MUHS MBBS Syllabus-1st Year, 2nd Year, 3rd Year Part-I, 3rd Year Part-II || Maharashtra University of Health Sciences
Course Content
(Based on Competency Table published by Medical Council of India. Students/Teachers are directed to refer the details published on MCI Website for details)
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Subject: Biochemistry
Year: First MBBS
| Competency No. | Topics & Subtopics | |
|---|---|---|
| 1 | Basic Biochemistry | |
| 1.1 | Molecular and functional organization of cell and its sub cellular components. | |
| 2 | Enzymes | |
| 2.1 | Explain fundamental concepts of enzyme, isoenzyme, alloenzyme, coenzyme & co-factors. Enumerate the main classes of IUBMB nomenclature. | Biochemical nature of enzyme, isoenzyme, alloenzyme, IUBMB enzyme classification |
| 2.2 Observe | Estimation of SGOT (AST)& SGPT (ALT) with its normal range | |
| the estimation of SGOT & SGPT | ||
| 2.3 | Describe and explain the basic principles of enzyme activity | Mechanism of enzyme action, factors affecting enzyme kinetics with special reference to Vmax & Km. |
| 2.4 | Enzyme inhibition. Various inhibitors as drugs and poisons | |
| Describe and discuss enzyme inhibitors as poisons and drugs and as therapeutic enzymes | Diagnostic and therapeutic importance of various serum enzymes | |
| 2.5 | Describe and discuss the clinical utility of various serum enzymes as markers of pathological conditions. | Analytical uses of Enzymes in laboratory investigations |
| 2.6 | Discuss use of enzymes in laboratory investigations (Enzymebased assays) | |
| 2.7 | Interpret laboratory results of enzyme activities & describe the clinical utility of various enzymes as markers of pathological conditions. | Interpret various serum enzymes of liver & biliary tract, found in various disorders |
| 3 | Chemistry & Metabolism of Carbohydrates | |
| 3.1 | Discuss and differentiate monosaccharides, di-saccharides and polysaccharides giving examples of main carbohydrates as energy fuel, structural element and storage in the human body | Classification of carbohydrates with examples and functions, examples as energy fuel, glycosides and its therapeutic examples and importance, polysaccharides with examples like glycogen, structural elements like glycosaminoglycan's, starch, glycemic index, and dietary fiber. Clinical importance |
| 3.2 | Describe the processes involved in digestion and assimilation of carbohydrates and storage. | Digestion & absorption, transport and storage of carbohydrates, sucrase deficiency disorders |
| 3.3 | Describe and discuss the digestion and assimilation of carbohydrates from food. | |
| 3.4 | Define and differentiate the pathways of carbohydrate metabolism(glycolysis, gluconeogenesis, glycogen metabolism, HMP shunt). | Pathway, energetics, regulation & clinical diseases / disorders, Rappaport Leubering cycle, Gluconeogenesis, Glycogen pathway, Uronic acid pathway, Galactose & Fructose metabolism. |
| 3.5 | Describe and discuss the regulation, functions and integration of carbohydrate along with associated diseases/disorders. | |
| 3.6 | Describe and discuss the concept of TCA cycle as a amphibolic pathway and its regulation. | TCA cycle Pathway, energetics, regulation & its concepts |
| 3.7 To be clubbed with 3.4 & 3.6 | Describe the common poisons that inhibit crucial enzymes of carbohydrate metabolism (eg: fluoride, arsenate) | Common poisons that inhibit crucial enzymes of carbohydrate metabolism lodoacetate, fluoride & arsenite as poisons that inhibit glycolysis Fluoroacetate, arsenite & malonate as poisons that inhibit TCA cycle |
| 3.8 & 3.10 | ||
| 3.8: Discuss and interpret laboratory results of analytes associated with metabolism of carbohydrates. (to be clubbed with comp no 11.17- Diabetes Mellitus) | Interpretation of the results of blood glucose, Glycated Hb, ADA guidelines in Diabetes mellitus including gestational diabetes investigation like urinary glucose, urinary ketone bodies | |
| 3.10 | Interpret the results of blood glucose levels and other Laboratory investigations related to disorders of carbohydrate metabolism. | Interpretation of the results of blood & urinary galactose Interpretation of blood G6PD levels |
