Syllabus for FCPS Part-1- Paediatrics

Post Date : 2017-03-19 | Category : Medical Education

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Syllabus for FCPS - Paediatrics


 

ThBIObJective of FCPS- Paediatrics will be to find out person who :


 

Isfafle and w‘umg to take responsibility for the management

0 a 1 range of acute and chronic condition in paediatrics,


 

_ h,as the ability to adopt a problem-solving approach to clinical

Situatlon,


 

_ ls able .to plan and interpret a program of investigation

aPpi‘opriate to the clinical situation with due regards to

patients Comfort, safety and economic capability,


 

_ ha_s the up to Slate knowledge on the recent developments in

allied branches and the skill of using the available technology

for the betterment of the sick child,


 

-— is aware of the role of the paediatrician in health/welfare

professmnal team and the society and has the willingness to

work co-operatively within such team,


 

' —- has acceptable communication skill for patient-doctor,

relation-doctor, nurse-doctor and doctor-doctor relation,


 

has the intention for maintenance and further development of

own knowledge and skill through continuing education.


 

Evaluation of the necessary knowledge and skill will be assessed


 

through two stages: .

Part-I : This part will assess the basic knowledge and skill

appropriate for the subject. This will include applied basic science

as detailed below in the course content together with behavior,

attitude and communication skill. These aspect will be assessed

through:


 

Written examination


 

Practical examination

Part-II : This part will assess advanced skill of data collection

(both clinical and laboratory), interpretation, judgement and

decision making. This will be evaluated through:


 

Written examination


 

Clinical examination

Structured oral examination/ OSCE


 


 

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The Part-I examination will comprise 0f fonowing three written


 

papers :


 

- paperJ; Anatomy, Behavioral Science, Medical Statistics and

Communication Skill


_ PaperJI; Physiology, Clinical Biochemistry and Clinical

Pharmacology


 

- Paper-III: Pathology (Microbiology, Immunology, Virology,

Genetics, Molecular biology and Histopathology)


 

In the following section the course content for each paper is


 

elaborated sometimes showing the functional aspect of it. Each of


 

the paper ends with a table showing distribution of question for

theory paper on each section.


 

Course content


 

Paper - I .' Anatomy, Behavioral Science, Medical Statistics and


 

Communication Skill


 

Points to remember :


 

0 Following are the course content for FCPS part-I in

Paediatrics in paper-l. The contents should be approached

which is relevant to Paediatrics discipline and not for surgical

or other true basic science discipline. ' ,


 

o In the study of different parts/organs blood supply, 13$~ phatic

drainage, structural relations are excluded (except in places

clearly mentioned in the content). However, nervous and

endocrine controls are retained.


 

0 Identification of viscera and body parts are excluded from the

examination.


 

Cell biology : structural details of a cell with functional


 

implications, cell cycle, cell division and its anomalies.


 

Recommended reading: Basic Histology - Junqueira; Basic


 

Histology -Ross; Gray '3 Anatomy


 

Developmental anatomy (general): Anatomical relevance of


 

the followmg phySiological aspects~ period of life, teratogenesis,

sensitive period of life, fetal circulation and changes at birth,

placental function, multiple pregnancy and general and

proportional growth and development of body features from birth

(as differentiated from adulthood) with emphasis on sexual

maturity. , '

Recommended reading: Embryology - Langman's and Moore '8


 


 


 

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_ Developmental anatomy (Special) : development of important"

parts and organs, specially the gonads, vital organs and bones;

mechanism of developmental anomalies of different organs.

Recommended reading: Embryology - Langman's and Moore's

General anatomy (systemic approach to the body

structures) :

Basic ideas on tissues

Osteology- histology, development and its anomalies, important

ossxfication centers,

Angiology including lymphoid system- circulation through special

organs like brain, heart, kidney, liver, spleen, gut and lungs.

General plan of the lymphatic drainage, and important groups of

clinically 1mportant lymph nodes and there drainage region.

Recommended reading: Basic Histology - Junqueira; Gray's

Anatomy

Topographic anatomy (including surface anatomy) :

General body features including secondary sex characteristics;

‘ topographic anatomy of different parts and organs of a child

including the variation in a newborn (in practical examination

relevant topics will be assessed by using bones, viscera, model and

figures).

Recommended reading: Gray '3 Anatomy

Histology : Light, dissecting and electron microscopic features

and their functional implications of following structures - liver,

kidney, GI tract, pancreas, respiratory passages and alveoli,

endocrine glands, heart, blood vessel, muscles, lymphoid organs

(the learning objective of this chapter will be to learn the general

histology covering the functional principle of the 4 basic tissue. In

practical examination these parts will be assessed using projected

photomicrograph and printed photographs).

