Medicinal Biochemistry: Pharm.D First Year

List of Topics for Biochemistry

1. Introduction to Biochemistry

  • Cell and Its Biochemical Organization
  • Cellular components and their functions
  • Cellular organelles and biochemical processes
  • Transport Processes Across Cell Membranes
  • Passive transport (diffusion, osmosis)
  • Active transport (primary and secondary active transport)
  • Facilitated diffusion
  • Endocytosis and exocytosis
  • Energy-Rich Compounds
  • ATP (Adenosine Triphosphate)
    • Structure and function
    • Role in energy transfer and cellular processes
  • Cyclic AMP (cAMP)
    • Structure and function
    • Role in signal transduction pathways
    • Biological significance in cellular responses

2. Enzymes

3. Carbohydrate Metabolism

  • Glycolysis Introduction
  • Overview of glycolysis pathway
  • Regulation of glycolysis
  • Citric Acid Cycle (TCA Cycle)
  • Overview of TCA cycle
  • Key enzymes and intermediates
  • Regulation of TCA cycle
  • HMP Shunt (Hexose Monophosphate Shunt)
  • Pathway overview
  • Key enzymes and intermediates
  • Significance of HMP shunt
  • Glycogenolysis
  • Pathway of glycogen breakdown
  • Key enzymes and regulation
  • Gluconeogenesis
  • Pathway of glucose synthesis
  • Key enzymes and regulation
  • Glycogenesis
  • Pathway of glycogen synthesis
  • Key enzymes and regulation
  • Metabolic Disorders of Carbohydrate Metabolism
  • Diabetes mellitus
    • Types (Type 1, Type 2, gestational)
    • Pathophysiology and symptoms
    • Diagnostic methods and treatment
  • Glycogen storage diseases
    • Types and clinical features
    • Biochemical basis and management
  • Glucose and Galactose Tolerance Tests
  • Procedure and interpretation
  • Clinical significance
  • Hormonal Regulation of Carbohydrate Metabolism
  • Role of insulin
  • Role of glucagon
  • Role of other hormones (epinephrine, cortisol)

List of Topics for Advanced Biochemistry

4. Lipid Metabolism

  • Oxidation of Saturated Fatty Acids
  • β-Oxidation
    • Overview of β-oxidation pathway
    • Key enzymes and intermediates
    • Energy yield from β-oxidation
  • Ketogenesis and Ketolysis
  • Pathway of ketogenesis
  • Conditions leading to ketogenesis (e.g., fasting, diabetes)
  • Ketolysis pathway and utilization of ketone bodies
  • Biosynthesis of Fatty Acids
  • De novo fatty acid synthesis pathway
  • Key enzymes (e.g., acetyl-CoA carboxylase, fatty acid synthase)
  • Regulation of fatty acid synthesis
  • Biosynthesis of Lipids
  • Pathway of triglyceride synthesis
  • Phospholipid and sphingolipid synthesis
  • Metabolism of Cholesterol
  • Pathway of cholesterol synthesis
  • Regulation of cholesterol synthesis (e.g., HMG-CoA reductase)
  • Cholesterol transport and excretion
  • Hormonal Regulation of Lipid Metabolism
  • Role of insulin, glucagon, and epinephrine in lipid metabolism
  • Defective Metabolism of Lipids
  • Atherosclerosis
    • Pathophysiology and risk factors
    • Role of lipids in plaque formation
  • Fatty Liver (Hepatic Steatosis)
    • Causes and pathogenesis
    • Clinical significance and management
  • Hypercholesterolemia
    • Types (primary and secondary)
    • Genetic and environmental factors
    • Diagnostic criteria and treatment

5. Biological Oxidation

  • Coenzyme Systems Involved in Biological Oxidation
  • NAD+/NADH
  • FAD/FADH2
  • Electron Transport Chain (ETC)
  • Components of the ETC (complexes I-IV, cytochrome c, coenzyme Q)
  • Mechanism of energy capture in the ETC
  • Regulation of the ETC
  • Inhibitors of the ETC (e.g., cyanide, rotenone)
  • Uncouplers of ETC
  • Mechanism of action of uncouplers (e.g., DNP, thermogenin)
  • Physiological and pathological implications
  • Oxidative Phosphorylation
  • ATP synthesis via ATP synthase
  • Chemiosmotic theory
  • Regulation and efficiency of oxidative phosphorylation

