THE TAMILNADU DR.

MGR MEDICAL UNIVERSITY,CHENNAI

BIOCHEMISTRY SYLLABUS-AUGUST 2010

Department of Biochemistry
KIMS

NOT TO BE
NICE TO
TOPIC ESSENTIAL TO KNOW TESTED IN
KNOW
EXAMINATION
1 CELL Basics of cell structure,
. including overview of basic
structure of cellular
organelles and their
functions
Basic concepts of separation
of sub-cellular organelles
(no details required)
2 ENZYMES

Nomenclature Systematic name, Sub-classes of

and recommended name, enzymes
classification IUPAC classification of
enzymes, main classes of
enzymes only (names,
definition, general reaction
catalyzed and one specific
example of each class)
Properties of Active site, lock and key and Concept of Amino acids present
enzymes induced fit models of amino acids in active sites of
enzyme-substrate binding, necessary in the enzymes
specificity of enzymes- active site of an
(reaction and substrate enzyme
specificity – definition and an
example for each More examples
of enzyme
Mechanism of action of an specificity
enzyme with regard to
concept of activation energy
of a reaction

Cofactors - metals and

coenzymes (definition,
constituents, classification,
examples of coenzymes) and
names of enzymes that
require them
Factors that pH, Lineweaver Burk
influence temperature, curve
enzyme activity substrate concentration,
(concept of Km, Michaelis -
Menten equation only),
concentration of enzyme
concentration of products
Inhibition of Types of enzyme inhibition Effects of Effects of inhibitors
enzymes (competitive, non inhibitors on the on the Lineweaver
competitive, suicide Lineweaver- Burk curve
inhibition), basic concepts Burk curve
with an example for each
type of inhibition, effects of
inhibitors on Km and Vmax
of an enzyme-catalysed
reaction, examples of
commonly used drugs that
act by competitive
inhibition of enzymes,
examples of non-
competitive enzyme
inhibition (eg,
organophosphorus / cyanide
poisoning).
Isoenzymes Definition, examples Details of separation
(lactate dehydrogenase and and quantitation of
creatine kinase), concept of isoenzymes
separation of isoenzymes
by electrophoresis
Diagnostic and AST, ALT, ALP, LDH, CK 5-nucleotidase,
therapeutic and amylase (normal values gamma-glutamyl
enzymes and conditions in which transferase
(Clinically levels are abnormal). (normal values
useful Examples of enzymes used and conditions in
Enzymes) in treatment and their which levels are
indications abnormal)
Regulation of Overview of mechanisms
enzyme activity involved in regulating the
activity of enzymes
(induction, repression,
covalent modification -
phosphorylation and
dephosphorylation- and
allosteric regulation, with 2
examples for each)
3 CHEMISTRY AND METABOLISM OF CARBOHYDRATES
Chemistry of Functions, basic overview of Structures of
carbohydrates classification of carbohydrates,
carbohydrates with isomerism of sugars,
physiologically important mutarotation,
examples, basis of chemical reactions of
Benedict’s test for reducing sugars,
sugars, concept of deoxy and mucopolysaccharidosi
amino sugars,components of s
physiologically important
disaccharides and
polysaccharides, concept of
homo- and
heteropolysaccharides with
physiologically important
examples and their
importance in the body.
Metabolism of
carbohydrates

Digestion of Examples of common

carbohydrates dietary carbohydrates and
the foods that they are
present in, enzymes
involved in digestion of
carbohydrates, sources, sites
and actions of the enzymes
that digest carbohydrates,
end products of digestion
and their absorption,
rationale for the composition
and use of oral rehydration
solutions (ORS), lactose
intolerance.
Glycolysis Definition, importance, Pathway of glycolysis
cellular site, pathway,
importance of aerobic and Role of fructose 2,6
anaerobic forms of bisphosphate in
glycolysis, energetic, regulation of
overview of regulation of glycolysis
glycolysis, Rapaport-
Leubering shunt and its
physiological importance,
concept of lactic acidosis
and common causes and
 conditions in which seen,
importance of inhibition of
enolase by fluoride in blood
samples collected for
glucose estimation, concept
of substrate level
phosphorylation
Citric acid Pyruvate dehydrogenase as a Pathway of citric acid
cycle link between glycolysis and cycle
Krebs’ cycle (no details of
reaction mechanism Regulation of
required), definition, pathway
importance, cellular site,
pathway (including
intermediates and enzymes
involved, excluding details
of reactions involved),
concept of anaplerosis,
amphibolic nature of TCA
cycle, energetics
HMP shunt Definition, importance, Pathway of HMP
organ sites, cellular site, shunt
overview of pathway
showing starting material
and products, importance of
end-products formed - ribose
for nucleic acid synthesis
and NADPH for synthesis of
various lipids, maintenance
of reduced form of iron in
haemoglobin, reduced
glutathione and its
importance in maintaining
red cell membrane integrity,
medically relevant enzymes
in the pathway (glucose-6-
phosphate dehydrogenase
(G6PDH) and transketolase),
clinical relevance of the
deficiency of G6PDH.
Metabolism of
glycogen