Recommended reading: Basic Histology - Junqueira; Basic

Histology - Ross.

Clinical Neuroanatomy: Central and peripheral nervous

system with special importance on the development and related

anomalies; anatomy of the common injury including birth injuries,

clinical neuroanatomy in relation to joint movement.

Recommended reading: Snell and book of NMS series.


 


 


 

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Sectional anatomy and anatomy of imaging : basic of

sectional anatomy of different parts/organs relevant to paediatrics

helping to identify the normal appearance leading to

identification of organ or its parts and the abnormal situations

(Radiograph, USG, CT and MRI materials are to be used for

relevant anatomy ofimag'ing).

Recommended reading: Caffey's Paediatric Radiology, relevant

introductory section in Nelson/Forfar textbook ofPaediatrics

Basic anatomy of relevant physiological processes and

related disorders : respiration, sucking, swallowing, vomiting,

nasal regurgitation, peristalsis, defecation, micturition, walking,

vision, hearing, equilibration, olfaction, taste, reflexes. V

Recommended reading: Moore Clinical Anatomy, Ganong's

Physiology

Anatomy relevant to clinical procedures and related

problems : lumbar puncture, tracheostomy, laryngoscopy,

otoscopy, venepuncture, liver biopsy, renal biopsy, I

peritoniocentesis and thoracocentesis. '

Recommended reading: Moore Clinical Anatomy, Hutchison's

Clinical Method

Behavior science, medical ethics and communication

skill :

There has to be some brief introduction of the' topic initially and

elaborated in the second part. Later on most ofit shall be covered

in first part. Communication skill to cover both patient-doctor,

doctor-attendant, doctor-doctor and doctor to other professionals

in the field.

Medical statistics : Definition of different terms commonly used

in the practice, basic concepts, fundamentals of biostatistics and

epidemiology, sampling, data, analysis, frequency tables, central

tendency and measure of dispersion, distribution probability, test

of probability, significance, confidence interval, data presentation,

etc.

Recommended reading: Essential of Medical Statistics, By Betty

Kirkwood, by Bradford-Hill


 

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Format of examination :

It will comprises of

- Vritten

- Practical

W 'tt ' ' . . .

CO::3retrl::xam:n::0n ' The Questions 1n general anatomy should

d.“ par 5 at are relevant to paediatrics. Distribution of

l erent parts of anatomy to be represented in the written

question are as follows ;

I


 

1. Cell biology 34


 

2 Developmental (general and special) anatomy 6-8


 

3. General anatomy and Topographic anatomy 6-8


 

4. Histology 3_5


 

5. Clinical neuro-anatomy 5


 

6. Sectional anatomy and anatomy ofimaging 4-6


 

7. Anatomical basis of procedure and related problems 4-6


 

8. Anatomy of physiologic processes and disorders 4-6


 

9. Behavioral science, medical ethics, code of conduct 3


 

10. Medical Statistics 3


 

Paper-II: Physiology, Clinical Biochemistry and Clinical


 

Pharmacology


 

Points to remember:


 

Cl Following are the course content for FCPS part-I in

Paediatrics in paper-II. The contents should be approached

which is relevant to Paediatrics discipline and not for true

basic science discipline.


 

C] The study shonld be directed in understanding of the 'baSIC

physiological processes in relation to specific clinical entity so

that one understand the pathophySiOIOgy 0f the dlsease

process clearly in later part.


 


 

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A. PhySiOIOgy . . - ' leCt lar b' l v ~

Cell/membrane Physmlogy "winding mo 1 '1 1110‘ 0g? T

F t. 18 of each organelle mcludmg t ieir re ationship;

unc 101 ~ . ‘

Intercellular communication and receptor diseases,

Recommended reading .' Ganong “31040”

Pathophysiology of body fluid, electrolytes and there

derangement: _ . _ _

Body fluid compartments and its relevance in clinical practice.

Physiology of important solutes (sodium, potassium, chloride,

phosphate, calcium) and impact of there derangement.

Buffering system including acidosis and alkalosis and their

consequences.

Consequences of fluid, electrolytes and acid/base disturbances on

different system.