6. Protein and Amino Acid Metabolism

  • Amino Acids Chemistry
  • Introduction to Proteins
  • Protein Chemistry
  • Classification of Proteins
  • Protein Turnover
  • Mechanisms of protein synthesis and degradation
  • Role of ubiquitin-proteasome system
  • Autophagy-lysosome pathway
  • Nitrogen Balance
  • Definition and importance of nitrogen balance
  • Positive and negative nitrogen balance
  • Factors affecting nitrogen balance
  • Catabolism of Amino Acids
  • Transamination
    • Mechanism of transamination
    • Key enzymes (aminotransferases)
    • Role of pyridoxal phosphate (PLP)
  • Deamination
    • Mechanism of oxidative and non-oxidative deamination
    • Enzymes involved (e.g., glutamate dehydrogenase)
  • Decarboxylation
    • Mechanism and significance
    • Examples of decarboxylation reactions
  • Urea Cycle
  • Overview of the urea cycle
  • Key enzymes and intermediates
  • Regulation of the urea cycle
  • Metabolic disorders related to the urea cycle (e.g., ornithine transcarbamylase deficiency)
  • Production of Bile Pigments
  • Breakdown of heme to bilirubin
  • Conjugation and excretion of bilirubin
  • Formation of bile pigments (bilirubin, biliverdin)
  • Metabolic Disorders Related to Bile Pigments
  • Hyperbilirubinemia
    • Causes and types (unconjugated vs. conjugated)
    • Clinical significance and symptoms
  • Jaundice
    • Types of jaundice (pre-hepatic, hepatic, post-hepatic)
    • Diagnostic methods and treatment
  • Porphyria
  • Definition and types of porphyria
  • Pathophysiology and symptoms
  • Diagnosis and treatment
  • Metabolic Disorders of Amino Acids
  • Phenylketonuria (PKU)
    • Genetic basis and pathophysiology
    • Symptoms and treatment
  • Maple Syrup Urine Disease (MSUD)
    • Enzyme deficiency and metabolic pathway
    • Clinical presentation and management
  • Homocystinuria
    • Biochemical basis and symptoms
    • Diagnostic methods and therapeutic approaches
  • Other amino acid metabolism disorders (e.g., alkaptonuria, tyrosinemia)

7. Nucleic Acid Metabolism

  • Metabolism of Purine Nucleotides
  • Synthesis of purine nucleotides (de novo and salvage pathways)
  • Catabolism of purine nucleotides
  • Regulation and disorders (e.g., gout, Lesch-Nyhan syndrome)
  • Metabolism of Pyrimidine Nucleotides
  • Synthesis of pyrimidine nucleotides
  • Catabolism of pyrimidine nucleotides
  • Regulation and disorders
  • Protein Synthesis
  • Steps of protein synthesis (transcription, translation)
  • Role of ribosomes, tRNA, mRNA
  • Genetic Code
  • Characteristics of the genetic code
  • Codons and their corresponding amino acids
  • Inhibition of Protein Synthesis
  • Mechanisms of inhibition (antibiotics, toxins)
  • Examples (e.g., tetracyclines, chloramphenicol)
  • Mutation and Repair Mechanism
  • Types of mutations (point mutations, frameshift mutations)
  • DNA repair mechanisms (base excision repair, nucleotide excision repair, mismatch repair)
  • DNA Replication
  • Semiconservative model of DNA replication
  • Onion peel model
  • Enzymes involved in DNA replication (DNA polymerase, helicase, ligase)
  • DNA Repair Mechanisms
  • Mechanisms to repair DNA damage (direct repair, excision repair)
  • Disorders related to defective DNA repair (e.g., xeroderma pigmentosum)

List of Topics for Clinical Chemistry

8. Introduction to Clinical Chemistry

  • Cell Composition
  • Major cellular components (nucleus, cytoplasm, organelles)
  • Biochemical composition of cells (proteins, lipids, carbohydrates, nucleic acids)
  • Cell Malfunction
  • Common cellular dysfunctions (apoptosis, necrosis)
  • Pathophysiology of cell damage and disease
  • Role of the Clinical Chemistry Laboratory
  • Functions and services of a clinical chemistry lab
  • Importance in diagnosis, monitoring, and treatment of diseases
  • Common biochemical tests performed in clinical chemistry

