Biochemistry
About Biochemistry
Chemical natures, functions, genetics, body fluids, both normal and abnormal, molecular level knowledge, latest hi-tech equipment and their use.
Objectives
The broad goal of teaching undergraduate students in biochemistry is to make them understand the scientific basis of the life processes at the molecular level and orient them towards applying the knowledge acquired in solving clinical problems.
Course Contents
(A) KNOWLEDGE :
At the end of the course, the student shall be able to Describe the molecular and functional organization of a cell and list its sub-cellular components Delineate structure, function and inter-relationship of biomolecules and consequences of deviation from normal Summarise 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 the maintenance of body fluid and pH homeostasis Outline the molecular mechanisms of gene expression and regulation of the principles of genetic engineering and their application in Medicine summarise the molecular concept of body defenses and their application in Medicine Outline the biochemical basis of environmental health hazards the biochemical basis of cancer and carcinogenesis Familiarise 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 diagnosisTHEORY SYLLABUS
CELL
Subcellular components – Molecular and functional organisation. The plasma membrane, cytoplasm, Nucleus and subcellular components like Mitochondria, Endoplasmic reticulum, lysosomes, peroxisomes, cytoskeleton, Golgi apparatus etc.BIOMOLECULES
Introduction Chemistry of Carbohydrates –Chemistry of Lipids – Classification, fatty acids
Chemistry of protein – classification of amino acids
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).
ENZYMES
Fundamental aspects of enzymology – definition, classification, mechanism of action, factors affecting enzyme activity – Enzyme regulation – Coenzymes – Isozymes – enzymes of clinical importance.
NUTRITION
Digestion and assimilation of Nutrients: Carbohydrates, proteins, lipids, vitamins and minerals. Nutritional requirements: RDA, SDA, Balanced diet and limiting amino acids. Vegetarianism Consequences of malnutrition: Marasmus, Kwashiorkor, overnutrition.
METABOLISM AND REGULATORY PATHWAYS:
Introduction to metabolism. Emphasise the purpose of metabolism like energy production, interconversion and synthesis of important biomolecules etc. High energy compounds Biological oxidation – enzymes involved – oxidative phosphorylation – theories – shuttles. Metabolic pathways, regulation and metabolic errorsCARBOHYDRATES
Glycolysis – HMP Pathway – gluconeogenesis – uronic acid pathway – glycogen metabolism – fructose and galactose metabolism and TCA cycle. Regulation of blood glucose – Diabetes Mellitus – hypoglycaemia – Hyperglycaemia. Inborn errors of carbohydrate metabolism.
Clinically important investigations are pertaining to carbohydrate metabolism – reduction test of urine, the 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 derivatives. Apoproteins – Fatty liver lipotropic factors.
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 acids Biologically important compounds are obtained from amino acids, including Gamma-aminobutyric acid and Polyamines. Clinically important investigations pertaining to protein metabolism – Total protein – albumin – globulin – AG ratio – Serum protein electrophoresis – Blood urea – BUN – Serum creatinine – urea and creatinine clearances – Amino acid chromatography for screening inborn errors.
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 Jaundice and investigations pertaining to these disorders.
GENE EXPRESSION AND REGULATION
Principles of Genetic Engineering and their application in Medicine. Basics of Genetics – Chromosomal structure – arrangement of the coding sequence and genetic code. Biosynthesis of Proteins with Posttranslational modification Cell Cycle 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.INBORN ERRORS
Biochemical basis of inherited disorders with their associated sequelae. Introduction to various types of inheritance and types of mutation defects in relation to various inherited disorders. Carbohydrates: Glycogen storage disease, galactosaemia G6PD deficiency. Lactose Intolerence, Fructose intolerance, Fructosuria, Pentosuria, Lipids: Disorders of FA Oxidation, Sphingolipidosis, dyslipoproteinemia, Proteins: Urea cycle disorders, inborn errors associated with each amino acid. Porphyrias, hyperbilirubinemia (congenital and acquired) Hyperuricaemia, Gout, Orotic Aciduria, Lesch Nyhan Syndrome. Neonatal screening for and prenatal diagnosis of inborn errors.HOMOEOSTASIS
Mechanisms involved in the maintenance of body fluids and pH homeostasis. Metabolism of water and electrolytes homeostasis of pH – buffer system, Role of Kidney and Lungs – Acid-base disorders. Blood gas analysis and its interpretation and correlation to acid-base disorders.IMMUNITY
Molecular concept of body defence and application in Medicine Immunoglobin structure, type, synthesis and function – Antigen binding – monoclonal antibodies – Hype and Hypogamma globulinaemia Immunodeficiency and AIDS – Biochemical methods of assessing the Immunoglobulin RIA, ELISA.ENVIRONMENTAL HAZARDS AND CANCER
Biochemical basis of Environmental Hazards – occupational hazards (lead, organophosphorus compounds, etc.) Due to modern industrialisation industrialisation (H S) and traffic pollution (CO) Xenobiotics, Hazards. Biochemical basis of cancer and carcinogenesis – Tumour markers.LABORATORY INVESTIGATION
Principles of Various conventional and specialized Laboratory investigations and Instrumentation analysis and interpretation of data. Principles of conventional and specialized Lab investigation including instrumentation analysis. Conventional: manual colorimetric methods for the biochemical parameter (dealt with in practical classes). Flame photometer Spectroscopy Specialized: automated techniques Semi and random auto analyzer – ELISA – RIA – Fluorimetry – Blood Gas Analyser. Interpretation of data : Normal range of biochemical parameters – Causes for deviation from normal.CLINICAL CHEMISTRY
Experiments to support the 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 confirm the clinical diagnosis of a disease and its 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 Spotters: The student must identify the spotter and write one most important use of the spotter.
pH paper Colourimeter Centrifuge Ryle’s tube Urinometer Copper Sulphate Spectroscope Electrophoresis apparatus Oxyhaemoglobin Methaemoglobin Carboxyhaemoglobin Glucosazone / Fructosazone Lactosazone Maltosazone Haemin crystals Electrophoresis paper – normal pattern Electrophoresis paper – nephrotic syndrome Electrophoresis paper – cirrhosis of the liver Electrophoresis paper – multiple myeloma Chromatography paper Picric acid Benedict’s qualitative reagent Structure of t RNA Structure of cholesterol Structure of glucose Structure of fructose
Suggest investigations for a case of Jaundice Diabetes mellitus Acute renal failure Proteinuria Oedema Rickets Myocardial infarction Acidosis Alkalosis Glycosuria Aminoaciduria Hype and Hypo parathyroidism Hyper and hypothyroidism Calculate the Albumin Globulin ratio with total protein and albumin values Calculate minute volume from 24 hours of urine volume Calculate creatinine clearance with the required parameters given.
Interpret Electrophoresis patterns – normal, cirrhosis liver, hepatic syndrome, Multiple myeloma Normal GTT and diabetes mellitus glycosurias Acute pancreatitis Myocardial infarction Acute renal failure and nephrotic syndrome Acidoses, alkalosis Hypo and hyper thyroidsm Hypo and hyper parathyroidism Rickets Jaundice
SKILLS
At the end of the course, the student shall be able to: Use conventional techniques/instruments to perform biochemical analysis relevant to clinical screening and diagnosis. AnalyseAnalyse and interpret investigative data; Demonstrate skills in solving scientific and clinical problems and decision-making. Teaching & Learning methods Structured Interactive sessions, Tutorials, Group Discussions, Seminars, Projects, Self-learning modules and e-modules etc.