INFECTIONS

The students should be able to recapitulate the following enabling objectives from the previous courses:

• Recapitulate the general mechanisms by which hosts resist colonization by pathogenic bacteria
• Describe the normal bacterial flora and the ways in which it contributes to the balance between health and disease
• Discuss the specific host defenses against infection which do not require prior contact with the infecting organism
• Recapitulate the categories of infectious agents, their microbiological properties and the special techniques for the diagnosis of infectious diseases
• Explain with examples the different mechanisms by which infective agents can damage tissues such as direct cell injury, endotoxin mediated, exotoxin mediated, immune complex mediated, shared antigens, T cell response
• Recapitulate the etio-pathogenesis, macro and microscopic appearances,  and critical features of the common infectious diseases such as meningitis, infective endocarditis, pneumonia, urinary tract infection, sexually transmitted diseases, gastroenteritis, septisemia, infections in the immunocompromised and HIV/AIDS.

 
Specific learning objectives: (Pathophysiology)

• Compare and contrast the clinical vignettes for diseases listed (under 2) with reference to:
  • Risk factors
  • Etiology
  • Pathogenic mechanism
  • Altered morphology, physiology
  • Signs and symptoms
  • Basis for signs and symptoms
  • Differential diagnosis
  • Nutritional factors/aspects involved in the disease/disorder
  • Prognosis, complications, mortality/survival
  • Investigations (screening and confirmatory/, list the principles involved and the results expected)
  • Principles of  the use of pharmacological agents

• Develop an algorithm for the laboratory investigations in a patient with fever of unknown origin

• Create clinical vignettes including the typical clinical presentations of the infections listed below and generate at least 1 MCQ for each to test an important concept:
  • Streptococcal-pharyngitis, skin infections
  • Pneumococcal-pneumonia, meningitis
  • Staphylococcal-skin infection, otitis media, bacteremia, Toxic shock syndrome (TSS)
  • Clostridial-gas gangrene, tetanus, botulism
  • Diphtheria
  • Listeria
  • Infective endocarditis
  • Whooping cough
  • Meningococcal meningitis
  • H. influenza
  • Maroxella
  • Legionellosis
  • Salmonellosis
  • Shigellosis
  • E.coli
  • Cholera
  • Campylobacter
  • Brucellosis
  • Tularemia
  • Gonoccocal
  • H.ducreyi
  • Actinomycosis
  • Mycobacterial infections-Mycobacterium tuberculosis, atypical mycobacteria, Mycobacterium leprae
  • Chlamydial infections-LGV, urethritis, psittacosis
  • Viral infections:Herpes simplex, Infectious mononucleosis, Hepatitis A,B,C,D&E, Rabies, Gastroenteritis, Echovirus
  • Rickettsial infections: Typhus group, Rocky mountain spotted fever, Rickettsial pox, Tick typhus, Q fever
  •  Spirochetal infections: Syphilis, Leptospirosis, Lyme’s disease 
  •  Protozoal infections: Malaria, Trypanazomiasis, Leishmaniasis, Toxoplasmosis, Ameobiasis, Giardiasis, Trichomonas
  • Fungal infections : Candidiasis, Histoplasmosis, Pneumocystosis, Mucormycosis 
  • Helminthiasis: Schistosomiasis, Clonorchiasis, Cysticercosis, Echinococosis, Strongylloidiosis, Filariasis, Onchocercara
  • Infectious diarrhea, Traveler’s diarrhea
  • Infections in immunocompromised (CMV, HSV, candida, tuberculosis, pneumocystis, cryptococcus)
  • Hospital associated infections
  • HIV/AIDS  

 

IMMUNOLOGY & RHEUMATOLOGY

The students should be able to recapitulate the following enabling objectives from the previous courses:

• Explain the mechanisms by which a host defends against infection (innate and acquired factors)
  
• Recapitulate the specific and nonspecific components of the cellular and noncellular limbs of the immune system
  
• Explain the role of macrophages in the immune system, and identify the functions of the products secreted by them
  
• Distinguish the categories of lymphocytes. Explain the role of lymphocytes in the immune system. Identify the products they secrete
  
• Describe the role of eosinophils, basophils and epithelial cells in the immune system. Identify the products they secrete
  
• Distinguish the primary and secondary lymphoid organs. Describe their roles in the functioning of the immune system
• Identify the components of and distinctions between the innate and adaptive forms of immunity
  
• Distinguish the type I and Type II forms of MHC. Explain the  phenomenon  of MHC restriction
  
• Describe the mechanism of activation of helper T lymphocytes and cytotoxic T lymphocytes
  
• Explain the common structural features of immunoglobulins (antibodies). Identify the different mechanisms by which antibodies can induce the    elimination of foreign antigens
  
• Recapitulate the etio-pathogenesis, macro and microscopic appearances, and critical features of rheumatologic diseases such as rheumatoid arthritis, SLE, scleroderma, immune complex vasculitis, Gout. 
  
• Recapitulate the mechanisms of host defense against tumors (tumor immunity) 

Specific learning objectives: (Pathophysiology)

• Compare and contrast the clinical vignettes for diseases listed (under 2)     with reference to:
  • Risk factors
    
  • Etiology
    
  • Pathogenic mechanism
    
  • Altered morphology, physiology
    
  • Signs and symptoms
    
  • Basis for signs and symptoms
    
  • Differential diagnosis
    
  • Nutritional factors/aspects involved in the disease/disorder
    
  • Prognosis, complications, mortality/survival
    
  • Investigations (screening and confirmatory list principles involved and        results expected)
    
  • Principles of  the use of pharmacological agents
• Create clinical vignettes including the typical clinical presentations of the    diseases listed below and generate at least 1 MCQ for each to test an important concept:
  
  •   Immunodeficiency Disorders:
    
    • Hypersensitivity reactions Type I – Type IV
      
    • Transplant rejection reactions – Hyperacute, Acute and Chronic rejections
      
    • Severe Combined Immunodeficiency Disease (SCID)
      
    • DiGeorge Syndrome (Congenital Thymic Aplasia)
      
    • Bruton’s agammaglobulinemia (X-Linked Agammaglobulinemia)
      
    • Transient hypogammaglobulinemia of Infancy
      
    • Common Variable Immunodeficiency
      
    • Selective IgA Deficiency
      
    • Hyper-IgM Immunodeficiency
      
    • Hyper-IgE Immunodeficiency
      
    • ChediakHigashi Syndrome
      
    • Chronic Granulomatous Disease
      
    • Leukocyte adhesion deficiency
      
    • Nezelof Syndrome
      
    • WiskottAldrich syndrome
      
    • Ataxia telangectasia
      
    • Complement deficiencies: C1 Inhibitor Deficiency, C5-C9 Deficiency, C3 Deficiency, C4 Deficiency
      
