Course book

COURSE BOOK | Course coordinator and list of teachers | Two Lectures on Introduction &

COURSE BOOK
RADIOLOGY page 7 UROLOGY page 15
ANESTHESIA page 23 OTOLARYNGOLOGY page 26
DERMATOLOGY page 37 GYNECOLOGY page 42
MEDICINE page 57 OPHTHALMOLOGY page 60
PEDIATRICS page 70 SURGERY page 75
PRACTICAL SESSIONS page 78

2011 1 Fifth stage Course Book


Extended Contents
COURSE BOOK .............................................................................................................................1
RADIOLOGY .................................................................................................................................7
Course coordinator and list of teachers ............................................................................................ 7
Course Overview ................................................................................................................................ 7
Reading lists: ...................................................................................................................................... 7
Syllabus .............................................................................................................................................. 8
Detail of Syllabus................................................................................................................................ 8
 Two Lectures on Introduction & Technical Considerations: given by Dr. Ameer .................................... 8
 Spine: Two Lectures given by Dr. Ameer ................................................................................................. 9
 Skull & brain; 2 Lectures given by Dr. Ameer .......................................................................................... 9
 Sinuses, Orbits & Neck one lecture by Dr. Ameer: ................................................................................ 10
 Interventional Radiology: one Lecture by Dr. Ameer. ........................................................................... 10
 Plain abdominal radiographs: One lecture given by Dr. kawa Abdulla ................................................. 10
 GIT Contrast examination & other imaging modalities: Five Lectures by Dr. kawa .............................. 10
 Hepato - biliary system; three Lectures given by Dr. kawa ................................................................... 11
 Peritoneal cavity & retroperitoneum; two Lectures given by Dr. kawa ................................................ 11
 Chest: Seven lectures given by Dr. Abeer Kadum Abass ....................................................................... 11
 Cardiovascular system (CVS) : Four lectures given by Dr. Abeer Kadum Abass. ................................... 12
 Bone & Joint diseases: Four Lectures by Dr. Salah Kalary ..................................................................... 13
 Bone Trauma: One Lecture by Dr.Salah Kalary. ..................................................................................... 14
UROLOGY .................................................................................................................................. 15
Course coordinator and list of teachers .......................................................................................... 15
Course Overview .............................................................................................................................. 15
Course Objectives ............................................................................................................................ 15
Course Reading List .......................................................................................................................... 16
Syllabus ............................................................................................................................................ 16
Detail of Syllabus.............................................................................................................................. 17
 Lectures titles (the kidney) .................................................................................................................... 17
 Lectures titles (the Prostate) ................................................................................................................. 17
 Lectures title: (Urinary bladder) ............................................................................................................ 18
 Lectures titles (the penis and urethra) .................................................................................................. 18
 Lectures titles (the testis) ...................................................................................................................... 19
Student feedback for the subject of a lecture ................................................................................. 19
Examinations.................................................................................................................................... 20
 Types of questions: ................................................................................................................................ 20
 The number of questions and marks are divided as follows: ................................................................ 20
 Advices and directions for all students before and during exams. ....................................................... 20
 Sample Questions .................................................................................................................................. 20
Student feedback on the course ...................................................................................................... 22



ANESTHESIA ............................................................................................................................... 23
Anesthesia Lectures ......................................................................................................................... 23
Detailed Syllabus .............................................................................................................................. 23
 Introduction to anesthesia 5 Hrs ........................................................................................................... 23
 Types of Anesthesia 1Hr ........................................................................................................................ 23
 Drugs used in anesthesia 4hrs ............................................................................................................... 23
 Post operative complications 3hrs ........................................................................................................ 24
 Pain management 2hrs .......................................................................................................................... 24
 Airway Management 5hr ....................................................................................................................... 24
 Monitoring 1hr....................................................................................................................................... 24
 Cardiopulmonary resuscitation 2hr ....................................................................................................... 24
 Intensive Care Unite 4hrs ...................................................................................................................... 24
 References ............................................................................................................................................. 24
Question Examples .......................................................................................................................... 24
OTOLARYNGOLOGY.................................................................................................................... 26
Course coordinator and list of teachers on this course................................................................... 26
Course Overview .............................................................................................................................. 26
Course Objectives ............................................................................................................................ 26
Syllabus ............................................................................................................................................ 27
Detailed Syllabus .............................................................................................................................. 28
Examinations.................................................................................................................................... 34
 Time of exam. ........................................................................................................................................ 34
 Samples of MCQ, Single choice, long and short essays ......................................................................... 34
 External examiner .................................................................................................................................. 36
DERMATOLOGY ......................................................................................................................... 37
Contents ........................................................................................................................................... 37
1 - Course coordinator and list of teachers on this course ............................................................. 37
2 - Course Overview ......................................................................................................................... 37
3 - Course objectives ........................................................................................................................ 38
4 - Course Reading list ..................................................................................................................... 38
5 - Syllabus ....................................................................................................................................... 38
6 - The Scientific contents:............................................................................................................... 39
7 - Exams .......................................................................................................................................... 39
8 - Samples of the expected questions and their answers .............................................................. 39
 Example for Compositional questions ................................................................................................... 39
 MCQs: .................................................................................................................................................... 39
GYNECOLOGY ............................................................................................................................ 42



Course Overview .............................................................................................................................. 42
Course objectives ............................................................................................................................. 42
Course Reading list........................................................................................................................... 43
Syllabus ............................................................................................................................................ 43
 Family Planning: ..................................................................................................................................... 44
 Early pregnancy problems: .................................................................................................................... 44
 Benign tumours of the uterus................................................................................................................ 45
 Menopause and HRT.............................................................................................................................. 46
 Operative Gynaecology ......................................................................................................................... 46
 Normal and abnormal sexual development .......................................................................................... 46
 Gynaecological disorders of childhood and adolescence ...................................................................... 47
 Infertility ................................................................................................................................................ 47
 Genital tuberculosis ............................................................................................................................... 47
 Premalignant conditions of the cervix. .................................................................................................. 48
 Cervical cancer ....................................................................................................................................... 48
 Hyperandrogenism, hirsutism and polycystic ovary s ........................................................................... 48
 Secondary amenorrhea ......................................................................................................................... 49
 Vaginal discharge ................................................................................................................................... 49
 Diseases of the vulva and vagina ........................................................................................................... 49
 Subject name: pelvic inflammatory disease. ......................................................................................... 49
 Endometriosis: ....................................................................................................................................... 50
 Ovarian tumours: ................................................................................................................................... 50
 Genital prolapse:.................................................................................................................................... 50
 Dysmenorrhoea ..................................................................................................................................... 51
 Sexually transmitted infections (2 hours) .............................................................................................. 51
 Primary amenorrhoea............................................................................................................................ 51
 Disorders of the menstrual cycle/ abnormal vaginal bleeding ............................................................. 52
 Post menopausal bleeding (PMB).......................................................................................................... 52
 Operative gyneacology/ laparoscopy .................................................................................................... 52
 Premalignant and malignant disorders of the uterine corpus .............................................................. 52
Student's feedback on the subject .................................................................................................. 53
Exams ............................................................................................................................................... 54
Types of questions: .......................................................................................................................... 54
Samples of the expected questions and their answers ................................................................... 54
 Long essay question:.............................................................................................................................. 54
 Short essays questions: ......................................................................................................................... 54
 Multiple choice questions...................................................................................................................... 55
 Single choice questions:......................................................................................................................... 55
External Examiner ............................................................................................................................ 56
MEDICINE .................................................................................................................................. 57
Course coordinator and list of teachers .......................................................................................... 57



Course Overview .............................................................................................................................. 57
Exams ............................................................................................................................................... 58
 Composition (Essay) ;............................................................................................................................. 58
 MCQs ..................................................................................................................................................... 59
OPHTHALMOLOGY ..................................................................................................................... 60
Course Information: ......................................................................................................................... 60
Course Description........................................................................................................................... 61
Class objectives: ............................................................................................................................... 61
Materials and Resources.................................................................................................................. 61
Expectations and Policies................................................................................................................. 61
Instruction methodology: ................................................................................................................ 62
Theoretical Lectures Outline............................................................................................................ 62
Practical Course Outline .................................................................................................................. 63
Grading............................................................................................................................................. 64
 Introduction to ophthalmology ............................................................................................................. 64
 The Ocular Examination......................................................................................................................... 65
Examinations.................................................................................................................................... 67
 The number of questions and marks are divided as follows: ................................................................ 67
 Sample of MCQ and long and short essays ........................................................................................... 67
PEDIATRICS ................................................................................................................................ 70
Course Book Content ....................................................................................................................... 70
Course overview .............................................................................................................................. 70
Course Reading list; ......................................................................................................................... 70
Syllabus ............................................................................................................................................ 71
Exams ............................................................................................................................................... 71
 Multiple choice questions: .................................................................................................................... 72
 True and false questions:....................................................................................................................... 72
 Problem solving questions ..................................................................................................................... 72
 Data questions; ...................................................................................................................................... 72
 Short assay questions ............................................................................................................................ 73
 Enumerate questions;............................................................................................................................ 73
 Exam’s duration: .................................................................................................................................... 74
 Clinical exams; ....................................................................................................................................... 74
SURGERY ................................................................................................................................... 75



Course Overview .............................................................................................................................. 75
Syllabus ............................................................................................................................................ 75
Examinations.................................................................................................................................... 76
Examples: ......................................................................................................................................... 76
PRACTICAL SESSIONS ................................................................................................................. 78
Medicine .......................................................................................................................................... 78
Neurosurgery ................................................................................................................................... 79
Thoracic and Cardiovascular Surgery............................................................................................... 81


RADIOLOGY | Course coordinator and list of teachers | Two Lectures on Introduction &

RADIOLOGY
Radiology for 5th Year Students of College of Medicine/ University of Sulaimani: 45 Lectures

Course coordinator and list of teachers
1 - Name of the Course: Radiology.
2 - Lecturer tutor in charge: Dr. Ameer Ahmad
3 - Department Branch and the college: Dept. Surgery/ college of medicine/ University of
Sulaimani
4 - Contacts:
- Address: University of Sulaimani/ College of medicine/ Dept.
of Surgery.
E - Mail: amirkurda@yahoo.com
U U

- Website Link:
- Other participant Lecturers:
1 - Dr. Kawa Abdulla
2 - Dr.Abeer Kadhum.
3 - Dr.Salal Fatih Tel no. 07701473771 salahkalary@yahoo.com
U U

4 - Dr. Nasreen Atrooshi

Course Overview
The student will be taught how to use the different imaging modalities properly & which imaging
modality fits particular situation.
The student should also learn how to read the radiographs of common clinical problems e.g. he or
she should learn how to diagnose different fractures, pneumothorax, pneumonia, intestinal
obstruction, pneumoperitoneum etc….. Not only that the graduated doctor should also learn how
to read CT scan in patients with Stroke & head injury.
Lastly the student should be taught about the update of Radiology & that radiology is no more used
for diagnosis only, it is taking part in the therapy as well i.e. Interventional Radiology.

Reading lists:
1 - Diagnostic Imaging …Peter Armstrong & Martin Wastie…..
Sixth edition ……2009
2 - Textbook of Radiology & Imaging …….David Sutton
Seventh Edition….2003
3 - Bailey & Love's Short Practice of Surgery
24th Edition…2004 2nd Chapter
4 - WWW.LearningRadiology
U U


RADIOLOGY | Syllabus | Two Lectures on Introduction & Technical Considerations: given b

Syllabus
No. Title of the Subject Lecturer's/Tutor's Name

2 Introduction Dr.Ameer

7 Chest diseases Dr.Abeer

4 Cardio - vascular diseases Dr.Abeer

1 Plain abdomen Dr.Kawa

5 GIT Dr.Kawa

Hepato - biliary system
3 Dr.Kawa
Pancreas & spleen

Peritoneal cavity and
2 Dr.Kawa
Retroperitoneum

7 Urinary tract Dr.Nasreen

3 OBGYN Dr.Nasreen

4 Bone & joint diseases Dr.Salah

1 Bone Trauma Dr.Salah

2 Spine Dr.Ameer

2 Skull & Brain Dr.Ameer

1 Sinuses, orbits & Neck Dr.Ameer

1 Interventional Radiology Dr.Ameer

45 Total

Detail of Syllabus
Two Lectures on Introduction & Technical Considerations: given by Dr. Ameer
Objectives:
- Proper use of imaging department.
- How X - rays are produced in Conventional Radiography.


RADIOLOGY | Detail of Syllabus | Spine: Two Lectures given by Dr. Ameer

Syllabus:
- The basic radiographic densities.
- Projections in conventional radiology:…PA. AP. Lateral, Horizontal X - ray
beam, Lateral decubitus
- CT Scan, Ultrasound, MRI, Radionuclide imaging & PET, Basic principles
- Contrast agents in Conventional Radiography & CT.. Definition & side effects
- PACS
- Radiation Hazards

Spine: Two Lectures given by Dr. Ameer
Objectives:
- Role of different imaging modalities in the diseases of the spine. (Plain
radiographs, MRI, CT, Myelography)

Syllabus:
- Signs of abnormality on plain films.
- How metastases/ myeloma/ lymphoma appear on different imaging modalities and which one is
the best.
- Infection of spine; Pyogenic & TB spondylodiscitis.
- Spinal Trauma.
- Degenerative disc disease (DDD) ; plain film & MRI findings.
- Disc herniation.
- Failed back syndrome.
- Spinal canal stenosis.
- Ankylosing Spondylitis.
- Spinal dysraphism.
- Spondylolisthesis.
- Spinal cord compression.
- Intrinsic disorders of the spinal cord..

Skull & brain; 2 Lectures given by Dr. Ameer
Objectives:
- Role of different imaging modalities in head injury, Stroke, Brain tumors.

Syllabus:
- Plain film; normal & abnormal intra - cranial calcification.
- Signs of raised intra - cranial pressure on Plain films.
- Normal & abnormal Brain CT.
- Cardinal signs of abnormal CT brain.
- CT angiography.
- MRI of the brain.
- MRA.
- US of the Brain in neonates.
- Brain Tumors; How common brain tumors appear by CT & MRI? e.g. glioma, meningioma,
acoustic neuroma, pituitary tumors & metastases.
- Stroke; Role of CT to exclude hemorrhage initially.
- CT in subarachnoid hemorrhage...


RADIOLOGY | Detail of Syllabus | Sinuses, Orbits & Neck one lecture by Dr. Ameer:

- Role of CT in infarction.
- Role of MRI in infarction. DWI
- AVM in MRI & MRA.
- Infection & brain abscesses.
- MS.
- Head injury; Role of CT to show epidural, subdural & parenchymal hemorrhage. Contusion &
fractures.

Sinuses, Orbits & Neck one lecture by Dr. Ameer:
Objectives
- Role of Plain film & CT in sinusitis.
- Different causes of opaque sinuses.
- Role of CT in blow out fracture.
- Exophthalmus.
- Diseases of Salivary glands & Role of plain radiograph, Sialography, CT & MRI.
- Thyroid nodules; Role of US & radionuclide scan.

Interventional Radiology: one Lecture by Dr. Ameer.
Objectives
To let the student know that Imaging has not only the role in diagnosis of diseases, but it can be of
great help in treatment & may replace surgical procedures.:
How can imaging guide biopsy? Draining abscesses? putting stents & e.g biliary drainage ?.
Different interventional procedures via angiography; e.g. embolisation, thrombolysis.

Plain abdominal radiographs: One lecture given by Dr. kawa Abdulla
Objectives:
Proper analysis of plain films
Illustration of causes of abnormal plain films

Syllabus:
- The basic plain abdominal radiographs.
- illustration of normal & abnormal plain films
- analysis of GIT dilatation
- analysis of extraluminal air.
- analysis of GIT opacities & calcification on plain films
- analysis of hepatic & splenic abnormalities on plain films
- analysis of ascites; abdomino - pelvic masses on plain films

GIT Contrast examination & other imaging modalities: Five Lectures by Dr. kawa
Objectives:
Analysis of role & findings of contrast studies & different imaging modalities in the GIT including US;
CT; MRI; isotope studies & angiography

Syllabus:
- proper technique; limitations & hazards of contrast examinations
- proper technique; limitations & hazards of other imaging modalities


RADIOLOGY | Detail of Syllabus | Hepato - biliary system; three Lectures given by Dr. kawa

- analysis of causes & findings of barium study abnormalities; including strictures; filling defects &
ulcerations
- dedicated evaluation of major topics: GIT malignancies; peptic ulcer; malabsorption syndrome;
ulcerative colitis & Crohns disease with diverticular disease.
- emphasis on the role & findings on US; CT; MRI
- emphasis on the role & findings of isotope studies& angiography especially in GI bleeding

Hepato - biliary system; three Lectures given by Dr. kawa
Objectives:
- analysis of role & findings of US; CT; MRI; isotope studies & angiography in Hepatic; biliary;
splenic & pancreatic problems
- analysis of role; findings; limitation& hazards of biliary contras examinations & isotope studies.

Syllabus:
- normal imaging appearances of liver; spleen; pancreas & biliary system with the gall bladder.
- analysis of causes & findings of liver masses; cysts & abscesses.
- analysis of findings in cirrhosis & portal hypertension and in liver trauma.
- analysis of role; findings; limitation& hazards of ERCP; PTC –
- analysis of imaging findings & limitations in cholecystitis ; GB & bile duct stones
- analysis of imaging evaluation of jaundice starting with non invasive studies US, CT; MRI & MRCP
with occasional isotope studies then to diagnostic & therapeutic ERCP & PTC
- dedicated evaluation of causes & findings in splenomegaly
- emphasis on the imaging findings in splenic trauma
- analysis of imaging role & findings in pancreatic tumors and in acute & chronic pancreatitis.

