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Courses and Syllabi
MBBS - Bachelor of Medicine & Surgery
MD - Doctor of Medicine (Biochemistry)
BDS - Bachelor of Dental Surgery
DCP - Diploma in Clinical Pathology
BPharm - Bachelor of Pharmaceutical Sciences
BSc MLT - Bachelor of Medical Laboratory Technology
BSc Nursing - Bachelor of Nursing
DMLT - Diploma in Medical Laboratory Technology
Course Summary
A basic understanding of biochemistry is an integral part of the medical sciences.
Duration of Course 2 semesters with total of 240 hours (lectures 80 and practicals, seminars, structured discussion, integrated teaching, projects, evaluation and revision 160).
Medical Biochemistry is designed to present the basics of biochemistry for the purpose of providing the student with the background necessary for their future studies.
Goal The broad goal of the teaching of undergraduate students in Biochemistry is to make them understand the scientific basis of the life process at the molecular level and to orient them towards the application of the knowledge acquired in solving clinical problems.
Objectives- at the end of the course, the student shall be able to:
Syllabus
Duration of the course : 2 semesters
Total number of hours : 240
Lectures : 80
Practicals : 160
Innovative session (Projects, seminars, structured discussion, integrated teaching, formative evaluation and revision): Along with Practicals
l. Introduction 1 hr.
Structure and functions of cell, cellular organelle and biomembranes
Structure and function of biomembrane. 2 hrs
(details of membrane transport and ion channels will be covered in Physiology, so
excluded from Biochemistry).
2. Biomolecules 14 hrs
A. Proteins:
Amino acids - classification based on structure. 1 hr.
Ionic properties of amino acids, isoelectric pH, 2 hrs
buffering action of aminoacids and proteins.
Structural organization of proteins - primary,
secondary, tertiary and quaternary, forces involved
in maintaining - Examples - Insulin, collagen, proteins. 2 hrs
Denaturation, coagulation, isoelectric precipitation,
precipitation of proteins using salt solutions,
classification of proteins (colour reactions to be
covered with practicals).
Electrophoresis and chromatography - brief mention on
separation techniques (details of techniques and
application in practical demonstration). 1 hr.
B. Carbohydrates:
Classification - monosaccharides; glucose, fructose,
galactose and mannose. Reactions; reducing property,
oxidation, reduction). Isomers, anomers and epimers.
Derivatives like amino sugars and deoxy-sugars.
Glycosidic bond. 2 hrs
Disaccharides; lactose, sucrose, maltose.
Polysaccharides; Starch, glycogen, dextrins,
glycosaminoglycans (basic structural features
and functions only), blood group antigens. 2 hrs
C. Lipids:
Definition, classification with examples,
saturated and unsaturated fatty acids,
triacylglycerol, phospholipids. 2 hrs
3. Enzymes 10 hrs
Nature of enzymes, coenzymes and cofactors, classification,
Mechanism of action, specificity of enzymes, active site
Enzyme kinetics, factors affecting enzyme activity,
Km value and significance (derivation not required).
Enzyme inhibition - competitive, noncompetitive, allosteric,
feed back, therapeutic agents like antimetabolites as examples.
Enzymes regulation in biological systems - allosteric regulation,
covalent modification, zymogen activation, induction and
repression (mention only).
Isoenzymes and their significance with suitable examples.
Clinical enzymology - Diagnostic importance of enzymes
(LDH, CPK, AST, ALT, ACP, GGT, GPD, 5’NTase, Cholinesterase,
Amylase, Lipase).
4. Digestion and absorption of nutrients 3 hrs
Carbohydrates, lipids and proteins:
Disorders of digestion and absorption.
Glucose transporters
Malnutrition - PEM
5. Vitamins 8 hrs
Classification, chemical nature (detailed structure not required),
coenzyme forms, biochemical role, sources, requirements,
deficiency and toxicity of the following vitamins.
i. Vitamins A, D, K and E - free radicals.
ii. Thiamine, riboflavin, niacin, biotin, pyridoxine, pantothenic acid
iii. Folic acid and one carbon groups and B12
iv. Ascorbic acid
6. Minerals 6 hrs
Sources, requirements, absorption, biochemical role,
deficiency and toxicity of the following minerals.
i. Calcium and phosphorus - role of PTH. 1,25-DHCC and CT.
ii. Iron, copper, magnesium and anaemias.
iii. Sodium potassium and chloride.
iv. Trace elements - Zn, F, I, Se, Mn
End of first three months teaching l3 x 5 hrs per week = 65 hrs.
