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The sound of Silence

A short story by Hamdan Ali Khan, 1st Year MBBS

The old man sat on the beach, barefooted and alone. Silence reigned everywhere except the occasional thrashing of waves which disturbed the acoustic equilibrium. Night it was, the sky filled with a million lanterns, the birds dozing off quietly and the sea like an old pirate sang a silent shanty. Oh! He missed his youth, when he could swim to the Black Rock without drowning, when he could shout at the vast ocean, his resonant voice fading upon the edges of horizon. But all good things come to an end, the voice that once resonated; now a husky whisper. The man who was the fastest swimmer; now an ancient remainder of time and its echoes. The doctors said he had terminal cancer that he would die in a week. He didn’t fear death, he had no family, nothing to lose except maybe the sight when someone would break his 50 years old record. The silence of the calm sea nurtured in him a desire to swim to the Black Rock once again, one last time. He …

Final Year Medicine Exam - Important and high-yield topics

Final Year Medicine Exam - Important and high-yield topics

(Special thanks to Tauseef bhai)

Medicine paper A. 
Cvs, GIT, Hepatobiliary, CNS, Respiratory, Hematology, Oncology.

Medicine paper B. Derma, Psychiatry, Endo, Rheumatology, Infectious dis, Poisoning, Renal.

Medicine Paper Pattern For The Year 2012;

Total marks=600 including 60 marks of internal assessment
Internal Assessment;
3rd Year=15 marks
4th Year=15 marks
Final year=30 marks
Written Paper;
Paper A=135
Paper B=135
Both Papers, A and B have same pattern follows;
MCQ's=30 (45 marks)
SEQ's= 3 (total 30 marks;each carrying 10 marks)
PBQ =1 (30 marks)
LEQ =1 (30 marks)
Paper A;1:CVS
2:GIT and Hepatobiliary
3:Respiratory System
5:Renal System
Paper B:1:Dermatology
4:Diabetes Mellitus
6:Infectious Diseases including DENGUE
7:Fluid And Electrolytes
(Note;from derma and psychiatry there will be no LEQ's only SEQ's will be taken.)
Total Marks=270
1:OSCE=10 stations( 30 marks...3 at each station)
Drugs=2 stations
instruments=2 stations
X-ray/CT Scan/ECG=1 station
Clinical scenarios=3 stations
Interactive stations(e-g pt counselling..)=2 stations
2:Short Cases;There will be 2 Short cases each carrying 60 marks=120
3:Long Case;One case carrying 80 marks
4:Table Vivas:There will be 2 vivas taken by external and internal examiners...may be along with short cases or seperately...depends on the respective examiner...
each carrying 20 marks=40

  • Stroke(CVAs), 
  • Subarachnoid hemorrhage, 
  • Multiple sclerosis, 
  • Mysthenia gravis, 
  • Meningitis (all types),
  • Transverse myelitis, 
  • GB Syndrome, 
  • Alzheimers disease, 
  • Parkinsonism, 
  • Motor neuron disease, 
  • Spinal cord compression, causes n clinical pic of Raised intracrainal pressure,
  • Epilepsy. 
  • Headache & migraine, 
  • Diff bw upper n lower motor neuron lesion, 
  • Paraplegia
  • Causes of chest pain, 
  • Heart failure, 
  • Rheumatic Fever, 
  • Endocarditis, 
  • Valvular heart diseases esp MS,MR,AS,AR, 
  • Myocardial infarction,
  • Angina,
  • Atrial fibrillation,
  • Hypertension,
  • VSD,
  • Hypertrophic cardiomyopathy,,
  • Myocarditis 
  • Pericarditis.
GIT topics
  • Indications,contraindications n complications of Colonoscopy n upper GI endoscopy,
  • Dysphagia,
  • Acute upper GI bleed vimp,
  • Causes of lower GI bleed,
  • Chronic diarrhoea,
  • Ulcerative colitis,
  • Crohns disease,
  • Peptic ulcer,
  • GERD,
  • Coeliec disease,sprue,whipple disease,
  • Protein losing enteropathy,
  • Abdominal TB medical managment,
  • Irritable bowel syndrome(IBS).
  • Classication/Causes of Mono,poly n oligoarthritis, 
  • Osteoarthritis, 
  • Rheumatoid arthritis, 
  • Felty's Syndrome, 
  • Ankylosing spondolytis, 
  • Psoriatic arthritis, 
  • Gout, 
  • Septic arthritis, 
  • Osteoporosis treatment, 
  • SLE, 
  • Mixed Connective tissue disease, 
  • Sjogren Syndrome, 
  • Giant cell arteritis, 
  • Wegners granulomatous(briefly)
BLOOD/Hematology :
  • Anaemia(classification), 
  • Fe deficiency anaemia, 
  • Causes of splenomegaly,
  • Thalasemia,
  • Multiple myeloma, 
  • ITP, 
  • Hemophilia, 
  • DVT
Do Add Madam Samina Naeem's Notes from 4th Year Pathology..they cover everything