| 3.9 | Discuss the mechanism and significance of blood glucose regulation in health and disease. | Regulation of blood glucose in fed and fasting state in normal and diabetes mellitus. |
| 4 | Chemistry & Metabolism of Lipids | |
| 4.1 | Describe and discuss main classes of lipids (Essential/nonessential fatty acids, cholesterol and hormonal steroids, triglycerides, major phospholipids and sphingolipids) relevant to human system and their major functions. | Definition & classification of lipids including classification, nomenclature, numbering, functions & biological importance of fatty acids, cholesterol, hormonal steroids, triglycerides, major phospholipids and sphingolipids |
| 4.2 | Describe the processes involved in digestion and absorption of dietary lipids and also the key features of their metabolism | Digestion, absorption and transport of lipids along with malabsorption. Metabolism of fatty acids (ß-oxidation of even and odd chain fatty acids), energetics and disorders associated with oxidation of fatty acids, ketone bodies, its significance, regulation and associated disorders In brief de novo fatty acid biosynthesis- site & organs, precursor, product formed & regulatory steps. Biosynthesis of triacylglycerol and fate of triacylglycerol and its significance and regulation, Metabolic role of adipose tissue, transport and storage like fatty liver. In brief Cholesterol biosynthesis- site & organs, precursor & regulatory step, metabolic fate & excretion |
| 4.3 | Explain the regulation of lipoprotein metabolism & associated disorders. | Metabolism of various lipoproteins and hyperlipoproteinemias hypolipoproteinemiasabetalipoproteinemias & Tangiers disease |
| 4.4 | Describe the structure and functions of lipoproteins, their functions, interrelations & relations with atherosclerosis | Classification structure and functions of lipoproteins- (Types) Metabolic interrelationship between various lipoproteins transport of cholesterol and reverse cholesterol transport (to be clubbed with 4.3) |
| 4.5 & 4.7 | Interpret laboratory results of analytes associated with metabolism of lipids | Various lipid profile tests with their biological reference values and results in various disorders like hyper/hypolipoproteinemia syndrome, disorders of thyroid etc. |
| 4.6 | Describe the therapeutic uses of prostaglandins and inhibitors of eicosanoid synthesis. | Various eicosanoid classes (prostaglandins, leukotrienes, thromboxanes) functions. Key features of synthesis of eicosanoids and therapeutic uses of prostaglandins |
| 4.7 | Interpret laboratory results of analytes associated with metabolism of lipids. | Same as 4.5 |
| 5 | Chemistry and Metabolism of Proteins | |
| 5.1 | Describe and discuss structural organization of proteins. | General nature of amino acid, classification and importance with examples, peptide bond formation, biologically important protein structure including disulfide & weak bonds with significance. |
| 5.2 | Describe and discuss functions of proteins and structurefunction relationships in relevant areas e.g. hemoglobin and selected hemoglobinopathies | Definition, various classifications with examples and functions of proteins, structure - function relationship of proteins like hemoglobin |
| 5.3 | Describe the digestion and absorption of dietary proteins. | Digestion, absorption and transport of dietary proteins Hartnup disease, cystinuria & glycinuria. |
| 5.4 | Describe common disorders associated with protein metabolism. | Role of transamination & deamination reactions in metabolism formation of ammonia with their clinical significance. Transport of ammonia, pathway of urea cycle, its significance and disorders associated with urea cycle. Metabolic pathways for Glycine, Phenylalanine & Tyrosine, Sulphur containing amino acids (Methionine, Cysteine & Cystine) and branch chain amino acids (Valine, Isoleucine, Leucine), their role in biosynthesis of variety of specialized products and metabolic disorders For Tryptophan- Only important biomolecules formed & their significance |
| 5.5 | Interpret laboratory results of analytesassociated with metabolism of proteins. | Interpret laboratory results of protein metabolism for example Levels of various metabolites in blood or urine in metabolic disorders, Phenylketonuria, Tyrosinemia, Alkaptonuria, cystinuria & homocystinuria |
