clinical biochemistry- phase i -...
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Clinical Biochemistry- Phase I
Faculty of Medical Sciences,
University of Sri Jayewardenepura
23.07.2017 Version 1.0
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Introduction
Module Committee
Prof. P. P. Rasika Perera (Chairperson, Department of Biochemistry)
Prof. H. Peiris
Prof. S. Ekanayake
Prof. U. G. Chandrika
Prof. S. Suresh
Prof. L. V. Athiththan
Dr. U. P. K. Hettiaratchi
Dr. S. MAhavithanage
Dr. U. Senarathna
Dr. Indika Liyanage
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General objective
At the end of the Clinical Biochemistry, the student should be able to:
1. explain the significance of biochemical investigations in the diagnosis and
prognosis of cardiovascular, gastrointestinal and genitourinary systems
disorders and explain the biochemical basis of some selected disorders.
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Main Content Areas
Main Content Area Lectures
(Hours)
Practical/Dissections Tutorials/SGD
No. of (2hrs) sessions
1. Plasma Protein 01 - -
2. Serum Enzymology 03 - -
3. Introduction to liver function tests 01 1.5
4. Kidney function tests & clinical relevance 02 - -
5. Biochemical basis of selected disorders 02 - -
6. Cancer 01 - -
7. Interpretation of laboratory results - 1.5 -
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Clinical Biochemistry – Phase I
A-Essential to know B- Good to know C- Nice to know
1. PLASMA PROTEIN
Intermediate Objectives
Broad Content Areas
Activity
Duration
Department
State the basic principles of
assessing plasma protein in
diagnosis of diseases
List the functions of plasma proteins (recall).(A)
Differentiate between plasma and serum (recall).(A)
Explain the significance of assessing the following
plasma proteins in normal & disease states. (A)
- α1,α2,β1,β2and γ globulins
- Albumin and pre-albumin
- Acute phase reactants
- Clotting factors
Lecture
1 hr
Biochemistry
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2. CLINICAL ENZYMOLOGY
Intermediate Objectives
Broad Content Areas
Activity
Duration
Department
State the significance changes in
blood levels of given enzymes in
clinical diagnosis.
Explain the importance of non functional enzymes in
blood.(A)
Define the terms upper and lower normal limits
(ULN, LNL) & time window.(A)
Use of enzymes & isoenzymes in (A)
- localization of tissue damage (MI)
- diagnosis of disease (AST, ALP, Amylase,
Lipase, Aldolase)
- Diagnosis of congenital disorders (G6PD &
G6Phosphatase)
Lecture
1 hr
1 hr
1 hr
Biochemistry
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3. INTRODUCTION TO LIVER FUNCTION TESTS
Intermediate Objectives
Broad Content Areas
Activity
Duration
Department
Explain the alteration in the pattern
of serum enzyme activity and
metabolite concentration in liver
disease.
List the tests that are used to assess the liver
function. (A)
Explain the biochemical basis of the above liver
function tests.(A)
Explain the biochemical changes seen in main
hepatobiliary diseases. (A)
Explain the significance of serum ALT and AST
(markers of inflammation of liver) & γ-GT
(diagnosis of hepatobiliary dysfunction). (A)
Differentiate between the three types of jaundice
using liver enzymes, bilirubin & urobilinogen
(recall). (A)
Lecture
Practical
1 hr
1.5 hrs
Biochemistry
Biochemistry
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4. KIDNEY FUNCTION TESTS & CLINICAL RELEVANCE
Intermediate Objectives
Broad Content Areas
Activity
Duration
Department
Explain the principles of
biochemical investigations in
assessing the renal function.
List the tests that are used to evaluate renal
function.(A)
Describe the basis of the following tests in assessing
renal function (A)
- Creatinine / Calcium clearance
- Albumin / Creatinine ratio
- Serum Cystatin C levels
- Estimated GFR (eGFR)
Lecture
2 hrs
Biochemistry
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5. BIOCHEMICAL BASIS OF SELECTED DISORDERS
Intermediate Objectives
Broad Content Areas
Activity
Duration
Department
Explain the biochemical basis of
selected neurological disorders.
Biochemical basis of (A)
- Alzheimer’s
- Parkinsonism
- Prion diseases
Lecture
2 hrs
Biochemistry
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6. CANCER
Intermediate Objectives
Broad Content Areas
Activity
Duration
Department
Describe the mechanisms that lead
to cancer.
Overview of biochemical
test/markers used in the diagnosis
of cancer
List the cancer causing agents (environmental factors,
chemical, radiation and viral) and mechanism of
oncogenesis. (A)
Genetic factors that could lead to cancer (DNA
mutations in enzymes, oncogenes, tumor suppressor and
apoptotic genes) (A)
Explain the importance of proto- oncogenes for normal
cell growth and differentiation. (A)
Explain the mechanisms of transformation of proto-
oncogenes to oncogenes. (A)
Outline the mechanism of action of tumor suppressor
genes. Explain the biochemical basis of apoptosis and its
association with cancer. (A)
Explain the use of tumor markers in diagnosis and
management of cancer (CA 125, CA 19-9, PSA, α -
feto-protein, CEA). (A)
Lecture
1 hr
Biochemistry
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7. INTERPRETATION OF LABORATORY RESULTS
Intermediate Objectives
Broad Content Areas
Activity
Duration
Department
To understand the principles of
interpretation of laboratory results
Interpretation of laboratory test reports on (A)
- Thyroid profile
- Liver Profile
- Renal Profile
- Cardiac Profile
- Lipid Profile
Practical
1.5 hrs
Biochemistry
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Recommended readings
Note- Students are expected to read the latest edition
Clinical biochemistry by William Marshall, Marta Lapsley, Andrew Day
Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics by
Carl. A, Burtis and David E. Bruns. Elseviers
Lecture notes on Clinical Chemistry – L.G. Whitby, A.F. Smith and I.W.
Percy-Robb