Glycogenesis Physiological importance of Pathway of synthesis

glycogen storage in the body and breakdown of
(including sites and glycogen
importance of each site),
overview of pathway of
synthesis (starting material,
action of glycogen synthase
and branching enzyme and
product), role of hormones
on the process (action of
glycogen synthase) (details
of regulation not required)

Glycogenolysis Physiological importance of

glycogen breakdown in the
body, overview of pathway
of breakdown in the liver
and muscle (starting
material, action of
phosphorylase and
debranching enzyme and
products obtained), role of
hormones on the process
(action of phosphorylase)
(details of regulation not
required), importance of
reciprocal regulation of
glycogenesis and
glycogenolysis, examples of
glycogen storage diseases
(Von Gierke’s disease and
McArdle’s disease)
Gluconeogenesi Definition, substrates used, Pathway of
s physiological importance, gluconeogenesis
sites, overview of pathway
with key intermediates and
enzymes, Cori cycle, Role of fructose 2,6
glucose-alanine cycle, role bisphosphate in
of hormones in regulation, regulation of
concept of reciprocal gluconeogenesis
regulation of glycolysis and
gluconeogenesis (no details
required)
Uronic acid Overview of pathway Pathway of uronic
pathway showing starting material acid formation,
(glucose) and product essential pentosuria
(glucuronic acid),
importance in conjugation of
bilirubin and drugs.
Metabolism of Dietary sources of galactose, Pathway of galactose
galactose overview of pathway by metabolism
which galactose is
metabolized (showing the
sites of 3 main enzymes
involved), eventual fate of
galactose in the body,
galactosemia (definition,
causes, clinical
manifestations and rationale
of therapy)
Metabolism of Dietary sources of fructose, Pathway of fructose
fructose overview of pathway by metabolism and
which fructose is associated disorders
metabolized (showing entry
into glycolysis and into
formation of
triacylglycerol),
importance of fructose in
seminal fluid
Minor Polyol pathway and its
pathways of importance in pathogenesis
carbohydrate of complications of diabetes
metabolism mellitus
Regulation of Role of dietary
blood glucose carbohydrates, role of
levels hormones (insulin,
glucagon, glucocorticoids,
catecholamines), role of
liver and kidney.
Diabetes Types and pathogenesis,
mellitus concept of insulin resistance,
metabolic derangements,
clinical features,
relevant investigations,
diagnostic criteria (WHO
criteria), concept of
impaired fasting glucose and
 impaired glucose tolerance,
basic principles of treatment.
Laboratory Blood glucose estimations
investigations (fasting and post-prandial),
in diabetes glycated haemoglobin,
mellitus urinalysis for glucose,
ketone bodies, proteins
microalbuminuria, role of
glucose tolerance test in
diagnosis of diabetes
mellitus, indications for and
interpretation of results of a
glucose tolerance test
(OGTT), serum lipid profile
in diabetics

Hypoglycemia Definition, importance,

causes, clinical
manifestations, treatment.

3 CHEMISTRY AND METABOLISM OF LIPIDS

Chemistry of lipids

General Definition of a lipid,

features properties with regard to
solubility and
hydrophobicity,
important functions of lipids
in the human body,
importance of lipids in
causation of disease
(atherosclerosis with
subsequent myocardial
infarction and stroke,
obesity, cholecystitis)

Classification Major types of lipids in the

of lipids body (classification into Structures of various
simple, complex and types of lipids
precursor or derived lipids),
medically relevant examples
 of each type and the
importance of each type in
the body

Fatty acids Composition of a fatty acid, Structures of fatty

system of nomenclature acids
(including systematic names
and symbols), with C and n
numbering of fatty acids,
classification system based
on chain length, degree of
saturation (saturated and
mono- and polyunsaturated
fatty acids), and nutritional
requirement, concept of
saturated fatty acids in
animal fat and unsaturated
fatty acids in plant fats,
names of essential fatty
acids and their functions,
importance of 3 and 6
fatty acids (dietary sources
and their health benefits),
concept of importance of
saturated and unsaturated
fats in one’s diet (including
hydrogenation of oils).

