ISSH-Guide Medical Sciences

8/14/2019 ISSH-Guide Medical Sciences

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Al-Azhar Medical Students' AssociationStanding Committee On Medical Education

Influence of Studying on Students' HealthGuide

Medical Sciences

:Introduction

Medicine is one of the most important fields which is essential forsurvival of Mankind, so to be able to break it's code you need tounderstand & study medical sciences .

:Classification1-Basic : It's included basic medical sciences e.g Anatomy ,Pharmacology , Biochemistry .2-Clinical : It's included sciences which concerned of practicalaspect of medicine e.g Ophthalmology, Internal Medicine ,Surgery.Now let's start with brief introduction about them

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Basic Sciences-1

Anatomy & EmbryologyPhysiology

BiochemistryHistologyPathology

Pharmacology

Microbiology & ImmunityParasitology


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Embryology&Anatomy:Definition

Anatomy: It's the scientific study of morphology of human bodyand it's internal structures .Embryology: It's the scientific study developmental changes of anfertilized ovum cell and it's differentiation into tissue and organs .

:General CurriculumIt's classified according to regional groups to:

1-Head & Neck: includes everything in Head and Neck tothoracic inlet .

2-Upper limb " Arm "3-Thorax " Chest "

4-Abdomen .5-Pelvis and Perineum .6-Lower limb " Thigh , leg and foot "7- Neuro Anatomy: studying brain , spinal cord and nerves

morphology .* Embryology is divided to :-General : which tell you how embryo is formed from one cell .-Special : which tell you how different body system and organ are

formed .

:Embryology&Importance of Study AnatomyAnatomy & Embryology is one of the basic knowledge instudying medicine, it's A B C of medical student to be aware ofstructures of human body .

?How can you study it1- Terminology : there are some latin and English terms whichmay describe shape or site try to know it's meaning in Arabic .2-Bones: start studying with know names of each part as it'smajor part of many branches .

3- Colored diagrams : draw diagrams with your hand to organ,bone e.g will help you to imagine the structures as you see withyour nacked eye also colored atlas will help you to understandmany topics like arteries and nerves.4 - Animations : try to use new technology to understand whatyou study .. in Anatomy and specially embryology animationsare great helpers to give you real picture about what you can'tsee.


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Physiology:Definition

It's the science of mechanical , physical and biochemical functionsof human in good health ,their organs and the cells of which theyare composed .It's helped you to know the mechanism " the way " of doingfunction of each system.

:General CurriculumIt's classified according to body systems to:1-Cell, Nerve and Muscle .2-Autonmic Nerves System .3-Blood and Body Fluids .

4-Metabolism .5-Centeral Nervous System .6-Respiration.7-Circulation .8-Kideny and Electrolytes .9-Gastrointestinal Tract.10-Special Senses.11-Endocrine .12-Reproduction.

:Importance of Studying PhysiologyPhysiology is one of the most important basic science of medicine

because it's provided you with knowledge about mechanism ofeach biological processes either at cell level or organ level ,and how each system works individually and integrate withother, so if any error happens you can easily identify it, " in orderto know abnormal u should know normal " .

?How can you study it

1-Defintions : you have to study defintions very well as in manytopics it's the key to understand it .2-Diagrames and Animations : they can help you to visualize thewhole biological process at cell level or system level .3-Equations : try to follow up the process as story or equation byidentify the causes then the results and factors may be increased ordecreased the end result .4-The Body is not isolated systems : put in your mind that allsystems influence each other and integrate , so try to know affects


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of the biological processes on other systems , that will help you alot to connect between information and other .

Biochemistry:DefinitionBiochemistry is the application of chemistry to the study of

biological processes at the cellular and molecular level.:General Curriculum

The curriculum can be broken down into :1-Carbohudrates .2-Lipids.3-Proteins.4-enzyemes.5-Chemistry of nucleotides and nucleic acids.6-Vitaminns .7-Physical and organic chemistry .

a-Waterb-Acids and Basis.c-Buffers .d-Indicators .

e-Osmosis and Osmotic Pressure.f-Types and functions of functional groups.

:BiochemistrydyingImportance of stu Biochemistry is both a life science and a chemical science -

it explores the chemistry of living organisms and themolecular basis for the changes occurring in living cells. Ituses the methods of chemistry, physics, molecular biologyand immunology to study the structure and behaviour of

the complex molecules found in biological material and theways these molecules interact to form cells, tissues andwhole organisms.

Biochemists are interested, for example, in mechanisms ofbrain function, cellular multiplication and differentiation,communication within and between cells and organs, andthe chemical bases of inheritance and disease. The

biochemist seeks to determine how specific molecules such

as proteins, nucleic acids, lipids, vitamins and hormones


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function in such processes. Particular emphasis is placed onregulation of chemical reactions in living cells.

Biochemical techniques are used in clinical diagnosis ofinfectious diseases, genetic disorders, and cancer; as well as

in many forms of research to improve the quality of ourlives.

*Biochemistry has become the foundation for understandingall biological process , It has explanations for causes of manydiseases in human, animal and plants.. so you should beoriented with it very well.

How can you study it ?

1- In each chapter you have to know : Definition, Importance,Physical and Chemical Properties, Classification and finallyFormed Compounds .

