Download study guide for endocrine module

STUDY GUIDE
ENDOCRINE MODULE
SECOND YEAR MBBS
SEMESTER 3
Insulin
LIAQUAT NATIONAL HOSPITAL
& MEDICAL COLLEGE
2017
LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
STUDY GUIDE FOR ENDOCRINE MODULE
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CONTENTS
Overview
Introduction to Study Guide
Learning Methodologies
Module 3: Endocrine
Importance of Endocrinology
Objectives and strategies
Learning Resources
Assessment Methods
Semester Examination Rules And Regulations of JSMU
Modular Examination Rules And Regulations (LNMC)
Schedule
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
Module name: Endocrine
Semester: Three
Year: Two
Duration: 4 weeks (Feb 2017 – March 2017)
Timetable hours: Lectures, Case-Based Learning (CBL), Self-Study, Practical, Skills,
Demonstrations, Visit to Wards & Laboratory
Credit hours: 3 credit hours in theory and 1.5 credit hours in practical
MODULE INTEGRATED COMMITTEE
MODULE COORDINATOR:

CO-COORDINATORS:
 Professor Nighat Huda, DHCE
 Dr. Ahsan Ashfaq (Physiology)
Professor Syed Hafeez-ul-Hassan
(HoD Physiology)
DEPARTMENTS’ & RESOURCE PERSONS’ FACILITATING LEARNING
BASIC HEALTH SCIENCES
CLINICAL AND ANCILLARY DEPARTMENTS
ANATOMY
ENDOCRINOLOGY
 Dr. Aqiba Sarfaraz
 Professor Zia-ul-Islam
 Professor Faiz Muhammad Sheikh
BIOCHEMISTRY
FAMILY MEDICINE
 Dr. Faridah Amin
 Professor Jawed Altaf Baig
COMMUNITY MEDICINE
 Professor Rafiq Soomro
RESEARCH & SKILLS DEVELOPMENT CENTER
 Dr Kahkashan Tahir
PATHOLOGY
 Professor Naveen Faridi
PHARMACOLOGY
 Professor Nazir Ahmad Solangi
PHYSIOLOGY
 Professor Syed Hafeezul Hassan
DEPARTMENT of HEALTHCARE EDUCATION
 Professor Nighat Huda
 Dr. Mirza Aroosa Beg
LNH&MC MANAGEMENT
 Professor Amir Ali Shoro, Dean & Principal, Director FHS
LNH&MC
 Dr. Shaheena Akbani, Controller A.A & R.T
LNH&MC
STUDY GUIDE COMPILED BY: Department of
Health Care Education
2017
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
Dr. Muhammad Suleman Sadiq
Dr. Rabia Mahmood
Dr. Afifa Tabassum
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
INTRODUCTION
WHAT IS A STUDY GUIDE?
It is an aid to:

Inform students how student learning program of the semester-wise module has been
organized

Help students organize and manage their studies throughout the module

Guide students on assessment methods, rules and regulations
THE STUDY GUIDE:

Communicates information on organization and management of the module.
This will help the student to contact the right person in case of any difficulty.

Defines the objectives which are expected to be achieved at the end of the module.

Identifies the learning strategies such as lectures, small group teachings, clinical skills,
demonstration, tutorial and case based learning that will be implemented to achieve the
module objectives.

Provides a list of learning resources such as books, computer assisted learning programs,
web- links, journals, for students to consult in order to maximize their learning.

Highlights information on the contribution of continuous and semester examinations on the
student’s overall performance.

Includes information on the assessment methods that will be held to determine every student’s
achievement of objectives.

