1. Cell, its Organelles and Transport
Across Cell Membranes 1
y Cell Types and Subcellular Components 1
y Structure and Functions of Cell Membrane 3
y Structure and Functions of
Subcellular Organelles 5
y Cytoskeleton 10
y Cell Fractionation and Marker Enzymes
for Different Organelles 10
y Membrane Transport 11
y Transport Mechanisms Across
Cell Membrane 12
2. Chemistry of Carbohydrates 21
y Definition, Functions and Classification of
Carbohydrates 21
y Monosaccharide: Structure and Isomerism 23
y Biologically Important Monosaccharide
Derivatives 25
y Glycoside and Its Importance 28
y Disaccharides: Examples and Importance 29
y Polysaccharides (Glycans):
Examples and Importance 30
y Glycoproteins 35
3. Chemistry of Lipids 38
y Lipids: Definition, Classification, and
Functions 38
y Fatty Acids: Definition, Functions, and
Classification 40
y Essential Fatty Acids: Importance and
Deficiency Manifestations 43
y Advantages of Unsaturated Fatty Acids
and Disadvantages of Saturated and
Trans Fats in Food 44
y Triglyceride: Composition and
Importance 45
y Phospholipids: Composition, Types,
and Clinical Importance 46
y Sphingolipids: Structure, Types,
and Functions 50
y Lipoproteins: Composition, Types,
and Importance 52
y Cholesterol: Structure and Importance 53
4. Chemistry of Amino Acids
and Proteins 58
y Amino Acid: Definition, General Nature,
and Classification 58
y Nonstandard Amino Acids 64
y Properties of Amino Acids 65
y Biologically Important Peptides 67
y Protein: Definition, Classification,
and Functions 69
y Structural Organization of Proteins 72
y Denaturation of Protein 77
y Structure-Function Relationship
of Proteins 77
y Plasma Proteins and their Functions 78
y Acute Phase Response and Acute Phase
Proteins (Reactants) 84
5. Enzymes 89
y Enzymes: Definition, General Properties and
IUBMB Classification with Examples 89
y Cofactors and Coenzymes 92
y Mechanism and Enzyme Specificity 93
y Enzyme Kinetics: Factors Affecting
the Velocity of Enzyme Reaction 95
y Regulation of Enzyme Activity 98
y Enzyme Inhibition: Types, Examples, Kinetics,
Clinical and Therapeutic Importance and
Enzyme Inhibitors as Poisons 101
y Isoenzyme: Definition, Examples and
Diagnostic Importance 105
y Alloenzymes 107
y Diagnostically Important Serum Enzymes 107
y Serum Enzyme Assays (Profile): Myocardial
Infarction, Liver Diseases, and Pancreatitis 111
xii Contents
y Use of Enzymes in Laboratory Investigations
(Enzyme-based Assays) 113
y Therapeutic Use of Enzymes 113
6. Chemistry of Nucleic Acids 119
y Structure and Functions of Nucleotides 119
y Biologically Important Free Nucleotides 122
y Synthetic Analogs of Nucleotides or
Antimetabolites 123
y DNA Structure and Function 124
y DNA Organization 126
y RNA Structure and Function 127
7. Chemistry of Hemoglobin and
Hemoglobinopathies 134
y Structure and Functions of
Hemoglobin 134
y Binding Sites for Oxygen, Hydrogen (H+)
and Carbon Dioxide (CO2
) with
Hemoglobin 135
y Cooperative Oxygen Binding of
Hemoglobin 135
y Effect of 2,3-Bisphosphoglycerate on
Binding of Oxygen to Hemoglobin 136
y Types of Normal Human Hemoglobin 137
y Types of Derivatives of Hemoglobin 138
y Hemoglobinopathies 141
8. Biological Oxidation 147
y Free Energy and Redox Potential 147
y Biochemical Processes Involved in
Generation of ATP in Cells 148
y Enzymes, Coenzymes and Electron Carriers
involved in Biological Oxidation 148
y Mitochondrial Electron Transport Chain 149
y Inhibitors of Electron Transport Chain and
Oxidative Phosphorylation 153
y Brown Adipose Tissue Metabolism 155
y Shuttle Systems for Oxidation of
Extramitochondrial NADH 155
y Disorders of Mitochondrial Electron
Transport and Oxidative
Phosphorylation 157
9. Vitamins 160
y Definition and Classification of Vitamins 160
y Water Soluble Vitamins: Structure, Metabolism,
Active/Coenzyme form, Sources, Biochemical
Functions, Nutritional Requirement and
Deficiency Manifestations and Toxicity of
Excessive Intakes 161
y Fat Soluble Vitamins: Structure, Metabolism,
Active/Coenzyme form, Sources, Biochemical
Functions, Nutritional Requirement and
Deficiency Manifestations and Toxicity of
Excessive Intakes 178
