The Oxford Medical college, Hospital & Research Centre

Department of Biochemistry
II Assignment
Date: 3.3.23
Date of submission – 13, 14, 15/03/2023 during respective practical hours
Topic: Metabolism of carbohydrates
Long Essay:
1. A 55 year old male was brought to the emergency department in a disoriented state. On examination
he was conscious, but not oriented, his respiratory rate was increased and his breath had a peculiar
fruity odour. The following results were obtained on laboratory investigation.
Blood glucose -500mg/dl, Plasma pH-7.14, Serum Bicarbonate – 12 mEq/L
a. What is your probable diagnosis?
b. Mention the additional biochemical tests for confirmation of diagnosis.
c. Describe the normal mechanism of blood glucose regulation.
2. Define glycolysis. Describe the reactions of glycolysis in detail. Add a note on energetics of aerobic
glycolysis.
3. A medical student who had an exam on the next day did not eat anything the previous night. Next day
morning, he had severe headache and giddiness before exam. His fasting plasma glucose was 48
mg/dl.
a. Interpret the plasma glucose value
b. Name the metabolic pathways which maintain blood glucose in fasting state
c. Explain the metabolic pathway that synthesise glucose from pyruvate
4. What is the importance of TCA cycle? Describe the reactions of citric acid cycle in detail.
5. What is glycogenesis and glycogenolysis? Describe in detail glycogenesis. Add a note on glycogen
storage disorders.
6. Discuss HMP pathway with respect to (5+2+3 =10 )
a. Reactions of HMP pathway.
b. Importance of HMP pathway.
c. Disorders associated with HMP pathway.
7. Discuss in detail Uronic acid pathway. Add a note on inherited disorder associated with this pathway
8. Glucose-6-phosphate dehydrogenase enzyme and its clinical importance.
9. Energetics of complete oxidation of one molecule of glucose.
Short essays:
10. A three months old home delivered male baby was brought to the pediatric OPD.
O/E – doll like face with fat cheeks, thin extremities, protruded abdomen.
Systemic examination: Hepatomegaly +
Blood examination reveals
FBS : 35 mg/dl
ALT : 150 U/L
AST : 30 U/L
ALP : 40 U/L
Uric acid : 9.5 mg/dl
Triglycerides : 300 mg/dl
Cholesterol : 350 mg/dl
Lactate : 95 mg/dl

Page 1 of 4
 Urine analysis:
For glucose : Negative
Histopathological examination of liver biopsy: Distended hepatocytes with glycogen & lipid vacuoles.
a. What is the probable diagnosis?
b. Name the enzyme deficiency
c. Comment on the report.
11. A male baby aged 7 days old referred from a general practitioner presenting with vomiting, jaundice &
failure to thrive admitted to pediatric ward of medical college.
O/E – Bilateral cataract: +
Hepatomegaly : +
Laboratory findings:
Blood galactose : ↑
Blood Glucose : Normal
Bilirubin : 14 mg/dl
Urine galactose : + ve
a) What is your probable diagnosis
b) Mention the defective enzyme
c) Explain the basis of cataract development.
12. A 10 yr old girl, on routine urine analysis gave a +ve Benedict’s test. But the fasting & post-lunch
blood glucose levels are normal.
She did not have any presenting complaints. When her urine was tested specifically for different
sugars,
The lab data reveals:
Bial's test: Positive
a) What is the probable diagnosis?
b) What is the Biochemical defect in this disorder?
c) How will you differentiate this disease from Diabetes mellitus
13. Galactose metabolism
14. Fructose metabolism
15. What is substrate level phosphorylation. Give examples.
16. Formation and fate of Pyruvate.
17. Energetics of oxidation of glucose in aerobic condition.
18. How propionyl coA coverts to succinyl CoA.
19. Describe the reactions of glycogenolysis in the liver.
20. Energy yielding reactions in TCA cycle.
21. Anabolic role of TCA cycle.
22. Reciprocal regulations of glycogen metabolism
23. How alcohol is detoxified? What are the biochemical changes in alcoholism?
24. Rapaport Leubering cycle and it importance.
Short answers:
25. Lactic acidosis
26. Cori’s cycle and its importance
27. Glucose alanine cycle and its importance
28. Anaplerotic reactions
29. Substrates for gluconeogenesis.
30. Importance of gluconeogenesis.

Page 2 of 4
31. Hereditary fructose intolerance.