Recommended reading: Ganong/Guyton, Nelson/Forfar

Physiology of Growth and Development :

Period of life including puberty, teratogenesis, sensitive period of

foetal life, theory of growth and development, factors influencing

growth/development, concept of growth curve, measuring growth,

fetal circulation and changes at birth, placental function,

physiological derangements in specific growth and developmental
 

- disorders, multiple pregnancy and development of general body

features and proportion.

Recommended reading: Nelson /Forfar

Physiological processes and there clinical application
 

0 Respiratory system- respiration including its regulation,

surfactant, respiratory membrane, types of respiration,

production of breath sound and there variants, lung function

test and its interpretation in different situation, cough,

acidbase balance and respiratory system, principles of oxygen

therapy, pathophysmlogy of hypox1a and respiratory failure.


 

0 Gastrointestinal system - physiology and disorder of gut

motility, mucosal protection of stomach, digestion and

absorption of different food components, liver function, bile

production and metabolism, iaundice, liver function test and

there. interpretation 111 different situation, pancreatic

function, gut hormones, mechanism of abdominal pain.


 

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. Cardiovascular system - properties of Cardiac muscle, cardiac

cycle, conduction pathways, ECG, blood pressure, pulse,

cardiac arrhythmia, hemodynamics and correlation with


 

' Doppler/ECHO, peripheral circulation, circulation of brain,

kidney, liver, lungs and GI tract, pathophysiology of heart

failure, oedema, shock and dyspnoea.


 

. Hemopoietic system - constituents of blood and there

importance, hemoglobin formation and metabolism,

hemopoiesis, factors controlling hemopoiesis, iron kinetics,

pathophysiology of anemia, hemolytic disorder, bleeding

disorder and coagulation disorders.


 

0 Nutrition - micro and macronutrients-definition, function,

deficiency, physiological derangement in malnutrition of

different nutrient, measuring nutrition, dietetics


 

0 Renal System -- glomerular and tubular functions, water-g

electrolyte balance, formation of urine, micturition and its

control mechanism.


 

0 Musculoskeletal system - muscle contraction, physiology of

bone formation, factor influencing it and its disorder.


 

, 0 Endocrinology - physiological role, control of secretion,

_ metabolism, feature of hypo and hyper function, test for

functioning status of— thyroid gland, pituitory gland, adrenal

gland, parathyroid gland, pancreas and gonads. Also includes

I physiology of pregnancy, parturition, breast milk and breast

feeding, diabetes mellitus and puberty.

I Recommended reading: Ganong/Guyton, Nelson /Forfar

Physiology of imaging:

Principles of X-ray, CT, MRI, PET, USG, ECHO, Doppler, Isotope

' and other scanning of thyroid, kidney, liver, brain, bone, etc.

Recommended reading: Relevant section, in the introductory chapters

in different systems in Nelson/Forfar

Neurophysiology :

Physiology of speech, disorders of speech - mechanism, tests.

Physiology of smell and tests of smell function.

Physiology of vision- visual path, light and accommodation reflex,

visual field, color vision, and tests for above functions and their

interpretation.


 


 

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Hearing and eQUilibrium- tests and interpretation of their

functions.


 

Physiology of taste and the tests for taste.


 

Motor neurone- upper and lower, physiology of deep tendon

TeflexeS, superficial reflexes, primitive reflexes and withdrawal

reflexes.


 

supeFfiCial and deep pain, visceral sensations, referred pain,

taCtile localisation, two point discrimination, steriognosis.


 

Functions of basal ganglia and cerebellum - posture, balance and

111115619 tone, physiologic principle of coordination, ataxia.

Hypothalamus - secretion, functions and there control, physiology


 

0f hunger, thiFSt, bOdy temperature. Physiologic basis of tests to

measure the different functions.


 

CSF .— production, control, function, circulation and physiological ‘

consequences of abnormalities. Physiological basis of EEG. ‘

Recommended reading: Ganong/Guyton, Nelson/Forfar ‘

B. Clinical Biochemistry 1

Physiologic and clinical significance of important steps and I:

regulation of glycolysis, citric acid cycle, gluconeogenesis, ‘

glycogenesis, glycogenolysis and HMP shunt.


 

_ Physiologic and clinical significance of important steps and '

regulation of lipogenesis, lipolysis, ketogenesis, cholesterol

biosynthesis.

