Download Rajiv Gandhi University of Health Sciences (RGUHS) MBBS (Bachelor of Medicine and Bachelor of Surgery) 1st Year (First Year) Biochemistry Syllabus Syllabus
Teaching hours ? 160 hours
Sl
Topic (Competency No) No.
1. Relevance of Biochemistry in Medicine Core:
1 hr
Importance of Biochemistry in health and disease
(Orient
Examples of normal biochemical process
ation
Examples of biochemical derangements involved in disease development
lecture)
Examples of application of laboratory medicine in screening, diagnosis and
prognosis of diseases
2
Cell and organelles, Cell membrane, Transport across cell membranes (BI1.1)
2 hrs
Core:
Prerequisite: Concept of prokaryotic and eukaryotic cell
Cell organelles ? Structure, Biochemical functions, Marker enzymes
Cell Membrane Fluid mosaic model, composition, Fluidity of membrane
Transport across cell membranes with examples
Passive transport ? Diffusion and facilitated transport (ion channels)
Active transport ? Primary and Secondary
Endocytosis and Exocytosis
Aquaporins
ABC family of transporters
Non core:
Cytoskeleton ?
Structure and functions of microtubules, actin filaments, intermediate filaments
Intercellular communication
Separation of cell organelles
9 hrs
3
Enzymes (BI2.1, BI2.3, BI2.4, BI2.5, BI2.6, BI2.7)
Core:
Enzymes Definition, General properties, IUBMB Classification.
Coenzymes and Cofactors
Mechanism of Enzyme action Concept of activation energy, transition state, binding energy, active
site; Substrate binding to active site Koshlands Induced fit theory
Factors affecting enzyme activity
Effect of substrate concentration Michaelis Menton theory, Km value, Vmax and its significance
(derivation not required)
Enzyme specificity
Enzyme inhibition Competitive and Noncompetitive inhibition with examples of clinical
importance
Suicide inhibition
Enzymes as toxins ? Eg. Snake venom phospholipase
Enzyme regulation by Short term (Covalent modification, Zymogen activation,
97
Allosteric regulation, Feedback regulation) and long term regulation (Induction
and repression)
Clinical Enzymology ? Concept of plasma functional and nonfunctional enzymes
Diagnostic Importance of enzymes ? LDH, CK, AST, ALT, ALP, GGT, Amylase,
Lipase, G6PD, Cholinesterase, ACP, 5'nucleotidase
Isoenzymes ? Definition, Diagnostic Importance of isoenzymes with examples.
Enzymes as Therapeutic agents
Enzymes used in diagnostic assays
Ribozymes
Non core:
Mechanisms of enzyme catalysis (List)
4
Chemistry of Carbohydrates (BI3.1)
3 hrs
Core:
Definition, Biomedical importance
Classification with examples
Monosaccharide derivatives ? Uronic acids, aminosugars, Glycosides, Sorbitol,
Mannitol and their Clinical significance.
Disaccharides, oligosaccharides composition, importance
Polysaccharides ?Homopolysaccharides ? Composition and Importance of starch,
glycogen, Dextran, Cellulose and Inulin.
Heteropolysaccharides ? Mucopolysaccharides (Composition and function)
Concept of glycation and glycosylation
Importance of Glycoproteins
Non core:
Sialic acid ? importance
Blood group substances
5
Carbohydrate metabolism (BI3.2, BI3.3, BI3.4,BI3.5, BI3.6, BI3.7, BI3.9)
14hrs
Core:
Digestion and absorption
Mechanism of absorption
Lactose intolerance
Glucose transporters
Insulin dependent and Insulin independent uptake of glucose by tissues
PATHWAYS ? Significance, Site, reactions, key steps, energetics, regulation,
inhibitors and associated disorders of
? Glycolysis, Rapaport Leubering cycle and its significance
? Citric acid cycle, Amphibolic role, Anaplerotic reactions
? Gluconeogenesis, Cori's cycle
? Glycogenesis, Glycogenolysis, Glycogen storage disorders
Significance of HMP shunt pathway and uronic acid pathway
Glucose6Phosphate dehydrogenase deficiency
98
Galactosemia, Essential Fructosuria, Hereditary fructose intolerance Regulation
of blood glucose levels in well fed condition and fasting/starvation
Non core:
Galactose and Fructose metabolism
Details of Pyruvate dehydrogenase (PDH) reaction
Essential pentosuria
6
Chemistry of lipids (BI4.1, BI11.24)
3 hrs
Core:
Definition, Modified Bloor's classification with examples.