Simple lipids Basic concept of cis and

(fats) trans forms of fatty acids
and the health hazards of
trans fats, basic concept of
structure of a fat with its
components of glycerol and
fatty acids, basic concept of
mono, di- and
triacylglycerols and where
they are found in the body.

Steroids Ability to recognize the

structure of the steroid
nucleus and that of
cholesterol, functions of
cholesterol, health hazards
associated with high blood
levels of cholesterol, basic
concepts of involvement of
 lipids in the pathogenesis of
atherosclerosis,
cholelithiasis and obesity

Complex lipids Phospholipids (definition,

components, amphipathic
nature, functions, examples
and importance of each type
- viz. phosphatidylcholine
[including importance of
surfactant in health and
disease, phosphatidylinositol
and sphingomyelin),
glycolipids (definition,
components, functions,
examples [basic concept of
cerebrosides and
gangliosides] and
importance of each type in
the body

Miscellaneous Basic concept of

involvement of lipids in
demyelinating diseases and
sphingolipidosis,
lipoproteins (definition,
basic structure, types,
components of each type,
function of each type,
importance in health and
disease), micelles
(definition, structure and
importance), liposomes
(definition, structure and
importance), biological
membranes (structure and
importance)
Metabolism of lipids
Digestion of Names of main lipids
lipids present in the diet, enzymes
responsible for digestion of
lipids and their sources and
sites of action, actions of the
various enzymes, role of bile
in lipid digestion and
absorption,
 names of end-products of
lipid digestion, process of
absorption of lipids,
steatorrhoea, salient features
of formation and metabolism
and physiological
importance of chylomicrons
Fatty acid Importance of oxidation of End-products of Pathway of beta
oxidation fatty acids in the body, types beta-oxidation of oxidation
of oxidation fatty acids can odd chain fatty
undergo, beta-oxidation of acids. End-products of beta-
fatty acids (site, activation of oxidation of odd
a fatty acid, the role of Alpha-oxidation chain fatty acids.
carnitine, outline of steps of fatty acids and
involved and energetic) its importance Alpha-oxidation of
fatty acids and its
Conditions importance
where fatty acid
oxidation is Conditions where
impaired fatty acid oxidation is
impaired
Pathway of
biosynthesis of fatty
acids

Biosynthesis of Conditions under which it Elongation and Elongation and

fatty acids occurs and sites involved, desaturation of desaturation of fatty
starting material and end fatty acids acids
products, source of acetyl
CoA, role of acetyl CoA
carboxylase, overall role of
fatty acid synthase
(individual enzymes and
reactions not required),
Importance of NADPH in
the pathway and its sources,
role of the nutritional state
and insulin as factors that
regulate synthesis of fatty
acids

Metabolism in Concept of esterifcation of

the adipose fatty acids to form TAG
tissue stored in adipose tissue,
metabolism in the adipose
tissue with regard to
lipogenesis and lipolysis
 (conditions where it occurs,
enzymes involved and
products obtained) and its
regulation by hormones
Metabolism of Names of the ketone bodies,
ketone bodies their importance, pathway of
ketogenesis and utilization
of ketone bodies and sites
where these occur, factors
that favour ketone body
formation, abnormalities
associated with metabolism
of ketone bodies and their
clinical relevance,
conditions that lead to
ketoacidosis
Metabolism of Functions of cholesterol, Pathway of
cholesterol sources of cholesterol in the biosynthesis of
body (dietary and cholesterol
endogenous), cellular site of
biosynthesis of cholesterol,
basic overview of
biosynthesis of cholesterol
(showing formation of HMG
CoA and action of HMG
CoA reductase and
formation of cholesterol
without showing any other
intermediates), regulatory
enzyme involved in
biosynthesis of cholesterol,
importance of maintaining
normal cholesterol levels in
blood and ways to reduce
blood cholesterol levels
(including mechanism of
action of statins and other
lipid lowering agents)

Bile acids (names, source Pathway of

and functions), overview of biosynthesis of bile
synthesis (regulatory acids
enzyme), enterohepatic
circulation of bile salts,
pathogenesis of
cholelithiasis
Metabolism of Brief overview of Lipoprotein (a)
lipoproteins metabolism of VLDL, LDL
and HDL (including normal
values).

Pathogenesis of
atherosclerosis, association
of high levels of VLDL and
LDL with atherosclerosis
and anti-atherogenic effect
of HDL.

Dyslipidemias – causes and

consequences (secondary
causes and familial
hypercholesterolemia)

Risk factors for

atherosclerosis and coronary
artery disease, prevention of
coronary artery disease.