Physiologic and clinical significance of important steps and ‘

metabolism of phenylalanine, tyrosine, methionine, tryptophan. ‘

Folic acid and vit B 12

Purine metabolism and formation of uric acid 4

Glycoproteins proteoglycan and mucopolysaccharoidoses

Metabolism - Basal metabolic rate and factor influencing it

Collagen — types and principles of synthesis


 

. . . . I1

Prmc1ples of commonly used biochemical tests and factors (both l

physiological and procedural) that may affect the test. '


 

Recommended reading: Harpers textbook of Biochemistry an"

relevant section in the introductory chapters on different system

Nelson /Forfar


 


 


 


 


 

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C. Phamacology:

V Basic pharmacology:

tion, di t 'b ' . .

Drug absorp s n ution, e] . I

tion half life. peak and t ‘mma‘m’ mechanism of drug

‘ ac _, . rough level, dose r ,

, principle of therapeutics, esponse relation,

Pharmmongy of some Commonly used drugs -

pharmacological effects, classifications, me'chanism f ,

side greets fand Clrug interaction of the follow'0 acuons’

analgesmé/antlpyretlcw antimicrobials and antihelm‘mgl drugs.-

°h°1‘“‘?’g‘°’ Smathémimmeucs, drugs used in p13“? ‘2”

diuretics' antlhlStammesv brOIIChOdilatorS, laxativesp vitdliifijs

and mmerals, hormones’ hypOglycaemic agents, anticohvulsant

Recommended reading: Basic d ' 4

Katzung an Clinical Pharmawlogy by BG

Format of examination : ‘

It will comprise of

— Written

— Practical

The written part will be assessed with MCQ. Questions shall be '

mostly clinical use of basic science knowledge rather than true,

physiological processes or biochemical reaction etc. Distribution of

different parts to be represented in the written questions are ;

d

1. Cell physiology and molecular biology 4-5

2. Pathophysiology of body fluid, electrolytes

and there derangement 3-5

3. Physiology of growth and development 4-5

4. Endocrinology 4-6

5. Physiological processes & its clinical application 10—15

6. Physology ofimaging 2‘3

7. Neurophysiology 6‘7

8. Clinical biochemistry 5'6

9- Clinical pharmacology 6‘8

w ”/


 


 

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Paper-III: Pathology (Microbiology, Immunology, Virology, '

Genetics, MOICCular biology and Histopathology) Points to

remember:


 

0 Following are the course content for Paediatrics FCPS part-1

in paper-III. The contents should be approached which is .

relevant to Paediatrics discipline and not for true basic science

discipline or other clinical subjects.


 

A. Pathology


 

General pathology : The following conception are to be


 

correlated with different clinical entity- cellular injury and death,


 

inflammation and repair, granulomatous disorder, neoplasm,

thrombosis, embolism, oedema.


 

Principles of commonly used cytological and histopathological ,


 

investigations, factors affecting the quality of specimen and


 

reporting scope and limitations of such investigations


 

Immunology : basic principles, concept of host-agent- ‘-


 

environment, mechanisms of immunity and auto-immunity, .

immune mediated diseases including graft versus host and tumor ‘

immunity, pathological basis of different investigative tools ‘

available based on immunological principles. ‘

Genetics and molecular biology : basic concept, molecular

- basis of diseases, genetical basis of diseases, investigative tools

available for these, their uses and limitations, pedegree analysis, ’

genetic counseling principles.

Special pathology : A student will be expected to know the _‘

following of the individual pathological situation enumerated J

below

0 Site of lesion including the microstructure

0 General pathological description of the type of lesion I

0 Functional derangement following the lesion I2;

0 Micro-structural and chemical changes of the lesion

0 Pathological explanation of presenting feature

Respiratory system .' Pneumonia, bronchiolitis, tonsillitis, :

bronchial asthma, lung abscess, bronchiecstasis, pleural effusion.

Haematology and Oncology .' Anaemia (nutritional, hemolytic,

haemorrhagic and others), bleedng disorder (ITP, hemophilia»


 


 

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|__’—_W—


 

- ' leb ' .


 

Von W11 rands disease), Hodgkins and non_H0d kins


 

Lymphoma, leukaemia Wilm t i g


 

neuroblastoma ’ S UmOI‘, retmoblastoma,


 

Cal‘dm‘fascuza".Systefn .' Rheumatic heart diseases, congenital


 

heart diseases, infective endocarditis. _


 

Central nervous System I Meningitis, encephalitis, GB syndrome,


 

and hydrocephalous.


 

Gastrointestinal system ; Hirschsprung diseases, appendicitis,


 

hepatltls ' acute & Chronic, cirrhosis ofliver, portal hypertension.


 

Gen‘m'urmar)’ ' system .' Urinary tract infection, acute


 

glome'rulonephnusi nePhrotic syndrome, acute renal failure,


 

chronic renal failure.