Peritoneal cavity & retroperitoneum; two Lectures given by Dr. kawa
Objectives:
- analysis of imaging role & findings in ascites; peritoneal tumors & intra - peritoneal abscesses
- analysis of imaging role; findings & limitation in evaluation of the adrenal glands; abdominal
aorta; para - aortic lymphadenopathy & retroperitoneal
tumors and abscesses

Syllabus:
- analysis of imaging role & findings in ascites
- analysis of role & findings of US; CT & isotope studies in intra - peritoneal abscesses
- analysis of findings on US & CT in peritoneal tumors
- US; CT & MRI appearance of normal retroperitoneal structures
- US & CT evaluation of para - aortic lymphadenopathy.
- imaging evaluation of adrenal adenoma - functioning, cons, Cushing's and non functioning
adenomas
- US; CT; MRI & isotope studies evaluation of pheochromocytoma & adrenal metastases
- Aortic aneurysms US; CT; MRI & angiographic evaluation.
- imaging evaluation of retroperitoneal abscesses & tumors

Chest: Seven lectures given by Dr. Abeer Kadum Abass
Objectives:
Role of different imaging modalities in the evaluation of different chest diseases.


RADIOLOGY | Detail of Syllabus | Cardiovascular system (CVS) : Four lectures given by Dr.

Proper reading of normal CXR.
Correlation between clinical & CXR findings for accurate way of achieving diagnosis.

Syllabus:
Normal CXR interpretation.
Abnormal chest radiograph; Silhouette sign & radiological signs of lung diseases: air space filling
(pul. Odema & pul. consolidation), pul. collapse, spherical pul. Shadows, band like pul. Shadow,
wide spread small shadows.
Pleura; CXR findings, & causes in pleural effusion (free & loculated).
Pleural thickening.
Pleural tumors.
Pneumo thorax (diagnosis, causes & types).
Mediastinum; compartment, plain chest film findings in mediastinal masses & complementary CT.
Pneumo - mediastium (causes & CXR findings).
Hilar enlargement; unilateral & bilateral; causes & CXR findings.
Diaphragm: Normal anatomy, variant & causes of marked unilateral elevation of hemi diaphragm.
Specific diseases : Infection : Bacterial pneumonia, viral & mycoplasma pneumonia, lung abscess,
pulmonary TB (Primary & post primary), fungal & parasitic disease, pneumonia in
immunocompromised host, Sarcoidosis, diffuse pulmonary fibrosis ; CXR findings & try to
determine the cause of the abnormal CXR findings.
Diseases of air way passages (Asthma, bronchiolitis, acute bronchitis, chronic obstructive air way
diseases, cystic fibrosis) ; definition, & CXR findings).
Respiratory distress in the new born (Meconium aspiration & hyaline membranes disease) CXR
findings & complications of therapy.
ARDS; causes & CXR findings.
Pulmonary embolism & infarction (CXR diagnosis, role of CT angiography & Radionuclide scanning).
Trauma to the chest (CXR & CT) findings.
CA Bronchus (CXR findings in peripheral & central), spread.
Metastatic neoplasm to the chest (lung, chest wall, pleura, & mediastium).
Lymphoma in the chest.
Mammography; indications, plain radiograph & US findings in benign & malignant focal lesions.

Cardiovascular system (CVS) : Four lectures given by Dr. Abeer Kadum Abass.
Objectives:
1 - Role of imaging techniques in evaluation of cardiovascular disease.
2 - Proper interpretation of the CXR; regarding normal & cardiac diseases emphasized that CXR is
useful for looking at the effects of cardiac diseases on the lung & pleural cavity, but provide only
limited information about the heart itself.

Syllabus:
Evaluation of the CVS, with CXR, Echo & Doppler, CT & CT angiography, MRI & MRA, Radionuclide
techniques, cardiac catheterization & angiography.
Cardiac disease; size (common causes of chamber enlargement), Chamber hypertrophy &
dilatation.
Valve movement deformity & calcification.
Ventricular contractility.
Pericardial diseases (effusion & calcification).


RADIOLOGY | Detail of Syllabus | Bone & Joint diseases: Four Lectures by Dr. Salah Kalary

Pulmonary vessels: increased flow (CXR appearance & causes), decreased flow (CXR appearance &
causes).
Pulmonary arterial hypertension causes & CXR appearance.
Pulmonary venous hypertension causes & CXR appearance.
Pulmonary odema: Types, causes & CXR findings.
Specific cardiac disorders; Heart failure, valvular heart disease, LT – atrial myxoma & other
intracardiac tumors.
Common Congenital heart diseases; LT –RT shunt, coarctation of aorta, Tetrology of Fallot.

Bone & Joint diseases: Four Lectures by Dr. Salah Kalary
Objectives:
First: principal of reading of bone images in different modalities specially plain X - ray
Second: how student can approach focal bone lesion & steps of imaging consequences
Third: principles of differentiation between aggressive & benign bone lesions
Fourth: principles of differentiation between joint degenerative changes like OA & inflammatory
joint diseases like RA
Fifth: information about criteria of differentiation between most common types of polyarticular
joint diseases.

Syllabus:
Imaging techniques used in Dx of bone disease (role of different imaging modalities in approaching
the bone disease
Signs of bone disease in plain X - ray
Types of bone diseases; focal, generalized & alteration in the trabecular pattern or changes in the
shape
Radiological approach for diagnosis of solitary bone lesions
Bone tumors, including primary (benign & malignant) & secondaries
Bone infection: Pyogenic (acute & chronic) & TB
Generalize decreased bone density (osteopenia)
Osteoporosis.
Rickets & Osteomalacia.
Hyperparathyroidism.
Multiple myeloma.
Generalized increase in bone density
1 - Paget’s disease
2 - Thalassemia
3 - Radiation induced bone diseases
Changes in bone shapes
Diaphyseal aclasia
Joints diseases (2 lectures each of 1 hr)
Imaging technique (roles of each modalities in Dx of joint disease)
Approach in Dx of arthritis & radiological features of deferent type of arthritis including OA,
inflammatory & metabolic arthritis & principle differentiating radiological points between them
Osteochondritis including Perthe’s, Kienbock’s disease
Freiberg’s disease Kohler’s disease
Slipped femoral epiphysis
Developmental dysplasia of the hips (DDH or CDH)


RADIOLOGY | Detail of Syllabus | Bone Trauma: One Lecture by Dr.Salah Kalary.

Internal derangement of the knee joint
Shoulder Rotator cuff tear

Bone Trauma: One Lecture by Dr.Salah Kalary.
Objectives:
Role of plain radiograph in bone trauma.
Signs of Fracture & dislocation.
Role of nuclear medicine, CT & MRI in bone trauma,
Stress fracture.
Insufficiency fracture.
Pathological fracture.
Salter Harris classification.
Non - accidental trauma.


UROLOGY | Course coordinator and list of teachers | Bone Trauma: One Lecture by Dr.Sala

UROLOGY
Fifth Stage
Department of Surgery
College of Medicine
2010 - 2011

Course: urology
Course coordinator: Dr. Ali Kamal
Department: surgery
College: Medicine
Course coordinator link: alikamal22@yahoo.com
Tel. +9647705449905
List of teachers on this course:
Dr. Ismaeel Hama Ameen
Dr. Aso Omer Rasheed
Dr. Sarwar Noore Mahmoud
Dr. Ali Kamal M.Sami
Dr. Ahmed Abdulhameed

Course Overview
The course of urology is dedicated to deal with undergraduate level to know the importance of
urology in the daily activities of the junior doctors and the sessions and the lectures are overall
based on simple principles and standards for the juniors in urology to understand the physiology
and pathology and management of these problems in simple and qualified methods in 16 lectures.
The subjects should enable the students to understand the procedures of intervention in urology
and the justification of such intervention and when to decide to treat conservatively and when to
interfere with the disease process with a wide base of knowledge that will help the students to
widen their experiences through journals and textbooks after understanding the basics of urology.

Course Objectives
At the end of the course of urology, the students should be able to master and perform the basic
skills that are considered fundamentals in urology and to have basic urological experience needed
for doctors in urology department or in case of urological emergency, and some of these objectives
include:
1. Insertion of urethral Foley’s catheter.
2. Performing suprapubic cystostomy


UROLOGY | Course Reading List | Bone Trauma: One Lecture by Dr.Salah Kalary.

3. Diagnosing urine retention with its management.
4. Suspecting urethral injury and urethral rupture.
5. Diagnosing and treatment of urological diseases.
6. Suspecting malignancy and differentiating from benign lesions.

Course Reading List
1. 1 - Baily and Love, short practice of surgery
2. 2 - Smith’s urology
3. 3 - Journal of Urology. American Urological Association.
4. 4 - European association of urology, clinical guidelines.

Syllabus

No. Title of subject Lecturer/Tuttor’s name

1 kidney and urinary symptoms Dr. Aso Omer Rasheed
2 Investigation in urology Dr. Aso Omer Rasheed
3 Congenital anomalies of UT Dr. Aso Omer Rasheed
4 infection Dr. Aso Omer Rasheed
5 Anuria Dr. Aso Omer Rasheed
6 hydronephrosis Dr. Aso Omer Rasheed
7 Urolithiasis Dr. Aso Omer Rasheed
8 renal truma Dr. Aso Omer Rasheed
9 renal tumor Dr. Aso Omer Rasheed
10 Prostate infections 1 Dr. Sarwar Noore
11 Prostate inferctions 2 Dr. Sarwar Noore
BPH 1
12 Dr. Sarwar Noore

13 BPH 2 Dr. Sarwar Noore
14 Carcinoma of prostate 1 Dr. Sarwar Noore
15 Carcinoma of prostate 2 Dr. Sarwar Noore
No. Title of subject Lecturer/Tuttor’s name
16 Urinary bladder anatomy, physiology and pathology Dr. Ali Kamal
17 Rupture of urinary bladder, urine retention Dr. Ali Kamal
18 Neuropathic bladder + urinary incontinence Dr. Ali Kamal
19 Urinary bladder stones, vesical fistula, bladder diverticulum Dr. Ali Kamal
20 Bladder tumors Dr. Ali Kamal


UROLOGY | Detail of Syllabus | Lectures titles (the kidney)

21 Urinary bladder schistosomiasis, Dr. Ali Kamal
22 Urethra and penis, anatomy and congenital anomalies Dr. Ahmed Abdulhamed
23 Hypospadias Dr. Ahmed Abdulhamed
24 Acquired urethral stricture Dr. Ahmed Abdulhamed
25 Disorders of female urethra Dr. Ahmed Abdulhamed
Ectopic testis and cryptorchidism
26 Dr.Ismaeel Hama amen
Dr.Ismaeel Hama amen
27 Hydrocele

28 Orchitis Dr.Ismaeel Hama amen
29 Torsion of the spermatic cord Dr.Ismaeel Hama amen
30 Tumors of the testis Dr.Ismaeel Hama amen

Detail of Syllabus
Lectures titles (the kidney)
Lecturer (dr. Aso Omer)

Objectives:
these lectures are dedicated to help the medical students understand the importance of the
kidneys in daily practice as a common problem that they will face every day in the hospital and
urinary emergency of renal trauma or renal stones or anuria or infection of the kidneys, the
objectives are:
a. The function of kidneys.
b. The investigations needed to diagnose and define renal problems.
c. To differentiate between anuria and urine retention.
d. To be clinically capable of differentiation between renal colic and acute abdomen.
e. Management of renal colic.
f. The lines of treatment of renal colic and renal pain.
g. Surgical treatment of renal tumor.

The lectures include:
a. Introduction to kidney function and physiology of urine formation.
b. Causes of renal colic, renal tumor, hydronephrosis, anuria, renal trauma and their managment

Lectures titles (the Prostate)
Lecturer (dr. Sarwar Noore)

Objectives:
these lectures are dedicated to help the medical students understand the importance of the
prostate as a common problem that they will face every day in the hospital and urinary emergency
of hematuria or urine retention or infection of the prostate, the objectives are:
1. To understand the function of prostate.


UROLOGY | Detail of Syllabus | Lectures title: (Urinary bladder)

2. The investigations needed to diagnose and define prostate infections and relation to LUTS.
3. To differentiate between benign prostatic hyperplasia and prostatic carcinoma.
4. To be clinically capable of performing rectal examination.
5. Management of BPH.
6. Surgical treatment of prostatic carcinoma.

a. Introduction to prostate anatomy and physiology.
b. Presentation, diagnosis and treatment of prostatic problems.

Lectures title: (Urinary bladder)
Lecturer name: Dr. Ali kamal

Objectives:
Theses lectures are directed to dedicated to help the medical students understand the functions
and anatomy and micturition process and the mechanism of urinary retention in daily practice as a
common problem that they will encounter while dealing with patients suffering from urinary
frequency and hematuria or urinary bladder carcinoma, also the rupture of bladder.the objectives
are:
1. The causes of urinary retention, also the causes of urinary bladder rupture.
2. The difference between the urinary retention and anuria
3. To differentiate between acute and chronic retention.
4. To be clinically capable of differentiate between intraperitoneal and extraperitoneal rupture
of bladder.
5. Management of retention.
6. The contraindications to catheterization in cases of urine retention with urethral injury.
7. Surgical treatment of rupture of urinary bladder, , vesical fistula.

a. Introduction to urinary bladder function and physiology of micturition. and meaning of urine
retention.
b. presentation and management of bladder stones, infections, and malignancy, fistulas,
congenital anomalies.
c. Causes of urine retention and classification of urine retention acute and chronic, neurogenic
and obstructive and presentation of patients.
d. What is difference between intraperitoneal and extraperitoneal bladder rupture, how to
diagnose both and treatment of both types.

References:
1. Baily and Love short practice of surgery
2. Journal of urology.

Lectures titles (the penis and urethra)
Lecturer (dr. Ahmed abdulhameed)


UROLOGY | Student feedback for the subject of a lecture | Lectures titles (the testis)

Objectives:
These lectures are dealing with the penis and urethra and are intending to introduce the penis and
urethral problems as congenital and acquired diseases.
the objectives are:
1. To understand the anatomy of penis and urethra.
2. The investigations needed to diagnose and treat urethral diseases.
3. To differentiate between hypospadias and epispadius.
4. To be clinically capable of catheterizing the urethra in female and male.
5. Management of urethral injury.
6. The lines of diagnosing female urethral problems.
7. Surgical treatment of urethral strictures.

a. Introduction to penis and urethral anatomy.
b. presentation and treatment of congenital and acquired urethral problems in male and in
females.

Lectures titles (the testis)
Lecturer (dr. Ismaeel Hama Ameen)

Objectives:
these lectures are dealing with the testes and the congenital abnormalities as well as the acquired
problems of the testis, and a the emergency of testicular and spermatic conditions.
the objectives are:
1. The function, anatomy and physiology of testes.
2. The investigations needed to diagnose and define testicular problems.
3. To diagnose the emergency of testicular torsion and infection of testes.
4. To be clinically capable of diagnosing hydrocele and varicocele.
5. Management of renal colic.
6. The lines of treatment of renal colic and renal pain.
7. Surgical treatment of renal tumor.

a. Introduction to testis anatomy, function and physiology,
b. presentation and treatment of testicular torsion and hydrocele and varicocele and ect Causes
of renal colic, renal tumor, hydronephrosis, and ectopic testis, also infection.

Student feedback for the subject of a lecture
Date: course: year: lecturer: title:
NO. EVALUATION QUESTIONS SCORE (1 - 5) SUBJECTIVE REMARKS
The objectives and key messages of the subject
1
were clear
The contents of the subject were useful and
2
related to the main objectives of the course
3 The materials were prepared carefully as needed
4 The lecturer/ tutor while lecturing tried to analyze


UROLOGY | Examinations | Types of questions:

the principles, contents and the important points
of the subject simply and properly.
The lecturer/ tutor while lecturing kept my
5
attention.
The lecturer/ tutor came into the classroom on
6 time and was committed to the duration of the
lecture.
The lecturer's behavior in the classroom was calm
7
and respectful
The slides used in the lecture were clear and
8
attractive.
At the end of the lecture, the lecturer gave the
9 students a chance for questions and comments.
His/ her answers were complete.
The reading sources are new and compatible with
10
the subject.
Total score
1 - very bad 2–bad 3–medium 4 - good 5 - verygood

Examinations
Time of exam. 3 Three hours.

Types of questions:
1 - short essay.
2 - long essay.
3 - multiple choice questions.

The number of questions and marks are divided as follows:
30 Marks for long essays.
30 Marks for short essays.
60 Marks for MCQs.
The methods of correction of answers depend on key answers and key for multiple choice
questions and correction and marks are given accordingly.

Advices and directions for all students before and during exams.
1. Read the question twice before answering.
2. Think of the answer before writing.
3. Plan your answer in a separate page before writing it down on the answer paper.
4. Arrange the answer in the form of introduction, contents and the final part so that the student
organizes his/her answer

Sample Questions
MCQ
Regarding the penis all are true except:
a. has a fixed root and a body that hangs free.
b. the bulb of the penis is traversed by the urethra and covered on its outer surface by
bulbospongiosus muscle.


UROLOGY | Examinations | Sample Questions

c. the corpora cavernosa supplied by branches from the external femoral arteries.
d. the corpus spongiosum at its end expands to form the glans penis.
e. nerve supply is from the pudendal nerve and the pelvic plexus

the correct answer is (c)
Which of the following is correct regarding urethrorectal and vesicorectal fistula:
a. they are very common congenital abnormality.
b. they are almost always associated with imperforate anus.
c. urorectal septum has developed completely.
d. the fistula opens on the anterior abdominal wall.
e. cystoscopy and panendoscopy can not show the fistulous opening.

The correct answer is (d)
Classification of hypospadias according to location include all the following except:
a. perineal.
b. glandular.
c. suprapubic.
d. coronal.
e. penoscrotal.

The correct answer is (c)
Which of the following is not a clinical finding in Peyronie’s disease:
a. painful erection.
b. curvature of the penis.
c. poor erection distal to the involved area.
d. the patient has moderate to severe pain when the penis is in nonerect state.
e. Examination of the penile shaft reveals a palpable dense, fibrous plaque involving the tunica
albuginea.

The correct answer is (d)
Treatment of acquired urethral stricture and its complications, all are correct but one:
a. dilation of urethral stricture is not usually curative.
b. urethrotomy under endoscopic direct vision.
c. short strictures (≤2 cm) of the anterior urethra should be completely excised and primary
anastomosis done.
d. strictures >2 cm in length can be managed by patch graft urethroplasty.
e. periurethral abscess self - limited and will heal spontaneously.

