R Alagappan Manual of practical medicine pdf free download (latest edition) - direct link

 



R Alagappan Manual of practical medicine book pdf free download ⬇️⬇️⬇️⬇️

General medicine is one of the major subjects in medical studies. Medicine is a vast subject and also very important. Many students feel difficult to study medicine. One should choose best, good and easy book for their studies. One of the most popular book is R Alagappan manual of Practical medicine,it is very much useful for final year students.

Contents of the book:

1. Introduction to Internal Medicine. 

• History Taking 

General Examination 

• Examination of the skin 

• Hair 

• Face 

• Eyes 

• The Tongue 

• Characteristic Types of Fades 

• Constitution 

• Stature 

• State of Nutrition 

• Posture 

• Hands and Fingers 

• Feet and Toes 

• The Skin in Clinical Medicine 

• Nails in Clinical Medicine 

Temperature 

• Normal Temperature Regulation in the Body 

• Factors Determining Rate of Heat Production 

• Fever 

• Pain 

• Chest Pain 

• Abdominal Pain 

• Pain due to Disorders of GIT 

• Renal Pain 

• Peripheral Vascular Pain Arterial Occlusion 

• Venous Pain 

• Neurogenic Claudication 

Oedema 

• Aetiology and Types of Oedema 

• Pathophysiology of Oedema 

• Characteristic Features of Oedema of Various

Aetiologies 

Shock 

• Control of Arterial Blood Pressure 

• Control Mechanism 

• Classification 

• Fundamentals in Genetics 

• Normal Chromosome Number and Structure 

• Chromosomal Abnormalities 

• Single Gene Disorders 

• Histocompatibility Antigens 

• Transplant Rejection 

• Autoimmune Diseases 

• Immunology and Malignancy 

2. Nutrition 

• Classification of Nutrients 

• Water 

• Mocro-nutrients 

• Classification of Nutritional Disorders 

• Pathological Couses of Nutritional Disorders 

• Effects of Malnutrition 

• Protein-Enery Malnutrition 

Vitamins 

• Vitamin A (Retinol) 

• Vitamin D 

• Vitamin E 

• Vitamin K 

• Thiamine (Vitamin B.) 

• Riboflavin (Vitamin B2) 

• Niacin (Nicotinic Acid and Nicotinamide) 

• Pyridoxine (Vitamin B6)

• Biotin 

• Vitamin B12 and Folate 

• Vitamin C (Ascorbic Acid) 

• Inorganic Nutrients 

• Sodium 

• Potassium 

• Calcium 

• Phosphorus 

fron 

lodine 

• Zinc

• Fluorine 

• Magnesium 

• Manganese 

• Copper 

• Cobalt 

• Nickel 

• Chromium 

• Selenium 

• Obesity 

• Types of Obesity 

• Aetiology 

• Pathology 

• Prognosis 

Anorexia Nervosa and Bulimia 

• Anorexia Nervosa 

Bulimia 

• Mosaicism 

• Chimerism 

• Multifactorial or Polygenic Inheritance 

• Genomic Imprinting 

• Trinucleotide Repeat 

• Mitochondrial Disorders 

• Common Chromosomal Disorders 

• Immunology 

• The Immune System and the Basis of Immunity 

. Clinical Aspects of Immunology 

Immunoglobulins 

• Disorders of Immunoglobulins 

Immunodeficiency States 

• Hypersensitivity Reactions 

3. Infectious Diseases

Bacterial Infections 

• Staphylococcal Infections 

• Streptococcal Infections 

• Meningococcal Meningitis 

Gonococcal Infection 

Diphtheria

Tetanus 

Botulism 

Gas Gangrene (Clostridial Myonecrosis) 

C. difficile Infection (Pseudomembranous Colitis) 

Listeriosis 

Anthrax 

Haemophilus influenzae 

Legionella (Legionnaires Disease) 

Whooping Cough (Pertussis) 

Gram-negative Enteric Bacteria 

Escherichia coli 

Campylobacter 

Enteric Fever 

Shigellosis: Bacillary Dysentery 

Cholera 

Brucellosis (Undulant Fever) 

Plague 

Helicobacter pylori 

Anaerobic Infections 

Nocardiosis 

Atypical Mycobacteria 

Extrapulmonary Tuberculosis 

Leprosy (Hansen's Disease) 

Chancroid 

Granuloma Inguinale 

Chlamydial Infections 

Mycoplasma Infections 

Spirochetal Diseases 

Syphilis 

Yaws (Framboesia) 

Endemic Syphilis (Bejel)

Pinta 

Leptospirosis (Weil's Disease)

Relapsing Fever

Rat-bite Fever

Lyme Borreliosis 

Rickettsial Infections 

Epidemic Louse-Borne Typhus 

Endemic Flea-Borne Typhus (Murine Typhus) 

Scrub Typhus (Tsutsugamushi Fever)

Rocky Mountain Spotted Fever 

Rickettsialpox

Tick Typhus (Rickettsial Fever) 

