Unit 1457: Clinical Biochemistry

1. Introduction to Clinical Biochemistry

• Definition and scope of clinical biochemistry
• Role of biochemistry in medicine
• Biochemical tests in diagnosis: types and applications
• Understanding normal vs abnormal biochemical parameters

2. Biomolecules in Clinical Biochemistry

2.1 Carbohydrates

• Structure and classification
• Clinical significance: glucose monitoring, glycogen storage diseases

2.2 Lipids

• Types: triglycerides, phospholipids, cholesterol
• Role in health and disease: atherosclerosis, hyperlipidemia

2.3 Proteins

• Structure and function: enzymes, transport proteins, antibodies
• Clinical markers: albumin, globulins, plasma proteins

2.4 Nucleic Acids

• DNA and RNA overview
• Relevance in clinical diagnostics: genetic testing, mutations

3. Enzymes and Enzyme Kinetics in Clinical Biochemistry

• Enzymes as biological catalysts
• Enzyme kinetics: Michaelis-Menten theory, factors affecting activity (pH, temperature, inhibitors)
• Clinical enzyme assays: diagnostic and monitoring applications
• Examples: AST, ALT, ALP, CK

4. Metabolic Pathways and Disorders

4.1 Major Metabolic Pathways

• Glycolysis
• Tricarboxylic Acid (TCA) Cycle
• Oxidative phosphorylation

4.2 Metabolic Disorders

• Biochemical basis: enzyme deficiencies, genetic mutations
• Examples: diabetes mellitus, phenylketonuria, mitochondrial diseases
• Diagnostic markers and laboratory tests
• Treatment approaches

5. Hormones and Endocrine Function

• Biochemical properties of hormones: peptide, steroid, amine hormones
• Hormone regulation and signaling pathways
• Clinical biochemistry in endocrine assessment
• Diagnosis of hormone-related disorders: thyroid, adrenal, pituitary
• Monitoring hormone replacement therapy

6. Acid-Base Balance and Electrolyte Disorders

• Principles of acid-base homeostasis
• Buffer systems and pH regulation
• Electrolyte homeostasis: Na+, K+, Ca2+, Mg2+, Cl-
• Common electrolyte disorders: hyponatremia, hyperkalemia
• Clinical manifestations and biochemical basis
• Laboratory evaluation and interpretation

7. Tumor Markers and Cancer Biochemistry

• Definition and types of tumor markers
• Use in cancer diagnosis, prognosis, and treatment monitoring
• Biochemical alterations in cancer: metabolic reprogramming, enzyme expression changes
• Examples of tumor markers: PSA, CA-125, CEA

8. Clinical Enzymology and Liver Function Tests

• Liver function tests overview
• Enzyme assays: AST, ALT, ALP, GGT
• Bilirubin metabolism and measurement
• Other biochemical markers of liver injury
• Clinical interpretation in liver diseases: hepatitis, cirrhosis

9. Therapeutic Drug Monitoring

• Principles and importance
• Biochemical assay methods for drug level measurement
• Factors influencing drug metabolism: genetics, interactions
• Clinical applications: optimizing dosage, preventing toxicity

10. Quality Control and Assurance in Clinical Biochemistry

• Importance of accuracy and precision in laboratory testing
• Internal quality control procedures
• External quality assessment programs
• Strategies to maintain and improve laboratory performance