PCCN PDF obtain - AACN Progressive Critical Care Nursing Updated: 2023

UPSC Medical Science Syllabus: Medical Science is a popularly chosen optional subject in the UPSC Mains exam. It mainly assesses the candidate’s knowledge of basic concepts and usage of knowledge to address the issues faced by the patient. Scoring Good Score in this subject is crucial as it can boost the overall marks in the UPSC IAS exam. Candidates with science backgrounds can opt for Medical Science as their UPSC optional to excel in this subject. 

Going by the past five years' statistics, approximately 150-250 aspirants pick Medical Science optional subject, and the success rate hovers around 10%. It is recommended to adhere to the Medical Science Syllabus for UPSC to prepare comprehensively for the civil service exam. As per the past UPSC test analysis, it is found that the difficulty level of the UPSC Medical Science optional subjects was medium in nature.

In this article, we shared the UPSC Medical Science Syllabus PDF for Mains, question weightage, preparation tips, and best books.

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UPSC Medical Science Syllabus PDF

The UPSC Medical Science optional syllabus comprises two papers, i.e., Papers 1 and 2. The UPSC Medical Science subject is conducted for a total of 500 marks, with each paper carrying 250 marks. Candidates must carefully review the UPSC Medical Science Syllabus PDF for Papers 1 and 2 to get an idea of the important courses and build a robust approach. obtain the topic-wise UPSC Medical Science Syllabus PDF for papers 1 and 2 tabulated below.

UPSC Medical Science Optional Syllabus For IAS Mains

There are two papers in the UPSC Medical Science Optional Syllabus i.e., Paper 1 and Paper 2. Before commencing the preparation, it is vital to check the topic-wise UPSC Medical Science syllabus for main optional papers 1 and 2 as it will allow them to differentiate between important and unimportant topics.

UPSC Medical Science Syllabus for Paper 1

The UPSC Medical Science Paper I syllabus covers courses like Human Anatomy, Human Physiology, Biochemistry, Pathology, Microbiology, Pharmacology, Forensic Medicine and Toxicology. Check the topic-wise UPSC Medical Science Optional Syllabus for Paper I below.

1. Human Anatomy:

Applied anatomy including blood and nerve supply of upper and lower limbs and joints of shoulder, hip and knee.

Gross anatomy, blood supply and lymphatic drainage of tongue, thyroid, mammary gland, stomach, liver, prostate, gonads and uterus.

Applied anatomy of the diaphragm, perineum and inguinal region.

Clinical anatomy of kidney, urinary bladder, uterine tubes, vas deferens.

Embryology: Placenta and placental barrier. Development of heart, gut, and kidney, uterus, ovary, testis and their common congenital abnormalities.

Central and Peripheral Autonomic Nervous System: Gross and clinical anatomy of ventricles of the brain, circulation of cerebrospinal fluid; Neural pathways and lesions of cutaneous sensations, hearing and vision; Cranial nerves distribution and clinical significance; Components of the autonomic nervous system.

2. Human Physiology:

Conduction and transmission of impulse, mechanism of contraction, neuromuscular transmission, reflexes, control of equilibrium, posture and muscle tone, descending pathways, functions of the cerebellum, basal ganglia, Physiology of sleep and consciousness.

Endocrine System: Mechanism of action of hormones; formation, secretion, transport, metabolism, function and regulation of secretion of pancreas and pituitary gland.

Physiology of Reproductive System: Pregnancy menstrual cycle, lactation, pregnancy.

Blood: Development, regulation and fate of blood cells.

Cardio-vascular, cardiac output, blood pressure, regulation of cardiovascular functions.

3. Biochemistry:

Organ function tests—liver, kidney, thyroid Protein synthesis.

Vitamins and minerals.

Restriction fragment length.

polymorphism (RFLP).

Polymerase chain reaction (PCR).

Radio-immunoassays (RIA).

4. Pathology:

Inflammation and repair, disturbances of growth and cancer, Pathogenesis and histopathology of rheumatic and ischaemic heart disease and diabetes mellitus. Differentiation between benign, malignant, primary and metastatic malignancies, Pathogenesis and histopathology of bronchogenic carcinoma, carcinoma breast, oral cancer, cancer cervix, leukaemia, Etiology, pathogenesis and histopathology of— cirrhosis liver, glomerulonephritis, tuberculosis, acute osteomyelitis.

