Biochemistry and Clinical Biochemistry

Introduction: body composition and concept of homeostasis. Carbohydrates, lipids and proteins: structure and metabolic and structural roles. Classification of proteins, antibodies and chromoproteins. Enzymes: Energy aspects, principles of enzymatic catalysis, activation energy. Enzymatic activity. Meaning of Km, competitive and non-competitive inhibition. Enzymes in the metabolic pathways. Principles of regulation of enzymatic activity, allosterism. Nomenclature of enzymes. Vitamins and coenzymes. Biological membranes: structure, proteins and membrane lipids, regulation of fluidity. Transport systems.
Metabolism. Anabolism and catabolism, ADP phosphorylation at the substrate level and oxidative phosphorylation, the mitochondrial respiratory chain, ATP biosynthesis, regulation, inhibitors and decouplers.
Cellular communication. Signal / receptor molecule interaction, surface cellular receptors, the signal molecules, first and second messenger. Hypothalamic / pituitary / endocrine glands axis.
Nutritional needs. Energy needs, body mass index, basal and functional metabolism, induced thermogenesis. Plastic requirements, indispensable amino acids and nitrogen balance.
Metabolism.
Carbohydrates: Digestion, absorption and transport. Hormonal regulation of glucose, insulin / glucagon. Glycolysis, energy balance and its regulation. The Krebs cycle energy balance and its regulation. The cycle of pentose phosphates, products and regulation. Glycogen metabolism and its regulation.
Lipids: Digestion, absorption and delivery of lipids. Lipoprotein metabolism and electrophoresis. Oxidative metabolism of fatty acids, mitochondrial oxidation. Metabolism of ketone bodies, regulations and energy yields. Catabolism and biosynthesis of endogenous triglycerides. Biosynthesis, elongation and desaturation of fatty acids and their regulation. Complex lipid metabolism. Cholesterol metabolism and its regulation. Vitamin and cofactors involved in lipid metabolism and carnitine.
Proteins: Digestion and amino acid metabolism. Transamination, oxidative deamination, urea cycle, biogenic amines, ammonia toxicity. Vitamin and cofactors involved in the amino acid metabolism. Nucleotides: purine and pyrimidine metabolism, biosynthesis, catabolism and metabolic regulations.
Metabolic integrations and Functional biochemistry: gluconeogenesis, metabolic relationships between lipids, carbohydrates and amino acids in different tissues., biochemistry of the adipose tissue, energy balance and thermogenesis. Free radicals and antioxidant defences. Renal, muscle and liver biochemistry. Biochemistry of the extracellular matrix, bone and dental tissue. Iron metabolism. Biochemistry of nervous tissue

Principles and applications of the main genetic investigation techniques. Congenital metabolic diseases of the metabolism.

General Clinical Biochemistry
Introduction, purpose, potential and limits of laboratory tests. Levels of laboratory intervention. Diagnostic test concepts and their purposes (screening, in-depth diagnostic, disease monitoring). Analytical profile concept. Examination of organ or apparatus function. Operation of a centralized Laboratory and Point-of-Care; organizational, technical and economic aspects.
The pre-analytic phase and its sources of variability. The preparation of the patient. Collection, treatment and storage of biological samples for diagnostic purposes: blood, urine and feces cephalorachidian fluid (liquor), fluids pouring into the serous cavities, synovial fluid, amniotic fluid, seminal fluid, gastric juice, sweat. Acceptability criteria for biological samples by the Analytical Laboratory. Post-analytical variability: Lab-report.
Analytical and biological variability. Types of errors. Reliability of a dosing method. Analytical variability and factors that influence it. . Biological variability and factors that influence it. Analytical goals. Overview of quality control.
The terms of comparison of biochemical-clinical data: reference intervals, desirable levels, decision levels and critical values, critical difference.
Diagnostic logic: sensitivity and clinical specificity predictive values, ROC curves
Clinical Biochemistry of Systems
Deepening of some topics of the teacher's choice (for example: Role of the laboratory in the diagnosis and surveillance of diabetes, in the diagnosis of liver diseases, in the diagnosis of jaundice, lipid structure, renal function, saliva, coagulative function, cardiac markers, plasma proteins, markers ... Principles and applications of the main techniques used in clinical biochemistry. Enzymes and other macromolecular markers of function and lesion. Diagnostic potential of plasma proteins. Evaluation of haemostatic functionality