PA PROGRAMA ANALITIC SYLLABUS FOR STUDENTS OF THE FACULTY PUBLIC HEALTH

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1 PROGRAMA ANALITIC RED: 0 DATA: SYLLABUS FOR STUDENTS OF THE FACULTY PUBLIC HEALTH Name of the Course: Biochemistry Code of the course: F.0.O.014, F.0.O.01 The type of course: Compulsory discipline The total number of hours 170 hours including lectures 68 hours, practical classes 10 hours Number of credit-tests provided for the course: 7 credits Teaching staff: Protopop Svetlana, PhD., associate professor Chi in u 014

2 I. The purpose of the Biochemistry discipline: to study the structure of chemical compounds and constituents of living matter, the fundamental metabolic processes underlying the functioning of living organisms, diseases caused by deficiencies of enzymes involved in metabolic processes; molecular mechanisms of inherited and acquired diseases; to study the main principles of nutrition necessary for normal functioning of the body; to obtain skills in biochemical investigations of clinical and diagnostics utility; to train skills in analysis and interpretation of laboratory data; II. The objectives of the discipline Biochemistry in training medical students: a) at the level of knowledge and understanding : to learn the structure and physico-chemical properties of the main chemical compounds of medical interest; to know basic metabolic processes of viability and reproduction in the human body; to know structural and metabolic particularities of organs and organ systems in physiological conditions and in major hereditary and acquired diseases; to understand neuro-endocrine mechanisms of metabolism regulation that underlie the maintenance of normal body activity; to understand the influence of different factors (vitamins, drugs) on the main metabolic processes; to know normal physiological variations of the key biochemical indices; to understand the clinical and diagnostic value of changes in biochemical parameters; b) at the level of application: to determine biochemical parameters of clinical and diagnostics utility; to be able to use the main tools in biochemical laboratory (simple and automatic pipettes, ph meters, spectrophotometers, centrifuges etc.). to assess usefulness of certain biochemical investigations in the diagnostics of diseases; to give reasons for the need of certain biochemical investigations in specific biochemical disorders; to give a correct interpretation of biochemical test results. c) at the level of integration: to appreciate the importance of Biochemistry in medical context and its integration with basic and clinical disciplines; to understand the relationships and interdependence of structural biochemistry, general clinic; to assess the progress of metabolic processes and their disorders that determine the development of various pathologies; to demonstrate different mechanisms regulating metabolic processes both in norm and in pathology; to assess the utility of evaluation of some biochemical parameters in certain nosologic units;

3 to define purposes of a scientific research in biochemistry, to develop specific research projects and to base their applicability in clinical practice. III. Conditioning and preliminary requirements: Biochemistry is a biological and medical discipline; it s study at the university will enable future doctors to know the molecular basis of metabolic and physiological processes, biochemical mechanisms regulating all vital functions, to understand the causes and pathogenesis of hereditary and acquired diseases, to give reasons of the necessity of biochemical investigations, to interpret laboratory results and to correlate them with clinical and functional data for a diagnosis, correction of hygiene and nutrition and indications for a therapy adapted to the biochemical mechanisms producing pathology. The discipline requires deep knowledge of chemistry and biology, obtained during the undergraduate studies as well as of bioorganic chemistry, molecular biology, human genetics, and histology, obtained in previous years of study. IV. Basic contents of the course: A. Theoretical classes: I semester Theme Hours 1 Importance of biochemistry in the medical education system. Specific features of living matter. The polypeptide theory. The chemical structure and biological role of proteins. The levels of organization of the protein molecule. The classification of proteins. Simple and conjugated proteins. Calcium-binding proteins. Collagen - the structural specific features. Physico-chemical properties of proteins: molecular weight, termolability, solubility, electro-chemical properties. Denaturation of proteins. 4 Enzymes. The chemical nature and the biological role of the enzymes. Enzyme structure. Active center. The mechanism of the action of enzymes. Cofactors: classification, structure. The role of vitamins as cofactors. Hypovitaminosis. 5 Nomenclature and classification of enzymes. The expression of enzyme activity. General properties of enzymes. Regulation of the enzyme activity. 6 Nucleic acids. Chemical structure and functions of nucleotides. Chemical structure, functions and distribution of nucleic acids in the cell. 7 Deoxyribonucleic acid biosynthesis (replication). Ribonucleic acid biosynthesis (transcription). DNA repair. Mutations. 8 The genetic code. Protein biosynthesis. Stages. Energy needs. Regulation of protein biosynthesis. 9 General metabolism and methods of studying metabolism. Energy metabolism. Stages. General pathways of oxidation of proteins, lipids, carbohydrates. Macroergic compounds. Free energy. 10 Oxidative decarboxylation of pyruvate. Krebs cycle. 11 Biological oxidation. Respiratory chain. Oxidative phosphorylation. Chemiosmotic theory. Uncoupling of oxidation and phosphorylation processes. 1 Carbohydrates. Classification, structure and functions of carbohydrates. The role of carbohydrates in the diet. Digestion and absorption of carbohydrates. 1 Biosynthesis and mobilization of glycogen. Regulation of the processes. Glycolysis: the biological role, reactions, regulation.

