CBME – THEORY

12. Endocrine, metabolism & DM

DEPARTMENT OF MEDICINE
KMC – Manipal
Version 1.0 © 2023
Instructions

1. Please find the topic list and space for competency numbers against them. Also find
competency list as per NMC document in table below.
2. Please ensure all the competencies under knowledge (K) is covered in the theory class
allotted without fail. Also other competencies to be covered subject to availability of time.
3. Each class to start with showing the list of competencies going to be covered in that class
and also spell out specific learning objectives.
4. Also fill the list of competencies covered in SLCM attendance portal without fail for
respective class
Endocrine, Metabolism & DM – 8th semester
Medicine 12
Introduction - principles in endocrinology, Hormones and
assays
Syndromes of pituitary hypo function & Small stature
Syndromes of pituitary hyperfunction
Diabetes insipidus & SIADH
Hypothyroidism, Hyperthyroidism and other thyroid disorders
Cushing’s syndrome
Addison’s Disease
Pheochromocytoma and Conn syndrome
Hypogonadism, Impotence & Hirsutism
Calcium metabolism, hypocalcemia and hypercalcemia, Hyper
& Hypoparathyroidism, Vit D deficiency and excess
Lipid disorders
Amyloid disorders & Porphyria
Diabetes Mellitus 1 (Introduction, classification,
Aetiopathogenesis and Clinical features)
Diabetes Mellitus 1 (Investigations, diagnosis and treatment)
Acute and chronic Complications of Diabetes & their
management
Surgery, Pregnancy, acute illness and Diabetes
Hours CBME Competency Medicine Topic Number
20 Number
1 Medicine 12.1
1 Medicine 12.2
1 Medicine 12.3
1 Medicine 12.4
2 Medicine 12.5
Medicine 12.6
1 Medicine 12.7
1 Medicine 12.8
1 Medicine 12. 9
1 Medicine 12.10
2 Medicine 12.11
Medicine 12.12
1 Medicine 12.13
1 Medicine 12.14
1 Medicine 12.15
2 Medicine 12.16
Medicine 12.17
2 Medicine 12.18
Medicine 12.19
1 Medicine 12.20
Number COMPETENCY listed by Domain Level Core Y/ Suggested Suggested Number Vertical Horizontal
K/KH/ N Learning Assessment required Integration
CBME NMC document K/S/A/C Integration
SH/P methods methods to certify
The student should be able to
P

Topic: 12.0 Endocrine including Thyroid dysfunction Number of competencies: (15)

Number of procedures that require certification : (NIL)

IM Introduction to clinical
12.19 endocrinology
Pituitary hypo and
IM hyperfunctioning and small
12.20 stature
IM
Diabetes Insipidus and SIADH
12.21
Adrenal Hypo and
IM Hyperfunctiong (addisons and
12.22 cushings)
IM Pheochromocytoma and
12.23 Conn's syndrome
Male Hypogonadism,
IM Impotence, Hirsuitism, PCOD
12.24 medical aspects
SU22.6 Describe and discuss the K KH Y Lecture written: Medicine
clinical features of hypo - and short
hyperparathyroidism and the notes or
principles of their part of
management structured
assay
 SU22.6.1 - Describe primary, K KH Y Lecture written: Medicine
secondary and tertiary short
hyperparathyroidism notes or
part of
structured
assay

SU22.6.2 -Discuss the clinical K KH Y Lecture written: Medicine

features of short
hyperparathyroidism and notes or
hypoparathyroidism part of
structured
assay
SU22.6.3 - Discuss the K KH Y Lecture written: Medicine
investigations for Hyper and short
Hypoparathyroidism notes or
part of
structured
assay
SU22.6.4 - Discuss the
management of Hyper and
Hypoparathyroidism
SU23.2 Describe the aetiology, K KH Y Lectures written: Medicine
clinical features and short
principles of management of notes or
disorders of adrenal gland part of
structured
assay

23.2.1 The disorders of K KH Y Lectures written: Medicine

adrenal cortex, & discuss short
aetiopathogenesis, clinical notes or
features, diagnostic part of
evaluation, management for structured
each of them. assay
23.2.2 The disorders of K KH Y Lecture written: Medicine
adrenal medulla & neural short
crest derived tissue. notes or
part of
structured
assay
 23.2.3 Aetiopathogenesis,
clinical features,
management of disorders of
adrenal medulla & neural
crest derived tissue.

SU23.3 Describe the clinical features, K KH Y Lectures written: Medicine

principles of investigation short
and management of Adrenal notes or
tumours part of
structured
assay

23.3.2 The principles of

estimation of the hormones
& imaging studies in
diagnosis of adrenal tumours.