2- Formula and Diagrams : will help you to understand so studyit very well .

3- From time to time try to review what you study and practiceby answering MCQ and evaluate yourself .

4- Choose easy source will help you a lot specially if the author

depended on formula and equation in his explanation.

Histology:Definition

It's the microscopic study of intact living human tissues and cells .:General Curriculum

The curriculum can be broken into :1-Introduction : Microscopes , Micro-Techniques & Stains .

2-Cytology : Cell membrane , Cytoplasm , Cell organelles &Nucleus .3-Cytogenetics: Cell cycles ( Meiosis-Mitosis ), HumanChromosomes & Chromosomal Aberrations .4-Epithelial Tissue : Simple , Stratified , Glandular , Neuro , Myoepithelium & polarity , Specialization of epithelium .5-Connective Tissue : Proper Connective tissue , Cartilage & bone .6-Blood : Red blood corpuscles , White blood cells , Blood platelets

& Haemopoesis .7-Muscular Tissue : Skeletal , Cardiac & Smooth .


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8-Nervous Tissue : Neurons , Neuroglia , Nerve Ending &Peripheral nervous system .9-Circulatory System : Blood vessels .10-Lymphatic System : Lymph vessel , Lymphatic tissue, Immune

system & Macrophages .11-Skin .

:Importance of studing Histotogy Histological studies let us to know normal number ,size

,shape ,arrangement and even component of cells in everyorgan of our body SO it will be very helpful in diagnosis andtreatment of any disease .

Histological studies help us in detection of tissue

abnormalities and the treatment for the diseases causing theabnormalities .

In the modern histology , lab immunological and molecular(DNA) techniques are frequently utilized to provide accuratetumor identification which will aid the clinician in selecting amode of therapy that offers that greatest probability of cure.

During your study of Histology you will be able to perform acomplete blood picture report and to diagnose any changes

occurred to this report (such as Anemia ,leukemia ,) . Studying of Histology will greatly help you in studying of

other academic and clinical subjects .?How can you study it

1-Don't try to copy histology in your brain but try to understandevery slide also understanding the different stains will help you .2-Study a lot and put your own scheme that will help you toorganize all the sections .3-Use diagrams , animations & colored atlas to imagine the real

picture.4- Answer MCQ and always evaluate your self and review thesubject from time to time will help you in the exams .

Pharmacology:Definition

Pharmacology is the study of interactions that occur between

living tissues and exogenous chemicals that alert normalbiochemical functions .


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You can consider it as the study of drug action .:General Curriculum

Drugs are classified into pharmacological groups according tosystemic effect to :

1- Autonomic Nervous System Drugs .2-Autacoids : they are active substances in body of unknown exactfunction but has therapeutic effect .3- Central Nervous System Drugs.4- Anesthesia : group of drugs affect nerves system to initiate lossof sensation , motor activity and consciousness for limited period .5- Diuretic Drugs : group of drugs affect renal system to increasevolume of urine by increasing water and solute excretion .

6- Cardio Vascular System Drugs .

7-Respiration System Drugs .8- GastroIntestinal Tract Drugs .

9- Hormones .10-Blood .11- Chemotherapy .12- Vitamins .

:Importance of studying PharmacologyStudying pharmacology for medical student is essential cause you

need to understand the mechanism of action of differentsubstances on tissues, it's effect either positive or negative ontissues, and how you can use it in treatment of diseases .

?How can you study it1- Before you study any drug , they are some definitions youshould know and cover during your study :- Drug : It's a chemical substance , when absorbed into the body ofliving organism alerts normal body function .- Kinetics of drug : It's effect of body on drug " A D M E "

* A = Absorption : transform of drugs from their administrationto the systemic circulation .

* D = D : how drug spread in body and site of storage .* M = Metabolism : chemical transformation of drugs to active ,

non-ionized and lipid soluble substance " Metabolite " so it'll beeasily excreted .

* E = Excretion : route which body gets rid of drugs .- Dynamics of drugs : It's effect of drug on body " Mechanism &

Action "* Mechanism : the way drug do it's effect .


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* Action of drugs : effect of drug either on it's target system orother system .- Therapeutics of drugs : usage of drug in medical treatment " uses& dosage "

- Side effect and toxicity : unwanted effect of drug which may betoxic to some tissues & system .- Contraindications : states which drug which a drug shouldn't betaken .- Interaction of drugs : effect of some drugs on each other .2- try to draw diagrams and equations to understand mechanismof action and factors may increase or decrease this action .3- Tables to differentiate between similar drugs will help you .

4- Try not to keep the commercial name of drug but keep thepharmacological name of the group and scientific name of drugcause commercial names always change from company to other .5- Connect between the different systems and effect of a drug onother system even it's not the specific target .

Pathology:Definition

Pathology literally means the study (logos) of suffering

(pathos).This science is the bridging discipline between the basicsciences and the clinical practice,It's the study and diagnosis of diseases through examination oftissues, organs & body fluids, beside the scientific study ofdiseases processes .

:General CurriculumIt's classified into:1- General Pathology : It's also called investigative pathology

which seeks understand the mechanisms of injury to cells &tissues , as well as the body's means of responding to andrepairing injury.