4 14 Shuttle systems of hydrogen transport from the cytosol into the mitochondria. Energy efficiency of aerobic and anaerobic glycolysis. Gluconeogenesis. 15 Pentose-phosphate pathway of glucose oxidation. The biological role, reactions, regulation. Galactose and fructose metabolism. 16 Regulation of carbohydrate metabolism. Hereditary and acquired pathologies of carbohydrate metabolism. 17 Lipids: functions, classification, structure. Biological membranes: structure, functions, properties. II semester Theme Hours 1 The role of dietary lipids. Essential fatty acids. Digestion and absorption of lipids in the gastro-intestinal tract. Bile acids - structure, functions. Resynthesis of lipids in intestinal epithelium. Plasma lipids transport. Lipids catabolism. Beta-oxidation of fatty acids. Energy efficiency of fatty acid oxidation. Oxidation of glycerol. Biosynthesis and utilization of ketone bodies. Lipid biosynthesis. Biosynthesis of fatty acids, triglycerides, phospholipids, cholesterol. 4 Regulation of the lipid metabolism. Hereditary and acquired pathologies of the lipid metabolism. Prostaglandins (general concepts). Liposoluble vitamins. Their role in the diet. Hypo-and hypervitaminosis. 5 Simple protein metabolism. Nitrogen balance. The biological value of food proteins. Digestion and absorption of proteins. Putrefaction of the amino acids in the intestine. 6 General pathways of metabolism of amino acids: deamination, transamination and decarboxylation of amino acids. 7 The end products of nitrogen metabolism. Ammonia detoxification mechanisms. 8 The specific metabolism of some amino acids. Biosynthesis of non-essential amino acids. 9 Regulation and pathology of the metabolism of simple proteins. Connection between the metabolism of carbohydrates, lipids and proteins. 10 The purine and pyrimidine nucleotides metabolism. Structure and metabolism of chromoproteins. 11 Hormones, biological role, classification, mechanism of action. Neuro-hormonal regulation of metabolism. Hypothalamic-pituitary hormones, parathyroid hormones. 1 Pancreas and thyroid hormones. The structure, biosynthesis, regulation of secretion, metabolic role. 1 Adrenal hormones. The structure, biosynthesis and regulation of secretion, metabolic role. Sex hormones. The structure, metabolic role. 14 Blood chemistry. Composition of blood plasma. Plasma proteins, blood enzymes, residual nitrogen, minerals. 15 The transport of gases in the blood. The acid-base balance. Coagulation factors coagulation mechanisms. Anticoagulant and fibrinolytic systems. 16 Nutrition. Nutritional needs. Energy needs. The diet composition and energy. 17 Nutrients: carbohydrates, lipids, proteins, vitamins, minerals, dietary fiber, bioactive food substances, water.

5 B Practical classes: I semester Theme Hours 1 Importance of biochemistry in the medical education system.amino acids. The polypeptide theory. Color reactions for the identification of proteins and amino acids. Chemical structure and biological role of proteins. Levels of structural organization of the protein molecule. The classification of proteins. Identification of amino acids by paper chromatography method. Physico-chemical properties of proteins, their specific features in dependence on the amino acid composition. Dialysis of proteins. 4 Enzymes. The chemical nature and the biological role of the enzyme. Cofactors. Mechanism of action of enzymes. Nomenclature and classification of enzymes. The role of vitamins as cofactors. Hypovitaminosis. Identification of vitamins B1, B, B6, PP. 5 General properties of enzymes. Regulation of enzyme activity. The methods of separation, purification and determination of enzyme activity. Determination of amylase activity. 6 Test "Proteins. Enzymes " 7 Nucleic acids. The chemical structure of nucleotides and nucleic acids (RNA and DNA). Quantitative determination of the DNA. 8 Deoxyribonucleic acid biosynthesis (replication). Ribonucleic acid biosynthesis (transcription). DNA repair. Mutations. Quantitative determination of RNA. 9 Protein biosynthesis. Stages. Energy needs. The genetic code. Regulation of protein biosynthesis. Determination of total protein in serum. 10 Test "Nucleic acids". 11 General metabolism. Energy metabolism. General pathways of the proteins, lipids, carbohydrates oxidation. Oxidative decarboxylation of pyruvate. Krebs cycle. Determination of pyruvate in urine. 1 Biological oxidation. Respiratory chain and oxidative phosphorylation. Regulation. ATP synthesis of the chemiosmotic theory. Uncoupling of oxidation and phosphorylation processes. Determination of catalase activity. 1 Biochemical mechanisms of digestion and absorption of food carbohydrates in the gastrointestinal tract. Pathways of the absorbed carbohydrates utilization. Biosynthesis and mobilization of glycogen. Reciprocal regulation of the processes. Identification of monosaccharides in biological fluids. 14 Glycolysis - reactions, biological role, the energy efficiency of anaerobic and aerobic oxidation of glucose. Gluconeogenesis. Reciprocal regulation of the processes. Determination of the fructose-1, 6-diphosphate aldolase activity. 15 Pentose-phosphate pathway of glucose oxidation. Fructose and galactose metabolism. Reaction of the differentiation of ketoses and aldoses. 16 Regulation of carbohydrate metabolism. Hereditary and acquired disorders of carbohydrate metabolism. Determination of glucose in serum. 17 Test: "Bioenergetics. Carbohydrate metabolism ".

