Biochemistry and clinical biochemistry

A.Y. 2021/2022
Overall hours
BIO/10 BIO/12
Learning objectives
Acquisition of the basics to understand the composition and molecular organization of the cell. Learning of cellular metabolism and of the most important metabolic relationships between the various tissues and between the various organs. Acquisition of the metabolism of the extracellular substance, bone and dental tissue. Understanding of the basics for ascertaining nutritional status and haemostasis. Acquisition of the concept of biological and analytical variability as well as of the total quality of care services, especially those relating to chemical-clinical determinations of the main analytes.
Expected learning outcomes
Overview of human metabolism. Acquisition of the notion that pathological states are determined by metabolic alterations of the substances of which the human body is composed. Understanding of work protocols in general and their improvement. Interpretative skills of the most common analytes and specifically those concerning nutritional status, bone remodelling and haemostasis.
Course syllabus and organization

Single session

More specific information on the delivery modes of training activities for academic year 2021/22 will be provided over the coming months, based on the evolution of the public health situation.
Prerequisites for admission
The student must have complete mastery of the concepts covered in the courses of Chemistry and Biochemistry Propaedeutic and Biology.
Assessment methods and Criteria
The learning verification will be carried out with a written test of questions (60 questions) based on MOODLE plus SEB with only one correct answer: 45 for biochemistry e 15 for clinical biochemistry. The evaluation will be proportional to the correctly answered questions. To pass the exam, it is necessary to answer half plus 1 of the answers correctly for both modules (23 answers for biochemistry and 8 answers for Clinical Biochemistry) The result of the written test, expressed in thirtieth, will be recorded using the specific website of the University.
Assessment methods and criteria ( emergency phase)
The exams will be organized by using the on-line procedure based on MOODLE plus SEB according with the instructions available on UNIMI home page
Course syllabus
Introduction: body composition and concept of homeostasis. Carbohydrates, lipids and proteins: structure and metabolic and structural roles. Classification of proteins, antibodies and chromoproteins. Enzymes: Energy aspects, principles of enzymatic catalysis, activation energy. Enzymatic activity. Meaning of Km, competitive and non-competitive inhibition. Enzymes in the metabolic pathways. Principles of regulation of enzymatic activity, allosterism. Nomenclature of enzymes. Vitamins and coenzymes. Biological membranes: structure, proteins and membrane lipids, regulation of fluidity. Transport systems.
Metabolism. Anabolism and catabolism, ADP phosphorylation at the substrate level and oxidative phosphorylation, the mitochondrial respiratory chain, ATP biosynthesis, regulation, inhibitors and decouplers.
Cellular communication. Signal / receptor molecule interaction, surface cellular receptors, the signal molecules, first and second messenger. Hypothalamic / pituitary / endocrine glands axis.
Nutritional needs. Energy needs, body mass index, basal and functional metabolism, induced thermogenesis. Plastic requirements, indispensable amino acids and nitrogen balance.
Carbohydrates: Digestion, absorption and transport. Hormonal regulation of glucose, insulin / glucagon. Glycolysis, energy balance and its regulation. The Krebs cycle energy balance and its regulation. The cycle of pentose phosphates, products and regulation. Glycogen metabolism and its regulation.
Lipids: Digestion, absorption and delivery of lipids. Lipoprotein metabolism and electrophoresis. Oxidative metabolism of fatty acids, mitochondrial oxidation. Metabolism of ketone bodies, regulations and energy yields. Catabolism and biosynthesis of endogenous triglycerides. Biosynthesis, elongation and desaturation of fatty acids and their regulation. Complex lipid metabolism. Cholesterol metabolism and its regulation. Vitamin and cofactors involved in lipid metabolism and carnitine.
