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Welcome to KemUnited! The official blog of King Edward Medical University, Lahore, Pakistan. (Formerly King Edward Medical College). Of the students, by the students and for the students! It focuses on news/events/happenings around the campus and provides guidance articles, past-papers and study-aids.

Gynae/Obs History Pattern

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A Detailed Study guide for 4th year By Kanza Afzal

A Detailed Study guide for 4th year

By Kanza Afzal

(Batch 2012-2017)

So, now that the Third professional exam is finally over for our batch; and we set foot into final year *gasp*, we can proudly welcome the new 4th year or should I say officially 4th year? ;) Almost a month has passed already since classes began for you guys and this guide is a teensy bit late, but you know what they say – it’s better late than never. Let’s get started then!
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Global Health Learning Opportunities (GHLO): A new era for foreign electives’ aspirants

Global Health Learning Opportunities (GHLO): A new era for foreign electives’ aspirants

By Muhammad Asad Hanif
Final Year MBBS

KE’s participation in the GHLO collaborative has proved to be a milestone in aiding students to secure electives abroad. Nevertheless, there is still a lack of awareness among Kemcolians about this amazing opportunity which is at their disposal. So I am writing this blog with the hope of rectifying this issue.
GHLO is the AAMC's (American Association of Medical Colleges) service that makes it easier for medical students to pursue clinical and research electives outside their home countries. GHLO's international network of institutions offers nearly 2,000 clinical, public health, and research opportunities in more than 36 countries. So what this basically means for most of us at KEMU is a more convenient and effective method of applying for and securing clinical electives in the USA to strengthen our chances of acquiring a residency there. So that will be the main focus here.

Creating an account:
                                    The first step is to create a user account on the GHLO application service. For this you’ll have to approach Rashid Bhai (Kamcaana Lab) with your student ID (or any other ID to prove that you are an enrolled student, like anatomy card etc.). He will make your account right away and send a link on your email ID for you to complete the process.  

Searching and Applying for Electives:
                                                                  Once your account has been created it is very simple to search and apply for electives as the GHLO Application Service is very user friendly. Still, in case of any ambiguity refer to the GHLO Student Handbook via the following link:

Important Information and Tips:
·        PLAN EARLY! Keep the required documents (transcripts, CV, titers etc.) ready right after you enter fourth year officially (i.e. right after your third year prof. result is out) so that you can pounce at any elective opportunity available on GHLO just as it starts accepting applications. And believe me when I say this ‘Time is Money!’ It is in my opinion the single most important factor in getting an elective and especially a free one (like the Wayne State University- Internal Medicine – Urban Medicine clinical elective).

·        Electives via GHLO can be done during fourth year and final year.
·         Always CONSULT your trusted seniors in person before doing things like getting your transcripts issued, or your titers done etc. as they may give you some extremely useful advice that will save you a lot of time and money.
·        When you write a letter of intent or anything of that sort (a requirement for many elective programs), avoid making any spelling or grammatical mistakes and get it all checked by some trusted senior once.

·         Check the GHLO Application Service regularly (once a week or so) for new elective offerings and opening of applications. You can also save an elective profile to make it easy to review and keep a check on when it starts accepting applications.
·        The required documents for the various elective programs are clearly mentioned on their respective profile pages and all these are to be uploaded on the GHLO Application Service, which is very convenient as compared to the usual methods of sending documents via courier service etc.

·        GHLO charges a mere $45 application fee. The application and tuition fee for each elective is separately charged by the Host Institution (the institution offering the elective), it is free for only a few electives (like Wayne State University- Internal Medicine – Urban Medicine clinical elective).All this is mentioned on the respective elective profiles and the payment is to be made online via credit card which is again much more convenient than the usual bank drafts, cashier cheques etc.

·        Also help and guide your fellow students undergoing this process to the best of your knowledge! Your competition is with the world and not your own friends and class fellows so don’t ‘hesitate’ in giving them good advice and sharing useful information.

