NExT Medicine and Allied Specialties (General Medicine, Dermatology, Psychiatry, Radiology) Syllabus

Medicine and Allied Specialties (General Medicine, Dermatology, Psychiatry, Radiology) 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 Specialties (General Medicine, Dermatology, Psychiatry, Radiology) in NExT, not a summary of it.

1. 1

   Cardiovascular System

   6 topics

   • Ischemic Heart Disease
     • Stable angina, ACS, STEMI vs NSTEMI
     • Thrombolysis and primary PCI indications
     • Secondary prevention and antiplatelet therapy
   • Heart Failure
     • HFrEF vs HFpEF classification
     • GDMT: ARNI, beta-blockers, MRA, SGLT2 inhibitors
   • Arrhythmias and Conduction Disorders
     • Atrial fibrillation and CHA2DS2-VASc scoring
     • Heart blocks and pacemaker indications
   • Valvular Heart Disease and Rheumatic Fever
     • Mitral stenosis and Jones criteria
     • Aortic stenosis and regurgitation
   • Systemic Hypertension
     • Staging, secondary causes, hypertensive emergency
   • Infective Endocarditis
     • Duke criteria and prophylaxis
2. 2

   Respiratory System

   6 topics

   • Obstructive Airway Disease
     • Bronchial asthma: GINA staging and management
     • COPD: GOLD grading and exacerbation
   • Pulmonary Tuberculosis
     • NTEP/RNTCP diagnostics and CBNAAT
     • DOTS regimens and drug-resistant TB
   • Pneumonia and Respiratory Infections
     • CAP, HAP, CURB-65 scoring
   • Interstitial Lung Disease
     • IPF, sarcoidosis, hypersensitivity pneumonitis
   • Pleural Effusion and Pneumothorax
     • Light's criteria, exudate vs transudate
   • Pulmonary Embolism and Pulmonary Hypertension
3. 3

   Gastroenterology, Hepatology and Nephrology

   6 topics

   • Acute and Chronic Liver Disease
     • Cirrhosis, portal hypertension, Child-Pugh and MELD
     • Viral hepatitis serology
   • Inflammatory and Functional Bowel Disorders
     • Crohn disease vs ulcerative colitis
     • Malabsorption and celiac disease
   • Peptic Ulcer Disease and GI Bleeding
     • H. pylori eradication, upper vs lower GI bleed
   • Acute Kidney Injury
     • Prerenal, intrinsic, postrenal; KDIGO staging
   • Chronic Kidney Disease
     • eGFR staging, dialysis indications, mineral bone disease
   • Glomerular Diseases
     • Nephritic vs nephrotic syndrome
4. 4

   Endocrinology and Metabolism

   5 topics

   • Diabetes Mellitus
     • Diagnosis, classification, HbA1c targets
     • Oral agents, insulin, DKA and HHS
   • Thyroid Disorders
     • Hypothyroidism, hyperthyroidism, thyroid storm
   • Adrenal Disorders
     • Cushing syndrome, Addison disease, pheochromocytoma
   • Pituitary Disorders
     • Acromegaly, prolactinoma, diabetes insipidus
   • Calcium and Bone Metabolism
     • Hyper/hypoparathyroidism, osteoporosis
5. 5

   Infectious Diseases, Hematology and Rheumatology

   6 topics

   • Tropical and Vector-borne Infections
     • Malaria, dengue, chikungunya, leptospirosis
     • Enteric fever and scrub typhus
   • HIV/AIDS
     • Staging, ART, opportunistic infections
   • Anemias
     • Iron deficiency, megaloblastic, hemolytic anemias
     • Thalassemia and sickle cell disease
   • Hematological Malignancies
     • Leukemias, lymphomas, multiple myeloma
   • Bleeding and Coagulation Disorders
     • ITP, hemophilia, DIC, von Willebrand disease
   • Connective Tissue Disorders
     • SLE, rheumatoid arthritis, vasculitides
6. 6

   Neurology, Dermatology and Psychiatry

   6 topics

   • Cerebrovascular Disease
     • Ischemic vs hemorrhagic stroke, thrombolysis window
   • Seizure Disorders and Epilepsy
     • Classification, status epilepticus, antiepileptics
   • Neuromuscular and Demyelinating Disorders
     • Guillain-Barre, myasthenia gravis, multiple sclerosis
   • Common Dermatological Conditions
     • Psoriasis, eczema, vesiculobullous disorders
     • Leprosy classification and management
   • Mood and Psychotic Disorders
     • Depression, bipolar disorder, schizophrenia
   • Anxiety, Substance Use and Emergencies
     • Alcohol withdrawal, suicide risk assessment

Medicine and Allied Specialties (General Medicine, Dermatology, Psychiatry, Radiology) flashcards for NExT

22 of 52 cards from the Medicine and Allied Specialties (General Medicine, Dermatology, Psychiatry, Radiology) deck — real questions with worked answers.