Focuses on information pertaining to examination policy, rules and regulations.
CURRICULUM FRAMEWORK
Students will experience integrated curriculum in 3rd and 4th semesters at LNMC in accordance with the
JSMU guidelines and most recent developments that have an impact on individual health.
INTEGRATED CURRICULUM comprises of system-based modules such as Head and Neck, Neurosciences
and Endocrinology which links basic science knowledge to clinical problems. Integrated teaching means
that subjects are presented as a meaningful whole. Students will be able to have better
understanding of basic sciences when they repeatedly learn in relation to clinical examples.
Case-based discussions, computer-based assignments, early exposure to clinics, wards, and skills
acquisition in skills lab and physiotherapy department are characteristics of integrated teaching program.
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
LEARNING METHODOLOGIES
The following teaching / learning methods are used to promote better understanding:
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Interactive Lectures
Hospital / Clinic visits
Small Group Discussion
Case- Based Learning
Practicals
Skills session
Self Study
INTERACTIVE LECTURES
In large group, the lecturer introduces a topic or common clinical conditions and explains the underlying
phenomena through questions, pictures, videos of patients’ interviews, exercises, etc. Students are
actively involved in the learning process.
HOSPITAL VISITS: In small groups, students observe patients with signs and symptoms in hospital or
clinical settings. This helps students to relate knowledge of basic and clinical sciences of the relevant
module.
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
SMALL GROUP DISCUSSION (SGDS): This format helps students to clarify concepts acquire skills or
attitudes. Sessions are structured with the help of specific exercises such as patient case, interviews or
discussion topics. Students exchange opinions and apply knowledge gained from lectures, tutorials and
self study. The facilitator role is to ask probing questions, summarize, or rephrase to help clarify concepts.
CASE- BASED LEARNING: A small group discussion format where learning is focused around a series of
questions based on a clinical scenario. Students’ discuss and answer the questions applying relevant
knowledge gained in clinical and basic health sciences during the module.
PRACTICAL: Basic science practicals related to anatomy, biochemistry, pathology, pharmacology and
physiology are scheduled for student learning.
SKILLS SESSION:
Skills relevant to respective module are observed and practiced where applicable in
skills laboratory or Department of Physiotherapy.
SELF STUDY: Students’ assume responsibilities of their own learning through individual study, sharing and
discussing with peers, seeking information from Learning Resource Center, teachers and resource
persons within and outside the college. Students can utilize the time within the college scheduled hours
of self-study.
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
SEMESTER 3 MODULE 3 : ENDOCRINE
INTRODUCTION
The Endocrine system relays information and maintains a constant internal environment of the body called
homeostasis. It acts through chemical messengers called hormones that influence growth, development, and
metabolic activities. The action of the endocrine system is measured in minutes, hours, or weeks and is more
generalized than the action of the nervous system.
This M.B.B.S second year module will help you develop knowledge and understanding of the:
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Basic concepts of molecular endocrinology that underpin hormone actions, how dysfunction relates to
primary pathogenesis, and how this knowledge informs improvement in diagnosis and the potential
for novel therapies
Hypothalamic - pituitary axes and their role in health and disease, including the reproductive, adrenal,
and thyroid axes
Neuro-endocrine control of food intake, energy expenditure and obesity
Theories of the etiology and pathogenesis of type 2 diabetes mellitus
Similarly, this module of endocrine system will enable you to recognize the clinical presentations of common
endocrinological and metabolic disorders and relate clinical manifestations to basic sciences. This Endocrine
module will be revisited in the following years.
The study guide will help you prioritize the important topics for learning in relation to the module objectives
through lectures, demonstrations, tutorials, practicals and skills lab sessions.
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
COURSE OBJECTIVES AND STRATEGIES
At the end of the module the students will be able to:
FACULTY
LEARNING
STRATEGY
a) Describe the structure of endocrine glands in the body
Anatomy
Interactive Lecture
b) List the major and minor endocrine glands in the body
Pathology
Interactive Lecture
