve & factors
oxygen
affecting it
• Describe transport of CO2 in the
RESP-S1-Phy-8
29 blood & gasses exchange between
Transport of CO2
blood & body cells (chloride shift)
• Enlist respiratory centers
• Describe mechanisms of nervous RESP-S1-Phy-9
30 regulation of respiration Nervous regulation
• Describe reflexes involve in of respiration
nervous regulation
• Record effect of exercise on RESP-S1-Phy-10
respiration in healthy adult on Record the lung
power lab & plot a graph volumes and
31 Practical OSPE & OSCE
• Interpret Pulmonary Function capacities on
Tests power lab & plot a
graph
Biochemistry
RESP-S1-Bio-6
32 • Describe the Glycosis in detail.
Glycosis
RESP-S1-Bio-7 Interactive
SBAs & OSPE
• Describe role of TCA Cycle in Role of TCA Cycle Lecture
33
cellular respiration in cellular
respiration
• Demonstrate the Arterial blood RESP-S1-Bio-8
gases significance Arterial blood
34 Practical OSPE & OSCE
• Describe the ABG’s interpretation gases (ABGs)
with various respiratory disorders interpretation
Pathology
• Define chronic obstructive lung
disease (COPD) RESP-S1-Path-2
Chronic Interactive
35 • Classify the types of COPD SBAs & OSPE
obstructive lung Lecture
• Describe its pathogenesis &
diseases (COPD)
clinical features.
Pharmacology
• Classify drugs used to treat dry and
productive cough according to their RESP-S1-Pharm-
mechanism of action. 1
Interactive
36 • Describe adverse effects, The treatment of SBAs & OSPE
Lecture
contraindications and drug the dry and
interactions of the drugs used to productive cough
treat various types of cough.
Clinical
RESP-S1-MED-2
• Define hypoxia and its types.
Hypoxia
• Explain effects of the hypoxia.
Cyanosis Interactive
37 • Explain psychogenic dyspnea & SBAs & OSPE
CO2 poisoning Lecture
causes of psychogenic dyspnea
• Define cyanosis.

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 • Explain prevention strategies of
cyanosis.
• Enlist three principal reasons of
cyanosis.
• Define CO2 poisoning.
• Explain the effects of
CO2poisoning and preventing
measures of CO2.

Theme 3: Lung Parenchyma and Interstitial and their Conditions or

Diseases
TEACHING
S. # LEARNING OBJECTIVES TOPIC ASSESSMENT
STRATEGY
Anatomy
RESP-S1-Ana-G-9
Define structure and neve supply of
38 Anatomy of the
pleura
pleurae
RESP-S1-Ana-G-
• Describe gross anatomy of the 10
lungs. Anatomy of the
39
• Discuss the phases of the lungs
respiration Mechanism of the SBAs, OSPE &
Demonstration
respiration-1 OSCE
RESP-S1-Ana-G-
• Define bronchopulmonary 11Anatomy of the
segments. lungs
40 • Define types of the respiration. Mechanism of the
• Discuss clinical conditions related respiration-2
with lungs. (bronchopulmonary
segment)
RESP-S1-Ana-G-
• Define blood and nerve supply of
12
the lungs.
41 Anatomy of the
• Discuss clinical conditions related
lungs-3
with lungs. (Blood supply)
RESP-S1-Ana-G-
• Define clinical significance of chest 13
42
X-ray in respiratory diseases. Radiology: Basics
of chest X-ray Interactive
SBAs & OSPE
• Discuss formation of laryngo- Lecture
tracheal groove & respiratory
diverticulum or lung buds. RESP-S1-Ana-E-4
• Define anomalies related with Formation of the
43 development of the lung buds. lung buds
• Discuss stages of development / The maturation of
maturation of the lungs. the Lungs
• Discuss anomalies related with the
lung maturation
• Identify structure of the alveoli and
interalveolar septum under RESP-S1-Ana-H-3
44 microscope and correlate functions The Histology of Practical OSPE & OSCE
of different types of cells, forming the Lungs: Alveoli
the alveolar wall.

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 • Identify structure and function of
the blood air barrier.

Physiology
• Describe chemical control of
respiration RESP-S1-Phy-9
• Explain chemoreceptor involved in Chemical regulation
45 chemical respiration. of
• Describe regulation of respiration respirationRegulati
during exercise. on during exercise
• Explain Periodic breathing
• Describe pulmonary circulation &
blood flow through various zones of
lung (1, 2, 3).
• Explain pulmonary capillary RESP-S1-Phy-10
Interactive
dynamics. Pulmonary SBAs & OSPE
46 Lecture
• Explain mechanism of development Circulation & V/Q
of pulmonary edema, pleural relationships
effusion
• Ventilation perfusion ratio (V/Q
ratio)
• Define respiratory changes RESP-S1-Phy-11
47 associated with High altitude High altitude &
• Discuss hypoxia and its types. Hypoxia
RESP-S1-Phy-12
• Explain deep sea diving Physiology
48 Deep sea Diving
• Describe caisson’s disease
Physiology
Biochemistry
RESP-S1-Bio-9
Describe organization of the Electron Organization of
49
Transport Chain Electron Transport
Chain Interactive
SBAs & OSPE
RESP-S1-Bio-10 Lecture
Describe Oxidative phosphorylation & Oxidative
50
ATP Synthesis phosphorylation &
ATP Synthesis
RESP-S1-Bio-11
Role of
Demonstrate role of emulsification in
51 Emulsification in Practical OSPE & OSCE
respiration and digestion.
respiration and
digestion
Pathology
• Define pneumonia.
• Discussetiological classification of
pneumonia.
• Discuss its clinical presentation.
RESP-S1-Path-3 Interactive
52 • Describe diagnostic tools for Pneumonia Lecture
SBAs & OSPE
pneumonia.