9. Kidney Function Tests

  • Role of the Kidney
  • Functions of the kidney (filtration, reabsorption, secretion, excretion)
  • Homeostasis and regulatory roles (electrolyte balance, acid-base balance)
  • Laboratory Tests for Normal Kidney Function
  • Urine Analysis
    • Macroscopic examination (color, clarity, odor)
    • Physical examination (specific gravity, pH)
    • Quantitative and semi-quantitative tests (glucose, protein, ketones, hemoglobin)
  • Tests for Non-Protein Nitrogen (NPN) Constituents
    • Creatinine clearance test
    • Urea clearance test
    • Determination of blood and urine creatinine
    • Determination of blood and urine urea
    • Determination of uric acid levels
  • Urine Concentration Test
    • Purpose and procedure
    • Interpretation of results
  • Urinary Tract Calculi (Stones)
    • Types of urinary stones (calcium oxalate, uric acid, struvite, cystine)
    • Pathophysiology of stone formation
    • Diagnostic methods and treatment options

10. Liver Function Tests

  • Physiological Role of the Liver
  • Metabolic functions (carbohydrate, lipid, protein metabolism)
  • Storage functions (glycogen, vitamins, minerals)
  • Excretory functions (bile production and secretion)
  • Protective functions (detoxification, immune functions)
  • Circulatory functions (blood filtration, synthesis of plasma proteins)
  • Function in blood coagulation (synthesis of clotting factors)
  • Tests for Hepatic Dysfunction
  • Bile Pigments Metabolism
    • Pathways of bilirubin metabolism
    • Clinical significance of bile pigment levels
  • Tests for Hepatic Function
  • Serum Bilirubin
    • Total bilirubin, direct (conjugated) bilirubin, indirect (unconjugated) bilirubin
  • Urine Bilirubin
    • Methods of detection and clinical significance
  • Urine Urobilinogen
    • Normal levels and interpretation of abnormal levels
  • Dye Tests of Excretory Function
  • Types of dye tests (Bromsulphthalein test)
  • Procedure and interpretation
  • Tests Based Upon Abnormalities of Serum Proteins
  • Albumin and globulin levels
  • A/G ratio
  • Protein electrophoresis
  • Selected Enzyme Tests
  • Liver enzymes (ALT, AST, ALP, GGT)
  • Clinical significance of elevated enzyme levels

11. Lipid Profile Tests

  • Lipoproteins
  • Composition and classification (chylomicrons, VLDL, LDL, HDL)
  • Functions of lipoproteins in lipid transport
  • Determination of Serum Lipids
  • Total Cholesterol
    • Methods of determination and reference ranges
  • HDL Cholesterol
    • Importance and methods of measurement
  • LDL Cholesterol
    • Calculation (Friedewald formula) and clinical significance
  • Triglycerides
    • Methods of determination and reference ranges

12. Immunochemical Techniques

  • Determination of Hormone Levels and Protein Levels in Serum
  • Techniques for endocrine disease diagnosis
  • Techniques for infectious disease diagnosis
  • Radioimmunoassay (RIA)
  • Principle and procedure
  • Applications and advantages
  • Limitations and safety considerations
  • Enzyme-Linked Immunosorbent Assay (ELISA)
  • Principle and procedure
  • Types of ELISA (direct, indirect, sandwich, competitive)
  • Applications in clinical diagnostics

13. Electrolytes

  • Body Water and Compartments
  • Distribution of water in body compartments (intracellular, extracellular)
  • Mechanisms of water balance
  • Electrolyte Distribution
  • Role of electrolytes in physiological functions
  • Distribution of major electrolytes (sodium, potassium, calcium, chloride, bicarbonate)
  • Determination of Electrolytes in Body Fluids
  • Sodium
    • Methods of determination and clinical significance
  • Calcium
    • Methods of determination and clinical significance
  • Potassium
    • Methods of determination and clinical significance
  • Chlorides
    • Methods of determination and clinical significance
  • Bicarbonates
    • Methods of determination and clinical significance

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