Pathology
Interactive Lecture
Physiology
Interactive
Lecture/Small
Group Discussion
Biochemistry
Interactive
Lecture/Small
Group Discussion
Anatomy
Interactive Lecture
Pathology
Interactive Lecture
OUTCOMES & OBJECTIVES
1. Give an overview of the endocrine glands in the
body
2. Define endocrine, neurocrine, autocrine, paracrine,
synergistic and antagonistic effects; up and down
regulation. Describe the concept of second
messenger Explain the principles of negative and
positive feedback of hormonal secretion
a) Define the different signaling pathways including
endocrine, paracrine, autocrine and juxtacrine
b) Define the terms endocrine, paracrine and autocrine
c) Describe the concept of hormone receptors and
second messenger in hormone action.
d) Describe the synthesis, functions and regulations of
the hormones
e) Describe the regulation of hormone secretion by
positive and negative feedback
3. Classify the hormones on the basis of structure,
biochemical function and mechanism of action
a) Classify the different hormones and describe their
chemical structure
b) Describe the biochemical function of hormones
4. Discuss hypothalamic-pituitary end organ axis
a) Describe the Development and congenital anomalies
of Pituitary gland
b) List the hormones secreted by the pituitary gland
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2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
LIAQUAT NATIONAL MEDICAL COLLEGE
c) Describe the structural and functional relationships
Pathology
Interactive Lecture
between the hypothalamus and the pituitary gland
d) Describe the hormones secreted by the anterior
pituitary gland and describe their hypothalamic
control
Physiology
Interactive
Lecture/Small
Group Discussion
e) Discuss the anterior pituitary secretions and related
disorders
Physiology
Interactive
Lecture/Small
Group Discussion
f)
Pathology
Interactive Lecture
Anatomy
Skills/Practical
b) Describe the gross anatomy , neurovascular supply
and clinical importance of Pituitary gland
Anatomy
Small Group
Discussion/CaseBased
Learning/Interactive
Lecture
c) List the hormones secreted by the pituitary gland
Describe structural and functional relationships
between the hypothalamus and the pituitary gland
Pathology
Interactive Lecture
Biochemistry
Interactive
Lecture/Small
Group Discussion
Physiology
Interactive
Lecture/Small
Group Discussion
Biochemistry
Interactive
Lecture/Small
Group Discussion
Briefly describe posterior pituitary syndromes
5. Describe the development, structure, secretion,
mode of action, functions, anomalies and common
related disorders of hypothalamus and pituitary
a) Describe the Microscopic features of pituitary gland
d) Describe the structure, secretion, mode of action,
function and common related disorders of
hypothalamus
6. Explain biochemical functions of growth hormones.
Growth hormones and its effects on carbohydrates,
protein and lipid metabolism. metabolic effects of
growth hormones
a) Describe physiological function of growth hormone
and related disorders
b) Describe the structure, biosynthesis, actions and
regulation of growth hormone
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
Biochemistry
Interactive
Lecture/Small
Group Discussion
Biochemistry
Interactive
Lecture/Small
Group Discussion
b) Discuss the biochemical function of anterior pituitary
hormones
Biochemistry
Interactive
Lecture/Small
Group Discussion
c) Discuss the clinical manifestations of anterior pituitary
disease
- Discuss the classification of pituitary adenomas
Pathology
Interactive Lecture
Biochemistry
Interactive
Lecture/Small
Group Discussion
Physiology
Interactive
Lecture/Small
Group Discussion
Biochemistry
Interactive
Lecture/Small
Group Discussion
Pathology
Interactive Lecture
Biochemistry
Interactive
Lecture/Small
Group Discussion
c) Describe the effect of growth hormone on
carbohydrates, proteins and lipids
7. Discuss molecular structure, biochemical function of
anterior pituitary
a) Describe the molecular structure of anterior pituitary
hormones
8. Classify the hormones of posterior pituitary. Explain
their biochemical functions of oxytocin and ADH and
their related disorders
a) List the hormones secreted by posterior pituitary gland
and describe their effects
b) Describe posterior pituitary secretions and disorders
c) Describe the biochemical functions of oxytocin and
ADH and their related disorders
d) Correlate this knowledge to clinical conditions
related to hypo- and hypersecretion of growth
hormone.
9. Differentiate between hypo and hyper secretion of
hypothalamus and pituitary, based on a given set of
data
a) Interpret a given data to differentiate between hypo
and hyper secretion of hypothalamus & pituitary
hormones
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2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
Biochemistry
Case-Based
Learning
Physiology
Interactive
Lecture/Small
Group Discussion
a) Describe the development and congenital anomalies