| 6 | Metabolism and Homeostasis | |
| 6.1 | Discuss the metabolic processes that take place in specific organs in the body in the fed and fasting states. | Integration of carbohydrate, protein and lipid metabolism at organ level with its significance, Metabolic processes with role of hormones and starvation states. |
| 6.2 | Describe and discuss the metabolic processes in which nucleotides are involved. | Important steps in de novo biosynthesis of purine and pyrimidine nucleotides regulation, enzymes of the nucleotide biosynthesis that are regulated salvage pathway for the synthesis of purine nucleotides and disorders of purine and pyrimidine nucleotides. |
| 6.3 | Describe the common disorders associated with nucleotide metabolism. | Disorder of nucleotide metabolism like gout, Lesch-Nyhan syndrome diagnostic tests & biochemical mechanism of nutritional disorders |
| 6.4 | Discuss the laboratory results of analytes associated with gout & Lesch-Nyhan syndrome. | Lab results of analytes related with gout & Lesch-Nyhan syndrome in blood & urine and presence of urate crystals in synovial fluid |
| 6.5 | Describe the biochemical role of vitamins in the body and explain the manifestations of their deficiency | Sources, biochemical functions, daily requirement and deficiency manifestations of fat soluble vitamins (Vitamin A, D, E & K). Sources, biochemical functions and deficiency manifestations of water soluble vitamins (Thiamine, Riboflavin, Niacin, Pantothenic acid, Pyridoxine and vitamin C) |
| 6.6 | Describe the biochemical processes involved in generation of energy in cells. | Electron transport chain, mechanism of oxidative phosphorylation (chemiosmotic theory), substrate level phosphorylation, Uncouplers & inhibitors of ETC chain, shuttle systems for transport of extra-mitochondrial NADH |
| 6.7 | Describe the processes involved in maintenance of normal pH, water & electrolyte balance of body fluids and the derangements associated with these. | Acids, bases and buffers, mechanism of action of buffers, maintenance of normal pH of body fluids. Role of blood buffers, respiratory and renal regulation of blood pH. Disorders associated with blood pH (acidosis and alkalosis), compensatory mechanisms, anion gap & its clinical importance. |
| 6.8 | Discuss and interpret results of Arterial Blood Gas (ABG) analysis in various disorders. | Total body water and its compartmental distribution, various electrolytes like sodium, potassium and chloride, their distribution and clinical consequences of level alterations, maintenance of normal water and electrolyte balance and disorders associated with water and electrolyte imbalance. Interpretation of results of arterial blood gas (ABG) analysis in various disorders |
| 6.9 | Describe the functions of various minerals in the body, their metabolism and homeostasis. | Dietary food sources, daily requirement, biochemical functions and homeostasis of: Calcium, phosphorus & magnesium, trace elements (copper, fluoride, iodine, iron, manganese, selenium & zinc) |
| 6.10 | Enumerate and describe the disorders associated with mineral metabolism. | Clinical conditions related to plasma level alterations of calcium, phosphorus & magnesium Trace elements (copper, fluoride, iodine, iron, manganese, selenium & zinc) |
| 6.11 | Describe the functions of heme in the body and describe the processes involved in its metabolism and describe porphyrin metabolism | Structure and functions of hemoglobin, role of 2,3-bisphosphoglycerate in oxygen binding and delivery, biosynthesis of heme (iron containing porphyrin ring) and its functions in the body, disorders of heme biosynthesis (porphyrias) catabolism of heme, various types of jaundice |
| 6.12 | Describe the major types of hemoglobin and its derivatives found in the body and their physiological/pathological relevance. | Types of normal human hemoglobin, types of normal & abnormal hemoglobin, various hemoglobinopathies: Sickle cell anemia |
| 6.13 | Describe the functions of the kidney, liver, thyroid and adrenal glands. | 1. Functions of liver, disorders& liver function tests 2. Functions of kidney, disorders& kidney function tests 3. Functions of Thyroid, disorders& thyroid function tests 4. Functions of Adrenals , disorders& Adrenal function tests |