The correct answer is (e)

long and short essays
Question: Enumerate the causes of priapism
Answer:
a. Idiopathic in 60% of cases.
b. Secondary in 40% of cases due to the following diseases:
1. Leukemia.
2. Sickle cell disease.


UROLOGY | Student feedback on the course | Sample Questions

3. Pelvic tumors.
4. Pelvic infections.
5. Penile trauma.
6. Spinal cord trauma.
7. Medications (trazodone). Currently, intracavernous injection therapy for impotence may
be the most common cause

Question: write short assay on the diagnosis of urethral diverticulum.
Answer :
Diagnosis:
1. feeling a rounded cystic mass in the anterior wall of the vagina that leaks pus from the
urethral orifice when pressure is applied.
2. Endoscopy may reveal the urethral opening.
3. The postvoiding film of an IVU series may demonstrate the lesion.
4. Transvaginal ultrasonography.

Student feedback on the course
Date : course: year lecturer:
SCORE SUBJECTIVE
NO. EVALUATION QUESTIONS
(1 - 5) REMARKS
1 The objectives and key messages of the subject were clear
The contents of the subject were useful and were related to the main
2
objectives of the course
3 The coordinator teacher had worked hard to prepare the materials
The coordinator teacher had worked hard to cooperate and prepare the
4
course
5 The lecturers were carefully selected and were expert in their fields
The coordinator teacher gave a good attention to the students'
6
criticisms and claims
7 Information on the Examination process was well provided
8 The questions of the exams were related to the contents of the course
There is a potential to promote and develop the course in the following
9
areas:
10 Total of the levels

1 - very bad 2 - bad 3 - medium 4 - good 5 - very good


ANESTHESIA | Anesthesia Lectures | Introduction to anesthesia 5 Hrs

ANESTHESIA
Fifth Stage
College of Medicine
2010 - 2011

Anesthesia Lectures
Dr. Amir Boujan
Dr. Gona Ahmed

Detailed Syllabus
Introduction to anesthesia 5 Hrs
Objectives:
the student will learn about
History of anesthesia.
Preoperative preparation of a patient to anesthesia which includes preoperative visit of the
anesthetist to the patient.
History (including drug history and its effect on anesthesia)
clinical examination
Interpretation of laboratory data
Consent
Planned management of anesthesia
Methods available for relief of post operative pain
Fasting guidelines
Assignment the physical status classification
Premedication and

Types of Anesthesia 1Hr
Objectives:
The student should know the aim of anesthesia, the definition of general anesthesia and the
meaning of induction maintenance and recovery.
Also the student will learn about local anesthesia and the types of local anesthesia procedures (e.g.
regional anesthesia)

Drugs used in anesthesia 4hrs
Objectives:
The student will learn about different groups of anesthesia drugs, there effects, side effects also
drug interaction.


ANESTHESIA | Question Examples | Post operative complications 3hrs

Post operative complications 3hrs
Objectives:
The student should know the postoperative anesthesia complications and how to manage them

Pain management 2hrs
Objectives:
The student will learn about pain, types of pain and the methods available to control acute pain and
the methods to control chronic pain

Airway Management 5hr
Objectives:
the student will learn about:
Anatomy of the airway
Airway assessment and difficult airway
Endotracheal intubation, it’s indications and complications
Surgical intervention to control the airway

Monitoring 1hr
Objective:
The student will learn about patient monitoring in the operation room or in the ICU.

Cardiopulmonary resuscitation 2hr
Objectives:
The student should know the ABC of Cardiopulmonary resuscitation and how to deal with patient
developed cardiac arrest

Intensive Care Unite 4hrs
Objectives:
The Student will learn about:
ICU and the instrument available in it (e.g. respiratory support instruments)
Criteria for admission to ICU
Criteria for patient to discharge from ICU
Care to critical ill patient
Dealing with specific conditions in ICU (e.g. Salicylic acid poisoning)
Total parenteral nutrition

References
Robert K.stoetling, Ronald D.Miller, Basics of anesthesia 2004
Kith G.Allman, Iain Wilson, Oxford Handbook of Anaesthesia 2007
A.R. Aitkenhead, G.Smith, Textbook of Anaesthesia

Question Examples
Q1/ Enumerate the Important aspects of the preoperative evaluation.
Answer/ Important aspects of the preoperative evaluation includes the followings:


ANESTHESIA | Question Examples | References

History
Review of current drug therapy
Physical examination
Interpretation of laboratory data
Consent
Planned management of anesthesia
Methods available for relief of post operative pain
Fasting
Assignment the physical status classification
Premedication
Q2/ Write short notes on the causes of post operative hypertension.
Answer/ the causes are:
Arterial hypoxemia.
Enhanced sympathetic nervous system activity (pain, bladder distension).
Preoperative hypertension.
Hypervolemia.
Hypercarbia
Q2/ Match items in table A (1 - 12) with the appropriate items in table B (a - t) : (each items in
table B should be used once only) (answer on this paper) (1mark/each)
Table A
Halothane J, O
Atracurium H, R
Thiopenton L
Fentanyl
Pentazocine T
Ketamine I, Q, S
Remifentanil P
Propofol B
Bupivacaine D, F, N
Succinylcholine A, E, G, K, M
Neostigmine C
Pethidine
Q/choose the most approperiat answer
The sources of blood clot embolization in the arteries are all except:
U U

a. Mural thrombus
b. Following myocardial infarction
c. Mitral stenosis
d. Aortic stenosis
e. Atrial fibrillation

Answer/c


OTOLARYNGOLOGY | Course coordinator and list of teachers on this course | References

OTOLARYNGOLOGY
Fifth Stage
College of Medicine
2010 - 2011

Course coordinator and list of teachers on this course
Course: otolaryngology
Course coordinator: Dr. Hewa As'ad
Department: surgery - otolaryngology
College: Medicine
Course coordinator link: hewa_ent@yahoo.com
Tel. +9647701580087
Dr. Hewa As'ad Abdelkareem
Dr. Yousif Ibrahim chalabi
Dr. Muaid Ismaiel Aziz
Dr. Sherko Saeed Fathullah

Course Overview
The course of otolaryngology – head & neck surgery is dedicated to deal with undergraduate level
to know the importance of otolaryngology in the daily activities of the junior doctors and the
sessions and the lectures are overall based on simple principles and standards for the juniors in
otolaryngology to understand the physiology and pathology and management of common diseases
& how to deal with emergency situations that they may be faced in their practical work, these
lectures given in simple and qualified methods in 28 lectures.

Course Objectives
At the end of the course of otolaryngology, the students should be able to master and perform the
basic otolaryngology assessment & examinations that are considered fundamentals and learn how
to be able to deal with emergency situations. some of these objectives include:
Performing ENT examination.
Deal with a patient complaining of nasal bleeding.
How to manage a patients with foreign bodies inhalations or ingestion.
How to manage a patients with an obstructed upper airway obstruction (stridor).
Diagnosing and treatment of common otolaryngological diseases.


OTOLARYNGOLOGY | Course Reading List | References

Course Reading List
1 - Scott - Brown otolaryngology
2 - Logans Turners diseases of ear, nose, throat
3 - Synopsis otolaryngology
4 - Makhbool otolaryngology
5 - Essential Otolaryngology
6 - Oxford handbook of ENT emergences
7 - American journal of otolaryngology - head & neck Surgery
8 - journal of laryngoscope
9 - www.emedicine.com

Syllabus
NO TITLE OF SUBJECT LECTURER/TUTTOR’S NAME

1 Anatomy and physiology of the larynx Dr.Hewa asaad

2 Traumatic conditions of the larynx. Dr.Hewa asaad

3 Inflammations of the larynx: Acute laryngitis. Dr.Hewa asaad

4 Inflammations of the larynx: Chronic laryngitis. Dr.Hewa asaad
Neoplasms of the larynx: Benign tumors and
5 Dr.Hewa asaad
cysts
6 Neoplasms of the larynx: Malignant tumors. Dr.Hewa asaad

7 Hoarseness Dr.Hewa asaad
Anatomy, Embryology & physiology of the nose
8 Dr Yousif Chalabi
& PNS
9 congenital anomalies and trauma to the nose Dr Yousif Chalabi

10 Acute & Chronic nasal &PNS sinus inflammation Dr Yousif Chalabi

11 Epistaxis Dr Yousif Chalabi

12 Allergic rhinitis & nasal polyposis Dr Yousif Chalabi

13 The deformed nose & nasal obstruction Dr Yousif Chalabi

14 Tumors of nose & paranasal sinuses Dr Yousif Chalabi

15 Anatomy, physiology of the ear Dr. Muaid Ismaiel Aziz
Physical& radiological assessment of the ear
16 Dr. Muaid Ismaiel Aziz
diseases
17 Symptomatology in ear diseases Dr. Muaid Ismaiel Aziz
Diseases of the external ear (cong.anomalies,
18 Dr. Muaid Ismaiel Aziz
infections, tumors)
19 Diseases of the middle ear (acute otitis media) Dr. Muaid Ismaiel Aziz

20 Diseases of the middle ear (chronic otitis media) Dr. Muaid Ismaiel Aziz


OTOLARYNGOLOGY | Detailed Syllabus | References

21 Diseases of the inner ear, ear surgeries Dr. Muaid Ismaiel Aziz

22 Anatomy and physiology of the pharynx Dr. Sherko Saeed Fathullah

23 Common diseases of the buccal cavity Dr. Sherko Saeed Fathullah

24 Pharyngitis and pharyngeal abscesses Dr. Sherko Saeed Fathullah

25 Tonsillitis and adenoids Dr. Sherko Saeed Fathullah

26 Tumors of the pharynx Dr. Sherko Saeed Fathullah
Miscellaneous conditions of the pharynx and
27 Dr. Sherko Saeed Fathullah
throat
28 Neck masses and salivary glands Dr. Sherko Saeed Fathullah

Detailed Syllabus
Lecture title: Anatomy and physiology of the larynx.
Lecturer name: Dr. Hiwa As'ad
Objectives:
This lecture is dedicated to help medical students understand anatomy and physiology of the larynx
and their clinical importance, the lecture includes:
a. Introduction to laryngeal structure.
b. Description of laryngeal structure (laryngeal cartilages and membranes, muscles of the larynx
and their actions) demonstrated by figures
c. Description of surface anatomy of the larynx.
d. Blood supply, nerve supply, and lymphatic drainage of larynx and their clinical importance.
e. Description of functions of larynx.
Lecture title: Traumatic conditions of the larynx
Lecturer: Dr. Hiwa As'ad
Objectives:
This lecture is dedicated to help medical students understand management of trauma of larynx and
neck which is a common clinical condition that they will face frequently in their practice in hospital
and emergency department, the lecture includes:
a. Introduction to laryngeal and neck trauma.
b. Description of mechanism of injury (blunt trauma injury and penetrating trauma).
c. Initial evaluation, clinical assessment, endoscopic assessment and imaging of the larynx.
d. Classification of laryngeal injury according to extent of damage.
e. Management of laryngeal trauma, goals of laryngeal exploration, laryngeal repair, and
management of associated vascular and esophageal injuries.
f. Outcome of management of this condition.
Lecture title: Inflammations of the larynx: Acute laryngitis
Objectives:
This lecture is dedicated to help medical students understand this common problem that they will
face in their practice in outpatient clinic, emergency department or if they work in otolaryngology
or pediatric departments, the lecture includes:
a. Introduction to acute laryngitis and its etiological factors.



b. Description of clinical types of acute laryngitis.
c. Comparison between pediatric patients and adult patients and relative clinical points to be
considered.
d. Treatment options and outcome.
Lecturer title: Inflammations of the larynx: Chronic laryngitis
Lecturer name: Dr. Hiwa as'ad
Objectives: This lecture is dedicated to understand this troublesome condition caused by various
etiological factors, and its types (specific and non specific), the lecture includes:
a. Definition and etiological factors of chronic laryngitis.
b. Clinical classification of chronic laryngitis into specific and non - specific, and subgroups of each
type.
c. Pathology, clinical features, and treatment modality for each type.
Lecture title: Tumors of the larynx: Benign tumors
Objectives: This lecture is dedicated to help medical students understand this important conditions
that might affect respiration and voice of patients that needs specific management, the lecture
includes :
a. Introduction.
b. Classification of benign tumors.
c. Clinical features, diagnosis and treatment of each type.
d. Pseudotumors types, clinical features and management of each type.
Lecture title: Tumors of the larynx: Malignant tumors
Objectives: This lecture is dedicated to help medical students understand this serious condition and
develop high sense of suspicious for early diagnosis. It also demonstrates treatment options of this
condition, the lecture includes:
a. Introduction.
b. Classification of carcinoma of larynx.
c. Demonstration of etiological factors.
d. Clinical features, examination of the larynx and the neck.
e. Radiological investigations and other relevant investigations to assess tumor extension and
spread.
f. Staging and grading of Ca larynx.
g. Demonstration of strategy of treatment and the options available for this condition.
Lecture title: Hoarseness
Objectives: to understand the students the meaning of the hoarseness & its causes &its treatment,
were all objectives included in the lecture.
Lecture title: Anatomy & Physiology of nose & paranasal sinus
Lecturer : Dr. Yousif Chalabi
Objective: To emphasize the importance of anatomy &its variations especially the osteomeatal
complex in the clinical managements of common nose &sinus chronic diseases & correction of nose
& nasal septum both for physiological & cosmetic purposes, the lecture includes
an embyrological introduction to explain some congenital variation of nose like choanal atresia
anatomy of external nose &its skeleton to explain the anatomical dangerous region of nose
&anatomical & physiological background of cosmetic nasal surgery.
anatomy &physiology of nasal fossae & its wall, their role in respiration



anatomy of paranasal sinuses &their variation with its impact on pathogenesis of chronic sinus
diseases & facial pain
Lecture title: congenital anomalies and trauma to the nose
Lecturer: Dr Yousif Chalabi
Objectives : to emphasize the importance of early diagnosis of some congenital anomalies as a
cause of embarrassed respiration in neonates & infants for urgent interference &to explain the
clinical managements of broken nose &face both medically &legally in addition to its impact on
possible intra cranial, base of skull, cosmetic & respiratory complications to guarantee early proper
detection &management to prevent subsequent sequels. The lecture includes a quick review of
embryological formation of nose. its openings & anatomy of nasal skeleton, Choanal atresia,
fracture nasal bone &facial bones (Leforts) fractures, Foreign bodies in nose & their managements.
Lecture title : Acute & Chronic nasal &paranasal sinus inflammation
Objectives: To consider the predisposing factors& their prevention in the etiology of acute nasal &
paranasal sinus (PNS) infections & to emphasize the effects of prompt & early treatments in
prevention of persistence of infections & changing to chronic state. And how to manage whether
medically or surgically the chronic state.
The lecture includes
A quick review of key points of previous lecture
Acute viral &bacterial infections of nose &PNS
Chronic non - specific nasal &PNS inflammation
Chronic specific nasal & PNS infection
Managements including the medical & surgical way of treatments
Lecture title: Epistaxis
Objectives : This lecture is dedicated to emphasize the importance of epistaxis as one of common
acute emergencies in medicine in general & to teach the students how to manage it as first - aid,
general &specific ENT managements. How to identify its causes as a local nasal causes or general
systemic causes especially the blood dyscriasis causes. How to be treated specifically, generally &
how to prevent & guard against it.
an introduction to epistaxis
Causes as a local nasal causes &general systemic causes
Management including the lab hematological., radiological & endoscopical way to find the cause as
local nasal or general systemic. how to be treated whether medically or surgically conservatively or
radically &how to be followed up properly.
Lecture title: Allergic Rhinitis & Nasal polyposis
Objectives: to emphasize the role of preventative measures especially the avoidance of
allergens.proper use of immunization & medical treatments
In reducing the complaint & severity of allergic patients. How to differentiate the different causes
of wet nose including infections allergy & intrinsic vasomotor rhinitis &how to be treated
properly.The lecture is dedicated to make the students understand the nature of common nasal
problem of polyposis & how to differentiate it from normal or hypertrophied turbinates. To
emphasize the role of medical treatment as an effective measures in the early & small polypi or as a
preliminary measures for effective radical treatment or follow up for those treated surgically.