of thyroid
Anatomy
Interactive Lecture
b) Describe the microscopic features of thyroid gland
Anatomy
Skills/Practical
Anatomy
Small Group
Discussion/CaseBased
Learning/Interactive
Lecture
Physiology
Interactive
Lecture/Small
Group Discussion
Physiology
Case-Based
Learning/Interactive
Lecture
Biochemistry
Interactive
Lecture/Small
Group Discussion
Pathology
Interactive Lecture
b) Discuss acromegaly and dwarfism
c) Identify pituitary abnormalities, dwarfism and
acromegaly
10. Describe the development, structure, secretions,
mode of actions, metabolism, anomalies and
common related disorders of thyroid
c) Describe the gross anatomy , neurovascular supply
and clinical importance of thyroid gland
d) Describe thyroid gland hormones and their functions
e) Discuss abnormalities of thyroid hormones
f)
Describe the structure, synthesis, mode of
action and metabolic functions of thyroid
g) Briefly describe the hypothalamus-pituitary-thyroid
homeostasis
- Define Hypothyroidism
- List the major causes of hypothyroidism
- List The main clinical features of hypothyroidism
- Define Hashimotos Thyroiditis
- Discuss the pathogenesis of Hashimoto’s Thyroiditis
and its clinical manifestations
- Define hyperthyroidism
- List the causes of hyperthyroidism
- List the main clinical features of hyperthyroidism
- Discuss Grave’s disease including pathogenesis and
clinical features
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
11. Differentiate between hypo and hyperthyroid and
parathyroid gland, based on a given set of data
a) Interpret thyroid function tests (T3, T4, TSH, I2 &
LATS)
b) Describe the diagnostic modalities available to
diagnose thyroid pathology
- Interpret thyroid function tests
c) Identify the signs and presentation of
hypothyroidsm/hyperthyroidism in clinics
d) Discuss hyperthyroidism
e) Discuss the pathogenesis of Hashimotos Thyroiditis
and Graves Disease
f)
Revise the pathogenesis of Hashimotos Thyroiditis and
Graves Disease
Biochemistry
Interactive
Lecture/Small
Group Discussion
Pathology
Case Based
Learning
Endocrinology
Interactive Lecture
Physiology
Small group
learning
Pathology
Interactive Lecture
Pathology
Small group
learning
Pharmacology
Cased Based
Learning
12. Discuss the treatment protocol and thyroid
hyposecretion. Enumerate drugs used for it and
explain kinetics and dynamics of the drugs used to
treat hypothyroidism
a) Describe how drugs influence the steps in synthesis
and release of thyroid hormones
- Describe the clinical presentation and treatment of
hypothyroidism
- Describe clinical presentation and treatment of
endemic goiter
13. Classify antithyroid drugs and mention diseases
causing hyperthyroidism. Explain basic and clinical
pharmacology of the antithyroid drugs
a) Describe the clinical presentation and pharmacology
of drugs used in hyperthyroidism
- Describe the treatment of thyroid storm and
myxedema coma
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
14. Overview of the concept of iodine deficiency,
effects, control measures and fortification of iodine
in food
a) Describe the causes and effects of iodine deficiency
on brain and control of this problem
Community
Medicine
Interactive Lecture
a) Describe the Development and congenital anomalies
of parathyroid glands
Anatomy
Interactive Lecture
b) Describe the Microscopic features of parathyroid
glands
Anatomy
Skills/Practical
c) Describe the gross anatomy , neurovascular supply
and clinical importance of parathyroid glands
Anatomy
Small Group
Discussion/CaseBased
Learning/Interactive
Lecture
d) Discuss secretion, action, functions of parathyroid
hormones
Physiology
Interactive Lecture
e) Briefly discuss function of parathyroid glands
- Define hyperparathyroidism
- Discuss the causes of hyperparathyroidism and clinical
manifestations
- Define Hypoparathyroidism
- Discuss causes and clinical manifestations of
hypoparathyroidism
Pathology
Interactive Lecture
Endocrinology
Interactive Lecture
Physiology
Interactive Lecture
Pharmacology
Interactive Lecture
15. Explain the development, structure, secretions,
mode of action, functions, metabolism, anomalies
and common related disorders of parathyroid Gland
f)
Identify the signs and presentation of parathyroid
disorders in clinics
16. Review of kinetics and control of calcium in the
body. Classify drugs/drug groups used to treat hyper
and hypocalcemia and to explain their basic and
clinical pharmacology
a) Discuss calcitonin hormone and role of vitamin D
b) Discuss the role of parathyroid hormone, calcitonin
and Vitamin D in Calcium homeostasis
- Name the causes of hypercalcemia, including drug
induced hypercalcemia
- Describe the signs symptoms and complications of
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2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
LIAQUAT NATIONAL MEDICAL COLLEGE
hypercalcemia
- Discuss the treatment of hypercalcemia
- Explain the etiology of hypocalcemia