Ehrlichiosis and Anaplasmosis 

Diagnosis of Rickettsial Infections 

Q-Fever

Kawasaki Disease 

Viral Diseases

Classification of Viral Disorders 

Viral Infections and Cancer 

Viral Pathogenesis 

Immunity-Viral Diseases 

Diagnostic Virology 

Viral Respiratory Disorders 

Parainfluenza 

Influenza 

Respiratory Syncytial Virus Infections  

Herpes Virus Infections 

Varicella Zoster Infections 

Epstein-Barr Virus (HHV-4) and Infectious

Mononucleosis 

Cytomegalovirus 

Human Herpesviruses Types-6,7 and 8

Human Papillomavirus and Parvovirus Infections 

Parvovirus Intections 

Variola (Small Pox) 

Measles (Rubeola)

Rubella (German Measles) 

Mumps 

Poliomyelitis 

Rabies 

Dengue Fever (Break-bone Fever) 

Yellow Fever 

Japanese B Encephalitis 

Chikungunya Virus Infection 

Gastrointestinal Virus Infections 

Hepatitis Viruses (A-E) 

COxsackie Virus Infections 

Human Immunodeficiency Virus (HV) Infection and

Acquired lmmunodeficiency Syndrome (AIDS) 

Protozoal Infections 

Malaria 

Amoebiasis 

Giardiasis 

Cryptosporidiosis 

Trichomoniasis

Balantidiasis 

Isosporiasis 

Leishmaniasis 

Trypanosomiasis 

Toxoplasmosis

Pneumocystis jiroveci 

Helminthic Infestations

Classification of Helminths that Infest Humans 

Ankylostomiasis (Hookworm) 

Ascariasis 

Strongyloidiasis

Enterobius Vermicularis (Threadworm or

Pinworm)

Trichuris Trichiura (Whipworm) 

Tissue-dwelling Human Nematodes 

Lymphatic Filariasis 

Tropical Pulmonary Eosinophilia 

Loiasis

Onchocerciasis (River Blindness)

Dracunculiasis (Guinea Worm Infection) 

Zoonotic Nematodes 

Trichinosis (Trichinellosis)

Cutaneous Larva Migrans (CLM) 

Trematodes (Flatworms/Flukes) 

Schistosomiasis (Blood Flukes) 

Hepatobiliary Flukes 

Intestinal Flukes 

Lung Flukes 

Cestodes (Tapeworms) 

Taenia Saginata 

Taenia Solium and Cysticercosis 

Echinococcosis

Hymenolepiasis Nana 

Diphylobothrium latum 

Fungal Infections 

Candidiasis 

Histoplasmosis 

Coccidioidomycosis 

Pneumocystosis (Pneumocystis jiroveci

Pneumonia) 

CryptOcOccosis 

Aspergillosis 

Mucormycosis (Zygomycosis/Phycomycosis) 

Penicillium Marneffei Infections 

Mycetoma (Maduromycosis and

Actinomycetoma) 

 Immunisation Against Infectious Diseases 

Milestones in Vaccine Evolution 

Adult Immunisation 

Cardiovascular System 

Symptoms and Signs

Dyspnoea 

Angina Pectoris 

Palpitation 

Syncope 

Cyanosis 

Arterial Pulse 

Blood Pressure 

Examination of Neck Veins 

Jugular Venous Pressure 

Jugular Venous Pulse 

General Examination 

External Features of Cardiac Disease 

Eyes in Cardiology 

Inspection 

Palpation 

Percussion 

Auscultation 

Heart Sounds 

Heart Murmurs 

Dynamic Auscultation 

Electrocardiogram 

Electrical Axis 

Left Atrial Enlargement 

Right Atrial Enlargement 

Left Verntricular Hypertrophy 

Right Ventricular Hypertrophy 

Biventricular Hypertrophy 

Right Bundle Branch Block 

Left Bundle Branch Block 

Hemiblocks (Fascicular Blocks) 

Bi-fascicular Block 

Tri-fascicular Block 

ECG in Coronary Artery Disease

ECG in Electrolyte Imbalance 

ECG Changes with Drug IntOxication 

ECG in Acute Pulmonary Embolism 

ECG Features of COPD 

ECG Features of Hypothermia 

ECG in Various Arrhythmias 

Congenital Heart Diseases 

Classifcation of Congenital Heart Diseases 

Cardiac Malposition

Cardiac Abnormalities with Various Genetic

Disorders 

Maternal Disease causing CHD 

Atrial Septal Defect 

Ventricular Septal Defect 

Patent Ductus Arteriosus 

Eisenmenger Syndrome 

Tetralogy of Fallot 

Pulmonary Stenosis 

Congenital Aortic Stenosis 

Coarctation of the Aorta 

Anomalous Pulmonary Venous Connection

Ebstein's Anomaly 

Complete Transposition of the Great Vessels (D-Transposition) 

Congenitally Corrected Transposition of the Great Vessels 

Truncus Arteriosus

Tricuspid Atresia 

Congenital Complete Heart Block

Idiopathic Dilatation of the Pulmonary Artery 

Congenital Abnormalities of the Coronary

Arteries 

Rheumatic Fever 

Valvular Heart Disease 

Mitral Stenosis (MS) 

Mitral Regurgitation (MR) 

Mitral Valve Prolapse Syndrome (MVPS)

Aortic Stenosis (AS) 

Aortic Regurgitation (AR) 

Tricuspid Stenosis (TS) 

Tricuspid Regurgitation (TR) 

