Biochemistry

Departmental Objective
At the end of the course in Biochemistry the students should be able to:
 acquire the basic & integrated knowledge on major biomolecules, enzymes, hormones and
nutrients with fundamental chemical process within body system upon which life depends.
 demonstrate skills in performing and interpreting Biochemistry laboratory tests and procedures
with emphasis on those used in Bangladesh.
 demonstrate skills in using the modern biochemical appliances.
 equip themselves with requisite knowledge for higher studies and research.
 develop sound attitude towards the need for continuing self-directed learning.

List of Competencies to acquire:

After completing the course of Biochemistry in MBBS course the students will-
1) apply the learned knowledge of biochemistry in medicine.
2) familiar with the biomolecules forming the structure of human body, their functions and
role in health and diseases.
3) explain the role of enzymes in the diagnosis and treatment of diseases.
4) identify the source of energy in human body and the process by which this energy is
derived from food.
5) explain metabolism of the body in fed and fasting state and consequences of prolonged
starvation.
6) explain the role of liver in metabolism and derangement of metabolism in impaired liver
function. Explain dyslipidemia and their clinical consequence
7) describe the water and electrolyte content of human body and their functions. Identify the
types, causes and consequences of dehydration and over hydration. Explain the causes the
consequences of electrolyte imbalance.
8) describe the sources of acids and bases in our body and the mechanism of their normal
balance. Explain the causes and consequences of acidosis and alkalosis and the parameters
to diagnose them.
9) demonestrate their basic conception about nutrients, balanced diet. Describe the common
nutritional disorders of our country and their causes and consequences.
10) describe the components of balanced diet and explain the basic principles of making a diet
chart. Attain the skill to assess nutritional disorders anthropometrically.
11) explain the basis of genetics and molecular biology and the common genetic disorders and
explain the modern technology in molecular biology in the diagnosis and treatment of
diseases.
12) diagnose diabetes mellitus, impairment of renal, liver and thyroid functions.

Attain the skill to perform and interpret the common biochemical tests in the diagnosis of
diseases. Attain the skill to perform common bedside biochemical tests.

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 Distribution of teaching - learning hours
Lecture Tutorial Practical Total Integrated Formative Exam Summative exam
teaching teaching
hours hour for Prepar Exam Preparat Exam
Phase I atory time ory leave time
leave

117 100 100 317 hrs 36 hrs 35 42 days 30 days 30

hours hours hours days days
Time for integrated teaching, examination, preparatory leave of formative & summative assessment is
common for all subjects of the phase
Related behavioral, professional & ethical issues will be discussed in all teaching learning sessions

Teaching - learning methods, teaching aids and evaluation

Teaching Methods
Large group Small group Self learning Teaching aids In course evaluation

OHP
Lecture Tutorial Assignment, Video tapes, Audio player  Item Examination
Integrated Practical self assessment Slide Projector (oral or written)
teaching Demonstration and self study. Charts, Flip charts, Models,  Card final (only
Problem solving Specimens written)
White board and marker  Term Examination
Chalk board and chalk  Term final (written,
Computer and multimedia oral+ practical [OSPE
Study guide and manuals & traditional ])

Related Equipments:
Glass wares, micropipette, distilled water plant, pH meter.
Laboratory equipments:
Photoelectric colorimeter, Centrifuge machine, PCR mechine, Incubator, Water bath, Hot air oven,
Height and weight measuring instrument.

1st Professional Examination:

Marks distribution of Assessment of Biochemistry:
Total marks – 400
 Written=200 (Formative- 20+MCQ (SBA+MTF) 40+(SAQ+SEQ)140)
 SOE=100
 Practical= 100 (OSPE-50+ Traditional-40 + Assignment-10)

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 Learning Objectives and Course Contents in Biochemistry
Biophysics & Biomolecules

