30 Days Challenge Program

Day - 01
Topics :
1. Brachial Plexus
2. Sternal Angle
3. Content of Axilla
4. Abdominal aorta and IVC
5. Development of Heart
6. Meiosis & Cell cycle
7. Floor of 4th Ventricle
8. Femoral triangle
9. Structure deep to parotid gland
10. Thyroid gland, Position & Blood supply

Day - 02
Topics :
1. Absorption of drugs.
2. Bioavailability of drugs.
3. Enzymes inducers and inhibitors.
4. Teratogenic drugs and their effects.
5. Classification of antibiotics according to their action.
6. Anti pseudomonal antibiotics.
7. Aminoglycosides.
8. Anti TB antibiotics.
9. Anti hypertensive.
10. Drug used in heart failure

Day - 03
Topics :
1. Cytoskeleton, Junctional Complex
2. Intermediate filament distribution, lymph node
3. Neural crest derivatives
4. Pharyngeal arches, Cavernous sinus
5. Epiploic foramen, Renal fascia
6. Relation of 1st, 2nd, 3rd Part of duodenum
7. Ectopic & Undescended testis
8. Ulnar nerve, Median nerve
9. Rotator cuff, Female mammary gland
10. Femoral triangle, Popliteal Fossa, GSV

Day - 04
Topics :
1. Covering epithelium distribution
2. Distribution of collagen, Composition of bones
3. Skin & Skin’s appendages
4. 1st & 2nd weeks of development
5. Pancreas, Liver abdominal & pelvic organ lymphatic drainage
6. The diaphragm, Hand muscle
7. Cranial nerve, Middle ear, Inner ear
8. Inguinal canal, Perineum
9. Flexor retinaculum of hand, leg & structures passing through it
10. Basal ganglia, Internal capsule limbic system, Internal capsul
 Day - 05
Topics :
1. Drugs crossing BBB and BPB
2. Half life
3. Drug causing gynecomastia
4. Prodrugs
5. Therapeutic index
6. Atropine
7. Sympatholytic drugs
8. SSRI
9. Drugs used in Parkinsonism
10. Anti convulsant

Day - 06
Topics :
1. Local anesthetics
2. Genarel anesthetics
3. Propofol
4. Ketamin
5. Morphine and pethidine
6. Diuretics
7. Adverse effects of anti hypertensive
8. Anti platelets and anti coagulants
9. Anti Diabetic
10. NSAIDs

Day - 07
Topics :
1. Basic physiology of neuron and neurotransmitters
2. Function of tract and effect of lesion
3. Spinal cord lesion
4. Reflex with root value, UMNL vs LMNL
5. Eye : Light & accommodation reflex, Refractive error, Pupillary disorders
6. Sign of cerebellar lesion, Blood brain barrier
7. Different transport mechanism(e.g. active transport, passive transport)
8. Homeostasis(example of positive and negative feedback mechanism)
9. Physio-anatomy of heart
10. Physics of blood flow(Laminar and turbulent flow, factors related with blood flow, resistance of
blood flow, velocity

Day - 08
Topics :
1. Cardiac cycle
2. Heart sound+Murmur
3. Factors of cardiac output & venous return
4. Blood pressure+Pulse+Pulse pressure(Factors and significance)
5. Blood pressure regulation
6. ECG
7. Heart rate+JVP
8. Site of hematopoiesis,platelet granules
9. Process of hemostasis
10. Causes of raised BT,CT,PT,APTT
 Day - 09
Topics :
1. DIC,HUS,TTP
2. Blood transfusion (diseases transmitted by BT, hazards of massive transfusion, electrolyte
imbalance on stored blood)
3. Structure and defects of Hb
4. Oxy-Hb dissociation curve
5. Iron deficiency anaemia and anaemia of chronic disorder
6. Macrocytic anaemia (Causes and specially Vit B12 and folate deficiency details)
7. Hemolytic anaemia (Causes, classification and sign of hemolysis)
8. Myeloproliferative disorders, leucoerythroblastic blood picture, leukaemoid reactions, multiple
myeloma, tumor lysis syndrome, lymohoma (In short)
9. Interpretation of lung function tests
10. Chloride shift, Bohr effect, Haldene effect

