BMS 648 Medical Biochemistry:  5 Credit Hours

Placement in the Curriculum:  Year One, Fall Semester

Duration:  September – December

The Medical Biochemistry and Nutrition course is taught in an integrated curriculum in the fall semester of the M1 year.  The Medical Biochemistry component is comprised of 44 lectures and is taught in the first ~12 weeks of the semester.  The Nutrition component consists of 13 lectures and overlaps with the medical biochemistry component, starting in the 5th week of the course and lasting ~8 weeks.


Synopsis:
   Medical biochemistry teaches the basic principles of biochemistry that govern human physiology in health and in disease.  The course is designed to link basic principles in biochemistry and metabolism to physiology, pathology, pharmacology, clinical diagnosis and nutrition.  Students initially learn about the structural and basic functions of nucleic acids, proteins, lipids and carbohydrates.  The biosyntheses, trafficking and degradation of macromolecules and their relevancy to disease are discussed.  Principles of enzymes catalysis and characterization of enzyme inhibitors as drugs is introduced.   Fuel metabolism sessions discuss energy conversion in our body, how foods are digested and absorbed, ATP is synthesized and utilized in various cellular coupling processes.  Students learn all the major pathways that regulate carbohydrate, amino acid, nucleic acid and lipid metabolism.  Special emphasis is put on their integration, hormonal regulation and interrelationships in different tissues and organs during both normal physiologic and disease states.  Clinical correlations for each of the metabolic pathways are discussed at length, including diabetes and hypoglycemia, lysosomal storage diseases, hypercholesterolemia and atherosclerosis, defects in amino acid and nucleic acid metabolism etc.  The final part of the course focuses on cellular responses to oxidative damage, drug metabolism, ethanol metabolism and alcoholism, hormonal regulation of metabolism, and the biochemistry underlying inflammation and cancer proliferation.

Medical Nutrition introduces the biochemistry of macro- and micro-nutrients and the metabolic roles of vitamins and minerals, and the diseases caused by their deficiency and overdose. Macronutrient lectures discuss food intake and metabolism, and protein-energy malnutrition in starvation, including kwashiorkor and marasmus.  Functional food metabolism and basic knowledge of herbal supplements related to metabolic regulation are discussed.  The final part of the course focuses on clinical nutrition.  Topics include nutritional assessments, clinical nutrition support, sports nutrition, obesity, nutrition in diabetes, anemias, chronic kidney failure, heart diseases, and maternal and pediatric nutrition.  The course includes examples and discussions of clinical cases relevant to medical nutrition.

 

Competencies:  In completing this course, the students will have acquired the basic knowledge in biochemistry that is related to physiology, pathology and pharmacology, the etiology of various diseases the their diagnostic methods.  The students should have an thorough understanding on the importance of nutrition as the front line treatment and prevention of diseases.  The goal of this course is to build the foundation of biochemistry knowledge that allow students to enter clinical sciences with an understanding of the molecular basis of diseases and their treatments.  In the process of completing Nutrition  course, the student will have acquired the following competencies:  Recognize and describe the role of nutrition in the cause, prevention, and treatment of disease.

 

Assessment:  There are three formal examinations in Medical Biochemistry and one formal examination in Medical Nutrition. Exam questions are based on lecture material, readings, case studies and team based learning clinical sessions. Team Based Learning (TBL) sessions include both individual and team-based readiness assessment testing.  The comprehensive final exam for the course is an NBME USMLE Step I shelf exam, which is given at the end of the Spring semester after students have completed other courses such as Medical Genetics that are also covered within the blueprint of this exam.

 

Instructional Features: Lectures, Team-Based Learning Sessions, Discussion Boards, Self-study modules, Topical and Pre-exam reviews, Practice questions and exams for self-assessment.

 

Key Words: Biochemistry and structures of biopolymers; Biochemistry and etiology of disease; Molecular Biology – DNA, RNA, gene transcription, protein translation; Enzyme catalysis and kinetics; Metabolism – catabolic and anabolic pathways; Oxidative phosphorylation; Fuel metabolism; generation/utilization of ATP as bio-energy; Carbohydrate metabolism – glycolysis and gluconeogensis, glycogen metabolism; Lipid metabolism and blood lipid biochemistry; Amino acid metabolism; Nucleic acid metabolism; Urea cycle; Heme biosynthesis and degradation; Jaundices; Anemias; Biochemistry of vitamins and minerals;  Hormonal regulation and integration of metabolic pathways; Oxidative damage; Drug metabolism; Biochemistry of inflammation; Biochemistry of  cancer; Micronutrients and macronutrients; Nutritional support in disease; Obesity and weight control; Alcoholism; Nutrition; Eating disorders; Pediatric Obesity; Medical Nutrition in Pregnancy, Sports, Obesity,