Main topics in General pathology are:

-Cellular adaptation, Cell injury, and Cell death: These topicsdescribes how the cell is affected by the injurious agent that causesthe disease-Inflammation: this is the response of the body to the injuriousagent mainly by the immune system.

-Tissue renewal and repair: Regeneration Healing, and Fibrosiswhich may occurs after the pathological processes.


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Infections: by the various agents studied in microbiology and theresponses to the infectious agents.Neoplasia: This is the study of tumorsOther topics: as immunity diseases and genetic diseases.

2-Systemic Pathology : Concerned with specific response ofspecialized organs and tissues to a more or less well definedstimuli. Main topics in Special pathology:Cardiovascular systemRespiratory systemGastrointestinal systemGenitourinary and renal systemNervous systemEndocrinal systemBlood vessels and heamatological systemSoft tissues: as skin and breastHard tissue: the bone

:How you can study it

1-The pathology course starts with the general pathology which

gives an introduction about the basics of the science that is sharedfor all different systems in the body and it gives a place for someterminology.Next Special pathology takes place, it is studied systematicallytaking a closer look at every system in the body and what are themain diseases that affect it primarily.2- The visual experience about the altered structure is importantand interesting in the same time on the naked eye level which can

be supplied by images or some jars that contains the diseasedorgan, as well as how the histological pattern is changed under themicroscope this can be provided by the microscopic slides orimages as well can be useful.3- Each disease that affects any system should be discussed fromfour aspects,1) Etiology, or (the cause) the major causes of disease are:-Traumatic: Physical and mechanical forces causes a damage to thetissues as the car accident for example.


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-Inflammatory: as above the inflammation is the reaction of thebody to some factors, these factors can be the famous infectiousagents but also can be because of chemicals or some other factors.-Neoplastic: tumors may arise at any site of the body such as brain

tumors, tumors of the breast and many others-Degenerative: These diseases are characterized by progressivedestruction of the tissue over time a famous example is Alzheimerdisease.-Metabolic or toxic: These factors are disturbed chemicalmetabolism inside the body another famous example is Diabetesmellitus. Many causes can do the disturbance in metabolismincluding the toxic agents as Lead poisoning.

2) Pathogenesis or the mechanism by which the disease occurs.3)Morphology, how the diseased organ, tissue and cells lookThis will be the core of the practical part of the course:

how the organs look at the naked eye level:Gross)ae tissue looks under the microscopehow th:Microscopic)b

4) Clinicopathologic correlation, the correlation ofmorphology and laboratory data with clinical features of disease

Microbiology:Definition

Medical Microbiology is t he study of the role of microbes in humanillness , include the study of microbial pathogenesis, epidemiology and

it's relation to pathology and immunology .

:Importance of studying microbiology

It's one of the most widely studied and followed branch due to its great

importance to medicine. Along with providing a deep knowledge andunderstanding of the nature of pathogens , this line of study has also been

applied in several immunological innovations in the field of medical

science . Through development of vaccines against invading deadly

diseases, some of them have been eradicated or become more treatable

due to efforts exerted in Microbiology .

:General CurriculumMicrobiology is divided into four branches :

Bacteriology Virology Mycology Immunology

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BacteriologyMedicalIt's the medical study of pathogen and non pathogen bacteria .There are a lot of classification for bacteria one of them :1- coccus bacteria : rounded shape bacteria , according to stain

they are :- Gram Positive cocci : Staphylococci & Streptococci .- Gram Negative cocci : Neisseriae .

2- Bacillus bacteria : rod shaped bacteria , according to stain theyare :

- Gram Positive bacilli : Corynebacteria " Diphtheriae &Diphtheroids " , Bacillus " Antheracis & Cereus "

Clostridium " Tetani ,Perfringens & Difficile " .

- Gram Negative bacilli : Escherichea Coli , Klebsiella ,Citrobacter

Salmonella , Shigella , ProteusPseudomonas , Vibrios , Yersinia .

3- Coccobacillus bacteria : they are ,- Gram Negative : Haemophilus " Influenzae , Aegytius , Ducreyi

"

Bordetella .Brucella .

4- Mycobacteria : It's type of bacteria resist Gram stain and needspecial stain .5-Mycoplasms , Legionellae .6- Spirochaetes : spiral shaped bacteria , they are,

Terponema .Borrelia .Leptospira .

7- Rickettsiae .8- Chlamydiae .9- Actinomyces and Nocardia .

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Medical MycologyIt's the medical study of pathogenic fungiIt's classified according to morphology into :

1- Yeast fungi : Cryptococcus Neoformans .2- Yeast like fungi : Candida Albicans.


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3- Filmentous fungi : Dermatophytes , Aspergillus .4- Dimorphi : Histoplasma Capsulatum .

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Medical VirologyIt's the medical study of pathogenic viruses .It's classified according to nucleic acid into :1- DNA Viruses: They are group of viruses have DNA , they are,

-Herpesvirdiae : Herpes Simplex " Type I & Type II ".Herpes Zoster " Varicella Zoster ".Cytomegalovirus .Epstein-Barr Virus .Human Herpes Virus 6 , 7 & 8 .

