35-Day Study Plan | NTR University 1st MBBS

Subject Overview (NTR University Pattern)

Phase-wise Plan

PHASE 1 - Weeks 1 & 2 (July 16 - July 29) | Cover All Topics Once

• Morning (6 AM - 12 PM): Anatomy - 6 hrs
• Afternoon (1 PM - 4 PM): Physiology - 3 hrs
• Evening (5 PM - 8 PM): Biochemistry - 3 hrs
• Night (9 PM - 10 PM): Review notes from the day - 1 hr

• Upper limb + Lower limb (joints, muscles, nerves, vessels)
• Thorax (heart, lungs, mediastinum)
• Abdomen + Pelvis (organs, peritoneum)
• Head & Neck (cranial nerves, skull, orbit)
• Neuroanatomy (brain, spinal cord)
• Histology (all tissues, organs)
• Embryology (early development, organ systems)

• Blood & Body Fluids
• CVS (cardiac cycle, ECG, BP)
• Respiratory system
• Renal physiology + Acid-base
• GIT physiology
• Endocrinology
• Neurophysiology + Special senses

• Carbohydrate metabolism (glycolysis, TCA, glycogen)
• Lipid metabolism (fatty acids, ketone bodies, lipoproteins)
• Protein & Amino acid metabolism
• Enzymology
• Vitamins & Minerals
• Molecular biology (DNA, RNA, protein synthesis)
• Hormones (mechanism of action)

PHASE 2 - Weeks 3 & 4 (July 30 - Aug 12) | Revision + Previous Year Questions

• Morning (6 AM - 11 AM): Anatomy revision - high-yield topics + PYQs
• Afternoon (12 PM - 3 PM): Physiology revision - diagrams, applied physiology, PYQs
• Evening (4 PM - 7 PM): Biochemistry revision - pathways, clinical correlations, PYQs
• Night (8 PM - 10 PM): Write answers / practise long & short notes

• NTR University previous year patterns (5-mark, 10-mark questions)
• Commonly repeated topics
• Clinical application questions
• Draw and label diagrams (Anatomy + Physiology)
• Write metabolic pathways from memory (Biochemistry)

PHASE 3 - Final Week (Aug 13 - Aug 19) | Rapid Revision

• Day 1-2: Anatomy rapid revision (mnemonics, last-minute facts, practicals)
• Day 3-4: Physiology rapid revision (diagrams, normal values, applied)
• Day 5-6: Biochemistry rapid revision (pathways, enzymes, vitamins)
• Day 7 (Aug 19): Light review only, rest, sleep by 10 PM

High-Yield Topics for NTR University

Anatomy (Most Repeated)

• Brachial plexus, Lumbosacral plexus
• Cubital fossa, Femoral triangle, Popliteal fossa
• Thoracic duct, Azygos vein
• Circle of Willis, Ventricular system of brain
• Histology of liver, kidney, testis, ovary, skin
• Development of heart, kidney, gut

Physiology (Most Repeated)

• Cardiac cycle + Pressure-volume loop
• ECG waves and their significance
• Starling's law of heart
• JGA and renin-angiotensin system
• Haemostasis and blood coagulation
• Oxygen and CO2 transport
• GFR regulation
• Neuromuscular junction

Biochemistry (Most Repeated)

• HMP shunt / Pentose phosphate pathway
• Beta-oxidation of fatty acids
• Urea cycle
• Cholesterol synthesis and bile acids
• DNA replication, transcription, translation
• Enzyme inhibition (competitive vs non-competitive)
• Deficiency diseases (vitamins)

Recommended Books (NTR University Standard)

Practical Exam Tips

• Anatomy: Know all bones, joints, models; practice spotting
• Physiology: Know all normal values; practise graph interpretation (ECG, spirometry)
• Biochemistry: Know all experiments (Benedict's, Biuret, etc.) and their principles

Daily Routine Template

• Explanation of any topic - just ask
• Previous year questions - ask for any subject
• Quick revision notes - I'll generate them
• Diagrams explained - I can walk you through them

Upper Motor Neuron (UMN) vs Lower Motor Neuron (LMN) Lesions

1. Basic Definitions

• Neurons of the corticospinal tract (and corticobulbar tract) that project from the cerebral cortex down to the anterior horn of the spinal cord
• Also includes brainstem neurons that control spinal motor neurons
• Their axons travel in descending pathways (pyramidal tract)

• Neurons whose cell bodies lie in the anterior horn of the spinal cord (or cranial nerve motor nuclei in the brainstem)
• Their axons exit via peripheral nerves and terminate directly on skeletal muscle
• Also called the "final common pathway"

Key rule: Lesion above the anterior horn = UMN. Lesion at or below the anterior horn = LMN.

2. Comparison Table (Most Important for Exams)

3. Pathophysiology Explained

Why is tone INCREASED in UMN?

• UMN carries descending inhibitory signals that keep spinal reflex arcs in check
• When UMN is damaged, these inhibitory influences are lost
• This causes increased excitability of anterior horn motor neurons
• Result: brisk reflexes + increased tone = spasticity
• Note: It is actually damage to descending inhibitory pathways traveling alongside the corticospinal tract (not just the corticospinal tract itself) that causes spasticity

Why is tone DECREASED in LMN?

• The alpha motor neuron itself is damaged
• Direct connection to muscle is lost
• Without motor nerve input, the muscle becomes flaccid and gradually atrophies
• Fasciculations occur due to spontaneous activity in dying/damaged motor neurons

Important Exception - "Spinal Shock"

• In acute UMN lesions (e.g., sudden spinal cord injury), there is initially:
  • Flaccid paralysis + decreased tone + decreased reflexes
• This is called spinal shock and can last hours to months
• Only later does it convert to the classic spastic UMN picture
• This is a common exam trap!

4. Clinical Examples

5. Special Case - Facial Nerve (CN VII)

6. Memory Aids (Mnemonics)

• Weakness
• Hyperreflexia
• Atrophy (mild/disuse only)
• Reflex - Babinski present
• Fasciculations absent
• Spasticity (increased tone)

• Weakness
• Atrophy (severe)
• Fasciculations present
• Areflexia / hyporeflexia + flaccidity

7. Quick Revision Summary

UMN Lesion → Loss of inhibition → Spasticity, Hyperreflexia, Babinski +ve, No atrophy
LMN Lesion → Loss of nerve supply → Flaccidity, Areflexia, Fasciculations, Severe atrophy
ACUTE UMN → Initially looks like LMN (spinal shock) → later converts to UMN picture
ALS → BOTH UMN + LMN signs simultaneously