Textbook of Medical Biochemistry

5th Edition - November 13, 2022
Imprint: Elsevier India
Author: Dinesh Puri
Language: English
Paperback ISBN:
9 7 8 - 8 1 - 3 1 2 - 6 4 8 9 - 8
eBook ISBN:
9 7 8 - 8 1 - 3 1 2 - 6 4 9 0 - 4

The fifth edition of this book is thoroughly revised and updated as per guidelines of NMC in accordance with the competency-based curriculum of Biochemistry. It focuses pr… Read more

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The fifth edition of this book is thoroughly revised and updated as per guidelines of NMC in accordance with the competency-based curriculum of Biochemistry. It focuses primarily on clarity of the fundamental concepts with a logical sequence of events that aids learning. The organization of content in this profusely illustrated book provides the essential knowledge of biochemistry without extraneous details.
Authentic resource material for undergraduate medical students, NEXT, USMLE, PLAB, etc.
New to this Edition
• Addition of new chapter on Processing and Targeting of Proteins.
• Systematically modified chapters on Cancer; Recombinant DNA Technology and Genetic Engineering; Molecular Biology: Eukaryotic Gene Expression; Immunology; Organ Function Tests; Carbohydrates and Lipid Metabolism; and Energy Metabolism and Nutrition to cater to various competencies recommended by new curriculum.
• Inclusion of clinical boxes in each chapter highlighting horizontal- and vertical integration of topics to foster solid understanding.
• Enriched text with additional new line diagrams, clinical photographs, tables and boxes for easy understanding and reproducibility.
• Multiple-choice questions have been given chapterwise to evaluate the level of understanding and memory recall of the students.
Salient Features
• Extensively revised and updated all chapters, in line with recommendations of CBME and subject requirement.
• Important points have been threaded throughout the text in yellow boxes, reemphasizing the core concepts.
• Selected advanced learning concepts are highlighted in blue boxes or enclosed in numbered boxes for postgraduate students and inquisitive undergraduates.
• Nearly all figures have been modified or redrawn to make reading soothing for better retention.
• Inclusion of new questions at the end of book for self-assessment of the topics studied.
• Clinical cases along with case discussions – important pillar of the CBME are presented for problem-based learning and knowledge.
Online resources at www.medenact.com
• Complementary access to full e-book
• Whiteboard Lectures
• Question Bank

Cover image
Title page
Table of Contents
Copyright
Dedication
Foreword to the Fourth Edition
Preface to the Fifth Edition
Preface to the First Edition
Acknowledgements
Competency map: Biochemistry
List of Tables
List of Illustrations
Section 1. Biomolecules
Introduction
1. Water, buffers and acid–base chemistry
Water as principal biological fluid
Acids, bases, pH and pK
Buffers
Chapter summary
Exercises
2. Chemistry of carbohydrates
Classification
Biological significance of carbohydrates
Monosaccharides
Disaccharides
Sugar derivatives
Glycosides
Oligosaccharides
Polysaccharides
Chapter summary
Exercises
3. Chemistry of lipids
Biological functions of lipids
Fatty acids BI 4.1
Classification of lipids BI 4.1
Chapter summary
Exercises
Clinical case
4. Amino acids, peptides and proteins
Characteristics and roles of amino acids
Acid–base properties of amino acids
Special functions of some amino acids
Reactions of biological significance involving amino acids
The peptide bond
Peptides
Classification of proteins
Levels of protein structure
Physical properties of proteins
Chapter summary
Exercises
Clinical cases
5. Plasma proteins and immunoglobulins
Electrophoresis BI 11.16
Albumin BI 5.2
Globulins BI 5.2
Fibrinogen
Immunoglobulins BI 10.3
Chapter summary
Exercises
Clinical case
6. Enzymes
Properties of enzymes BI 2.1
Mechanism of enzyme catalysis
Enzyme classification and nomenclature BI 2.1
Enzyme–substrate binding
Enzyme kinetics BI 2.3
Factors affecting enzyme activity
The michaelis–menten model
Enzyme inhibition
Regulation of enzyme activity
Isoenzymes
Chapter summary
Exercises
Clinical cases
7. Enzymes in clinical diagnosis
Clinical applications of diagnostic enzymes BI 2.5, BI 2.7
