MBBS Biochemistry Curriculum

MBBS Biochemistry Curriculum

SN Topic Learning Objectives(at the end of the session the student should be able to know ) Teaching guidelines Methodology Time
Introduction to Biochemistry and its relevance to  Medical practice Define Biochemistry; appreciate its intimate relations with medical sciences and the rational practice of medicine and also to appreciate the role of various biochemical laboratory tests in the diagnosis and treatment of various diseases. Overview of the role of biochemistry in the medical and health related sciences emphasizing on its role in diagnosis and treatment Student Interactive Session 1 hr
2 Cell and sub cellular organelles Structure and function of cell and its components Importance of cell structure and organization in health and disease. Student Interactive Session Tutorials 1 hr
3 Cell membrane and transport Structure and function of cell membrane Transport across the cell membrane Fluidity of cell membrane
Mechanism of active and passive transport
Role of different modes of transport in health and disease
Student Interactive Session
Tutorials
2 hrs
4 pH, water, buffers and acid base balance and its disorders To appreciate water as an ideal biologic solvent, role of  pH and buffers  in acid base balance Define properties of water, pH, buffers and emphasize on their role in acid base balances and their disorders Student Interactive Session
Practical
Tutorials
Demonstration
1 hr
5 Physical biochemistry Surface tension, viscosity, and their applications, Gibbs Donnan membrane equilibrium, osmosis and osmotic pressure, colloids types and uses. Application of various physical phenomenons to the understanding of normal function and its relevance in abnormal conditions. Student Interactive Session
Tutorials
1 hr
6 Chemistry of carbohydrates Definition, functions, classification, properties, isomerisms, epimers, anomers, diastereomers, structural configuration of glucose, glycogen and starch, GAGs amino sugars, NANA, Glycosides, Understand the structure and functions of carbohydrates
Conceptual knowledge of the reactions of carbohydrates
Role in health and disease
Student Interactive Session
Tutorials
3 hrs
7 Chemistry of lipids Definition, biomedical importance, classification, properties of fatty acids, Properties of lipids
Essential fatty acids
Role of PUFA and MUFA in health and diseases
Student Interactive Session
Tutorials
3 hrs
8 Chemistry of amino acids General structure, classification based on their side chain, nutritional requirement, DL isomerism Classification of amino acids
Nutritional requirement and metabolic fate Important biochemicalproperties Physical and chemical properties
Student Interactive Session
Tutorials
Practical
5 hrs
9 Structure and functions of proteins General properties, classification, different levels of organization, biologically active peptides, plasma proteins
Functions of plasma proteins, transport proteins, acute phase proteins
Understanding the details of structural organization of proteins and understand the dynamics of protein function Separation techniques Student Interactive Session
Tutorials
Practical
5
10 Hemoglobin and myoglobin Structure and functions of hemoglobin and myoglobin,  Oxygen dissociation curves and factors affecting it
Types of hemoglobin, its variants and hemoglobinopathies
Transport of gases and acid and buffering action Basis of Hemoglobinopathies Fetal hemoglobin High altitude dwelling Student Interactive Session
Tutorials
2
11 Enzymes Nature of enzymes, Coenzymes & cofactors, Classification Mechanism of enzyme activity, active site, specificity Enzyme kinetics, Factors affecting enzyme activity, Km value and ts Significance Types of enzyme inhibition – competitive, non-competitive, uncompetitive, suicidal, allosteric , feedback inhibition, kinetics and their clinical applications Enzyme regulation in biological systems – allostericregulation, covalent modification, zymogen activation, induction and repression. Clinical enzymology – functional and non-functional enzymes, Isoenzymes, Diagnostic importance of enzymes – LDH, CPK, AST, ALT, ALP, ACP, GGT, TP,GPD, cholinesterase, amylase, lipase Cardiac markers Therapeutic enzymes Mechanism of action of enzymes Classification and factors affecting enzymes enzyme kinetics and its applications Regulation of enzyme activity according to body requirement Isoenzymes in health and disease Student Interactive Session
Tutorials
Practical
5
12 Thermodynamics and Biological oxidation Definition, bioenergetics – entropy, free energy, coupled reactions, high energy compounds, oxidation-reduction reactions – definition, redox potential, electron carriers Description, localization, organization of electrontransport and uncouplers of oxidative phosphorylation, basic concepts of mechanism of oxidativephosphorylation, and inhibitors of electron transport chain High energy compounds Redox potential and pairs Movement of electron in the ETC and formation of ATP Inhibitors of ETC including uncouplers Student Interactive Session
