Paper-2 content

Paediatrics Paper-2:

Format of examination:

Total number of questions: 50

MCQ-25

SAB – 25 

PAPER-II PHYSIOLOGY, CLINICAL BIOCHEMISTRY AND CLINICAL PHARMACOLOGY Points to remember:

A. PHYSIOLOGY

1.Cell/membrane Physiology including molecular biology

Functions of each organelle including their relationship; Intercellular communication and receptor diseases.

• Recommended books: Guyton and Hall Textbook of Medical Physiology, Ganong's Review of Medical Physiology

2.Physiology of body fluid, electrolytes and there derangement:

Body fluid compartments and its relevance in clinical practice. —

Physiology of important solutes (sodium, potassium, chloride, phosphate, calcium) and impact of there derangement.

Buffering system including acidosis and alkalosis and their consequences.

Consequences of fluid, electrolytes and acid/base disturbances on different system.

• Recommended books: Guyton and Hall Textbook of Medical Physiology, Ganong’s Review of Medical Physiology,Samson Wright's Applied Physiology Nelson Textbook of Pediatrics and Forfar&Arneil’s Textbook of Pediatrics.

3.Physiology of Growth and Development :

Period of life including puberty, teratogenesis, sensitive period of foetal life, theory of growth and development, factors influencing growth/development, concept of growth curve, measuring growth, fetal circulation and changes at birth, placental function, physiological derangements in specific growth and developmental - disorders, multiple pregnancy and development of general body features and its proportion.

• Recommended books: Nelson’s Textbook of Pediatrics and Furcarbanil’s Textbook of Pediatrics.

Applied Physiology:

1.Physiological processes and their clinical application:

O Respiratory system respiration including its regulation, surfactant, respiratory membrane, types of respiration, production of breath sound and their variants, lung function test and its interpretation in different situations, cough, acid-base balance and

respiratory system, principles of oxygen therapy, the pathophysiology of hypoxia and respiratory failure.

2.Gastrointestinal system - physiology and disorder of gut motility, mucosal protection of stomach, digestion and absorption of different food components, liver function, bile production and metabolism, jaundice, liver function test and there interpretation in different situation, pancreatic function, gut hormones, mechanism of abdominal] pain.

3.Nutrition - micro and macronutrients-definition, function, deficiency, physiologica] derangement in malnutrition of different nutrient, measuring nutrition, dietetics

4.Cardiovascular system - properties af cardiac muscle, cardiac cycle, conduction pathways, ECG, blood pressure, pulse, cardiac arrhythmia, hemodynamics and correlation with Doppler/ECHO, peripheral circulation, circulation of brain, kidney, liver, lungs and GI tract, pathophysiology of heart failure, oedema, shock and dyspnoea. Common congenital heart diseases and their hemodynamics.

5.Hemopoietic system - constituents of blood and there importance, hemoglobin formation and metabolism, hemopoiesis, factors controlling hemopoiesis, iron kinetics, pathophysiology of anemia, hemolytic disorder, bleeding disorder and coagulation disorders. Blood grouping, blood group incompatibility

6.Renal System - glomerular and tubular functions, water-electrolyte balance, formation of urine, micturition and its control mechanism.Mechanism of acid base balance.

7.Musculoskeletal system - muscle contraction, physiology of bone formation, factor influencing it and its disorder. Common musculoskeletal disorders.

8.Endocrinology - physiological role, control of secretion, metabolism, feature of hypo and hyper function, test for functioning status of - thyroid gland, pituitary gland, adrenal gland, parathyroid gland, pancreas and gonads. Also includes physiology of pregnancy, parturition, breast milk and breastfeeding, diabetes mellitus and puberty.Hormonal influence on growth and development.

9.Neurophysiology - Physiology of speech, disorders of speech - mechanism, tests. Physiology of smell and tests of smell function. Physiology of vision-visual path, light and accommodation reflex, visual field, color vision, and tests for above functions and their interpretation. Hearing and equilibrium-tests and interpretation of their functions.

Physiology of taste and the tests for taste:

Motor neuron-upper and lower, physiology of deep tendon reflexes, superficial reflexes, primitive reflexes and withdrawal reflexes. Features of upper and lower motor neuron lesion.

Superficial and deep pain, visceral sensations, referred pain, tactile localization, two point discrimination, steriognosis. Pathway of different sensation.

Functions of basal ganglia and cerebellum - posture, balance and muscle tone, physiologic

principle of coordination, ataxia. Hypothalamus - secretion, functions and there control, physiology of hunger, thirst, body

temperature. Physiological basis of tests to measure the different functions.

CSF - production, control, function, circulation and physiological consequences of abnormalities.Physiological basis of EEG.

• Recommended books: Nelson Textbook of Pediatrics and Forfar&Arneil’s Textbook of Pediatrics.

Physiology of imaging:

 Principles of X-ray, CT, MRI, PET, USG, ECHO, Doppler, Isotope and other scanning of thyroid, kidney, liver, brain, bone, etc. Recommended books: Relevant section in the introductory chapters in different systems in Nelson’s Textbook of Pediatrics and Forfar & Arneil’s Textbook of Pediatrics.

B. CLINICAL BIOCHEMISTRY

Physiologic and clinical significance of important steps and regulation of glycolysis, citric acid cycle, gluconeogenesis, glycogenesis,glycogenolysis and HMP shunt.

Physiologic and clinical significance of important steps and regulation of lipogenesis, lipolysis, ketogenesis, cholesterol biosynthesis.

Physiologic and clinical significance of important steps and metabolism of phenylalanine, tyrosine, methionine, tryptophan.

Folic acid and vit B 12 Purine metabolism and formation of uric acid Glycoproteins proteoglycan and mucopolysaccharidoses.

Metabolism - Basal metabolic rate and factor influencing it.

Collagen - types and principles of synthesis Principles of commonly used biochemical tests and factors (both physiological and procedural) that may affect the test.

• Recommended books: Harper’s Illustrated Biochemistry and relevant section in the introductory chapters on different system in Nelson Textbook of Pediatrics and

Forfar&Arneil’s Textbook of Pediatrics.

C. CLINICAL PHARMACOLOGY

Basic pharmacology: Drug absorption, distribution, elimination, mechanism of drug action, half life, peak and trough level, dose-response relation, principle of therapeutics.

Pharmacology of some commonly used drugs : Pharmacological effects, classifications, mechanism of actions, side effects and drug interaction of the following drugs analgesics/antipyretic, antimicrobials, antitubercular and antihelminthic, anti-cholinergic, sympathomimetic, drugs used in peptic ulcer, diuretics, antihistamines, bronchodilators, laxatives, vitamins and minerals, hormones, hypoglycemic agents, anticonvulsant "

• Recommended books: Basic and Clinical Pharmacology by BG Katzung