5. Microbiology:

Humoral and cell mediated immunity.

Diseases caused by and laboratory diagnosis of —

Meningococcus, Saimonella

Shigella, Herpes, Dengue, Polio

HIV/AIDS, Malaria, E. Histolytica, Giardia

Candida, Cryptococcus, Aspergillus.

6. Pharmacology:

Mechanism of action and side effects of the following drugs :

Antipyretics and analgesics, Antibiotics,

Antimalaria, Antikala-azar, Antidiabetics,

Antihypertensive, Antidiuretics, General and cardiac vasodilators, Antiviral, Antiparasitic, Antifungal, Immunosuppressants,

Anticancer.

7. Forensic Medicine and Toxicology

Forensic examination of injuries and wounds; Examination of blood and seminal stains; Poisoning, sedative overdose, hanging, drowning, burns, DNA and fingerprint study.

UPSC Medical Science Syllabus for Paper 2

The UPSC Medical Science Paper II Syllabus focuses on courses like General Medicine, Paediatrics, Dermatology, General Surgery,  Obstetrics and Gynaecology including Family Planning, and Community Medicine (Preventive and Social Medicine). Check the topic-wise UPSC Medical Science Optional Syllabus PDF for Paper II below.

1. General Medicine

• Aetiology, clinical features, diagnosis and principles of management (including prevention) of—Typhoid, Rabies, AIDS, Dengue, Kala-azar, and Japanese Encephalitis.
• Aetiology, clinical features, diagnosis and principles of management of :
• Ischaemic heart disease, pulmonary embolism.
• Bronchial asthma.
• Pleural effusion, tuberculosis, Malabsorption syndromes; acid peptic diseases, Viral hepatitis and cirrhosis of the liver.
• Glomerulonephritis and pyelonephritis, renal failure, nephrotic syndrome, renovascular hypertension, complications of diabetes mellitus, coagulation disorders, leukaemia, Hypo and hyper thyroid, meningitis and encephalitis.
• Imaging in medical problems, ultrasound, echocardiogram, CT scan, MRI.
• Anxiety and Depressive Psychosis and schizophrenia and ECT. 

2. Paediatrics

Immunization, Baby friendly hospital, congenital cyanotic heart disease, respiratory distress syndrome, broncho— pneumonia, kernicterus. IMNCI classification and management, PEM grading and management. ARI and Diarrhea of under five and their management.

3. Dermatology

Psoriasis, Allergic dermatitis, scabies, eczema, vitiligo, Stevan Johnson’s syndrome, Lichen Planus.

4. General Surgery

• Clinical features, causes, diagnosis and principles of management of cleft palate, harelip.
• Laryngeal tumour, oral and esophageal tumours.
• Peripheral arterial diseases, varicose veins, coarctation of aorta.
• Tumours of Thyroid, Adrenal, Glands.
• Abscess cancer, fibroadenoma and adenosis of the breast.
• Bleeding peptic ulcer, tuberculosis of the bowel, ulcerative colitis, cancer stomach.
• Renal mass, cancer prostate.
• Haemothorax, stones of the Gall bladder, Kidney, Ureter and Urinary Bladder.
• Management of surgical conditions of Rectum, Anus and Anal canal, Gall bladder and Bile ducts.
• Splenomegaly, cholecystitis, portal hypertension, liver abscess, peritonitis, carcinoma head of pancreas.
• Fractures of the spine, Colles’ fracture and bone tumours.
• Endoscopy.
• Laparoscopic Surgery.

5. Obstetrics and Gynaecology including Family Planning

• Diagnosis of pregnancy.
• Labour management, complications of 3rd stage, Antepartum and postpartum haemorrhage, resuscitation of the newborn, Management of abnormal life and difficult labour. Management of small for date or premature newborns.
• Diagnosis and management of anaemia. Preeclampsia and Toxaemias of pregnancy, Management of Postmenopausal Syndrome.
• Intra-uterine devices, pills, tubectomy and vasectomy. Medical termination of pregnancy including legal aspects.
• Cancer cervix.
• Leucorrhoea, pelvic pain; infertility, dysfunctional uterine bleeding (DUB), amenorrhoea, Fibroid and prolapse of uterus.