Tutorials
3
13 Introduction to metabolism Introduction and overview of metabolism compartmentalization ofmetabolic pathways in cells and the biologic advantage of such compartmentalization
Stages of catabolism of molecules:
i) Break down with no energy trap
ii) Break down with some force energy trap
iii)Final pathway consisting of Citric acid cycle, electron transport chain and oxidativephosphorylation.
Phosphorylation at the substrate level.
Overview and outline of the metabolic pathways and their interconnection Student Interactive Session
Tutorials
1
14 Carbohydrate metabolism Digestion & absorption of Carbohydrates,Glucose transporters, disorders associated, dietary fibre Glycolysis -reactions, regulation in brief, energetic Rappaport-Leubering cycle, Fate of pyruvate inaerobic anaerobic conditions, PDH reaction
Gluconeogenesis, key enzymes, regulation and significance, Cori cycle Glycogenesis, glycogenolysis ,regulation in brief ,inborn errors associated HMP Shunt pathway ,tissues where operating, NADPH generation, Transketolasereaction, G6PDdeficiency, functional significance of HMP shunt (non-oxidativephase need not be elaborated) Uronic acid pathway, Metabolism of galactose, fructose, polyol pathway, inborn errors associated Regulation of Blood Glucose level Action of insulin, receptors, glucagon, cortisol,growth hormone, adaptation during fed state, fasting state. & in starvation. Diabetes mellitus, aetiology, bio chemical abnormalities symptoms & biochemicalbasis of complications (acute in detail and chronic in brief), Lab diagnosis and monitoring of Diabetes mellitus, microalbuminuria, Glycated hemoglobin.
Metabolic syndrome – Insulin resistance Glycosurias and reducing substances. GTT- procedure, criteria of normal and diabetic status, interpretation of graph.
Various metabolic pathways of carbohydrates with special discussion of regulation and clinical importance in health and disease. Student Interactive Session
Tutorials
PBL
8
15 Lipid metabolism Digestion of lipids and Malabsorption syndrome. Fatty acid oxidation- beta oxidation, transport of fatty acids across mitochondrial membrane, regulation, energetics, alpha oxidation-points only, Refsums disease, Zellwegers syndrome. Oxidation of odd chain fatty acid ( need not be elaborated),fate of propionyl Co A Synthesis of fatty acids, fatty acid synthase complex, regulation, elongation and desaturation Formation and utilization of ketone bodies, ketoacidosis, in diabetes and Starvation Metabolism of adipose tissue, hormone sensitive lipase, action of hormones
insulin, glucagon, epinephrine and cortisol. Liver-adipose tissue axis, Fatty liver and lipotropic factors, obesity, Metabolic syndrome in brief. Structure, synthesis of cholesterol uptomevalonatein detail then mention the intermediates with basic Chemical changes, regulation, metabolic fate, bileacids
formation, bile salts, steroid hormones. Transport of plasma lipids, Lipoproteins-classification, metabolism, functions and
Disorders Dyslipidaemias, atherosclerosis, biochemical basis of management of hyper lipidaemia – diet anddrugs, lipid profile. Phospholipids and sphingolipids-inborn errors.
Eicosanoids – Prostaglandins, thromboxanes and leukotrienes-formation (major steps only), biochemical actions.
Details of important pathways and role in health and disease. Student Interactive Session
Tutorials
PBL
8
16 Amino acid metabolism Body amino acid pool, dynamic state of body proteins, inter organ transport of amino acids , glucogenic and ketogenic amino acids Reactions – Transamination, decarboxylation, oxidative deamination, transdeamination, formation and detoxification of ammonia, ureacycle, regulation and energetics, hyperammonemias –acquired and congenital Metabolism of glycine, compounds synthesized, associated inborn errors Metabolism of Sulphur containing amino acids-methionine and cysteine,transsulphuration, transmethylation, formation of taurine, PAPS, excretion of sulphur, inborn errors associated. Phenyl alanine and tyrosine metabolism, compounds synthesized inborn errors associate and VMA Tryptophan- metabolism, compound synthesized and inborn errors associated, Hartnupsdisease,5HIAA & carcinoid syndrome Histidine metabolism and inborn errors Glutamic acid, GABA, Glutamine, asparagine, Aspartic acid- serine, threonine,arginine, NO andpolyamines ( synthesis and function ), Brached chain aminoacids- MSUD (pathway not required ).Biologically important amines, organic acidurias