6 II semester Theme Hours 1 Structure, classification and functions of lipids. Biological membranes. Determination of triglycerides in serum. The role of dietary lipids. Indispensable fatty acids. Digestion and absorption of lipids in the digestive tract. Plasma lipoproteins. Oxidation of lipids (triglycerides, glycerol, fatty acids). Ketone body metabolism. Identification of bile acids. Determination of lipase activity in serum. Biosynthesis of lipids in tissues: biosynthesis of fatty acids, triglycerides, phospholipids, cholesterol. Identification of ketone bodies in urine. Determination of cholesterol in serum. 4 Regulation of the lipid metabolism. Pathology of the lipid metabolism. Liposoluble vitamins. Hypo-and hypervitaminosis. Prostaglandins. Determination of betalipoproteins. 5 Test: "Metabolism of lipids 6 The metabolism of simple proteins. Nitrogen balance. The biological value of food proteins. Digestion and absorption of proteins. Putrefaction of the amino acids in the intestine. Determination of gastric acidity. 7 General pathways of the amino acids metabolism: deamination, transamination and decarboxylation of amino acids. The end products of nitrogen metabolism. Ammonia detoxification mechanisms. The determination of urea in blood serum and urine. Aetermination of the aminotransferases (ALT and AST) activity. 8 The specific metabolism of some amino acids. Biosynthesis of amino acids. Regulation and pathology of the simple proteins metabolism. The determination of creatinine in blood serum and urine. Homogentisic acid determination in urine. 9 Purine and pyrimidine nucleotide metabolism. Determination of uric acid in the urine. 10 Structure and metabolism of chromoproteins. Jaundice. Connection between the metabolism of carbohydrates, lipids and proteins. Determination of total and direct bilirubin in serum. 11 Test "Metabolism of simple and conjugated proteins. 1 Hormones, biological role, classification, mechanism of action. Hormonal regulation of metabolism. Hypothalamic-pituitary hormones, parathyroid hormones. Determination of inorganic phosphate in serum. Determination of serum calcium. 1 Pancreas and the thyroid hormones. Adrenal hormones. Sex hormones. Structure, biosynthesis, metabolic role, and regulation of their secretion. Reaction of 17- cetosteroizilor identification in urine. Determination of adrenaline. 14 Blood chemistry. The chemical composition of the blood plasma. Plasma proteins, blood enzymes, residual nitrogen, minerals. Determination of total protein, albumin in the serum. 15 The blood gases transport. Acid-base balance. Coagulation: coagulation factors, mechanisms. Anticoagulant and fibrinolytic systems. Determination of hemoglobin. 16 Test: "Hormones. Blood ". 17 Admission to the exam.

7 V. Recommended bibliography: A. compulsory: 1. Lîsîi L. Biochimie medical (edi ia a doua). Chi in u, Dinu V., Tru ia E., Popa-Cristea E., Popescu A. Biochimie medical. Mic tratat. Bucure ti, Stroev E. Biochimie. Chi in u, Lîsîi L. Biochimie. Teste. Test-minim. Chi in u, Lîsîi L. i al ii. Biochimie. Lucr ri practice. Chi in u, For students studying biochemistry in Russian: , A.., , www. biochemistry.ru....., ( ). B. Supplementary: 1. Nelson D.L., Cox M.M. Lehninger A. Principles of Biochemistry. Sixth Edition Bhagavan N.V., Ha Chung-Eun. Essentials of Medical Biochemistry: With Clinical Cases. Academic Press; 1st edition, Campbell P.N. Smith A.D. Biochemistry illustrated. Internatinal edition, Murray R.K., Granner D.K., Mayer P.A., Rodwell V.W. Harper s illustrated Biochemistry. 6-th international edition, Champe Pamela C., Harvey Richard A. Biochemistry. Lippincott s Illustrated Reviews. Gavriliuc Ludmila. Biochemistry. Lectures for student of Medical Departments. Chisinau pag. 6. Lehninger A.L. Principles of Biochemistry The Johns Hopkins University School of Medicine, Worth Publishers Inc., Metzler D.E. Biochemistry. The chemical reactions of living cells. Second edition, vol.1-. Academic Press, Marshall W.J. Clinical Chemistry. 4th edition, Mosby press, UK, London, Stryer L. Biochemistry. Freeman and Company, San-Francisco, USA, 000. VI. The methods of teaching and learning used: Biochemistry is taught in accordance with the standard classical university method: theoretical classes and practical classes. The theoretical classes are held by the teaching staff. At first during practical classes theoretical issues are discussed as it is described in methodological indications; problems and tests based on clinical cases are solved; interactive methods of teaching and learning are applied; then laboratory works are carried out and discussion of the importance of determined clinical and biochemical diagnostic indices takes place; the work is finished by filling in the protocols.

