Medico Guides 4th Block (Module No 06) Biochemistry Guidelines

by

Prepared by:

                     Hanzala Masood (G14)

Compiled by:

                     Hafiz Muhammad Umair Noor (G12)

Reference Books:

  • Lippincott Illustrated Reviews: Biochemistry 8th Edition (Chapter numbers are mentioned according to this edition)
  • Satyanarayana Biochemistry 6th Edition
  • Medicnetic or Medico Express block 4

NOTE:

In biochemstry of block 4, try to focus mainly on figures and diagrams. the best way is to shortlist the text

CARBOHYDRATE METABOLISM

GIT-B-001

➡️ For this LO, there are multiple sources. You can cover these topics from Lecture slides, Medicnetic/medico express or Mushtaq Biochemistry. Same topics are also given in Hashmi’s biochemistry book

 Saliva:

  • Saliva (composition and importance) v.imp
  • Xerostomia v.v.imp

Gastric juice:

  • Gastric juice (composition and importance)
  • Mechanism of HCL secretion v.imp (For this you have to understand and memorize its diagram) this diagram also given in Guyton (Chp 65 fig 65.6 pg 812)
  • Achlorhydria (imp) and Gastric ulcer
  • Alkaline Tide (v imp IT WAS OUR PROFF Q so prepare it completely)

Pancreatic juice & Bile:

  • Pancreatic juice and bile (composition and importance)
  • Pancreatitis, cystic fibrosis and cholelithiasis.

Digestion and absorption of dietary carbohydrates:

➡️ From Lippincott chapter 7 pg no 95 till end.

  • Flowcharts 7.9,7.10 & 7.11 v.imp
  • Lactose intolerance and Sucrase isomaltase deficiency (v.v.imp)

GIT-B-002

➡️ From Lippincott Chapter 8 topics: Glucose Transport into The Cells

  • Table 8.1 (v.imp)

GIT-B-003

➡️ Not an important topic OR You can cover this topic from medicnetic/medico express.

GIT-B-004

➡️ From Lippincott Chapter 8: Glycolysis

  • Don’t skip even a single thing, entire chapter is v.imp so cover it entirely.
  • Steps , All Regulations , Arsenic poisoning (v.v.imp), Pyruvate kinase deficiency, Pyruvate reduction to lactate, Energy yield, Hormonal regulation , Alternate fates of pyruvate.

GIT-B-005

➡️ From Lippincott Chapter 9: TCA Cycle

  • Cover entire chapter as whole chapter is v.imp.
  • Everything is important:
  • Actyl CoA production
  • Pdh complex , it’s regulation including fig 9.2 (v.v.imp)
  • Deficiency of thymine and Leigh syndrome boxes
  •  Arsenic poisoning ( v.v.imp)
  • Energy produced ( v.imp)
  • Cycle regulation ( v.imp)

GIT-B-006 & 007

➡️ From Lippincott Chapter 10: Gluconeogenesis

  • Cover entire chapter as whole chapter is important.
  • Also in this chapter, everything is important:
    • Substrates (Glycerol, lactate and Amino acids)
    • Fig 6.2 (Cori Cycle) v.v.imp
    • Reactions ( all v.imp)
    • Must remember all enzymes, regulations, transports of molecules included in steps of Gluconeogenesis.
    • Fig 10.7 ( v.imp)
    • Regulation
    • By glucagon (v.imp )
    • By substrate availability, acetyl CoA and AMP ( imp)
    • Glucose Alanine cycle (v.imp) from LIPPINCOTT CHAPTER 19 FIG 19.3

GIT-B-008

➡️ From Lippincott Chapter 10: Glycogen Metabolism

  • Cover entire chapter as whole chapter is important
  • Everything also in this chapter is important:
    • Storage and function (read)
    • Synthesis (Glycogenesis)
    • For steps, add points from text to figs of Lippincott and then mainly remember those points and especially fig
    • Fig 11.5 (v.imp)
    • Degradation (Glycogenolysis)
    • For this, focus on figs and points in the same manner as synthesis.
    • Regulation (complete and focus on figs)
    • Glycogen storage diseases: (Very Important)
      • One of the most important topics in biochem block 4.
      • Examiners always focus this topic for Qs
      • Learn / Cram them completely. Their Types, Numbers, Other names, Enzyme deficient, Signs and symptoms
      • Table 11.1 for Cori , Andersen , Hers and Tarui diseases
      • Points from fig 11.8 for Von Gierke , Pompe and McArdle diseases
      • Also must remember points that are specific for a particular disease eg cardiomegaly occurs in Pompe disease
      • Qs From this topic are mostly given in the form of scenarios and anything can be asked so try to practice their mcqs form any source especially scenarios)
      • Make nemonics or use other ways but must remember them completely.