Overview of metabolic
syndrome
Eicosanoids Names and functions of Therapeutic uses Pathway of
various eicosanoids, of prostaglandins biosynthesis of
overview of pathway of eicosanoids
synthesis (site of action of
PLA2 and cyclooxygenase to
be emphasized and site of
action of NSAIDs; role of
aspirin as an anti-platelet
agent)
Phospholipids Clinical relevance of Basic structure Structure and
lecithin-sphingomyelin (L/S) of phospholipid synthesis of
ratio in amniotic fluid phospholipids
Sites of action of
various
phospholipases

Examples of Sphingolipidosis
sphingolipidosis other than the
(Niemann- examples specified.
Pick’s, Tay-
Sach’s and
Gaucher’s
 disease)
Miscellaneous Role of liver in lipid
metabolism, fatty liver
(causes, including role of
lipotropic factors, and
consequences)

Overview of metabolism of
alcohol
4 CHEMISTRY AND METABOLISM OF PROTEINS
Amino acids General structure, Structures of amino
classification based on side acids
chains, nutritionally
essential and non essential
amino acids, properties of
amino acids (viz. peptide
bond formation, zwitter ion
formation, reaction with
ninhydrin)
Peptides and Names of some Outline of the Methods of
proteins physiologically important elucidation of elucidation of
peptides, structure of primary structure structure of protein
proteins (at primary, of a protein,
secondary, tertiary and precipitation
quaternary levels), reactions of protein
schematic representation function of chap-
of primary and secondary erone proteins
structures, classification of
proteins based on axial
ratio (fibrous and globular),
physiologically rekevant
properties of proteins,
denaturation.

Overview of structure and

importance of
haemoglobin, myoglobin
and collagen
Digestion and Enzymes involved in the Meister cycle
absorption digestion of proteins, sites
of action, end-products Disorders of protein
formed, overview of amino digestion and
acid absorption absorption.
General Transamination and Details of
pathways of deamination, enzymes and mechanisms of the
amino acid coenzymes involved, reactions
catabolism products formed and
importance of each of these
reactions
Ammonia Sources of ammonia, role of Structures of
metabolism glutamine and urea intermediates of
formation, urea cycle with urea cycle
enzymes involved, disorders
associated with ammonia Regulation of urea
metabolism, pathogenesis of cycle
hepatic coma and
biochemical basis of its
treatment, disorders of the
urea cycle, normal blood
urea level, blood urea
nitrogen (BUN) levels,
azotemia and its clinical
significance
Metabolism of Functions and Concept of Metabolic pathways
individual physiologically important maple syrup of synthesis and
amino acids reactions in which glycine, urine disease in catabolism of any
methionine, phenylalanine, abnormality in amino acids
tyrosine, tryptophan and metabolism of
histidine are involved. branched chain Maple syrup urine
amino acids disease
Specialized products
derived from amino acids

Disorders associated with

amino acid metabolism
(hyperphenylalaninemia
and phenylketonuria,
alkaptonuria).

Importance of neonatal
screening for inborn errors
of amino acid metabolism.
Plasma Classification, examples Details of process of
proteins and functions of plasma electrophoresis
proteins, separation by
electrophoresis, normal
values of total proteins and
albumin.
 Common clinical
conditions in which plasma
protein levels are abnormal
and the reasons why these
changes occur.

Importance of the albumin:

globulin ratio (A: G ratio),
normal value and common
clinical conditions in which
the ratio is abnormal.
5 VITAMINS
General Definition, classification,
properties of comparison of clinically
vitamins relevant features of fat and
water soluble vitamins.