Day - 10
Topics : (Physiology)
1. Regulation of respiration and respiratory centres
2. Changes during inspiration and expiration, Surfectant, Apex and base relative differentiation
3. Classification of hormone according to chemical nature, location of receptor, mechanism of
action.
4. Hormones maintaining-
A) Circadian rhythm
B) Sodium retention
C) Plasma osmolarity
5. Cellular Endocrinology(Endocrine glands without pituitary control, cells and secretion of
pituitary gland, cells and secretion of adrenal gland, name of insulin insensitive cells)
6. Thyroid hormone synthesis, common clinical features and lab findings in hypothyroid or
hyperthyroid
7. Factors increasing or decreasing secretion of-
A) Growth hormone
B) Insulin
C) Glucagon
D) ADH
8. Actions of:
A) Growth hormone and ADH
B) Insulin and Glucagon
C) Thyroid hormone
9. Actions of :
Glucocorticoid (Metabolic, permissive and hematopoietic functions must and Aldosterone
Testosterone, Oestrogen and Progesterone
10. Calcium homeostasis: Function of PTH, Vitamin D and Calcitonin on different sites
 Day - 11
Topics : Physiology
1. Mesangial cells, Renin angiotensin aldosterone system and JGA
2. Factors affecting
A) GFR
B) Renal blood flow
3. Tubular reabsorption and secretion of important substances
4. Renal function tests and interpretation
5. Renal tubular acidosis
6. Water and electrolyte imbalance (e.g. cause of hyponatraemia, hypernatraemia, hypokalaemia,
hyperkalaemia, hypercalcaemia, hypocalcaemia)
7. GIT hormones:Function & factors of secretion(Gastrin)
8. Body juice : Saliva, Bile, pancreatic juice
9. Site of digestion and absorption of important dietary products
10. Jaundice (Difference between three types and causes)

Day - 12
Topics :
1. Name of major pathways in mitochondria; Respiratory Chain
2. Glycolysis vs HMP shunt
3. Sources and metabolic fates of :
1. Acetyl coA
2. Pyruvate
3. Ammonia
4. TCA cycle & Urea cycle
5. Gluconeogenesis vs Glycogenesis vs Glycogenolysis
6. Beta oxydation of fatty acid and Ketone body metabolism
7. Lipoprotein metabolism
8. Macro and microminerals (Zinc, Iron)
9. Vitamins:
1. Fat soluble vs water soluble vitamins
2. Source, function and deficiency features of:
Vitamin A, Vitamin D, Vitamin E, Vitamin K, Vitamin C, B1, B2, B3, B6, B7, B12, Folate
10. Acid base disorders
 Day - 13
Topics :
 Cell Injury
1. Cellular Adaptation (specially metaplasia)
2. Ultrastructural changes of Reversible cell injury and irreversible cell injury Necrosis, Apoptosis
(irreversible cell injury) Gangrene.
3. Pathologic calcification
4. Free radical

 Inflammation
5. Mediators of inflammation (box from robbins) and their function and their effects
6. Acute and chronic inflammation. Acute phase proteins
7. Granulomatous inflammation

 Genetics
8. Genetic disorders, autosomal dominant, autosomal rescessive X linked rescessive
9. Chromosomal aneuploidies, Turners syndrome, Klinefelter's syndrome, downs syndrome
10. Others :
a) Multifactorial disorders
b) Trineucleotide repeat mutation

Day - 14
Topics : Pathology (Tissue Repair, Hemodynamics)
1. Example of labile, Stable & permanent cell
2. Factors affecting wound healing
3. Oedema
4. Hypercoagulability, DIC
5. Thrombus and embolism, Deference Between Arterial and Venous Thrombi Fat Embolism
6. Infarction
7. Shock