Biomedical importance of lipids
Fatty acids Definition, examples and importance of Essential fatty acids, Mono
and Polyunsaturated fatty acids, n3 and n6 fatty acids, Transfatty acids.
Triacylglycerol ? composition and importance
Phospholipids Types, functions with clinical importance
Respiratory distress syndrome
Glycolipids ? Types and importance
Cholesterol structure and biological importance
Lipoproteins Types and functions
Amphipathic lipids Definition, examples and importance, Liposomes
Non core:
Fatty acids ? nomenclature and different types of classification
Synthesis of lung surfactant
7. Lipid metabolism (BI4.2, BI4.3, BI4.4, BI4.6)
12 hrs
Core:
Digestion and Absorption
Steatorrhea
Biosynthesis and breakdown of triacylglycerol
PATHWAYS ? Significance, Site, reactions, key steps, energetics, regulation, and
associated disorders of
Beta oxidation
Ketogenesis, ketolysis
Cholesterol biosynthesis upto mevalonate.
Other types of Oxidation of fatty acids and associated disorders
Lipoprotein metabolism Structure, Composition, Types, Functions, metabolism of
Chylomicrons, VLDL, LDL, HDL
Formation and functions of bile acids and bile salts
Fatty liver and lipotropic factors
Hyperlipoproteinemias
Biochemical basis of use of hypolipidemic drugs
Prostaglandins ? types and biomedical importance
Non core:
99
Fatty acid synthase multienzyme complex
Outline of Fatty acid biosynthesis
Lipid Storage Disorders
8
Chemistry of amino acids and Proteins (BI5.1, BI5.2)
3 hrs
Core:
Prerequisite: Amino acids ? Classification based on side chain properties, nutritional
requirement
Classification of Amino acids based on metabolic fate
Standard and non-standard amino acids
Biologically important peptides
Proteins ? Definition, Classification based on chemical nature and solubility,
functions, nutritional value
Structural organisation of proteins (primary, secondary, super secondary
structures/ motifs, domains, tertiary and quaternary structures)
Bonds stabilizing protein structure
Structure function relationship of proteins haemoglobin, myoglobin, collagen
and Insulin
Denaturation definition, causes, properties of a denatured protein, significance.
Non core:
Isoelectric pH
Nonprotein amino acids, Nonalpha amino acids, Damino acids
9
Protein and amino acid metabolism (BI5.3, BI5.4, BI5.5, BI11.17)
13 hrs
Core:
Digestion and absorption and associated disorders
Amino acid pool
General reactions ? Transamination, Transmethylation, Transdeamination,
Deamination Oxidative and nonoxidative and their significance.
Biogenic amines
Sources and fate of ammonia Trapping, Transport and Disposal of ammonia,
ammonia toxicity
Urea cycle and its disorders
Amino acid metabolism
Glycine ? specialised products and their importance
Phenylalanine, Tyrosine ? metabolic pathway, synthesis of catecholamines.
Pheochromocytoma
Other specialised products formed from tyrosine and their importance
Tryptophan synthesis of serotonin and melatonin and their importance
Carcinoid syndrome
Sulphur containing amino acids ? functions of cysteine, methionine synthesis of
SAM, SAH, Homocysteine
Formation of Nitric oxide and its importance
100
Inborn errors of metabolism ? enzyme defects, clinical features, laboratory
diagnosis and biochemical basis of management of ? PKU, Tyrosinosis,
Alkaptonuria, Albinism, Homocystinuria, Maple syrup urine disease (MSUD)
Important functions/products from histidine, serine, Aspartate, Asparagine,
glutamate, glutamine, serine, branched chain amino acids
Polyamines Examples and importance
Non core:
Techniques to separate and identify amino acids.