6. Community Medicine (Preventive and Social Medicine)

• Principles, methods approach and measurements of Epidemiology.
• Nutrition, nutritional diseases/disorders and Nutrition Programmes.
• Health information Collection, Analysis and Presentation.
• Objectives, components and critical analysis of National programmes for control/eradication of :
• Malaria, Kala-azar, Filaria and Tuberculosis,
• HIV/AIDS, STDs and Dengue.
• Critical appraisal of Health care delivery system.
• Health management and administration; Techniques, Tools, Programme Implementation and Evaluation.
• Objectives, Components, Goals and Status of Reproductive and Child Health, National Rural Health Mission and Millennium Development Goals.
• Management of hospital and industrial waste.

How to Prepare the UPSC Medical Science Syllabus 2023?

Candidates must follow the UPSC Medical Science syllabus and reshape the preparation strategy. This will help them to get a strong grip on the concepts and advanced chapters important from the test perspective. As the UPSC Medical Science optional syllabus is lengthy, aspirants should consider specific points during the IAS test preparation.

• Review the UPSC Medical Science optional syllabus thoroughly and segregate the courses based on marks weightage. This will enable them to finish the syllabus in a stipulated time period.
• Pick the highly recommended books and study resources to understand the concepts easily and comprehensively.
• Solve UPSC Medical Science's previous year's question paper to get an idea of the questions repeatedly asked over the years and question weightage.
• Revise all the important courses and chapters covered so far to retain concepts for a definite period.

Booklist for UPSC Medical Science Optional Syllabus

Numerous UPSC Medical Science optional books are available to strengthen the basics. Once they learn fundamentals, they should start covering core courses for the advanced preparation. The right books will help them to cover all the important courses specified in the UPSC Medical Science Optional Syllabus. Some of the best UPSC Medical Science Optional books are as follows.

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Download PDF instead of Previewing in Chrome

Google Chrome has its own PDF Viewer, so, when you click on a PDF, it will be opened with Chrome’s PDF on the browser itself. Therefore, we need to disable Chrome’s PDF viewer to obtain PFDs instead of previewing them.

1. To do that, launch Chrome
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If you don’t use Chrome but Mozilla Firefox, you can still obtain PDF instead of opening them. Firefox also has a built-in PDF Viewer, just like Chrome, so, when you click on a PDF, the document will open with Firefox PDF viewer. To obtain PDF instead of previewing them in Firefox, you can follow the given steps:

1. Launch Firefox, click on the three horizontal lines, and select Options.
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A teenage girl presented to the outpatient clinic with a one year history of persistent, progressive pain and swelling in her right lower leg. The swelling was exacerbated by walking, did not Excellerate with rest, and was affecting her daily life. She had no history of accurate trauma or fever. On clinical examination, compared with the left leg, the right lower leg was warm, accompanied by strong pulsation on palpation on the lesion area. The patient’s C reactive protein, alkaline phosphatase, and white cell count were normal. A plain radiograph of the right leg was requested (fig 1).

Mayo Clinic researchers have identified new scoring criteria allowing for the detection of treatable forms of rapidly progressive dementia (RPD) with reasonably high confidence during a patient's first clinical visit. This scoring criteria may allow physicians to substantially reduce the time it takes to begin treatment. The findings are published in the Annals of Neurology.

Rapidly progressive dementia is caused by several disorders that quickly impair intellectual functioning and interfere with normal activities and relationships. If patients' symptoms appear suddenly and they decline quickly, a physician may make the diagnosis of RPD. These patients can progress from initial symptoms of dementia to complete incapacitation, requiring full-time care, in less than two years.

The study analyzed data from 155 patients with RPD who were diagnosed at Mayo Clinic in Florida and Washington University in St. Louis. The median age of patients at the time of symptom onset was 69 years old. Patients underwent a standard evaluation, including brain MRI, electroencephalogram, blood tests and a spinal tap. They then were followed for up to two years.