-Papovaviridae : Human Papilloma Virus .Polyomavirus.Parvoviridae .Poxvirdiae " Variola , Vaccinia ".

-Hepatitis Viruses : Hepatitis A Virus .Hepatitis B Virus .Hepatitis C Virus .Hepatitis D Virus .

Hepatitis E Virus .Hepatitis GB Virus .- Adenovirdiae .

2- RNA Viruses: They are group of viruses have RNA, they are,- Arbo Viruses: Togaviradiae .

Flaviviradiae .Bunyaviradiae .Reoviradiae .

- Picornaviridae : Enterovirus .

Rhinovirus .Hepatovirus .Aphthovirus .

Cardiovirus .- Rhabdoviridae .- Orthomyxovirdiae " Influenza virus " .- Paramyxoviridae : Paramyxovirus .

Rubulavirus .

Morbillivirus .Pneumovirus .


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- Retroviridea : BLV-HTLV retrovirus " HTLV-1 & HTLV-2 "Lentiviruses " HIV-1 & HIV-2 "

- Coronaviridae : Corona virus .Torovirus .

SARS virus .- Filoviridae .- Arenavridae .- Reoviridae .

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ImmunologyIt's the study of all aspects of immune system .It deals with, among other things, the physiological functioning

of the immune system in states of both health and disease;malfunctions of the immune system in immunological disorders(autoimmune diseases, hypersensitivities, immune deficiency,transplant rejection); the physical, chemical and physiologicalcharacteristics of the components of the immune system in vitro, insitu, and in vivo.It's divided into :

1- Normal Immune Response : Innate immunity .Specific immunity .

Component .2- Abnormal Immune Response : Autoimmunity .

Tumor immunity .Immunodeficiency .Hypersensitivity .

How can you study microbiology ?1- In bacteria & fungi you need to cover :

- Morphology : it's shape,stain,size , arrangement , motility ,spore , capsule.

-Culture, Chemical Reaction & antimicrobial drug sensitivity :specific media which bacteria need to grow over ,shape offormed colonies , biochemical reaction with specificsubstance , it's sensitivity to antimicrobial agentsand resistant to others .

- Antigenic structure, pathogenicity & virulence factors .- Diseases caused by it .- Laboratory diagnosis : Specimens , Direct Smear with stain by

Gram , Culture and antibiotic susceptibility & Phagetyping for epidemiological purpose .


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- Treatment of disease .2- In virus , you need to cover :- Type of virus either DNA or RNA .- Pathogenesis & Clinical manifestation .

- Laboratory diagnosis .- Prophylaxis by vaccine if it available .- Treatment by Antiviral agent .

3- In immunity :- you must connect different events of immune response

together and make a general knowledge about what happen inour body in order to face an antigen .

- search for colored diagrams and animations about what happen

in the immune responses ,this will help you in understandingthe mechanisms of immune responses .- understanding the mechanism of immune responses is the base

to understand immunology and even microbiology .- never try to copy this branch inside your memory ,if you do

this you will forget it in no time .

Parasitology:Definition

It's the study of organisms that cause or transfer diseases to human .:General Curriculum

Parasitology includes :1- Helmenthology :" worms " includes,

- Tape worms .- Segmented worms .

- Rounded worms .2- Entomolgy : insects .3- Protozoology : protozo means one cell organism .

:Importance of studying parasitologyIt's important for medical student to be oriented with pathologicaleffect of parasite ,diseases which cause by it , treatment and how toprotect others from infection " Protection is better than Cure " .

?w can you study itHo1- In worms, Insects & Protozoa, you need to cover :

- Route of infection .


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- Habitate : site where worm lives .- Definitive host : the organism which has the pathologicaleffect of the worm " target of worm to affect ".

- Intermediate host : organism could be a part of worm life

cycle but it doesn't make disease in him .- Life Cycle .- Pathology and diseases caused by it .- How to diagnose infection .- How to treat it .- Prevention and control in case of epidemic diseases .

2- After studying of each group or family do a table or digram and listthe basic information you need to cover and compare between them .

3- At the end of each part of the three parts make a conclusion e.g what

can infect you through eating meet or fish , it's common question you

may be asked .

4- Don't worry from all that drawing because you don't have to know

most oh them, all you have to know is infective stage , diagnostic stage &

practical slides .

Clinical Sciences-2

Ophthalmology

Forensic & ToxicologyCommunity MedicineEar , Nose & ThroatInternal Medicine

PediatricsSurgery

Gynecology & Obstetrics

Ophthalmology

:DefinitionOphthalmology is the branch of medicine which deals with thediseases and surgery of the visual pathways, including the eye,

brain, and areas surrounding the eye, such as the lacrimal systemand eyelids.Simply it is the anatomy, functions, pathology, and treatment of

the eye.


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:General CurriculumOphthalmology theoretical curriculum is based on diseases ofdifferent anatomical parts of the eye, so anatomy including bloodand nerve supply of different parts of the eye should be knownwell which facilitate studying different diseases of that part withclear understanding of pathogenesis and regimen of treatmentincluding understanding principles.

It should cover diseases of:1- Eye lids.2- Lacrimal apparatus .3- The conjunctiva.4- The cornea.

