Medical Biochemistry

Study Course Description

Course Description Statuss:Approved

Course Description Version:14.00

Study Course Accepted:09.05.2024 10:01:09

Study Course Information
Course Code:		CFUBK_072		LQF level:		Level 7
Credit Points:		11.00		ECTS:		16.50
Branch of Science:		Chemistry; Biochemistry		Target Audience:		Medicine
Study Course Supervisor
Course Supervisor:		Dace Reihmane
Study Course Implementer
Structural Unit:		Department of Human Physiology and Biochemistry
The Head of Structural Unit:
Contacts:		Riga, 16 Dzirciema Street, cfbkrsu[pnkts]lv, dace[pnkts]reihmanersu[pnkts]lv, +371 67061550
Study Course Planning
Full-Time - Semester No.1
Lectures (count)		16	Lecture Length (academic hours)		2	Total Contact Hours of Lectures		32
Classes (count)		71	Class Length (academic hours)		1	Total Contact Hours of Classes		71
Total Contact Hours								103
Full-Time - Semester No.2
Lectures (count)		11	Lecture Length (academic hours)		2	Total Contact Hours of Lectures		22
Classes (count)		51	Class Length (academic hours)		1	Total Contact Hours of Classes		51
Total Contact Hours								73
Study course description
Preliminary Knowledge:
Physics, chemistry, biology, anatomy.
Objective:
To provide theoretical and practical knowledge of biochemical processes (digestion and metabolism) occurring in human organism on a molecular level. To facilitate the understanding of regulatory mechanisms of biochemical processes both on molecular as well as on physiological level. To elucidate differences in and specific adaptations of biochemical processes in various tissues/organs (cell metabolism). To gain insight in pathological processes related to energy metabolism. To know the use of important biochemical markers and understand basic principles of their quantitative and qualitative detection methods.
Topic Layout (Full-Time)
No.	Topic			Type of Implementation		Number	Venue
1	Organic Compounds. Functional Groups and Isomers.			Lectures		1.00	auditorium
2	Functional groups, isomers, basic organic compounds.			Classes		3.00	other
3	General properties of functional groups. Reaction types (Oxidation – Reduction; Condensation and Hydrolysis; SN1, SN2, E1, E2).			Lectures		1.00	auditorium
4	Functional groups, reaction mechanisms (oxidation – reduction; condensation, hydrolysis; SN, E mechanisms). Chemical bonds.			Classes		3.00	auditorium
5	Carbohydrates. Structure. Properties.			Lectures		1.00	auditorium
6	Reducing properties of sugars.			Classes		2.00	laboratory
7	Structure, optical and structural isomers, mono-, di-, poli-saccharides.			Classes		3.00	other
8	Fats. Structures. Properties.			Lectures		1.00	other
9	Amino acids and Proteins. Structure. Properties.			Lectures		1.00	auditorium
10	Denaturation of proteins.			Classes		2.00	laboratory
11	Lipids. Structures. Properties. Amino acids, proteins, structures. Intermolecular forces.			Classes		3.00	other
12	Enzymes, enzyme classes, enzyme specificities.			Lectures		1.00	auditorium
13	Influence of temperature and pH on enzyme activity.			Classes		2.00	laboratory
14	Test: Macromolecules and reaction mechanisms. / Recognizing and describing enzyme classes.			Classes		3.00	other
15	Enzyme activation and inhibition mechanisms.			Lectures		1.00	auditorium
16	Specificity of enzymes.			Classes		2.00	laboratory
17	Enzyme activation and inhibition mechanisms, their use in medicine.			Classes		3.00	auditorium
18	Regulation of Enzyme activity in metabolic pathways, vitamins as biological catalysts.			Lectures		1.00	auditorium
19	Activation and inhibition of salivary amylase, changes in amyloclastic force.			Classes		2.00	laboratory
20	General metabolic regulation and vitamin derived cofactors.			Classes		3.00	other
21	Digestion and absorption of carbohydrates and proteins.			Lectures		1.00	auditorium
22	Analysis of glucosidases in digestive juices.			Classes		2.00	laboratory
23	Hydrolysis of nutrients, peptide chain cleavage.			Classes		3.00	other
24	Digestion and absorption of lipids, synthesis and functions of bile acids/salts.			Lectures		1.00	auditorium
25	Functions of the lipase and bile, structure of bile acids.			Classes		2.00	laboratory
26	Hydrolysis of nutrients, diseases related to digestion.			Classes		3.00	auditorium
27	Colloquium I.			Classes		3.00	auditorium
28	Glycolysis			Lectures		1.00	auditorium
29	Regulation of glycolysis, differences in various tissues			Classes		3.00	auditorium
30	Oxidative decarboxylation. The Citric Acid (Tricarboxylic acid, Krebs) Cycle.			Lectures		1.00	auditorium