 

Collagen disorder : Acute rheumatic fever, JCA.


 

NUtritional diforC-Zer .‘ PEM, macro and micro nutrient deficiency


 

syndromes, iodine deficiency disorder, rickets, scurvy,


 

xerophthalmia.


 

Neonatology .' Low birth weight, respiratory distress syndrome,


 

TORCH infection, neonatal 'aundice, birth as h xia, hemorrhagic


 

. J p y


 

disease of newborn.


 

Inborn error ofmetabolism : Phenylketonuria, Galactossaemia


 

Endocrinology: Thyroid - hypo and hyper function, pituitory


 

,anterior and posterior - hypo and hyper function, Pancreas -

diabetes, adrenal gland — adrenal hyperplasia,

pheochromocytoma.


 

Recommended boo/es: Relevant section in Robbin's Pat/lologic


 

Basis of Diseases, Jawetz, Melnick and Adelberg's Medical


 

Microbiology and Nelsons/Forfar Textbook ofPaediatrics.


 

B. Bacteriology '


 

0 Basic bacteriology: Classification of microbial agents, normal

microbial flora in human body, infection, sepsis, septicemia,

bacteraemia, spread ofinfection, control of infection.


 

0 Bacterial culture, principles of bacterial grthh, CUltUFe

media, principles of serological techniques used . in

bacteriology, scope and limitation of bacteriological studies,

collection and preservation of sampleS.


 


 

page--12


 

i


 

O Pathogenesis and laboratory diagnosis of-

Typical/atypical mycobacteria, diphtheria, pertusis, tetanus,

pneumonia, enteric fever, meningitis, tetanus, gangrene, 'I

gonorrhoea. dengue, syphilis including congenital infection, 1

staphylococcal and streptococcal infection, secretary and =

. . _ I

mvaswe enterocolitis


 

0 Infection and immunosuppression :


 

Recommended books: Relevant section in Nelsons/Forfar Textbook


 

of Paediatrics and Jawetz, Melnick and Adelberg's Medical


 

Microbiology


 

C. Virology


 

0 Basic virology : viral structure, classification, replication,

mode of transmission, pathogenesis and diagnosis of viral

infection.


 

0 Pathogenesis and diagnosis of diseases cause by-

Adenoviruses, Herpesvirus, Hepatitis virus, Rotavirus, Rabies

virus, Slow virus, Reovirus, Arbovirus, HIV, Measles and

rubella, mumps, poliornyelitis


 

0 Viral infection in congenital or acquired immuno-

compromised child

Recommended books: Relevant section in Nelsons/Forfar

Textbook ofPaediatrics, Medical Microbiology.


 

D. Parasitology


 

0 General parasitology: classification of parasites, transmission,

infestation, body response to infestation, pathological basis of

different laboratory diagnosis.


 

0 General features of rhizopodes, flagellates, nematodes,

cestodes and trematodes.


 

0 Life cycle of parasites, pathogenesis and diagnosis of diseases

caused by- malaria, leishmaniasis, toxoplasmosis,

pneumocystosis, ascariasis, ankylostomiasis, strongyloidiasis,

enterobiasis, filariasis, taeniasis, echinococcosis, sarcoptes

scabii.


 

Recommended books: Relevant section in Parasitology by


 

Chatterjee and Nelsons/ F orfar Textbook of Paediatrics.


 


 


 

page--13


 

r - -W

 

E. Mycology ‘ ~

 

0 General mycology : properties of fungus, claSSlficatlon 0‘

 



 

fungi, laboratory diagnosis of fungal diseaSCS-

 

° Pathogenesis, clinical consequences and laboratory diagHOSlS

 

of superficial and cutaneous mycosiS, deep IDYCOSIS

 

Recommended books: Relevant section in Nelsons/Forfar Tc-TtbOOk

 

of Paediatrics

 



 

Format of examination in pathology:

 

It will comprise of

 

- Written

 



 

- Practical

 

The written part will be assessed through MCQ assessing the

 

clinical use of basic science knowledge rather than true

 

pathological process.

 

Distribution of different parts in the written questions.

 

Cigarts No. of question

 

1. General pathology 8-10

 

2. Immunology 4-6

 

3. Systemic pathology 12-15

 

4. Genetics and molecular biology 3-5

 

5. Bacteriology 6-8

 

6. Virology 3-5

 

7. Parasitology 2-3

 

8. Mycology 2-3

 

9. Pathological procedures, sterilisation/disinfection g