10. Carbohydrate Metabolism 194
y Digestion, Absorption, Transport of
Carbohydrates and Associated Disorders 195
y Glycolysis: Pathway, Energetics, Significance,
Regulation and Associated Disorders 198
y Metabolic Fates of Pyruvate and
Associated Disorders 206
y Citric Acid Cycle: Pathway, Energetics,
Regulation and Significance 208
y Gluconeogenesis: Pathway, Regulation
and Significance 212
y Glycogen Metabolism: Pathway, Significance,
Regulation and Associated Disorders 217
y Hexose Monophosphate Pathway (HMP):
Regulation, Significance and Associated
Disorders 222
y Uronic Acid Pathway and its
Significance 226
y Galactose Metabolism: Pathway,
Significance and Associated Disorders 227
y Fructose Metabolism: Pathway, Significance
and Associated Disorders 228
y Regulation of Blood Glucose Level
in Fed and Fasting State 229
y Diabetes Mellitus: Types, Symptoms, Clinical
Features and Metabolic Changes Occur in
Diabetes Mellitus 232
y Laboratory Investigation for the
Diagnosis of Diabetes 235
11. Lipid Metabolism 246
y Digestion, Absorption, and Transport
of Dietary Lipids with Associated
Abnormalities 246
y Lipoprotein Metabolism and
Associated Disorders 249
y Triacylglycerol Metabolism: Synthesis,
Breakdown, Regulation and Associated
Disorder 257
y Fatty Acid Oxidation: b-Oxidation, Energetics,
Regulation and Associated Disorders 261
y Ketone Bodies Metabolism: Synthesis,
Breakdown, Regulation, Significance
and Associated Disorders 267
y Biosynthesis of Fatty Acids 271
Contents xiii
y Cholesterol Metabolism: Synthesis,
Regulation, Metabolic Fates, Excretion
and Associated Disorders 275
y Eicosanoids: Types, Functions, Synthesis,
Inhibitors of Synthesis and Therapeutic
Uses of Prostaglandins 281
y Lipid Profile Tests and Interpretations
with Various Disorders 284
12. Protein Metabolism 293
y Digestion and Absorption of Proteins 293
y Amino Acid Pool 295
y Stages of Catabolism of Amino Acids 296
y Formation and Transport of Ammonia 297
y Urea Cycle: Pathway, Significance, Regulation
and Associated Inborn Disorders 300
y Metabolism of Amino Acids: Their Role in
Biosynthesis of Variety of Specialized Products
and Associated Inborn Disorders 305
y Biogenic Amines and Polyamines 325
13. Integration of Metabolism and
Metabolic Processes in Fed, Fasting,
and Starvation States 333
y Integration of Metabolism: At Cellular
and at Tissue or Organ Level and its
Significance 334
y The Metabolic Processes and Role
of Specific Organs in Fed, Fasting,
and Starvation States 336
14. Hemoglobin Metabolism 346
y Biosynthesis of Heme: Pathway, Regulation,
Significance and Associated Disorder 346
y Catabolism of Heme: Formation, Transport,
Conjugation and Excretion of Bilirubin 350
y Disorders of Bilirubin Metabolism: Jaundice
and Congenital Hyperbilirubinemia 351
y Laboratory Tests Done to
Differentiate Jaundice 354
15. Minerals 357
y Metabolism of Sodium and Potassium 357
y Metabolism of Calcium, Phosphorus,
and Magnesium 359
y Metabolism of Trace Elements 364
16. Water and Electrolyte Balance 374
y Total Body Water and its Distribution 374
y Electrolytes and their Distribution
in ICF and ECF 376
y Regulation of Water and Electrolyte
Balance 376
y Disorders of Water and Electrolyte
Balance 378
17. Acid-Base Balance 383
y Acids, Bases, and Buffers and Normal
pH of the Body Fluids 383
y Metabolic Sources of Acids and Bases which
Tend to Alter pH of the Body Fluids 384
y Maintenance of Normal Blood pH 384
y Disorders Associated with
Acid-base Balance 389
y Arterial Blood Gas Analysis in
Acid-base Imbalance 391
y Anion Gap 392
18. Purine and Pyrimidine
Nucleotide Metabolism 397
y De Novo Synthesis of Purine Nucleotides 397
y Salvage Pathway of Purine Nucleotides
Synthesis and its Significance 399
y Catabolism of Purine Nucleotides and
Associated Disorders 400
y Biochemical Basis of Clinical Manifestations
of Gout and Lesch-Nyhan Syndrome 403
y De Novo Synthesis of Pyrimidine
Nucleotides 404
y Catabolism of Pyrimidine Nucleotides, and
Associated Disorders 405
19. DNA Replication and Repair 410
y Replication in Prokaryotes, Inhibitors of
Replication and its Clinical Importance 410
y Eukaryotic Replication 413