31	Determination of succinate dehydrogenase.			Classes		2.00	laboratory
32	Anabolic role of CAC. Calculations of acquired energy.			Classes		3.00	other
33	Bioenergetics, role of ATP in human metabolism. Oxidative stress.			Lectures		1.00	auditorium
34	Determination of antioxidant enzymes (catalase, peroxidase).			Classes		2.00	laboratory
35	Oxidative stress. Activators and inhibitors of ETC.			Classes		3.00	other
36	Anaerobic glycolysis, buffer systems, gluconeogenesis, cori cycle.			Lectures		1.00	other
37	Determination of pyruvate, lactate.			Classes		2.00	laboratory
38	Lactic acidosis - symptoms, causes and treatments.			Classes		3.00	auditorium
39	Malate-aspartate shuttle. Glycerol-3P shuttle. Pentose Phosphate Pathway. Fructose metabolism.			Lectures		1.00	auditorium
40	Metabolism of glycogen and galactose. Blood glucose homeostasis.			Lectures		1.00	auditorium
41	Oxidation of carbohydrates. Dismetabolism.			Classes		3.00	other
42	Storage of carbohydrates. Dismetabolism.			Classes		3.00	other
43	Colloquium II.			Classes		3.00	auditorium
44	Transport and storage of lipids. Biosynthesis of cholesterol, functions.			Lectures		1.00	auditorium
45	Lipoproteins (HDL, LDL), Cholesterol, relation to high CH diet, hypercholesterolaemia.			Classes		3.00	other
46	Fatty Acid Catabolism, Ketogenesis			Lectures		1.00	auditorium
47	Energy in lipid metabolism – calculations. Carnitine deficiency, ketoacidosis.			Classes		3.00	other
48	Lipid biosynthesis (Fatty acids, TAGs and membrane Phospholipids).			Lectures		1.00	auditorium
49	Lipid biosynthesis - calculations, related pathologies.			Classes		3.00	auditorium
50	Protein catabolism, amino acid oxidation and the production of urea.			Lectures		1.00	auditorium
51	Transamination, deamination, role in various tissues. Importance of clinical biomarkers (ALT and AST).			Classes		3.00	other
52	Biosynthesis of amino acids, their derivates – biogenic amines, creatine, glutathione. Biosynthesis and degradation of purines, pyrimidines, heme.			Lectures		1.00	auditorium
53	Variety of nitrogen containing compounds and their functions in body.			Classes		3.00	auditorium
54	Hormones – classification and characteristics based on structure, general action mechanisms.			Lectures		1.00	auditorium
55	Hormonal regulation (insulin, glucagon) of metabolism in absorptive/postabsorptive periods.			Classes		3.00	other
56	Blood and urine biomarkers of nitrogen metabolism.			Classes		3.00	auditorium
57	Colloquium III.			Classes		3.00	auditorium
58	Liver metabolism.			Lectures		1.00	auditorium
59	The role of liver in detoxification. Enzymes in diagnostics (e.g. ALT, AST, Alkaline phosphatase).			Classes		3.00	other
60	Obesity, body weight regulation.			Lectures		1.00	auditorium
61	Factors related to increased risk of obesity.			Classes		3.00	other
62	Fuel metabolism during exercise.			Lectures		1.00	auditorium
63	Aspects that determine the use of different energy systems. Heath benefits provided by regular physical activity.			Classes		3.00	other
64	Can we "run away" from Metabolic Syndrome?			Lectures		1.00	auditorium
65	Metabolic syndrome and type II diabetes.			Classes		3.00	other
66	Metabolic aspects of oncological disease.			Lectures		1.00	auditorium
67	Big data analysis with R.			Classes		3.00	other
68	Colloquium IV.			Classes		3.00	auditorium
69	General overview about enzymes and digestion.			Classes		3.00	auditorium
70	General overview about carbohydrate metabolsim.			Classes		3.00	auditorium
71	General overview about protein and lipid metabolism.			Classes		3.00	auditorium
Assessment
Unaided Work:
Study course includes 238 hours of independent work, 22 of those are going to be in the form of organized work for preparation of presentations. Other 216 hours include the following: • independent study of sources provided in e-studies (books, review articles); • prior preparation of homework given in e-studies (multiple tasks representing the main concept of the colloquium) for each practical class and covering topics from previous lectures; • completing on-line tests in e-studies prepared for each practical class for self-control; • preparation of practical work reports; • use of ones own knowledge in resolving cases (list of clinical tasks can be found on e-studies); • analysis of scientific publications; • individual preparation for colloquiums and exam; • voluntary research work. In order to evaluate the quality of the study course as a whole, the student must fill out the study course evaluation questionnaire on the Student Portal.