| 6.14 | Describe the tests that are commonly done in clinical practice to assess the functions of these organs (kidney, liver, thyroid and adrenal glands). | |
| 6.15 | Describe the abnormalities of kidney, liver, thyroid and adrenal glands. | |
| 7 | Molecular Biology | |
| 7.1 | Describe the structure and functions of DNA and RNA and outline the cell cycle | Structure and functions of nucleotides, biologically important nucleotides and their importance, major types of synthetic analogs of nucleotides and their clinical significance, structure and functions of DNA and RNA |
| 7.2 | Describe the processes involved in replication & repair of DNA and the transcription & translation mechanisms. | Replication of DNA in Eukaryotes, inhibitors of DNA replication, DNA repair systems of DNA Transcription in Eukaryotes and posttranscriptional modifications of transcription & its significance Genetic code and wobble hypothesis, Translation in Eukaryotes, protein folding and posttranslational modifications |
| 7.3 | Causes and types of genetic mutations with examples. Regulation of Eukaryotic gene expression | |
| 7.4 | Describe gene mutations and basic mechanism of regulation of gene expression | Recombinant DNA technology, restriction endonucleases, recombinant DNA and its applications in medicine, DNA sequencing, southern blotting, northern blotting & western blotting Polymerase chain reaction and its application in medical diagnosis and treatment of diseases with genetic basis. |
| 7.5 | Describe the role of xenobiotics in disease | Mechanisms of biotransformation of xenobiotics & associated disorders |
| 7.6 | Describe the anti-oxidant defense systems in the body. | Enzymatic and non-enzymatic antioxidant defense system |
| 7.7 | Describe the role of oxidative stress in the pathogenesis of conditions such as cancer, complications of diabetes mellitus and atherosclerosis. | Free radical, biological sources of reactive oxygen species, antioxidants and oxidative stress, roll of oxidative stress in cancer, diabetes mellitus and atherosclerosis |
| 8 | Nutrition | |
| 8.1 | Discuss the importance of various dietary components and explain importance of dietary fiber. | Importance of carbohydrates, lipids, proteins & vitamins in diet, different types of dietary fibers and their importance in the diet. |
| 8.2 | Describe the types and causes of protein energy malnutrition and its effects. | Protein energy malnutrition, Kwashiorkor and Marasmus |
| 8.3 | Provide dietary advice for optimal health in childhood and adult, in disease conditions like diabetes mellitus, coronary artery disease and in pregnancy. | Balanced diet in adult, in childhood and in pregnancy for normal and diabetes mellitus & coronary heart disease |
| 8.4 | Describe the causes (including dietary habits), effects and health risks associated with being overweight/ obesity | Causes, effects and health risk associated with overweight/ obesity |
| 8.5 | Summarize the nutritional importance of commonly used items of food including fruits and vegetables (macro-molecules & its importance) | Nutritional importance of commonly used items of food like milk, egg, fish, fruits and vegetables and their normal dietary requirements |
| 9 | Extracellular Matrix | |
| 9.1 | List the functions and components of the extracellular matrix (ECM). | Types & functions of the extracellular matrix (ECM), Collagen, proteoglycans, glycoproteins & major proteins of ECM |
| 9.2 | Discuss the involvement of ECM components in health and disease. | Disorders associated with components of ECM like Osteogenesis imperfecta, Ehlers-Danlos Syndrome, Mucopolysaccharidoses, Scurvy & Menkes disease |
| 9.3 | Describe protein targeting & sorting along with its associated disorders(It is non-core: N) | Types of protein targeting and sorting, disorders due to defective targeting signals and defects in peroxisomal matrix proteins |
| 10 | Oncogenesis and Immunity | |
| 10.1 | Describe the cancer initiation, promotion oncogenes & oncogene activation. Also focus on p53 & apoptosis | Characteristics of cancer cell, molecular basis of cancer, chemical carcinogens and initiator, promoter of carcinogens, oncogenes and proto-oncogenes, tumor suppressor genes (retinoblastoma, RB and p53), cell cycle and its physiologic and pathologic conditions. |