The study team reviewed the data, assigned clinical diagnoses and determined which diseases would be considered potentially treatment-responsive. The team then compared symptoms and test results between patients with treatment-responsive and non-treatment-responsive causes. This identified key factors that were present at the time of the patient's first visit and were associated with treatment-responsive causes of RPD.

Seizures, tumors, MRI features of autoimmune encephalitis, movement abnormalities and other conditions were each associated with treatment-responsive causes of RPD in the study. Of patients with these conditions, 95% were captured through a screening score developed by the Mayo researchers. The score was calculated by assigning points for clinical findings present during a patient's first visit for evaluation of cognitive decline.

"Many conditions that cause rapidly progressive dementia can be treated and even reversed. We found that more than half of the patients in our study with rapidly progressive dementia had a treatable underlying condition. We may be able to identify many of these patients early in the symptomatic course by intentionally searching for key clinical symptoms and test findings and integrating these with results of a brain MRI and spinal tap," says the study's senior author, Gregory Day, M.D., a clinical researcher, neurologist and vice chair of research of the Department of Neurology at Mayo Clinic in Florida.

Dr. Day's previous research found that other diseases may mimic a rare brain disorder called Creutzfeldt-Jakob's disease, which also is linked to dementia.

"It's crucial to treat patients sooner by identifying a condition that is causing their rapidly progressive dementia," says Nihal Satyadev, M.D., a neurology resident at Mayo Clinic in Florida and the study's first author. "It's equally important to recognize patients who are less likely to benefit from treatment, as this can allow the focus of care to shift to supporting quality of life and appropriate counseling."

The study authors plan to continue research to Excellerate diagnosis and treatment of patients with RPD, and to make it easier for clinicians to apply their tool to recognize patients with RPD. The team has already completed a project considering spinal fluid biomarkers that may Excellerate diagnosis and early recognition of treatable patients. These findings are also published in the Annals of Neurology.

Neurodegenerative conditions are debilitating ailments marked by the progressive decline in brain function and impact millions of individuals on a global scale.

As of January 2023, the FDA approved lecanemab, marketed as Leqembi^™ by Eisai, as a therapeutic option for Alzheimer’s disease.

This significant milestone represents the second drug approval in this category, with aducanumab, known as Aduhelm^™, having received approval in 2021, signifying a notable advancement in immunotherapy for neurodegenerative disorders.

Currently, the primary models utilized for researching brain diseases typically rely on postmortem human brain tissue, non-human primate tissue, or 2D in vitro experiments. However, these approaches are constrained by resource limitations and disparities in brain structure among different species.

In accurate times, a hopeful alternative has surfaced in the form of 3D brain organoids, which are cultivated from either embryonic stem cells (ESCs) or induced pluripotent stem cells (iPSCs). These organoids are proving to be a promising model for investigating neurodegenerative diseases.

Organoids derived from various brain regions, such as the forebrain, midbrain, and hippocampus, are cultured and employed as in vitro models for investigating neurobiological and neurodevelopmental disorders. The presence of cytokines in brain organoid cultures is of critical importance.

To illustrate, growth factors like FGF2, EGF, Noggin/NOG, and BMP4 have guided cellular differentiation along specific organ lineages. Furthermore, FGF2, SDF1, and FGF19 are utilized in the cultivation of cerebellar organoids, which are instrumental in the study of conditions like spinocerebellar ataxia.

Sino Biological offers a comprehensive array of products suitable for brain organoid culture, including human EGF, FGF2, NOG, BMP4, FGF8, FGF19, and more. These resources greatly support research efforts focused on neurodegenerative diseases.

Figure 1. Brain organoid: an emerging model for investigating neurological development in vitro. Image Credit: Sino Biological US Inc

Featured cytokines for brain organoid culture

Sino Biological has created an extensive collection of bioactive recombinant cytokines sourced from a diverse range of species, including humans, mice, cynomolgus monkeys, rhesus monkeys, rats, and dogs.

