Syllabus
BASIC BIOCHEMSITRY AND METABOLISM
Basic and physical chemistry
Chemical bond. Disperse systems and osmosis. Chemical equilibrium – acid base balance, precipitation and complex balance. Medical chemistry calculation. The International System of Units (SI). Conversions of multiples and fractions of units. Composition of mixtures: mass and volume ratio. Dilution. Mass concentration. Calculation of pH of solutions of strong acids and bases. Osmolarity and osmolality.
Basic biochemistry
Basic bioorganic chemistry. Structures of organic compounds. Basic types of organic reactions. Organic compounds containing oxygen, nitrogen and sulphur.
Intermediary metabolism.
Anabolic, amphibolic and catabolic reactions, metabolic turnover. Overview of metabolism.
Introduction to membranology
Structure, composition and properties of biological membranes. Membrane transport.
Enzymology
Mechanisms of enzyme catalysis. Structure and function of enzymes. Thermodynamic aspects of enzyme catalysis. Mechanisms of enzyme catalysis and its regulation. Classification of enzymes. Importance of enzymes in medicine. Enzymopathies. Kinetics of enzyme reactions. Chemical kinetics. Kinetic characterisation of enzymes, Michaelis-Menten equation. Types and mechanisms of enzyme inhibition. Cofactors. Coenzymes and prosthetic groups. Importance of the cofactor for the enzyme reaction course.
Bioenergetics
Bioenergetics. Basic terms of thermodynamics. First and second laws of thermodynamics. Enthropy. Gibbs energy. ATP and nother macroergic (high-energy) compounds . Oxidative phosphorylation and mitochondrial transport systems. ATP functions in preservation and transformation of chemical energy, electron transport chain and the Mitchell chemiosmotic theory, synthesis of ATP. Citrate cycle. The central role of citrate cycle in the intermediary metabolism, production of reduced cofactors. Anaplerotic reactions.
Carbohydrate metabolism
Carbohydrates. Structure, function and properties of carbohydrates. Glycolysis. Anaerobic and aerobic mechanisms of glucose degradation, connections with other metabolic pathways, regulation of glycolysis and its crucial enzymes. Gluconeogenesis. Mechanisms of glucose de novo synthesis, substrates of gluconeogenesis, compartmentation and regulation of gluconeogenesis. Cori cycle. Glycogen. Glycogen metabolism, regulation of its biosynthesis and degradation. Liver and muscle glycogen. Glycogen metabolic disorders. Pentose phosphate pathway. Pentose phosphate pathway importance for the metabolism of a cell, NADPH production and its utilisation in reductive syntheses. Mutual conversions of monosaccharides. Metabolism of fructose and galactose, entry points of monosaccharides to the metabolism. Enzymatic disorders of fructose and galactose metabolism. Regulation of the saccharide metabolism. Interconnection of saccharide metabolic pathways, types of regulations, crucial enzymes. Principles of hormonal regulation in saccharide metabolism: insulin and glucagon.
Lipid metabolism
Lipids. Structure, function and properties of fatty acids and other lipids. Biosynthesis and degradation of fatty acids. Biosynthesis of fatty acids, elongases, desaturases. β-Oxidation of fatty acids in mitochondria and peroxisomes. β-Oxidation energy yield. Metabolism of glycerolipids and sphingolipids. Synthesis and degradation of acylglycerols and sphingolipids. Metabolic disorders. Cholesterol and its transport. Biosynthesis and degradation of cholesterol, cholesterol transport, lipoprotein complexes and their metabolism, cholesterol utilisation for other syntheses, cholesterol degradation. Disorders of cholesterol metabolism. Regulation of lipid metabolism. Interconnection of lipid metabolic pathways, types of regulation, crucial enzymes. Principles of hormonal regulation in lipid metabolism.
Metabolism of proteins and nitrogen containing compounds.
Proteins.
Structure, function and properties of amino acids and proteins. Metabolism of amino acids. Synthesis and degradation of amino acids. Inter-tissue transport of nitrogen, role of liver in ammonia detoxication. Glucogenic and ketogenic amino acids. Selected disorders of amino acid metabolism. Urea cycle. Urea cycle and its importance. Intermediates of the urea cycle and their fate in metabolism. Transaminases. Disorders of urea cycle. Conversions of amino acids to special products. Amino acids as substrates for synthesis of hormones and other biologically active substances (neurotransmitters, creatine, S-adenosylmethionine). Biosynthesis and degradation of proteins. Role of the ribosome, initiation, elongation and termination phases of proteosynthesis. Proteases and proteasome. Nucleic acids and nucleotides. Structure, function and properties of nucleic acids and nucleotides.
Metabolism of nucleotides.