Clinical

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Liaquat Institute of Medical and Health Sciences, Thatta
 • Define RDS.
• Describe sign and symptoms of the
RESP-S1-Med-3
respiratory distress syndrome. Interactive
53 Respiratory distress SBAs & OSPE
• Enlist the causes of the respiratory Lecture
syndrome
distress syndrome
• Discuss the management

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Liaquat Institute of Medical and Health Sciences, Thatta
 Blueprint of Assessment
Purpose of Assessment: Summative Assessment First Professional MBBS
Curriculum: Integrated Modular Curriculum
Module: Respiratory Module-1

S. Subject Week- Week- Week- Week- Week-5 Total Weightage Weightage Total
No 1 2 3 4 % after Number of
Rounding Questions
(100)
Gross Anatomy 03 02 02 02 09 17.3 17 17

Embryo 02 02 02 01 07 13.4 13 13
Histo 01 00 01 01 04 7.6 08 08
Physiology 04 04 03 02 13 24.07 24 24
Biochemistry 01 01 03 02 07 13.4 13 13
Pharmacology 00 00 01 00 02 3.8 04 04
Pathology 01 01 00 01 03 5.7 06 08
Parallel subjects 02 02 02 01 07 13.4 13 13
(CM, IT, BS, Res,
BME)
TOTAL ------- ------- ------- 52 100% 100
Subject in Proportion Weightage Test Instrument/tool/method Explanation
Module of
subjects
in module
What to assess? How to assess?
MCQs (SBAs) OSPE OSCE Any Proportion of test
Level 1 & 2 stations Level 3 Other instruments to be
Level 1 used:
&2 Theory
Gross Anatomy 17 17 01 MCQs (SBAs)=
Embryology 13 13 01 100 %;
Practical
Histology 08 08 01 OSPE=80%
OSCE= 20%
Physiology 24 24 03
Biochemistry 13 13 03 Competency level &
Learning Domain at
Pathology 04 04 01 Miller’s Pyramid:
Cognition:
Pharmacology 06 08 01
Know (Level-1)&
Parallel subjects 13 13 01 How to know (Level-
(CM, IT, BS, 2)
Res, BME) Skills & Attitude:
Show (Level-3) &
Does (Level-4)
100% 100% 80% 20%

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Liaquat Institute of Medical and Health Sciences, Thatta
 6 EXAMINATION ASSESSEMENT

ASSESSMENT PLAN FOR EACH PAPER END OF YEAR INTERNAL TOTAL %AGE
ASSESMENT EVALUATION
THEORY (SBAS) 80% 20% 100%
PRACTICAL EXAM (OSPE; OSPE) 80%

ALLOCATION OF INTERNAL ASSESSMENT MARKS

COMPONENT SCORING MATRIX PERCENTAGE
ATTENDANCE (>90%=03; 89- 3%
THEORY 80%=02; 79-70%=01;<70%=00
Module tests 3%
Block tests 4%
10%
ATTENDANCE (>90%=03; 89- 3%
80%=02; 79-70%=01;<70%=00
PRACTICAL Module tests including ethics, 3%
conduct, practicals, assignments)
Block tests 4%
10%
TOTAL 20%

7 LEARNING RESOURCES

Anatomy:
❖ GROSS ANATOMY
• Clinical Anatomy by Richard S. Snell
• K.L. Moore, Clinically Oriented Anatomy
• Neuro Anatomy by Richard Snell
❖ HISTOLOGY
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Liaquat Institute of Medical and Health Sciences, Thatta
 • B. Young J. W. Health Wheather’s Functional Histology
❖ EMBRYOLOGY
• Keith L. Moore. The Developing Human
• Langman’s Medical Embryology
Biochemistry:
❖ TEXTBOOKS
• Harper’s Illustrated Biochemistry
• Lehninger Principle of Biochemistry
• Biochemistry by Devlin
Community Medicine:
❖ TEXT BOOKS
• Community Medicine by Parikh
• Community Medicine by M Illyas
• Basic Statistics for the Health Sciences by Jan W Kuzma
Pathology / MicroBiology:
❖ TEXT BOOKS
• Robbins & Cotran, Pathologic Basis of Disease, 9th edition.
• Rapid Review Pathology, 4th edition by Edward F. Goljan MD
Pharmacology:
❖ TEXT BOOKS
• Lippincot Illustrated Pharmacology
• 2. Basic and Clinical Pharmacology by Katzung
Physiology:
❖ TEXTBOOKS
• Textbook of Medical Physiology by Guyton And Hall
• Ganong‘ S Review of Medical Physiology
• Human Physiology by Lauralee Sherwood
• Berne & Levy Physiology
• Best & Taylor Physiological Basis of Medical Practice
❖ REFERENCE BOOKS
• Guyton & Hall Physiological Review
• Essentials of Medical Physiology by Jaypee
• Textbook of Medical Physiology by InduKhurana
• Short Textbook of Physiology by Mrthur
• NMS PhysiologyMonoo’s Physiology

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