Learning Objectives Contents Teaching Hours

At the end of the course, students will be able to: CORE: Lecture:
 define biochemistry and explain its importance in medicine.  Introduction to Biochemistry
 define solution, standard solution and types of standard solution.  Concept of solutions 18 hours
 describe colloid and crystalloid with example, define dialysis and mention its  Colloids and crystalloids.
biomedical importance.  Concept of pH and buffer. Tutorial:
 define pH, pK and pH scale and mention their importance.  Concept of isotope.
 define acid, base, strong acid and weak acid.  Concept of Biomolecules: 25 hours
 define buffer. State the body fluid buffers with their basic mechanism of action. Carbohydrates.
 state Handerson Hasselbach equation and its importance.  Amino acids and proteins. Practical:
 define and classify isotope. State its biomedical importance.  Lipids and fatty acids.
20 hours
 define and classify carbohydrates. Mention the sources and importance of  Enzymes
biologically important monosaccharides, disaccharides and polysaccharides. Total teaching hours:
 describe the reducing property of carbohydrate.
 define amino acid, peptide, polypeptide and protein. 65 hours
 state their sources and functions.
 explain the structure of protein and denaturation of protein.
 define and classify lipids, state their sources, functions and biomedical
importance.
 define and classify fatty acids, state their sources, function and biomedical
importance, mention eicosanoids with their origin.
 state the sources and importance of essential fatty acids: omega-3 fatty acid,
omega-6 fatty acid and transfatty acid.
 define steroids and sterols.
 describe the sources, and biomedical importance of cholesterol.
 define and classify enzymes, describe the factors affecting enzyme activity.
 define isoenzyme with example and mention their clinical application.
 state the biomedical importance of enzyme.
 co-factors and mention their functions.

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 Food, Nutrition, Vitamins and Minerals

Learning Objectives Contents Teaching Hours

At the end of the course, students will be able to:
CORE: Lecture:
 define and explain nutrients, essential nutrients, macro and
micronutrients, food, proximate principles of food, diet, balanced
 Basic concepts of food, nutrition and 18 hours
diet.
dietary principles.
 define and explain with full meaning of the abbreviations- BMR,
 Energy balance and calculation of energy Tutorial:
BMI, SDA.
equivalent of food.
 mention the basis of calculating the calorie requirement of a person.
 Nutritional aspect of carbohydrates, fats 15 hours
 describe the sources, requirement and function of carbohydrate as
and proteins, Fibers.
nutrient and describe the importance of fibers in diet.
 Vitamins and minerals. Practical:
 state glycaemic index (GI) with its importance.
 Common Nutritional disorders.
 describe sources, requirement and function of protein as nutrients; 10 hours
mention the name and significance of essential amino acid; state the
biological value of protein. Total teaching hours:
 describe the sources, requirement and function of lipids as nutrients.
 mention the sources and nutritional role of PUFA 43 hours
 define and classify vitamins.
 describe the sources, function, RDA, deficiency disorders of water-
soluble vitamins.
 describe the sources, functions, RDA, deficiency disorders and
toxicity of fat-soluble vitamins.
 state the role of minerals as nutrients, define trace elements.
 state the importance of minerals: sodium, potassium, calcium, iron,
iodine, fluoride, selenium, manganese, copper, zinc etc.
 describe iron metabolism.
 describe the biochemical basis of the common nutritional disorders
e.g. PEM, night blindness, goiter, obesity, nutritional anaemia.

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 Digestion, Absorption, Bioenergetics and Metabolism

Learning Objectives Contents Teaching Hours

At the end of the course, students will be able to: CORE: Lecture:
 Introduction to metabolism
 define digestion, absorption, metabolism, anabolism, and catabolism.  Biological oxidation, respiratory chain and 29 hours
 describe the phases of metabolism oxidative phosphorylation.
 describe biological oxidation, respiratory chain and oxidative  High and low energy compounds. ATP Tutorial:
phosphorylation.  Phases of metabolism (digestion, absorption
 enumerate high and low energy compounds, describe ATP. and intermediary metabolism) 18 hours
Carbohydrate Metabolism:  Glycolysis
 describe digestion and absorption of carbohydrate with endproducts.  Citric acid cycle Practical:
 define glycolysis and describe the pathway, state the conversion of  Glycogenesis and glycogenolysis
25 hours
pyruvate to lactate, acetyl CoA and oxaloacetate.  Hexose monophosphate shunt
 calculate the amount of energy liberated in glycolysis and oxidative  Gluconeogenesis
decarboxylation of pyruvate.  Blood glucose homeostasis Total teaching hours:
 describe citric acid cycle and explain why it is called an amphibolic  Cori cycle
and final common metabolic pathway.
73hours
 calculate the amount of energy liberated in TCA cycle and total
energy liberated from complete oxidation of a mole of glucose in
aerobic and in anaerobic conditions.
 define glycogenesis and glycogenolysis and state their role in storage
and supply of glucose to meet body’s demand.
 state the importance of HMP pathway.
 define gluconeogenesis and describe its process and importance.
 describe glucose homeostasis and mention its importance,
 state the glucostatic functions of liver with other biochemical
functions.