That’s all from my side.I hope this blog serves its purpose and a greater number of Kemcolians acquire good electives via GHLO each year. Best of luck!  

For GHLO, one of the most important things is to apply to different universities. It increases your chances to bag yourself an elective.
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TOS 4th year

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By Hamza Ashraf

 1. Brief history of Anatomy. Different disciplines of the subject
2. Anatomical nomenclature-descriptive terms
3. Skeletal system-bones
• Axial skeleton
• Appendicular skeleton
• Functions of bone
• Classification on the basis of shape, development, region
and structure
• General concepts of development & ossification of
• Parts of young bone
• Blood supply
• Properties of bones and cartilages
• Applied aspects

4. Joints
• Structural classification
• Regional classification
• Functional classification
• Characteristics and classification of Synovial joints
• Movements of Synovial joints
• Anatomy of joints with reference to dislocation, sprain
and inflammation

5. Muscle
• Parts of a muscle
• Classification
• Blood supply and nerve supply of muscle
• Neuromuscular junction
• Applied anatomy of muscle with reference to spasm,
paralysis, atrophy and regeneration

 6. Cardiovascular system
• Heart & Blood vessels
• Types of circulation
• Anastomoses

7. Lymphatic system
• Introduction
• Lymph capillaries
• Lymph Vessels
• Lymph nodes
• Main channels

8. Somatic Nervous system
• Introduction
• Different parts of Central Nervous System (CNS) with
their brief functions
• Peripheral nervous system (cranial and spinal nerves) —

9. Autonomic nervous system
• Introduction to parasympathetic and sympathetic nervous

 10. Skin and fasciae
• Parts of skin
• Appendages of skin
• Types of fasciae

11. Embalming & museum keeping
1. Upper limb
2. Lower limb
3. Thorax

 • Histology will be taught concurrently with Anatomy throughout
the course. Underlying principles of histological techniques and
staining should be given due consideration. Most of teaching
will be done on stained and mounted sections and every type of
normal tissue will be covered.

1. Cell
• Cell as a whole
• Cell Membrane
• Interior of cell
• Nucleus
2. Microscopy
3. Epithelial tissues
4. Connective tissue proper
5. Cartilage
6. Bone
7. Muscular tissue
8. Nervous System
• Nervous tissue
• Cerebral cortex
• Cerebellar cortex
• Spinal cord
 9. Lymphoid organs
10. Circulatory system
11. Integumentary system
12. Routine histological techniques


Embryology should be taught with the object of making students understand and grasp those fundamental principles, which result in better comprehension of the structural organization in the body. Stress should be
laid on those developmental processes such as growth and differentiation,
which have a direct bearing on clinical subjects. The genesis of congenital
malformations should be one of the chief aims. All details should be kept on
the essential outlines.
 1. Male & female reproductive systems
2. Cell Division and Gametogenesis
3. Fertilization, cleavage, blastocyst formation and implantation
4. Development during second week
5. Development during third week
6. Embryonic period
7. Foetal period
8. Foetal membranes and Placenta
9. Introduction to genetics.

During study of Gross Anatomy, emphasis should be given on applied
aspect, radiological anatomy, surface anatomy and cross-sectional


 Introduction of Biochemistry:
 Biochemistry of the Cell:
a) Introduction to cell (Biochemical point of view)
b) Scientific methods to study the cell biochemistry
c) Biochemical composition of the cell
2. Biochemistry of the Cell and Body Fluids:
a) Ionization of water & weak acids, bases
b) Concept of pH, and pH scale
c) Dissociation constant & titration curve of weak acids, the
concept of pK values
d) Buffers, their mechanism of action
e) Henderson-Hesselbalch Equation (No derivation)
f) Types of particles, solution
g) Importance of selectively permeable membranes, osmosis,
osmotic pressure, surface tension, viscosity & their importance
related to body fluids

a) Definition, biochemical function and classification
b) Structure and functions of Monosaccharides, and their
c) Disaccharides, their important examples
d) Oligosaccharides, their combination with other macromolecules
e) Polysaccharides, their important examples and biochemical role
f) The biomedical importance of carbohydrates

a) Definitions, Biomedical importance and classification of proteins
based on
- Physiochemical properties
- Functional
- Nutritional
- Structural
b) Amino acids, their structure, properties & functions
c) Classification and nutritional significance of amino acids
d) Dissociation, titration and importance of amino acid in pH
e) Structure of proteins and their significance
f) Separation of proteins e.g. salting out, Electrophoresis,
Chromatography, Centrifugation
g) Immunoglobulins and its biomedical significance
h) Plasma Proteins & their clinical significance