Concepts of hypo and

hypervitaminosis and
recommended daily
allowances.
Fat-soluble vitamins
Vitamin A Dietary sources. Hypervitamino- Structure and
Precursor form. sis A chemical properties of
Absorption from diet. vitamin A
Various forms of vitamin A.
Biochemical functions
Role in Wald’s visual cycle,
Daily dietary requirement.
Deficiency – causes,
manifestations and treatment
Vitamin D Dietary sources of vitamin Structure and
D3. chemical properties of
Synthesis in the body. vitamin D
Conversion to calcitriol.
Biochemical functions
Role in bone mineralization
and calcium homeostasis.
Daily requirement,
deficiency (rickets and
osteomalacia) – causes,
manifestations, Biochemical
findings in blood and
principles of treatment.
Vitamin E Dietary sources Structure and
Role as an antioxidant. chemical properties of
Relationship to action of vitamin E
glutathione peroxidase.
Deficiency leading to
fragility of RBCs
Vitamin K Sources, Structure and
Intestinal synthesis, chemical properties of
Absorption from GIT, vitamin K
Forms (K1, K2 and K3),
Biochemical role,
Vitamin K cycle.
Basis of action of dicumarol,
Requirement.
Deficiency – causes,
manifestations (including
hemorrhagic disease of the
new born), and principles of
treatment
Water soluble vitamins
Thiamine Dietary sources. Assessment of
Functions (coenzyme form, thiamine status by
physiologically most assaying the
important reactions in which activity of RBC
it is required). transketolase
Requirement.
Deficiency – causes,
manifestations (including
Wernickes Korsakoff
syndrome - causes, clinical
features and principles of
treatment).
Riboflavin Dietary sources.
Functions (coenzyme forms,
physiologically most
important reactions in which
they are required).
Requirement.
Deficiency – causes and
manifestations
Niacin Sources (including from
tryptophan).
Functions (coenzyme forms,
physiologically most
 important reactions in which
they are required).
Requirement.
Deficiency – causes and
manifestations
Pyridoxine Dietary sources. Mechanism of
Functions (coenzyme forms, transamination
physiologically most reactions
important reactions in which
they are required)
Requirement.
Deficiency – causes and
manifestations.
Rationale for
supplementation in
treatment of tuberculosis
Biotin Sources.
Role in carboxylation
reactions.
Examples of most important
enzymes that require biotin
Folic acid Dietary sources.
Functions (coenzyme forms,
physiologically most
important reactions in which
they are required
Role of folic acid in 1C
metabolism - 1C donor
reactions (serine
hydroxymethyl transferase)
and 1C acceptor reactions
(methionine synthase,
thymidylate synthase, and
purine synthesis)
Relationship with Vit. B12.
Folate trap.
Requirement.
Deficiency – causes and
manifestations.
Importance of
supplementation in
periconceptual period.
Folate antagonists (actions
of methotrexate,
aminopterin,
 sulphonamides)
Vitamin B12 Dietary sources.
Absorption and role of
intrinsic factor.
functions (coenzyme forms,
reactions for which they are
required).
Role in RBC maturation.
Requirement
Deficiency – causes and
manifestations
(megaloblastic and
pernicious anemia, anemia)
Importance of combined B12
and folic acid administration
in treatment of megloblastic
anemia
Vitamin C Dietary sources. Role of vitamin
Functions (in collagen C in the
synthesis, iron absorption conversion of
and as an antioxidant). tyrosine to
Requirement. catecholamines,
Deficiency – causes and cholesterol to
manifestations bile acids and
catabolism of
tyrosine
Vitamin-like
substances

Lipoic acid Role in reactions involving Mechanism of the

pyruvate and alpha role of lipoic acid in
ketoglutarate in the citric these reactions
acid cycle
7 NUCLEOTIDE CHEMISTRY AND METABOLISM
Nucleotide Purine and pyrimidine bases Structures of purine
chemistry found in DNA and RNA and pyrimidine bases.
Definition and examples of
nucleosides and nucleotides.
Functions of physiologically
important nucleotides
Examples of synthetic
analogues of
purine/pyrimidine bases and
nucleosides used as
 therapeutic agents (anti-
cancer drugs, anti-viral
drugs and allopurinol)
Nucleotide Overview of the pathway of Pathways of de novo
metabolism de novo synthesis of purine synthesis of purines
nucleotides, with names of and pyrimidines
only important
intermediates, regulatory Pathways of
enzyme involved, degradation of
salvage pathway for purine purines and
bases and nucleosides. pyrimidines.
Lesch- Nyhan syndrome
(cause, biochemical basis of
clinical features), overview
of the pathway of
degradation of purines to
form uric acid.
Hyperuricemia and gout
(causes, clinical features,
principles of treatment,
including mechanism of
action of allopurinol and
probenecid).

Overview of pathway of
pyrimidine nucleotide
synthesis, regulatory
enzyme, synthesis of
thymidylate from dUMP
(thymidylate syntase),
salvage pathway for
pyrimidines bases and
nucleosides.

Mechanism of action of
methotrexate and 5-
flurouracil (anti-cancer
drugs)
8 BIOENERGETICS

Role of ATP Role of ATP as the “energy Concept of free

currency” of the cell. energy, enthalpy,
Role of high energy entropy, endergonic
phosphates in energy capture and exergonic
and transfer e.g., role of reactions.
 creatine in muscle. First and second laws
of thermodynamics