Total suggested classes - 41 hours.
A. Metabolism of Carbohydrates 14 hrs
i. EMP Pathway: Reactions, regulation in brief, energetics,
Rapaport Leubering cycle, fate of pyruvate in aerobic and
anaerobic conditions, PDH reaction. 3 hrs
ii. Gluconeogenesis, key enzymes, regulation and significance,
Cori’s cycle. 1 hr.
iii. Glycogen synthesis and degradation, regulation (brief),
inborn errors associated. 2 hrs
iv. HMP shunt pathway, NADPH generation, transketolase reaction.
tissues where operating, G6PD deficiency, metabolic importance
(non oxidative phase need not be elaborated). 2 hrs.
iv. Metabolism of galactose, fructose, polyol and
uronic acid pathways - inborn errors associated. 2 hrs
v. Blood glucose regulation - action of insulin, glucagon,
cortisol, growth hormone. 1 hr.
vi. Diabetes mellitus - Etiology, biochemical abnormalities,
symptoms and complications. 1 hr.
viii. Glycosurias - differential diagnosis of reducing sugars. 1 hr.
ix. GTT - procedure, criteria of normal & diabetic status,
interpretation of graphs, glycated Hb. 1 hr.
B. Lipids 13 hrs.
i. Beta oxidation of fatty acids, transport of fatty acids
across mitochondrial membrane, regulation and energetics. 1 hr.
ii. Synthesis of fatty acids, fatty acid synthase complex,
regulation, elongation and desaturation, 2 hrs.
iii. Formation and utilization of ketone bodies,
ketoacidosis in diabetes and starvation. 2 hrs.
iv. Metabolism of adipose tissue, hormone sensitive lipase,
action of Hormones (insulin, glucagon, epinephrine and cortisol),
liver adipose tissue axis, fatty liver, lipotrophic factors. 2 hrs.
iv. Cholesterol - structure synthesis (crucial intermediates only),
regulation, metabolic fate, bile acids and steroid hormones
formation from cholesterol. 2 hrs.
v. Transport of plasma lipids, lipoproteins, metabolism,
apoproteins, functions, lipid profile and dyslipidemias,
atherosclerosis, biochemical basis of management of
hyperlipidemias - diet, PUFA and dietary fibre, drugs. 2 hrs.
vi. Eicosanoids - prostaglandins, thromboxanes and leukotrienes,
structure and formation (major steps only), actions. 1 hr.
viii. Phospholipids and sphingolipids - inborn errors.1 hr.
C. Amino acids 13 hrs
i. Body amino acid pool, dynamic state of body proteins,
inter-organ transport of amino acids, nitrogen balance,
glucogenic and ketogenic amino acids. 1 hr.
ii. Transamination (reaction only), decarboxylation, oxidative
deamination, transdeamination, formation of ammonia. 1 hr.
Disposal of ammonia, urea cycle, hyper ammonemias. 1 hr.
iii. Metabolism of glycine, compounds synthesized, creatine
and creatinine, hyperglycinemias, glutathione. 2 hrs
iv. Metabolism of sulphur containing amino acids, methionine and cysteine,
transsulphuration, transmethylation reactions, formation of taurine, PAPs,
excretion of sulphur, homocystinuria, cystinuria and cystinosis. 2 hrs
v. Phenylalanine and tyrosine - metabolism, PKU and alkaptonuria,
synthesis of thyroid hormones, synthesis and catabolism
of catecholamines, albinism, tyrosinemia. 2 hrs
vi. Tryptophan - formation of NAD (important steps only),
serotonin and S HIAA, xanthurenic acid, melatonin,
formation of indican, Hartnup’s disease, branched chain
amino acids - MSUD (pathway not required). 2 hrs
vii. Glutamic acid, glutamine, GABA, aspartic acid,
asparagine, serine, (metabolic role and compounds synthesized
using these amino acids only), polyamines. 2 hrs
D. TCA Cycle 6 hrs
i. Reactions, regulation and energetics. 1 hr.