 Nucleotide & Nucleic Acid:
a) Chemistry and structure of nucleosides and their biochemical
b) Nucleotides, structure, their derivatives and their biochemical
c) Synthetic derivatives of purine and pyrimidines, their role in
health and disease
d) Nucleic acids, their types, structure and functions

a) Definition, biomedical function
b) Classification of lipids
c) Phospholipids, Glycolipids, Sphingolipids and their Biochemical
d) Fatty acids, chemistry, classification and biochemical function
e) Essential fatty acids
f) Eicosanoids, their classification and functions in health and
g) Steroids, Sterol e.g. Cholesterol, their chemistry, functions and
clinical significance
h) lipid peroxidation and its significance

Biological Membrane:
a) Biochemical composition
b) Biochemistry of cell membrane, chemical composition,
importance of lipid and proteins in membranes, chemistry of
signals and receptors
c) Biochemistry of membrane transport mechanism, active
transport, passive transport, simple and facilitated diffusion

a) Introduction, definition, mechanism of catalysis
b) Coenymes, co-factors
c) Isoenzymes, their clinical importance
d) Factors affecting enzymes activity, Michaelis-Menten Equation,
Lineweaverburk equation and their application in enzyme
kinetics (no derivation of equations)
e) Enzyme inhibitors and their classification & biomedical
f) Application of enzyme in clinical diagnosis and therapeutic use

 Prophyrins & Hemoglobin:
a) Chemistry and biosynthesis of porphyrins and its disorders
b) Structures, functions and types of haemoglobin
c) Oxygen binding capacity of haemoglobin, factors affecting and
regulating the oxygen binding capacity of haemoglobin
d) Degradation of heme, formation of Bile pigments, its types,
transport and excetion
e) Hyperbilirubinimea, their biochemical causes and
differentiation, jaundice and its types
f) Haemoglobinopathies (Hb-S, thalassaemia etc.) and their
biochemical causes.

a) Introduction, classification
b) Chemistry, Biochemical Functions, Deficiency manifestations,
daily allowances and source of water soluble and fat-soluble
c) Hypervitaminosis

A)omega fatty acids
B)Rda ,DRI and related terms
C)protein energy mal nutritions

Mineral & Trace Elements:
a) Classification and Biochemical role of:
- Macro minerals (Na, K, Ca, Cl, PO4)
- Micro minerals (Fe, Zn, Mg, Se, I, Cu, Cr, Cd, Mn)

Laboratory Practicals
Introduction to use of laboratory facilities / equipments
Basic techniques and fundamental information
Preparation of solutions-Normal solution and Normal saline
Experiments on Carbohydrates qualitative analysis
Experiments on proteins-qualitative analysis
Experiments on Fats-qualitative analysis


 Basic Concepts & Clinical/Applied Concepts
1) General Physiology/Cell
 Functional organization of human body Abnormalities of the cell and
its organelles

2) Homeostasis
 Control systems in the body
 Cell membrane and its functions
 Intercellular Connections
 Cell organelles
 Transport through cell membrane

3) Blood
 Composition and General Functions
 Plasma Proteins
 Red Blood Cell (Erythropoiesis) Anaemia
 Haemoglobin & Blood Indices, Iron
metabolism, Fate of Hb.
Blood indices in various

 White Blood Cells,
Leucopaenia, Leucocytosis
 Platelets Thrombocytopaenia
 Haemostasis Clotting disorders
(Haemophilia etc.)