Topic: Fat soluble vitamins

Long essays:
1. A two year old child visited ophthalmology OPD with C/O poor vision in night, ulceration and
watering from the eye, dry and rough skin and stunted growth. Mother of the child reported the child
was finding it difficult to locate things in the dim light and during night time.
O/E, Bitot’s spots present in the conjunctiva, cornea is opaque and perforated, Follicular hyperkeratosis
also present. Dark adaptation time is increased.
The blood analysis shows:
 Serum Retinol Binding Protein : 1.5 mg/dl ( 3.0 – 6.0 mg/dl)
 Serum Vitamin-A : 10 μg/d (30.0 – 65.0 μg/dl)
a. What is the probable diagnosis?
b. Which bio molecule is deficient in the diet?
c. Name the RDA and source of this bio molecule?
d. Give any four functions of this deficient bio molecule?
e. Wald’s visual cycle.
2. An 8 yr old boy admitted to orthopedic ward with a H/O retarded growth, difficulty in walking,
delay in teeth formation, bony pain and generalized weakness. O/E, frontal bossing, bow legs,
pigeon chest and bony tenderness present.

The blood analysis shows:

 Serum Calcium : 7.0 mg/dl
 Serum Inorganic Phosphate : 2.0 mg/dl
 Serum Alkaline Phosphatase (ALP) : 600.0 units/L
 Serum Vitamin - D3 (25-Hydrocholecalciferol) : 0.8 µg/dl
a. What is the probable diagnosis?
b. Which bio molecule is deficient in the diet?
c. Name the RDA and source of this bio molecule?
d. What is the active form of this bio molecule?
e. How this active form is formed and what are the functions of this active bio molecule?
3. What are the functions of vitamin K and E
Short Answers
4. Give examples for
a. Synthetic analogue of vitamin K
b. Sources of vitamin E
c. Fat soluble Antioxidant vitamins
d. Pro-vitamins of vitamin A
e. Pro-vitamins of vitamin D
5. Rickets
6. Vitamin K cycle
7. Sparing action of vitamin E on selenium.

Page 3 of 4
 Topic: Chemistry of lipids

Long essay:
1. Define lipids. Classify lipids with examples. Add a note on functions of phospholipids.
Short essays:
2. What are phospholipids? Classify phospholipids. Write their functions.
3. Prostaglandins and their functions.
4. What are lipoproteins? How they are separated? Write the composition and functions of each
lipoprotein.
5. Essential fatty acids and their functions.
6. What are Glycolipids? Give examples. Write their functions.
Short Answers:
7. Saponification number and its significance.
8. Iodine number and its significance.
9. What is Rancidity? What are the different types of rancidity and causes for rancidity?
10. Omega fatty acids and their functions.
11. Composition and clinical importance lung surfactant.

Page 4 of 4
 The Oxford Medical college, Hospital & Research Centre
Department of Biochemistry
IV Assignment Date: 26/04/2023
Date of submission: 8, 9, 10/05/2023 during respective practical hours
Topic: Chemistry of amino acids and proteins and Digestion and absorption of proteins
Long essay
1. Discuss in detail various levels of structural organizations of proteins with examples.
2. Discuss in detail different types of classification of amino acids with examples.
3. Discuss in detail different types of classification of proteins with examples.
Short essay
4. Essential amino acids.
5. Biogenic amines.
6. Biologically important peptides.
7. Discuss in detail digestion, absorption, and transport of proteins.
Short answers
8. Isoelectric pH, and its importance.
9. Give examples for a) Non protein amino acids, b) Derived proteins, c) High biological value
proteins
10. Give example for a) Branched chain amino acids, b) Contractile proteins, c) Derived amino acids
11. Denaturation of proteins.
12. Meister cycle
13. Proteolytic enzymes and their specificity.
14. Disorders associated with defective transport of amino acids.
15. Bonds responsible for higher levels of structural organization of proteins.