    • Decay Activating factor deficiency (CD55, CD59) Diseases
      
    • Secondary Immunodeficiency: AIDS, Malnutrition, Malignancy, Renal disease and Sarcoidosis
                
  • Rheumatologic Diseases:
    
    • Rheumatoid arthritis
      
    • Systemic lupus erythematosis (SLE)
      
    • Systemic Sclerosis
      
    • CREST Syndrome (Limited Scleroderma)
      
    • Inflammatory myopathies: Polymyositis, Dermatomyositis
      
    • Sjoergen’s Syndrome
      
    • Immune complex vasculitis: Takayasu arteritis, Polyarteritis nodosa, Kawasaki disease, Wegener granulomatosis, Henoch-Schonlein purpura
• Explain the concept of transplant rejection and distinguish the 3 main types   (hyperacute, acute and chronic) based on clinical features, pathogenesis, structural changes and prognosis using renal graft as an example. Explain the concept of graft versus host reactions, pathogenesis and clinical features
• Explain the immunologic damage produced by HIV-AIDS, clinical features,           diagnostic tests and reasons why it is difficult to cure AIDS

RESPIRATION

The students should be able to recapitulate the following enabling objectives from previous courses:

• Recapitulate the normal anatomy and histology of the respiratory system
  
• Explain pulmonary circulation and its unique features. Describe the relevance of bronchopulmonary segments. Distinguish the different roles of the pulmonary and bronchial arteries
  
• Explain the role played by the connective tissue and surfactant systems in lung function
  
• Describe the role of ciliary action of the respiratory epithelium in the normal defense
  
• Explain why medium-sized bronchi rather than small airways are the major sites of resistance to airflow in the lungs
  
• Distinguish the physiologic functions of the efferent parasympathetic, sympathetic, and NANC neural systems of the lung
  
• Describe the types of afferent vagal sensory receptors and their function
  
• Explain the mechanism by which pulmonary arteries match alveolar perfusion with ventilation
  
• Describe the defense system of the lungs: components of the nonspecific defense system of the lungs and the humoral and cellular components of the specific immune defense system of the lungs
  
• Explain the mechanics of lungs - components of lung elastic recoil and the role of surfactants
  
• Describe the changes in various pressures (intrathoracic, intra-alveolar, transmural pressures) during the breathing cycle.
  
• Describe various lung volumes and capacities with the help of a spirogram.
  
• Explain how to interpret FEV1, Flow-volume curves in normal and diseased states
  
• Recapitulate the following formulae to calculate and interpret various respiratory parameters commonly used in pulmonary lab: Respiratory minute volume; Alveolar ventilation; Total or physiological dead space; Alveolar ventilation equation; Alveolar gas equation; Lung compliance; %FEV1 
  
• Define lung and chest wall compliance and explain how they influence total compliance of the respiratory system in normal and diseased states
  
• Explain the factors affecting the airway resistance
  
• Explain the mechanism of transport of oxygen and carbon dioxide from lungs to tissues. Explain the concept of P50 and its importance in clinical medicine.
  
• Explain the factors that regulate ventilation, and those factors that regulate perfusion, normal ventilation and perfusion match in different zones of lungs.
  
• Describe the effects of changing CO2 and O2 levels on respiratory control. Explain the role of respiratory chemoreceptors in the control of breathing.
  
• Distinguish the different types of hypoxia and cyanosis.
  
• Recapitulate the common pathogens involved in acute and chronic respiratory illnesses.
  
• Recapitulate the morphology and pathogenesis of common respiratory diseases such as: Bronchial asthma, COPD, Emphysema, bronchiectasis, Tuberculosis, sarcoidosis, pneumonias, pulmonary fibrosis, lung abscess, pneumothorax, pulmonary embolism, bronchogenic carcinoma, mesothelioma, paraneoplastic syndromes.

 

Specific learning objectives: (Pathophysiology)

• Compare and contrast the clinical vignettes for diseases listed (Pneumonias, Pulmonary tuberculosis, Bronchial asthma, Chronic bronchitis, Emphysema, Bronchiectasis, Lung abscess, Idiopathic pulmonary fibrosis, Pulmonary edema, Pulmonary embolism, Pleural   effusion, Carcinoma lungs) with reference to:
  • Risk factors
    
  • Etiology
    
  • Pathogenic mechanism
    
  • Altered morphology, physiology
    
  • Signs and symptoms
    
  • Basis for signs and symptoms
    
  • Differential diagnosis
    
  • Nutritional factors involved in the disease/disorder
    
  • Prognosis, complications, mortality/survival
    
  • Investigations (screening and confirmatory list principles involved and results expected)
    
  • Principles of  the use of pharmacological agents
• Interpret pulmonary function tests in the differential diagnosis of obstructive and restrictive respiratory diseases.
• Create clinical vignettes including the typical clinical presentations of the diseases listed below and generate at least 1 MCQ for each to test an important concept:
  
  • Pneumonias
    
  • Pulmonary tuberculosis
    
  • Bronchial asthma
    
  • Chronic bronchitis
    
  • Emphysema
    
  • Bronchiectasis
    
  • Lung abscess
    
  • Idiopathic pulmonary fibrosis
    
  • Pulmonary edema
    
  • Pulmonary embolism
    
  • Pleural effusion
    
  • Mesothelioma
    
  • Chronic obstructive pulmonary diseases
    
  • Restrictive pulmonary diseases
    
  • Acute respiratory failure – acute respiratory distress syndrome (ARDS)
    
  • Lung collapse, atelectasis
    
  • Pneumothorax, pyothorax, hemothorax
    
  • Carcinoma lungs

CARDIOLOGY

The students should be able to recapitulate the following enabling objectives from previous courses:

• Recapitulate the normal anatomy and histology of the heart
  
• Explain the coronary circulation and its features.
  
• Distinguish the electrical properties of the conducting system of heart from ventricular myocyte
  
• Describe pressure-time analysis through the cardiac cycle.
  
• Describe pressure-volume analysis through the cardiac cycle.
  
• Describe how the preload and after load affect P-V loops of ventricle.
  
• Describe the molecular mechanism of electromechanical coupling in cardiac myocyte contraction.
  