Pulmonary Stenosis (PS) 

Pulmonary Regurgitation (PR) 

Infective Endocarditis (1E) 

Cardiac Failure 

Aetiology 

Pathophysiology 

Classification of Cardiac Failure High Output and Low Output Failure 

Treatment of Cardiac Failure 

Systemic Hypertension 

Recommendations of the Eighth Joint National Committee (UNC 8) 

Strategies in the usage of Antihypertensive Drugs 

Causes of Isolated Systolic Hypertension 

Factors Influencing Prognosis 

Non-drug Therapy

Drug Therapy 

Special Considerations in Antihypertensive Therapy 

Acute Coronary Syndrome (ACS) 

Unstable Angina 

Myocardial Infarction (MI) 

Incidence 

Risk Factoors

Symptoms 

Signs

Myocarditis

Giant Cell Myocarditis 

Cardiomyopathies 

Dilated (Congestive) Cardiomyopathy 

Tako Tsubo Cardiomyopathy 

Arrhythmogenic Right Ventricular Dysplasia

(ARVD) 

Restrictive (Obliterative) Cardiomyopathy

Hypertrophic Obstructive Cardiomyopathy

Primary Cardiomyopathies 

Secondary Cardiomyopathies 

Peripartum Cardiomyopathy (PPCM) 

• Pericarditis 

Aetiologic Classification 

Cardiac Tamponade 

Causes

Cardiac Arrest 

• Causes 

Cardiopulmonary Resuscitation (Basic Life

Support) 

Cardioversion (DC Shock) 

Cardiac Surgery 

• Cardiac Transplantation 

Contraindications to Cardiac Transplantation 

5. Respiratory System

Anatomical Landmarks

Bronchopulmonary Segments 

• Borders of the Lung 

. Pleural Border 

• Pulmonary Circulation 

Circulation (Bronchial Circulation) 

• Symptoms and Signs 

• Sputum 

Dyspnoea 

• Chest Pain 

General Examination 

• Clubbing 

• Examination of the Neck 

Scalene Lymph Node 

• Significant Node 

Lymphatic Drainage of

the Lung and Pleura 

• Presence of Veins over the Chest Wall 

• External Manifestations of Respiratory Diseases 

• Examination of the Respiratory System

• Inspection of Upper Respiratory Tract 

• Inspection of Lower Respiratory Tract 

Position of Trachea 

• Position of Apex Beat 

Symmetry of Chest 

• Chest Deformities 

• Spinal Deformity 

• Movement of the Chest 

Palpation 

Tracheal Tug-Oliver's Sign 

Inspiratory Tracheal Descent 

Confirmation of Apical Impulse 

• Measurement of the Chest Expansion 

• Assessing Symmetry of Chest Expansion 

• Assessment of Anterior Thoracic Movement 

• Assessment of Posterior Thoracic Movement 

• Tenderness over the Chest Wall 

• Detection of Subcutaneous Emphysema 

• Tactile Fremitus 

• Friction Fremitus 

• Vocal Fremitus 

Percussion of the Lung Fields 

General Principles 

• Areas of Percussion 

• Auscultation 

• General Principles of Auscultation 

• Auscultatory Areas 

• Technique of Auscultation 

• Importance of Auscultation 

• Breath Sounds 

• Added Sounds 

• Voice Sounds 

• Miscellaneous Sounds 

Other Features of Clinical Significance 

• Others 

• Cavity 

• Thick-walled Cavity 

• Thin-walled Cavity 

• Fibrosis 

• Types of Fibrosis 

• Investigations 

• Sputum Examination 

• Lung Function Tests 

• Bed Side Lung Function Tests 

• Spirometry

• Lung Volume Estimation 

• Peak Expiratory Flow Rate 

• Chest X-ray 

• Causes of Bilateral Hilar Enlargement

Causes of Unilateral Hilar Enlargement 

• Unilateral Hypertransradiant Hemithorax 

• Hemithorax Opacity 

• Widespread Alveolar Opacities 

• Honeycomb Lung (Air Containing Cysts 0.5-2.0 cm

in Diameter) 

• Miliary Mottling (0.5-2 mm Opacities) 

• Solitary Pulmonary Nodule 

• Multiple Medium Sized Pulmonary Nodules

(5-10 mm) 

• Lung Cavities 

• Unilateral Elevated Hemidiaphragm 

• Bilateral Elevated Hemidiaphragm 

• CT Scan 

Ultrasound Scan 

• MRI Scan 

• Gas Diffusion Capacity 

• Arterial Blood Gas Analysis 

• Ventilation-Perfusion Imaging 

• Pulmonary Angiography 

• Bronchoscopy 

• Pleural Aspiration and Percutaneous

Pleural Biopsy 

• Oxygen Therapy 

• Respiratory Diseases 

• Classification of Respiratory Diseases 

• Bronchial Asthma 

• Obstructive Sleep Apnoea-Hypopnoea Syndrome

(OSAHS) 

• Chronic Obstructive Pulmonary Disease (COPD) 

• Bronchiectasis 

• Cystic Fibrosis 

• Tuberculosis 

• Pneumonia 

• Lung Abscess 

• Pleural Effusion 

• Pneumothorax 

• Interstitial Lung Disease 

• Bronchogenic Carcinoma 

• Mediastinal Mass 

• Acute Respiratory Distress Syndrome (ARDS) 