| 10.2 | Describe various biochemical tumor markers and the biochemical basis of cancer therapy. | Biochemical tumor markers, biochemical basis of chemotherapy, targeted drug therapy and immunotherapy. |
| 10.3 | Describe the cellular and humoral components of the immune system & describe the types and structure of antibody | Cells of the Immune System, types of immune systems, cellular and humoral components of innate and adaptive immune system the formation of antibodies, types, structure and mechanism of action (Immunoglobulins), primary and secondary response |
| 10.4 | Describe & discuss innate and adaptive immune responses, self/non-self-recognition and the central role of T-helper cells in immune responses | Innate and adaptive immune systems, immunological memory, development, role of helper T cells (CD4+ T cells) and cytotoxic T cells in immune responses, Brief concept of MHC Disorders - Immunodeficiency, autoimmunity & hypersensitivity |
| 10.5 | Describe antigens and concepts involved in vaccine development. | Antigens, concept involved in vaccine development and types of vaccines |
| 11 | Biochemical Laboratory Tests | |
| 11.1 | Describe commonly used laboratory apparatus and equipments, good safe laboratory practice and waste disposal. | Common lab equipments and apparatus like test tubes, pipettes, auto pipettes, centrifuge, balances, oven, water bath good safe laboratory practice and management of needle stick injury & latest guidelines of BMW management |
| 11.2 | Describe the preparation of buffers and estimation of pH. | Preparation of buffer -acidic and alkaline. Measurement of pH |
| 11.3 | Describe the chemical components of normal urine. | Chemical constituents of normal urine |
| 11.4 & 11.20 | ||
| 11.4: Perform urine analysis to estimate and determine normal and abnormal constituents. | Physical characteristics and organic constituents of urine Collection of random & 24 hour urine sample Urine Report: Physical characteristics and abnormal constituents | |
| 11.20: Identify abnormal constituents in urine; interpret the findings and correlate these with pathological states. | Interpretation of Urine Abnormalities | |
| 11.5 | Describe screening of urine for inborn errors & describe the use of paper chromatography. | Urine: Screening of inborn errors. Paper chromatography |
| Club Paper chromatography of amino acid & TLC from competency no 11.16 | ||
| 11.6 | Describe the principles of colorimetry. (Club spectrophotometry from competency no 11.18) | Colorimeter- Principle, Beer and Lambert's law & applications of spectrophotometry. |
| 11.7,11.8, 11.21 & 11.22 | ||
| 11.7- Demonstrate the estimation of serum creatinine and creatinine clearance | Estimation of serum creatinine, urine creatinine and calculation of their clinical interpretation. | |
| 11.8- Demonstrate estimation of serum proteins, albumin and A:G ratio | Estimation of serum proteins, albumin and calculation of A:G ratio and their clinical interpretation. | |
| 11.21- Demonstrate estimation of glucose, creatinine, urea and total protein in serum. | Estimation of plasma glucose, serum urea and their clinical interpretation | |
| 11.22- Calculate albumin: globulin A:G ratio and creatinine clearance | ||
| 11.9 | Estimation of serum total cholesterol and HDL cholesterol and their clinical interpretation. | |
| 11.10 | Demonstrate the estimation of triglycerides | Estimation of serum triglycerides and their clinical interpretation |
| 11.11 | Demonstrate estimation of calcium and phosphorous | Estimation of serum calcium and phosphorus their clinical interpretation |
| 11.12 | Demonstrate the estimation of serum bilirubin | Estimation of serum bilirubin: Total, direct and indirect, and their clinical interpretation |
| 11.13 & 2.2 | 11.13- Demonstrate the estimation of SGOT/ SGPT | Estimation of SGOT (AST)/ SGPT(ALT) and their clinical interpretation |
| 11.14 | Demonstrate the estimation of alkaline phosphatase | Estimation of serum ALP and their clinical interpretation |
| 11.15 | Describe & discuss the composition of CSF | Physical characteristics and chemical composition of CSF |