- Describe signs symptoms and lab evaluation of
hypocalcemia
- Discuss treatment of hypocalcemia
17. Discuss the basic and clinical aspects of the relevant
drugs leading to clarification of the concepts
Pharmacology
Case Based
Learning
Anatomy
Interactive Lecture
Anatomy
Skill/Practical
c) Describe the gross anatomy , neurovascular supply
and clinical importance of Pancreas
Anatomy
Small Group
Discussion/CaseBased
Learning/Interactive
Lecture
d) Discuss the molecular structure, mode of action &
biochemical functions of Insulin
Biochemistry
Interactive Lecture
Physiology
Interactive Lecture
Biochemistry
Interactive Lecture
Physiology
Interactive
Lecture/Small
Group Discussion
Biochemistry
Interactive Lecture
Pathology
Interactive Lecture
a) Describe the drugs used in hyper and hypothyroidism
18. Discuss the development, anomalies, structure,
secretions, mode of action and metabolism of
pancreatic hormones
a) Describe the development and congenital anomalies
of Pancreas
b) Describe the Microscopic features of Pancreas
e) Describe Hormones of pancreas and insulin
f)
Discuss the molecular structure & biochemical
function of Glucagon & somatastatin
g) Describe Glucagon, somatostatin and Pancreatic
Polypeptides
19. Explain the regulation of blood glucose with referred
level and their completion
a) Explain the regulation of blood glucose level, hyper &
hypoglycemia complications of Diabetes Mellitus
b) Define diabetes mellitus
- Describe the diagnostic criteria and guidelines for
diagnosis of diabetes
- Discuss the classification of diabetes mellitus
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2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
LIAQUAT NATIONAL MEDICAL COLLEGE
- List the differences between Type 1 and Type 2 DM
- Discuss the pathogenesis of diabetes mellitus
- List the complications of DM
Small group
Pathology
c) Discuss the pathogenesis of Diabetes Mellitus
learning
Pathology
Case-Based
Learning
Community
Medicine
Interactive Lecture
Biochemistry
Skills/Practical
a) Classify Oral hypoglycemic drugs
- Describe the pharmacology of oral hypoglycemic
agents, adverse effects and important drug
interactions
Pharmacology
Interactive Lecture
/Case Based
Learning
b) Formulate graph of GTT on the basis of given data
Biochemistry
Skills/Practical
Pathology
Case-Based
Learning
Endocrinology
Interactive Lecture
Pharmacology
Interactive Lecture
/Case-Based
Learning
d) Interpret Laboratory diagnosis of Diabetes mellitus
20. Overview of the concepts of diabetes, screening of
diabetes in population. Control and preventive
measures
a) Explain different types of diabetes its
complications, treatment and prevention
21. Demonstrate estimation of blood glucose level by kit
method
a) Demonstrate the estimation of blood glucose level by
Kit method & Laboratory interpretations for diagnosis
of diabetes mellitus
22. Overview of oral hypoglycemic and antidiabetic
drugs classes and appraise of the kinetics and
dynamics of sulfonylureas and their clinical
application
c) Discuss the pathogenesis of Diabetes Mellitus
d) Explain diabetes and its complications
23. Discuss basic and clinical pharmacology and kinetics
and dynamics of different lnsulin preparations
a) List the different insulin preparations: Classification,
onset, peak and duration of action
- Describe Conventional and Intensive insulin therapy
Explain their advantages and disadvantages
- Describe the adverse effects of insulin
- Describe injectable hypoglycemic drugs other than
insulin: pramlintide and exenetide
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2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
LIAQUAT NATIONAL MEDICAL COLLEGE
b) Demonstrate S/C insulin injection technique using an
Small Group
insulin syringe
Discussion (videoResearch & Skills
Based Learning)
24. Overview of the concept of obesity, how to measure
it, control measure and explain the body mass index
a) Explain the various levels of obesity on the basis
Community
Medicine
Interactive Lecture
Family Medicine
Interactive Lecture
a) Describe the Development and congenital anomalies
of Adrenal gland
Anatomy
Interactive Lecture
b) Describe the Microscopic features of Adrenal gland
Anatomy
Skill/Practical
Anatomy
Small Group
Discussion/CaseBased
Learning/Interactive
Lecture
d) Describe the chemistry, synthesis & metabolic
functions of glucocorticoids & mineralocorticoids
Biochemistry
Interactive Lecture
e) Explain Hormones of adrenal cortex and related
disorders
Physiology
Interactive Lecture
Biochemistry
Interactive Lecture
of body mass index, hazards and prevention
b) Explain different measures of Obesity (BMI, Waist
circumference, Waist hip ratio) and its measurement
- To highlight the clinical significance of Obesity (grades
of obesity), explaining the complications of obesity
- Enlist the causes of obesity
- Explain the impact of obesity on physical, social and
mental well being of a patient
- Briefly describe the management of Obesity through