8 VII. Suggestions for individual activity: From the pedagogical point of view, one of the least effective methods of learning is passive listening to the lectures, even if they are well structured and explained. If you want to learn Biochemistry successfully, you should work actively with the material. For this purpose you can follow a few tips: Before coming to classes, it is useful to get acquainted with the material to listen to. Don t take notes of lectures automatically, but go through the information provided by the professor. If you do not understand the material enough, ask the teacher, colleagues, refer to the manuals. In preparation for practical classes, tests, exams make notes, diagrams, work in groups. After you have learned the material, test your knowledge doing tests and solving problems given at the end of each theme and chapter or in the tests collections. Participate actively in discussions during practical lesson, only when you are able to formulate your ideas clearly and when you are understood by your professor and group mates you may be sure that you have acquired the material. Try to find a link between the information obtained in biochemistry and the one obtained in other basic subjects. Focus upon the medical aspects; apply knowledge gained in biochemistry to clinical disciplines. VIII. Methods of assessment: Current assessment The university course of Biochemistry includes 6 tests: Semester I: Test no. 1: Proteins. Enzymes. Test no. : Nucleic acids. Test no. : General metabolism. Carbohydrate metabolism. Semester II: Test no. 4: Lipid metabolism. Test no. 5: Simple and combined protein metabolism. Test no. 6: Hormones. Blood. The test consists of two parts: a written/oral test and a computer test. The written test consists of 6-10 items (depending on the test); students have up to 1 hour and 0 minutes to do it. A computerized test consists of 0 questions of each version (simple choice and multiple choice). Students are given 0 minutes to do it. Each test is assessed by grades from 0 to 10. The test can be done one time, but in case of failure the second time in the last week of the semester. Annual mark is the average mark of all tests. Only the students who have an annual mark equal to 5 and over and no more than 1 missed practical lesson are admitted to the final examination in Biochemistry. Final assessment: The final exam in Biochemistry consists of a multiple-choice test (option "Test Editor") and oral exam. The multiple-choice test consists of 100 questions, 40 of which are simple

9 choice and 60 - multiple choice. The students have hours to do the test; knowledge is assessed with marks at the range from 0 to10. The oral test is based on question papers containing 4 questions. The students have 0 minutes to prepare a response to the questions. Knowledge is assessed with marks at the range from 0 to10. Questions for the examination (tests and list of questions for the oral test) are approved at the Department meeting and offered to students at least one month before the examination. The final mark consists of components: the annual average mark (coefficient 0.5), oral test (coefficient 0.) and multiple-choice test (coefficient 0.). Knowledge is assessed with marks from 10 to 1 without decimals as follows: Mark 10 or 'excellent' (equivalent ECTS - A) is given for the assimilation of % of the material; Mark 9 or "very good" (equivalent ECTS - B) is given for the assimilation of 81-90% of the material; Mark 8 or "good" (equivalent ECTS - C) is given for the assimilation of 71-80% of the material; Marks 6 and 7 or "satisfactory" (equivalent ECTS - D) is given for the assimilation of 61-65% and 66-70% respectively of the material; Mark 5 or "poor" (equivalent ECTS - D) is given for the assimilation of 51-60% of the material; Marks and 4, or "satisfactory" (equivalent ECTS - FX) is given for the assimilation of 1-40% and 41-50% respectively of the material; Marks 1 and or "unsatisfactory" (equivalent ECTS-F) is given for the assimilation of - 0-0% of the material; Marks rounding method : The sum of notes from current assessments and final examination Final mark 5 5 5,1-5,5 5,5 5,6-6,0 6 6,1-6,5 6,5 6,6-7,0 7 7,1-7,5 7,5 7,6-8,0 8 8,1-8,5 8,5 8,6-9,0 9 9,1-9,5 9,5 9, Absence at the examination without good reason shall be recorded as "absent" and is equivalent to the grade 0 (zero). The student has the right to two repeated examination. IX. Language of instruction: Romanian, Russian.