ii. Interrelation of CHO, lipid, and amino acid metabolism. 1 hr.
iii. Anaplerotic reactions, amphibolic role of TCA cycle and
metabolic adaptations during fed state and starvation. 2 hrs
iv. Electron transport chain - components and sites of ATP synthase,
inhibitors and uncouplers, ATP synthase
and mechanism of oxidative phosphorylation (briefly). 2 hrs
7. Hemoglobin 5 hrs
Synthesis and degradation. 2 hrs
Hemoglobinopathies and thalassemias, porphyrias
(brief mention only as examples in each case). 3 hrs
8. Maintenance of Homeostasis 6 hrs
i. Acid base regulation - acid and bases, pH, buffers,
Henderson - Hasselbach’s equation (derivation not required),
buffer capacity. 1 hr.
ii. Acids and bases in the body, plasma buffers, respiratory and
renal regulation of pH. 2 hrs
iii. Acidosis and alkalosis, major causes and compensatory
mechanism, anion gap, assessment of acid base status. 2 hrs
iv. Fluid and electrolyte balance - distribution of body Water
disorders (hormonal regulation covered in Physiology). 1 hr.
End of second three months teaching 13 x 5 hrs per weeks ~ 65 hrs.
Total suggested classes - 57 hours.
9. Nucleic Acids 23 hrs
A . i. Structure of purines, pyrimidines. nucleosides, nucleotides: 2 hrs
ii. Purine: nucleotide synthesis and catabolism (synthetic
pathway need. not be considered in detail with names of
intermediates. Only the source of different atoms and
sequence of addition). Salvage pathway and regulation,
hyperuricemia and gout, Lesch Nyhan syndrome. 2 hrs
iii. Pyramidine: nucleotide synthesis, regulation, orotic aciduria,
formation of deoxy nucleotides, thymidylate synthase reaction,
folic acid antagonists and nucleotide analogues as
chemotherapeutic agents. 1 hr.
iv. Nucleic acids: Structure of DNA, different types of DNA,
mitochondrial DNA, base pairing rule, differences between
DNA and RNA, mention different types of RNA. 2 hrs
B. DNA replication, DNA polymerase, DNA repair. 1 hr.
C. Transcription, RNA polymerase, post-transcriptional
modifications, splicing, inhibitors, reverse transcriptase,
ribozyme. 2 hrs
D. Genetic code, t-RNA, ribosomes. 1 hr.
E. Translation, steps, post-translational modifications,
inhibitors. 2 hrs.
F. Regulation of gene expression, induction,
repression and derepression. 1 hr.
G. Recombinant DNA technology, restriction endonucleases.
Southern, Northern and Western blotting. RFLP,
DNA, finger printing, polymerase chain reaction,
anti sense therapy, application of molecular biology in
clinical situations, gene therapy. 5 hrs.
H. Biochemical basis of inherited disorders: Mutations,
pathogenesis of inborn errors in general, types of
mutations with examples in each case, mode of inheritance.
10. Immunoglobulins 2 hrs.
Structure and functions, hyper and hypo gamma globulinemias,
immuno assays, AIDS, monoclonal antibodies.
11. Biochemistry of Cancer - Cell Cycle 5 hrs.
Mutagens, carcinogens, role in carcinogenesis, viruses in
carcinogenesis, tumour markers and oncogenes. 2 hrs.
Biochemical basis of environmental health and environmental
toxicology. Biotransformation of xenobiotics in general and
absorption, transport, effects and biotransformation. 3 hrs.
12. Conventional Laboratory Investigations 6 hrs.
i. Liver Function Tests including formation of bilirubin,
hyperbilirubinemias and differential diagnosis of jaundice
(S. bilirubin, serum enzymes, A/G ratio, BSP test, urine tests). 2 hrs.
ii. Gastric Function Tests (Pentagastrin test, total and free
acidity of gastric juice, AHT and Hollander’s test) and
Pancreatic Function tests including tests for malabsorption. 2 hrs.
iii. Renal Function Tests - clearance tests, tests of tubular
function, NPN urine analysis. 2 hrs.
iv. Specialized Laboratory Investigations - RIA, EIA,
principles of colorimetry. 1 hr.
v. Radioactivity - diagnostic, research and therapeutic
applications and radiation hazards. 1 hr.