 

Detoxification of ammonia and defects involving it Pathways and regulation in amino acids. Congenital and acquired defects of amino acid metabolism Student Interactive Session
Tutorials
PBL
8
17 Nucleotide chemistry Structure of purines, pyrimidines, nucleosides, nucleotides Understanding of ring structure of purines and pyrimidines an sources of their molecules in ring structure Student Interactive Session
Tutorials
2
18 Nucleotide metabolism Purine: nucleotide synthesis and catabolism and inborn errors (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, LeschNyhan syndrome, hypouricemia Pyrimidine: nucleotide synthesis, regulation, oroticaciduria, formation of deoxy-nucleotides, thymidylate synthase reaction, folicacid antagonists and nucleotide analogues as chemotherapeutic agents (Antimetabolites) Metabolic pathway and their defects. Student Interactive Session
Tutorials
PBL
2
19 Heme metabolism Heme synthesis&porphyrias- Breakdown of Hb, Biochemical basis of jaundice and distinguishing features of different types of jaundice, neonatal hyperbilirubinemias, lab diagnosis Heme synthesis and associated disorders Heme breakdown and associated disorders Student Interactive Session
Tutorials
PBL
2
20 Introduction to molecular biology Overview of molecular biology, central dogma and recombinant technologyrelated to health and diseases.  

 

Student Interactive Session
Tutorials
1
21 Structure and function of nucleic acids Nucleic acids: structure and organization of DNA, different types of DNA,mitochondrial DNA, base pairing rule, differences between DNA and RNA,different types of RNA Structure and types of DNA
Topology of DNA
Structure of mRNA and tRNA
Student Interactive Session
Tutorials
2
22 DNA replication DNA replication, Telomerase, DNA polymerase, DNA repair (basic mechanism of repair and disorders Mechanism of replication in prokaryotes and eukaryotes Various methods of repair and their defects Student Interactive Session
Tutorials
3
23 Transcription Transcription, RNA polymerase, posttranscriptional modifications, splicing, inhibitors, reverse transcriptase, ribozyme Mechanism of transcription in prokaryotes and eukaryotes Inhibitors of transcription Student Interactive Session
Tutorials
3
24 Translation tRNA, ribosomes Translation, steps, post-translational modifications, inhibitors, Protein folding in brief and conformational disorders – chaperon, prion disease, protein targeting Mechanism of Translation in prokaryotes and eukaryotes Inhibitors of transcription Student Interactive Session
Tutorials
2
25 Genetic code & mutations Genetic code, Biochemical basis of inherited disorders: Mutations, Pathogenesis of inborn errors of metabolism in general, types of mutations with examples in each case, mode of inheritance, Mitochondrial DNA and mitochondrial myopathies Types of mutations and their effects Genetic and code and its characteristic features Student Interactive Session
Tutorials
1
26 Regulation of gene expression Regulation of gene expression, induction, repression and depression. Gene rearrangement in brief

 

Regulation of gene at different levels in the central dogma Operons Gene activation and inhibitions Student Interactive Session
Tutorials
2
27 Recombinant DNA technology Recombinant DNA technology, restriction endonucleases; southern, Northern and Western blotting. RFLP,DNA finger printing, Polymerase chain reaction, anti-sense therapy, Gene therapy, clinical application of above techniques, cloning Formation of chimeric DNA
Molecular scissors Advantages of RDT
Student Interactive Session
Tutorials
3
28 Cell cycle and cancer Cell cycle, apoptosis, mutagens, Role of carcinogens in carcinogenesis, Tumoursuppressor genes, oncogenes, viruses in carcinogenesis tumour markerscommonparameters and their utility in clinical practice.