An introduction to the types of hypersensitivity reactions &nature of nasal allergy
Etiology of allergy &types of allergens
Management including the differentiation &how to diagnose different types of wet nose. Allergy
dermatological & hematological test in addition to proper way of prevention &treatments
Nasal polyposis as a pathogenesis, diagnosis & treatments whether medically emphasizing the role
of proper use of cortisone in a non contra - indicated patients or surgically whether conservatively
or radically by FEES or conventionally by traditional surgical way
Lecture title : The deformed nose & nasal obstruction
Objectives: This lecture is dedicated to emphasize the role of cosmetic nasal surgery with
consideration of nasal passage for proper respiratory functions which so frequently threatened by
some surgeon not considering the physiological aspect of nasal function &how to deal with nose
surgically both for physiological & cosmetic purposes. It also aims to make the students
understanding the causes of nasal obstruction &to differentiate the pathological from normal
physiological obstructions of nasal cycle.The lecture includes
A quick review of the key points of previous lecture
A review of the nasal respiratory physiology &anatomy of the nasal skeleton
Causes of deformed nose &nasal obstruction
Management including the requested examination whether endoscopically or by imaging (CT SCAN)
to determine the causes &sites of obstructions & how to be treated whether medically or surgically
whether for cosmetic or physiological purpose separately or in combinations.
Lecture title : Tumors of nose & paranasal sinuses
Objectives: The lecture is dedicated to make the students understanding the nature of tumors
&how the malignant tumors present with specific signs & symptoms to be differentiated from
benign one.What are the predisposing factor & the definite causes to be diagnosed early before
extension to nearby vital & dangerous area of eye & intracranially. Although generally they are rare
tumors but they carry a great morbidity & mortality necessating a special considerations by the
juniors &the surgeon. Also to teach the students how these tumors presents with different signs &
symptoms making the patients wandering among different specialty until diagnosed too late as a
nasal or paranasal malignant tumors.
The lecture includes:
A quick reviews of key points of previous lecture
classifications of tumors as benign & malignant with their different types. Histological classification
& staging of tumors
predisposing & etiological factor for tumor causation
Managements including the diagnosis of tumors whether benign or malignant &the best selected
way of treatments whether surgically or by DXRT or combined in addition to their prognosis
Lecture title : Embryology, anatomy, physiology of the ear
Lecturer name: Dr. Muaid Ismaiel Aziz
Objectives: This lecture is dedicated to help medical students understand embryology, anatomy
and physiology of the ear and their clinical importance, the lecture will deal with followings :
Embryological development of the ear
Anatomical parts of the ear
Anatomical landmarks of the ear



Functions of the ear
Lecture title: Physical & radiological assessment of the ear diseases
Objectives: in this lecture the students will learn how to examine & get diagnosis of the ear diseases
as its includes;
The different ways of ear examination
What you will see in normal ear examination to make differentiation from disease ear
Audio logical assessment & its interpretation
Role of plain x - ray & ct scan in ear disease & their indications.
Lecture title: Symptomatology in ear diseases
Objectives: to know different ear disease symptoms as deafness (hearing loss), tinnitus (perceptive
noisy sound), vertigo (rotating movement of the surrounding or the patient himself with fixed
environment), otalgia (pain in the ear). So you will get information about above topics shortly
including their classifications, differential diagnosis, diagnosis & treatments.
Lecture title: Diseases of the external ear
(cong. anomalies, infections, tumors)
Objectives: to make the student oriented with the different ear diseases starting from external ear
diseases, in this lecture will discuss the congenital diseases like auricle deformity (bat ear),
preauricular sinus, otitis externa & its most common causes & types & its treatment, also will
concentrate on benign & malignant tumors like osteoma, basal cell carcinoma.
Lecture title : Diseases of the middle ear (acute otitis media)
Objectives: in this lecture the student will face the most important & commonest pathology which
is middle ear infection (otitis media), pathology, types, causes, diagnosis & treatment.
Lecture title : Diseases of the middle ear (chronic otitis media)
Objectives: chronic OM classified into safe & unsafe disease, so its important to know both types &
its pathology & treatment, also will discuss different classifications for CSOM & which of them is
useful.
Lecture title : Diseases of the inner ear, ear surgeries
Objectives: in this lecture some of the inner ear disease which is more common than other inner
ear disease like otosclerosis, meniers disease will discussed briefly in addition the students will get
good & sufficient information about the common ear surgeries like myringotomy, myringoplasty.
Lecture title : Anatomy and physiology of the pharynx
Lecturer name: Dr. Sherko Saeed Fathullah
Objectives: in this lecture the students will get enough information Concentrating on boundaries
and parts of the pharynx including naso, oro and laryngopharynx, as well as muscles, nerve supplies
with short notes on the anatomy of soft palate.
In physiology, function of pharyngeal lymphoid tissue and deglutition are discussed
Lecture title : Common diseases of the buccal cavity
Objectives: Some of the common diseases of otolarygologist interest are described including :
stomatitis, aphthous ulcers, Behcet’s syndrome tongue ulcers and AIDS, notes on cysts of mouth,
carcinoma of the toungue, ludwing’s angina and tumours of the oral cavity


OTOLARYNGOLOGY | Student feedback for the subject of a lecture | References

Lecture title : Pharyngitis and pharyngeal abscesses
Objectives: in this lecture the students will know about common disease in the community
(pharyngitis) Acute and chronic specific and non specific pharyngitis as well as acute and chronic
pharyngeal abscesses, Pharyngitis and pharyngeal abscesses, & how these conditions can be dealt
with.
Lecture title : Tonsillitis and adenoids
Objectives: Concentrating on acute and chronic tonsillitis with their complications.Tonsillectomy
and post operative cares, Peritonsillar abscess, Clinical features of nasopharyngeal tonsillitis, its
complication and adenoidectomy, Pharyngitis and pharyngeal abscesses
Lecture title : Tumors of the pharynx
Objectives: in this lecture will deal with important subject which is tumors of pharynx & its include
Tumors of the nasopharynx
Tumors of the oropharynx
Tumors of the laryngopharynx
Lecture title : Misceleneous conditions of the pharynx and throat
Objectives: including Globus hysterics, palate and pharyngeal palsy, pharyngeal spasm, pharyngeal
pouch, trismus, cleft palate and elongated styloid process
Lecture title : Neck masses and salivary glands
Objectives: in this lecture will discuss Thyroglossal cyst and fistula, branchial cyst, cystic hygroma
sternomastoid tumor as well as mumps, submandibular gland calculus and sialography.

No. Evaluation Questions Score (1 - 5) Subjective Remarks
The objectives and key messages of the subject were
1
clear
The contents of the subject were useful and related
2
to the main objectives of the course
The lecturer/ tutor while lecturing tried to analyze
4 the principles, contents and the important points of
the subject simply and properly.
5 The lecturer/ tutor while lecturing kept my attention.
The lecturer/ tutor came into the classroom on time
6
and was committed to the duration of the lecture.
The lecturer's behavior in the classroom was calm
7
and respectful
8
attractive.
9
students a chance for questions and comments. His/


OTOLARYNGOLOGY | Examinations. | Types of questions:

her answers were complete.

The reading sources are new and compatible with
10
the subject.
Total score

Examinations.
Types of questions:
1 - short essay.
2 - long essay.
3 - multiple choice questions.
4 - Single choice questions

Time of exam.
3 Three hours.
The number of questions and marks are variables :
The methods of correction of answers depend on key answers of single choice and key for multiple
choice questions & its usually that false answer will council the true answer in MCQ (either one for
one or two for one) and correction and marks are given accordingly.

Read the question twice before answering.
Think of the answer before writing.
Plan your answer in a separate page before writing it down on the answer paper.
Arrange the answer in the form of introduction, contents and the final part so that the student

Samples of MCQ, Single choice, long and short essays
Single choice question
middle turbinate is formed by:
(….) A. vomer bone
(….) B. Ethmoid bone
(….) C. Maxilla bone
(….) D. All of the above
(….) E. none of the above
the correct answer is (B)
MULTIPLE CHOICE QUESTIONS
Regarding carcinoma of the larynx:
SCC is the most common pathology
Smoking has no any role in incidence
Neck mass (lymph node invasion) is more incident with glottis carcinoma
Surgery always curative
The answers as fallow a. T, b. F, c. F, d. F
SHORT ASSAY ON TREATMENT OF ALLERGIC RHIINITIS


OTOLARYNGOLOGY | Examinations. | Samples of MCQ, Single choice, long and short essay

ANSWER
Treatment: includes allergen avoidance, pharmacotherapy, immunotherapy & surgery which is
rarely needed when there is local pathology affecting the regress of the symptoms like septal
deviation, turbinate hypertrophy, nasal polyp.
Medication include :
Antihistamines : these rapidly relieve running, itching, & sneezing, but have little effect on
blockage. 1st generation antihistamines (chlorphenramine & diphenhydramine) should be avoided
because of sedation effect, its better to use non - sedative 2nd generation like (loratidine,
fexofenadine).
Topical corticosteroids: these are most effective for treatment of rhinitis especially if started prior
to allergen exposure, it reduces inflammation, nasal, eye symptoms & improve sense of smell e.g
(mometasone, beclomethasone, fluticasone).
Sodium cromoglicate: its weak effective against all rhinitis symptoms but useful for children aged
less than 4 years.
Decongestant : topically used for reducing nasal obstruction, but increase rhinorroea. Systemic
decongestant not effective with systemic side effects.
Ipratropium bromide : this atropine –like nasal spray is useful against rhinorrhoea.
Systemic corticosteroids : oral steroids used for very sever symptoms during hay fever season.
Antileukotrienes : effective against congestion & mucous
Production.
8. Nasal douching : Its effective in seasonal rhinitis.
9. Immunotherapy : Indicated in patients with sever
symptoms not get response to routine medical
treatments.
write long assay on an intrinsic rhinitis
Answer : Is a non - infective, non allergic condition. Like many diseases whose etiology is obscure,
its also termed as perennial rhinitis or vasomotor rhinitis which is still perhaps the commonest
term.
The term (non allergic rhinitis) is commonly applied to a diagnosis of any nasal condition in which
the symptoms are identical to those seen in allergic rhinitis but an allergic etiology has been
excluded.These non allergic entities can be broadly be classified as :
Idiopathic rhinitis (vasomotor rhinitis, or non allergic non infectious perennial rhinitis)
Non allergic occupational rhinitis
Hormonal rhinitis
Drug - induced rhinitis
Other forms (non allergic rhinitis with esinophilia syndrome, rhinitis due to physical & chemical
factors, food - induced rhinitis, emotional rhinitis, atrophic rhinitis).
unlike allergic rhinitis there are no specific diagnostic tests for non allergic rhinitis & diagnosis is
made on the basis of rhinitis symptoms in the absence of identifiable allergy (by allergy skin test),
structural abnormality, immune deficiency, sinus disease or other causes.
Clinical presentation : there are 6 main symptoms of rhinitis, these are nasal congestion, sneezing,
nasal itching, rhinorrhoea, hyposmia & postnasal discharge, of these nasal symptoms significant
sneezing & itching are highly suggestive of allergic rhinitis & tend not to occur with intrinsic rhinitis,
very marked nasal congestion & significant hyposmia tend to be symptoms of non allergic rhinitis.
Rhinitis presenting in childhood is almost invariably of allergic etiology, whereas adult onset rhinitis
is more likely to be due to intrinsic rhinitis.


OTOLARYNGOLOGY | Examinations. | External examiner

Allergic rhinitis is always associated with nasal eosinophilia (more than 25% of nasal smear cells are
eosinophils), whereas non allergic rhinitis (intrinsic rhinitis) may or may not associated with
eosinophilia, approximately 1/3 of intrinsic rhinitis patients have nasal secretion eosinophilia, so
clinically IR classified into Eosinophilic (obstruction syndrome) & Non - eosinophilic (rhinorrhoea
syndrome) groups.
The eosinophilic variety of (IR) was characterized by marked nasal congestion, profuse rhinorrhoea,
hyposmia, marked inferior turbinate hypertrophy which is mild in the other group& mucoid nasal
secretion, also nasal polyposis is more frequent in eosinophilic groups.
Rhinorrhoea is profuse in both groups but more in non - eosinophilic group which is a predominant
feature. The rhinorhoea group tend to occur in relatively advanced age whereas the nasal
obstruction group tend to occur in middle age.
Other clinical differences between the 2 groups are marked mucosal thickening frequently occurs in
the eosinophlic group which is evident on plain radiological examination of the sinuses, also noted
that patient with eosinophilic (IR) frequently have asthma & occasionally aspirin sensitivety, neither
of which occurs in the non - eosinophilic (IR) group. One of the most clinically obvious differences is
dramatic response of the eosinophilic group to intranasal steroids & poor response of the other
group to any therapy apart from anticholinergic agents.
----------------------------------------------------------------------------
---------------------------------------------------------------

External examiner
From now on every course should have its own external examiner with identified roles.
The one who can play the role of an external examiner should:
Have an academic post with the scientific rank of assistant Professor and higher.
He/she should be an active, reputable and experienced academic staff in his field or a related field
to the course.
He/she should have not participated in lecturing or administering of the course.
The roles of the external examiner are:
Evaluating the contents and the program of the course.
Prior to the exam, he /she should contribute to choosing the questions and looking at the ideal
answers.
Evaluating the process of the examinations: he/she should see all the marked exam papers, then
choose randomly nine marked papers: three with high marks, three with medium and three with
low marks.
Evaluating the students' feedbacks
He/she should participate in the final meeting of the first round examinations committee and give
his assessment on the entire course and the examination process, then to give his opinion about
the final results.
He/she should participate in the final meeting of the second round examinations committee and
should have a main vote on those problems that may face them.
Then the lecturer/ tutor in charge will respond to the external examiner's questions and will reply
officially to all the questions and clarify the reasons.


DERMATOLOGY | Contents | External examiner

DERMATOLOGY
Contents
Course overview:
Course objectives:
Course Reading list.
Course Contents:
Syllabus:
Exams: Rules and instructions. 100%
Samples of expected questions and their answers.
External examiners.
Student's feedback.

1 - Course coordinator and list of teachers on this course
1 - Name of the Course: Dermatology
2 - Lecturer tutor in charge:
- Dr. Faraedon Kaftan: The coordinator.
- Dr. Muhamad Yousif.
- Dr. Ali Al - Ethawi.
- Dr. Darseem Abdulla.
- Dr. Kazhan A. Kadir
3 - Department Branch and the college: Medicine, Dermatology, College of Medicine, University of
Sulaimani
4 - Contacts:
- Address: College of Medicine, University of Sulaimani.
- E - mail:
* Dr. Faraedon Kaftan: The coordinator faraedonkaftan@yahoo.com
U

* Dr. Muhamad Yousif. mohammadjaaf35@yahoo.com
U U

* Dr. Ali Al - Ethawi. elethawi67@yahoo.com
U U

* Dr. Darseem Abdulla. darseem75@yahoo.com
U U

* Dr. Kazhan A. Kadir. kazhankadir@hotmail.com,
U

- Website Link: …..
- Other participant Lecturers: No other Lecturers.

2 - Course Overview
- Unlike the small number in previous years now there are five
instructors who are teaching the students the common subjects in
dermatology to enable students to diagnose and treat skin


DERMATOLOGY | 3 - Course objectives | External examiner

diseases through theoretical and clinical teaching by showing
them data show and patients.

3 - Course objectives
First: To teach the students the ABC of the special language of the
dermatology.
Second: To make the students familiar with the common skin
diseases and be able to diagnose and treat them.

4 - Course Reading list
Instructors’ data show and handout.
Short notes in dermatology.
There is no internet access to the instructors’ lectures.

5 - Syllabus
No. Title of the Subject Lecturer's/Tutor's Name
1 - Anatomy, Organization, Histology, Functions Dr Faraedon Kaftan
of human Skin and Diagnosis.

2 - Keratinization Disorders. Dr Faraedon Kaftan

3 - Psoriasis and PR (Pityriasids Rosea). Dr Faraedon Kaftan
4 - Bullous Diseases Dr Faraedon Kaftan
5 - Autoimmune diseases and CT Diseases. Dr Faraedon Kaftan
6 - Dermatitis (Eczema) including Atopy. Dr Muhammad Yousif
7 - Viral Infections. Dr Muhammad Yousif
8 - Disorders of Skin Color. Dr Muhammad Yousif
9 - Myclogy Dr Muhammad Yousif
10 - Bacterial Infections. Dr Muhammad Yousif
11 - Disorders of the Nail. Dr Ali Al - Ethawyi
12 - Disorders of the Hair. Dr Ali Al - Ethawyi
13 - Drugs' Reactions. Dr Ali Al - Ethawyi
14 - Lichen Planus and Lichenoids. Dr Ali Al - Ethawyi
15 - Genetics and Genodermatosis. Dr Ali Al - Ethawyi
16 - Skin tumours and Nevi. Dr Dersim Muhammad Abdulla
17 - Pruritus. Dr Dersim Muhammad Abdulla
18 - Metabolic and Nutritional Disorders. Dr Dersim Muhammad Abdulla
19 - Erythema, Purpura, Urticaria, Mastocytosis, Dr Dersim Muhammad Abdulla
EM, SJS and TEN.
20 - Disorders of Sebaceous and Sweat Glands. Dr Dersim Muhammad Abdulla
21 - Systemic Diseases and the Skin Dr Kazhan Ali Tofiq
22 - Systemic Diseases and the Skin Dr Kazhan Ali Tofiq
23 - Topical and Systemic Therapies Dr Kazhan Ali Tofiq
and General Aspects of treatment


DERMATOLOGY | 6 - The Scientific contents: | Example for Compositional questions

24 - Physical and Laser Therapies. Dr Kazhan Ali Tofiq
25 - General Principles in Dr Kazhan Ali Tofiq
Histopathology of the Skin.
26 Occupational Dermatosis and Mechanical & Dr Kazhan Ali Tofiq
Thermal injuries.
27 - Clinical dermatology. Dr Dersim Muhammad Abdulla
28 - Clinical dermatology. Dr Ali Al - Ethawyi
29 - Clinical dermatology. Dr Muhammad Yousif
30 - Clinical dermatology. Dr Faraedon Kaftan

6 - The Scientific contents:
Important messages of the subject are delivered to the student by describing the basic contents
that the student should know in order to pass the exams.
Main references of the subject:
Now the students have no other reading sources.

7 - Exams
Advises are given to the students in order to pass the exams successfully. For example:
To read the questions twice
Think carefully before answering
Plan the answer on a separate paper
* Total 100% score distributed as below:
- Two theoretical exams: Mid - year (20°) and (60°) final.
- One clinical exam (20°) at the end of 3 weeks (45 hours) clinical course after seeing patients daily.

8 - Samples of the expected questions and their answers
Compositional questions: Previously they were included but nowadays questions are only MCQs.

Example for Compositional questions
Q1. Enumerate the clinical types of Psoriasis and talk about clinical pictures, diagnosis and
treatment of one of them.
Q2. Classify Icthyosis and write the clinical pictures, diagnosis and treatment of its most common
type.