Topic: Chemistry of plasma proteins and Immunoglobulins

Short Essay:
1. Name major plasma proteins, normal values and their functions. How you are going to separate
plasma proteins.
2. Write the normal serum electrophoretic pattern and electrophoretic pattern in diseased conditions.
3. Transport proteins in the blood.
4. Bence-Jones proteins (Multiple myeoma)
or
A 60 yrs old man admitted to a hospital with a H/O low back ache, easy fatigability, difficulty in
walking and loss of weight. O/E, tenderness over the bones and anemia present.
Laboratory investigation reveals:
• Hb : 7.0 gm %
• Serum Calcium : 13.0 mg/dl
• Serum Urea : 70.0 mg/dl
• Serum Creatinine : 2.0 mg/dl
• Serum Uric Acid : 10.0 mg/dl
• Serum Total Proteins : 8.9 gm/dl
• Serum Albumin : 3.0 gm/dl
• Serum Globulins : 5.9 gm/dl
• Alkaline Phosphatase : 45.0 U/L
• ESR : 100 mm/hr
• Electrophoresis shows a thick band in the gamma globulin region.
a) Write your probable diagnosis?
b) Interpret the laboratory data.
c) Write the structure of Immunoglobulin. Write the different types of immunoglobulins and their
functions.
Short Answers:
6. Acute phase proteins
7. Acute negative phase proteins
 8. C- Reactive protein
9. Hypoalbunemia
10. Ceruloplamin
11. α1 antitrypsin
12. Hybridoma technology
Topic: Heme chemistry and metabolism
Long Essay:
1. 10 year old man presented with l week history of episodic severe abdominal pain associated with
vomiting 3-4 times per day and dark reddish in urine. He had 2 episodes of similar abdominal pain
along with altered sensoriam and generalized epileptic for which he was on treatment. On physical
examination, neurological and abdominal examination was unremarkable. There was no
photosensitivity. Lab examination shown Hb of 11 gms% and urine was strongly positive for
phorphobilinogen. (1+3+6+=10)
a. Suggest the probable diagnosis
b. What is the biochemical basis for the above mentioned lab findings
c. Explain the pathway implicated in this condition
2. 10 years old male came to dermatology OPD with history of redness of skin, dermatitis, scaling of
skin, reddish brown colour teeth, passing red coloured urine since 10 days. O/E pallor present, spleen
palatable. Laboratory investigation shows hemoglobin 11 gms%, urine was strongly positive for
uroporphyrin and corproporphyrins. There is an increased corproporphyrins in feces (1+3+6+=10)
a. Suggest the probable diagnosis
b. What is the biochemical basis for the above mentioned lab findings
c. Explain the pathway implicated in this condition
3. A 40 year old women admitted with recurrent pain abdomen with vomiting and yellowish
discoloration of skin and sclera, passing yellow colored urine and clay colored stool.
(1+1+3+5= 10)
Laboratory investigation reveals
Serum total bilirubin – 20 mg/dl
Serum direct bilirubin (conj.) – 16 mg/dl
Serum indirect bilirubin (unconj.) – 4mg/dl
AST – 85.0 IU/L
ALT – 98.0 IU/L
ALP – 1000 IU/L
a. What is your diagnosis?
b. What are the most likely causes?
c. What are the urinary changes to confirm your diagnosis?
d. Discuss bilirubin metabolism in detail.
4. A 15 yrs old boy student studying in boarding school admitted to hospital with a history of vomiting,
nausea, loss of appetite, abdominal pain since 15 days. Also gives history of passing dark yellow
colored urine. O/E, yellowish coloration of skin and conjunctiva present. Liver is just palpable.
Blood and Urine analysis revealed the following data:
Serum bilirubin : 7.5 mg/dl
Serum direct bilirubin (Conjugated) : 4.5 mg/dl
Serum indirect bilirubin (Unconjugated) : 3.0 mg/dl
AST(SGOT) : 600 U/L
ALT(SGPT) : 700 U/L
Serum Alkaline phosphatase : 120.0 U/L
Serum HbSAg(Hepatitis B surface antigen: “-Ve”
Urine analysis:
Bile pigments : “ +Ve”
Bile Salt : “ +Ve”
Urobilinogen : Present
Fecal Stercobilinogen : “ +Ve”
a. Interpret the laboratory data & Write the probable diagnosis.
 b. What is your diagnosis?
c. What are the most likely causes?
d. What are the urinary changes to confirm your diagnosis?
e. Discuss bilirubin metabolism in detail.
5. A new born baby had yellowish discoloration of skin and conjuctiva after 3 days of birth. The
neonatologist advised phototherapy. Later child become normal.
a. What is jaundice? (1+3+2+1+3 =10)
b. What are the types of jaundice?
c. What are the tests to be done in this child?
d. Why did phototherapy benefit the child?
e. What are the other types of jaundice that may be seen in a new born baby?
6. A 45 year old man admitted to medical OPD complaining of pain abdomen, loss of appetite, weight
loss, weakness, fatigue, itchy skin and lite yellowish coloration of skin. Patient gives H/O of chronic
alcoholism. O/E mild jaundice positive, pallor present and liver enlarged. Serum looks opalescent,
turbid and lipemic. (1+3+3+3 =10)
a. What is your probable diagnosis?
b. What are the causes for your diagnosis?
c. What are the biochemical parameters measured under lipid profile and enzymes?
d. Explain how lipotropic factors prevent above condition?
Short Essay:
7. Interpret the following liver function test report
Total bilirubin Direct bilirubin ALP Ehrlich’s test Stool sample
7.7 mg/dl 3.6 mg/dl 265 IU/L Negative Clay colored
a. What is the probable diagnosis?
b. Mention the possible causes for the above condition
c. Substantiate with reasons for increasing conjugated fraction of liver
8. Define jaundice. Classify jaundice. How will you investigate a case of jaundice?
9. Define porphyrias. Write different types of porphyrias with enzyme deficiency and biochemical
findings.
10. A 16-year-old African girl was admitted to the emergency room with complaints of fever and
recurrent pain in arms and legs.
Laboratory tests revealed the following:
Hb : 8.0 g/dl
Hematocrit : 9.1 %
Serum iron : 11 μg/dl
Serum albumin : 4.4 g/dL
Blood smear showed target cells, poikilocytosis, hypochromasia, sickle red cells, nucleated RBCs and
Howell Jolly bodies. Hb electrophoresis showed a slow-moving band.
a. What could be the probable diagnosis?
b. What is the defect?
c. Describe molecular basis, manifestations and laboratory diagnosis of above disease
11. Congenital hyperbilirubenemias.
12. Normal and abnormal hemoglobin derivatives.
13. Hemoglobinopathies
14. Thalassemias.
15. Write the structure of hemoglobin and discuss different types of normal hemoglobin.