5- The sclera.6- The uveal tract and pupil.7- The crystalline lens.8- The vitreous body.9- The retina .10- The optic nerve.11- The visual pathways (neuroophthalmology).12-Orbital cavity.13- Glaucoma .14- Optics and refractive errors.15- Ocular motility and strabismus.16- Ocular Injuries.Ophthalmology clinical curriculum includes:History taking (current history, past history, family history,

medical history) .Examination includes: visual acuity, ocular motility,

examination of different anatomical parts, intraocular

pressure, visual field and colored vision.

:Importance of studying ophthalmologyAlthough Ophthalmology is considered sophisticated to

some degree specially to undergraduate students, but you shouldknow principles of how to diagnose simple eye diseases and eyeemergencies with special concern to causes of red and painful eye.

?How you can study it

1-Your knowledge about each disease should be fulfilled :


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1-Definition.2- Etiology & pathophysiology.3-Diagnosis:

In order to diagnose any disease u should:

1. Take proper history knowing patient complain e.g. blurred vision and ask the patient if there is anyother complain.

2. Clinical picture:It includes : Symptoms (subjective, felt by patient, and not

measured) as diplopia, pain, photophopia,etc

Signs (Objective, indicates clinical fact, andnotice by the ophthalmologist during eyeexamination) as conjunctival papillae intrachoma, Keratic precipitates (KPs) withiridocyclitis, etc

3. Investigations:Which are a kind of medical procedure performedto detect, diagnose, or evaluate disease, diseaseprocesses, susceptibility, and determine a course of

treatment, usually utilizing technological methodsas autorefractometer to measure errors of refraction,regurgitation test in epiphora, visual evokedresponse, etc

4. Differential diagnosis: is a systematic method usedto identify unknownsCareful differential diagnosis involves first makinga list ofpossible diagnoses using data obtained fromhistoryand clinical picture, and then attempting toremovediagnoses from the list until at most onediagnosisremains.

4-Teatment: follows proper diagnosis , It includes both medicaland surgical treatment :

-Medical treatment includes drugs (you should know names ofdrugs, its action, main side effects and route of intake) and alsoincludes visual aids as spectacles, contact lenses, etc

-Surgical intervention which resemble corner stone in treatmentat Ophthalmology and indicated for many diseases as in cataract,


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glaucoma, strabismus, etc including also operations to correcterrors of refraction as LASIK.

Your knowledge should cover indication, principles, procedureand complications of every operation.

2- As ophthalmology deals with tiny and complicated structuresyou should know clearly the anatomy using diagrams speciallythose with 3D features in order to be easy to imagine pathologyalso using colored atlas of diseases will help, on other handwatching movies for operations and attending live operations willhelp you to understand them also recurrent visiting of outpatientclinic would be of great help to identify and observe major signs.

edicineMForensic:Definition

The medical study that deals with the application of medicalknowledge to legal problems and legal proceedings. Also calledlegal medicine

Eg. Post-mortem of the body by the forensic medicine department

is used as a testimony to decide the possible cause of death.:Usage of Forensic Medicine&Importance

The branch of medicine concerned with the resolution of legalissues by the application of scientific medical knowledge. Theissues may be of criminal or civil nature.The development of forensic medicine began in Europe in theearly nineteenth century. Although forensic medicine has its

basis in the specialty of pathology, physicians in other specialties,

such as psychiatry, orthopedics, cardiology, and neurology aswell as specialists in other disciplines, may be called on to resolvelegal questions posed by judges, attorneys, investigators, andhearing boards.It's used in :

1- In death investigations, a number of forensic specialists maywork together. A forensic odontologist may be called in to identifythe deceased person through dental examination, or the

perpetrator of bite marks left on the deceased's body. A forensicanthropologist may be needed to identify skeletal remains; a


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forensic toxicologist for the identification of poisons or drugs; anda criminalist for investigation at the scene and collection ofevidence, or for study of trace evidence such as blood stains, hair,paints, and seminal fluid. In cases of equivocal suicides, forensic

psychiatrists and psychologists may be called in. Recently thebiomechanical engineer has been added to the roster of forensicspecialists, to test and study injury patterns to determine how theinjury came about. The forensic medical specialist may express anopinion in writing or may be required to testify in person in thecourtroom. As with all legal proceedings, the physician witnessmust be cognizant of issues such as the degree of proof, the chainof custody of specimens or evidence, competency of the witness,

and court procedures.

2- An important development in forensic medicine is geneticanalysis. Every individual has a unique genetic contentdetermined by deoxyribonucleic acid (DNA) sequences. The DNApresent in forensic samples such as hair, bloodstains, and seminalfluid can identify a suspect. One analysis technique is called DNAfingerprinting; it can be used to compare the DNA sequence of asuspect or a defendant with material evidence at the crime scene..

Paternity exclusion by ABO blood typing has been replaced byDNA fingerprinting.