MCQs:
* Indicate (T) in front of the True statement and (F) in front of the False statement.
* A wrong answer cancels a right one in the same question.
1. Based on the thickness of the epidermis, skin can be classified as thick or thin:
F A. Thin skin covers palms and soles.
T B. Thick skin has sweat glands.
T C. Thick skin lacks hair follicles.
T D. Thin skin has arrector pili muscles.
F E. Thin skin lacks sebaceous glands.
2. The skin melanocytes:


DERMATOLOGY | 8 - Samples of the expected questions and their answers | MCQs:

F A. Are associated with langerhans cells forming epidermal melanin unit.
F B. Are not dendritic.
F C. Have desmosomes.
F D. Are mostly suprabasal.
F E. Originated from bone marrow and contain melanosomes synthesize melanin.
3. The skin langerhans cells:
F A. Originated from neural crest.
F B. Do not contain tennis racket granules.
F C. Are 80 cells/mm2.
F D. Are not dendritic.
F E. Are basal.
4. Regarding skin Wheal:
F A. The borders of a wheal are sharp, stable and can not move from involved to adjacent
uninvolved areas over hours.
F B. The epidermis is affected.
T C. Are pale red or white especially in the center.
F D. Wheals are not a common allergic reaction.
T E. A wheal may be large coalescing plaques as in the allergic reaction.
5. The skin Papule:
T A. Is small solid elevation of skin< 5 mm in diameter.
T B. Projects above the plane of the surrounding skin.
T C. Flat - topped in lichen planus.
T D. Dome shaped in xanthomas.
T E. Spicular if related to hair follicles.
9 - External Examiner
By now there are no external examiners.
Student's Feedback on the Course
Date: Course: Year: 2009 - 2010
Lecturer/ Dr. Kazhan Ali Tofiq
Evaluation Questions Subject's Subjective Remarks
Level
1-5
1 The objectives and key messages of the 5
subject were clear

2 The contents of the subject were useful 5
and were related to the main objectives
of the course
3 The coordinator teacher had worked hard 5
to prepare the materials

4 The coordinator teacher had worked hard 5
to cooperate and prepare the course

5 The lecturers were carefully selected and 5
were expert in their fields


DERMATOLOGY | 8 - Samples of the expected questions and their answers | MCQs:

6 The coordinator teacher gave a good 5
attention to the students' criticisms and
claims
7 Information on the Examination process 5
was well provided

8 The questions of the exams were related 5
to the contents of the course.

9 Total of the levels 40/40

10 There is a potential to ...........
promote and develop
the course in the
following areas:

Course Book Standards to evaluate the level of the contents
Contents
1 2 3 4 5
on this course.
Very Bad Medium Good Very good
Course overview
bad
Course objectives.
Course Reading list.
Course Contents.
Syllabus.
Exams: Rules and instructions.
Samples of expected questions and their answers.
External examiners.
Student's feedback.


GYNECOLOGY | Course coordinator and list of teachers on this course | MCQs:

GYNECOLOGY
1 - Name of the Course: gynecology.
2 - lecturer/tutor in charge: Dr Hanaa alani
3 - Department Branch and the college: Department of Obstetrics and Gynecology/ College of
Medicin
4 - Contacts:
- Address: University of Sulaimani/ College of Medicine/ Department of Obstetrics and Gynecology.
- E - mail:HA_GRD @yahoo.com
- Website Link:
- Other participant Lecturers:
1 - Dr. Sallama Kamel Nasir.
2 - Dr. Sundus Yousif Kellow.
3 - Dr. Hanaa Abbas Al - ani.
4 - Dr. Mahabat Salih Saeed

Course Overview
The clinical and basic science of gynecology deals with female genital organs (external and internal).
This involves the normal development, physiology and functions of the female genital organs, as
well as abnormal development.
The course deals with all diseases (including infections and malignancies) of the female
reproductive organs.It also deals with infertility and contraception.

Course objectives
The fifth year students usually have about 30 theoretical lectures/ year in gynaecology (2 hours /
week), and they have three weeks/ year of clinical session (3hours/day, 5days/ week) in suliamani
maternity teaching hospital.
For theoretical lectures by the end of the year the students should have knowledge about:
- Normal and abnormal sexual development and puberty
- The normal menstrual cycle
- Disorders of the menstrual cycle
- Fertility control (contraception).
- infertility
- Disorders of early pregnancy (abortion, ectopic pregnancy and trophoblastic diseases).
- Infections of the female genital organs
- Benign and malignant tumours of the female genital organs
- Endometriosis and adenomyosis
- Urogynaecology
- Uterovaginal prolapse


GYNECOLOGY | Course Reading list | MCQs:

- Menopause.
Regarding the clinical sessions:
The 5th year students will have 3weeks /year of clinical sessions during which the student will learn
how to take history from a woman with gynecological problem and how to examine a woman as
well as they are going to see instruments, contraceptive methods and x rays used in gynecology.

Course Reading list
REFRENSES:
Gyaenecology by Ten Teachers 18th edition.
Further reading:
1 – Essentials of Obstetrics and Genecology 4th edition.
2 – Lecture notes obstetrics and gynaecology 2nd edition.
3 - Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith Edmonds
Syllabus
NO. TITLE OF THE SUBJECT LECTURER'S/TUTOR'S NAME
Developmental &congenital malformation of
1. Dr Hanaa Alani
female genital tract
2 Physiology and menstruation Dr Hanaa

3 Vaginal discharle Dr Hanaa

4 Adolescence & puberty Dr Hanaa

5 PID Dr Salama

6 Tuberculosis of the lenital tract Dr Hanaa

7 Infertility & IVF Dr Hanaa

8 Sexually transmitted diseases and AIDS Dr sundus

9 Family planning Dr mahabat

10 Abortions (miscarriages) Dr mahabat

11 Dysmenorrhea & premenstrual syndrome Dr sundus

12 Abnormal uterine bleeding Dr Salama

13 Early pregnancy problems and ectopic pregnancy Dr mahabat

14 Trophoblastic disease Dr mahabat

15 Endometriosis Dr Salama

16 Primary Amenorrhea Dr sundus
Secondary amenorrhea &polycystic ovarian
17 Dr Hanaa
syndrome
18 Intersexuality Dr Hanaa


GYNECOLOGY | Detail of Syllabus | Family Planning:

19 Genital prolapsed Dr Salama

20 Urine incontinence Dr mahabat

21 Tumours of the vulva (benign &malignant Dr Hanaa

22 Tumours of the vagina (benign &malignant Dr Hanaa

23 Benign tumours of the uterus Dr mahabat

24 Premalignant diseasesof the cervix Dr Hanaa

25 Malignant diseases of the cervix Dr Hanaa

26 Carcinoma of the endometrim Dr sundus

27 Menapouse &HRT Dr mahabat

28 Postmenapousal bleeding Dr sundus

29 Operative gynecology Dr mahabat

30 Chronic pelvic pain Dr sundus

31 Ovarian tumours (benign) Dr Salama

32 Malignant ovarian tumours Dr Salama

33 Pre &postoperative evaluation Dr Hanaa

Detail of Syllabus
Family Planning:
Lecturer/tutor’s name: Dr. mahabat Salih saeed

Learning Objectives:
1) to outline the types of contraception
2) to evaluate the methods of contraception, the advantage and disadvantage of each method.
3) to determine the complications of contraception.

Reference:
Gynaecology by ten teachers, 18th edition, Chapter 6, fertility control
- Obstetric and Gynaecology by Lawrence Impey, Printed in 1999
Chapter 12 Contraception, page 78.
- Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith Edmonds
7th edition 2007, Chapter 32, page 299

Early pregnancy problems:
Lecturer/tutor’s name: Dr. Mahabat Salih Saeed

1. Miscarriages
Learning objectives:
1) To familiarise the students with the cause of early pregnancy bleeding,


GYNECOLOGY | Detail of Syllabus | Benign tumours of the uterus

2) To learn about the risks of morbidity and mortality associated with miscarriages
3) To learn the methods of diagnosis
References:
- Gynaecology by ten teachers, 18th edition, Chapter 8, Disorders of early pregnancy.
7th edition 2007, Chapter 12 + 13, page 94, 100
Chapter 14, page 94

2) Ectopic Pregnancy
1) To learn about risks of Ectopic pregnancy
2) To understand the seriousness of the delayed management
3) To outline the methods of management
References:
- Gynaecology by ten teachers, 18th edition, Chapter 8, page 97
Chapter 14, page 97

3) Trophoblastic disease
1) To determine the types of trophoblastic disease, differentiate between benign and malignant
types.
2) To understand the types of management
References:
Gynaecology by ten teachers, 18th edition, Chapter 8, page 99
Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith Edmonds
Obstetric and Gynaecology by Lawrence Impey, Printed in 1999
Chapter 14, page 100

Benign tumours of the uterus
1) to understand the effect of this problem on pregnancy
2) To provide a framework for different ways of managing this problem. 3) To learn about the types
and locations of fibroids.

References:
Gynaecology by ten teachers, 18th edition, Chapter 9, page 103
Obstetric and Gynaecology by Lawrence Impey
Printed in 1999
Chapter 3, page 18


GYNECOLOGY | Detail of Syllabus | Menopause and HRT

Menopause and HRT
1) to know the definition of menopause and age of menopause
2) to recognise the psychological and physical signs of menopause
3) to raise awareness about the benefits and risks of HRT

References:
Gynaecology by ten teachers, by Ash Monga
18th edition
7th edition 2007
Printed in 1999
Chapter 13, page 86

Operative Gynaecology
1) to learn about the technique of laparoscopy and hysteroscopy
2) To understand the risks of laparoscopy and hysteroscopy.
3) To determine the indications for these procedures.

References:
Gynaecology by ten teachers, by Ash Monga
18th edition
Appendix 1, common gynaecological procedures, page 232

7th edition 2007
Hysteroscopy and laparoscopy, chapter 50, page 560
Printed in 1999

Normal and abnormal sexual development
• Genetic sex is determined by the presence of the sex chromosomes X and Y.
• The presence of a Y chromosome determines male development; the absence of a Y chromosome
leads to a female phenotype.
• In Turner's syndrome, the absence of a second X chromosome leads to streak ovaries.
• If the testis fails to develop or cannot function, the default state is female.
• True hermaphrodites have both ovarian and testicular tissue.The effect is determined by the
dominant cell line
Congenital absence of the uterus and vagina is the second
most common cause of primary amenorrhoea.
• Uterine maldevelopment does not usually result in reproductive failure.


GYNECOLOGY | Detail of Syllabus | Gynaecological disorders of childhood and adolescence

• External genitalia in girls may be virilized by excessive androgen exposure in utero.
• Puberty is genetically determined and controlled from the hypothalamus.

References
Gynaecology by Ten Teachers, 2006, 18th Edition, P21

Gynaecological disorders of childhood and adolescence
Gynaecological problems in the prepubertal child and at adolescence create great levels of anxiety
in parents
The end result of puberty is the establishment of the fully physically mature adult woman capable
of reproductive performance and fully psychologically developed as an adult.
Precocious puberty is defined as the onset of secondary sexual characteristics prior to the age of 8
years. The aetiology of this is varied.
Delayed pubertyis rare with only 1% of females not having had menarche by the age of 18. If there
are no secondary sexual characteristics by the age of 14 delay is diagnosed and investigation is
appropriae.

References
Gynaecology by Ten Teachers, 2006, 18th Edition,

Infertility
History, examination, investigations and counselling must include both partners
Treatment should be initiated taking into account the duration of infertility, the female partner's
age, previous conception history and success rates.
Men with abnormal sperm analysis should have endocrine assessment; those with low «5
million/mL) or no sperm must be offered chromosomal analyses.
Couples must be given written information regarding the risks of ovarian hyperstimulation
syndrome, multiple gestation and ovarian tumours.
FSH and human menopausal gonadotrophin should be used in low dose in clomiphene - resistant
women ; clomiphene is an effective treatment in anovulatory women.
• All ovulation induction cycles should be monitored

References
Gynaecology by Ten Teachers, 2006, 18th Edition, P30
Dewhurst’s textbook of obstetrics and gynaecology. / edited by D. Keith Edmonds. –7thed. 2007

Genital tuberculosis
Genitourinary TB is almost always secondary to infection elsewhere in the body, usually pulmonary
TB, but active pulmonary disease can be documented in only one third of patients
Vascular dissemination is responsible for infection of fallopian tubes in almost all patient with
genitalTB, & involvement of endometrium follows in 90%
Most patients are cured by medical management alone, patients who respond poorly or who have
other problems (e.g tumer or fistula) may require total hysterectomy & BSO after a trial of
chemotherapy.

References
Current obstetric &gynecologic diagnosis &treatment, fiftht edition, p421 - 422, 2003


GYNECOLOGY | Detail of Syllabus | Premalignant conditions of the cervix.

Premalignant conditions of the cervix.
Dysplasia The process of metaplasia can be disrupted by external influences& can lead to
disordered squamous epithelium called dysplastic epithelium (HPV, smoking, immune suppression
may act as coagent
Observation and repeat Pap smears and biopsies can confirm such spontaneous self - correction.
Currently, there is no treatment per se for CIN I, which either resolves or progresses to CIN II, which
is treated.
If CIN does not resolve but instead progresses, or is detected at CIN stage II or III, treatment is
needed to prevent the development of invasive disease.
CIN lesions may be treated on an outpatient or inpatient basis.

References
Gynaecology by Ten Teachers, 2006, 18th Edition

Cervical cancer
The cervix is made up of two kinds of cells: columnar cells and squamous cells. Columnar cells
constantly change into squamous cells in an area of the cervix called the transformation zone. As a
result of this natural process of change, some cervical cells can become abnormal. Infection can
also cause abnormal cervical cell changes. When abnormal cell changes persist over time (years)
and become severe, these cells may develop into cervical cancer
Surgery is generally only employed in early stage cervical cancers.
Higher stage disease is usually treated with radiation and chemotherapy, but sometimes surgery is
employed if cervical cancer comes back after it has already been treate

References
Current obstetric &gynecologic diagnosis &treatment, fiftht edition, p903, 2003

Hyperandrogenism, hirsutism and polycystic ovary s
The most common clinical presentation of hyperandrogenism in reproductive - aged women is
hirsutism or acne with or without evidence of anovulation such as oligoamenorrhea - or
amenorrhea or dysfunctional uterine bleeding.
PCOS is the most common cause of hirsutism and the most common endocrinopathy in
reproductive aged women.
The etiology of anovulation in PCOS is often explained by high intraovarian androgen levels which
induce atresia and prevent the emergence of a dominant follicle
There are many therapies for the induction of ovulation in PCOS patients.
The aim of medical therapy in hirsutism is to suppress androgen production, block androgen
receptors or decrease the conversion of testosterone to dihydrotestosterone by inhibition of the
enzyme 5a - reductase

References
Current obstetric &gynecologic diagnosis &treatment, fiftht edition, p1001, 2003


GYNECOLOGY | Detail of Syllabus | Secondary amenorrhea

Secondary amenorrhea
the cessation of menstrual flow for a period of 6 months or more in the absence of pregnancy,
breastfeeding or menopause.
The problem may lie in the hypothalamus and the pituitary, or the uterus or the ovary.
Other endocrine glands like the thyroid, the pancreas and the adrenal cortex also have a role to
play in causing amenorrhoea.

References
Gynaecology by Ten Teachers, 2006, 18th Edition

Vaginal discharge
In children, vaginitis usually involves infection with GI tract flora (nonspecific vulvovaginitis).
Women of reproductive age: In these women, vaginitis is usually infectious. The most common
types are bacterial vaginosis, candidal vaginitis and trichomonal vaginitis which is sexually
transmitted.
Postmenopausal women: Usually, a marked decrease in estrogen causes vaginal thinning,
increasing vulnerability to infection and inflammation.
Normal vaginal discharge is white, becoming yellowish on contact with air, due to oxidation.

References
Dewhurst’s textbook of obstetrics and gynaecology. / edited by D. Keith Edmonds. –7thed, 2007
Obstetrics and gynaecology an evidence - based text for MRCOG

Diseases of the vulva and vagina
•Be familiar with common inflammatory conditions affecting the vulva and vagina. Know which are
infectious and which are frequently transmitted sexually.
• Understand the relationship between HPV, VIN, VAIN, and squamous cell carcinoma.
• Be familiar with “Bowen’s disease” and “extramammary Paget’s disease.”
• Understand the relationship between DES, vaginal adenosis and clear cell carcinoma of the
vagina.
• Know which mesenchymal tumors (benign and malignant) can involve the vagina.

References
Dewhurst’s textbook of obstetrics and gynaecology. / edited by D. Keith Edmonds. –7thed, 2007
Obstetrics and gynaecology an evidence - based text for MRCOG

Subject name: pelvic inflammatory disease.
This subject is given in two hours.

Objectives:
This lecture is included in the program so that the student can understand the following
1. The natural defense mechanisms against genital infection.
2. The conditions that predispose to genital infection.
3. What is pelvic inflammatory disease?
4. causes of PID.


GYNECOLOGY | Detail of Syllabus | Endometriosis:

5. Pathological changes of PID.
6. Clinical presentation and diagnosis of PID.
7. Complications of PID.
8. Treatment of PID.

References
Gynecology by ten teachers 18th edition.
Current for obstetrics and gynecology.
Dweharts for obstetrics and cynecology 7th edition

Endometriosis:
This lecture is included so that the student will understand the following:
1. The definition of endometriosis.
2. The theories that explain the development of endometriosis.
3. The pathological features of endometriosis.
4. Clinical features and diagnosis of endometriosis.
5. The relationship between endometriosis and infertility and endometriosis.
6. Treatment of endometriosis.

References:
Dwehurts obstetrics and gynecology 7th edition.

Ovarian tumours:
This subject is given in two hours.

Objectives:
This subject is included so that the student should understand:
1. The classification and different pathological types of ovarian tumours.
2. What is functional ovarian cysts and how to differentiate between functional ovarian cysts and
true ovarian tumours?
3. How to differentiate between benign and malignant ovarian tumor.
4. How to diagnose ovarian tumours.
5. Risk factors of malignant disease of the ovary.
6. Staging of malignant ovarian tumours.
7. Management of ovarian tumours.
8. Prognosis and 5years survival.

References:

Genital prolapse:
Objectives:
1. Defenition of genital prolapse.
2. Classification of genital prolapse.
3. Structures that support the genital organs and prevent prolapse.
4. Factors that predispose to genital prolapse.
5. Clinical presentation of genital prolapse.
6. Treatment of genital prolapse.


GYNECOLOGY | Detail of Syllabus | Dysmenorrhoea

Reference:
Dwehurts obstetrics and gynecology 7th edition.

Dysmenorrhoea
Objectives:
At the completion of this presentation, the participant should know:
1 – Definition and classification of dysmenorrhoea.
2 – Etiology, diagnosis and management of primary dysmenorrhoea.
3 – Etiology, diagnosis and management of secondary dysmenorrhae
4 – Definition and the various hypothesis behind the etiology of premenstrual syndrome.
5 – Diagnosis and management of premenstrual syndrome.

References:
1 –Gynaecology by ten teacher 17th edition.
2 –Current 2003 obstetric and gynaecologic diagnosis and treatment 9th edition.