Pathology (Neoplasm)
8. Dysplasia, Pre-cancerous conditions
9. Carcinogens, Occupational cancer
10. Grading & staging of a tumour
11. Para-neoplastic syndrome, Tumour marker cytology

Day - 15
Topics :
General & Systemic Bacteriology
1. Classification of bacteria specially anaerobe,.0bligate and facultative intracellular bacteria example
2. Staphylococcal-toxin ,super antigen, diseases
3. Streptococcal-type, toxin, diseases, cause of atypical pneumonia
4. Gonoccoous-cause of urethritis, complication of gonorrhea, fastidious organism
5. Maningococcus-cause of meningitis
6. Tuberculosis- MT TEST-false positive,negative, anti tubercular drug-s/E,Primary site of tb Leprosy-
difference between TL and LL,Iepra reaction
7. Syphilis-stage with c/t, VDRL TEST
8. H.Pylori- virulence factor,investigation.diseases
9. Salmonella-investigation, complication
10. Sterilization -autociave principle
 Day - 16
Topics : Virology
1. Classification
2. Different viruses Giant cell forming virus latent virus with site conginetal infection conginetal
anomaly Oncogenic virus Mode of transmission -vertical, blood
3. HSV 1, 2- DISEASESE
4. Complication of meseales congenital rubella
5. HBV
6. HIV-opportunistic infection
7. Viral vaccine
8. Corona virus
9. Parvo virus
10. Dengue virus

Day - 17
Topics : Parasitology & Mycology
1. Parasite causing auto infection,
2. Parasite having heart lung migration
3. Parasite cussing meningitis, brain abscess
4. Intestinal and hemo flagellates
5. Lishmenia -amastigote, promastigote, Iab investigation
6. Malaria-difference between 4 typess, lab investigation
7. Difference between amoebic and bacillary dysentery
8. Classification of fungus,fungal spore.
9. Opportunistic fungus, systemic fungus, dermatophytes
10. Toxoplasmosis, hook worm, ascariasis

Day - 18
Topics :
1. Difference between innate and acquired immunity
2. Cells of innate and acquired immunity
3. Difference active and passive immunity
4. Macrophage details
5. Examples of acute phase proteins pse
6. Biological properties & function of immunoglobulin’s specially ige, IgM & IgA
7. Important functions of complements
8. Examples of all the types of hypersensitivity
9. Primary and congenital immunodeficiency disorder examples specially
10. B-cell deficiency and T cell deficiency. complement deficiency
 Surgery Faculty
Day - 19
Topics:
1. Gastric carcinoma (Gastric outlet obstruction)
2. Colon cancer
3. Ulcerative colitis
4. Cause of vomiting in infant
5. Infantile hypertrophic pyloric stenosis
6. Intestinal obstruction in children
7. Shock
8. Autologus blood transfusion
9. Carcinoma of Thyroid
10. Intra-abdominal abscess

Day - 20
Topics:
1. Suture material
2. Energy sources used in Surgery
3. MEN ( Multiple endocrine neoplasia)
4. Metabolic response to trauma
5. Base of skull fracture
6. Causes of miscarriage
7. Bone malignancy
8. Causes of oligohydramnios/Polyhydroamnios
9. Cataract
10. Reactionary Haemorrhage

Day - 21
Topics:
1. Pressure sore
2. Splenectomy
3. CSOM
4. Fractures
5. Deafness
6. Acute appendicitis
7. Blood transfusion
8. Wound healing-
9. Advantages/Disadvantages of minimal access surgery
10. Glasgow coma scale

Day - 22
Topics:
1. Red eye
2. Causes of stridor
3. Tracheostomy
4. Compartment syndrome
5. Abdominal wound dehiscence/infection/factor for healing
6. Meleny's synergistic Gangrene/ Necrotising fasciitis
7. Hospital acquired infection
8. Burn
9. Post operative hypoxia
10. Radiological appearance of important surgical pathology
 Pediatrics Faculty
Day - 19
Topics :
1. SAM
2. Radiological findings of scurvy n rickets
3. Pneumonia
4. Bronchiolitis
5. D/F between croup in laryngomalacia
6. Dengue fever
7. Chickungunia fever
8. RF
9. JIA
10. SLE