Enzymes as therapeutic agents BI 2.4
Chapter summary
Exercises
Clinical cases
8. Characteristics of cells and membrane transport
Cell structure BI 1.1
Biological membranes BI 1.1
Transport across cell membrane: Small molecules BI 1.1
Transport of macromolecules across cell membrane BI 1.1
Chapter summary
Exercises
Clinical case
9. Extracellular matrix
Collagen BI 9.1, BI 9.2
Elastin BI 9.1, BI 9.2
Glycoproteins BI 9.1
Keratins BI 9.1
Chapter summary
Exercises
Clinical cases
Section 2. Metabolism
Introduction
10. Overview of metabolism and cell bioenergetics
Overview of metabolism
Bioenergetics: Principles BI 6.6
Chapter summary
Exercises
11. Metabolism of carbohydrates I: Mainline metabolic pathways
Transport of glucose into cells BI 3.4
Glycolysis BI 3.4, BI 3.5
Rapaport-leubering cycle
Feeder pathways for other monosaccharides BI 3.5
Pyruvate dehydrogenase complex: A bridge between glycolysis and TCA cycle BI 3.5
Tricarboxylic acid cycle BI 3.6
Gluconeogenesis BI 3.4, BI 3.5
Cori cycle or lactic acid cycle
Pasteur effect
Chapter summary
Exercises
Clinical cases
12. Metabolism of carbohydrates II: Glycogen metabolism and regulation
Glycogenolysis BI 3.4, BI 3.5
Glycogenesis BI 3.4, BI 3.5
Regulation of glycogen metabolism BI 3.5
Glycogen storage diseases BI 3.5
Chapter summary
Exercises
13. Metabolism of carbohydrates III: Secondary pathways and regulation of blood glucose levels
Pentose phosphate pathway BI 3.4
Uronic acid pathway BI 3.4
Metabolism of other sugars
Regulation of blood glucose BI 3.9
Chapter summary
Exercises
Clinical cases
14. Metabolism of lipids I: Metabolism of fatty acids and compound lipids
Fatty acid oxidation BI 4.2
Fatty acid synthesis BI 4.2
Regulatory circuits of fatty acid metabolism
Chain elongation and desaturase systems
Triacylglycerol metabolism BI 4.2
Adipose tissue metabolism BI 4.2, BI 6.1
Ketone bodies BI 4.2, BI 6.7
Metabolism of complex lipids BI 4.2
Sphingolipidoses BI 4.2
Chapter summary
Exercises
Clinical case
15. Metabolism of lipids II: Lipoproteins, cholesterol and prostaglandins
Lipoproteins BI 4.3, BI 4.4
Metabolism of different lipoprotein classes BI 4.3, BI 4.4
Disorders of lipoprotein metabolism BI 4.3, BI 4.4, BI 11.17
Atherosclerosis BI 4.4
Fatty liver syndrome BI 6.15
Cholesterol metabolism
Metabolism of bile acids and bile salts
Prostaglandins BI 4.6
Chapter summary
Exercises
Clinical cases
16. Amino acid and protein metabolism I: Nitrogen metabolism and urea cycle
Nitrogen metabolism
Amino acid degradation
Fate of α-amino group
Glucose–alanine cycle
Chapter summary
Exercises
Clinical case
17. Amino acid and protein metabolism II: Catabolism of carbon skeletons and inherited disorders
Glycogenic and ketogenic amino acids
Amino acids that form pyruvate (Fig. 17.2)
Amino acids that form TCA cycle intermediates (Fig. 17.1)
Amino acids that form acetyl-CoA or acetoacetyl-CoA (fig. 17.11)
Inborn errors of amino acid metabolism BI 5.4
Disorders of aromatic amino acid metabolism BI 5.4
Inborn errors of branched-chain amino acids BI 5.4
Inborn errors of histidine metabolism BI 5.4
Inborn errors of sulphur-containing amino acids BI 5.4
Other inborn errors BI 5.4
One-carbon metabolism
Chapter summary
Exercises
Clinical cases
18. Amino acid and protein metabolism III: Biosynthesis and derivatives
Biosynthesis of nonessential amino acids
Biosynthesis of semiessential and essential amino acids
Amino acids as precursors of specialized products
Chapter summary
Exercises
Clinical case
19. Biological oxidation and electron transport chain
Sources of electrons for ETC BI 6.6
Electron transport: An overview BI 6.6
Localization of ETC BI 6.6
Redox potential BI 6.6
Sequence of electron flow BI 6.6
Inhibitors of ETC BI 6.6
Oxidative phosphorylation BI 6.6
Mitochondrial membrane transporters
Mitochondrial diseases BI 7.3
Chapter summary
Exercises
Clinical case
20. Integration of metabolism
Hormones as metabolic regulators BI 3.5
Metabolic interconnections and organ specialization BI 6.1
Feeding and fasting BI 6.1
Metabolic alterations in diabetes resemble starvation BI 11.17
Diabetes mellitus BI 3.5, BI 11.17
Management of diabetes mellitus BI 8.3
Chapter summary
Exercises
Clinical cases
Section 3. Physiological Chemistry
Introduction
21. Haem metabolism
Structure BI 6.11