Sexually transmitted infections (2 hours)
Objectives:
1 – Principles of management of sexually transmitted infections (STDs).
2 – Why STDs are a significant problem, classification of STDs.
3 – Chlamydia trachomatis; prevalence, signs and symptoms, diagnosis and treatment.
4 – Gonorrhea; incidence and epidemiology, diagnosis and treatment.
5 – Classification of genital ulcer diseases.
6 – Herpes simplex virus; epidemiology, primary and recurrent herpes infection, diagnosis,
treatment and complications.
7 – Syphilis; epidemiology, clinical features, diagnosis and treatment.
8 – Tropical Genital Ulcer Disease; Lymphogranuloma venereum (LGV) and Chancroid. Their clinical
features and treatment.
9 – Human papilloma virus; epidemiology, diagnosis and treatment.
19 - HIV infection; virology, diagnosis, transmission, natural history and principles of treatment,
gynecological manifestations of HIV, Vertical transmission of HIV and how to minimize it.

References:

Primary amenorrhoea
Objectives:
1 – Definition of primary amenorrhoea.
2 – Causes of primary amenorrhoea.
3 – Description of the various causes of primary amenorrhoea.
4 – General investigations of primary amenorrhoea.
5 – Management of the various causes of primary amenorrhoea.


GYNECOLOGY | Detail of Syllabus | Disorders of the menstrual cycle/ abnormal vaginal

References:

Disorders of the menstrual cycle/ abnormal vaginal bleeding
Objectives:
1 – Classification of menstrual disorders.
2 – Definition of the various terms used in abnormal uterine bleeding.
3 – Causes of abnormal uterine bleeding.
4 – MENORRHAGIA; definition, prevalence, classification and etiology.
5 – Diagnosis; clinical features, Initial investigations, Investigations in women who fail to respond to
treatment after 3 months.
6 –Treatment; various medical options and surgical treatment (different types and indications).

References:
2 – Essential of obstetrics and gynecology 4th edition.

Post menopausal bleeding (PMB)
Objectives:
1 – Definition of PMB.
2 – Causes of PMB; gynecologic causes and non gynecologic causes.
3 – Management of PMB including diagnosis, investigations and treatment options.

References:

Operative gyneacology/ laparoscopy
Objectives:
1 – What is pelvic endoscopy.
2 – What is laparoscopy; indications and contraindications of the procedure.
3 – Equipment for laparoscopy.
4 – Technique of laparoscopy.
5 – Complications of the procedure.

References:
1 – Dewhursts textbook of obstetrics and gynaecology 7th edition.

Premalignant and malignant disorders of the uterine corpus
Objectives:


GYNECOLOGY | Student's feedback on the subject |

1 – Epidemiology and incidence.
2 – Etiology and risks factors for endometrial hyperplasia and cancer.
3 – Classification; endometrial hyperplasia and malignant endometrial cancer.
4 – Pathology, spread, and FIGO staging of endometrial cancer.
5 – Clinical presentation and diagnosis.
6 – Differential diagnosis and prognosis.
7 – Treatment of the different stages of endometrial cancer.

References:
:

Student's feedback on the subject
Date: Course: Year: Lecturer/ tutor:
NO. EVALUATION QUESTIONS SUBJECT'S LEVEL /1 - 5 SUBJECTIVE REMARKS
1
were clear
2
The materials were prepared carefully as
3
needed
The lecturer/ tutor while lecturing tried to
analyze the principles, contents and the
4
important points of the subject simply and
properly.
5
attention.
lecture.
The lecturer's behavior in the classroom was
7
calm and respectful.
8
attractive.
9 students a chance for questions and
comments. His/ her answers were complete.
The reading sources are new and compatible
10
with the subject.
Total of the levels

STANDARDS TO EVALUATE THE LEVEL OF THE
CONTENTS
1 2 3 4 5

Very bad Bad Medium Good Very good


GYNECOLOGY | Exams | Long essay question:

Exams
The fifth year students will have one clinical exams and one written final exam.
The clinical exams is at the end of the course & it includes all the gynecological cases that have
been discussed in an outpatient clinic in maternity hospital, the student is asked about history,
examination, investigation& how to manage these cases including medical & surgical management.
For the written exam, it is only one exam at the end of the year lasts for 3 hours and includes the
following types of questions:

Types of questions:
1. An essays questions (there will be long and short essays
For long essays the student will asked the following:
Discuss, write in details about, how you manage, mention the causes, presentation and
management, ect.
For such type of question the student should write in details about the subject.
For short essays, the student will be asked to enumerate, write briefly, and Mention the causes,
ect.
For such question the student should answer briefly according to the question.
We advice the students to do the following in order to have proper answer:
- To read the questions twice.
- Think carefully before answering.
- Plan the answer on a separate paper.
- The answer should contain preface, main contents and conclusion.
2. Multiple choice questions:
For such questions, there will be a statement and below it four different answers.
For each answer the student should write true or false.
3. Single choice questions:
For such question there will be a statement, and below it four different answers, the student should
select one answer only which is the right answer.

Samples of the expected questions and their answers
Long essay question:
A 32 - year - old lady with 8 weeks amenorrhea came to outpatient clinic with mild vaginal bleeding
and she feels no more pregnant and ultrasound result showed no fetal heart. What is your
management plan:
To answer such question, the student should analyze its component:
Woman with 8weeks amenorrhea and she feel no more pregnant, this means that she is pregnant
8weeks.
Clinically she feels disappearance of symptoms of pregnancy and her ultrasound showed no fetal
heart sound so the pregnancy is not viable, so the diagnosis is missed abortion.
3.Treatment of such woman will be treatment of missed abortion at 1st trimester and the student
should write about treatment in details.

Short essays questions:
1. What are the complications of fibroid on pregnancy?
2. Enumerate the types of urinary incontinence.


GYNECOLOGY | Samples of the expected questions and their answers | Multiple choice

To answer such questions is only by mentioning the complications and enumerating the types.

Multiple choice questions
In the presence of a positive pregnancy test and vaginal bleeding, the following are possible
differential diagnoses if the CERVIX is closed:
(T) a – Ectopic pregnancy.
(F) b – Incomplete miscarriage.
(T) c – Threatened miscarriage.
(F) d – Inevitable miscarriage.
(T) e – Complete miscarriage.
– Regarding the pathophysiology of pelvic organ prolapsed:
(F) a – Pelvic organ prolapse is commoner in nulliparous than in multiparous women.
(F) b – Pelvic organ prolapsed is never seen in nulliparous women.
(T) c –Prolapse is commoner after the menopause partly due to oestrogen deficiency
(F) d – Epidural in labour is a risk factor for subsequent development of prolapse.
(T) e – Forceps delivery is a risk factor for the development of prolapse.
The main tissues which provide support to the uterus include:
(T) a - uterosacral ligaments
(F) b - perineal body
(F) c - round ligament
(T) d - cardinal ligaments
(F) e - broad ligaments

Single choice questions:
Select the ONE lettered answer or completion that is BEST in each statement below.
1–The most common symptom of endometrial hyperplasia is:
a –Vaginal discharge.
T (b) –Vaginal bleeding.
c –Amenorrhoea.
d –Pelvic pain.
e –Abdominal distensions.
2 –Hirsutisim is associated with all the following EXCEPT:
a – Polycystic ovary syndrome.
b – Congenital adrenal hyperplasia.
c – Cushing syndrome.
d – Increased androgen utilization by skin.
(T) e – Hyperprolactinemia.

For each description below, choose the SINGLE most appropriate answer from the above
list of options. Each option may be used once, more than once, or not at all.
1 –Gynaecological investigation:
a –colostomy.
b –laparoscopy.
c –hysteroscopy.
d –hysterosalpingography.
e –ultrasound.
F –more than one of the above.


GYNECOLOGY | External Examiner | Single choice questions:

G – None of the above.
D 1 - A procedure that assesses both the uterine cavity and tubal lumen.
B 2 - A procedure that visualizes pelvic endometriosis.
C 3 - A procedure that visualizes the endometrial cavity.
F 4 - A procedure that assesses the tubal patency.

External Examiner
From now on every course should have its own external examiner with identified roles.
The one who can play the role of an external examiner should:
Have an academic post with the scientific rank of assistant Professor and higher.
He/she should be an active, reputable and experienced academic staff in his field or a related field
to the course.
He/she should have not participated in lecturing or administering of the course.
The roles of the external examiner are:
Evaluating the contents and the program of the course.
Prior to the exam, he/she should contribute to choosing the questions and looking at the ideal
answers.
Evaluating the process of the examinations: he/she should see all the marked exam papers, then
choose randomly nine marked papers: three with high marks, three with medium and three with
low marks.
Evaluating the students' feedbacks
He/she should participate in the final meeting of the first round examinations committee and give
his assessment on the entire course and the examination process, then to give his opinion about
the final results.
He/she should participate in the final meeting of the second round examinations committee and
should have a main vote on those problems that may face them.
Then the lecturer/ tutor in charge will respond to the external examiner's questions and will reply
officially to all the questions and clarify the reasons.


MEDICINE | Course coordinator and list of teachers | Single choice questions:

MEDICINE
University of Sulaimani
College of Medicine
Department of Medicine
Course Book
Of
5th Year students

Course book
1 - Name of the Course: Medicine for fifth year students
2 - Lecturer tutor in charge: Dr. Saber Mohamed Amin
3 - Department Branch and the college: Medicine
4 - Contacts:
- Address: College of Medicine / Univ. of Sulaimani
- E - mail: sm_ameen4@yahoo.com
- Website Link:
1. www.emedicine.com
2. Google Search.
3. www.pubmed.com
Other participant Lecturer
1 - Dr. Rasool Mohamed Hasan
2 - Dr. Taha Mahwy
3 - Dr. Mohamed Shaikhani
4 - Dr. Abdulla Sharief
5. Dr. Mohamed Tahir
6. Dr. Kawa Husain
7. Dr. Raoof Merza
8. Dr. Hasan Jumaili
9. Dr. Nazar M. Amin
10. Dr. Saman Anwar Faraj
11. Dr. Rebwar Ghareeb Hama

Course Overview
Fifth year curriculum of Medicine include lectures in hematology, endocrinology, neurology,
nephrology, toxicology and psychiatry.


MEDICINE | Course objectives | Composition (Essay) ;

Lectures are given in the studying halls of the College of Medicine five hours per week in the form
of power - point format displayed on a white board by aid of data show device, and copied by
students at end of each session.
Information given includes basic knowledge of diseases in each subject in addition to recent
advances which are usually taken from internet and latest versions of medical books.
The overall course is designed to supply future junior doctor with basic medical knowledge to be
able to deal with common every day practice diseases and important emergencies and to take life -
saving measures at appropriate and critical moments.

Course objectives
First: to understand diseases epidemiology and causes.
Second: to be able to diagnose diseases and make differential diagnosis
Third: to know how to investigate and treat diseases
Fourth: to know how and when to refer to tertiary care
Fifth: to know how to pass the exams.

Course Reading List
Davidson’s principles and practice of medicine
Cecil’s essentials of medicine
Kumar and Clark’s clinical medicine
Hutchison’s methods of clinical examination
Macleod’s clinical examination
Psychiatry references mentioned in psychiatry paper

Exams
Types of the exam usually include both composition and multiple choices or single choice.
Exam’s duration: usually 3 hours.
Number of questions about 10 compositions and between 30 to 40 MCQs or single choice
questions.
Marks: each composition is given 10 marks and each MCQ 2 marks.
Advice: to think carefully before answering and lecturer in charge usually attend to explain the best
way to answer the question
.
Samples of the expected questions and their answers
Two samples of compositional questions, five samples of multiple choices and some useful hints
will be provided to the students which help them in planning their answers.
Sample questions

Composition (Essay) ;
How would you investigate a patient who has pallor, faint jaundice and splenomegaly?
Answer:
The patient most likely has a hemolytic anemia, therefore first we have to prove this we should
send blood samples for Hb level, reticulocyte count, serum bilirubin: with both direct and indirect
(in which the latter will be high), serum LDH (high), and haptoglobin (low). By now we prove
hemolytic process, we do Coomb’s test if positive (autoimmune hemolytic anemia) and if negative
(non - immune). If non - immune: we see bloob film morphology:


MEDICINE | Exams | MCQs

Sickle cells indicate sickle cell anemia, shistocytes may indicate microangiopathic hemolytic anemia.
Special tests may be done like: osmotic fragility test (for hereditary spherocytosis), sickling test
(sickle cell disease), Ham’s test (PNH), etc.
Write short notes on the symptoms and signs and medical treatment of subarachnoid hemorrhage.
Answer:
Symptoms: sudden, devastating typically occipital headache. Vomiting, collapse (± seizures), and
coma often follow. Coma/ drowsiness may last for days.
Signs: neck stiffness; Kernig’s sign takes 6 hr to develop; retinal and subhyaloid hemorrhage. Focal
neurological deficits (e.g: pupil changes indicating a IIIrd nerve palsy with a posterior
communicating artery aneurysm).
Medical treatment: cautious control of severe hypertension; analgesia for headache; bed rest±
sedation for~4wk. Keep hydrated. Nimodipine 60 mg/4hr PO for 3 wk is calcium antagonist that
improves outcome (Vasodilator).

MCQs
Recognized features of multiple sclerosis include:
Double vision (T)
Telangiectasia of face (F)
Difficulty in micturition (T)
Difficulty in swallowing (T)
Sore throat (F)
Factors predisposing to acute renal failure include:
Severe hypoperfusion of kidneys during surgery (T)
Endotxic shock (T)
Obstructive jaundice (F)
Hemolytic transfusion reaction (T)
Long - standing renal disease (T)
Hallucinations are characteristic of the following conditions:
Obsessive compulsive disorder (F)
Alcohol withdrawal (T)
Schizophrenia (T)
Sleep deprivation (F)
Depression (F)
The following complications can occur in rheumatoid arthritis:
Acanthosis nigricans (F)
Episcleritis (T)
Malabsorption (F)
Carpal tunnel syndrome (T)
Amyloidosis (T)
Normocytic normochromic anemia is known to occur in:
Uremia (T)
Folate deficiency (F)
Secondaries in bone marrow (T)
Hereditary elliptocytosis (F)
Splenectomy (F)


OPHTHALMOLOGY | Course Information: | MCQs

OPHTHALMOLOGY
University of Sulaimani
College of Medicine
Ophthalmology Unit
(Ophthalmology Course Book)
Ophthalmology Syllabus for Fifth Year Med Students (2010 - 2011)

Course Information:

Course Title: Ophthalmology
Credit Hours : 72hours. (27hours theoretical lectures&45hours practical
cessions)

Theoretical: 1 Lecture per week 1 - 2p.m (Monday) (27
Practical: lectures)
9a.m - 12.00p.m for 3 weeks
Location
Theoretical: college halls (3)
Practical: Shahid Dr.Aso Teaching Eye Hospital
Head of Unit: Dr. Tara Mahmood Hassan
Coordinator: Dr. Ali Kamal
Unit Location: Department of Surgery
Email Address of unit :anwar772000@yahoo.com
Tel..+96407702171917.
Course coordinator link: alikamal22@yahoo.com
Tel. +9647705449905

Dr. Khaled Saeed Abd Almajeed
Dr. Ali Abdullah Taqi
Dr. Bakhtiar Qadir Hamasalleh
Dr. Tara Mahmood Hassan


OPHTHALMOLOGY | Course Description | MCQs

Course Description
The class of Ophthalmology includes series of theoretical lectures in the following titles
1.Anatomy & Embryology of the eye
2. physiology and function of the eye
3. Orbit
4. Eye lids diseases
5. Lacrimal apparatus
6. Conjunctiva
7. Cornea
8. Sclera
9. Lens and its diseases (cataract)
10. Refractive errors
11. Glaucoma
12. Uveitis
13. Retina &Optic nerve
14. Ocular motility & Strabismus
15. Systemic diseases and the eye
16. Eye emergencies and trauma
17. Neurophthalmology
The practical part of the course includes daily 3 hours practical training on ophthalmic
history taking, uses of ophthalmic instruments (slitlamp, magnifying aiding lenses, direct and
indirect ophthalmoscope, retinoscope, tonometers, snellen chart & perimeters)
Also examining with students different clinical cases and we concentrate on clinical cases of eye
emergencies, eye trauma, differential diagnosis of red eye

Class objectives:
1. Train the students how they can obtain a detailed ophthalmic history and examination technique
of different eye diseases and concentrating on special practical points.
2. How to use different ophthalmic instruments
3. Diagnosis and management of different eye diseases
4. How they can manage eye trauma and emergencies
5. The differential diagnosis of different eye diseases for example red eye

Materials and Resources
Material
Required Readings Lecture notes In ophthalmology (text book),
Parsons disease of eye (text book)
Recommended Readings Clinical Ophthalmology Kanski (text book)
Related Resources American Academy of Ophthalmology series
web site www.aao.org

Expectations and Policies
Our policy in this course is to encourage the students to share in the theoretical and practical
knowledge of Ophthalmology by building a strong relation between the students and their teachers


OPHTHALMOLOGY | Instruction methodology: | MCQs

based on friendship and respect and training them to use the basic instruments especially the direct
ophthalmoscope & slit - lamp & how they can manage general ophthamological problems and
emergencies and when they have to refer the patient to the specialist, all the above done with
regular monitoring of class performance by assessment and personal evaluation at the end of the
practical course.