Details of free energy,

enthalpy, entropy
The respiratory Sources of reducing Concept of redox Details of mechanism
chain and equivalents in the cell potentials and of electron transfer in
oxidative (NADH and FADH2). proton motive each electron
Role of mitochondria as the force (pmf) transport complex
phosphorylatio
“power house” of the cell
n Substrate level and oxidative Role of ADP in Q cycle
phosphorylation regulatin g ATP
Schematic representation synthesis “Binding change”
of the electron transport (respiratory mechanism of ATP
chain control) synthesis in complex
Role of the respiratory chain V
as an electron transporter Transporters
and a proton pump present on the
Overview of chemiosmotic inner
theory of oxidative mitochondrial
phosphorylation membrane
Examples of inhibitors of
electron transport chain and
uncouplers of oxidative Structure of
phosphorylation complex V
(physiological and
pharmacological)
Role of brown fat (non-
shivering thermogenesis and
role of uncoupling protein/
thermogenin).
Transport of cytosolic
NADH into the
mitochondria (mitochondrial
shuttle systems)
9 HOMEOSTATIC MECHANISMS IN THE BODY
Acid base Definition of acid, base and
balance buffer
Normal pH of body fluid
and importance of
maintaining normal pH
Sources of hydrogen ions in
the body.
Buffers of body fluids
Henderson – Hassalbalch
 equation
Maintenance of acid – base
balance
Role of buffers (with
emphasis on the
bicarbonate buffer
system)
Role of the lungs
Role of the kidneys
Simple acid-base disorders:
Major causes and clinical
features of:
Metabolic acidosis
(including importance of
anion gap) and alkalosis
Respiratory acidosis
and alkalosis
Assessment and
interpretation of arterial
blood gas (ABG)
Rules of compensation in
metabolic/respiratory
acidosis/alkalosis
Fluid and Distribution of water in
electrolyte various body
balance compartments.
Intra- and extracellular fluid
composition (sodium and
potassium)
Blood volume and
osmalality
Regulation of osmolality
– role of anti-diuretic
hormone (ADH)
Major causes and
clinical features of
dehydration
Composition of
commonly used
intravenous fluids and
their indications.
Sodium:
normal levels in the
blood
physiological functions
regulation (renin-
angiotensin-aldosterone
 system)
major causes, clinical
features and basic
principles of treatment
of:
hyponatremia
hypernatremia
Potassium:
normal levels in the
blood
physiological
functions
regulation
major causes, clinical
features and basic
principles of treatment
of:
hypokalemia
hyperkalemia
Chloride :
normal levels in the
blood
physiological functions
regulation
Immunology: Concepts of innate and Cell-mediated Cell-mediated
adaptive immunity immunity immunity
Types of immune
responses – Humoral and Major Major
cell-mediated histocompatibilit histocompatibility
Types and functions of y complex complex
immunoglobulins
Structure of IgG Complement Complement system
(diagrammatic system
representation)
Multiple myeloma –
biochemical abnormalities
and laboratory diagnosis.
Immunoassays – principles
Basic concepts of
congenital and acquired
immunodeficiency
syndrome (AIDS)
MINERALS Concept of macro and
micro minerals and
examples.
Calcium:
Sources and daily
requirement
Functions
Absorption (and
regulation of
absorption)
Regulation (only role of
PTH and Vitamin D)
Major causes, clinical
features, laboratory
diagnosis and principles
of treatment of
hypocalcemia and
hypercalcemia
Iron:
Sources and daily
requirement
Functions
Absorption (and
regulation of
absorption).
Overview of role of
divalent metal
transporter-1 (DMT-1),
duodenal cytochrome b
(dcytb), haephestin,
ferroportin and
hepcidin.
Storage and transport
(role of ferritin and
transferrin)
Major causes, clinical
features, laboratory
diagnosis and principles
of treatment of iron
deficiency and
overload states
Copper:
Sources and daily
requirement
Functions
Role of ceruloplasmin
Wilson’s and Menke’s
disease
Zinc:
Sources and daily
 requirement
Functions (inc. role of
metallothionein)
Causes and clinical
features of zinc
deficiency
Magnesium:
Sources and daily
requirement
Functions
Iodine:
Sources and daily
requirement
Functions
Causes and clinical
features of iodine
deficiency.
Flourine:
Sources and daily
requirement
Functions
Causes and clinical
features of fluorosis
Functions of selenium,
molybdenum
HAEM Importance of haem (heme- Pathway of Pathway of synthesis
METABOLISM containing proteins – synthesis of of haem
hemoglobin, myoglobin, haem Types and causes of
cytochromes) Types and causes other porphyrias
Basic features of structure. of other
Heme synthesis porphyrias
Overview of heme
synthesis and its
regulation
Porphyria: major types
(acute intermittent
porphyria (AIP) and
congenital
erythropoietic porphyria
(CEP)) – causes, basis
of clinical features in
each type.
Acquired porphyria:
lead poisoning.
Heme degradation:
Pathway of formation of
bilirubin
 Conjugation and
excretion of bilirubin
(incl. congenital
disorders)
Hyperbilirubinemia –
causes and differential
diagnosis
Important physiological
and pathological causes
of jaundice in the
newborn
FUNCTION TESTS:
Renal function Functions of the kidney
test: Estimation of non-protein
nitrogenous substances in
blood (urea and
creatinine)
Estimation of creatinine
clearance and its
importance
Tests to assess tubular
function – measurement
of plasma and urine
osmolality, basic
principles of water
deprivation test (ADH
test) and urinary
acidification test.
Urinalysis:
Physical
characteristics and
composition of
normal urine.
Major causes for
presence of protein,
reducing sugar,
blood, ketone bodies,
bile salts and bile
pigments in urine
Principles of
important tests to
detect the above
mentioned
substances in the
urine
(Sulphosalicylic acid
 test for proteins,
Benedict’s test for
reducing sugar,
Benzidine test for
blood, Rothera’s test
for ketone bodies,
Hay’s test for bile
salts and Fouchet’s
test for bile
pigmens).