• Define cardiac output (CO). Identify the factors affecting CO. Give the formula to calculate CO.
• Explain the invasive and non-invasive methods for determination of CO.
  
• Explain the determinants of mean arterial blood pressure by applying Ohm’s law.
  
• Compare the histological features of blood vessels of different sizes and their functional significance.
  
• Describe various forces that govern the movement of fluid across the capillary wall (Starling’s equation) and explain the genesis of edema
  
• Explain the modes of transport of fluids and electrolytes across the capillary wall.
  
• Describe the relationship between the diameter of the arterioles and vascular resistance and its influence on the blood flow to an organ.
  
• Explain the relationship between the velocity of blood flow and area of cross section of different blood vessels in the cardiovascular system
  
• Describe the factors involved in regulating the diameter of arterioles
  
• Distinguish the principal hormonal vasoconstrictors and vasodilators based on their action.
  
• Explain the mechanism by which NO, produced by endothelial cells, acts as a vasodilator
  
• Explain the role of baroreceptors in the feedback regulation of the high- and low-pressure portions of the circulatory system.
  
• Distinguish the various components of a normal EKG and correlate them   with the cardiac cycle.
  
• Recapitulate the morphology of common cardiovascular lesions: Atherosclerosis, coronary thrombosis, ischemic heart disease, hypertension, rheumatic carditis, viral myocarditis, cardiomyopathy, endocarditis, pericarditis, myxoma, vasculitides (Takayashu, wegners,      polyarteritis, Kawasaki, Temporal arteritis, Buerger’s disease)

 

Specific learning objectives: (Pathophysiology)

• Compare and contrast the clinical vignettes for diseases listed (Brady arrhythmias, Tachyarrhythmia, Congestive heart failure, Left ventricular failure, Right ventricular failure. Valvular heart diseases-MS, MR, AS, AR. Coronary artery disease-Angina, unstable angina, myocardial infarction, Pericardial diseases-Pericarditis, Pericardial effusion, Pericardial tamponade, Atherosclerosis, Hypertension, Shock-Hypovolemic, Distributive, Cardiogenic, Obstructive shock)  with reference to:
  • Risk factors
    
  • Etiology
    
  • Pathogenic mechanism
    
  • Altered morphology, physiology
    
  • Signs and symptoms
    
  • Basis for signs and symptoms
    
  • Differential diagnosis
    
  • Nutritional factors/aspects involved in the disease/disorder
    
  • Prognosis, complications, mortality/survival
    
  • Investigations (screening and confirmatory list principles involved and        results expected)
    
  • Principles of the use of pharmacological agents
• Locate the site of infarct and identify the type of arrhythmias based on the EKG tracings.
• reate clinical vignettes including the typical clinical presentations of the diseases listed below and generate at least 1 MCQ for each to test an important concept:
  • Brady arrhythmias
    
  • Tachyarrhythmia
    
  • Congestive heart failure
    
  • Left ventricular failure
    
  • Right ventricular failure
    
  • Valvular heart diseases-MS, MR, AS, AR
    
  • Coronary artery disease-Angina, unstable angina, myocardial infarction
    
  • Pericardial diseases-Pericarditis, Pericardial effusion, Pericardial    tamponade
    
  • Atherosclerosis
    
  • Congenital heart diseases-Atrial septal defect, Ventricular septal defect, Patent ductus arteriosus, Tetrology of Fallot, Transposition of great vessels, Coarctation of aorta
    
  • Cardiomyopathies-Dilated, Hypertrophic, Restrictive
    
  • Hypertension
    
  • Shock-Hypovolemic, Distributive, Cardiogenic, Obstructive shoc

FEMALE GENITAL SYSTEM

The students should be able to recapitulate the following enabling objectives from previous courses:

• Recapitulate the normal anatomy and histology of the female genital system
  
• Explain the basis of genital, gonadal and genital sex in females
  
• Describe the embryological development of female internal and external genitalia. List the common malformations of the female genital tract and the embryological basis for them.
  
• Explain the endocrine function of the ovaries
  
• Describe the stages of oogenesis and the factors essential for it
  
• Explain the hormonal regulation of the menstrual cycle.
  
• Explain the regulation of functioning of the ovaries by hypothalamo- hypophysio-ovarian axis during various phases of the menstrual cycle
  
• Describe the source, synthesis, transport, metabolism and functions of estrogen and progesterone in females
  
• Explain development of female breast during different stages of life
  
• Explain the milk ejection reflex. Describe the role of prolactin and oxytocin on reproductive function of the female
  
• Describe the role of maternal and placental hormones during pregnancy
  
• Describe the maternal changes during pregnancy
  
• Explain the importance of feto-placental unit
  
• List the common organisms causing female genital tract infection and their identification
  
• Recapitulate the morphology and pathogenesis of common diseases of the female genital system such as: Vaginitis, cervicitis, cervical intraepithelial neoplasm, carcinoma cervix, endometritis, endometriosis,  dysfunctional uterine bleeding, tumors of endometrium and myometrium, polycystic ovaries, tumors of the ovaries, ectopic pregnancy, gestational         trophoblastic diseases, toxemia of pregnancy, Urinary tract infection,  Sexually transmitted diseases.

 

Specific learning objectives: (Pathophysiology)

• Compare and contrast the clinical vignettes for disorders listed (under 3)    with reference to:
  • Risk factors
  • Etiology
    
  • Pathogenic mechanism
    
  • Altered morphology, physiology
    
  • Signs and symptoms
    
  • Basis for signs and symptoms
    
  • Differential diagnosis
    
  • Prognosis, complications, mortality/survival
    
  • Investigations (screening and confirmatory list principles involved and  results expected)
    
  • Principles of  the use of pharmacological agents
• Discuss the differential diagnosis and evaluation of a couple with female infertility.
• Create clinical vignettes including the typical clinical presentations of the diseases listed below and generate at least 1 MCQ for each to test an important concept:
  • Vaginitis
    
  • Cervical polyps
    
  • Cervical intraepithelial neoplasm
    
  • Carcinoma cervix
    
  • Endometritis
    
  • Endometriosis
    
  • Dysfunctional uterine bleeding
    
  • Leiomyoma
    
  • Endometrial cancer
    
  • Uterine artery embolisation
    
  • Polycystic ovarian syndrome
    
  • Tumors of the ovaries
    
  • Ectopic pregnancy
    
  • Hydatiform mole
    
  • Choriocarcinoma
    
  • Diabetes in pregnancy
    
  • Hemolytic disease of the fetus
    
  • Primary and secondary amenorrhea
    
  • Turner’s syndrome
    
  • Androgen insensitivity syndrome
    
  • Congenital adrenal hyperplasia
    
  • Prolactinoma
    
  • Urinary tract infection in females
    
  • Sexually transmitted diseases
    
  • Menopause
    
  • Disorders of female breast-Fibrocystic changes, mastitis, tumors of the breast

HEMATOLOGY

The students should be able to recapitulate the following enabling objectives from previous courses:

• Recapitulate the normal anatomy and histology of the bone marrow
  
• Explain the normal development of the formed elements of blood from bone marrow stem cells (hematopoiesis)
  
• Describe the role of various cytokines in regulation of the hematopoiesis
  
• Describe the morphology and functions of formed the elements of blood (red blood cells, white blood cells and platelets).
• List the coagulation factors. Describe the mechanism of coagulation of blood by both intrinsic and extrinsic pathways
  
• Explain fibrinolysis and thrombolytic pathway
  
• List the various anticoagulants and their mechanism of action
  
• Explain how the various laboratory tests for coagulation help in distinguishing the common causes for coagulation process
  
• Recapitulate the blood picture, bone marrow picture, etio-pathogenesis and critical features of blood disorders such as: Normocytic, Microcytic,   Macrocytic anemias, Leukemias, Lymphomas, Leukocytopenias, Thrombocytopenias, Coagulation disorders.
  
• Describe the sources, absorption and storage forms of iron.
  
• Describe the role of folate in metabolic reactions and how folate contributes to DNA synthesis
  
• Describe the common mechanism in B12 deficiency and in folate deficiency that results in megaloblastic maturation.  (folate trap hypothesis)
  
• Explain how the Philadelphia chromosome results in increased cell proliferation in CML
  
• Describe the role of Vitamin K in clotting.
  
• Describe the biochemical defect in Sickle cell anemia.
  
• Describe the genetic mechanisms involved in thalassemias.
  
• Describe the function of G6PD enzyme

Specific learning objectives: (Pathophysiology)

• Compare and contrast the clinical vignettes for disorders listed (Iron deficiency anemia, Megaloblastic anemias, Hemolytic anemias,  Normocytic anemias, Lymphomas, Myeloproliferative disorders, Acute and chronic myelogenous leukamias, Myelodysplastic syndromes, Cyclic neutropenia, Thrombocytopenias, Thrombocytosis, Qualitative platelet disorders, Coagulation disorders-deficiency of clotting factors, DIC, Hypercoagulable states) with reference to:
  • Risk factors
    
  • Etiology
    
  • Pathogenic mechanism
    
  • Altered morphology, physiology
    
  • Signs and symptoms
    
  • Basis for signs and symptoms
    
  • Differential diagnosis
    
  • Nutritional factors involved in the disease/disorder
    
  • Prognosis, complications, mortality/survival
    
  • Investigations (screening and confirmatory list principles involved and results expected)
    
  • Principles of  the use of pharmacological agents

 

• Discuss the differential diagnosis and evaluation of a patient with anemia   by using blood indices, blood and bone marrow picture.
• Discuss the differential diagnosis and evaluation of a patient with    coagulation disorder. Describe how various tests for coagulation help in   arriving at a specific diagnosis.
• Create clinical vignettes including the typical clinical presentations of the    diseases listed below and generate at least 1 MCQ for each to test an important concept:
  
  • Iron deficiency anemia
    
  • Megaloblastic anemias
    
  • Hemolytic anemias
    
  • Normocytic anemias
    
  • Lymphomas
    
  • Acute and chronic myelogenous leukamias
    
  • Cyclic neutropenia
    
  • Thrombocytopenias
    
  • Thrombocytosis
    
  • Qualitative platelet disorders
    
  • Coagulation disorders-deficiency of clotting factors, DIC, Hypercoagulable states
    
  • Myeloproliferative disorders-polycythemia vera, CML, myelofibrosis

GASTROINTESTINAL, HEPATOBILIARY & EXOCRINE PANCREAS

The students should be able to recapitulate the following enabling objectives from previous courses:

• Recapitulate the normal anatomy and histology of the gastrointestinal tract
• Explain the major functions of the GI tract and the role played by various structures and biochemical agents in these function.
• Describe the mechanism of electrolyte transport across epithelial cells and explain the factors that play a role in the process.
• Describe the defense mechanisms of the GI tract.
• Describe the components of the enteric nervous system. Recapitulate the three general types of enteric neuron
• Describe the parasympathetic and sympathetic innervation of the GI tract. Explain the relationship between the enteric and central nervous systems
• Explain the kind of electrical activity that occurs at sphincters, and  its consequences
• Describe the functions of interstitial cells of Cajal
• Explain the general types of contractions observed in the GI tract after feeding
• Distinguish the histology of proximal one third and the distal two thirds of the esophagus and explain why this distinction is important.
• Compare the functions of the upper and lower esophageal sphincters, and how they are regulated
• Describe the three phases of the swallowing reflex.
• Compare the cell types found in the mucosa of the gastric body and antrum, and indicate the products of each cell type.
• Distinguish the roles of the proximal and distal stomach
• Describe the ionic basis of secretion of HCl from the gastric parietal cells and steps that can be therapeutically blocked so that the acid secretion can be reduced.
• Identify the neurotransmitter, hormone, and paracrine agent that stimulates acid secretion from parietal cells.
• Identify a peptide that inhibits acid secretion from the parietal cells.
• Distinguish the mechanisms of the cephalic, gastric, and intestinal phases of gastric acid secretion.
• Identify the two processes by which the gastric mucosa is protected from the acid in the lumen.
• Distinguish the patterns of motility in the body and the antrum of stomach
• Describe the factors affecting the rate of gastric emptying
• Describe the hormonal reflex by which fat in the intestinal contents stimulates the secretion of bile.
• Describe the mechanism by which glucose is absorbed across the apical   and basolateral membranes of an enterocyte.
• Explain the role of bile in lipid absorption in the intestine
• Explain the mechanisms of absorption of Na+ ions in the small intestine.
• Describe the mechanism of fluid and electrolyte secretion in the crypts of Lieberkühn.
• Describe how  certain bacterial toxins stimulate fluid and electrolyte secretion in the crypts of Lieberkühn
• Describe the pattern of intestinal motility during fasting and after feeding.
• Identify the neurotransmitters that mediate the ascending and descending limbs of the peristaltic reflex.
• Explain how colonic motility differs from that in the small intestine
• Compare and contrast the portal and systemic blood flow into the liver and recapitulate the venous drainage of the liver.
• Describe the cell types make up the liver, and their distinguishing characteristics and functions
• Explain the important roles of the liver in carbohydrate, protein, and lipid metabolism
• Describe the physiologic mechanisms by which the body transports cholesterol
• Explain phase I and phase II reactions in drug detoxification.
• Explain the clearance or protective functions of the liver. Recapitulate the biochemical changes that occur in hepatic failure.
• Describe the histologic features of exocrine and endocrine pancreas
• Describe the volume, composition, and functions of pancreatic juice
• Discuss the neural and hormonal regulation of exocrine pancreatic function
• Recapitulate the etio-pathogenesis, macro and microscopic appearance of  the conditions listed below.