Assessment Criteria:
The protocol of laboratory work includes justification of the results obtained, interpretation of the results in the clinical aspect, answers to an additional individual question related to the topic Colloquium include detailed multiple choice questions that require specific theoretical and practical knowledge; various assignments assessing students’ understanding of biochemical processes and their regulation; clinical tasks estimating the ability to use the acquired knowledge by analyzing simplified clinical tasks. Examination (final assessment) includes general multiple choice questions on all topics covered during the study course; various written assignments requiring detailed knowledge of the main digestive and metabolic processes; oral questions which are designed to evaluate students’ general understanding of the relationship between biochemical processes that provide homeostasis in the body and potential dismetabolism or related pathologies. The final grade in study course Medical Biochemistry will be cumulative assessment of interim (50%) and end-of-course (50%) examinations. During the study course there will be 4 Interim examinations – colloquiums. Grade of colloquiums will be cumulative assessment of: • actual results of colloquium (85%); • average results of the mandatory quizzes held after each seminar (15%). For successful preparation for seminars bonus points to the respective colloquium can be gained. If quiz before seminar is filled out with ≥ 70% correct answers, student earns additional 1% to the colloquium grade. To gain access to Interim examinations: • all corresponding E-protocols must be passed (≥ 85% correct answers); • all quizzes after seminars must be held; • for first colloquium (Semester 1) additionally Test "Macromolecules and reaction mechanisms" must be passed. • for fourth colloquium (Semester 2) additionally Presentation "Novelty of the year in biochemistry" must be made. After successful interim examinations one written final exam will be held.
Final Examination (Full-Time):		Exam (Written)
Final Examination (Part-Time):
Learning Outcomes
Knowledge:		On completion of the course students will be able to: • explain and describe the synthesis and hydrolysis of proteins, lipids, nucleic acids, and carbohydrates; • name factors influencing enzyme activity; • classify digestive enzymes according to their mechanism of action and name the enzymes involved in digestion of the main nutrient classes; • recognise and name the basic metabolites of carbohydrate metabolism, name enzymes and characterise their principle of action, explain the role and regulation of various metabolic pathways and cycles (e.g. glycolysis, oxidative decarboxylation and the Krebs cycle, glycogen synthesis and breakdown); • identify and recognise the major metabolites of lipid metabolism, name enzymes and describe their principle of action, explain the role and regulation of various metabolic pathways (e.g. beta oxidation, fatty acid and cholesterol synthesis); • recognise and name the major metabolites of amino acid metabolism, name enzymes and characterise the principle of action, explain the role and regulation of metabolic pathways (e.g. ammonium detoxification and urea cycle); • describe metabolic pathways in human metabolism that connect carbohydrates, lipids and amino acids and allow these groups of substances to transform into each other, name hormones that affect these transformations; • name and explain complications related to dysfunction of biochemical pathways studied in the course (e.g. lactoacidosis and ketoacidosis); • name and explain differences between biochemical processes of various tissues/organs (cellular metabolism) and their specific adaptations; • learn methods required for basic biochemistry analysis performed in medicine.
Skills:		1. Use of knowledge – ability to: • explain how enzymes activity is affected, based on the mechanism of action of enzymes; • explain how molecules are sequentially digested during digestion process, identify end products of digestion process; • explain step by step using the appropriate metabolic pathways, carbohydrates degradation for energy generation and carbohydrate storage; • explain sequentially with appropriate metabolic pathways, lipid breakdown for energy extraction and carbohydrates storage; • explain sequentially using the appropriate metabolic pathways, the degradation of amino acids for energy generation, fate of the carbon skeleton and the ammonia detoxification; • explain step by step using the appropriate metabolic pathways, interactions between fats and sugars and evaluate in which metabolic situations these transformations take place; • explain the application and basic principle of biochemical tests of biological samples (blood and urine) used to determine the functional state of the human body. 2. Problem solving skills. 3. Skills to use scientific literature as a source of information. 4. Laboratory safety skills. 5. Communication skills gained through organized team work.