Liver function Functions of the liver.

tests: List the tests done to
assess liver function in
clinical practice
Importance of estimation
of common tests done to
assess liver function:
1. Detoxification:
Conjugated and
unconjugated bilirubin
(van den Bergh’s test)
2. Synthetic functions:
Total protein and
serum albumin levels,
Prothrombin time
3. Markers of liver
injury: alanine
transaminase (ALT),
aspartate transaminase
(AST),
Markers of cholestasis:
alkaline phosphatase
(ALP).
Differential diagnosis of
the causes of jaundice
using liver function tests.

Thyroid Regulation of secretion of

function test: thyroid hormones
Thyroid function tests
(TSH and thyroxine
levels).
Importance of estimation
of TSH in assessment of
thyroid function tests.
Measurement of total and
 free thyroxine levels.
Basic principles behind
the laboratory diagnosis
of hypothyroidism and
hyperthyroidism

Adrenal Functions of the adrenal

function tests: cortex and medulla.
Regulation of secretion of
adrenocortical hormones.
Basic test done for the
laboratory diagnosis of
adrenal hypofunction and
hyperfunction (including
principles for suppression
and stimulation tests)
MOLECULAR BIOLOGY
The cell cycle, Overview of the cell cycle Details of Details of eukaryotic
DNA and RNA (including overview of eukaryotic replication
structure, mitosis and meiosis) replication
replication and Modes of inheritance: Details of structure
repair: autosomal (dominant and Details of and types of
recessive), X-linked structure and chromosomes
inheritance. types of
Watson and Crick model of chromosomes Details of DNA repair
DNA structure mechanisms and other
Structure and functions of Details of DNA disorders of DNA
different types of RNA. repair repair.
Differences between mechanisms and
nuclear and mitochondrial other disorders
DNA. of DNA repair.
Structure of nucleosomes
and function of histone
proteins.
Overview of organization
of DNA in a chromosome.
Semi-conservative
mechanism of DNA
replication (basic concept
only)
Overview of DNA
replication in prokaryotes
and eukaryotes (including
important differences
between the two):
Role of DNA
 polymerase (including
proof reading
function), helicase,
primase, topoisomerase
and DNA ligase
Diagrammatic
representation of the
events at the
replication fork
Okazaki fragments and
its importance in
replication.
Overview of role of major
DNA repair mechanisms
– mismatch repair, base
excision repair, nucleotide
excision repair and double
strand break repair.
Diseases associated with
abnormalities of DNA
repair systems –
xeroderma pigmentosum
and hereditary non-
polyposis colon cancer
(HNPCC)
Structure and function of
telomeres and role of
telomerase (including
end-replication problem
and role of telomerase in
cancer cells and stem
cells)

Transcription Structure of a gene -

concepts of exons and
introns (concepts of Details of eukaryotic
mono- and polycistronic transcription.
mRNA)
Overview of the process
of transcription in Details of splicing
prokaryotes and reactions,
eukaryotes – initiation, spliceosomes and
elongation and ribozymes (“snurps”)
termination (including
important differences)
Regulation of initiation of Gene
transcription – role of rearrangement in
 transcription factors, immunoglobulin
promoter, heavy chain
enhancers/repressors and
response elements
Post-transcriptional
processing – capping,
tailing and splicing (no
details)

Translation The genetic code and its

and genetic characteristics (universal,
code: unambiguous, degenerate, Intracellular protein
continuous/commaless), trafficking
basis of degeneracy of the
genetic code (wobble Details of the process
hypothesis). of translation

Basic structure of
prokaryotic and eukaryotic
ribosomes.
Structure of tRNA (diagram
of clover leaf model of
tRNA structure) and its
function in protein
synthesis.
Function of aminoacyl
tRNA synthase.
Overview of the process of
translation – initiation,
elongation and termination
(including important
differences between
prokaryotic and eukaryotic
translation).
Inhibitors of prokaryotic
translation – antibiotics
Post-translational
modifications – five
examples and physiological
importance.
Overview of protein folding
and role of chaperones.

