About Biochemistry Chemical natures, functions, genetics, body fluids both normal and abnormal, molecular level knowledge, latest hi-tech equipments and their use. Objectives
The broad goal of the teaching under-graduate students in biochemistry is to make them understand the scientific basis of the life processes at the molecular level and to orient them towards the application of the knowledge acquired in solving clinical problems.
(A) KNOWLEDGE :
At the end of the course, the student shall be able to :
Describe the molecular and functional organisation of a cell and list its sub-cellular components;
Delineate structure, function and inter-relationship of biomolecules and consequences of deviation from normal;
Summarize the fundamental aspects of enzymology and clinical application wherein regulation of enzymatic activity is altered: Describe digestion and assimilation of nutrients and consequently or malnutrition consequences of malnutrition;
Integrate the various aspects of metabolism and their regulatory pathways;
Explain the biochemical basis of inherited disorders with their associated sequelae;
Describe mechanisms involved in maintenance body fluid and pH homeostatis;
Outline the molecular mechanisms of gene expression and regulation the principles of genetic engineering and their application in medicine; summarize molecular concept of body defences and their application in medicine;
Outline the biochemical basis of environmental health hazards; biochemical basis of cancer and carcinogenesis;
Familiarize with the principles of various conventional and specialized Laboratory investigations and instrumentation analysis and interpretation of a given data; Suggest experiments to support theoretical concepts and clinical diagnosis.
I. CELL :
Subcellular components – Molecular and functional organization.
II. BIOMOLECULES :
Plasma membrane, cytoplasm, Nucleus and subcellular components like Mitochondria, Endoplasmic reticulum, lysosomes, peroxisomes, cytoskeleton, Golgi apparatus etc.
Chemistry of Carbohydrates – Monosaccharides, disaccharides homo and hetero Polysaccharides.
Chemistry of Lipids – Classification, fatty acids Eicosanoids and derivatives
Triglyceride, Phospholipids, Cholesterol, and lipoprotein.
Chemistry of protein – classification of amino acids; peptides, peptide hormones eg. Insulin, glucagon, parathyroid hormone, and few pituitary hormones. Plasma proteins – classification, method of Separation and Electrophoretic pattern of plasma protein in health and disease. Protein structure and function.
Nucleic acids : Nucleotides – DNA & RNA Structure, Nucleic acid analogues of medical importance.
Structure of Haemoglobin, Myoglobin – structural relationship with the function. Abnormal haemoglobin – Congenital and acquired;
Vitamins and Minerals – (in brief details in Nutrition).
III. ENZYMES :
Fundamental aspects of enzymology – definition, classification, mechanism of action, factors affecting enzyme activity – Enzyme regulation – Coenzymes – Isozymes – enzymes of clinical importance.
IV. NUTRITION :
Digestion and assimilation of Nutrients :-
Carbohydrates, proteins, lipids, vitamins and minerals.
Nutritional requirements – RDA, SDA, Balanced diet and limiting amino acid.
Vegetarianism Consequences of malnutrition : Marasmus, Kwashiorkor, overnutrition.
V. METABOLISM AND REGULATORY PATHWAYS
Clinically important investigation pertaining to lipids and lipoproteins. Protein metabolism : Dynamic state of body proteins – Interorgan transport of amino acids – Ammonia production – Transport and body amino acid pool – its disposal – Urea cycle. Metabolism of individual amino acidsBiologically important compounds obtained from amino acids including Gamma aminobutyric acid and Polyamines. Clinically important investigations pertaining to protein metabolism – Total protein – albumin – globulin – A.G. ratio – Serum protein electrophoresis – Blood urea – BUN – Serum creatinine – urea and creatinine clearances – Amino acid chromatography for screening inborn errors.
Introduction to metabolism. Emphasize the purpose of metabolism like energy production, interconversion and synthesis of important bio molecules etc. High energy compounds Biological oxidation – enzymes involved – oxidative phosphorylation – theories – shuttles. Metabolic pathways, regulation and metabolic errors :-
Carbohydrates:glycolysis – HMP Pathway – gluconeogenesis – uronic acid pathway – glycogen metabolism – fructose and galactose metabolism and TCA cycle. Regulation of blood glucose – Diabetes Mellitus – hypoglycaemia – Hyper glycaemia. Inborn errors of carbohydrate metabolism. Clinically important investigations pertaining to carbohydrate metabolism – reduction test of urine, differential diagnosis for glycosuria including chromatography. Blood sugar values, GTT, glycosylated haemoglobin, fructosamine. Lipid metabolism : Synthesis of fatty acid – Fatty acid oxidation – energetics of oxidation, ketone bodies, metabolism of unsaturated fatty acids – prostaglandine – prostacycline – Thromboxanes – Trilycerides – phospholipids – sphingolipids – Cholesterol and its derivtives. Apoproteins – Fatty liver lipotropic factors.
Integration of Metabolism
Main control sites of Metabolic pathways and key enzymes.
Metabolic adaptation during fed state and starvation.
Metabolism in Principal organs like liver, RBC, adipose tissue, muscle, kidney, heart and brain.
Nucleic acid Metabolism
Purine and pyrimidine synthesis and Degradation – Salvage pathways– Abnormalities of Nucleic and metabolism
Metabolism of Haemoglobin, Porphyrias and Bilirubinaemia
Porphyrias, Abnormal Hemoglobin and Janudice and investigations pertaining to these disorders.