Academic Honesty
Plagiarism. In speaking or writing, plagiarism is the act of passing someone else’s work off as one’s own. In
addition, plagiarism is defined as using the essential style and manner of expression of a source as if it were
one’s own. If there is any doubt, the student should consult his/her instructor or any manual of term paper
or report writing. Violations of academic honesty include:
1. Presenting the exact words of a source without quotation marks;
2. Using another student’s computer source code or algorithm or copying a laboratory report; or
3. Presenting information, judgments, ideas, or facts summarized from a source without giving credit.
Cheating. Cheating includes using or relying on the work of someone else in an inappropriate manner.
It includes, but is not limited to, those activities where a student:
1. Obtains or attempts to obtain unauthorized knowledge of an examination’s contents prior to the time
of that examination.
2. Copies another student’s work or intentionally allows others to copy assignments, examinations,
source codes or designs;
3. Works in a group when she/he has been told to work individually;
4. Uses unauthorized reference material during an examination; or
5. Have someone else take an examination or takes the examination for another

Instruction methodology:
We use data show, different slides, white board, medical instruments, patients

Theoretical Lectures Outline

NO. TOPICS LECTURER

1 Introduction to ophthalmology& Embryology, Dr.Bakhtiar

2 Anatomy& Physiology of the eye Dr.Bakhtiar

3 Orbit Dr. Tara

4 Orbit Dr. Tara

5 Eyelids Dr. Khaled

6 Lacrimal apparatus Dr. Khaled

7 Conjunctiva Dr.Ali

8 Conjunctiva Dr.Ali

9 Cornea & Sclera Dr. Bakhtiar


OPHTHALMOLOGY | Practical Course Outline | MCQs

10 Cornea & Sclera Dr.Bakhtiar

11 Lens & Cataract Dr.Khaled

12 Lens & Cataract Dr.Khaled

13 Glaucoma Dr.Ali

14 Glaucoma Dr.Ali

15 Optics & Refractive errors Dr.Tara

16 Optics & Refractive errors Dr.Tara

17 Uveitis Dr.Khaled

18 Uveitis Dr.Khaled

19 Retina & Optic nerve Dr.Bakhtiar

20 Retina & Optic nerve Dr.Bakhtiar

21 Ocular Motility & strabismus Dr.Tara

22 Ocular Motility & strabismus Dr.Tara

23 Systemic diseases & eye Dr.Khaled

24 Ocular Emergencies & Trauma Dr.Ali

25 Laser in Ophthalmology Dr.Tara

26 Neurophthalmology Dr.Bakhtiar

27 Differential Diagnosis of the Eye conditions Dr.Ali

Practical Course Outline

DATE TOPICS

Sat. Ophthalmic case history, slitlamp&fundus examination lenses

Sun. V.A. & Perimetry

Mon. Patients examinations, red eye, corneal ulcer, uveitis

Tues. Direct & indirect ophthalmoscope

Wed Review of instruments

Sat. Refraction &lenses

Sun. Trauma &Chemical burns

Mon. Patients examinations


OPHTHALMOLOGY | Grading | Introduction to ophthalmology

Tues. Lid problems &masses, Corneal lesions

Wed. Eye Emergencies

Sat. Cataract

Sun. Glaucoma

Mon. Patients examinations

Tues. Review

Wed. Assessment & clinical Exam.

Grading
Assessment methods:
Theoretical Mid - Year Exam 20%
Clinical exam 20%
Final exam 50%
Attendence & medical ethics 10%Theoretical Lectures&5% for practical
Grading scale:
90% to 100% = EXCELLENT
80% to 89% = VERY GOOD
70% to 79% = GOOD
60% to 69% = MEDIUM
50% to 59% = FAIR
< 50 % = FAIL

Detail of Syllabus
Introduction to ophthalmology
The eyeball, or globe, sits in a protective bony structure known as the orbit. Lined with muscle,
connective and adipose tissues, the orbit is about 4 cm in height, width, and depth and is shaped
roughly like a four - sided pyramid, surrounded on three sides by the sinuses:
The ethmoid (medially), the frontal (superiorly), and the maxillary (inferiorly).
The optic nerve and the ophthalmic artery enter the orbit at its apex through the optic foramen.
The anterior portion of the eye is protected by the eyelids, composed of thin elastic skin that covers
striated and smooth muscles. Tears are vitally important to the health of the anterior segment of
the eye. They are formed by the lacrimal gland and the accessory lacrimal glands.
The conjunctiva, a mucous membrane, provides a barrier to the external environment and
nourishes the eye. The sclera, commonly known as the "white of the eye, " is a dense fibrous
structure that composes the posterior five sixths of the eye
The cornea a transparent avascular domelike structure, forms the most anterior portion of the
eyeball and is the main refracting surface of the eye. Behind the cornea lies the anterior chamber,
filled with a continually replenished supply of clear aqueous humor, which nourishes the cornea.
The uvea consists of the iris, the ciliary body, and the choroid. The iris, or colored part of the eye, is
a highly vascularized, pigmented collection of fibers surrounding the pupil. The pupil is a space that
dilates and constricts in response to light. Directly behind the pupil and iris lies the lens, a
colorless and almost completely transparent biconvex structure held in position by zonular fibers. It


OPHTHALMOLOGY | Detail of Syllabus | The Ocular Examination

is avascular and has no nerve or pain fibers.
The lens is suspended behind the iris by the zonules and is connected to the ciliary body. The ciliary
body controls accommodation through the zonular fibers and the ciliary muscles. The posterior
chamber is a small space between the vitreous and the iris. Aqueous fluid is manufactured in the
posterior chamber by the ciliary body
The choroid is layered between the retina and the sclera and is a vascular tissue, supplying blood to
the portion of the sensory retina closest to it.
The ocular fundus is the largest chamber of the eye and contains the vitreous humor, a clear
gelatinous substance, mostly water, encapsulated by a hyaloid membrane, the vitreous humor.
Good visual acuity is not dependent solely on a healthy functioning eyeball but also on an intact
visual pathway. This pathway is made up of the retina, optic nerve, optic chiasma, optic tracts,
lateral geniculate bodies, optic radiations, and the visual cortex of the brain. The pathway is an
extension of the central nervous system. The optic nerve is innervated by the second cranial nerve.
Its purpose is to transmit impulses from the retina to the occipital lobe of the brain.

The Ocular Examination
Visual Acuity
After the patient's chief complaint and history have been established, visual acuity should be
assessed. This is an essential part of the eye examination and a measure against which all
therapeutic outcomes are based Most health care providers are familiar with the standard Snellen
chart. This chart is composed of a series of progressively smaller rows of letters and is used to test
distance vision. The fraction 6/6 is considered the standard of normal vision. Most people can see
the letters on the line designated as 6/6 from a distance of 6 meters. The External Eye
Examination
After the visual acuity has been recorded, an external eye examination is performed

Diagnostic evaluation
Direct Ophthalmoscopy
Is a hand - held instrument with varying plus and minus lenses. The lenses can be rotated into
place, enabling the examiner to bring the cornea, lens, and retina into focusIndirect
Ophthalmoscopy
Is an instrument commonly used by the ophthalmologist. It produces a bright and intense light. The
light source is fixed with a pair of binocular lenses, which are mounted on the examiner's head. The
ophthalmoscope is used in conjunction with a hand - held 20 - dioptcr lens. This instrument enables
the examiner to see larger areas of the retina, although in an unmagnified state.
Slit – Lamp Examination
Is a binocular microscope mounted on a table. This instrument enabls the user to examine the eye
with magnification of 10 to 40 times the real image.
Color Vision Testing
Because alteration in color vision is sometimes indicative of optic nerve problems, color vision
testing is often performed in a neuro - ophthalmologic workup.
Ultrasonography
Lesions in the globe or the orbit may not be directly visible and are evaluated by ultrasound.
Color Fundus Photography
Fundus photography is a technique used to detect and document retinal lesions. The patient's
pupils are widely dilated during the procedure, and visual acuity is diminished for about 30 minutes
due to retinal "bleaching" by the intense flashing lights


OPHTHALMOLOGY | Detail of Syllabus | Impaired vision

Tonometry
Tonometry is used to measure IOP by determining the amount of force necessary to indent or
flatten (applanate) a small anterior area of the globe of the eye.
Gonioscopy
Gonioscopy is used to visualize the angle of the anterior chamber to identify abnormalities in
appearance and measurements.
Perimetry Testing
Perimetry testing is used to evaluate the field of vision. A visual field is the area or extent of
physical space visible to an eye in a given position. Its average extent is 65 degrees upward, 75
degrees downward, 60 degrees inward, and 95 degrees outward when the eye is in the primary
gaze.

Impaired vision
Refractive errors
In refractive errors, vision is impaired because a shortened or elongated eyeball prevents light rays
from focusing sharply on the retina. Blurred vision due to refractive error can be corrected with
eyeglasses and contact lenses.

Glaucoma
Glaucoma is the term used to describe a group of ocular conditions characterized by optic nerve
damage, high intraocular pressure and visual field deffect.
Classification of glaucoma
Glaucoma can be open angle or angle closure, depending on which mechanisms cause the
impairment of the aqueous outflow. Glaucoma can also be primary or secondary, depending on
whether associated factors contribute to the rise in IOP.

Catarct
A cataract is a lens opacity or cloudiness
Clinical Manifestations
Painless blurring of vision is characteristic of cataracts. Commonly Used Ocular Medications
Topical Anesthetics
One to two drops of proparacaine hydrochloride and tetracaine hydrochlorid are instilled before
diagnostic procedures such as tonometry and gonioscopy and in minor ocular procedures such as
removal of sutures or conjunctival or corneal scrapings.

Mydriatics and Cycloplegics
Mydriasis, or pupil dilation, is the main objective of the administration of mydriatics and
cycloplegicsAnti - lnfectives
Anti - infective medications include antibiotics, antifungals, and antivirals. Most are available as
drops, ointments, or subconjunctival or intravitreal injections. Antibiotics include penicillin, the
cephalosporins, aminoglycosides, and fluoroquinolones. The main antifungal agent is amphotericin
B. Antivirals include acyclovir and ganciclovir. Corticosteroids and Nonsteroidal Anti - nflammatory
Drugs
The topical preparations of corticosteroids are commonly used in inflammatory conditions of the
eyelids, conjunctiva, cornea, anterior chamber, lens, and uvea. In posterior segment diseases that
involve the posterior sclera, retina, and optic nerve, the topical agents are less effective; hence, the
parenteral and oral routes are preferred.


OPHTHALMOLOGY | Examinations. | Types of questions:

Examinations.
Types of questions:
1. Short essay.
2. Long essay.
3. Multiple choice questions.
4. Blankets
5. True & false
Time of exam.
3 Three hours.

The number of questions and marks are divided as follows:
20 Marks for long essays.
20 Marks for short essays.
40 Marks for MCQs.
10 Marks for T&F
10 Marks for Blankets
The methods of correction of answers depend on key answers and key for multiple choice
questions and correction and marks are given accordingly.

1. Read the question twice before answering.
2. Think of the answer before writing.
3. Plan your answer in a separate page before writing it down on the answer paper.
4. Arrange the answer in the form of introduction, contents and the final part so that the student

Sample of MCQ and long and short essays
Chose the most appropriate answer (single choice)
1. Pigmented Layer of the Retina which is not true
a. consists of a single layer of cells.
b. these cells have a secretory function.
c. absorption of light is one of there functions.
d. consists of multiple layers of cells.
2. Adverse Risk Factors for diabetic retinopathy; all true except
a. poor metabolic control.
b. myopia.
c. obesity
d. smoking
3. Obstruction of the central retinal artery; the false answer is
a. mostly occur at the lamina cribrosa.
b. giant - cell arteritis.
c. subacute bacterial endocarditis.
d. cause reversible visual loss.


OPHTHALMOLOGY | Student feedback for the subject of a lecture | Sample of MCQ and lo

Put (T) in front the true one and (F) for false one and (D) if you don’t know
1. Keratic precipitates are inflammatory cell deposition over corneal endothelium.
2. Photophobia is one of the signs of acute iridocyclitis.

Answer by true (T) and false (F) (10 M)
1. Causes of ptosis could be: -
( ) a. senile aponeurotic.
( ) b. vascular.
( ) c. mechanical.
( ) d. self induced.
2. Epiphora caused by: -
( ) a. aqueous humor leakage.
( ) b. hyposecretion of tears.
( ) c. block of nasolacrimal duct.
( ) d. parasympathetic stimulation of lacrimal gland.

Chose the appropriate answer for each blanket (8 M)
Mature cataract……………………………………
Congenital cataract ………………………………
Hypermature cataract…………………………….
mitotics
corticosteroids
diabetes mellitus
lamellar or zonular cataract

Assay questions
Enumerate the possible the nerve affected & the muscles involved paralytic squint? Answer
1. Oculomotor nerve (3rd cranial nerve) palsy, it affects the following extraocular muscles: -
i - medial rectus.
ii - superior rectus.
iii - inferior rectus.
iv - inferior oblique.
2. Abducent nerve (6th cranial nerve) palsy, it affects the: -
lateral rectus muscle.
3. Trochlear nerve (4th cranial nerve) palsy it affects the : -
superior oblique muscle.

1
were clear
2
4


OPHTHALMOLOGY | Student feedback for the subject of a lecture | Sample of MCQ and lo

properly.
5
attention.
lecture.
7
calm and respectful
8
attractive.
10
with the subject.
Total score


PEDIATRICS | Course Book Content | Sample of MCQ and long and short essays

PEDIATRICS
Course Book Content
1 - Name of the cores; Paediatric
2 - Torter in charge; assistant professor Dr. Jamal Ahmad Rashid.
3 - Department / Branch and the college: Pediatrics / College of Medicine
4 - Contacs;
Web site links;
Dr.Jamal Ahmad Rashid; drfamalahmadrashid@yahoo.com
U U

Dr.Adanan Mohamad Hassan; adnan - alhamwandi@yahoo.com
U U

Dr. Haydar Fakher; hayderfmoh@yahoo.com
U U

Dr. Tara Hussain Tyib; tarahus73@yahoo.com
U U

Course objectives
Our main objective in this course is to provide the student with the important knowledge and skills
in basic pediatrics that will help him deal with children in general and encounter the important
clinical skills that will help him as a physician dealing with children whatever his specialty branch
would be latter on.
At the end of the cores students should be able to;
1 - Have the necessary skill to take a good history and perform a systemized and thorough clinical
examination.
2 - Be familiar with basic topics in pediatrics; including growth and development, main infectious
diseases, diarrhea and fluid and electrolyte management.
3 - Be familiar with pediatric emergencies such as respiratory distress and shock …etc.
4 - Students should have learned the ethics of communication with the child and their parents.

Course overview
The students have their theory study at collage in the form of lectures.
The practical cessions are performed at hospital in the form of clinical cessions on admitted
patients. Here they review history taking and physical examination they had studied in fourth year,
with more discussion and interpretation of data.
They are divided into 12 groups each group will come daily to paediatric teaching hospital for 3
weeks.

Course Reading list;
Student can benefit from the following reading list;
1 - Nelson essential of paediatrics.
2 - Nelson Text book of paediatrics.


PEDIATRICS | Syllabus | Sample of MCQ and long and short essays

3 - Furfur Text book of paediatrics.
4 - Lange clinical manual of Neonatology.

Syllabus
LECTURER SUBJECT
Dr. Adnan Hamawendi Attention deficit hyperactivity disorder
Dr. Adnan Hamawendi Enuresis
Dr. Adnan Hamawendi Habit disorders
Dr. Adnan Hamawendi Recurrent abdominal pain
Dr. Adnan Hamawendi Diarrhoea 1 (4 lectures)
Dr. Adnan Hamawendi Cystic Fibrosis
Dr. Adnan Hamawendi Constipation
Dr. Adnan Hamawendi Gastroesophageal reflux, peptic ulcer
Dr. Adnan Hamawendi Malabsorbtion
Dr. Adnan Hamawendi Neonatal cholestasis
Dr. Adnan Hamawendi Cerebral palsy
Dr. Adnan Hamawendi Encephalitis
Dr. Adnan Hamawendi Epilepsy (2 lectures)
Dr. Adnan Hamawendi Mental retardation
Dr. Adnan Hamawendi Neuromuscular disease
Dr. Adnan Hamawendi Seizure and epilepsy
Dr. Adnan Hamawendi
Dr. Adnan Hamawendi Evaluation of renal function and structure
Dr. Adnan Hamawendi Glomerulonephritis
Dr. Adnan Hamawendi Nephrotic syndrome
Dr. Adnan Hamawendi Renal tubular acidosis
Dr. Adnan Hamawendi UTI
Dr. Jamal Ahmad Rashid Introduction
Dr. Jamal Ahmad Rashid Congenital heart disease
Dr. Jamal Ahmad Rashid Cardiac Arrhythmias
Dr. Jamal Ahmad Rashid Poisoning
Dr. Jamal Ahmad Rashid Diabetes mellitus
Dr. Jamal Ahmad Rashid Diabetes insipidus
Dr. Jamal Ahmad Rashid Bleeding disorders
Dr. Jamal Ahmad Rashid Endocrine lectures
Dr. Jamal Ahmad Rashid Genetics
Dr. Jamal Ahmad Rashid Haematology (2 lectures)
Dr. Jamal Ahmad Rashid Homocystine urea
Dr. Jamal Ahmad Rashid Inborn errors of metabolism
Dr. Jamal Ahmad Rashid Paediatric oncology 2 lectures
Dr. Jamal Ahmad Rashid Skill cell anaemia

Exams
Department of paediatrics is accustomed to the following pattern of questions in the final
theoretical exams;


PEDIATRICS | Exams | Multiple choice questions:

Multiple choice questions:
We write down numbered statements followed by 4 - 5 answers, suggestions or completions. We
ask the student to encircle the lettered answer which perfectly fits (single choice only).
Example
Factors associated with increased susceptibility to acquire diarrhoea include
all the followings except:
a. Bottle feeding.
b. Age more than 5 years.
c. Introduction of weaning food at 6 months of age.
d. Shortage of water supplies.
e. Failure to wash hands after going to toilet.

Answer B

True and false questions:
Numbered statement is given followed by 4 - 5 lettered descriptions, suggestions or any
information in context with the aforesaid statement. The student is asked to write either (F) for
false or (T) for true in the parentheses cited after the lettered answer or suggestion. Department’s
policy is to cancel one right answer for every wrong one. It is advisable for the student not to write
down the (T) or (F) unless he’s /she’s absolutely sure about, if not the student is advised to put D in
between the brackets (short for I don’t know).
EXAMPLE ; - Precocious puberty:
(T) A. Is defined as the onset of sexual maturation before 10 years in girls & before
11 years in boys.
(T) B. Is more common in girls.
(F) C. Is less serious in boys
(F) D. Results in an increased final height
(T) E. May be caused by untreated celiac disease

Problem solving questions
Problem solving questions in which present the student with cases and ask him or her for his
approach as to which investigation he would send, differential diagnosis or a provisional diagnosis,
and may be some points on management.
EXAMPLE ;An eight - month - old infant presents with diarrhoea and vomiting of three days
duration, he looks lethargic, with sunken eyes and dry tongue, he drinks poorly and a skin pinch
goes back very slowly.
Q.1 what is hydration state of this infant? Severe dehydration
Q.2 what single investigation can help in his management? Blood urea and electrolyte
Q.3 what type of fluid is most suitable for treatment? Normal saline shoot, followed by ½ glucose
saline

Data questions;
In which we present the student with very short historical point as the age and sex of the patient
and his main chief complain or presentation and give him some laboratory data in which he should
be able to interpret.
Example


PEDIATRICS | Exams | Short assay questions

The following is the pedigree of the arrowed 10 - year old boy who had showed delayed motor mile
- stones since 2 - year of age & became Wheel - chair bound by 9 years of age.