 

Specific learning objectives: (Pathophysiology)

• Compare and contrast the clinical vignettes for disorders listed:
  • Leukoplakia and carcinoma of tongue,
  • Achalasia Cardia,
  • Hiatal hernia,
  • Reflux esophagitis,
  • Esophageal varices,
  • Mallory Weiss Syndrome,
  • Carcinoma of the esophagus,
  • Pyloric stenosis,
  • Acute and chronic gastritis,
  • Peptic ulcer disease,
  • Gastric carcinoma,
  • Gastrointestinal stromal tumor (GIST),
  • Meckle’s diverticulum,
  • Malabsorption syndrome,
  • Celiac disease,
  • Tropical sprue,
  • Whipple’s disease,
  • Carcinoid tumor,
  • MALT lymphoma,
  • Burkitt’s lymphoma,
  • Hirschprung’s disease,
  • Giardiasis,
  • Short bowel syndrome,
    
  • Infective diarrhea,
  • Irritable bowel syndrome,
  • Inflamative bowel disease,
  • Diverticular disease colon,
  • Inflammatory bowel disease (IBD),
  • Amebic colitis,
  • Pseudomembranous colitis,
  • Volvulus,
  • Chronic ischemic colitis,
  • Polyps,
  • Carcinoma colon,
  • Acute appendicitis,
  • Mucocele of the appendix,
  • Acute and chronic hepatitis,
  • Cirrhosis,
  • Hepatocellular carcinoma,
  • Obstructive jaundice,
  • Primary sclerosing cholangitis,
  • Hemochromatosis,
  • Wilson’s disease,
  • Portal hypertension,
  • Adenoma of liver,
  • Cholangio carcinoma,
  • Acute and chronic cholecystitis,
  • Cholelithiasis,
  • Acute and chronic pancreatitis,
  • Carcinoma of the pancreas,
  • Islet cell tumor
• Compare each of the above listed diseases with reference to:
  
  • Risk factors
    
  • Etiology
    
  • Pathogenic mechanism
    
  • Altered morphology, physiology
    
  • Signs and symptoms
    
  • Basis for signs and symptoms
    
  • Differential diagnosis
    
  • Nutritional factors/aspects involved in the disease/disorder
    
  • Prognosis, complications, mortality/survival
    
  • Investigations (screening and confirmatory; list principles involved and       results expected)
    
  • Principles of the use of pharmacological agents
• Discuss the differential diagnosis and evaluation of a patient with malabsorption syndrome.
• Describe various tests that help in arriving at a specific diagnosis.
• Describe the following function tests and explain how they are helpful in diagnosis of various disorders of GIT:
  
  • Gastric function tests
    
  • Pancreatic function tests
    
  • Liver function tests
• Create clinical vignettes including the typical clinical presentations of the diseases listed below and generate at least 1 MCQ for each to test an important concept:
  
  • Esophageal achalasia
    
  • Reflux esophagitis
    
  • Acid-peptic disease
    
  • Cholelithiasis
    
  • Gastroenteritis
    
  • Crohn’s disease
    
  • Ulcerative colitis
    
  • Diverticular diseases
    
  • Irritable bowel syndrome
    
  • Viral hepatitis
    
  • Drug induced hepatitis
    
  • Alcoholic hepatitis
    
  • Nonalcoholic fatty liver disease
    
  • Acute and chronic hepatitis
    
  • Cirrhosis
    
  • Portal hypertension
    
  • Hepatocellular carcinoma
    
  • Acute pancreatitis
    
  • Chronic pancreatitis
    
  • Carcinoma of pancreas
    
  • Malabsorption syndrome

RENAL SYSTEM

The students should be able to recapitulate the following enabling objectives from the previous courses:

• Recapitulate the normal anatomy, embryology, blood supply of kidney
  
• Describe the parts of a nephron, and the role played by each of them in renal function
  
• Explain the regulation of renal functions with special reference to neural and hormonal factors
  
• Describe juxtaglomerular apparatus and explain its functions.
  
• Describe glomerular filtration with reference to: Forces favoring and  opposing filtration, net filtration pressure, formula to calculate GFR, formula to calculate filtration fraction, factors affecting GFR, regulation of GFR.
  
• Discuss quantification of tubular functions by calculating filtered load, excretion rate, reabsorption rate, secretion rate of various substances.
  
• Describe the control of renal reabsorption of substances such as glucose, bicarbonate, sodium, potassium, water and their regulations.
  
• Describe concept of renal clearance with respect to: Formula to calculate clearance, prediction of renal handling of a substance when inulin   clearance is known, calculation of renal plasma flow and renal blood flow by using clearance, calculation of free water clearance and prediction of hydration state of the body.
  
• Discuss the role of kidney in the regulation of fluids, electrolytes, and blood pressure
  
• Describe the structural characteristics of the various parts of the nephron that make them particularly susceptible to certain types of injury
  
• Distinguish between prerenal, intrarenal, and postrenal causes of renal failure
  
• Describe the major categories of complications of inadequate renal function
  
• Recapitulate the etio-pathogenesis, macro and microscopic appearances, and critical features of disorders kidney such as: Acute renal failure, Chronic renal failure, Acute and chronic glomerulonephritis, Acute tubular   necrosis, Nephrotic syndrome, Renal stones, Pyelonephritis, Hydronephrosis, Cystitis, Carcinoma bladder.

