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Department of Medicine, Faculty of Medicine & Health Sciences, Stell. Univ.

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Format of the Part I Exam

FORMAT OF THE PART I EXAMINATION

  1. Part I of the FCP(SA) examination will consist of one MCQ paper of 3 hours duration.
  2. There will be 150 multiple choice questions in the “best of 5 options” format.
  3. There will be internal negative marking of - 0.25 per question.
  4. The pass mark will be 50%.
  5. Questions will be spread across all disciplines and based on the core syllabus and on the recommended learning resources.
  6. Questions from the Pathophysiology textbook (McPhee) will make up 25% of the paper.
  7. Candidates must bring an ordinary calculator to the examination.

BLUE PRINT OF THE MCQ PAPER

  • 12 questions each for cardiovascular, respiratory, renal, endocrine, haematology, GIT, infectious diseases, immunology, neurology
  • 10 questions each for cell biology and therapeutics
  • 5 questions each for pregnancy, the elderly, genetics and statistics
  • 1 question each for skin and bones and joints

The Basic Sciences Curriculum for Part I of the College Exam

CARDIOVASCULAR SYSTEM

Anatomy

  • Microanatomy of cardiac muscle
  • Structure and function of endothelium
  • Surface anatomy of the heart
  • Coronary circulation
  • Conducting system of the heart
  • Systemic arterial circulation and venous drainage

Physiology

  • Determinants, control and measurement of cardiac output
  • Myocardial perfusion
  • Mechanisms of cardiac muscle contraction and relaxation
  • Control of blood pressure
  • The cardiac cycle – integration of contraction, heart sounds, pressure curves and surface ECG
  • Changes with ageing
  • Changes with pregnancy
  • Changes with exercise

CELL BIOLOGY

CORE SCIENCES

  • Cell membrane - structure and function
  • Cytoplasmic organelles - structure and function
  • Cytoskeleton - structure and function
  • Cell membrane, cytoplasmic and nuclear receptors – structures and functions
  • Second messenger systems
  • Transport across cell membranes
  • Intercellular connections
  • Cell adhesion molecules - structure and function
  • The cell cycle including mechanisms of regulation
  • Cell death – apoptosis and necrosis
  • Oxidation of fuels and synthesis of ATP (Krebs cycle)
  • Free radicals
  • The biology of ageing

CONNECTIVE TISSUE, SOFT TISSUE AND JOINTS

Anatomy

  • Structure of synovial joints
  • Microanatomy and function of the synovium

Clinical chemistry

  • Purine metabolism
  • Collagen types and metabolism

Physiology

  • Changes with ageing

ENDOCRINE SYSTEM AND METABOLISM

Anatomy

  • Surface and microanatomy of the thyroid and parathyroid glands
  • Microanatomy of the hypothalamus and pituitary
  • Microanatomy of the adrenal glands
  • Structure and microanatomy of bone
  • Hypophyseal-pituitary portal blood supply

Clinical Chemistry

  • Lipid, carbohydrate and protein synthesis and metabolism
  • Purine metabolism
  • Vitamin metabolism
  • Porphyrin metabolism

Physiology

  • Hypothalamic-pituitary-adrenal axis
  • Anterior and posterior pituitary hormone synthesis, function and regulation
  • Thyroid hormone synthesis, function and regulation
  • Male and female endocrine function
  • Menopause
  • Changes of ageing
  • Glucose homeostasis
  • Calcium homeostasis and bone metabolism
  • Control of body temperature
  • Control of body weight

GASTROINTESTINAL TRACT AND LIVER

Anatomy

  • Surface anatomy of the liver
  • Microanatomy of the gastrointestinal tract, pancreas, liver and biliary tract
  • Anatomy of the stomach
  • Portal circulation
  • Blood supply and venous drainage of the liver

Physiology

  • Hormonal and autonomic control of GIT function
  • Acid secretion in the stomach
  • Digestive juices and pancreatic enzymes
  • Digestion and absorption of carbohydrates, lipids and proteins
  • Functions of the liver
  • Formation and excretion of bile
  • Changes of ageing

GENETICS

CORE SCIENCES

  • DNA synthesis, structure and function, including mitochondrial DNA
  • The cell cycle, including mitosis and meiosis
  • Chromosome structure and function, including mitochondrial chromosome
  • Patterns of Mendelian inheritance
  • Telomeres and immortality
  • Genetic mutations
  • Genetic basis of cancer – proto-oncogenes, oncogenes and tumour suppressor genes

 DIAGNOSTIC MODALITIES

  • Restriction enzymes and gel electrophoresis
  • Southern blotting and DNA probes
  • Polymerase chain reaction (PCR)
  • DNA cloning and sequencing
  • Restriction fragment length polymorphisms
  • Gene knockout mouse models