Day - 20
Topics :
1. SAM
2. Radiological findings of scurvy n rickets
3. Pneumonia
4. Bronchiolitis
5. D/F between croup in laryngomalacia
6. Dengue fever
7. Chickungunia fever
8. RF
9. JIA
10. SLE

Day - 21
Topics :
1. Causes of lymphadenopathy
2. Thalassemia
3. ITP
4. Hemophilia
5. Von willebrand dis
6. ALL
7. Lymphoma
8. DIC
9. Anemia
10. Common surgical emergencies

Day - 22
Topics :
1. Cynotic n acynotic heart disease
2. IE
3. AGN, NS
4. Hepatitis virus
5. Wilson disease
6. Febrile convulsion
7. Meningitis
8. CP
9. D/F between poliomyelitis, GBS, DMD
10. Congenial hypothyroid
 Medicine Faculty
Day - 19
Topics :
1. Box 7.7 Poisons effectively eliminated by multiple doses of activated charcoal, haemodialysis or
haemoperfusion/ P-136, Box 7.8 Complications of poisoning and their management/P-137, Box
7.14 Cholinergic features in poisoning* /P-146
2. Box 10.3 Causes of elevated serum troponin other than acute coronary syndrome/P-179, Box
10.7 How to differentiate seizures from syncopel P-182, Delirium- Box 10.8 Risk factors for
delirium/P-183 -Fig. 10.4 Common causes and investigation of delirium/P-184, Headache, Box
10.10 Primary and secondary headache syndromes/P-185, Box 10.11 'Red flag symptoms in
headache/P-185
3. Typhoid fever-Box 11.42 Clinical features of typhoid fever, Box 11.43 Complications of typhoid
fever, Leprosy , Box 11.46 Clinical characteristics of the polar forms of leprosy, Box 11.47
Reactions in leprosy, Malaria , Box 11.53 Relationships between life cycle of parasite and clinical
features of malaria, Box 154 Severe manifestations/complications of falciparum malaria and
their immediate management, Box 11.56 Chemoprophylaxis of malaria
4. Leishmania, Fig. 11.40 Life cycle of Leishmania., Investigations findings in Leishmania, Fig. 11.59
Classification of medically important fungi, HIV, Box 12.9 CD4 count and risk of common HIV-
associated diseases, Box 12.15 Opportunistic infections reduced by co-trimoxazole
5. Hyponatremia & Hypokalemia, Box 14.10 Causes of hyponatraemia, Box 14.11 Causes and
diagnosis of syndrome of inappropriate antidiuretic hormone secretion, Box 14.15 Causes of
hypokalaemia, Box, 19 Causes of metabolic acidosis, Box 14.25 Causes of secondary
hyperlipidaemia
6. Box 15.2 Limitations of estimated glomerular filtration rate (eGFR), Nephrotic & Nephritic
syndrome, Box 15.8 Investigation of nephritic syndrome, Box 15.11 Consequences of the
nephrotic syndrome and their management, Box 15.13 Causes of polyuria, Glomerular disease,
Box 15.14 Poor prognostic indicators in glomerular disease, Box 15.17 Causes of
glomerulonephritis associated with low serum complement, Box 15.18 Causes of acute
interstitial nephritis, Box 15.22 Presentation and clinical features of renal artery stenosis, Box
15.33 Causes of anaemia in chronic kidney disease
7. Box 16.3 Exercise testing, Box 16.9 Features of a benign or innocent heart murmur, Box 16.12
Mechanisms of heart failure, Box 16.21 Common causes of atrial fibrillation, Box 16.25 Features
more in keeping with ventricular tachycardia.
8. Box 16.26 Causes of long QT interval and torsades de pointes, Box 16.29 Classification of anti-
arrhythmic drugs by effect on the intracellular action potential*, Box 16.33 Digoxin toxicity, Box
16.65 Causes of secondary hypertension, Fig. 16.89 Clinical features that may be present in
endocarditis.
9. Cardiomyopathy, 16.105 Clinical features of hypertrophic Cardiomyopathy, 106 Risk factors for
sudden death in hypertrophic cardiomyopathy
10. Disease of Pericardium, 16.109 Clinical features of constrictive pericarditis, 16.110 Clinical
features of cardiac tamponade
 Day - 20
Topics:
01 . Box 17.16 How to interpret blood gas abnormalities in respiratory failure , 37. Box 17.22 Immediate
assessment of acute severe asthma, 38. Bronchiectasis ( 17.30 Causes of bronchiectasis ,17.31
Symptoms of bronchiectasis )39.Pneumonia, Fig. ( 17.32 Hospital CURB-65., 17.39 Indications for referral
to ITU