Specific learning objectives: (Pathophysiology)

• Compare and contrast the clinical vignettes for disorders listed below under 4 with reference to:
  • Risk factors
  • Etiology
    
  • Pathogenic mechanism
    
  • Altered morphology, physiology
    
  • Signs and symptoms
    
  • Basis for signs and symptoms
    
  • Differential diagnosis
    
  • Nutritional factors/aspects involved in the disease/disorder
    
  • Prognosis, complications, mortality/survival
    
  • Investigations (screening and confirmatory; list principles involved and results expected)
    
  • Principles of  the use of pharmacological agents
• Select and interpret renal function tests in a patient with the renal disease.
• Develop analytical algorithms for patients with hematuria, proteinuria
• Develop analytical algorithms for patient with acid-base disturbance when ABG (arterial blood gas) values are given. Also, include use of Davenport diagram in diagnosis of acid-base disturbances.
• Create clinical vignettes including the typical clinical presentations of the diseases listed and generate at least 1 MCQ for each to test an important concept:
  
  • Acute renal failure
    
  • Acute glomerulonephritis
    
  • Acute tubular necrosis
    
  • Malignant hypertension
    
  • Acute tubulointerstitial nephritis
    
  • Chronic renal failure (glomerulonephritis, benign hypertension, chronic       interstitial nephritis)
    
  • Nephrotic syndrome
    
  • Diabetic nephropathy
    
  • Lupus nephropathy
    
  • Renal amyloidosis
    
  • IgA nephropathy
    
  • Hereditary nephritis
    
  • Polyarteritis
    
  • Wagener’s granulomatosis
    
  • Goodpasture’s syndrome
    
  • Hemolytic uremic syndrome
    
  • Analgesic nephropathy
    
  • Drug induced interstitial nephritis
    
  • Pyelonephritis
    
  • Hydronephrosis
    
  • Xanthogranulomatous pyelonephritis
    
  • Urolithiasis
    
  • Polycystic kidney disease
    
  • Renal cell carcinoma
    
  • Transitional cell carcinoma
    
  • Renal transplant rejection
    
  • Acid-base disturbances

MALE GENITAL SYSTEM

The students should be able to recapitulate the following enabling objectives from previous courses:

• Recapitulate the normal anatomy and histology of the male genital system
  
• Explain the basis of genital, gonadal and genital sex in males
  
• Describe the embryological development of male internal and external genitalia and the influences of various hormones during the stages of development. List the common malformations of male genital tract and the embryological basis for them.
  
• Explain the endocrine function of the testis
  
• Describe the stages of spermatogenesis and the factors essential for it
  
• Explain anatomy and physiology of erection and ejaculation and the neurotransmitters involved in it
  
• Describe the source, synthesis, transport, metabolism and functions of testosterone and dihydrotestosterone
  
• Explain the role of Sertoli cells in the normal testicular functions
  
• Explain the regulation of androgen secretion and control of testicular function by hypothalamo-hypophysio-testicular axis
  
• List the common organisms causing male genital tract infection and their   identification
  
• Recapitulate the morphology and pathogenesis of common diseases of the male genital system such as: Balanitis, carcinoma penis, Cryptorchidism, Orchitis, testicular neoplasms, Prostatitis, Benign   hyperplasia prostate, Carcinoma of prostate, Urinary tract infection, Cystitis, Carcinoma bladder, Sexually transmitted diseases.

Specific learning objectives: (Pathophysiology)

• Compare and contrast the clinical vignettes for disorders listed (Male infertility, Balanitis, Carcinoma penis, Cryptorchidism, Orchitis, Testicular  neoplasms, Prostatitis, Benign hyperplasia prostate, Carcinoma of  prostate, Sexually transmitted diseases, Urinary tract infection, Cystitis,  Carcinoma bladder) with reference to:
  • Risk factors
    
  • Etiology
    
  • Pathogenic mechanism
    
  • Altered morphology, physiology
    
  • Signs and symptoms
    
  • Basis for signs and symptoms
    
  • Differential diagnosis
    
  •   Prognosis, complications, mortality/survival
    
  • Investigations (screening and confirmatory list principles involved and        results expected)
    
  • Principles of  the use of pharmacological agents
• Discuss the differential diagnosis and evaluation of a couple with male infertility.
• Create clinical vignettes including the typical clinical presentations of the diseases listed below and generate at least 1 MCQ for each to test an important concept:
  • Male infertility
    
  • Primary and secondary hypogonadism
    
  • Klinefelter’s syndrome
    
  • Kallmann’s syndrome
    
  • Kartagener’s syndrome
    
  • Cryptorchidism
    
  • Prolactinoma
    
  • Erectile dysfunction (impotence)
    
  • Balanitis
    
  • Carcinoma penis
    
  • Cryptorchidism
    
  • Orchitis
    
  • Testicular neoplasms
    
  • Torsion of testis
    
  • Epididymitis
    
  • Prostatitis: Acute and chronic
    
  • Benign hyperplasia prostate
    
  • Carcinoma of prostate
    
  • Sexually transmitted diseases
    
  • Urinary tract infection in males
    
  • Cystitis
    
  • Carcinoma bladder

GERIATRICS

GOAL: To enable the Family Medicine resident to develop the knowledge (K), skills (S) and attitudes (A) to address the needs of the elderly and their families

SPECIFIC OBJECTIVES:

• Discuss the unique multiple factors which promote or deter “wellness” in    the elderly such as physical, cognitive, psychological and social/supportive factors
  
• Recognize the unique and atypical ways that common illnesses often present in the elderly
  
• Describe age-related changes in body systems and tissues and integrates these with clinical practice
  
• Explain the causes, pathogenesis, clinical features, complications of   various geriatric problems  
  
• Describe the various clinical investigations of elderly patients
  
• Discuss the limitations of various investigative procedures such as mini mental status exams for the elderly
  
• Explain the panelling process for admission to a personal care home
  
• Discuss the common geriatric problems listed below:
  
  • Delirium/Acute confusional states
    
  • Dementia
    
  • Depression
    
  • Falls & Gait disorders
    
  • Immobility
    
  • Weight loss & Malnutrition
    
  • Urinary incontinence
    
  • Pressure Ulcers
    
  • Polypharmacy
• Compare each of the above listed problems with reference to:
  
  • Prevalence
    
  • Risk factors
    
  • Pathogenic mechanism
    
  • Altered morphology, physiology
    
  • Signs and symptoms
    
  • Basis for signs and symptoms
    
  • Differential diagnosis
    
  • Nutritional factors involved in the problems
    
  • Prognosis, complications, mortality/survival
  • Investigations (screening and confirmatory; list principles involved and       results expected)
    
  • Principles of  the use of pharmacological agents

ENDOCRINES

The students should be able to recapitulate the following enabling objectives from the previous courses:

• Recapitulate the normal anatomy, embryology, histology, blood supply and nerve supply of pituitary, adrenal, thyroid and parathyroid glands.
  