lifestyle modification and anti-obesity medications
25. Describe the development, gross and microscopic
structure, secretions, and mode of action, functions,
anomalies and common related disorders of adrenal
gland
c) Describe the gross anatomy , neurovascular supply
and clinical importance of Adrenal gland
f)
2017
Describe the chemistry of adrenal medullary
hormones with pheochromocytoma
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
g) Explain Hormones of adrenal medulla and
abnormalities
h) List the hormones secreted by adrenal gland
- Define hyperadrenalism
- Discuss the causes and clinical features of Cushing’s
syndrome
- Describe hyperaldosteronism
- List the adrenogenital syndromes
i)
Discuss adrenal function tests
Physiology
Interactive Lecture
/Small Group
Discussion
Pathology
Interactive Lecture
Pathology
Small group
Discussion
Pharmacology
Interactive Lecture
Community
Medicine
Interactive Lecture
Physiology
Interactive Lecture
& Small Group
Discussion
Community
Medicine
Interactive Lecture
Community
Medicine
Interactive Lecture
26. Classify corticosteroids and analyze their functions.
Explain kinetics and dynamics of glucocorticoids and
mineralocorticoids and discuss their inhibition
a) Explain the systemic effects of corticosteroids and to
relate these to the adverse effects, precautions and
contraindications of steroid therapy
- Classify
the
commonly
used
corticosteroid
preparations
- List the uses of corticosteroid preparations
- Explain corticosteroid withdrawal effect and its
prevention
27. Understand the concept of health management
system. Issues and challenges, solutions and
improvement of Health management system
a) Discuss the health management information of
Pakistan in general and specific to the district
28. Explain secretion of melatonin. Describe the
importance of melatonin in sleep cycle
a) Describe Endocrine functions of kidney ,heart and
pineal gland
29. Discuss the health education principles and health
education program of Pakistan
a) Describe the various stages of health education
and its principles
b) Describe the various methods and the health
education program of Pakistan
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
LEARNING RESOURCES
SUBJECT
ANATOMY
BIOCHEMISTRY
COMMUNITY MEDICINE
PATHOLOGY/MICROBIOLOGY
RESOURCES
A. GROSS ANATOMY
1. K.L. Moore, Clinically Oriented Anatomy
2. Neuro Anatomy by Richard Snell
B. HISTOLOGY
1. B. Young J. W. Health Wheather’s Functional Histology
C. EMBRYOLOGY
1. Keith L. Moore. The Developing Human
2. Langman’s Medical Embryology
A. TEXTBOOKS
1. Harper’s Illustrated Biochemistry
2. Lehninger Principle of Biochemistry
3. Biochemistry by Devlin
A. TEXT BOOKS
1. Community Medicine by Parikh
2. Community Medicine by M Illyas
3. Basic Statistics for the Health Sciences by Jan W Kuzma
A. TEXT BOOKS
1. Robbins & Cotran, Pathologic Basis of Disease, 9th edition.
2. Rapid Review Pathology, 4th edition by Edward F. Goljan MD
1. http://library.med.utah.edu/WebPath/webpath.html
2. http://www.pathologyatlas.ro/
PHARMACOLOGY
PHYSIOLOGY
2017
A. TEXT BOOKS
1. Lippincot Illustrated Pharmacology
2. Basic and Clinical Pharmacology by Katzung
A. TEXTBOOKS
1. Textbook Of Medical Physiology by Guyton And Hall
2. Ganong ‘ S Review of Medical Physiology
3. Human Physiology by Lauralee Sherwood
4. Berne & Levy Physiology
5. Best & Taylor Physiological Basis of Medical Practice
B. REFERENCE BOOKS
1. Guyton & Hall Physiological Review
2. Essentials Of Medical Physiology by Jaypee
3. Textbook Of Medical Physiology by InduKhurana
4. Short Textbook Of Physiology by Mrthur
5. NMS Physiology
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
OTHER LEARNING RESOURCES
Hands-on Activities/ Practical
Students will be involved in Practical sessions and hands-on activities that
link with the endocrine module to enhance the learning.
Utilize the lab to relate the knowledge to the specimens and models
Labs
available.
A skills lab provides the simulated learning experience to learn the basic
Skills Lab
skills and procedures. This helps build the confidence to approach the
patients.
Video familiarize the student with the procedures and protocols to assist
Videos
patients.
Computer
To increase the knowledge students should utilize the available internet
Lab/CDs/DVDs/Internet
resources and CDs/DVDs. This will be an additional advantage to increase
Resources:
learning.
Self Learning is scheduled to search for information to solve cases, read
Self Learning
through different resources and discuss among the peers and with the
faculty to clarify the concepts.
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
ASSESSMENT METHODS:
Theory (knowledge): Best Choice Questions (BCQs) also known as MCQs (Multiple Choice Questions)
and EMQs (Extending Matching Questions) are used to asses objectives covered in each module.
BCQs:
 A BCQ has a statement or clinical scenario of four options (likely answers).