General Curriculum :

Forensic medicine is a very interesting science and its curriculumbased on two major aspects identification and examinationIdentification

- Identification of bones

Include Human or not

One person or more

Sex

Age- Identification of deadInclude

age

sex clothes


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features

race

tattoo marks- Idenyification of the living

Include anthropometry

finger printsExamination

- Bloodstains- mechanical injuries- fire arm injuries- Burns

-

mechanical asphyxiation- Sexual offences- Infanticide and child abuse-

ToxicologyDefinition:

It's the study of the toxic or harmful effects of chemicals. It isconcerned with how toxins act, when their harmful effects occur,and what the symptoms and treatments are for poisoning.

:General CurriculumMost of topics are classified as follow:

- Condition of poisoning ( suicidal, homicidal or accidental )- Fatal dose- Mechanism of action:

-Local- Systemic

- Clinical picture:

- Local- Systemic

- Causes of death- Treatment:

- First aid- In hospital

- Investigation:- Routine investigation- Toxicologic investigation

How can you study it ?


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The most problem that face students in their study that theybecome confused by these huge amount of symptoms for eachtoxin.

The best method to simplify their studying is

a) To mark each toxin with the most important & characteristicsymptom for it. Such as follow:

SymptomToxin

Burns around mouth, lips,nose

Acids (nitric, hydrochloric,sulphuric)

Severe, unexplained diarrheaArsenic (metals, mercury,

copper, etc.)

Pupil of eye dilatedAtropine (Belladonna),Scopolamine

Burns around mouth, lips,nose

Bases (lye, potash, hydroxides)

Odor of disinfectantCarbolic acid (or other phenol)

Skin is bright cherry redCarbon monoxide

Quick death, red skin, odor of

peach

Cyanide

Vomiting, abdominal painFood poisoning

Diarrhea, vomiting,abdominal pain

Metallic compounds

ConvulsionNicotine

Pupil of eye contractedOpiates

Odor of garlicOxalic acid (phosphorous)

Convulsion, dark face andneck

Strychnine

b) Not keep investigation but try to find it from clinicalpicture .

Community Medicine:Definition

Community medicine is the branch of medicine that is concerned

with public health services , emphasizing preventive medicine andepidemiology for members of a given community or region, and it


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also deals with assessing and evaluating needs and trends ofdisease and health care to specific groups or communitypopulations.

:Importance of studying community medicine

Community medicine is an interesting branch of medicinethat deals with nearly all aspects of medicine (curative,preventive & public health etc), so studying of it preparesu to face properly your future life as a doctor.

Community medicine is most important applicable branch ofmedicine as it deals not only with disease after itsdevelopment but also deals with healthy population ,specially high risk groups to prevent development of diseasefrom the start.

Each part of community medicine can be considered aseparate science itself & has its own importance &applications ,e.g. : application of different types ofepidemiological studies is the corner stone in medicalresearches to interpret way to prevent disease , definingpopulations at risk of developing any health problems facingthe community.

Other part of community medicine prepare the medical

student to understand people & deal with them as humanbeings not only as diseased bodies or specimen throughstudying communication skills & knowing rules of patientdoctor relationship. And also teach u how to manage andlead teamwork and how to be part of it too throughunderstanding meaning of words as system, program &projectetc. It also teach you steps of project management &other management and leadership skills which may help youin your career as a part of the health care delivery system.

Community medicine is concerned with study of naturalhistory of different disease and health problems, so healthcare providers can develop measures interfering withdisease development in its different stages and break thechain of infection or other types of health problems. And thathelps in treatment of cases, prevention of its progression andspreadetc.


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Community medicine Curriculum:

The curriculum may slightly differ from college to another but thebasic concepts have to be studied & they include 3 main parts:

Introduction to community medicine including these topics:-basic definitions of community medicine & how to accessvarious parts of ite.g.: levels of prevention of a health problem in a riskgroup divided into:1. Primary prevention in which you should knowmeasures of health education, health promotion andspecific protection from this problem (i.e.: facing theproblem before its development)2. Secondary prevention in which you should know themeasures applied when the health problem already

established itself in the community that includesscreening & detecting activities by which we discoverundiagnosed affected individuals ,prevent progression orspread of the problem ,cure patients ,studying pre andpost pathology periods and prevent prolonged disabilitycaused by this problem.3.Tertiary prevention (rehabilitation) in which we try toapply measures to make maximal use of remainingcapacity in complicated cases & return them to a usefulplace in the community after the anatomic andphysiologic changes have been stabilized.You will also study in this section the following topics:- Epidemiologic methods, uses of epidemiology & how toperform epidemiological study.- Statistics which has a great importance in this subject asit teach u methods of data collection, analysis,interpretation and presentation of them that can be used

in various studies in medicine and knowing the vitalindices.

"community medicine is the main pillar in developing a healthy population and

application of its principles is the only way to decrease morbidity and mortality rates

in communities and this makes the difference between developed and non developed

countries in the field of health care delivery and this creates populations as healthy as

possible"


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- Demography and vital indices.- Environment and its interaction with health.

Epidemiology of different types of communicable and non

communicable diseases in which you should know thefollowing points: definition, occurrence, pre and postpathogenic period, how to prevent and control these diseaseswith above mentioned character.

Health care delivery system and health services provided todifferent risk groups including: reproductive health, child

health services, adolescent and school health, geriatric healthservices, mental health, populations of special needs andoccupational health.

With special consideration of project management, healtheducation and communication skills, components of health caresystem and family medicine.