• Pulmonary Hypertension 

Cor Pulmonale 

• Pulmonary Thromboembolism 

• Lung Transplantation 

• Indications 

• Types 

• Prognosis 

6. Abdomen

• Clinical Examination 

• Signs and Symptoms 

• General Examination 

• Signs of Liver Cell Failure 

• Regions of Abdomen 

• Inspection 

• Palpation 

Percussion 

• Auscultation 

• Causes of Hepatomegaly 

• Causes of Painful Hepatomegaly 

• Causes of Pulsatile Liver 

• Causes of Splenomegaly 

• Causes of Hepatosplenomegaly 

• Causes of Hepatosplenomegaly +

Lymphadenopathy 

• Gastrointestinal System 

• Dysphagia 

• Achalasia Cardia 

• Gastro-oesophageal Reflux Disease 

• Peptic Ulcer Disease 

• Zollinger-Ellison Syndrome 

Sez. Endoscopy 

• Gastrointestinal Bleeding 

• Diarrhoea 

• Malabsorption 

• Tuberculosis of Abdomen 

• Inflammatory Bowel Disease 

• Irritable Bowel Syndrome 

• Ischaemic Colitis 

• Carcinoid Tumours 

• Gastric Ulcer and Malignancy 

• Hepatology and Pancreas 

• Hepatic Segments 

• Liver Function Tests 

• Jaundice 

• Congenital Jaundice 

• Familial Defects in Hepatic

Excretory Function 

• HIV and the Liver 

• Pregnancy and the Liver 

• Viral Hepatitis 

• Chronic Hepatitis 

• Prevention of Hepatitis

• Autoimmune Hepatitis 

• Polycystic Liver Disease 

• Liver Abscess 

• Amoebic Abscess 

• Steatosis 

• Nonalcoholic Fatty Liver Disease 

• Cirrhosis of Liver 

• Variceal Bleeding 

• Ascites 

• Fulminant Hepatic Failure 

• Hepatic Coma (Hepatic Encephalopathy) 

• Hepatorenal Syndrome 

• Hepatocellular Carcinoma (Hepatoma) 

• Metabolic Liver Disease 

• Wilson's Disease 

• Haemochromatosis 

• Reye Syndrome (Fatty Liver with

Encephalopathy) 

• Budd-Chiari Syndrome 

• Acute Pancreatitis 

• Chronic Pancreatitis 

Tropical Pancreatitis 

• Liver Transplantation 

• Cadaver Donor Selection 

• Indications 

• Contraindications 

• Immunosuppression 

• Live Donor Transplantation 

• Auxiliary Liver Transplantation 

• Split Liver Transplantation 

• Bioartificial Liver 

• Success Rate 

• Molecular Adsorbent Recirculating System

(MARS) 

7. Haematology

• Haematopoiesis and Haematopoietic Growth

Factors 

• Cell Divisions 

• Haematopoiesis 

• Normal Haematopoiesis 

• Antigen Designation—Cellular Distribution 

• Haematopoietic Stem Cells 

• Haematopoietic Stem Cell Differentiation 

• Nature of the Marrow Stem Cell 

• Stem Cell Diseases 

• Therapeutic Application of Stem Cells

• Haematopoietic Growth Factors 

• Major Growth Factors 

Normal Reference Values in Haematology 

• Absolute Reticulocyte Count 

• Reticulocyte Index 

• Peripheral Film Morphology 

• WBC Count 

• Erythrocyte Sedimentation Rate 

• Automated Full Blood Analysis 

. Anaemia 

• WHO Definition 

• Practical Classification of Anaemia 

• Classification of Anaemia (Based on Reticulocyte Index) 

• Symptoms and Signs 

• Iron Deficiency Anaemia 

• Megaloblastic Anaemia 

• Anaemia of Chronic Disease (ACD) (Sideropenic

Anaemia, Simple Anaemia) 

• Haemolytic Anaemia 

• Hereditary Spherocytosis (HS) 

• Sickle Cell Disease 

• Thalassaemia 

• Pancytopenia 

• Aplastic Anaemia 

Blood Transfusion 

• Indications 

• Manipulation of Blood Products 

• Hepatorenal Syndrome 

• Hepatocellular Carcinoma (Hepatoma) 

• Metabolic Liver Disease 

• Wilson's Disease 

• Haemochromatosis 

• Reye Syndrome (Fatty Liver with

Encephalopathy) 

• Budd-Chiari Syndrome 

• Acute Pancreatitis 

• Chronic Pancreatitis 

Tropical Pancreatitis 

• Liver Transplantation 

• Cadaver Donor Selection 

• Indications 

• Contraindications 

• Immunosuppression 

• Live Donor Transplantation 

• Auxiliary Liver Transplantation 

• Split Liver Transplantation 

• Bioartificial Liver 

• Success Rate 

• Molecular Adsorbent Recirculating System

(MARS) 

