DNB CET Medicine and Allied Clinical Specialties Syllabus

Medicine and Allied Clinical Specialties syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Medicine and Allied Clinical Specialties in DNB CET, not a summary of it.

1. 1

   General Medicine

   6 topics

   • Cardiology - IHD, heart failure, arrhythmias, valvular disease
   • Respiratory - asthma, COPD, tuberculosis, ILD
   • Endocrinology - diabetes, thyroid, adrenal disorders
   • Nephrology - AKI, CKD, glomerulonephritis
   • Infectious diseases - tropical fevers, sepsis, HIV
   • Neurology - stroke, epilepsy, neuromuscular disorders
2. 2

   Pediatrics

   4 topics

   • Growth, development and immunization
   • Neonatology and birth asphyxia
   • Nutritional disorders and IMNCI
   • Common pediatric infections and genetic disorders
3. 3

   Dermatology and Psychiatry

   4 topics

   • Papulosquamous and vesiculobullous disorders
   • Leprosy and cutaneous infections
   • Mood, anxiety and psychotic disorders
   • Substance use disorders and psychiatric emergencies

Medicine and Allied Clinical Specialties flashcards for DNB CET

24 of 50 cards from the Medicine and Allied Clinical Specialties deck — real questions with worked answers.

1. In ischemic heart disease, which ECG finding distinguishes STEMI from NSTEMI/unstable angina?

   STEMI shows persistent ST-segment elevation (or new LBBB), reflecting complete coronary occlusion; NSTEMI/UA show ST depression or T-wave inversion without persistent ST elevation.

2. What is the most specific cardiac biomarker for myocardial infarction, and when does it rise and peak?

   Cardiac troponin (T or I) is most specific. It rises within 3-4 hours, peaks at 18-24 hours, and remains elevated for 7-14 days.

3. Name the four drug classes proven to reduce mortality in HFrEF (the 'four pillars').

   ARNI/ACE-inhibitor or ARB, beta-blocker, mineralocorticoid receptor antagonist (MRA), and SGLT2 inhibitor.

4. How is ejection fraction used to classify heart failure into HFrEF, HFmrEF, and HFpEF?

   HFrEF: LVEF less than or equal to 40%; HFmrEF (mildly reduced): LVEF 41-49%; HFpEF (preserved): LVEF greater than or equal to 50%.

5. In atrial fibrillation, what scoring systems are used to assess stroke risk and bleeding risk?

   CHA2DS2-VASc score estimates stroke/thromboembolic risk; HAS-BLED score estimates bleeding risk with anticoagulation.

6. What is the classic auscultatory finding and its radiation in severe aortic stenosis?

   An ejection systolic murmur, loudest at the right second intercostal space, radiating to the carotids, with a soft/absent S2 and pulsus parvus et tardus.

7. Differentiate the murmurs of mitral stenosis and mitral regurgitation.

   Mitral stenosis: mid-diastolic rumbling murmur with opening snap at the apex (left lateral position). Mitral regurgitation: pansystolic (holosystolic) murmur at the apex radiating to the axilla.

8. What spirometry finding defines an obstructive pattern, and how does the bronchodilator response differ in asthma vs COPD?

   Obstruction = FEV1/FVC less than 0.70. Asthma shows significant reversibility (FEV1 increase greater than or equal to 12% and 200 mL post-bronchodilator); COPD shows persistent, largely irreversible obstruction.

9. What is the GOLD definition/diagnostic criterion for COPD?

   Post-bronchodilator FEV1/FVC less than 0.70 in a patient with chronic respiratory symptoms and risk-factor exposure (e.g., smoking, biomass).

10. What is the standard initial intensive-phase regimen for new drug-sensitive pulmonary TB in adults?

    2 months of HRZE (isoniazid, rifampicin, pyrazinamide, ethambutol) followed by 4 months of HR (isoniazid + rifampicin).

11. Match the key adverse effects: isoniazid, rifampicin, pyrazinamide, ethambutol.

    Isoniazid: peripheral neuropathy (give pyridoxine) and hepatitis. Rifampicin: orange body fluids, hepatitis, enzyme induction. Pyrazinamide: hyperuricemia/gout, hepatitis. Ethambutol: optic neuritis (color vision/acuity loss).