• Various Species
• High Purity
• HPLC Verified
• Low Endotoxin
• High Activity

Human EGF protein, HPLC-verified

(Cat#: 10605-HNAE)

High-purity: ≥ 95 % as determined by SDS-PAGE & SEC-HPLC. Image Credit: Sino Biological US Inc

Activity-validated: Cell proliferation assay using Balb/C 3T3 mouse embryonic fibroblasts. Image Credit: Sino Biological US Inc

Human FGF2 protein

(Cat#: GMP-10014-HNAE)

Activity-validated: Cell proliferation assay using Balb/c 3T3 mouse embryonic fibroblasts. Image Credit: Sino Biological US Inc

Human Noggin/NOG protein, HPLC-verified

(Cat#: 10267-HNAH)

High-purity: ≥ 95 % as determined by SDS-PAGE & SEC-HPLC. Image Credit: Sino Biological US Inc

Activity-validated: Inhibit BMP4-induced alkaline phosphatase production by MC3T3E1 mouse preosteoblast cells. Image Credit: Sino Biological US Inc

Human BMP4 protein

(Cat#: 10609-HNAE2)

Activity-validated: Cell proliferation assay using NIH-3T3 mouse embryonic fibroblast cells. Image Credit: Sino Biological US Inc

More cytokines for brain organoid culture (partial list)

Source: Sino Biological US Inc

Featured antibodies related to brain organoid culture

Anti-SOX2 antibody

Rabbit mAb; (Cat#: 100106-R017)

Immunochemical staining of human SOX2 in human testis. Applications: IHC-P. Image Credit: Sino Biological US Inc.

Anti-beta-III tubulin/TUBB3 antibody

Rabbit pAb; (Cat#: 101288-T34)

Immunofluorescence staining of TUBB3 in hESC-H9 cells. Applications: WB, ICC/IF. Image Credit: Sino Biological US Inc

Anti-Nestin antibody

Mouse mAb; (Cat#: 103270-MM11)

Flow cytometric analysis of Human NES expression on SHSY5Y cells. Applications: WB, IHC-P, FCM, IP. Image Credit: Sino Biological US Inc

Learn More about Brain Organoids

Many disorders are caused by genetic variants; to make matters worse, the genetic origin of most disorders remains unknown. Now, in a study recently published in the Journal of Clinical Immunology, researchers have shed light on the specific variants responsible for one rare and serious disorder: 'RAD50 deficiency/Nijmegen breakage syndrome-like disorder'.

Together with MRE11 and NBN, RAD50 is one of three proteins that make up the 'MRN complex', which detects breaks in DNA and helps to initiate DNA repair. Because each of the three proteins is encoded by a separate gene, variants in any of the three genes can lead to altered functioning of the MRN complex. However, although MRE11 and NBN gene variants are known to cause other disorders, ataxia telangiectasia-like disorder and Nijmegen breakage syndrome, respectively, the pathological effects of RAD50 gene variants have remained somewhat unclear – until now.

When we looked at the literature, we realized that only three cases of RAD50 deficiency, which leads to symptoms similar to those of Nijmegen breakage syndrome, had been reported. Of these three, just one was reported to have RAD50 variants, with associated bone marrow failure and immunodeficiency."

Masatoshi Takagi, lead author of the study

When the research team came across a patient with progressive bone marrow failure and immunodeficiency combined with Nijmegen breakage syndrome-like manifestations, they decided to perform whole-exome sequencing to see if they could identify any gene variants that might lead to the observed symptoms.

"We found two different RAD50 variants in our patient, each of which was inherited from one of her parents," states Takagi. "We then tested the functional effects of these combined variants using fibroblast cells from the patient, which we grew in the lab."

The functional experiments suggested that the patient's RAD50 variants led to a loss of function of the RAD50 protein, and thus of the MRN complex. They also resulted in slower cell replication (i.e., mitosis), as expected. Interestingly, however, these variants did not cause hypersensitivity to radiation, unlike other known RAD50 variants.

"Together, the findings from our case and the three previously reported cases suggest that RAD50 deficiency/Nijmegen breakage syndrome-like disorder is characterized by growth retardation and microcephaly, which may coexist with bone marrow failure and immunodeficiency in some patients," says senior author of the study Hirokazu Kanegane. "This disorder may therefore increase susceptibility to infectious diseases and immune-related conditions."

Given the rarity of this disorder and our lack of knowledge about its genetic causes, the findings from this case are important. A better understanding of RAD50 and its effects on immunity can lead to improved diagnosis and treatment of patients with RAD50 deficiency.