Competencies:		On completion of the course students will be able to: • assess possible changes in the regulation of enzymes in various homeostatic disorders and predict the consequences on total metabolism; • analyse possible changes on the digestive process with low activity of certain digestive enzymes, and predict consequences on the total spectrum of absorbed nutrients; • analyse possible changes in human metabolism in the presence of some carbohydrate, lipid or amino acid pathway disorders and predict their effects on other metabolic pathways and human homeostasis; • use the skills acquired in laboratory work – prepare and conduct laboratory experiment, use the relevant equipment and evaluate the results in further practical or scientific work; • integrate knowledge of biochemistry as part of the knowledge of the individual by promoting a perception of the human as a single organism.
Bibliography
No.	Reference
Required Reading
1	Nelson, D. L. and Cox, M. M. 2017. Lehninger Principles of Biochemistry. 7th ed. New York: W. H. Freeman & Co (ISBN: 978-1464187964)
2	Baynes, J.W. and Marek H. Dominiczak M.H. 2019. Medical Biochemistry. 5th ed. Elsevier Limited.
Additional Reading
1	Murray, R. K., Granner, D.K., Mayes, P. A. and Rodwell, V.W. 2018. Harper’s Illustrated Biochemistry, 31th ed. USA: McGraw-Hill Companies.
2	Berg, J. M. , Tymoczko, J.L. and Stryer, L. 2015. Biochemistry. 5th ed. New York: W H Freeman.
3	Devlin, T.M. 2011. Textbook of Biochemistry with Clinical Correlations (Wiley-Liss; 7th ed.). 1240
4	Harvey, R.A. and Ferrier, D.R. 2010. Lippincott's Illustrated Reviews: Biochemistry (Lippincott's Illustrated Teviews Series). 544
5	Miķelsone, V. 2008. Bioķīmija. Jelgava, LLU.
6	Lieberman, M.A. and Peet, A. 2018. Marks' Basic Medical Biochemistry. 5th ed. Lippincott Williams& Wilkins
7	Ārvalstu studentiem/For international students:
8	Murray, R. K., Granner, D.K., Mayes, P. A. and Rodwell, V.W. 2018. Harper’s Illustrated Biochemistry, 31th ed. USA: McGraw-Hill Companies.
9	Devlin, T.M. 2011. Textbook of Biochemistry with Clinical Correlations (Wiley-Liss; 7th ed.). 1240
10	Harvey, R.A. and Ferrier, D.R. 2010. Lippincott's Illustrated Reviews: Biochemistry (Lippincott's Illustrated Teviews Series). 544
Other Information Sources
1	Zinātniskie raksti PubMed žurnālos
2	Currie, E., Schulze A., Zechner R., Walther, T. C., and Farese Jr., R. V. 2013. Cellular Fatty Acid Metabolism and Cancer. Cell Metabolism. 18 (2), 153–161.
3	Kaoutari, A. E., Armougom, F., Gordon, J. I., Raoult, D. and Henrissa, B. 2013. The abundance and variety of carbohydrate-active enzymes in the human gut microbiota. Nature Reviews Microbiology. 11, 497–504.
4	Mudgil, D. and Barak, S., 2013. Composition, properties and health benefits of indigestible carbohydrate polymers as dietaryfiber:A review. International Journal of Biological Macromolecules.61, 1-6. Science Direct. Research gate.
5	Vaishnavi, S. N., Vlassenko, A. G., Rundle, M. M., Snyder, A. Z., et.al. 2010. Proceedings of the National Academy of Sciences. 107 (41) 17757-17762.
6	Wu, F. and Minteer, S. 2015. Krebs Cycle Metabolon: Structural Evidence of Substrate Channeling Revealed by Cross‐Linking and Mass Spectrometry. Angewandte Chemie International Edition, 54: 1851-1854.
7	King, M. W. The medical biochemistry page.
8	Lipid absorption 2016. In Boron, W. and Boulpaep E,. ed. Medical Physiology. 3rd ed. Philadelpia: Elsevier.