Important points you should consider when you study

:community medicine

Make yourself interested in studying this subject aspossible as you can and understand well theapplication of it in medicine which will also benefityou in you upcoming life as a doctor.

Specify certain times per day or week to studycommunity & review what u already studied as it isthe biggest subject you have this year in quantity and

degrees at the final exam.Highlight important headlines in each topic and give

special consideration to key words under each one ofthem.

Diagrams and mind maps are of special value instudying all subjects specially community medicine,try to make your own ones if possible and make use ofthose you find in community medicine books.


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Try to write your own abstract of each topic afterstudying them as they help you very much tomemorize these topics.

Each part of community medicine has its importance

applications and better ways for studying.Concentrate well on definitions of community

medicine terms as they are very important in differenttypes of exams e.g.: primary health care, family doctor,occupational disease.etc.

After studying each topic try to answer as manyrelated questions and MCQ as possible as you can, thishelp you evaluate yourself continuously.

Throat&Nose,Ear:Definition

The science that deals with anatomy, physiology & clinicalpresentation of (ear-nose-throat) organs also teaching you how totreat their diseases & prophylaxis .General Curriculum :ENT comprises 3 constituents:

1-EAR:By studying ENT you have know that:(anatomy-physiology-general symptoms-acute & chronic diseases- operations)2-NOSE:(Anatomy-physiology congenital - traumatic inflammatory neoplastic disorders)3-THROAT:

-PHARYNX:(anatomy-physiology inflammation - neoplasticdisorders-operations)-LARYNX(anatomy-physiology inflammation - neoplastic)How can you study it ?When studying ENT u have to:1-Try to put different types of diseases in categoriesI.e. inflammatory degenerative immune induced diseases or

neoplastic diseases should be studied revised as one package, andso on, and you can do that through understanding the


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pathophysiology of each disease then you will easily predict mostother needed information about this disease as clinical picture,investigations and treatment as they mostly meet in many aspects .2-differantiate between lessons in studying as the following:

3-many topics you have to read well(reading)for MCQ &oral, suchas anatomy ,physiology some tumors-while other topics you should study well for various types ofquestions.-continuous reading is the key of perfect understanding.4- Keep up with the most common questions whether it is oral-written or MCQ question.5-dont miss the following topics

-EAR(ear wash-acute otitis media-chronic otitis mediacomplications-facial nerveHearing loss-vertigo-understanding the operations)-NOSE (foreign body in the nose-chronic atrophic rhinitis-sinusitis-epistaxis principles of operations)-PHARYNX (adenoid-pharyngeal suppuration-angiofibroma-tonsillectomy)-LARYNX (congenital diseases-foreign body-benign tumors-operations)

6-first of all when you talk about clinical picture of a disease youshould differentiate between symptoms whish are patient ownwords(no medical terms used) and sign which are know by thedoctor ,e,g,: pain is a symptom while tenderness is a sign, and soon.7- in each disease you should know:

Definition, in which you must start by the category ofdiseases & its most important diagnostic criteria.

Incidence, in which you should talk about incidence ofdisease according to age, sex ,lateralityetc.

Predisposing factors and sources of infection if if it isinfective disease.

Clinical picture that includes the symptoms and signs of thecases. And you should consider in examination of cases thegeneral and local symptoms as well as constitutional signsand local signs.

Complications that may occur due to this disease.


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Investigations that should be done for proper diagnosis ofthis disease which are laboratory investigations, imaginginvestigations(x ray, CT , ultra sound.etc.) or endoscopicinvestigations.

Treatment that may cure or manage the case.

NB:-IF YOU WANT REALY TO BE PERFECT IN SUCH ASUBJECT,ALLOW YOUR SELF TO VISIT ENT CLINICS IN YOURHOSPITAL PERIODACALY TO (DEAL WITH PATIANTS-LEARN DIAGNOSIS-TREATMENT-PERFORM EARWASH REMOVAL OF FB- ASKING ABOUT PROPYLAXIS WHENEVER

POSSIABLE)

Internal Medicine:Definition

Internal medicine is the medical specialty concerned with1. Diagnosis of diseases.

2. Non-surgical treatment.:Branches

This is a listing of branches that compose the curriculum Cardiology Endocrinology Gastroenterology Hematology/Oncology Infectious diseases

Nephrology Pulmonology Rheumatology Neurology Psychiatry

Each of these branches is concerned with the diagnosis andmanagement of disease in the corresponding system.Now we'll discuss the 2 pillars that make up Internal medicine.

:Diagnosis


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Diagnosis is the process of identifying a medical condition ordisease by its signs, symptoms, and from the results of variousdiagnostic procedures.Before beginning, I'll start by setting a few definitions that are

important to understand how diagnosis is reached.:Symptom

A symptom is any indication of a disease or injury(perceived by the patient),

:SignA sign is an objective indication (that is, one found byexamining a patient) of a disease, physiological malfunction,or injury.This means a symptom is identified by asking the patient about it,while a sign can only be detected by examining the patient.For example Pain is symptom, as it is experienced by the patientand cannot be detected by the physician, while tachycardia"Accelerated heart rate" is a sign , it's usually not felt by the patient

but can be detected by physician upon examination.Diagnosis is sequential process that is achieved through thefollowing:

History taking)1

Which is a process in which the physician asks the patientspecific questions about Symptoms the patient experienced.Example: Asking the patient about the presence of pain.