Correct answer carries one mark, and incorrect ‘zero mark’. There is NO negative marking.

Students mark their responses on specified computer-based sheet designed for LNHMC.
EMQs:
 An EMQ has:
o An option list of 5-15 nerve supply, functions, diagnosis, investigations etc
o A Lead In –Statement/Question
o Two to four Stems or Clinical Scenarios

Correct answer carries one mark and incorrect ‘zero mark’. There is NO negative marking.

Student mark their responses on a specified computer-based sheet for EMQs.
OSPE: Objective Structured Practical Examination

The content may assess application of knowledge, or practical skills.

Student will complete task in define time at one given station.

All the students are assessed on the same content by the same examiner in the same allocated
time.

There are observed, unobserved, interactive and rest stations.

Rest station is a station where there is no task given, and in this time student can
organize his/her thoughts.
2017
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
Internal Evaluation

During the module, students will be assessed to determine achievement of module objectives.

Module Examination: will be scheduled on completion of each module. The method of
examination comprises theory exam which includes BCQs, and practical (Objective
Structured Practical Examination).

20% marks of internal evaluation will be added in theory of semester exam. That 20%
may include class tests, assignment, journals and the modular exam which all have
specific marks allocation.
Example : Number of Marks allocated for Semester Theory and Internal Evaluation
Semester
Semester Examination
Theory Marks
80%
Internal Evaluation
(Class tests + Journals +
Assignments + Modular
Exam)
20%
Total (Theory)
100%
Formative Assessment

Individual department may hold quiz or short answer questions to help students assess
their own learning. The marks obtained are not included in the internal evaluation
More than 75% attendance is
needed to sit for the modular and
semester examinations
2017
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
SEMESTER EXAMINATION RULES & REGULATIONS OF JINNAH SINDH MEDICAL UNIVERSITY
(JSMU)

In one academic year there will be two semesters. The semester duration is approximately
sixteen weeks.

Each semester may have two to three modules from two to eight weeks duration.
JSMU EXAMINATIONS:

JSMU will schedule and hold Semester Examinations on completion of each semester.

In one academic year, there will be two semester examinations and one Retake Examination.
MBBS Second year:
 Semester III examination is scheduled on completion of Head & Neck, Neurosciences and
Endocrine module.
 Semester IV Examination is scheduled on completion of GIT & Liver, Renal and Reproductive
system module.
Examination Protocols:

In each semester, module will be assessed by theory paper comprising MCQs and EMQs. For
example, semester 3 will have separate paper for Head & Neck, Neurosciences and
Endocrinology.

There will be one OSPE (Objective Structured Practical Examination) which will cover all the
modules of semester 3.
1. Theory (Knowledge)

Theory paper will comprise of 80 one best type MCQs and 20 EMQs.

Time duration for theory paper will be 120 minutes.

Students will mark their responses on JSMU specified response sheets assessed by computer
software.

It will carry out 80% contribution in theory results of the Semester.

There is no negative marking.
2. OSPE:
2017

It is held at the respective college unless specified by JSMU.

It may comprise between 12- 25 stations. Each station will carry 10 marks.