Short answers:
16. Criggler- Najjar syndrome.
17. Hemolytic disease of newborn.
18. Van den bergh test.
19. Met-Hemoglobinemia
20. Difference between conjugated and unconjugated bilirubin.
 The Oxford Medical College, Hospital & Research Centre
Department of Biochemistry
Assignment Date: 13/09/2023
ORGAN FUNCTION TESTS
Liver function tests
Long Essays:
1. Classify liver function tests. Discuss in detail various tests done to assess excretory functions of liver.
(LE)
2. A 40 year old women admitted with recurrent pain abdomen with vomiting and yellowish
discoloration of skin and sclera, passing yellow colored urine and clay colored stool. (1+1+2+6=
10)
Laboratory investigation reveals
Serum total bilirubin – 20 mg/dl
Serum direct bilirubin (conj.) – 16 mg/dl
Serum indirect bilirubin (unconj.) – 4mg/dl
AST – 85.0 IU/L
ALT – 98.0 IU/L
ALP – 1000 IU/L
a. What is your diagnosis?
b. What are the most likely causes?
c. What are the urinary changes to confirm your diagnosis?
d. Discuss bilirubin metabolism in detail.
Short Essays:
3. Discuss in detail tests done to assess synthetic functions of liver.
4. Discuss in detail role of enzymes to assess functions of liver. (Enzymes helpful in the diagnosis of
liver diseases).
5. Define jaundice. How will you differentiate different types of jaundice?
6. Interpret the following liver function test report
Total bilirubin Direct bilirubin ALP Ehrlich’s test Stool sample
7.7 mg/dl 3.6 mg/dl 265 IU/L Negative Clay colored
a. What is the probable diagnosis?
b. Mention the possible causes for the above condition
c. Substantiate with reasons for increasing conjugated fraction of liver
Short Answers:
7. Prothrombin time and its importance (SA)
8. Van den-Berg reaction
9. Galactose tolerance test
10. Kernicterus
Renal function tests
Long Essay:
1. Classify renal function test. How will you assess tubular functions of Kidney. Write the clinical
importance of various clearance tests.
Short Essays:
2. How will you assess the glomerular functions of kidney?
3. Write the tests to assess the tubular functions of the kidney.
Short Answers:
4. Grade the Chronic kidney disease depending upon the GFR.
5. Renal threshold substances.
6. Proteinuria.
7. Microalbiminuria
8. Criteria’s to select a substance for clearance test.
 Thyroid function test
1. A 12 yrs old boy presented in the medical OPD with swelling of the neck, bulging of eye balls, loss of
weight, excessive sweating, nervousness and intolerance to heat.
O/E, sweating present. Patient is nervous and emotionally labile, pulse rate 140/min, tachycardia present.
O/E Skin is warm; Tremors present, Deep Tendon Reflexes are exaggerated.
Enlargement of thyroid gland present

Laboratory data reveals:

• Random Blood Glucose : 192.0 mg/dl
• Serum T3 : 3.4 ng/ml
• Serum T4 : 22.0 μg/dl
• Serum TSH : 0.3 mIU/ml
Comment on the laboratory report & Give the probable diagnosis.

2. A.40 yrs old patient admitted to hospital with a H/O weakness, constipation, weight gain and intolerance
to cold. O/E cold extremities, coarse, lusterless hair & pulse rate is 60/min.
Bradycardia present. Deep tendon reflexes are decreased and there is a slight swelling of thyroid
gland.
The blood analysis shows:
• Random Blood Glucose : 90.0 mg/dl
• Serum Cholesterol : 410.0 mg/dl
• Serum T3 : 0.3 ng/ml
• Serum T4 : 1.9 μg/dl
• Serum TSH : 30.0 mIU/ml
Comment on the laboratory report & Give the probable diagnosis.
Why serum cholesterol concentration is increased in the above patient.
3. Thyroid profile findings in case of primary and secondary hypothyroidism