VI. GENE EXPRESION AND REGULATION
Principles of Genetic Engineering and their application in Medicine.
Basics of Genetics – Chromosomal structure – arrangement of coding sequence and genetic code.
Biosynthesis of Proteins with Posttranslational modification
DNA Replication and its repair – RNA Synthesis and Processing – Mutation.
Gene Expression and Regulation.
Operon concept, genetic switch – Gene rearrangement – gene amplification – Gene protein Interaction.
Genetic engineering techniques and their application in medicine.
Restriction enzymes, Vectors genome library – DNA probes-Blot transfer techniques.
Recombinant DNA technology, PCR – Polymerase Chain Reaction – Clinical application of genetic engineering.
VII. INBORN ERRORS :
Biochemical basis of inherited disorders with their associated sequelae.
Introduction : to various types of inheritance and types of mutation defect in relation to various inherited disorders.
Glycogen storage disease, galactosaemia G6PD deficiency. Lactose Intolerence, Fructose intolerance, Fructosuria, Pentosuria,
Disorders of FA Oxidation, Sphingolipidosis, dyslipoproteinaemias,
Urea cycle disorders, inborn errors associated with each aminoacid.
Porphyrias, hyper bilirubinemia (congenital and acquired)
Hyperuricaemia, Gout, Orotic Aciduria, Lesch Nyhan Syndrome.
Neonatal screening for and prenatal diagnosis of inborn errors.
Mechanisms involved in the maintenance of body fluids and pH homeostasis.
Metabolism of water and electrolytes homeostasis of pH – buffer sytem, Role of Kidney and Lungs – Acid base disorders.
Blood gas analysis and its interpretation and correlation to acid base disorders.
Molecular concept of body defence and application in medicine
Immunoglobin structure, type, synthesis and function – Antigen binding – monoclonal anti bodies – Hype and Hypogamma globulinaemia Immunodeficiency and AIDS – Biochemical methods of assessing the Immunoglobulin RIA, ELISA.
X. ENVIRONMENTAL HAZARDS AND CANCER
Biochemical basis of Environmental Hazards – occupational hazards (lead, organo phosphorus compounds etc.) Hazards due to modern industrialisation (H S) and traffic pollution (CO) Xenobiotics.
Biochemical basis of cancer and carcinogenesis – Tumour markers.
XI. LABORATORY INVESTIGATION :
Principles of Various conventional and specialised Laboratory investigations and Instrumentation analysis and interpretation of data.
Principles of conventional and specialised Lab investigation including instrumentation analysis.
Conventional : manual colorimetric methods for biochemical parameter (dealt with in practical classes).
Specialised : automated techniques Semi and random auto analyser – ELISA – RIA – Fluorimetry – Blood Gas Analyser.
Interpretation of data :
Normal range of biochemical parameters – Causes for deviation from normal.
XII. CLINICAL CHEMISTRY :
Experiments to support theoretical concept and clinical diagnosis.
a) Biochemical tests to determine the functional ability of an organ – Liver function test – Renal function test – Pancreatic function test.
b) Investigations pertaining to hormones – Mode of action of hormone and its function – Thyroid function tests – Parathyroid function tests – Adrenal function tests.
Biochemical tests to confirm the clinical diagnosis of a disease and their interpretation.
Jaundice (haemolytic, hepatic and obstructive) – Cirrhosis liver – Acute Renal failure, chronic Renal failure, Nephrotic syndrome – Myocardial infarction – Diabetes mellitus, (mild, moderate and severe.) – Renal glycosuria – Alimentary glycosuria – Rickets – Hypo and hyperparathyroidism – Hypo and hyper thyroidism – Pancreatitis.
(Metabolic acidosis alkalosis & Respiratory acidosis alkalosis) - both uncompensated and compensated.
BIOCHEMISTRY PRACTICAL SYLLABUS
Spotters and Clinical Chemistry Exercise :-
1. SPOTTERS : The student must identify the spotter and write one most important use of the spotter.
Glucosazone / Fructosazone
Electrophoresis paper – normal pattern
Electrophoresis paper – nephrotic syndrome
Electrophoresis paper – cirrhosis of liver
Electrophoresis paper – multiple myoloma
Benedict’s qualitative reagent
Structrue of t RNA
Structure of cholesterol
Structure of glucose
Structure of fructose
Suggest investigations for a case of
Acute renal failure
Hype and Hypo parathyroidism
Hyper and hypothyroidism
1 .Albumin Globulin ratio with total protein and albumin values
2. Calculate minute volume from 24 hours urine volume
3. Calculate creatinine clearance with the required parameters given.
Electrophoresis patterns – normal, cirrhosis liver, hepatic syndrome Multiple myeloma
Normal GTT and diabetes mellitus glycosurias
Acute renal failure and nephrotic syndrome
Hypo and hyper thyroidsm
Hypo and hyper parathyroidism
At the end of the course, the student shall be able to:
make use of conventional techniques / instruments to perform biochemical analysis relevant to clinical screening and diagnosis.
Analyze and interpret investigative data;
Demonstrate the skills of solving scientific and clinical problems and decision making.
Teaching & Learning methods Structured Interactive sessions,
Self learning modules and
Anatomy | Physiology | Biochemistry
Pre-Clinical | Para-Clinical | Clinical