7. Haematology

• Haematopoiesis and Haematopoietic Growth

Factors 

• Cell Divisions 

• Haematopoiesis 

• Normal Haematopoiesis 

• Antigen Designation—Cellular Distribution 

• Haematopoietic Stem Cells

• Haematopoietic Stem Cell Differentiation 

• Nature of the Marrow Stem Cell 

• Stem Cell Diseases 

• Therapeutic Application of Stem Cells 

• Haematopoietic Growth Factors 

• Major Growth Factors 

Normal Reference Values in Haematology 

• Absolute Reticulocyte Count 

• Reticulocyte Index 

• Peripheral Film Morphology 

• WBC Count 

• Erythrocyte Sedimentation Rate 

• Automated Full Blood Analysis 

. Anaemia 

• WHO Definition 

• Practical Classification of Anaemia 

• Classification of Anaemia (Based on Reticulocyten Index) 

• Symptoms and Signs 

• Iron Deficiency Anaemia 

• Megaloblastic Anaemia 

• Anaemia of Chronic Disease (ACD) (Sideropenic

Anaemia, Simple Anaemia) 

• Haemolytic Anaemia 

• Hereditary Spherocytosis (HS) 

• Sickle Cell Disease 

• Thalassaemia 

• Pancytopenia 

• Aplastic Anaemia

Blood Transfusion 

• Indications 

• Manipulation of Blood Products 

• Disorders of the White Cells 

• Neutrophils 

• Lymphocytes 

• Eosinophils 

• Monocytes 

• Basophils 

• Myeloproliferative Disorders 

• WHO Classification of Myeloid Leukemia

• Polycythaemia Vera 

• Essential Thrombocythaemia (Primary

Thrombocytosis) 

• Primary Myelosclerosis (Myelofibrosis) 

• Myelophthisic Anaemia 

• Haematological Malignancies 

• Lymphoid Malignancies 

• Leukaemias 

• Myelodysplastic and Preleukaemic Syndromes

(MDS and PLS) 

• Lymphomas 

Plasma Cell Dyscrasias 

• Plasma Cell Disorders 

An Approach to Bleeding Disorders 

• History 

• Examination 

• Bleeding Disorders 

Immune Thrombocytopenic Purpura (ITP) 

Thrombotic Thrombocytopenic Purpura (TTP) 

Haemolytic Uraemic Syndrome (HUS) 

HIT-Heparin-induced Thrombocytopenia (White Clot

Syndrome) 

• Disorder due to Deficiency of Clotting Factors 

Bone Marrow Transplantation 

• Indications 

• Types of Bone Marrow Transplantation 

• Selection of the Donor 

• Preparation of the Patient 

• Marrow Aspiration and Infusion 

Bone Marrow Transplantation (BMT) in

Leukaemia 

Autologous BMT 

• Haematopoietic Stem Cell Transplantation 

• Allogeneic Stem Cell Transplant 

• Autologous Stem Cell Transplant 

• Peripheral Blood Stem Cell

Transplantation (PBSCT) 

8. Nephrology 

• Urine Analysis 

• Methods of Collection of Urine Specimens 

• Dipstick Testing 

• Microscopic Analysis 

• Haematuria

• Urinary Casts 

• Leucocytes in Urine 

• Renal Tubular Cells 

• Crystals 

• Proteinuria 

• Reducing Substances in Urine 

• 24-hour Urine Studies 

• Blood Tests for Evaluating Glomerular Disorders 

Serum and Urine Protein Electrophoresis 

• Urine Eosinophils 

• Renal Ultrasonography 

• IV Urography 

• Radionuclide Scanning 

• MRI Imaging and Angiography 

Creatinine Clearance (CI) 

• Urinary Tract Infection 

• Definitions 

• Risk Factors Associated with Urinary Tract

Infection 

•Pathogenesis 

• Symptoms of UTI 

• Principles of Treatment of UTI 

• Recommendations for Use and Care of Urinary

Catheters 

• Urinary Antiseptics 

• Prophylaxis for UTI 

• Glomerulopathies 

• Classification 

Classification of Nephritic Syndrome Based on

Complement Levels 

• HIV-associated Nephropathy 

• Nephrotic Syndrome 

Glomerulonephritis 

• Alport Syndrome 

• Fanconi Syndrome 

• Chronic GN 

• Tubulointerstitial Disease of Kidney 

• Acute Interstitial Nephritis 

• Renal Biopsy-Indications 

• Contraindications to Renal Biopsy 

• Chronic Interstitial Nephritis 

• Polycystic Kidney Disease 

Acute Kidney Injury/Acute Renal Failure (ARF) 

• Causes of ARF 

• Acute Tubular Necrosis 

• Renal Tubular Acidosis (RTA) 

• Chronic Kidney Disease 

• Chronic Renal Failure (CRF) 

• Dialysis 

• Haemodialysis (HD) 

• Haemofiltration 

• Intermittent Peritoneal Dialysis 

. Continuous Ambulatory Peritoneal Dialysis

(CAPD) 

• Renal Transplantation 

• Rejection 

• Immunosuppressive Therapy in Renal

Transplantation 

Fluid and Electrolyte Imbalance 

• Sodium 

• Potassium 

Acid-Base Balance and its Disorders 

• Definitions 

• Hydrogen lon Homeostasis 

• Approach to Acid-Base Disorders

9. Nervous System

• Higher Functions 

• Definitions 

• Examination of Higher Mental Functions 

• Consciousness 

• Causes of Coma 

• Approach to Coma 

• Appearance and Behaviour 

• Emotional State 

• Orientation

• Handedness 

• General Intelligence 

• Memory 

• Perceptions 

Visuospatial Functions 

• Sleep

• Speech and Language 

• Cognitive Scales 

• Examination of the Cranial Nerves 

First Cranial Nerve (Olfactory Nerve) 