Nomenclature BI 6.11
Biosynthesis of haem BI 6.11
Porphyrias BI 6.11
Catabolism of haem
Jaundice BI 6.15, BI 11.17
Chapter summary
Exercises
Clinical case
22. Oxygen transporters: Haemoglobin and myoglobin
Haemoglobin structure BI 5.2, BI 6.12
Allostery
Transport of oxygen in blood
Transport of carbon dioxide in blood
Myoglobin: Oxygen-binding characteristics
Haemoglobin variants BI 6.12
Haemoglobin derivatives BI 6.12
Haemoglobinopathies BI 11.16, BI 5.2
Sickle cell disease (sickle cell haemoglobin, HbS) BI 5.2, BI 7.3
Thalassaemias BI 5.2, BI 7.3
Anaemias
Chapter summary
Exercises
Clinical cases
Section 4. Nutrition
Introduction
23. Gastrointestinal pathobiochemistry
Overview
Digestion and absorption of carbohydrates BI 3.2, BI 3.3
Digestion and absorption of proteins BI 5.3
Digestion and absorption of lipids BI 4.2
Digestion and absorption of nucleic acids
Functions of liver BI 6.13, BI 6.14, BI 11.17
Tests for liver functions BI 6.14, BI 11.17
Chapter summary
Exercises
Clinical cases
24. Energy metabolism and nutrition
Calorific values BI 8.1
Respiratory quotient BI 8.1
Components of energy requirement BI 8.1
Recommendations for dietary nutrients BI 8.1, BI 8.3
Nutritional implications of diseases BI 8.2
Balanced diet BI 8.1, BI 8.5
Chapter summary
Exercises
25. Vitamins
Classification and nomenclature BI 6.5
Sources, daily requirements and deficiency of vitamins BI 6.5
Water-soluble vitamins BI 6.5, BI 8.1
Fat-soluble vitamins BI 6.5, BI 8.1
Chapter summary
Exercises
Clinical cases
26. Minerals
Major minerals BI 6.9
Trace elements BI 6.9, BI 6.10, BI 8.1
Lead: A heavy metal poison BI 6.9, BI 6.10
Chapter summary
Exercises
Clinical cases
Section 5. Nucleic Acid Metabolism and Molecular Biology
Introduction
27. Nucleic acid chemistry and nucleotide metabolism
Composition of nucleotides
Nucleotide metabolism BI 6.2
Biosynthesis of purines BI 6.2
Salvage pathways BI 6.2
Inhibitors of purine synthesis BI 10.2
Purine degradation
Disorders of purine metabolism BI 6.2, BI 6.3
Biosynthesis of pyrimidines BI 6.2, BI 6.3
Degradation of pyrimidines BI 6.2
Chapter summary
Exercises
Clinical cases
28. Molecular biology I: DNA structure, genetic role and replication
Chemical structure of DNA BI 7.1
The Watson–Crick proposal
Alternate higher-order structures of DNA BI 7.1
Some physical properties of DNA BI 7.1
DNA as genetic material BI 7.1
The human genome BI 7.1
Some commonly used terms related to molecular genetics BI 7.1
Replication BI 7.1, BI 7.2
Chapter summary
Exercises
Clinical case
29. Molecular biology II: Mutagenesis and DNA repair
Mutations BI 7.2, BI 7.3
Repair systems for mutated DNA BI 7.2
Defective DNA repair and human diseases BI 7.2
Genetic recombination
Chapter summary
Exercises
Clinical case
30. Molecular biology III: Transcription and translation
Ribonucleic acid BI 7.1
Transcription BI 7.2
Genetic code BI 7.2
Translation BI 7.2
Chapter summary
Exercises
Clinical case
31. Molecular biology IV: Regulation of prokaryotic gene expression and molecular genetics
Constitutive and inducible proteins
Control of gene expression in bacteria BI 7.3
Protein–DNA interaction in transcriptional regulation BI 7.3
Regulatory mechanism in viruses
Genetic diseases BI 7.4
Chapter summary
Exercises
Clinical case
32. Molecular biology V: Eukaryotic chromosome and gene expression
Replication has multiple sites of origin BI 7.2
Cell cycle BI 7.1
Architecture of human genome BI 7.3
Exon duplication and exon shuffling
Transcription BI 7.2
Translation BI 7.2
Regulation of eukaryotic gene expression BI 7.3
RNA interference BI 7.3
Advanced concepts
Chapter summary
Exercises
33. Recombinant DNA technology and genetic engineering
Techniques and enzymes used in manipulation of DNA BI 7.4
DNA amplification and cloning BI 7.4
DNA library BI 7.4
Nucleotide probes BI 7.4
Blotting techniques BI 7.4
In situ hybridization
Normal polymorphisms as genetic markers
Applications of recombinant DNA technology BI 7.4
Restriction fragment length polymorphism BI 7.4
Polymerase chain reaction BI 7.4
Human genome project: Current status and future goals BI 7.4
Chapter summary
Exercises
Multiple choice questions
Answer key to multiple choice questions
Clinical case
Section 6. Clinical Biochemistry
Introduction
34. Acid–base chemistry and associated disorders