• Describe the endocrine role of hypothalamus
  
• Explain the neuroendocrine axes and how do they work
  
• Describe the hormones of anterior pituitary and their role in the regulation of target organ secretion
  
• Explain the synthesis, storage, factors stimulating and inhibiting secretion, physiological action and regulation of hormones of the posterior pituitary (vasopressin and oxytocin)
  
• Describe the synthesis, storage, secretion, transport and metabolism of thyroid hormones
  
• Describe the physiological affects, mechanism of action and regulation of T3, T4 
  
• Explain the synthesis, transport, metabolism of glucocorticoids, mineralocorticoids and sex hormones of the adrenal cortex
  
• Describe the physiological actions and regulation of glucocorticoids
  
• Describe the synthesis, metabolism, regulation of secretion, mechanism of action and effects of insulin and glucagon
  
• Explain the hormonal regulation of intermediary metabolism
  
• Describe the synthesis, metabolism, regulation of secretion, mechanism of action and effects of parathyroid hormone (PTH)
  
• Describe the histology of bone tissue. Explain the role of different cells in bone remodeling.
  
• Describe the synthesis, metabolism, regulation of secretion, mechanism of action and effects of Vitamin D
  
• Describe the source, metabolism, regulation, mechanism of action and effects of calcitonin
  
• Recapitulate the etio-pathogenesis, macro and microscopic appearances, and critical features of endocrine disorders leading to hyperfunction/hypofunction of the following: Anterior and posterior pituitary, thyroid, parathyroid, adrenal cortex, adrenal medulla, islets of Langerhans.

Specific learning objectives: (Pathophysiology)

• Compare and contrast the clinical vignettes for disorders listed below (under 3) with reference to:
  • Risk factors
    
  • Etiology
    
  • Pathogenic mechanism
    
  • Altered morphology, physiology
    
  • Signs and symptoms
    
  • Basis for signs and symptoms
    
  • Differential diagnosis
    
  • Nutritional factors/aspects involved in the disease/disorder
    
  • Prognosis, complications, mortality/survival
    
  • Investigations (screening and confirmatory; list principles involved and       results expected)
    
  • Principles of  the use of pharmacological agents
• Select and interpret function tests in a patient with the thyroid and adrenal disease.
• Create clinical vignettes including the typical clinical presentations of the diseases listed and generate at least 1 MCQ for each to test an important concept:
  Pituitary adenoma
  • Prolactinoma
    
  • Growth hormone secreting adenoma
    
  • Cushing’s disease (ACTH secreting adenoma)
    
  • Hypopituitarism
    
  • Sheehan’s syndrome
    
  • Diabetes insipidus
    
  • SIADH
    
  • Hyperthyroidism
    
  • Graves’ disease
    
  • Hypothyroidism and myxedema
    
  • Hashimoto’s thyroiditis
    
  • Goiter
    
  • Tumors of the thyroid gland
    
  • Pheochromocytoma
    
  • Cushing’s syndrome
    
  • Micro and macronodular hyperplasia of adrenal gland
    
  • Addison’s disease
    
  • Waterhouse-Friderichsen syndrome
    
  • Primary and secondary Adrenocortical insufficiency
    
  • Primary and secondary Hyperaldosteronism
    
  • Congenital adrenal hyperplasia
    
  • Diabetes mellitus
    
  • Insulinoma
    
  • Primary and secondary hyperparathyroidism
    
  • Hypoparathyroidism and pseudohypoparathyroidism
    
  • Medullary carcinoma of thyroid
    
  • Osteoporosis
    
  • Osteomalacia
    
  • Multiple endocrine neoplasia (MEN) syndromes

NEUROLOGY

The students should be able to recapitulate the following enabling objectives from the previous courses:

• Recapitulate the histology and functions of the neurons and glial cells in the nervous system.
  
• Recapitulate the origin, course, distribution, clinical testing and lesion of various cranial nerves
  
• Explain the ionic basis of resting membrane potential, action potential, excitatory and inhibitory post-synaptic potentials
  
• Describe the blood supply of brain. Identify the areas of brain supplied by middle cerebral and posterior cerebral arteries.
  
• Compare and contrast upper motor neurons and lower motor neurons with reference to their origin, termination, function and lesion.
  
• Compare and contrast the origin, course, termination and function of the pyramidal and extrapyramidal motor pathways
  
• Correlate the structure and connections of the cerebellum with its functions
  
• Describe the anatomy, connections, functions and the neurotransmitters involved in basal ganglia
  
• Trace the pathways for various somatic sensations (pain, touch, temperature, vibration, proprioception) from the receptors upto the cortex.
  
• Explain the anatomy and physiology of eye ball movements.
  
• Trace the visual pathways from the retina upto the visual cortex. Explain the common visual defects and their anatomic basis
  
• Describe the anatomy of middle ear and inner ear. Identify the role played by each component.
  
• Trace the auditory pathways from the cochlea upto the cortex. Explain the principles tuning fork tests to differentiate the types of deafness
  
• Explain physiology of vestibular apparatus. Describe how vestibular information helps in maintaining posture and balance.
  
• Explain the neurophysiology of consciousness, arousal and cognition
  
• Describe different types of learning and memory. Identify the neuroanatomical, neurophysiological and molecular basis for learning and memory
  
• Discuss the anatomy and functions of the limbic system. Explain the neurophysiological basis of emotion
  
• Describe neurophysiology of speech and language. Compare and contrast various types of aphasias
  
• Explain the structure and functions of blood brain barrier.
  
• Discuss the formation, circulation, drainage, properties and functions of the cerebrospinal fluid (CSF). Describe the normal CSF findings.
  
• Recapitulate the etio-pathogenesis, macro and microscopic appearances,  and critical features of nervous system disorders such as: Cerebral edema, hydrocephalus, vascular malformations, cerebral infarcts, intracranial hemorrhages, neural tube defects, neurocutaneous syndromes, meningitis, astrocytoma, oligodendroglioma, ependymoma, medulloblastoma, meningioma, multiple sclerosis, Alzheimer disease,  neurofibromatosis and motor neuron disease.