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 Learning Objectives Contents Teaching Hours

Lipid Metabolism CORE:

 describe digestion and absorption of lipids (triacylglycerol,
phospholipids, cholesterol esters)  Digestion and absorption of lipid.
 enumerate the blood lipids with their sources and mention the  Blood lipids and pathways of lipid
anabolic and catabolic pathways of lipid metabolism. metabolism.
 describe the process of degradation of triacylglycerol.  Triglyceride metabolism.
 state the processes of fatty acid oxidation and describe beta-  Beta-oxidation
oxidation of even and odd chain fatty acids.  Ketogenesis and ketosis.
 state the sources and fate of acetyl-CoA.  Lipid transport and lipoprotein metabolism.
 name the ketone bodies.  Ecosanoids.
 describe ketogenesis and fate of ketone bodies, state the
biomedical importance of ketone bodies.
 define ketosis and mention the causes of ketosis and describe its
pathogenesis.
 enumerate the lipoproteins, state its general structure and
functions, describe the metabolism of chylomicron, VLDL, LDL
and HDL cholesterol, explain the clinical importance of LDL &
HDL cholesterol.
 state the role of HMG-CoA reductase in regulation of blood
cholesterol level.
 define eicosanoids, mention the basic steps of their synthesis.

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 Teaching Hours
Learning Objectives Contents

CORE:
Protein Metabolism
 describe digestion and absorption of protein.  Digestion and absorption of protein
 state the concept of protein turnover, amino acid pool  Protein turnover, common amino acid pool,
 define nitrogen balance, mention its types and state the routes of nitrogen balance
nitrogen loss.
 Pathways of protein metabolism
 state the pathways of amino acid catabolism.
 Deamination and transamination.
 define and describe transamination and deamination.
 describe sources and way of disposal of ammonia, explain  Fate of amino acid in the body
ammonia intoxication  Source and disposal of ammonia
 describe the urea cycle including sites, reactions and importance of
the cycle. ADDITIONAL:
 Role of liver in over all metabolisms.
• Integrated metabolism
Metabolic adjustment of fed, fasting and
starvation state.

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 Renal biochemistry, body fluid, electrolytes and acid-base balance

Learning Objectives Contents Teaching Hours

At the end of the course, students will be able to: CORE:
 define GFR, renal threshold, plasma clearance, osmolar clearance and free water Lecture:
clearance, describe mechanism of acidification of urine. Renal biochemistry in relation to
 state the body fluid compartments and state the composition of ECF and ICF water, electrolytes and acid base 20 hours
 state water turnover, water intake and output, describe volume homeostasis homeostasis
(water balance), enumerate volume disorders with example, define water  Total body water and body fluid Tutorial:
intoxication. compartments. Composition of
 explain the importance of major electrolytes (Na+, K+, Ca++, Mg++ and PO4- -) body fluids. 12 hours
and mechanism of their homeostasis.  Regulation of normal water
 describe acid base homeostasis & state the simple acid base disorder with causes balance. Practical:
of acidosis and alkalosis and mechanism of their compensation and correction.  Major electrolytes and their
 state acid base parameters, anion gap and base excess, homeostasis. 20 hours
 state the role of kidneys in water, electrolyte and acid-base balance.  Volume disorders.
 Acid base homeostasis & Total teaching hours:
 state abnormal constituents in urine with normal urine volume and obligatory
urine volume, explain limiting pH of urine. disorders.
52 hours
 define and classify diuresis with example.

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 Clinical Biochemistry and clinical endocrinology

Learning Objectives Contents Teaching Hours

At the end of the course, students will be able to: CORE: Lecture:
 state the basic concepts of clinical biochemistry eg quality
 Introduction to clinical biochemistry. 14 hours
control & quality assurance, specificity, sensitivity
 Normal biochemical values in conventional and
 mention measurements of unit eg SI unit Tutorial:
Sl. Units.
 list the common anticoagulants used in laboratory
 Clinical enzymology related to liver and
 state the laboratory hazards with its types and specimen used 15hours
myocardial diseases.
in labooratory
 Lipid profiles and dyslipoproteinemias.
 state the normal level of serum bilirubin and mechanism of Practical:
 Organ function tests (liver, kidney & thyroid)
causation of jaundice.
 Diagnosis of diabetes mellitus
 describe the common liver function tests with interpretation. 20 hours
 Bilirubin metabolism and Jaundice.
 explain the basis of application of clinical enzymology in
disease.  Proteinuria and microalbuminuria
Total teaching hours:
 state the lipid profiles of blood & their clinical importance.
 state the causes and consequence of hyperglycaemia and 49 hours
hypoglycaemia.
 state the laboratory diagnosis of diabetes mellitus, OGTT and
its interpretation, define IFG, IGT and HBA1c.
 state renal function tests
 define proteinuria and microalbuminuria, glycosuria.
 state thyroid function tests with interpretation.