02. TB 17.45 Factors increasing the risk of tuberculosis, 17.47 Features of primary tuberculosis, 17.48
Cryptic tuberculosis, 17.53 Main adverse reactions of first-line antituberculous drugs 41. Fungal
infections of lungs, (17.56 Factors predisposing to pulmonary fungal disease, 17.59 Risk factors for
invasive aspergillosis), 42. Box 17.64 Non-metastatic extrapulmonary manifestations of lung cancer 43.
Box 17.72 Presentation of sarcoidosis 44. Box 17.92 Causes of elevation of a hemidiaphragm

03. Thyroid problems, 18.5 How to interpret thyroid function test results ,18.9 Non-specific laboratory
abnormalities in thyroid dysfunction* , 18.13 Causes of thyroid enlargement 46. Box 18.25 Causes of
infertility, 47. Box 18.26 Causes of gynaecomastia, 48. Box 18.28 Features of polycystic ovarian
syndrome, 49. Box 18.32 Causes of hypercalcaemia

04. Box 18.42 Clinical and biochemical features of adrenal insufficiency, 51. Box 18.58 Causes of
hyperprolactinaemia, 52. Fig. 18.30 Clinical features of acromegaly

05. Box 20.9 Aetiological classification of diabetes mellitus

54. DKA & HHS

06. Box 21.2 Gut hormones and peptides, 56. Box 21.5 Upper gastrointestinal endoscopy, 57. Dyspepsia
(21.14 Causes of dyspepsia, 21.15 Alarm features in dyspepsia), 58. Fig. 21.19 Causes of acute upper
gastrointestinal haemorrhage

59. Box 21.19 Routine blood test abnormalities in malabsorption, 60. Box 21.25 Causes of oral
ulceration, 61. Fig. 21.26 Factors associated with the development of gastrooesophageal reflux disease.

62. H. Pylori (v Box 21.36 Indications for Helicobacter pylori eradication, 21.35 Common side-effects of
Helicobacter pylori eradication therapy,

07. 21.40 Risk factors for gastric cancer 63. Box 21.43 Important causes of subtotal villous atrophy
 Day - 21
Topics:
01. Box 21.49 Causes of protein-losing enteropathy, 65. Box 21.51 Comparison of ulcerative colitis and
Crohn's disease , 66. IBS ( Box 21.64 Supporting diagnostic features and alarm features in irritable bowel
syndrome, Box 21.65 Dietary management of irritable bowel syndrome) 67. Colorectal cancer ( Box
21.70 Dietary risk factors for colorectal cancer, Box 21.71 Non-dietary risk factors for colorectal cancer)
68. Box 21.80 Causes of acute pancreatitis

02. Box 22.3 Drugs that increase levels of y-glutamyltransferase, 70. Acute liver failure (1. Fig. 22.13
Causes of acute liver failure in the UK, 2. Box 22.11 Adverse prognostic criteria in acute liver failure*, 3.
Box 22.13 Complications of acute liver failure, 71. Jaundice (1. Box 22.15 Causes of cholestatic jaundice,
2. Box 22.17 Congenital non-haemolytic hyperbilirubinaemia )