Describe the epidemiology and

pathogenesis of hypothyroidism Lecture - 1
and hyperthyroidism including the Pathology,
IM12.1 K K Y Written/ Viva voce
influence of iodine deficiency and Physiology
autoimmunity in the pathogenesis SGD - 1
of thyroid disease
 Describe and discuss the genetic Lecture - 2
IM12.2 basis of some forms of thyroid K K N Written/ Viva voce
dysfunction SGD - 2
Describe and discuss the
physiology of the Lecture - 3
hypothalamopituitary - thyroid axis, Pathology,
IM12.3 K K Y Short notes
principles of thyroid function Physiology
testing and alterations in SGD - 3
physiologic function
Describe and discuss the
principles of radio iodine uptake in Lecture - 4 Short notes/ Viva
IM12.4 the diagnosis of thyroid disorders K KH Y
voce
SGD - 4
Elicit document and present an
appropriate history that will
Skill assessment/
establish the diagnosis cause of
Short
thyroid dysfunction and its Bedside
IM12.5 severity S SH Y
clinic - 1
History in a thyroid dysfunction
case
case

Perform and demonstrate a

systematic examination based on
the history that will help establish
the diagnosis and severity
including systemic signs of
Bed side
thyrotoxicosis and
clinic - 2 General
IM12.6 hypothyroidism, palpation of the S SH Y Skill assessment
pulse for rate and rhythm Surgery
abnormalities, neck palpation of
the thyroid and lymph nodes and
cardiovascular findings
Examination of a thyroid DOAP
dysfunction case session - 1
Bedside
IM12.7 Demonstrate the correct clinic - 3 General
S SH Y Skill assessment
SU22.3 technique to palpate the thyroid DOAP Surgery
session - 2
 Generate a differential diagnosis
based on the clinical presentation Bedside
and prioritise it based on the most clinic - 4
likely diagnosis General
IM12.8 K KH Y Short case
case based discussion – Surgery
SGD - 5
History & Examination

Order and interpret diagnostic

testing based on the clinical
Bedside
diagnosis including CBC, thyroid
clinic - 5
function tests and ECG and radio
General
IM12.9 iodine uptake and scan S SH Y Skill assessment
Surgery
Case based discussion – DOAP
Investigations session - 3
Lecture
Identify atrial fibrillation,
Bedside
pericardial effusion and General
IM12.10 S SH Y clinic - 6 Skill assessment
bradycardia on ECG Surgery
SGD - 6
Bedside
clinic - 7
Interpret thyroid function tests in General
IM12.11 S SH Y Lecture Skill assessment
hypo and hyperthyroidism Surgery
SGD - 7
Describe and discuss the
iodisation programs of the Lecture - 5
Community
IM12.12 government of India K KH Y Short note
Medicine
Bedside
clinic - 8
Describe the pharmacology,
indications, adverse reaction,
Lecture - 6 Viva voce/ Short General
IM12.13 interactions of thyroxine and K KH Y Pharmacology
antithyroid drugs note Surgery
SGD - 8
Write and communicate to the
IM12.14 patient appropriately a S/C SH Y SGD - 9 Skill assessment Pharmacology
prescription for thyroxine based
 on age, sex, and clinical and
biochemical status

Describe and discuss the

indications of thionamide therapy,
Bedside
radio iodine therapy and surgery
clinic - 9
in the management of
thyrotoxicosis Short note/ Viva General
IM12.15 K KH Y Pharmacology
Therapeutic options in Thyroid voce Surgery
disease - Case based SGD - 10
discussion

Parathyroid dysfunction (hypo

IM and Hyper parathyroidism) and
12.16 deranged Calcium Metabolism
and Vit D in health and disease
Osteoporosis and
IM 12.17
Osteomalasia
IM 12.18 Porphyrias

Topic: 11.0 Diabetes Mellitus Number of competencies: (24)

Number of procedures that require certification : (02)
Lecture - 1
IM11.1 Define and classify diabetes K KH Y Written/ Viva voce
SGD – 1
Describe and discuss the
epidemiology and pathogenesis
Lecture - 2
IM11.2 and risk factors and clinical K KH Y Written/ Viva voce Pathology
evolution of type 1 diabetes
SGD – 2
Describe and discuss the
epidemiology and pathogenesis
IM11.3 and risk factors economic impact K KH Y Lecture - 3 Written/ Viva voce Pathology
and clinical evolution of type 2
diabetes
 SGD – 3
Describe and discuss the genetic
background and the influence of Lecture - 4
IM11.4 the environment on diabetes K KH N Written/ Viva voce
SGD – 4
Describe and discuss the
pathogenesis and temporal
evolution of microvascular and Lecture - 5
macro vascular complications of
IM11.5 K KH Y Written/ Viva voce Pathology
diabetes
SGD - 5