Second Cranial Nerve (Optic Nerve) 

• The Oculomotor (Third), Trochlear (Fourth), and

Abducent (Sixth) Cranial Nerves 

Fifth Cranial Nerve (Trigeminal Nerve) 

Seventh Cranial Nerve (Facial Nerve) 

The Eighth Cranial Nerve (Vestibulocochlear Nerve) 

• The Ninth and Tenth Cranial Nerves (Glossopharyngeal

and Vagus Nerves) 

• Eleventh Cranial Nerve (Accessory Nerve) 

The Twelfth Cranial Nerve (Hypoglossal Nerve)

• Spinomotor System 

• Corticobulbar and Corticospinal (Pyramidal)

System 

• Extrapyramidal System 

• Neuromuscular System (Lower Motor Neurons) 

• Cerebellum 

• Sensory System 

• Positive Phenomena 

• Negative Phenomena 

• Cutaneous Afferent Innervation 

• Sensory Pathways 

. Modalities of Sensation to be Tested 

• Arrangement of Sensory Fibres 

• Sensory Dermatomes 

• Proprioceptive Sensations 

• Vibration Sense 

• Muscle Sensitivity 

• Cortical Sensations 

• Epilepsy 

• Classification of Seizures 

• Precipitating Factors for Epilepsy 

• Causes 

• Age-related Causes of Seizures 

• Status Epilepticus 

• Epilepsy in Pregnant Women 

• Psychogenic Seizures 

• Neurocutaneous Syndromes 

• Neurofibromatosis 

• Tuberous Sclerosis 

• Von Hippel-Lindau Syndrome 

• Sturge-Weber Syndrome 

• Ataxia Telangiectasia 

• Cerebrovascular Disorders 

• Stroke

• Young Stroke 

• Subclavian Steal Syndrome 

• Lacunar Infarction 

• Cortical Venous Thrombosis (Dural Sinus

Thrombosis) 

• Intracerebral Haemorrhage (ICH) 

• Subarachnoid Haemorrhage (SAH) 

Brain Death 

• Essential Neurological Signs 

Headache 

• Pain Sensitive Structures 

• Pain Insensitive Structures 

• Mechanisms of Production of Headache

• Headache Caused by Systemic Illness 

Neoplastic Disease of the Central Nervous System 

• Spinal Cord Tumours (Excluding Secondaries) 

• Cerebral Tumours 

• Ring Enhancing Lesion--Differential Diagnosis 

Movement Disorders 

• Classification 

• Parkinson's Disease 

Parkinsonism Plus Syndromes 

Motor Neuron Disease 

• Genetic Classification 

• Amyotrophic Lateral Sclerosis 

• Progressive Muscular Atrophy (Predominant LMN

Involvement) 

• Progressive Bulbar Palsy 

• Primary Lateral Sclerosis (Predominant UMN

Involvement) 

• Pseudobulbar Palsy (UMN Fibres Corticobulbar Tracts)

of Cranial Nerves 

• Variants of Motor Neuron Disease 

• Spinal Muscular Atrophy (SMA) 

Ataxic Disorders (Cerebellar and Spinocerebellar) 

• Hereditary Ataxia 

• Congenital Ataxias 

Ataxic Disorders with known Metabolic or Other

Causes 

• Ataxic Disorders of Unknown Aetiology of Early Onset 

Ataxic Disorders of Unknown Aetiology of Late

Onset 

• Multiple Sclerosis 

• Clinical Features not Suggestive of MS 

Features that Differentiate MS from Other

Demyelinating Disorders 

• Meningitis 

• Types of CNS TB 

• Complications of TB Meningitis 

Corticosteroids in CNS Tuberculosis 

• Encephalitis 

• Slow Virus Disease 

• Autonomic Nervous System 

• Horner's Syndrome 

• The Spine 

• Curvature Disorders 

• Spinal Cord 

• Vascular Syndromes of Spinal Cord 

• Spinal Cord Disorders 

• Traumatic Lesions of the Spinal Cord 

• Tuberculosis 

• Syphilis 

• Epidural Abscess 

• Epidural Haemorrhage and Haematomyelia 

• Cervical Spondylosis 

• Lumbar Canal Stenosis 

• Paraplegia 

• Syringomyelia 

• Subacute Combined Degeneration (Posterolateral

Sclerosis of the Spinal Cord) 

• Other Causes of Posterolateral Column

Syndrome 

• Craniovertebral Junction (CVJ) Anomalies

• Classification 

• Peripheral Neuropathy 

• Pathogenesis 

Classification of Peripheral Neuropathy 

• Symptoms 

• Guillain-Barré Syndrome 

Chronic Inflammatory Demyelinating

Polyneuropathy 

• Hereditary Sensory Motor Neuropathy (Charcot-Marie

Tooth Disease) 