 

Mechanism of cell cycle an its regulation Biochemistry of cancer Tumor markers in diagnosis Student Interactive Session
Tutorials
1
29 Immunology Structureand functions of immunoglobulins,  Reticuloendothelial system, components and functions of the innate and adaptive immunity. Role of T and B lymphocytes, antigen presentation Induction of immune response Cell mediated immune responseImmunoglobulin structure and functions Humoral immune response Fate of antigen antibody complex, Complement system Generation of antibody diversity, Hypersensitivities Immunoregulation, autoimmunity, tolerance HLA, disease association & transplantation Immunological techniques, application in medicine (vaccines, immunotherapy, immunoassays and immunodiagnostics) Structure and function of immunoglobins Mechanism of action of T cells and B cells MHC Antigen processing genetics of antibody diversity hypersensitivity reactions and immunodeficiency disorders along with their mechanism uses of immunology for health and disease Student Interactive Session
Tutorials
Demonstration
PBL
6
30 Nutrition Calorie requirements, qualitative and quantitative requirements, specific dynamic action, BMR, factors influencing BMR, respiratory quotient, biological value of proteins, formulation and computation of energy requirements for a medical student, balanced and adequate diets, formulation of diets in health and diseases, protein andprotein energy malnutrition, obesity, starvation. Balanced diet Calculation of BMR and factors affecting it
Disorders related to nutrition like obesity and malnutrition
Student Interactive Session
Tutorials
PBL
3
31 Hormones Molecular basis of hormonal action, signal transduction mechanisms. Chemistry, functions and mechanism of action of hormones of the pituitary, thyroid, parathyroid,adrenals, panaceas, and gonads. (Biosynthesis of steroid hormones their functions and mechanism of action.Pineal bodyEndorphins and encephalins,Calcium homeostasis. (Hormonal interplay in the regulation of metabolism. Mechanism of action of hormones and their classification Second messengers Endocrinal regulation of metabolism Student Interactive Session
Tutorials
4
32 Xenobiotics Biochemical basis of environmental health & environmental toxicology, mechanism of detoxification and role of cytochrome p 450 Deleterious effects of smoking , alcohol metabolism ,free radicals free radical scavenging system, lipid peroxidatrion, antioxidants Understanding of how xenobiotics are handled at the cellular level Preserving the environment Development of new & safe drugs Student Interactive Session
Tutorials
1
33 Vitamins (Classification, chemical nature, (detailed structure not required)Dietary sources,coenzyme form biochemical role, deficiency manifestations, daily requirementand toxicity of following vitamins. Vitamin A, D, K ,E Thiamin, Riboflavin, Niacin, Pyridoxine, Biotin, Pantothenic acid Folic acid, one carbon metabolism and B12Ascorbic acid and anti-vitamins Role of vitamins in health and disease Biochemical basis of vitamin deficiency disorders Student Interactive Session
Tutorials
PBL
6
34 Minerals Classification Dietary sources, requirements absorption, biochemical roledeficiency and toxicity of the following minerals Calcium and phosphorus – role of PTH, 1,25 DHCC and calcitonin Iron – metabolism and disorders Copper, magnesium , trace elements – Zinc ,iodine, Fluoride, Selinium, Manganese Sodium, Potassium chloride Biochemical basis of disorders related to minerals Student Interactive Session
Tutorials PBL
3
35 Free radicals diseases and antioxidants What are free radicals with examples Their role in health and disease Free radical action and their scavenging by vitamins, minerals and enzymes Student Interactive Session
Tutorials
1
36 Glycoproteins, proteoglycans,  extracellular matrix Structure and functions of glycoproteins, ECM proteins, GAGs, Genetic disorders associated with them and strategies to correct them. Structure and functionsof ECM Comparison of Glycoproteins, proteoglycans Student Interactive Session
Tutorials
2
37 Maintenance of homeostasis Acid base regulation: pH, Acids, Bases, Buffers, Henderson Hasselbalch Equation in relation to body systems ( derivation not required ), buffer capacity  Body buffers, Role of kidneys and lungs in Acid base homeostasis.  Acid base disorders, causes , compensatory mechanisms , anion gap, assessment of acid base status  Fluid and electrolyte balance – distribution of body water and disorders (hormonal regulation not in detail) Reading of ABG report Disorder of acid base balance and their biochemical basis Student Interactive Session
Tutorials
PBL
5
38 clinical chemistry Liver function tests- Common tests Performed serum bilirubin, enzymes, AG ratio, BSP test, urine tests and interpretation of laboratory reports. Thyroid function test and interpretation Renal function tests- BUN ,NPN, Clearance test , tests of tubular function urine analysis and clinical interpretation of laboratory reports, newer renal markers – Cystatin C Special laboratory investigations –RIA,ELISA, Principles of colorimetry,Radioactivity – diagnostic, research, & therapeutic applications and radiation hazards Various organ function tests and their interpretation in health and disease. Student Interactive Session
Tutorials
PBL
4