03. Box 22.21 Causes of ascites, 73. Cirrhosis ( 1. Box 22.25 Factors precipitating hepatic
encephalopathy, 2. Box 22.31 Complications of portal hypertension 74. Box 22.54 Examples of common
causes of drug-induced hepatotoxicity

04. Box 23.2 How to interpret red cell appearances, 76. Box 23.8 Classification
and causes of erythrocytosis, 77. Box 23.16 Causes of pancytopenia, 78. Box 23.17 Blood components
and their use, 79. Box 23.30 Investigations to differentiate anaemia of chronic disease from iron
deficiency anaemia

05. Megaloblastic anaemia ( 1. Box 23.31 Clinical features of megaloblastic anaemia, 2. Box 23.32
Investigations in megaloblastic anaemia, 3. Box 23.33 Neurological findings in B12 deficiency ), 81. Box
23.36 Investigation results indicating active haemolysis, 82. Box 23.67 Antiphospholipid syndrome (APS),
83 Box 23.68 Disseminated intravascular coagulation (DIC)

06. Box 24.1 Key regulators of bone remodelling, 85. Box 24.3 Radiographic abnormalities in selected
rheumatic diseases, 86. Box 24.7 Causes of an elevated serum creatinine phosphokinase (CPK), 87. Box
24.26 Causes of proximal muscle pain or weakness

07. Osteoarthritis (1.Box 24.36 Risk factors for osteoarthritis, 2.Box 24.37 Symptoms and signs of
osteoarthritis, 3.Box 24.38 Characteristics of generalised nodal osteoarthritis , 89. Hyperuricaemia and
gout (1.Box 24.42 Causes of hyperuricaemia and gout 2. Box 24.44 Indications for urate-lowering drugs)

08. Fibromyalgia. ( 1.Fig. 24.30 Possible causative mechanisms in fibromyal gia.,2. Box 24.47 The
spectrum of symptoms in fibromyalgia , 3.Fig. 24.31 Typical tender points in fibromyalgia.,) 91.
Rheumatoid disease (1. Box 24.53 Extra-articular manifestations of rheumatoid disease 2. Box 24.54
Felty's syndrome)

09. Spondyloarthropathies (1.Box 24.59 Features common to spondyloarthrop athies 2.Box 24.61 Extra-
articular features of 3.axial spondyloarthritis and ankylosing spondylitis)

10 Box 24.63 Criteria for the classification of systemic lupus erythematosus, 93. osteoporosis , Box 24.69
Risk factors for. Osteoporosis, Box 24.73 Adverse ef
 Day - 22
Topics:
01. Box 25.2 Cortical lobar functions, 95. Box 25.24 Causes of pseudobulbar and bulbar palsy

02. Parkinson's disease 1. Box 25.54 Causes of parkinsonism, 2. Box, 3.25.55 Physical signs in Parkinson's
disease, 3.Box 25.56 Dopamine agonists*, 4.Box 25.59 Drug-induced tremor (usually postural)

03. Box 25.60 Clinical features of motor neuron disease, 98. Box 25.84 Causes of polyneuropathy, 99.
Myasthenia & GBS

04. Fig. 25.53 Causes of acquired proximal myopathy. 99. Subarachnoid haemorrhage

05. 28.23 Symptoms of schizophrenia, 28.26 Adverse effects of antipsychotic drugs

06. 28.32 Diagnostic criteria for eating disorders

07. 29.23 Exacerbating factors in psoriasis, Fig. 29.34 The histology of psoriasis.

08. 29.29 Drug-induced pigmentation, 29.32 Provoking factors in erythema multi-forme

09. 29.33 Provoking factors in erythema nodosum.

10. 30.7 Drug treatment of hypertension during pregnancy