• Polymyositis 

• Classification 

Muscular Dystrophies 

• Classification 

• Mitochondrial Myopathy 

• Congenital Myopathies 

• Central Core Disease 

• Nemaline Myopathy 

• Centronuclear Myopathy 

• Myotonia Congenita (Thomson's Disease) 

• Paramyotonia Congenita 

• Myasthenia Gravis 

• Myasthenic Syndrome (Eaton-Lambert

Syndrome) 

10. Endocrine and Metabolic Disorders

• Hypothalamus and Pituitary Gland

• Anatomy 

• Anterior Lobe 

• Neurohypophysis 

• Hypopituitarism 

• Aetiology 

• Hypersecretory Disorders of Anterior Pituitary 

• Acromegaly and Gigantism 

• Hyperprolactinaemia 

• Pituitary Tumours 

• Pituitary Hyperplasia 

. Empty Sella Syndrome 

Craniopharyngioma 

• Disorder of the Neurohypophysis 

• Diabetes Insipidus 

• Syndrome of Inappropriate Antidiuretic Hormone

Secretion 

• Thyroid Disorders 

• Anatomy and Physiology of Thyroid Gland 

• Hyperthyroidism 

• Hypothyroidism 

• Thyroiditis 

• Malignant Tumours of the Thyroid 

• Medullary Carcinoma 

Disorders of Parathyroid Gland and Calcium and

Phosphorus Metabolism 

• Anatomy and Physiology 

• Actions of Parathormone 

• Actions of Calcitonin 

Parathormone Related Peptide (PTHrp)

• Causes of Hypercalcaemia 

• Primary Hyperparathyroidism 

• Hypercalcaemia in Malignancy

• Endocrine Causes of Hyperparathyroidism 

• Secondary Hyperparathyroidism (Increased PTH and Calcium may be Normal or Low) 

• Tertiary Hyperparathyroidism 

• Hypocalcaemic Disorder 

• Adrenal Glands 

• Anatomy and Physiology 

• Primary Hyperaldosteronism 

• Secondary Hyperaldosteronism 

• Cushing's Syndrome 

• Adrenal Insufficiency 

• Adrenal Crisis 

• Phaeochromocytoma

• Sexual Disorders 

• Diabetes Mellitus (DM) 

• Aetiologic Classification of Diabetes Mellitus 

• Risk Factors for Type 2 Diabetes Mellitus (Statistical Risk Disease) 

• Diagnosis

• Insulin Therapy 

• Type 2 Diabetes Mellitus 

• Acute Complications of Diabetes 

• Long-term Complications of Diabetes 

• Diabetic Foot 

• Diabetic Nephropathy (DN) 

Pregnancy and Diabetes 

• Surgery and Diabetes 

• Hypoglycaemia in Adults 

• Fed (Reactive) Hypoglycaemias 

• Hyperlipoproteinaemias 

• Structure

• Classification of Lipoproteins and their Composition 

• Osteomalacia

• Aetiology 

• Osteoporosis 

• Aetiology 

• Male Osteoporosis

• Paget's Disease 

11. Connective Tissue Disorders

• Arthritis 

• Approach to Musculoskeletal Pain 

• Classification 

• Rheumatoid Arthritis 

• Drug Therapy 

• Osteoarthritis (OA) 

• Spondyloarthropathy 

• Systemic Lupus Erythematosus (SLE) 

• Mixed Connective Tissue Disease 

• Progressive Systemic Sclerosis 

• Vasculitis Syndromes 

• Polyarteritis Nodosa 

• Churg-Strauss Disease (Allergic Angiitis or

Granulomatosis) 

• Wegener's Granulomatosis (WG) 

• Temporal Arteritis (Giant Cell Arteritis, Cranial Arteritis)

• Takayasu's Arteritis (Aortic Arch Syndrome) 

• Kawasaki Disease (Mucocutaneous Lymph Node Syndrome) 

• Behçet's Syndrome 

Sjogren's Syndrome (SS) (Autoimmune Exocrinopathy/

Autoimmune Epithelitis) 

• Antiphospholipid Antibody Syndrome (APS)

12. Oncology

• Basic Concepts 

Genes and Cancer 

• Tumour Suppressor Genes and Familial Cancers 

• Cell Biology of Cancer 

• Aetiology of Cancers 

• Carcinogens

• Clinical Features of Cancer 

• General Features 

• Specific Clinical Features 

Investigations 

• Diagnosis Staging 

• Performance Status 

• Cancer Screening 

• Complications 

• Vaccination of Cancer Patients 

• Paraneoplastic Syndromes 

• Endocrine Syndromes 

• Haematologic Syndromes 

• Neurologic Syndromes 

• Oncologic Emergencies 

• Superior Vena Caval Obstruction 

Increased Intracranial Pressure (Brain Metastasis) 

• Meningeal Carcinomatosis 

• Intracerebral Leucocytostasis (Ball's Disease) 