Specific learning objectives: (Pathophysiology)

• Compare and contrast the clinical vignettes for disorders listed below (under 2) with reference to:
  • Risk factors
    
  • Etiology
    
  • Pathogenic mechanism
    
  • Altered morphology, physiology
    
  • Signs and symptoms
    
  • Basis for signs and symptoms
    
  • Differential diagnosis
    
  • Nutritional factors/aspects involved in the disease/disorder
    
  • Prognosis, complications, mortality/survival
    
  • Investigations (screening and confirmatory; list principles involved and       results expected)
    
  • Principles of  the use of pharmacological agent
• Create clinical vignettes including the typical clinical presentations of the diseases/conditions listed and generate at least 1 MCQ for each to test an important concept:
  
  • Increased intracranial tensions
    
  • Herniation of the brain
    
  • Global cerebral hypoxia
    
  • Motor neuron disease (amyotrophic lateral sclerosis)
    
  • Parkinson’s disease
    
  • Huntington’s disease
    
  • Myasthenia gravis
    
  • Epilepsy
    
  • Dementia
    
  • Alzheimer’s disease
  • Trauma, Cerebrovascular accidents & Stroke
    
  • Cerebral edema
    
  • Hydrocephalus
    
  • Intracranial hemorrhages
    
  • Neural tube defects
    
  • Acute and chronic meningitis
    
  • Brain abscess
    
  • Major headaches-migraine, tension headache, temporal arteritis, head injuries and raised intracranial pressure induced headaches
    
  •   Astrocytoma
    
  • Oligodendroglioma
    
  • Meningioma
    
  • Ependymoma
    
  • Medulloblastoma
    
  • Multiple sclerosis
    
  • Peripheral neuropathy
    
  • Neurocutaneous syndromes
    
  • Viral encephalitis
    
  • Progressive multifocal leukoencephalopathy
    
  • Prion diseases (Creutzfeldt-Jacob disease, kuru, Gerstmann-Straussler syndrome, fatal familial insomnia)
    
  • Glioblastoma multiforme
    
  • Primary CNS lymphomas
    
  • Common metastaes to CNS
    
  • Leukodystrophies
    
  • Wernicke-Korsakoff syndrome

PSYCHIATRY AND HUMAN SEXUALITY

PSYCHIATRY:

• Name the First widely used Antipsychotic and Tricylic Antidepressant
• List and describe each of the 5 Axes of DSM
• List 4  criteria DSM IV uses to define illness
• Describe the epidemiology and symptomatology of Depression (MDE)
• List relevant differential diagnoses and investigations for depression
• Explain current hypotheses (including depression as a “multi-organ” illness) of depression
• Describe appropriate therapeutic strategies of depression, including the role of BDNF (brain derived nerve factor)
• Describe the epidemiology and symptomatology of schizophrenia
• List relevant differential diagnoses and investigations for schizophrenia
• Explain current hypotheses of schizophrenia
• Describe appropriate therapeutic strategies for schizophrenia and their complications
• Describe the epidemiology and symptomatology of Bipolar Disorder
• List relevant differential diagnoses and investigations for bipolar disorder
• Explain current hypotheses of bipolar disorder
• Describe appropriate therapeutic strategies for bipolar disorder
• Describe the epidemiology and symptomatology of the Anxiety Disorders
• List relevant differential diagnoses and investigations for Anxiety Disorders
• Explain current hypotheses of Anxiety Disorders
• Describe appropriate therapeutic strategies for Anxiety Disorders
• For the following conditions, explain the diagnostic criteria, prevalence and general therapeutic approach:
  
  • ADHD (Attention-Deficit/Hyperactivity Disorder)
    
  • Enuresis
    
  • Dementia
    
  • Delirium
    
  • Anorexia & Bulimia Nervosa
• Compare and Contrast the following:
  
  • Normal Sleep patterns (REM sleep and Slow wave sleep)
    
  • Sleep and Depression
    
  • Antidepressants and Sleep

HUMAN SEXUALITY:

• Explain the stages of human psychosexual development
  
• Differentiate gender identity and gender role
  
• Describe the normal human sexual response in male and female
  
• Explain the categories of sexual dysfunction such as sexual desire disorders, sexual arousal disorders, orgasm disorders, sexual pain disorder and others.
  
• Describe the etiological factors for sexual disfunction
  
• Describe various types of paraphilias, child sexual abuse and homosexual behaviour
  
• Explain the interview technique in basic sexual history taking

DERMATOLOGY

The students should be able to recapitulate the following enabling objectives from the previous courses:

• Recapitulate the histology of the skin and its appendages
  
• Describe the functions of the skin.
  
• Recapitulate the etio-pathogenesis, macro and microscopic appearances, and critical features of diseases of skin such as: Psoriasis, Erythema multiforme, Vesiculobullous dermatitis, Leukocytoclastic vasculitis, Allergic contact dermatitis, Erythema nodosum, Sarcoidosis, Acne, Melanoma, verrucae, squamous cell carcinoma, and basal cell carcinoma.
  
• Distinguish clinically macule, erythema, plaque, nodule, vesicle, bulla, blister, papule, pustule, eczema, lichenplan, scale, petechiae, purpura, echymosis, ulcer, verruca, erythema multiforme 

 

Specific learning objectives: (Pathophysiology)

• Compare and contrast the clinical vignettes for disorders listed below (under 2) with reference to:
  • Risk factors
    
  • Etiology
    
  • Pathogenic mechanism
    
  • Altered morphology, physiology
    
  • Signs and symptoms
    
  • Basis for signs and symptoms
    
  • Differential diagnosis
    
  • Nutritional factors/aspects involved in the disease/disorder
    
  • Prognosis, complications, mortality/survival
    
  • Investigations (screening and confirmatory; list principles involved and       results expected)
    
  • Principles of  the use of pharmacological agents
• Create clinical vignettes including the typical skin manifestations of the diseases listed and generate at least 1 MCQ for each to test an important concept:
  
  • Psoriasis
    
  • Erythema multiforme
    
  • Vesiculobullous dermatitis
    
  • Leukocytoclastic vasculitis
    
  • Allergic contact dermatitis
    
  • Erythema nodosum
    
  • Sarcoidosis
    
  • Acne
    
  • Fungal skin lesions
    
  • Mole, Malignant melanoma
    
  • Skin cancers (basal cell carcinoma, squamous cell carcinoma)
    
  • Herpes simplex/zoster
    
  • Tenia
    
  •   Molluscum contagiosum
    
  • Verucae (warts)
    
  • Measles
    
  • Rubella
    
  • AIDS
    
  • Insect bites
    
  • Scabies
    
  • Lyme disease
    
  • Roseola
    
  •  Arthopode bites-Scabies, lice