  • LFTS, JAUNDICE (imp) , 
  • CLD (Chronic Liver Disease ie ascites,portal hypertension,hepatic encepahlopathy,its grades,cirrhosis, Child Puggh Classification of cirrhosis, hepatopulmonary syndrome) , 
  • Upper GI Bleed (vimp), 
  • Hepatitis B n C (imp), 
  • Wilsons disease, 
  • Primary biliary cirrhosis, 
  • Liver abscess (medical management).

ENDOCRINE /Diabetes mellitus:

  • Features of Acromegaly,
  • Gigantism, 
  • Diabetes insipidus, 
  • Addison's Disease, 
  • Cushing's Disease, 
  • Hypothyroidism
  • Hyperthyroidism, 
  • Causes of hyper calcemia, 
  • Complications of uncontrolled diabetes, 
  • DIABETIC KETOACIDOSIS(DKA), HYPEROSMOLAR NON KETOTIC COMA (HONK), diabetic foot,its care n prevention, featurs of diabetic neuro n nephropathy. 
  • Nephrotic ,Nephritic Syndrome,
  • Pyelonephritis,
  • Acute & Chronic Renal Failure - Management and Causes
  • Acute Tubular Necrosis, 
  • Causes of chronic interstitial nephritis,
  • Post stretococcal Glomerulonephritis, 
  • GoodPasture Syndrome, 
  • Minimal Change disease,
  • Focal segmental GN,
  • Membranous nephritis,
  • Causes of Proteinuria, 
  • Causes of Hematuria,
  • Factors predisposing to kidney Stones: Investigations n their managemnt.
  • Renal function tests, 
  • Classfication of Glomerulpnephritis, 
  • Names of drugs causing renal damage,
  • Pyelonephritis, 
  • UTIs, 
  • Renal tubular acidosis, 
*all glomerulonephrits r v imp.


  • Asthma,
  • COPD - Acute exacerbations of COPD, 
  • TB, 
  • Pneumonia, 
  • Corpulmonale, 
  • Causes of dysnoea(from table), 
  • Causes of hemoptysis,
  • Light's Criteria of Pleural Effusion, 
  • Respiratory failure type1,type2, 
  • pulmonary embolism 
  • Bronchiectasis.


  • Morphological descrption of skin lesions from table, 
  • Impetigo, 
  • Herpes Zoster,
  • Scabies,
  • Eczema(Dermatitis),
  • Psoriasis,
  • Urticaria,
  • Acne vulgaris,
  • Erythema nodosum,
  • Erythema multiforme,
  • Steven Johnson Syndrome,
  • Pemphigus vulgaris, 
  • Malignant melanoma,
  • Vitiligo.


  • Definitions from 1st chapter of USMLE STEP 2 book 
  • Delusion,
  • Hallucinations,
  • Generalized Anxiety Disorder (GAD),
  • Depression, 
  • Obssessive Complusive disorder,
  • Conversion disorder,
  • Mania,
  • Hypomania, 
  • Drugs used to treat psychiatric diseases and Extrapyramidal side effects of these durgs,
  • Schizophrenia 
  • Deliruim 


  1. GREAT post. I found this as I was writing an article, albeit from a different viewpoint, about the same thing-

    Medical Mirror
    Medical Stethoscopes and Sphygmomanometers
    Electronic Cigarette
    Stark Hand
    Antiseptic 1847

  2. GReat post... really got a lot of help especially in renal topics... there i also another website which i will share with u guys that helped me a lot is it contained notes and all the e books which I require in my second year as medico... thank you so much guys��


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