| 11.16 & 11.19 | 11.16- Observe use of commonly used equipment's/techniques in biochemistry laboratory including: •pH meter •Paper chromatography of amino acid •Protein electrophoresis •TLC, PAGE •Electrolyte analysis by ISE •ABG analyzer •ELISA •Immunodiffusion •Autoanalyser •Quality control | Principle, application and working of following lab equipments paper chromatography of amino acids, protein electrophoresis, electrolyte analysis by ISE, ABG analyzer, ELISA, immunodiffusion, autoanalyser DNA isolation from blood/tissue (Paper chromatography of amino acid ,TLC clubbed with 11.16) |
| •DNA isolation from blood/tissue | ||
| 11.19 | Outline the basic principles involved in the functioning of instruments commonly used in a biochemistry laboratory and their applications. | |
| 11.17 | Explain the basis and rationale of biochemical tests done in the following conditions: - diabetes mellitus, - dyslipidemia, - myocardial infarction, - renal failure, gout, - proteinuria, - nephrotic syndrome, - edema, - jaundice, - liver diseases, pancreatitis, disorders of acid- base balance, thyroid disorders. | Basis and rational of biochemical tests required in the following conditions: Diabetes mellitus-blood & urine glucose, microalbuminuria, glycated hemoglobin – (Club with 3.8 & 3.10) Dyslipidemia-lipid profile (Club with 4.5 & 4.7) Myocardial infarction –CK, LDH, Troponin (Club with 2.5& 7 2.7) Renal failure & nephrotic syndrome, - BUN, Creatinine, cholesterol (Club with 3.8 & 3.10) Gout- serum uric acid, synovial fluid analysis (Club with 6.3 & 6.4) liver diseases & Jaundice- LFTs (Club with 6.1) Pancreatic disorders- Amylase, lipase (Club with 2.5& 7 2.7) Disorder of acid base balance- ABG analysis for pH, PO2, PCO2, bicarbonate, base excess (BE) (Club with 6.7,6.8) Thyroid disorder - serum free and total T3 & T4 |
| 11.18 | Discuss the principles of spectrophotometry. (Clubbed with 11.6) | Spectrophotometer -principle & use |
| 11.19 | Outline the basic principles involved in the functioning of instruments commonly used in a Biochemistry laboratory and their applications. (Clubbed with & 11.6 & 11.16) | Instruments commonly used in Biochemistry laboratory |
| 11.20 | Identify abnormal constituents in urine, interpret the findings and correlate these with pathological states. (Clubbed with 11.4) | |
| 11.21 | Demonstrate estimation of glucose, creatinine, urea and total protein in serum. (Clubbed with 11.7, 11.8) | |
| 11.22 | Calculate albumin: globulin (A/G)ratio and creatinine clearance (Clubbed with 11.7, 11.8) | |
| 11.23 | Calculate energy content of different food Items, identify food items with high and low glycemic index index and explain the importance of these in the diet. | Energy contents of lipids, carbohydrates & proteins in common food items |
| 11.24 | Enumerate advantages and/or disadvantages of use of unsaturated, saturated and trans fats in food. | Advantages of unsaturated fats, disadvantages of saturated and trans fats in food |
| Paper | Section | Topics | Competency nos. |
|---|---|---|---|
| I | A | MCQs on all topics of the paper I | |
| B & C | Basic Biochemistry | 1.1 | |
| Enzymes | 2.1-2.7 | ||
| Chemistry & metabolism of carbohydrates | 3.1-3.10 | ||
| Chemistry & metabolism of lipids | 4.1-4.7 | ||
| Biological oxidation | 6.6 | ||
| Xenobiotics | 7.5 | ||
| Antioxidants &defence system | 7.6-7.7 | ||
| Nutrition | 8.1-8.5 | ||
| Extracellular matrix | 9.1-9.3 | ||
| Oncology, oncogenesis & immunity | 10.1-10.5 | ||
| Biomedical waste | 11.1 | ||
| Physical characteristics and chemical composition of CSF | 11.15 | ||
| Energy contents of lipids, carbohydrates & proteins in common food items, | 11.23 & 11.24 | ||
| Advantages of unsaturated fats. | |||
| Disadvantages of saturated and trans fats in food | |||
| ?-1.4 | |||
| For long answer question and scenario based / application questions, topics will not be repeated. | |||
| II | A | MCQs on all topics of the paper II | |
| B & C | Chemistry & metabolism of proteins | 5.1-5.5 | |
| Integration & starvation | 6.1 | ||
| Nucleic acid metabolism | 6.2-6.4 | ||
| Vitamins | 6.5 | ||
| Water electrolyte balance & acid base balance | 6.7-6.8 | ||
| Mineral metabolism | 6.9-6.10 | ||
| Haemoglobin chemistry and metabolism | 6.11-6.12 | ||
| Organ function test | 6.13-6.15 | ||
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