10
Plasma proteins (BI5.2)
3 hrs
Core:
Functions and clinical significance of plasma proteins Albumin, , and globulins.
Acute phase reactants Positive and Negative (clinical significance)
Biological Reference range of serum total protein, albumin, total globulin, C reactive
protein
Multiple Myeloma
Non core:
Separation and identification of plasma proteins by electrophoresis and precipitation
reactions
11
Metabolism and homeostasis (BI6.1, BI3.8, BI4.5, BI4.7, BI3.10, BI11.17)
6 hrs
Core:
Metabolic processes taking place in specific organs in the body in fed, fasting and
exercise states.
Metabolic changes during starvation
Adipose tissue ? Hormones secreted from adipose tissue (adipokines ? leptin,
adiponectin) their functions and role in hunger and satiety.
Diabetes mellitus ? types, metabolic changes, complications.
Guidelines for diagnosis of Diabetes mellitus
Artificial sweeteners list, use, metabolic effects(briefly) and concerns (to be
discussed with in context of their use in Diabetes Mellitus).
Lipid profile, Dyslipidemia
Atherosclerosis ? definition, role of lipids in atherogenesis (LDL, Oxidised LDL, Lp(a), Small
dense LDL, HDL)
Lab tests in Myocardial infarction
Non core:
Advanced Glycation End (AGEs) products
12
Biological Oxidation (BI6.6)
3 hrs
Core:
Prerequisite: Bioenergetics ? Laws of thermodynamics, Free energy, Exergonic and
endergonic reactions, Chemical Coupling Redox pair, Redox potential.
High Energy Compounds ? Definition, Classification, biological significance.
Transport of reducing equivalents across mitochondria
101
Electron Transport Chain ? Organization, components, flow of electrons.
Oxidative Phosphorylation ? Sites, mechanism (Chemiosmotic theory).
Binding change mechanism of ATP synthesis by ATP synthase.
Inhibitors of Electron Transport Chain and oxidative phosphorylation. Uncouplers
and their significance.
Brown adipose tissue metabolism.
Non core:
ATPADP cycle.
Structure and organization of ATP synthase complex.
Mitochondrial myopathies
13
Heme metabolism (BI6.11, BI6.12, BI5.2, BI11.17)
7 hrs
Core:
Heme ?Outline of Synthesis, porphyrias
Degradation of Heme, Bilirubin metabolism ? synthesis, transport, conjugation,
excretion
Jaundice ? definition, types, causes, lab diagnosis
Congenital hyperbilirubinemias
Hemoglobin ? Adult, fetal and embryonic types
Abnormal hemoglobins? carboxy, sulph, metHb.
Hemoglobinopathies ? molecular defects, pathophysiological changes in
thalassemias and sickle cell anemia
Non core:
p50 of hemoglobins
14. Extracellular matrix (BI9.1, BI9.2)
4 hrs
Core:
Composition of ECM ? Proteins (Composition and functions of Collagen, elastin,
fibrillin, fibronectin, laminin) and Proteoglycans.
Involvement of ECM components in health and disease. Eg.
Osteogenesis Imperfecta, EhlerDanlos syndrome etc
Non core:
Bone tissue? Concept of Bone turnover, factors affecting bone turnover, Peak bone
mass, List of markers of bone formation and bone resorption.
15. Vitamins (BI6.5)
12 hrs
Core:
Prerequisite: Definition, difference between water and fat soluble vitamins
RDA, Sources, Metabolism, Biochemical functions, Deficiency manifestations,
Hypervitaminoses of Fat soluble vitamins (A,D,E,K), Water soluble vitamins
Vitamin C, Folic acid, Vitamin B12, Thiamine, riboflavin, Niacin, Pyridoxine, Biotin,
Pantothenic acid
Antivitamins
Non core:
Vitamers
102
Lipoic acid
16
Minerals (BI6.9, BI6.10)
8 hrs
Core:
Major elements and trace elements
Sources, RDA, absorption and transport, Homeostasis, Functions, Biological
reference range, disorders associated with ? Calcium, phosphorus, Iron
Functions and disorders associated with Copper, Zinc, Selenium, Fluoride,
Iodine, Magnesium, Molybdenum.