Describe and discuss the

pathogenesis and precipitating
factors, recognition and Lecture - 6
IM11.6 management of diabetic K KH Y Written/ Viva voce
emergencies
SGD – 6
Elicit document and present a
medical history that will
differentiate the aetiologies of
diabetes including risk factors, Bedside
precipitating factors, lifestyle, clinic - 1
nutritional history, family history,
IM11.7 S SH Y Skill assessment
medication history, co-morbidities
and target organ disease
History taking in Diabetes DOAP
Mellitus session - 1

Perform a systematic examination

that establishes the diagnosis and
severity that includes skin,
peripheral pulses, blood pressure Bedside
IM11.8 S SH Y Skill assessment
measurement, fundus clinic - 2
examination, detailed examination
of the foot (pulses, nervous and
deformities and injuries)
 Examination of a diabetic DOAP
patient session - 2

Describe and recognize the Lecture - 7

IM11.9 clinical features of patients who K KH Y Written/ Viva voce
present with a diabetic emergency SGD - 7
Generate a differential diagnosis
and prioritise based on clinical
Lecture - 8
features that suggest a specific
IM11.10 aetiology K KH Y Written/ Viva voce
Diabetes Case based
SGD - 8
discussion

Order and interpret laboratory

tests to diagnose diabetes and its
complications including: glucoses,
glucose tolerance test, Bedside
glycosylated hemoglobin, urinary clinic - 3
micro albumin, ECG, electrolytes,
IM11.11 S SH Y Skill assessment Pathology
ABG, ketones, renal function tests
and lipid profile
DOAP
Investigating a diabetic patient
session - 3

Bedside
Pathology,
Perform and interpret a capillary clinic - 4
IM11.12 S P Y Skill assessment 2
blood glucose test DOAP
Biochemistry
session - 4
Bedside
Pathology,
Perform and interpret a urinary clinic - 5
IM11.13 S P Y Skill assessment 2
ketone estimation with a dipstick DOAP
Biochemistry
session - 5
Recognize the presentation of
hypoglycemia and outline the Lecture - 9
IM11.14 principles on its therapy K KH Y Written/ Viva voce
SGD - 9
 Recognize the presentation of
diabetic emergencies and outline Lecture - 10
IM11.15 the principles of therapy K KH Y Written/ Viva voce
SGD - 10
Discuss and describe the
pharmacologic therapies for
diabetes their indications, Lecture - 11
IM11.16 contraindications, adverse K KH Y Written/ Viva voce Pharmacology
reactions and interactions
SGD - 11
Outline a therapeutic approach to
therapy of T2Diabetes based on
presentation, severity and Lecture - 12
IM11.17 complications in a cost effective K KH Y Written/ Viva voce
manner
SGD - 12
Describe and discuss the
pharmacology, indications,
adverse reactions and interactions Lecture - 13
of drugs used in the prevention
and treatment of target organ
IM11.18 damage and complications of K KH Y Written/ Viva voce Pharmacology
Type II Diabetes including
neuropathy, nephropathy,
retinopathy, hypertension, SGD - 13
dyslipidemia and cardiovascular
disease
Demonstrate and counsel patients
DOAP
IM11.19 on the correct technique to S/C SH Y Skill assessment Pharmacology
session - 6
administer insulin
Demonstrate to and counsel
patients on the correct technique DOAP
IM11.20 S/C SH Y Skill assessment
of self-monitoring of blood session - 7
glucoses
Recognize the importance of
DOAP
IM11.21 patient preference while selecting A KH Y faculty observation
session - 8
therapy for diabetes
 Enumerate the causes of
Lecture - 14
hypoglycemia and describe the Pathology,
IM11.22 K KH Y Written/ Viva voce
counter hormone response and Physiology
the initial approach and treatment SGD - 14
Describe the precipitating causes,
pathophysiology, recognition,
clinical features, diagnosis, Lecture - 15
IM11.23 stabilization and management of K KH Y Written/ Viva voce
diabetic ketoacidosis
SGD - 15
Describe the precipitating causes,
Lecture - 16
pathophysiology, recognition,
IM11.24 clinical features, diagnosis, K KH N Written/ Viva voce
stabilization and management of SGD - 16
Hyperosmolar non ketotic state
Surgery and diabetes /
IM 12.25
pregnancy and diabetes