12. What is the characteristic HRCT pattern of idiopathic pulmonary fibrosis (IPF)?

    Usual interstitial pneumonia (UIP) pattern: subpleural, basal-predominant reticulation with honeycombing and traction bronchiectasis, minimal ground-glass.

13. State the diagnostic HbA1c, fasting, and 2-hour OGTT cutoffs for diabetes mellitus.

    HbA1c greater than or equal to 6.5%; fasting plasma glucose greater than or equal to 126 mg/dL; 2-hour OGTT (75 g) greater than or equal to 200 mg/dL; or random glucose greater than or equal to 200 mg/dL with classic symptoms.

14. How do you distinguish DKA from hyperosmolar hyperglycemic state (HHS) biochemically?

    DKA: glucose usually 250-600 mg/dL, marked ketosis/ketonemia, high anion-gap metabolic acidosis (pH less than 7.3). HHS: glucose often greater than 600 mg/dL, serum osmolality greater than 320 mOsm/kg, minimal/no ketosis, pH greater than 7.3.

15. In primary hypothyroidism vs hyperthyroidism, how do TSH and free T4 change?

    Primary hypothyroidism: high TSH, low free T4. Primary hyperthyroidism: low (suppressed) TSH, high free T4 (and/or T3).

16. What are the classic biochemical findings of primary adrenal insufficiency (Addison's disease)?

    Hyponatremia, hyperkalemia, hypoglycemia, low cortisol with high ACTH, and an inadequate cortisol response to ACTH (Synacthen) stimulation; often hyperpigmentation.

17. How are Cushing's syndrome and Cushing's disease distinguished?

    Cushing's syndrome = any cause of chronic glucocorticoid excess. Cushing's disease specifically = ACTH-secreting pituitary adenoma (ACTH-dependent, the commonest endogenous cause).

18. Give the RIFLE/KDIGO definition of acute kidney injury (AKI).

    Rise in serum creatinine greater than or equal to 0.3 mg/dL within 48 h, or increase to greater than or equal to 1.5 times baseline within 7 days, or urine output less than 0.5 mL/kg/h for greater than 6 hours.

19. Classify the causes of AKI into the three main categories with examples.

    Prerenal (hypovolemia, hypotension, renal artery stenosis), intrinsic/renal (acute tubular necrosis, glomerulonephritis, AIN), and postrenal (urinary tract obstruction).

20. How is chronic kidney disease (CKD) staged by GFR?

    G1: GFR greater than or equal to 90; G2: 60-89; G3a: 45-59; G3b: 30-44; G4: 15-29; G5: less than 15 (kidney failure). Stages also require markers of kidney damage for greater than 3 months.

21. Differentiate nephritic from nephrotic syndrome.

    Nephritic: hematuria, RBC casts, hypertension, mild-moderate proteinuria, oliguria. Nephrotic: heavy proteinuria (greater than 3.5 g/day), hypoalbuminemia, edema, hyperlipidemia.

22. What is the classic presentation and timing of post-streptococcal glomerulonephritis?

    Nephritic syndrome (hematuria, edema, hypertension) 1-3 weeks after pharyngitis (or 3-6 weeks after skin infection) with group A Strep, low C3, and elevated ASO titre.

23. List the classic tetrad/criteria used to diagnose sepsis (qSOFA) at the bedside.

    qSOFA: respiratory rate greater than or equal to 22/min, altered mentation (GCS less than 15), and systolic BP less than or equal to 100 mmHg; greater than or equal to 2 suggests poor prognosis. Sepsis = suspected infection + SOFA increase greater than or equal to 2; septic shock = vasopressor need + lactate greater than 2 despite fluids.

24. How is malaria definitively diagnosed, and which species causes severe/cerebral malaria?

    Peripheral blood smear (thick and thin) or rapid diagnostic test (antigen). Plasmodium falciparum causes most severe and cerebral malaria.

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