y Telomere, Telomerase, and its
Importance 415
y DNA Repair Mechanisms with
Associated Disorders 417
y Cell Cycle 421
20. Transcription and RNA Processing 426
y Prokaryotic Transcription, and
Post-transcriptional Modifications 426
y Difference between Prokaryotic and
Eukaryotic Transcription 430
y Eukaryotic Transcription, and
Post-transcriptional Modifications 430
21. Genetic Code and Translation 439
y Genetic Code and Its Characteristics 439
xiv Contents
y Wobble Hypothesis for Codon-Anticodon
Interactions 441
y Eukaryotic Translation, Folding and
Processing of Proteins 442
y Post-translational Modifications 447
y Inhibitors of Translation and their
Clinical Importance in Medicine 448
y Protein Targeting and Sorting 449
22. Regulation of Gene Expression
and Gene Mutation 453
y Gene Expression 453
y Regulation of Gene Expression in
Prokaryotes 454
y Regulation of Gene Expression in
Eukaryotes 456
y Mutations 460
23. Molecular Techniques and Applications 465
y Recombinant DNA 465
y Cloning of the DNA 467
y Applications of Recombinant DNA
Technology 468
y Genomic and c-DNA Libraries 470
y DNA Probes 471
y Blot Transfer Techniques and its
Application 471
y Restriction Fragment Length
Polymorphism 472
y Polymerase Chain Reaction: Technique and
its Application in Medicine 472
24. Nutrition in Health and Disease 477
y Dietary Components Required for
Growth and the Maintenance of Life 477
y Importance and Requirement of
Carbohydrates, Dietary Fibers, Fats,
Proteins, Vitamins and Minerals 478
y Energy Requirements and Factors
Affecting Energy Expenditure 482
y Balanced Diet for Optimal Health 484
y Types, Causes and Effects of
Protein Energy Malnutrition 485
y The Causes, Effects, and Health Risk
Associated with Overweight/Obesity 487
y Dietary Advice in Adult, Childhood, and in
Pregnancy for Optimal Health 488
y Dietary Advice for Optimal Health in Diabetes
Mellitus and Coronary Heart Disease 490
y Groups of Food Items and their
Nutritional Importance 492
y Energy Content of Different Food Items
and its Calculation 494
y Glycemic Index and its Importance
in the Diet 494
25. Organ Functions, Disorders,
and Function Tests 498
y Functions, Disorders and Tests to Assess the
Functions of the Liver 498
y Functions, Disorders and Tests to Assess the
Functions of the Kidney 503
y Functions, Disorders and Tests to Assess the
Functions of the Thyroid 512
y Functions, Disorders and Tests to Assess the
Functions of the Adrenal Glands 516
y Cardiac Markers and Tests Used to Diagnose
Myocardial Infarction 519
26. Extracellular Matrix 525
y Types, Functions, and Components of
the Extracellular Matrix 525
y Structure and Functions of Major Proteins
of ECM 526
y Structure and Function of Proteoglycans and
Glycoproteins 529
y Disorders Associated with
Components of ECM 529
27. Immune System 533
y The Organs and Cells Involved
in the Immune System 533
y Innate and Adaptive Immune Systems
and their Components 536
y Antibody/Immunoglobulins:
Structure, Types, and Functions 539
y Self/Nonself-recognition 542
y Innate Immune Responses 543
y Adaptive Immune Responses and
the Role of Helper T cells 545
y Immunological Memory 548
y Antigen: Definition, Structure and Types 549
y Vaccine 550
y Disorders of Human Immunity 551
28. Biochemistry of Cancer 555
y Characteristics of Cancer Cell
and Biochemical Changes Occur in
Cancer Cell 555
y Molecular Basis of Cancer
(Carcinogenesis) 556
y Carcinogens 556
y Oncogenes and Proto-oncogenes 558
Contents xv
y Tumor Suppressor Genes 559
y Apoptosis 559
y Tumor Biomarkers 560
y Biochemical Basis of Cancer Therapy 562
29. Xenobiotics and Detoxification 566
y Biotransformation and Detoxification 566
y Phase-I: Reactions of Detoxification
of Xenobiotics 567
y Phase-II: Reactions of Detoxification
of Xenobiotics 568
y Role of Xenobiotics in Disease 570
30. Free Radicals and Antioxidants 573
y Free Radical, Reactive Oxygen Species and
Reactive Nitrogen Species 573
y Biological Sources and External
Sources of Free Radicals and
Reactive Oxygen Species 574
y Oxidative Damage 575
y Antioxidant Defense Systems 575
y Oxidative Stress and its Role in
Pathogenesis 577
Index 581