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 Fundamentals of Molecular Biology and genetics

Teaching Hours
Learning Objectives Contents
At the end of the course, students will be able to: CORE:
 Basic concepts of molecular biology. Lecture:
 explain chemistry, & functions of nucleic acid, nucleosides, and
nucleotides.  Nnucleic acid, nucleosides, and nucleotides. 18 hours

 describe the structure and functions of DNA.  Replication, transcription and translation.

 describe the structure, types and functions of RNA.  Gene, genome, allele, trait, genetic code, Tutorial:

mutation, mutagens. 15 hours

 describe DNA organization, cell cycle and genetic code.
 PCR, DNA cloning, recombinant DNA
 describe the the central dogma & processes of replication of DNA,
technology Practical:
 define gene, allele, genome, genotype, phenotype, trait, and codon.
 Biomedical aspects of medical 05 hours
 describe transcription and post transcriptional modification.
biotechnology: understanding & application.
 describe translation and post translational modification.
Total teaching hours:
 explain the concepts & application of medical Biotechnology
38 hours
 explain the concepts & application of recombinant DNA technology.
 explain the concept of DNA cloning, PCR, DNA fingerprinting
 define and classify mutations, mutagens.

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 Biochemistry practical

Learning Objectives Contents Teaching Aids Teaching Hours

 OHP 100 hours
Students will be able to:
CORE  Video tapes, Audio
 Identification of laboratory glass player.
 list the laboratory hazards and the wares and equipment.  Charts, Flip charts,
precautions to prevent them.  Preparation of solutions. Models, Specimens
 Sample collection & processing  White board and
 identify the different laboratory glass  Photometry. marker
wares and equipments. Mention their  Estimation, demonstration of  Chalk board and
uses. technique, calculation and chalks
interpretation of result:  Computer and
 prepare different type of standard  Blood glucose estimation. multimedia
solution from supplied solute, solvent  Serum cholesterol estimation.  Study guide and
and standard solution.  Serum urea manuals
 Serum creatinine  Glass ware,
 identify different parts of photoelectric  Serum total protein micropipette
colorimeter. Demonstrate its technique 
 Serum bilirubin Distil water plant
and the basic principle of calculation. 
 Abnormal constituents of urine and pH meter
their clinical significance.  Laboratory
 perform different biochemical tests equipments:
according to given method and manual.
 photoelectric
colorimeter
 know the clinical indication of
 Centrifuge machine
performing biochemical tests.
 PCR mechine
 Incubator
 interpret biochemical values to apply in
clinical situations.  Water bath
 Hot air woven
 Height and weight
measuring
instrument

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 Evaluation of Biochemistry
Summative Assessment (1st Professional Examination)

Components Marks Total Marks

Formative assessment 10+10 20

WRITTEN EXAMINATION
Paper – I- MCQ (SBA+MTF) 20
(SAQ+SEQ) 70 180
Paper - II- MCQ (SBA+MTF) 20
(SAQ+SEQ) 70

PRACTICAL EXAMINATION 50
OSPE 40
Traditional methods 100
10
Assignment on specific practical procedure

ORAL EXAMINATION (Structured) 100

Grand Total 400

 OMR sheet will be provided for MCQ.

 Pass marks 60 % in each of theoretical, oral and practical.

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 Continuous Assessment Card

Card No- 1. Biophysics and Biomolecules

No. Items Marks(10 in each item) Initials and date

1. Introduction of biochemistry, acid, base, pH, pK, buffer, Henderson-

Hasselbalch equation.
2. Solutions, crystalloid, colloid, dialysis and isotopes.

4. Carbohydrates.

5. Lipids

6. Amino Acids and Protein.

7. Enzymes, coenzymes, cofactors, isoenzsymes

Card No- 2. Food, nutrition and vitamins

No Items Marks( 10 in each item) Initial and date

1. Basic concepts of Nutrient, food, diet, balanced diet, essential dietary
components, , total calorie calculation,DRI, RDA, MR, BMR, BMI, SDA.
2. Dietary fibers, nutritional importance of carbohydrate, lipid & protein,
glycaemic index (GI) of food.
3. Minerals- (macro & micro), trace elements, common nutritional disorders,
PEM, BMI. obesity, iron metabolism and its deficiency, iodine deficiency

4. Water soluble vitamins

5. Fat soluble vitamins

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 Card No- 3. Digestion, absorption, bioenergetics and metabolism