GERIATRIC MEDICINE

Physiology

  • Biology of ageing
  • Age-related changes in body composition
  • Altered pharmacokinetics and pharmacodynamics
  • Homeostatic changes
  • Age-related changes in the different organs, tissues and cells

HAEMOPOIETIC SYSTEM

Anatomy

  • Surface anatomy and microanatomy of the spleen
  • Microstructure of bone marrow

Clinical chemistry

  • Haemoglobin structure
  • Iron, folate and vitamin B12 metabolism

Physiology

  • Blood and its constituents
  • Haemopoiesis
  • Functions of haemoglobin
  • Haemostasis, coagulation, fibrinolysis and antithrombotic pathways

IMMUNE SYSTEM

Anatomy

  • Microanatomy of the lymph node and thymus
  • Systemic lymphatic drainage

Physiology

  • Host defence mechanisms – innate and adaptive
  • Cells of the immune system
  • Neutrophil recruitment and functions
  • T cell recognition and activation
  • Antigen processing and presentation
  • Acute phase proteins, heat shock proteins, tumour necrosis factor
  • Complement system
  • Roles of cytokines, interferons and chemokines
  • Arachidonic acid metabolism
  • Mechanisms of inflammation including autoimmune responses
  • Synthesis, structure and function of immunoglobulins
  • Hypersensitivity immune responses – types I-IV
  • HLA system and function
  • Changes with ageing

INFECTIOUS DISEASES

Definitions of terms

  • Epidemic, pandemic and endemic

Microbiology

  • Classification and mechanisms of reproduction of microbial pathogens
  • Mechanisms of antimicrobial resistance

Physiology

  • Systemic response to inflammation and infection

Infection control measures

  • Measures to limit spread of infection and antimicrobial resistance
  • Limiting an outbreak of disease

NERVOUS SYSTEM

Anatomy

  • Microanatomy of nervous system cells
  • Gross structure of the brain and eye
  • Arterial supply and venous drainage of the brain
  • Circulation of cerebrospinal fluid
  • Structure of the basal ganglia, brain stem and cerebellum
  • Cranial nerve nuclei and pathways
  • Autonomic nervous system pathways
  • Visual pathways
  • Sensory and motor pathways
  • Structure of the meninges
  • Cross-section and blood supply of the spinal cord
  • Structure and relations of the cavernous sinus

 Physiology

  • Neurotransmitters
  • Reflex arc
  • Production of cerebrospinal fluid
  • Functions of neurons and neuromuscular junction
  • Cerebral cortex functions
  • Pain
  • Cerebellar functions
  • Autonomic functions
  • Arousal, consciousness and sleep
  • Changes of ageing

PHARMACOTHERAPEUTICS

CORE SCIENCES

  • Principles of pharmacokinetics and pharmacodynamics
  • Role of the liver and kidneys in drug metabolism
  • Principles of drug toxicity

RENAL SYSTEM, FLUID AND ELECTROLYTE BALANCE

Anatomy

  • Position, surface anatomy and microanatomy of the kidneys (nephron)

Physiology

  • Glomerular and tubular function
  • Acid-base balance
  • Water and electrolyte balance
  • Volumes and composition of body fluid compartments and control thereof
  • Endocrine functions of the kidney
  • Changes with ageing
  • Changes with pregnancy

Diagnostic Modalities

  • Creatinine clearance - Principles, calculation and interpretation

RESEARCH SKILLS AND USE OF EVIDENCE

Statistics

  • Definitions of mean, median, standard deviation, confidence intervals
  • Sensitivity and specificity
  • Positive and negative predictive values
  • Number needed to treat
  • Relative risk and hazard ratio
  • Differences between parametric and non-parametric data
  • Basic tests - student’s T test, Chi square analysis, ANOVA
  • Regression analysis

Clinical trials

  • Types
  • Bias
  • Generalisability from trials to clinical practice
  • Principles of meta analysis
  • Levels of evidence

Medical writing

  • Types of article
  • Principles of plagiarism, copyright and authorship

Medical literature

  • Principles of evaluating articles and submission and review processes
  • Journal and article ranking

Evidence-based medicine

  • Principles

RESPIRATORY SYSTEM

Anatomy

  • Respiratory tract, including sinuses
  • Surface anatomy of the lungs
  • Microanatomy of the respiratory epithelium and acinus

Physiology

  • Defence mechanisms of the lung
  • Mechanics of respiration
  • Control of breathing
  • Gas exchange and transport
  • Maintenance of normal PaO and PaCO
  • Changes with ageing
  • Adaptations to altitude

Clinical chemistry

  • Acid-base balance
  • Haemoglobin-oxygen dissociation curve

THE SKIN

Anatomy

  • Microanatomy of the skin

Physiology

  • Function of the skin

Applied Basic Sciences

  • Morphological description of skin lesions

 

 

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