Mutations and Mutagens with examples of

regulation of physical, chemical and
gene expression biological mutagens.
 Mutations (definition,
types of mutations [point Regulation of gene
mutation expression by:
{ substitution - transition 1. Alternative
and transversion}], splicing
deletion, insertion, frame 2. DNA methylation
shift mutation, mis-sense 3. Histone
mutation, non-sense acetylation /
mutation and silent deacetylation
mutation), chromosomal 4. RNA editing
mutations (deletion, 5. Alterations of
inversion and RNA stability
translocation).
Relationship with specific Other operon models
diseases – sickle cell e.g., Tryptophan
anemia and chronic operon
myeloid leukemia.
The lytic – lysogenic
Regulation of Prokaryotes - operon genetic switch in
gene concept in prokaryotes using lambda phage.
expression lac operon as an example.

Eukaryotes - Regulation of
initiation of eukaryotic
transcription: role of general
and gene specific
transcription factors
Small interference RNA
(siRNA) and micro RNA
(miRNA).

Recombinant Concepts of recombinant

DNA DNA, genetic engineering,
technology and biotechnology, cloning
techniques in Restriction endonucleases
molecular Vectors for cloning –
biology: plasmids and phages
Genomic and cDNA
libraries
Human genome project.
Applications of recombinant
DNA technology in
medicine:
Production of
therapeutic proteins
Gene therapy
Diagnosis of genetic
 diseases and genetic
counseling
Forensic investigation
DNA vaccines
Transgenic animals as
models of human
diseases
Principles and applications
of techniques in molecular
biology:
Polymerase chain
reaction (PCR)
Southern, northern and
western blotting
Restriction fragment
length polymorphism
(RFLP)
DNA fingerprinting
DNA sequencing
Microarrays
Fluorescent in situ
hybridization (FISH)
METABOLISM OF XENOBIOTICS
Xenobiotics (definition and
examples), biochemical
importance of the two
phases of xenobiotic
metabolism.
Cytochrome P450 enzyme
system (functions,
properties [especially
induction by drugs], its role
in conversion of
procarcinogens to
carcinogens.
Conjugation reactions
(biochemical role, examples
of glucuronidation and
sulfation, conjugation with
glutathione, acetylation and
methylation)
Poisoning and Causes, mechanism of
environmental toxicity, clinical features
hazards and principles of treatment
of poisoning by lead,
 organophosphates, mercury,
cyanide and arsenic.

Environmental hazards
(insecticides and pesticides,
air pollutants, industrial
hazards: e.g., Bhopal gas
tragedy)

Mechanisms of Classification and nature of

actions of hormones in each category,
hormones mechanism of action of
hormones.
Carcinogenesis Biomedical importance of Ames test for
cancers. mutagenicity of a
General features of tumours. chemical
Characteristics of benign
and malignant tumours.
Properties of cancer cells,
molecular events involved in
carcinogenesis (non-lethal
DNA damage involving
oncogenes, tumour
suppressor genes, DNA
repair genes and genes
involved in apoptosis and
clonal origin).
Role of radiation, chemicals
and viruses in
carcinogenesis.
Examples of cancer
produced by each type of
agent.
Conditions with defective
DNA repair that predispose
to development of cancer,
mutagens.
Involvement of oncogenes
and tumour suppressor genes
in development of cancers,
including examples and
mechanisms of activation of
oncogenes.
Examples, functions and
consequences of mutations
in tumour suppressor genes.
 Role of genes involved in
apoptosis and DNA repair in
carcinogenesis
Important biochemical
characteristics of malignant
cells.
Telomeres and telomerase
and their importance in
cancer cells.
Tumour markers -
characteristics of an ideal
marker, examples and uses.
Examples of drugs used in
chemotherapy of
malignancies and the
biochemical mechanism of
action of these drugs.
Nutrition Importance.
Components and importance
of each.
Concept of balanced diet,
glycemic index of food.
Importance of dietary fibre.
Basal metabolic rate.
Specific dynamic action.
Biological value of proteins.
Concept of limiting amino
acids.
Nitrogen balance.
PEM states.
Obesity (including
calculation and
interpretation of BMI).
Nutritional requirements in
diabetes mellitus, coronary
artery disease, pregnancy,
childhood,