• Seizures 

Spinal Cord Compression 

• Malignant Effusions 

• Airway Obstruction 

• Haemoptysis 

• Intestinal Obstruction 

• Urinary Obstruction 

• Biliary Obstruction 

• Other Emergencies 

Metastatic Cancer of Unknown Primary Site 

Biologic Behaviour

• Clinical Evaluation 

• Pathological Evaluation or Biopsy 

• Principles of Cancer Therapy 

• Surgery 

• Radiation Therapy 

• Chemotherapy 

• Therapy of Selected Cancers 

• Symptom Control in Severe Cancer 

• Pain 

• Nausea and vomiting 

• Pruritus 

• Hiccup 

• Breathlessness 

• Cachexia/Anorexia 

• Constipation 

• Complications of Therapy 

• Late Effects of Cancer Therapy 

13. Geriatric Medicine

• Ageing

• Postulated Mechanisms for Ageing 

• Some Physiological Effects of Ageing 

• Characteristics of Disease in Old Age 

Giants of Geriatric Medicine 

• Principles of Management of Geriatric Problems 

• Drugs Cleared by the Kidney which should be closely

Monitored in the Elderly 

14. Substance Abuse

• Alcohol 

• Risk Factors for Alcoholic Liver Disease 

• Effect of Alcohol on Liver 

• Alcohol and Central Nervous System (CNS) 

• Tobacco Alcohol Amblyopia 

• Nutritional Deficiency Syndrome 

• Pregnancy and Alcohol 

Gastrointestinal 

• Haematology 

• Cardiovascular System 

• Respiratory System 

• Genitourinary System

• Bone 

• Endocrine 

• Skin 

• Alcohol and Malignancy 

• Alcohol and Lymphatic System 

• Alcohol and Drug Interactions 

• Psychological 

• Social 

• Alcoholic Coma 

• Alcohol Withdrawal 

• Alcohol Dependence-Drugs Used for Management 

• Smoking 

• Contents of Cigarette Smoke 

• Pharmacology of Cigarette Smoke 

• Characteristics of Smokers 

• Clinical Correlations 

• Passive Smoking 

• Smoking and Drugs 

• Types of Smoking 

• Cessation Process 

• Cessation Methods 

15.Imaging Modalities in Internal Medicine

• X-ray 

• Chest Film 

• Plain Abdominal Film

• Plain X-ray Skull 

• X-ray Hands 

• Contrast Studies

• Intravenous Urography Pyelography (IVU or IVP) 

• Angiography 

• Radioisotope Scanning 

• Cardiac Scanning 

• Brain Scanning with 99mTc 

• Ventilation/Perfusion Scan (V/Q Scan) MTc Bone Scan

• Renal Scan 

• Adrenal Scan 

• Hepatobiliary Scan 

• Thyroid Scan 

• White Cell Scan 

• Gallium-67 Scan

Positron Emission Tomography (PET) 

Single Photon Emission Computed Tomography(SPECT)

• Ultrasound 

Abdominal Scan 

• Echocardiography

Thyroid Scan 

• Orbit and Eye 

Large Veins and Arteries 

Special Techniques 

• Computed Tomography (CT) Scan 

• CT Brain 

• CT Chest 

• CT Angiography 

• Benefits

• Risks 

• CT Coronary Angiography 

• CT-Abdomen 

• Magnetic Resonance Imaging (MRI) 

• Advantages of MRI 9

Diffusion-weighted MRI 

• Disadvantages of MRI 

16. Procedures

• Pleural Aspiration 

• Indications for Pleural Aspiration

Indications for Therapeutic Aspiration 

Site of Aspiration 

• Pleural Aspiration Needle 

Procedure 

• Pleural Biopsy 

Lumbar Puncture 

Indications 

• Contraindications 

• Lumbar Puncture Needle 

• Procedure 

• Queckenstedt's Test 

• Procedure

• Cisternal Puncture

• Pericardiocentesis

• Indications 

• Needle 

• Procedure 

• Aftercare 

Ascitic Fluid Aspiration (Paracentesis) 

• Indications 

• Procedure 

Aftercare 

Bone Marrow Aspiration 

• Indications 

• Contraindication 

• Needles 

• Procedure 

• Trephine Biopsy 

• Liver Biopsy 

• Indications 

• Contraindications 

Liver Biopsy Needles 

• Procedure 

Aftercare 

• Kidney Biopsy 

• Contraindications 

• Procedure 

• Aftercare and Complications 

• Setting up a Drip 

• Indications 

• Precautions 

• Procedure 

• Administration of Intravenous Cytotoxics 

• Procedure

• Contraindications for Cytotoxic Therapy 

• Problems

Percutaneous Central Venous Cannulation

• Procedure 

• Maintenance of Central Venous Cannulation 

• Passing a Nasogastric Tube 

• Procedure 

• Problems 

Aftercare and Complications 

. Urethral Catheterisation 

• Indications 

• Contraindications 

• Choice of Catheters 

• Procedure 

• Problems

Arterial Puncture 

Contraindications 

Site of Puncture

• Procedure

• Tracheostomy 

• Indications 

Types 

• Tracheostomy Tubes 

Procedure 

• Postoperative Care 

• Removal of Tube 

Endotracheal Intubation 

• Types 

• Procedure 

Laboratory Reference Values

Serum Biochemistry 

• Serum Enzymes 

• Haematologic Values 

• Urine 

• Stool

• Sweat 

• Hormones 

• Cerebrospinal Fluid

Index

About the Author :

Dr.R Alagappan MD FIPS

Formerly Director professor & Head, Institute of Internal Medicine,Madras Medical College and Government General Hospital Chennai, Tamil Nadu, India.

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