 Blood Groups,
Blood Transfusion & complications
Reticuloendothelial System – Spleen
Blood grouping/cross
matching & significance

4) Nerve and muscle
 The neuron-structure & functions
 Properties of Nerve Fibres Nerve conduction studies
 Physiology of action Potential including
compound action potentials
 Conduction of Nerve Impulse, Nerve
Degeneration and regeneration
Nerve Injury
 Structure of the Muscle
 Skeletal muscle contraction Rigor Mortis & Contractures
 Isometric and isotonic contraction
 Smooth muscle contraction
 Neuromuscular Transmission Myasthenia Gravis
 Excitation — contraction coupling Myopathies/Neuropathies
 Motor Unit
 Neuromuscular Blockers

 5)Cardiovascular system
Introduction to heart & circulation Correlation of cardiac cycle
with ECG & heart sounds

Physiology of cardiac muscle
Action potential in atrial & ventricular muscle
and pace-maker potential

Regulation of cardiac functions
Cardiac impulse-origin & propagation
Cardiac cycle – various events
Significance of Apex

ECG-Recording & interpretation ECG interpretation in cardiac
muscle abnormalities and
cardiac arrhythmias

Arrhythmias- mechanism of development Flutter, Fibrillation-Ectopics
Functional types of blood vessels
Haemodynamics of blood flow
Local control of blood flow Conduction defects
Systemic circulation, characteristics &

Regulation of peripheral resistance
Arterial pulse Jugular venous pulse
Arterial blood pressure (short/long term
Radial/other pulses
Cardiac output (regulation/measurement) Hypertension, types & effects
Heart Sounds/murmurs
Venous return & its regulation Clinical evaluation of heart
sounds and murmurs

Coronary circulation Ischemic Heart Disease
Splanchnic circulation Heart Failure
Pulmonary circulation Echocardiogram
Cerebral circulation
Cutaneous circulation- Triple response Types of shock
 Fetal circulation and readjustments at birth
Cardiovascular changes during exercise

6)Respiratory System
Organization/functions of Respiratory Tract Examination of Chest
Functions of Lungs ( respiratory & non
Types of respiration
(Intrapleural pressure,
pneumothorax, effusion)

Mechanics of Breathing Atelactasis
Surfactant and Compliance Lung function tests

Protective reflexes
Lung volumes and capacities Obstructive/Restrictive lung
disease (FEV1/FVC)

Dead space
Diffusion of Gases (gas laws, composition)
Ventilation/perfusion Abnormal

Transport of O2 in blood
Transport of CO2 in blood
Regulation of respiration
Respiratory failure
Abnormal breathing Asphyxia
Hypoxia-types and effects Hypoxia, cyanosis, dyspnoea
Physiology of Cyanosis Artificial respiration
Physiology of high altitude, space, deep sea
Oxygen therapy
Oxygen debt Caisson’s disease
Respiratory changes during exercise


Study of the microscope
Determination of:
Haemoglobin (Hb%)
Erythrocyte sedimentation Rate (ESR)
Packed cell volume (PCV)/Haematocrit
Bleeding Time (BT)
Clotting Time (CT)
Blood Groups
Study of Neubauer chamber
RBCs Count
Red cell indices
WBCs Count
Differential leucocyte Count (DLC)
Osmotic fragility of RBCs
Demontration of prothrombin time and thrombin time

Respiratory System
Clinical examination of chest
Measurement of Pulmonary volumes and capacities (Spirometry)

Cardiovascular System
Frog’s Heart
Recording of normal cardiogram and affect of temperature
Effect of drugs on cardiac contractility
Effect of Ions on cardiac contractility
Properties of cardiac muscle in frog’s heart (Demonstration)
Study of sheep’s heart
Cardiopulmonary resuscitation
Cold pressor test

Triple response
Examination of arterial pulse
ECG recording/interpretation
Measurement of arterial blood pressure
Effect of exercise & posture on BP
Examination of Apex Beat
Heart Sounds- auscultation of normal sounds/murmurs

Recording of body temperature

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