Clinical Examination)2Process by which a physician investigates the body of apatient for Signs of disease.Example: Measuring patient's arterial blood pressure orcounting his heart rate

Investigations)3Which are a kind of medical procedure performed to detect,diagnose, or evaluate disease, disease processes,susceptibility, and determine a course of treatment, usuallyutilizing technological methodsExample: Chest X-Ray , Complete Blood Picture (CBC), CTScan.With each step the physician is able to narrow down the numberof possibilities and thus come closer to diagnosis, however, In the

real world , diagnosing a disease isn't always straightforward,some diseases have similar symptoms and signs , the physician


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has to be able to differentiate between these similar conditions, thisprocessis called differential diagnosis, The following examplesimulates a real situation and will shed some light on how a finaldiagnosis can be reached.

Note: This example is stripped down to make it easier tounderstand.

A 55 year old patient comes to the hospital complaining of sudden onset of

chest pain radiating to his left arm , the patient also reported history of

"Shortness of breath and chest discomfort when moving heavy boxes in his

shop", On examination the patient had a blood pressure of 190/105 , He is

overweight with Respiratory rate of 17/min.

Let's break this situation down

)"Symptoms(What the patient said:History Sudden onset of chest pain Shortness of breath

Findings that were detected on examining:Clinical Examinationthe patient (Signs)"

Obesity Arterial blood pressure (190/105 Hypertensive patient") Respiratory rate 17/Minute

These symptoms and signs don't specifically occur in one disease,

some diseases can cause similar symptoms and signs,however,Based on these symptoms and signs the physician shouldnow be able to narrow the possibilities down to 2 or 3 diseases.Note : Symptoms and signs are collectively called Clinicalpicture

:Differential diagnosisSudden onset of chest pain with "Shortness of breath" inhypertensive patient can be caused by 4 diseases

1.

Myocardial infarction.2. Aortic dissection.3. Pulmonary embolism.4. Tension Pneumothorax.

The physician will now subject the patient to a series ofinvestigations to reach the diagnosis

Cardiac Enzymes "Creatine kinase level, Lactatedehydorgenase level ,etc" are elevated hours followinga myocardial infarction.

CT Scan to detect Aortic dissection.


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Plain Chest X-Ray to detect Tension Pneumothorax.Based on the results of investigations the physician arrives at thedefinite diagnosis and begins proper treatment of the condition.This brings us to the second pillar of Internal medicine which is

"Treatment".:Treatment

There isn't much to say about treatment except that internalmedicine is more concerned about non-surgical treatmentmostly by using drugs, You will be introduced to surgicaltreatment when you study "Surgery".Internal medicine CurriculumThe curriculum can be broken down into

:Theoretical part

Is mainly meant to provide medical student with knowledge"Information" about diseases regarding definition ,diagnosis and treatment.

The majority of topics are structured as follows

Definition

Aetiology Diagnosis

Clinical picture Symptoms Signs

Investigations Differential diagnosis ( Conditions that have similar

Clinical picture) Complications

Treatment

The term Management is usually used to refer toDiagnosis and Treatment.For example , If you're asked to discuss Management ofHypertension you should cover the following

Diagnosis Clinical picture

Symptoms Signs


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Investigations Differential diagnosis ( Conditions that have

similar Clinical picture) Treatment

It is recommended when studying any topic to keep these twomain pillars in mind ( Diagnosis & Treatment ) since a student isexpected to have the knowledge of how to diagnose and treat anycondition within the curriculum.

:Clinical partWhich is meant to provide medical student with theKnowledge about and Skills of history taking and clinicalexamination "i.e. detecting symptoms and signs".

Pediatrics:Definition

Is the branch of medicine that deals with the medical care ofinfants, children, and adolescents. The upper age limit ranges fromage 14 to 18, depending on the country, Like Internal Medicine it isconcerned with

3. Diagnosis of diseases.4. Non-surgical treatment.

There is a significant overlap between pediatrics and internalmedicine curricula regarding the topics discussed by both , butthey tend to differ in the depth by which these topics are discussed

because some disease are more prevalent in children than in adultsand vise versa

For instance rickets , protein energy malnutrition (PEM) and

bronchiolitis are diseases that occur almost exclusively amongchildren and are discussed in depth by the pediatrics curriculumwhile being given only brief attention in the internal medicinecurriculum.

Some topics are relevant only to pediatrics like

Growth and development

Breast feeding Neonatal diseases


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Pediatrics CurriculumThe curriculum can be broken down into

Theoretical part Clinical part

For more details please review the Internal medicine guide ,It is recommended to benefit from the significant overlap betweenthe curricula of Internal medicine and Pediatrics.

:ExampleA topic such as Leukemia is discussed in both curricula , Itwould be a good idea to study that topic from a single sourcee.g. Internal medicine text and add complementary notesto that topic about how is it different in pediatrics like

Difference in Clinical picture Difference in treatment or drug dosage

Best WishesAMSA Team

ISSH-Guide Medical Sciences

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