Q1 - What is the most probable diagnosis?
Duchene muscular dystrophy
Q2 - What is the mode of inheritance of his illness?
X linked recessive
Q3 - What investigation do you suggest?
EMG
Creatinine phosphokinase level
Muscle biopsy.

Short assay questions
Short assay questions in which we ask the student to write a short assay about a certain subject.
Example
Q) Write short notes about honey moon period.
Answer :
Honey moon of diabetic children: this is a temporary reduction in insulin requirement, which occurs
in about 70% of diabetic children within few weeks after initial diagnosis.
This period is probably due to transient recovery of islet cell function and some increase in insulin
production.
The period usually lasts about a month, but may rarely continue for up to 2 years.

Enumerate questions;
In which we ask the student to enumerate only, for example complications of a certain disease or
the contraindications of a certain procedure.
Example
Q) Enumerate the main lines in treatment of cerebral palsy
Answer :
Physiotherapy.
Orthopedic intervention.
Treatment of associated problems, like seizures, learning disabilities, strabismus, and behavioral
problems.


PEDIATRICS | Exams | Exam’s duration:

Exam’s duration:
Mid - year or final exam duration is three hours (standardized by the Council of the College of
Medicine).

Clinical exams;
Clinical examination is performed at the end of the course and there are also final exams at the end
of the term.
End of course exams include the following;
The clinical exam is in the form of long case examination by which we asses the skill of history
taking and examination, and their interpretation of the clinical data.


SURGERY | Course coordinator and list of teachers on this course | Clinical exams;

SURGERY
Course: Plastic and Reconstructive Surgery
Course coordinator: Dr. Ari Raheem Qader
Department: surgery
College: Medicine
Course coordinator link:drzangana@yahoo.com
Tel. +9647701526316
List of teacher on this course:
Dr. Ari Raheem Qader

Course Overview
The course of Plastic and Reconstructive Surgery is dedicated to deal with undergraduate level to
know the importance of Plastic and Reconstructive Surgery in the daily activities of the junior
doctors and the sessions and the lectures are overall based on simple principles and standards for
the juniors in Plastic and Reconstructive Surgery to understand the physiology and pathology and
management of these problems in simple and qualified methods in 6 lectures and 6 hours practical.
Course Objectives
At the end of the course of Plastic and Reconstructive Surgery, the students should be able to
master and perform the basic skills that are considered fundamentals in Plastic and Reconstructive
Surgery and to have basic Plastic and Reconstructive Surgery experience needed for doctors in
surgery department or in case of surgical emergency.

Course Reading List
1 - Baily and Love, short practice of surgery
2 - Grabb and Smiths plastic surgery.
3 - Journal of Plastic and Reconstructive Surgery. American Plastic and Reconstructive Surgery
Association.
4 - Mathes plastic surgery

Syllabus
NO. TITLE OF SUBJECT

1 Basic Principle

2 Reconstructive Ladder

3 Skin Graft


SURGERY | Student feedback for the subject of a lecture | Clinical exams;

4 Skin Flap

5 Cleft Lip and Palate

6 Vascular Anomalies

1
were clear
2
4
properly.
5
attention.
lecture.
7
calm and respectful
8
attractive.
10
with the subject.
Total score

Examinations.
It is part in general surgery examination
Types of questions:
1 - short essay.
2 - multiple choice questions
3 - Enumerate

Examples:
1 - Full thickness graft:
a - Have greatest sensory return.


SURGERY | Examples: | Clinical exams;

b - Contain less hair follicles.
c - Survival of graft more.
D - Harvest site can close primary.
E - have less cosmetic appearance.
2 - Skin flaps:
a - Has its own blood supply.
b - Is often simpler than skin graft.
c - Needed for covering recipient beds that have poor vascularity.
d - Muscle flaps may provide a functional motor unit.
e - Consist of skin only.


PRACTICAL SESSIONS | Medicine | Clinical exams;

PRACTICAL SESSIONS
Medicine
Objectives:
To enable students observe and perform physical examination on real patients to enhance their
clinical skills. Also students shown new hi - tech medical devices to be familiar with. Special
attention is given to emergency cases in the ER and how patients are dealt with.
Methods:
Each session is about 3 hr and students are divided in to 2 groups one attending general medicine,
cardiology and rheumatology, the other attending neurology. They are required to take history and
perform physical examination on patients and give differential diagnoses.
In neurology hours, full neurological examination is performed in front of them, later on to be
performed by the student and attend the EMG and EEG units. In cardiology they attend to the CCU
and observe how thrombolytic therapy is given and monitoring of patients. They attend exercise
test room and echocardiography to listen to cardiac murmurs.
In rheumatology hours they attend the outpatient and observe physiotherapy and articular
injection techniques.
In nephrology hours they are shown techniques of renal transplantation and renal biopsy.
Students also attend gastroenterology unit to see different types of endoscopies and endoscopic
ultrasound, ERCP and manometry.
In endocrinology sessions they attend to the diabetes centre and see how patients are treated and
keep files for them for future visits and notice injection techniques of insulin and blood sugar
monitoring.
Syllabus
1. Medicine group

Day Session Professor
Saturday Endocrine Dr. Taha Mahwy
Sunday GIT Dr. Taha Karbuly
Monday Renal Dr. Alaa Husain
Tuesday Rheumatology Dr. Raoof Merza
Wednesday Cardiology Dr. Dara Muhyadin
Thursday off

2. Neurology group

Day Session Professor
Saturday Neurology Dr. Hasan Jumaili
Sunday Neurology Dr. Hawar


PRACTICAL SESSIONS | Neurosurgery | Clinical exams;

Monday Neurology Dr. M. Tahir
Tuesday Neurology Dr. Hasan
Wednesday Neurology Dr. M. Tahir
Thursday off

Neurosurgery
IRAQI KURDISTAN REGION COLLEGE OF MEDICINE
COUNCIL OF MINISTERS Department of Surgery
Neurosurgery Unit
MINISTRY OF HIGHER EDUCATION
2009 - 2010/2010 - 2011
AND SCIENTIFIC RESEARCHES
E - mail med@univsul.net
UNIVERSITY OF SULAIMANI

Neurosurgery Syllabus for “5th” Year Medical Students
Course Title
Neurosurgery

Theoretical: (Every week: one Unit) Thursday: 8:00am - 9:00am
Practical: (Every week: three units) Monday: 9:00am - 12:00pm

Location
Theory: Lecture hall (3) in the College Of Medicine, University of Sulaimani
Practical: Neurosurgical Department, Sulaimani Teaching Hospital.
Head of Department: Dr.ari Sami Hussain Nadhim, Assist Professor.
Coordinator: Mazin Murad, senior lecturer.

Course Description
Neurosurgery (or Neurological Surgery) is the surgical specialty involved in the treatment of
disorders of the brain, spinal cord, and peripheral nerves.Neurosurgery is the branch of surgery that
deals with the diagnosis, assessment and surgical management of disorders of the nervous system.
The specialty developed in the first half of the twentieth century. Modern neurosurgery has
benefited greatly from advances in microsurgery, computer assisted imaging computed
U

tomography (CT) , magnetic resonance imaging (MRI) , positron emission tomography (PET) ,
U U U U U

magnetoencephalography (MEG) and the development of stereotactic surgery. Some neurosurgical
U U U U

procedures even involve the use of MRI and functional MRI intraoperatively
Course Objectives
The course in Neurosurgery aims that the student should be able to:
1 - corelates the theoretical information with the practical and clinical work in the ward, which
includes:


PRACTICAL SESSIONS | Neurosurgery | Clinical exams;

Investigation in Neurosurgery.
Congenital CNS anomalies.
Head injury.
Intracranial hemorrhages.
Raised intracranial pressure.
CNS tumours.
CNS infections.
Diseases of spine and spinal cord.
2 - Performing proper neurological examination.
3 - Discussion of common neurosurgical operative techniques
Materials and Resources
Required Readings (Textbooks) Short practice of surgery
Essentials of neurosurgery
Recommended Readings 1 - Principals of neurosurgery
2 - Hand book of neurosurgery.
Related Resources WWW.Neurosurgeryonline.com

Attendance and behavior

Attendance
Students are expected to attend all classes and to complete all assignments for courses in which they
are enrolled. An absence does not relieve the student of the responsibility to complete all
assignments. If an absence is associated with a university - sanctioned activity, the instructor will
provide an opportunity for assignment make - up. However, it is the instructor’s decision to provide,
or not to provide, make - up work related to absences for any other reason.
Academic Honesty
Plagiarism. In speaking or writing, plagiarism is the act of passing someone else’s work off as one’s
own. In addition, plagiarism is defined as using the essential style and manner of expression of a
source as if it were one’s own. If there is any doubt, the student should consult his/her instructor or
any manual of term paper or report writing. Violations of academic honesty include:
1. Presenting the exact words of a source without quotation marks;
2. Using another student’s computer source code or algorithm or copying a laboratory report; or
3. Presenting information, judgments, ideas, or facts summarized from a source without giving credit.
Cheating. Cheating includes using or relying on the work of someone else in an inappropriate manner.
It includes, but is not limited to, those activities where a student:
1. Obtains or attempts to obtain unauthorized knowledge of an examination’s contents prior to the
time of that examination.
2. Copies another student’s work or intentionally allows others to copy assignments, examinations,
source codes or designs;
3. Works in a group when she/he has been told to work individually;
4. Uses unauthorized reference material during an examination; or
5. Have someone else take an examination or takes the examination for another

Instruction methodology:
INTERACTIVE TEACHING
DEMONSTRATIONS
USE OF MODELS


PRACTICAL SESSIONS | Thoracic and Cardiovascular Surgery | Clinical exams;

SMALL GROUP TEACHING
Theory:

Topics Lecturer
1. Introduction to Neurosurgery and investigation in Neurosurgery. Dr. Ari Sami Hussain Nadhim
2. Congenital anomalies of the CNS. Dr. Ali Omer Saadon
3. Intracranial pressure. Dr. Ali Omer Saadon
4. Head injury and Traumatic CNS problems. Dr. Ari Sami Hussain Nadhim
5. Assessment of head injured patients. Dr. Ari Sami Hussain Nadhim
6. Complication of head injury. Dr. Ari Sami Hussain Nadhim
7. Intracranial hemorrhages. Dr. Ari Sami Hussain Nadhim
8. CNS infections and abscesses.
Dr. Ali Omer Saadon
9. Brain tumors: introduction and clinical features.
Dr. Khalid Shukir
10. Brain tumors: investigations and management.
11. Spine : trauma and diseases. Dr. Khalid shukir
12. Spinal cord injury. Dr. Mazin Murad
Dr. Mazin Murad
Clinical and practical topics:
1. History taking
2. Proper neurological examination.
3. Neuro - radiology and imaging.
4. Case discussion.
5. Management.
Grading Assessment methods

Theory:
MCQ & single choice question.
Short assy.
Practical:
OSCI
Grading scale:
90% to 100% = EXCELLENT
80% to 89% = VERY GOOD
70% to 79% = GOOD
60% to 69% = MEDIUM
50% to 59% = FAIR
< 50 % = FAIL
1 - End course Theoretical paper based examination (100 mark)
MCQ and Single choice question 40%
Short essay questions 60%
2 - End course practical based examination /OSCI (100 mark)
The semester final result will be from 50% which is the summation of 1 &2 (above) and the other
50%will be gain from the final written exam.

Thoracic and Cardiovascular Surgery
UNIVERSITY OF SULAIMANI



COLLEGE OF MEDICINE
DEPARTMENT OF SURGERY
UNIT OF THORACIC AND CARDIOVASCULAR SURGERY
COURSE BOOK
FOR ACADEMIC YEAR 2010 - 2011
FOURTH YEAR
TEACHING STAFF:
Dr. Abdulsalam Y Taha FICMS (CTVS). Professor
E mail: salamyt_1963@hotmail.com
Mobile phone: 07701 51 0420
Dr. Ahmed Ibraheem Abbass FICMS (CTVS) ; Lecturer
E mail: alazzawi_69@yahoo.com
Mobile phone: 07702163557
Dr. Aram Baram Mohammed MD, AFSCTCVS, MRCSEd ; Lecturer
e - mail: baram_aram@yahoo.com
Mobile phone: 009647702217248
SURGICAL OBJECTIVES
Glossary of Terms:
OBJECTIVE: What is hoped that the student will be able to demonstrate as learned knowledge.
SKILL: A technical ability.
RECALL: Rememberance of what has been learned from other disciplines which are applicable to
present course.
DESCRIBE: Detailed explanation of facts.
OUTLINE: Usually a brief explanation of principles.
DISCUSS: Be able to explain and argue about studied facts or problems.
LIST: Place, usually in order of priority or importance a number of causes, details or modes of
treatment.
IDENTIFY: Present in argument based on historical and clinical features.
CLINICAL FEATURES: Signs and symptoms of disease.
TREATMENT: Medical or surgical therapy.
MANAGEMENT: Whole care of a patient and his disease from initial presentation, clinical and
diagnostic features to treatment and final outcome.
COURSE OVERVIEW:
The unit of Thoracic and Cardiovascular Surgery is involved in theoretical teaching of Fourth Year
students as follows:
FOURTH YEAR:
Oesophagus, hiatal hernia and diaphragm - 5 lectures; given by Dr. Aram Baram Muhammad.
Symptoms and signs of vascular surgical disorders 1 lecture; given by Dr. Ahmed Ibraheem Al
Azzawi
Acute Arterial Disorders: 2 lectures; given by Dr. Ahmed Ibraheem Al Azzawi.
Chronic Arterial Disorders: 1 lecture; given by Dr. Ahmed Ibraheem Al Azzawi.
Symptoms and signs of cardiothoracic surgical disorders 1 lecture; given by Dr. Abdulsalam Y Taha.
Venous Disorders: 2 lectures; given by Dr. Abdulsalam Y Taha
Lymphatic Disorders: 1 lecture; given by Dr. Abdulsalam Y Taha
Total: 13 lectures.
SURGICAL OBJECTIVES:
OESOPHAGUS:



Recall the surgical anatomy of the oesophagus and the physiological process of peristalsis and
upper and lower sphincter action.
Recall the disturbances of oesophageal hypermotility (oesophageal spasm) and of hypomotility
(Achalasia).
Outline the clinical tests performed in the study of oesophageal motility and their diagnostic
significance.
Recall the pathogenesis of oesophageal diverticula.
List the types of oesophageal hiatal hernia.
Describe the clinical features of reflux oesophagitis and outline its causes, diagnostic tests and
principles of medical and surgical management.
Outline the emergency management following ingestion of corrosives and acids.
Outline the emergency management of ingestion of foreign bodies.
Outline the causes and clinical features of rupture of the oesophagus.
Describe the clinical features of carcinoma of the oesophagus and give a differential diagnosis and
investigations that would confirm the diagnosis.
Outline the methods of treatment of oesophageal cancer at various levels.
List causes of dysphagia and describe the diagnostic workup of a patient with this symptom.
DIAPHRAGM
Recall the surgical anatomy and function of the diaphragm.
Describe the clinical features, diagnostic methods and surgical treatments of congenital
diaphragmatic hernias.
Describe the aetiology and management of acute and chronic rupture of the diaphragm.
PERIPHERAL ARTERIAL DISEASE
Recall the surgical anatomy of the major arteries.
List the common causes of occlusive arterial disease.
Outline the patho - physiological changes resulting from occlusive disease in the subclavian -
axillary, aorto - iliac, femoro - popliteal, renal, superior mesenteric, carotid, vertebral regions and
pulmonary region.
Describe how should assess for possible vascular injury in extremity trauma.
Outline the consequences of untreated vascular injury.
List the cardinal manifestations of acute arterial occlusion.
Describe the clinical features of Aortic aneurysms and their complications.
Describe the causes, patho - physiology and local as well as general effects of arterio - venous
fistulae.
Outline current methods of investigations of flow in peripheral vascular disease.
Describe the non - operative treatment of intermittent claudication.
List the clinical features, diagnosis and role of surgery in the management of chronic arterial
obstruction.
Outline the causes, and pathophysiology, clinical features of arterial embolism.
Define (Reynaud’s phenomenon) ; list its causes and methods of management.
Discuss the role of diabetis, hyperlipidemia, smoking, exercise and drugs in the causation and
effects on therapy of peripheral arterial disease.
VENOUS DISEASE:
1. Recall the surgical anatomy of the venous system of the lower limb and the normal method of
venous return to the heart.
2. Describe the clinical features, pathophysiology and role of surgery in chronic venous varicosities
of the lower limb.



3. Recall the classification of ulcers of the lower limb and describe their diagnosis and surgical
management.
4. Outline methods of deep venous thrombosis prevention.
5. Recall the clinical features of deep venous thrombosis and outline its diagnosis and management.
6. Describe the pathophysiology, clinical features and management of post - thrombotic syndrome.
THE LYMPHATIC SYSTEM
Recall the surgical anatomy and physiology of the lymphatic vessels and system.
Describe the diagnostic methods of lymphoedema particularly lymphangiography.
Recall the pathology of lymphoedema and describe its clinical features and non - operative
management.
Describe surgical treatment of lymphoedema.
Recall the pathogenesis of chylus effusion in the thorax and abdomen.
READING LIST:
Bailey & Love’s SHORT PRACTICE OF SURGERY. 25TH EDITION.
PHYSICAL SIGNS. Hamilton Bailey’s Demonstrations of Physical Signs in Clinical Surgery.
NMS - Surgery 4th Edition. Edited by Bruce E. Jarrell and R. Anthony Carabasi, III


Course book

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