End of third three months teaching l3 x 5 hrs per week: = 65 hrs.
Total suggested classes - 36 hours.
The topics mentioned above have to be covered within the stipulated period of one year. Hence, the basic fundamentals may be covered as lectures and the other topics as tutorials, group discussions, integrated teaching sessions (Horizontal and vertical), seminars and symposia. In all these sessions active participation of students must be ensured. A few topics have identified for the nonconventional type of learning.
1. Reactions of carbohydrates: Glucose, fructose, lactose, sucrose. 3 sessions
2. Reactions of proteins (colour reactions and precipitation) 3 sessions
3. Reactions of urea and uric acid. 1 session
(Hypobromite and specific urease test for urea and
Benedict’s test and Schiff’s test for uric acid)
4. Identification of biochemically important compounds in given solution. 3 sessions
5. Normal urine - organic and inorganic constituents 2 sessions
End of first three months teaching 13 x 2 hrs per week - 26 hours.
Total suggested classes = 24 hours.
6. Abnormal urine - urinalysis (physical and chemical). 3 sessions
7. Demonstration of electrophoresis - agar gel –
interpretation of simple patterns. 1 session
8. Demonstration of chromatography –
paper TLC - Diagnostic importance. 1 session
9. Introduction to clinical chemistry - collection of samples,
anticoagulants and preservatives, principles of colorimetry. 1 session
10. Estimation of glucose - GTT curves -lab data analysis. 1 session
11 .Estimation of urea in serum - calculation of clearance
from given values of U and V. 1 session
12. Estimation of creatinine in urine or serum –
calculation of clearance. 1 session
13. Estimation of serum cholesterol - estimation of LDL cholesterol
from given values of HDL and TAG, lipid profile, data interpretation. 1 session
14. Estimation of total protein and albumin - A/G ratio. 1 session
15. Estimation of serum alkaline phosphatase. 1 session
End of second three months teaching 13 x 2 hrs per week = 26 hours.
Total suggested classes = 24 hours.
16. Spotters - Demonstration - simple instruments, graphs, tests, etc. 2 sessions
17. Laboratory data interpretation - liver diseases, renal diseases,
acid base disturbances, diabetes mellitus, lipid disorders, etc. 2 sessions
18. Problem solving exercises - short history of different conditions
may be given and students will be asked to suggest investigations
to arrive at a diagnosis. 2 sessions
19. Revision 5 sessions
End of third three months teaching 13 x 2 hrs per week = 26 hours.
Total suggested classes = 22 hours.
EVALUATION - General details
Biochemistry
Theory- Two papers of 50 marks each (three hrs) 100 marks
Oral 20 marks
Practicals 40 marks
Internal Assessment 40 marks
Total 200 marks
University Examination
Theory - Topic Division
Paper I - Introduction, biomolecules, enzymes, nutrients, vitamins and minerals, metabolism of carbohydrates, lipids and proteins and haemoglobin (topics 1-8)
Paper II - Maintenance of homeostasis, nucleic acids, immunoglobulins, cell cycle and laboratory investigations (topics 9-12)
Practicals I- (a) Quantitative experiment - (estimation of blood urea, glucose, total protein, albumin, creatinine etc. (skills, interpretation) 10 marks
(b) Interpretation of data / problem solving exercise (data on diabetes mellitus, jaundice, nephrotic syndrome, MI etc.) 10 marks
Practical II - (a) ~Qualitative experiment - (identification demonstration of normal constituents, detection of abnormal constituents etc. (skills, interpretation) 10 marks
(b) Spotting (10 numbers) 10 marks
Orals - 4 examiners - Topics to be divided and all examiners to examine each student.
Maximum Mark 20 marks
Course Summary
Syllabus
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Course Summary
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Course Summary
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Course Summary
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Course Summary
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Course Summary
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