Defences for maintaining acid–base balance BI 6.7
The acid–base disorders (Table 34.1) BI 6.7, BI 11.17
Acidosis
Alkalosis BI 6.7
Arterial blood gas analysis BI 6.8
Chapter summary
Exercises
Clinical cases
35. Sodium, potassium and water homoeostasis
Water distribution in the body BI 6.7
Water balance BI 6.7
Electrolyte distribution in the body BI 6.7
Regulation of water and electrolyte balance BI 6.7
Disturbances of water and electrolyte metabolism BI 6.7
Chapter summary
Exercises
36. Calcium and phosphate: Metabolism and regulation
Calcium BI 6.9
Phosphorus BI 6.9
Chapter summary
Exercises
Clinical cases
37. Organ function tests
The excretory system
Thyroid BI 6.13, BI 6.14, BI 6.15
Adrenals BI 6.13, BI 6.14, BI 6.15
Chapter summary
Clinical case
38. Cancer
Tumours: Benign and malignant
Growth characteristics of cancer cells BI 10.1
Biochemical changes in cancer cells BI 10.1
Cancer: A disease of genome BI 10.1
Aetiology of cancer BI 10.1
Molecular lesions in cancer BI 10.1
Role of viruses in carcinogenesis BI 10.1
Mitogenic signalling
Some oncoproteins and associated cancers BI 10.1
Antioncogene inactivation is more common than proto-oncogene activation
Molecular mechanism of antiongene action
Tumour markers BI 10.1, BI 10.2
Cancer therapy BI 10.1, BI 10.2
Apoptosis BI 10.1
Chapter summary
Exercises
39. Biochemical techniques
Separation and purification of proteins BI 11.16
Immunoassays
Separation of nucleic acids
Determination of amino acid sequence of peptides and proteins*
Determination of higher-order structure of proteins
Detection of protein movement
Chemical synthesis of proteins
Chapter summary
Exercises
Section 7. Biochemical Endocrinology
Introduction
40. Biochemical endocrinology
Signalling takes three forms
Classification of hormones
Other classification schemes
Transport mechanism
Mechanism of action
Other second messengers
Regulation of hormone–receptor interactions and associated diseases
Feedback concept related to hormone action
Chapter summary
Exercises
Clinical cases
41. Action of hormones
Hypothalamus–pituitary system
Hypothalamic hormones
Anterior pituitary hormones
Hormones of posterior pituitary
Hormones of thyroid gland BI 6.13
Hormones of adrenal cortex BI 6.13, BI 6.14, BI 6.15
Hormones of adrenal medulla BI 6.13
Gastrointestinal hormones BI 3.2, BI 3.3, BI 4.2, BI 5.3
Pancreatic hormones
Hormones of gonads
Menstrual cycle
Menopause
Chapter summary
Exercises
Clinical cases
Section 8. Contemporary Topics
Introduction
42. Free radicals in health and diseases
Incomplete reduction of oxygen BI 7.6
Transition metals BI 7.6
Causes of OFR generation BI 7.6
Free radical scavenger systems BI 7.6
Damage produced by free radicals BI 7.7
Free radicals in aetiology of disease BI 7.7
Chapter summary
Exercises
Clinical case
43. Xenobiotics
Overview BI 7.5
Metabolism of xenobiotics BI 7.5
Alcohol metabolism
Chapter summary
Exercises
44. Immunology
Historical milestones BI 10.3
Nonspecific and specific immune responses BI 10.4
Antigens and immunogens BI 10.3, BI 10.5
Role of lymphocytes BI 10.3, BI 10.4
Organs of the immune system BI 10.3, BI 10.4
Cells of the immune system BI 10.3, BI 10.4
Molecules of immune response BI 10.3
Immunoglobulins BI 10.3
The complement system BI 10.3, BI 10.4
The recognition of and response to nonself BI 10.4
Cellular cooperation in the immune response
Nonspecific effector cells are influenced by TH-cells and immunoglobulins
Specific immune responses to some infections
Vaccines BI 10.5
Immunological techniques BI 11.16
Immunological dysfunctions BI 10.3, BI 10.4
Chapter summary
Exercises
Clinical case
45. Processing and targeting of proteins
Folding into higher-order structure
Protein targeting BI 9.3
Destruction after finite lifespan
Chapter summary
46. Applications of radiation and radioisotopes in medicine
History
Radioactivity
Chapter summary
Exercises
47. Environmental pollutants and toxins
Classification of types of pollution
Types of pollutants
Air pollution
Water pollution
Soil pollution
Noise pollution
Radiation pollution
Toxic pollutants
Chapter summary
Exercises
Clinical case discussions
Reference range
Glossary
Index

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Textbook of Medical Biochemistry

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