GIT-B-009

 ➡️ From Lippincott Chapter 13: Pentose Phosphate Pathway and NADPH

  • Complete chapter is important
  • All Topics are equally significant:
    • Irreversible oxidative reactions imp)
    • Fig 13.2 (v.v.imp)
    • Reversible oxidative reactions
    • Fig 13.3 imp
    • Uses of NADPH ( v.v.imp)
    • Cover all uses completely
    • Fig 13.8 v.imp
    • G6PD deficiency and associated hemolytic anemia (v.v.imp)
    • Clinical Application 13.1 (imp)
    • Fig 13.10 v.imp
    • Precipitating factors (all v.imp)
    • Gene variants

GIT-B-010

 ➡️ Sorbitol Pathway from Lippincott Chapter 12: Mono and Disaccharide Metabolism

  • Topic: Glucose conversion to fructose via sorbitol.
    • Complete text along with its osmotic effects in diabetic patients and fig 12.4 (v.imp)
  • Uronic Acid Pathway from Satya Chapter 13 fig 13.25 (synthesis of glucuronic acid) complete

GIT-B-011

➡️ Ethanol Metabolism from Lippincott Chapter 23 pg 352

  • Start from the heading ALCOHOL RELATED HYPOGLYCEMIA
  • Complete text along fig 23.15 and BLUE BOX: How chronic alcohol consumption causes Fatty liver ( v.imp) OUR COLLEGE BLOCK 4 SEQ.

GIT-B-012 & 013

➡️ From Lippincott Chapter 6: Bioenergetics and Oxidative Phosphorylation

  • Complete the chapter in the following way:
    • Skip the starting topics Free energy and free energy change
    • Read and understand the topic ATP as energy carrier ( a good read)
      • Electron transport chain (ETC) it’s
        • Components
        • Organization
        • Reactions (read and understand the text and shortlist important points along with fig 6.8. Fig 6.8 is v.imp)
    • Site specific inhibitors (v.imp) from fig 6.10
    • Skip energy released
    • PHOSPHORYLATION OF ADP TO ATP (whole topic is v.imp)
    • Chemosmotic hypothesis along with ATP synthase it’s function and it’s diagram from fig 6.14 v.imp
    • Coupling
    • Oligomycin, Uncoupling proteins & synthetic Uncouplers (v.v.imp)
    • How Aspirin at high doses causes fever? ( V.v.imp given in synthetic Uncouplers) (College Block 4 SEQ.)
    • Membrane transport systems
      • Glycerol 3 Phosphate Shuttle
      • Malate Aspartate shuttle
      • From Fig 6.17 (v.imp)
    • Inherited defects in Oxidative phosphorylation (text + table 6.1)
    • Regarding TABLE 6.1: SEQ was asked from this table in proff 2023 but nothing significant was asked at our time (But try to memorize it to some extent to be on safe side)
    • Mitochondria and apoptosis (v.imp)

GIT-B-014 to 20

  • All of these LOS can be covered by doing from medicnetic or medico express
  • All these topics are scattered in different books
  • It’s preferable to do from medicnetic or medico express because they follow LOS and book wording and their content will be enough Insha Allah.

IMP TOPICS:

  • Macro and Micronutrients
  • Balanced diet and its importance
  • BMR complete
  • BMI complete
  • Malnutrition including protein energy malnutrition (Kwashiorkor and Marasmus) their symptoms difference features management (v.v.imp) Block 4 SEQ
  • Upper body and lower body obesity

NOTE:

  • Biochemistry syllabus in block 4 is a bit lengthy but it carries 37 marks in written and a viva station so try to do it completely and in a proper way to secure maximum marks.
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