No Items Marks( 10 in each item) Initial and date

1. Digestive juices, local hormone of GIT, digestion & absorption of
carbohydrate, lipid, protein.
2. Bioenergetics- biological oxidation, high energy phosphates, oxidative
phosphorylation, respiratory chain. metabolism-definition, phases; anabolism,
catabolism
3. Carbohydrate metabolism- glycolysis, fate of pyruvate, TCA cycle, HMP
pathway, gluconeogenesis, glycogenesis, glycogenolysis, blood glucose
regulation.
4. Lipid metabolism: lipolysis, Beta-oxidation of fatty acid, fate of Actyl-CoA,
ketone bodies, ketosis & its pathoghenesis. Lipoproteins & their metabolism,
Cholesterol metabolism.
5. Protein metabolism: Amino acid pool, Transamination, Deamination.
Source & fate of ammonia, ammonia intoxication, Urea cycle.

Card No- 4. Renal biochemistry, body fluid, electrolytes and acid base balance

No Items Marks( 10 in each item) Initial and date

1. Renal biochemistry- GFR, tubular load, TM, renal threshold, plasma
clearance, osmolar clearance, free water clearance, acidification of urine.
2. Body fluid- Body fluid compartments, daily water intake & output, water
turnover, body fluid volume regulation, volume disorders and diuresis.
3. Acid-Base Balance- origin of acids & bases, maintenance of static blood pH.
Acid base disorders, their compensation & coprrection, anion gap and base
excess.
4. Serum Electrolytes- Serum electrolytes & their reference ranges. Functions,
regulations, hypo & hyper states of serum [Na+], [K+] [Ca++] & [PO4--]

87
 Card No- 5. Clinical biochemistry and clinical endocrinology

No Items Marks( 10 in each item) Initial and date

1. Clinical biochemistry- S I unit, Laboratory hazards, Sample collection,
Photometry. Clinical enzymology, lipid profiles of blood.
2. Clinical enzymology and lipid profiles of blood.
3. Diagnosis of diabetes mellitus. OGTT, IGT, IFG and HbA1C.
4. Thyroid function tests and interpretation.
5. Commonly done LFT. Jaundice.
6. Renal function tests and interpretation.

Card No- 6. Fundamental of molecular biology and genetics

No Items Marks(10 in each item) Initial and date

1. Nucleic acids, nucleotides, DNA, RNA, DNA organization, Cell cycle.
2. The central dogma, Genome, Gene, Genetic code, Codon, Mutation,
mutagens, Genotype, Phenotype, trait, allele.
3. Replication, Transcription and post transcriptional modification,
4. Translation and post translational modification.
5. Recombinent DNA technology, PCR, Cloning.

88
 Total Teaching Hours for Biochemistry
System Lecture Tutorial Practical Integrated teaching
1. Biophysics and biomolecules’ 18 25 20

2. Food, nutrition, vitamins and 18 15 10

minerals

3. Digestion, absorption, 29 18 25
bionergetics and metabolism Common hour of Phase I

4. Body fluids, electrolytes and 20 12 20

acid base balance

5. Clinical biochemistry and 14 15 20

clinical endocrinology

6. Molecular Biology and 18 15 05

genetics ( Fundamentals)

Total Teaching Hours: (317) 117 100 100 36

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 Academic Calendar for Biochemistry

First Term
System(Two) Lectures Tutorials Practical Seminar
Card-1.Biophysics and biomolecules 18 hrs. 25 hrs. 20 hrs. 2 hrs.
and
Card-2. Food and Nutrition 18 hrs. 15 hrs. 10 hrs. 1 hrs.
36 hrs. 40 hrs. 30 hrs. 3 hrs.

Second Term
System(Two) Lectures Tutorials Practical Seminar
Card-3.Digestion,absorption, 29 hrs. 18 hrs. 25 hrs. 2 hrs.
bioenergetics and metabolism
Card-4.Bodyfluids, electrolytes,renal 20 hrs. 12 hrs. 20 hrs. 1 hrs.
chemistry and acid base balance 49 hrs. 30 hrs. 45 hrs. 3 hrs.

Third Term
System (Three) Lectures Tutorials Practical Seminar
Card-5.Clinical biochemistry and 14 hrs. 15 hrs. 20 hrs. 02 hrs.
clinical Endocrinology 18 hrs.
Card-6.Molecular Biology 32 hrs. 15 hrs. 05 hrs. 02 hrs.
30 hrs. 25 hrs. 04 hrs.

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