Synthesis and degradation of purine and pyrimidine nucleotides, regulation of nucleotide metabolism. Uric acid and hyperuricemia. Porphyrins and bile pigments. Synthesis and degradation of haeme, bile pigments. Porphyrias.
Minerals and a vitamins
Minerals and trace elements. Biologically important minerals and trace elements, their occurence in biological structures and contribution to regulation of metabolic processes. Metabolism of iodine, calcium, phosphate and selenium. Vitamins. Structure and function of vitamins. Water and fat soluble vitamins. Metabolism of selected vitamins (folic acid, cobalamine, vitamin D, vitamin A, vitamin C, vitamin E a vitamin K). Metabolism of iron. Mechanisms of vitamin absorption and recycling, their regulation and relationships to pathologies.
Cell signalling
Mechanisms of signal transduction into the cell. Mechanisms of signal transduction into the cell, G-protein coupled receptors, ion-channel coupled receptors, receptors with enzyme activity, intracellular receptors. Intracellular signalling by calcium. Calcium importance for signal transduction, calcium-binding proteins and calcium signalling pathways.
Special subjects
Glycoproteins and mucins, structure, sugar components, biological functions. Chemical composition and main types of mucins, their role in biological processes. Metabolism of eicosanoids. Metabolism of arachidonic acid. Cyclooxygenase and lipooxygenase pathways. Subcellular compartmentation and metabolism integration. Intracellular organelles as sites of specific metabolic pathways. Interconnections of metabolic pathways. AMP- activated protein kinase.
FUNCTIONAL AND ORGAN-LEVEL BIOCHEMISTRY
Blood
Proteins of the blood plasma. Sorting of blood plasma proteins. Biological importance of selected proteins, electrophoresis of blood plasma proteins. Acute phase reactants (CRP and others), sedimentation. Metabolism of erythrocytes. Metabolism of erythrocytes, types of haemoglobin: phoetal haemoglobin, pathological forms. Erythrocyte membrane. Cooperative kinetics and oxygen saturation of haemoglobin. Transport of blood gasses and the Bohr effect. Haemoglobinopathies and methemoglobinemia.
Biochemistry of immune system and of inflammation.
Chemical structure of antigens. MHC glycoproteins of the classes I. and II. The complement. Metabolism of granulocytes and thrombocytes. NADPH oxidase and respiratory burst. Composition of the lymph. Immunoglobulins and immunochemical reactions. Types of immunoglobulins and structure of antibodies, the antigen-antibody binding, monoclonal and polyclonal antibodies. Employing the antigen-antibody interaction for analytical purposes. Immunochemical methods.
Biochemistry of the muscle.
Contractile apparatus and muscle contraction. Energy substrates (fuels) for the muscle function. Rigor mortis. Basic biochemical markers of muscle injury.
Biochemistry of the heart and blood vessels.
Energy metabolism of myocardium. Energy metabolism of dysfunctional myocardium. Ischemic injury and its diagnostics, cardial markers (ANP, BNP, troponins). Metabolism of nitric oxide.
Biochemistry of the lungs and heart.
Lung biochemistry, chemical composition of the surfactant and its functions, effects of oxygen concentration changes on the tissues. Lungs as an organ of special metabolic pathways.Atherosclerosis. Pathobiochemical mechanisms of atherosclerosis development.
Endocrinology
Biochemistry of peptidic and amino-acid based hormones. Principles of hormonal signalling. Biosynthesis and degradation of peptidic and amino-acid based hormones. Selected hormones and their effects. Biochemistry of steroid hormones. Basic mechanisms of steroid hormone biosynthesis, individual types of steroid hormones, main metabolic pathways regulated by steroid hormones. Biochemical aspects of gravidity and lactation. Maternal milk composition. Biochemistry of thyroid hormones. Thyroid hormone biosynthesis and its regulation, metabolic conversions of thyroid hormones, biological processes regulated by thyroid hormones. Pathobiochemistry of diabetes. Effects of insulin, glucagon, glucocorticoids, catecholamines and growth hormone on the blood sugar level. Overview of metabolic changes and pathological processes elicited by diabetes at the molecular level – protein glycation. Glycated haemoglobin. OGTT.
Biochemistry of adipose tissue.
Adipose tissue as an endocrine organ. Metabolic processes taking place in the adipose tissue. Role of the brown adipose tissue, mechanism of heat production at the mitochondrial level, function of uncoupling proteins. Hormones of the adipose tissue. PPAR.
Connective tissue.
Proteins of the extracellular matrix.
Role of collagen, elastin and other proteins in the extracellular matrix function, their synthesis and degradation, protease inhibitors, matrix metalloproteinases. Biochemistry of the bone and tooth. Chemical composition of the bone and tooth, role of osteoblasts and osteoclasts in the bone metabolism, hormonal regulation of calcium metabolism. Markers of bone formation and degradation.
Biochemistry of the s