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1.        MED COURSE 341


      Giving Lecture on Gastroenterology

      Clinical bedside teaching once a week for 2 – 3 hours. 

Med Course 341 is the first clinical course for the medical students. It is a 10 credit hours course of theoretical part (lectures) and clinical part (bedside teaching). The main objective of the course is mastering history taking: learning the technique of how do physical exam and know the physical sings of patients. The course was taught over 28 week’s period.


THEORETICAL PART:   There shall be three lectures per week covering all the general medicine aspect such as cardiology, rheumatology, pulmonology, endocrinology, nephrology, gastroenterology, hematology/oncology, infectious diseases and neurology given over 84 lectures during 28 weeks.  

CLINICAL BEDSIDE TEACHING:   There shall two clinical sessions per week. The teaching consists mainly of basic history taking, basic technique of different system examinations and definition and identification of physical sings.


A.               Textbook of Medicine

Any one of the following excellent books:

1.    Clinical Medicine – A textbook for Medical students and doctors

    P.J Kumar and M.L. Clark “Latest Edition”


    2. Textbook of Medicine – by Souhami and


                                       – Latest Edition

3.Davidson’s Principles and Practices of Medicine – 

   C.R. Edward and Ian, A.D Bonchir

   – Latest Edition.

B.               Physical Examination

Any one of the following books: 

1.    A guide to physical examination and history taking, by Barbara Bates – Latest  


2.    Macleod’s Clinical Examination by John Munro and C. Edwards.

3.    Clinical Examination – 2nd Edition by Nicholas Talley and Simon O’Connor.


CONTINUOUS ASSESSMENT EXAM is 40% from the total 100% marks.

-                     This is the first exam done after the students finished the first half of the course and it

Consists of Written Exam (20%) and Clinical – Long Case Exam (20%) 

FINAL EXAMINATION is 60% from the total 100% marks.

-                     This will be the second exam after the students finished the 28 weeks of teaching and

Just like the first exam it consists of written exam (30%) and clinical – long case exam (30%)  

WRITTEN EXAM – IS COMPOSED OF 45 QUESTIONS OF TRUE OR FALSE ANS 15 QUESTIONS OF SINGLE BEST, each question is required to have five stems, setting the questions in a standard form, 5 statements a to e. There shall be 1 mark to be awarded for each correct statement answered in True or False questions (i.e. 1 x 5 = 5) and 5 full marks on every correct answer in the Single Best questions. There is no negative marking in the written exam. Students are advice to answer all the questions and make sure to submit the answer sheets with out any empty space.


2.    MED COURSE 441



   Meeting with the students for three to four times a   week for one hour discussion of cases and 20 minutes Lecture Presentation.   


      Taking students in round for three hours.

      Seeing patients for three hours

      Discussing the cases.

      Doing examination of the cases.

      Reviewing the result  of medication for some patient.      

          Course Specification 

For Guidance on the completion of this template, please refer to          of Handbook 2  Internal Quality Assurance Arrangements

Institution             King Saud University              

College/Department  Medicine / Internal Medicine

1.       Course title and code: 441 med

2.        Credit hours: 11

3.       Level/year at which this course is offered  Fifth year (Final year student)

a.       Bed site teaching sessions with group discussion of various topics

b.      Each student will assigned to two blocks each for 6 weeks in the medical floors.

The student is considered to be an integral part of the ward team.

         Teaching strategies to be used to develop these skills

Biweekly Bedside teaching on medical floor

Students will contribute to the daily rounds by:

         Methods of assessment of students numerical and communication skills

a.       Oral case presentations during bi-weekly bedside teaching with students mentor.

b.      Case write-ups; clarity and organization.

c.       Midterm and Final clinical examinations.


Assessment task (eg. Essay, test, group project, examination etc.)

Week due

Proportion of Final Assessment


Written examination

Week 12



Midterm Clinical examination

Week 7



Ward clinical assessment

Week 1-12



Final OSCE

Week 13


1.     Required Text(s)

1.       Dennis K. Kasper, et al., eds. Harrison’s Manual of Medicine

2.       Lee Goldman, J. Claude Bennett, eds. Pocket Companion to Cecil Textbook of Medicine.

2.     Essential References

1.       Dennis K. Kasper, et al., eds. Harrison’s Principles of Internal Medicine

2.       Lee Goldman, J. Claude Bennett, eds. Cecil Textbook of Medicine

3.       Recommended Books and References Material (Journals,  Reports, etc) (Attach List)

1.       Annals of Internal Medicine

2.       New England Journal of Medicine

3.       Journal of the American Medical Association (JAMA)

4.       The American Journal of Medicine


Multiple choice questions (sample)

1. 1.     A 45 year old man is referred by his primary care physician because of new onset of dysphagia of 4 wks duration. The pt has a history of heartburn self medicated. An UGIT study showed a distal esophageal mass lesion. Which of the following statements are incorrect?

a.     The lesion is most likely due to metastatic cancer

b.     Pt probably has had Barrets

c.     Bx would show adenoca

d.     Sq cell cancer is unlikely in this location

2.   2.    Endoscopy was performed on the previous pt and the findings confirm your suspicion. You now want to begin to stage the mass. Which of the following would be the first procedure of choice?

a.     Positron emission tomography (PET)

b.     CT of chest and upper abd

c.     EUS with FNA if lymph nodes are present

d.     Video assisted thoracoscopy with bx

3.   3.   A 75 year old lady presented to ER with SOB, melena and a hg of 6.9. her PMH is remarkable for AF, OA and a question of PUD. Medications include: warfarin, digoxin, and indomethacin. Gastroscopy confirms the presence of gastric ulcer with stigmata of recent bleeding. Which of the following placed this pt at increased risk for GI bleeding from use of NSAIDs?

a.     Age

b.     Past h/o DU

c.     Anticoagulant therapy

d.     History of Cardiovascular dz

e.     All of the above

4.  4.     From speaking with the physician of the previous pt, it is apparent that she suffers from severe pain if she does not take NSAIDs. He asks you if she can continue taking NSAIDs. Your recommendations would be:

a.     Switch from indomethacin to a cox-2 inhibitor

b.     Evaluate for HP and eradicate if found

c.     Add a daily PPI as prophylaxis

d.     Reasses the risk-benefit ratio of warfarin therapy for a pt who has had GI bleeding

e.     All of the above

5. 5.     A 45 yr old male presents with melena and has a coffee ground NG aspirate, hg of 11.9 with evidence of orthostais and tachycarida. Which of the following would warrant endoscopic Rx?

a.     a nonbleeding vissible vessel in a 1cm gastric ulcer

b.     A flat red spot in a 2cm DU

c.     An oozing DU

d.     Oozing from a mosiac mucosa in the stomach

e.     1 & 3

f.        2 & 4

6.  6.    Which of the following is not a predictor of increased mortality in UGI bleeding?

a.     Pt who is an 82 year old

b.     Bleeding in a pt who has pneumonia and sepsis

c.     Pt with red hematemesis at ER

d.     Pt with a nonbleeding visible vessel in a large gastric ulcer

7.  7.    A 24 year old women presented e 3m h/o diarrhea and wt loss e no fhx, travel hx, alcohol abuse and no associated symptoms, labs showed mild IDA. A fecal study shows 28 g of fat/24hrs. Abn D-xylose test but normal SBFT. Endomysial ab is increased. The next step is

a.     Pancreatic function tests

b.     Quantitative SB culture

c.     SB biopsy

d.     Treat with a gluten free diet

e.     Serum test for tissue transglutaminase

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