PRACTICALS /DEMONSTRATIONS


SN
Topic Learning Objectives (at the end of the session the student should be able to know ) Teaching guidelines Methodology Time
1 Introduction to Biochemistry laboratory Describe the instruments, glassware, chemicals used, biosafety measures to be taken while working Orientation towards the laboratory and briefing about biosafety measures to be taken. Practical/theory/ display of laboratory equipment 2 hrs.
2 Demonstration of pH meter Describe the principle, working of pH meter clinical utility of measuring pH concept of acidosis and alkalosis Demonstration of pH meter Demonstration/practicals 2 hrs
3 General tests of carbohydrates Perform Molisch test, Benedicts test, Barfoedstest, Iodine test, Selivinoffs Test Osazone test Demonstrate the tests mentioned Theoryin brief/demonstration/practicals 2 hrs
4 General tests of proteins perform tests of color reactions and precipitation reactions of proteins Demonstrate the tests mentioned with relevance to health sciences Brief theory/ demonstrations/ practicals 2 hrs.
5 Identification of carbohydrates Identify carbohydrates in the given sample Explain the algorithm followed to identify carbohydrates Evaluate each students performance 2 hrs.
6. Reactions of R group proteins Perform and identify the tests related to r group of proteins Demonstrate the tests mentioned Demonstrations/practicals/group discussions 2 hrs
7 Normal urine Spell out definition, composition and formation, specific gravity and its calculations using urinometer, calibration of urinometer theory in brief/ demonstration of urinometer / calculations Demonstrations/ practicals 2 hrs
8 Abnormal urine Identify abnormal constituents of urine by performing the tests Demonstration of tests of abnormal urine Demonstration/practicals 2 hrs
9 Principles of colorimetry Express principles of colorimetry, relationship between absorbance and transmittance , Beers Lamberts Law, able to find out the concentration of unknown analyte quantitatively, functioning of colorimetry Didactic/demonstration of the functioning of  colorimeter practicals  2 hrs
10 Standard curve in colorimetry by using protein standard Perform and demonstrate the standard the curve Demonstration Practicals 2 hrs
11 Blood sugar estimation Analyse and interpret the result of blood sugar in the given sample Demonstration practicals 2 hrs
12 Quantitative estimation of serum total proteins Analyse and interpret the result of total proteins in the given sample Demonstration Practicals 2 hrs
13 Glucose tolerance test Describe how to perform GTT and appreciate the importance of GTT in diagnosing Diabetes Mellitus demonstrations Practicals 2 hrs
14 Test for blood urea  Blood urea test and interpret the test Demonstration Practicals 2 hrs
15 Urea clearance test Explain urea clearance in kidney diseases demonstration practicals 2 hrs
16 Serum creatinine test Estimate and interpret the result demonstration Practicals 2 hrs
17 Electrophoresis Explain principles and importance of electrophoresis demonstrations Practicals 2 hrs
18 Chromatography Describe principles and importance of chromatography demonstration practicals 2 hrs
19 Liver function tests Enlist the tests performed in liver disorders demonstration Problem based learning 2hrs
20 Kidney function tests Enlist the tests performed in kidney disorders demonstration problem based learning 2hrs
21 Thyroid function tests Enlist the tests performed in thyroid  disorders demonstration PBLs 2hrs
22 Gastric function tests Enlist the tests performed in gastric disorders demonstration PBLs 2hrs