All students begin and end at the same time.

The content assessed is the same for all students.

The time allocated for each station is the same.
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
3. JSMU Grading System

It will be based on GPA – 4 system
Marks obtained in
Percentage range
Numerical Grade
Alphabetical Grade
80-100
75-79
70-74
67-69
63-66
60-62
56-59
50-55
<50 Un-grade-able
4.0
4.0
3.7
3.3
3.0
2.7
2.3
2.0
0
A+
A
AB+
B
BC+
C
U

A candidate obtaining GPA less than 2.00 (50%) is declared un-graded (fail).

Cumulative transcript is issued at the end of clearance of all modules.
4. Retake Examination

The failures are to re-appear in subsequent examinations.

It is held once a year that is after the even number semesters. For example at the end of second,
fourth, sixth, eighth or tenth semester.

Retake examinations are for those students who fail in semester examinations, and who wish to
improve grades (GPA) secured in semester examinations.

The candidate who has passed the semester examinations with GPA less than 3.0 GPA may reappear in respective retake examination to improve grades.

MBBS first year Candidates failing in retake examinations may re-appear in semesters’
examinations of the following year. The format is exactly the same as in semester examinations.
EXAMPLE OF PROMOTION RULES:
A student who fails in Semester One Examination and passes Semester Two, s/he will take Retake for
Semester One Examination. S/he passes Semester one retake and is promoted to 2nd year. If that
student FAILS in Retake, s/he will be promoted to 2nd year BUT will have to Pass Semester One
examination in Second year along with Semester Three and Four examinations for promotion to third
year.
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
5. Promotion to next class

Students who pass both semester examinations are promoted from first year to second year.

Students who fail the MBBS first year semester retake examination will be promoted to second
year.

Students will be promoted from second year to third year and onward only if they have passed
the semester examinations of that year.

Clearance of all modules and their components of semester one to four are mandatory for
promotion from second year to third year (as per PMDC rules).

As per PMDC rules any candidate failing to clear a module or its component in four (1+3)
attempts is NOT allowed to carry out further medical education.

To pass all modules and their components of semester/s are mandatory for promotion from
third year onward.
(Albert Einstein)
2017
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LIAQUAT NATIONAL MEDICAL COLLEGE
2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
MODULAR EXAMINATION RULES & REGULATIONS (LNH&MC)

Student must report to examination hall/venue, 30 minutes before the exam.

Exam will begin sharp at the given time.

No student will be allowed to enter the examination hall after 15 minutes of scheduled
examination time.

Students must sit according to their roll numbers mentioned on the seats.

Cell phones are strictly not allowed in examination hall.

If any student is found with cell phone in any mode (silent, switched off or on) he/she will be not
be allowed to continue their exam.

No students will be allowed to sit in exam without University Admit Card, LNMC College ID Card
and Lab Coat

Student must bring the following stationary items for the exam: Pen, Pencil, Eraser, and
Sharpener.

Indiscipline in the exam hall/venue is not acceptable. Students must not possess any written
material or communicate with their fellow students.
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2ND YEAR MBBS, SEMESTER 3 ENDOCRINE MODULE
LIAQUAT NATIONAL MEDICAL COLLEGE
SCHEDULE:
WEEKS
WEEK 1
WEEK 2
WEEK 3
WEEK 4
WEEK 5
Mon 14thNov’ 2016
HEAD & NECK
MODULE
MODULAR EXAM
WEEK 1
WEEK 2
WEEK 3
WEEK 4
WEEK 5
WEEK 6
Fri 16th Dec 2016
Mon 19 Dec & Tue 20th Dec 2016
Wed 21st Dec 2016
th
NEUROSCIENCES
MODULE
MODULAR EXAM
WEEK 1
WEEK 2
WEEK 3
WEEK 4
DATES
2nd YEAR SEMESTER 3
ENDOCRINOLOGY
MODULE
MODULAR EXAM
31st Jan 2017
Fri 7th Feb & Sat 8th Feb 2017
Thursday 9th Feb 2017
Fri 10th March 2017
Tue 14th Mar & Wed 15th Mar 2017*
PREPARATORY LEAVE
SEMESTER EXAM
Mon 10th April – Wed 19th April’2017**
*Final dates will be announced later.
**Date for Semester Exam as per JSMU calendar for Batch 2015
2017
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