1. In ST-elevation MI (STEMI), what is the target door-to-balloon time for primary PCI, and the target door-to-needle time for fibrinolysis?

   Primary PCI: door-to-balloon ≤90 minutes. Fibrinolysis: door-to-needle ≤30 minutes.

2. Name the four MONA(B) components of initial management of acute coronary syndrome.

   Morphine, Oxygen (if SpO2 <90%), Nitrates, Aspirin, plus Beta-blocker. Modern emphasis: dual antiplatelet (aspirin + P2Y12 inhibitor) and anticoagulation; oxygen only if hypoxic.

3. Which ECG leads correspond to inferior wall MI, and which coronary artery is most often involved?

   Leads II, III, aVF; usually the right coronary artery (RCA).

4. What cardiac biomarker is most sensitive and specific for myocardial infarction, and when does it rise, peak, and normalize?

   Cardiac troponin (I or T): rises in 3-4 hours, peaks at 18-24 hours, stays elevated up to 7-14 days.

5. Define heart failure with reduced ejection fraction (HFrEF) versus preserved ejection fraction (HFpEF) by LVEF cutoffs.

   HFrEF: LVEF ≤40%. HFpEF: LVEF ≥50%. HFmrEF (mildly reduced): LVEF 41-49%.

6. Which four drug classes form the guideline-directed 'four pillars' of HFrEF therapy?

   ARNI/ACEi/ARB, beta-blockers, MRA (mineralocorticoid receptor antagonists), and SGLT2 inhibitors.

7. What biomarker is used to diagnose and assess severity of heart failure, and how does obesity affect its level?

   BNP / NT-proBNP (elevated in HF). Levels are falsely lowered in obesity and raised in renal impairment, age, and AF.

8. What is the first-line treatment for hemodynamically unstable tachyarrhythmia (with hypotension, ischemia, or shock)?

   Immediate synchronized DC cardioversion (defibrillation if pulseless VT/VF).

9. In atrial fibrillation, what does the CHA2DS2-VASc score assess, and at what score is anticoagulation recommended in men?

   It estimates stroke risk in AF. Anticoagulation is recommended for men with score ≥2 (and women ≥3); consider at 1 (men).

10. What ECG finding characterizes complete (third-degree) heart block?

    AV dissociation: P waves and QRS complexes are independent (no relationship), with atrial rate faster than the slower ventricular escape rate.

11. What is the classic ECG triad of Wolff-Parkinson-White (WPW) syndrome?

    Short PR interval (<120 ms), delta wave (slurred QRS upstroke), and widened QRS.

12. Which valvular lesion classically causes a mid-diastolic rumbling murmur with an opening snap, best heard at the apex?

    Mitral stenosis (most commonly rheumatic in origin).

13. State the revised (modified) Jones criteria requirement for diagnosing a first episode of acute rheumatic fever.

    Evidence of preceding GAS infection PLUS either 2 major criteria OR 1 major + 2 minor criteria.

14. List the five major Jones criteria for acute rheumatic fever (mnemonic JONES).

    Joints (migratory polyarthritis), O (carditis - ❤), Nodules (subcutaneous), Erythema marginatum, Sydenham chorea.

15. What murmur characterizes aortic stenosis, and what triad of symptoms indicates poor prognosis?

    Ejection systolic murmur radiating to the carotids. Triad: angina, syncope, and dyspnea/heart failure (SAD).

16. Per current guidelines, define the blood pressure thresholds for hypertension stage 1 and stage 2 (ACC/AHA 2017).

    Stage 1: 130-139/80-89 mmHg. Stage 2: ≥140/≥90 mmHg. Normal: <120/<80.

17. What is the first-line antihypertensive class for a young patient with hypertension and proteinuric diabetic nephropathy?

    ACE inhibitor or ARB (they reduce intraglomerular pressure and proteinuria).

18. Name the most common cause of secondary hypertension and the screening test used.

    Primary hyperaldosteronism (Conn syndrome); screened by the plasma aldosterone-to-renin ratio (ARR).

19. State the modified Duke criteria definition of definite infective endocarditis (clinical).

    2 major, OR 1 major + 3 minor, OR 5 minor criteria.

20. List the classic peripheral immunologic/vascular signs of infective endocarditis.

    Osler nodes (painful, fingers/toes), Janeway lesions (painless, palms/soles), Roth spots (retina), splinter hemorrhages, and glomerulonephritis.

21. What spirometry ratio defines an obstructive ventilatory pattern, and how does COPD differ from asthma in reversibility?

    FEV1/FVC <0.70 defines obstruction. Asthma shows significant bronchodilator reversibility (≥12% and 200 mL improvement in FEV1); COPD obstruction is largely irreversible.

22. What is the GOLD classification of COPD severity based on post-bronchodilator FEV1 % predicted?

    GOLD 1 (mild): FEV1 ≥80%; GOLD 2 (moderate): 50-79%; GOLD 3 (severe): 30-49%; GOLD 4 (very severe): <30%.

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