17
Chemistry of Nucleic acids (BI7.1)
2 hrs
Core:
Prerequisite: Nitrogenous bases: Purines and Pyrimidines (Major, Minor, Free Bases);
Nucleosides and Nucleotides ? Structure, examples, Importance
Nucleoside derivatives: NMP, NDP, NTP cAMP, SAM, PAPS, UDP sugars etc
Synthetic Nucleotide Analogues and their application
Structure and function of DNA (BDNA)
Structural organization of DNA to form chromatin (Primary and Secondary)
Types of RNA (hnRNA, mRNA, rRNA, tRNA, snRNA) with structure and
functions
microRNA (miRNA) and small interfering RNA (siRNA) and their applications in
medicine
Non core:
Different types of DNA
18
Nucleotide metabolism (BI6.2, BI6.3, BI6.4)
4 hrs
Core:
Prerequisite: Sources of atoms of Purine and pyrimidine ring
Salvage pathways of Purine and pyrimidine synthesis
Catabolism of Purines, Uric acid and its importance
Etiology, manifestations and biochemical basis of clinical manifestations of ? Gout,
LeschNyhan syndrome,
Non core:
SCID, Oroticaciduria
Diagnostic importance of Adenosine deaminase
19
Molecular Biology (BI7.1, BI7.2, BI7.3, BI9.3)
11 hrs
Core:
Concept of Genomics, proteomics and metabolomics
DNA Metabolism
Cell cycle
DNA replication prokaryotic and eukaryotic replication, requirements, process,
inhibitors
Telomere, Telomerase and its importance
DNA repair mechanisms
103
Diseases associated with DNA repair ? Eg. Xeroderma Pigmentosum
Mutations, causes, types of mutation, Consequences with examples
RNA Metabolism
Transcription process
Transcriptional units, promoter regions, RNA polymerases in prokaryotes and
eukaryotes
Differences between prokaryotic and Eukaryotic transcription
Inhibitors of transcription process
Post transcriptional modifications of all types of RNA
Protein Biosynthesis
Genetic Code and its characteristics
Requirements and activation of amino acids
Translation in Eukaryotes
Inhibitors of Translation
Post translational modifications
Regulation of Gene expression
Gene, introns, exons, cistron
Regulation of gene expression in prokaryotes with illustration of Lac Operon
Regulation of gene expression in eukaryotes ? Role of enhancers, repressors, DNA
regulatory elements, gene amplification, gene rearrangement, RNA processing,
RNA editing, mRNA stability.
Non core:
Role of transcriptional activators and coregulators
Protein folding ? Role of Chaperones and Heat shock proteins, Alzheimers
disease, Prion diseases
Protein targeting and sorting with associated disorders Eg, I cell disease
Protein motifs in DNA regulatory proteins
Chromatin remodeling in regulation
Epigenetics
20. Molecular biology techniques and Gene therapy (BI7.4)
4 hrs
Core:
Recombinant DNA technology, DNA cloning process and application
PCR technique and its application
Blotting techniques
Concept, types and application of gene therapy.
DNA Polymorphism, SNP, VNTR, RFLP
DNA genomic and cDNA libraries
DNA Probes
DNA Microarrays
Overview of Human Genome Project HGP
21
Biochemistry of Cancer (BI10.1, BI10.2)
5 hrs
Core:
104
Cell cycle, regulation, abnormal cell growth, programmed cell death (apoptosis)
Cell signaling (action of hormones and growth factors) ? Cell surface receptors G
protein coupled signaling, catalytic receptor signaling, steroid receptor signaling.
Mutagens and carcinogens: Definitions, examples and their actions in carcinogenesis
Protooncogenes and their activation, oncogenes, tumour suppressor genes and
their role in development of cancer
Oncogenic viruses (HPV and cervical cancer)
Growth factors and their receptors
Tumour markers and their importance in diagnosis and prognosis of cancer
Biochemical basis of cancer therapy ? alkylating agents, antimetabolites,
topoisomerase inhibitors, antibiotics, hormones, receptor blockers, radiotherapy etc
Monoclonal antibodies and their application
Non core:
Hybridoma technology
Estrogen and progesterone receptors and their clinical importance in breast cancer
22
Immunology (BI10.3, BI10.4, BI10.5)
1 hr
Core:
Cellular and humoral components of immune system
Immunoglobulins ? Classes, structure function relationship
Innate and adaptive immune responses, self/nonselfrecognition
Role of Thelper cells in immune responses
Ig class switching
Concept of Immune tolerance and Autoimmunity
Antigens and concepts in vaccine development ? types of vaccines, immunological
basis of vaccine development, recombinant DNA technology in vaccine development.
Non core: Hypersensitivity reactions
Concept of graft rejection
Phases of vaccine development.
23. Nutrition and dietetics (BI8.1, BI8.2, BI8.3, BI8.4, BI8.5, BI11.17, BI11.23, BI11.24)
7 hrs
Core:
Energy content of food items
BMR ? Definition, Normal values, Factors affecting and biomedical importance
SDA ? Definition and significance (Thermogenic effect of food)
Nitrogen balance
Balanced diet ? definition, composition
Dietary fibers ? definition, examples, importance
Glycemic index ? definition, calculation, importance
Nutritional importance of Carbohydrates, Lipids, Proteins, Vitamins and minerals,
commonly used food items including fruits and vegetables.
Nutritional indices
Calculation of calorie requirement
105
Dietary advice for optimal health in childhood and adults, special conditions like
diabetes mellitus , coronary artery disease, pregnancy.
Types, causes and effects of Protein energy malnutrition
Obesity ? Definition, BMI, types, causes, role of GI peptides and adipokines in
obesity, associated health risks (eg., metabolic syndrome)
24
Organ function tests (BI6.13, BI6.14, BI6.15, BI11.17)
11 hrs
Core:
Functions of Liver, Kidney, Thyroid and adrenals.
Liver Function Tests: Tests based on Synthetic, Excretory, and Role of enzymes in
hepatic dysfunction
Renal Function tests ? Tests to assess glomerular and tubular functions
Mechanism of action of Group I and Group II hormones
Thyroid function tests
Adrenal function tests
Non core:
Lab tests for evaluation of Infertility.
25
Acid base balance (BI6.7, BI6.8, BI11.17)
4 hrs
Core:
Prerequisite: Concept of Acids, Bases and buffers, HH Equation and its application
Regulation of pH of blood by buffers, respiratory and renal mechanisms
Anion gap and its significance
Acidosis and alkalosis (metabolic and respiratory) ? causes, compensatory mechanisms
and lab findings
26
Water and electrolyte balance (BI6.7)
3 hrs
Core:
Distribution of water and electrolytes in ICF and ECF
Osmolality of ECF
Regulation of water and electrolyte balance
Disorders of electrolyte imbalance ? causes and clinical features of Hyperkalemia,
Hypokalemia, Hypernatremia, Hyponatremia
Dehydration
27
Free Radicals and Antioxidants (BI7.6, BI7.7)
3 hrs
Core:
Free radicals, Reactive oxygen species (ROS), Reactive nitrogen species (RNS)
Damaging effects of ROS on biomolecules, lipid peroxidation
Antioxidant defence system of our body ? enzymes, vitamins, metabolites as antioxidants
Role of oxidative stress in atherosclerosis, diabetes mellitus and cancer
Non core:
Fenton and Haber Weiss reactions
28
Xenobiotics and Detoxification (BI7.5)
1 hr
Core:
106
Xenobiotics and disease caused. Biotransformation
Phase ?I reactions
Oxidation
Hydroxylation
Cytochrome P450
PhaseII reactions
Conjugation reactionsGlucuronic acid, Glutathione, Glycine
Non core:
Other detoxification reactions reduction, hydrolysis, Acetylation, Methylation and reduction
29
Clinical chemistry (BI11.16)
2 hrs
Core:
Basic concepts of clinical chemistry laboratory
Automation advantages
Quality control concepts (Internal and external quality control, precision, accuracy)
Specimen collection and Common Preanalytical errors
Biological reference intervals
Critical alerts
Ethics in Laboratory Medicine
Note:
1. Students are expected to familiarize by themselves the contents mentioned as prerequisite (in
italics)
107
This post was last modified on 29 June 2021