Proteins: Digestion and amino acid metabolism. Transamination, oxidative deamination, urea cycle, biogenic amines, ammonia toxicity. Vitamin and cofactors involved in the amino acid metabolism. Nucleotides: purine and pyrimidine metabolism, biosynthesis, catabolism and metabolic regulations.
Metabolic integrations and Functional biochemistry: gluconeogenesis, metabolic relationships between lipids, carbohydrates and amino acids in different tissues., biochemistry of the adipose tissue, energy balance and thermogenesis. Free radicals and antioxidant defences. Renal, muscle and liver biochemistry. Biochemistry of the extracellular matrix, bone and dental tissue. Iron metabolism. Biochemistry of nervous tissue
Teaching methods
The topics will all be covered by using power point presentation (PPT) and available on ARIEL web site of the course
Teaching Resources
Siliprandi and Tettamanti, Medical Biochemistry, Piccin Ed.
Marks A, Lieberman M, Biochimica medica: Un approccio clinico, Casa Editrice Ambrosiana
Ferrier . D. LE BASI DELLA BIOCHIMICA, (Ed Zanichelli) volume unico pagine ISBN: 978880835400
Clinical biochemistry and molecular biology
Course syllabus
Principles and applications of the main genetic investigation techniques. Congenital metabolic diseases of the metabolism.
Teaching methods
The topics will all be covered by using power point presentation (PPT) and available on ARIEL web site of the course
Teaching Resources
Laboratory medicine - G Federici - Ed. McGraw-Hill
Clinical interpretation of laboratory tests - Ronald A. Sacher - Ed. McGraw-Hill
Clinical biochemistry
Course syllabus
General Clinical Biochemistry
Introduction, purpose, potential and limits of laboratory tests. Levels of laboratory intervention. Diagnostic test concepts and their purposes (screening, in-depth diagnostic, disease monitoring). Analytical profile concept. Examination of organ or apparatus function. Operation of a centralized Laboratory and Point-of-Care; organizational, technical and economic aspects.
The pre-analytic phase and its sources of variability. The preparation of the patient. Collection, treatment and storage of biological samples for diagnostic purposes: blood, urine and feces cephalorachidian fluid (liquor), fluids pouring into the serous cavities, synovial fluid, amniotic fluid, seminal fluid, gastric juice, sweat. Acceptability criteria for biological samples by the Analytical Laboratory. Post-analytical variability: Lab-report.
Analytical and biological variability. Types of errors. Reliability of a dosing method. Analytical variability and factors that influence it. . Biological variability and factors that influence it. Analytical goals. Overview of quality control.
The terms of comparison of biochemical-clinical data: reference intervals, desirable levels, decision levels and critical values, critical difference.
Diagnostic logic: sensitivity and clinical specificity predictive values, ROC curves
Clinical Biochemistry of Systems
Deepening of some topics of the teacher's choice (for example: Role of the laboratory in the diagnosis and surveillance of diabetes, in the diagnosis of liver diseases, in the diagnosis of jaundice, lipid structure, renal function, saliva, coagulative function, cardiac markers, plasma proteins, markers ... Principles and applications of the main techniques used in clinical biochemistry. Enzymes and other macromolecular markers of function and lesion. Diagnostic potential of plasma proteins. Evaluation of haemostatic functionality
Teaching methods
The topics will all be covered by using power point presentation (PPT) and available on ARIEL web site of the course
Teaching Resources
Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. 8th Edition- Nader Rifai-Ed. Elsevier
Biochimica Clinica e Medicina di Laboratorio -M. Ciaccio, G. Lippi-Ed. Edises
Trattato Italiano di Medicina di Laboratorio. Fondato da Angelo Burlina. Vol- VII Interpretazione degli Esami di Laboratorio, Panteghini -Ed. Piccin.
Medicina di laboratorio - G Federici - Ed. McGraw-Hill
Interpretazione clinica degli esami di laboratorio - Ronald A. Sacher - Ed. McGraw-Hill
BIO/10 - BIOCHEMISTRY - University credits: 6
Lessons: 60 hours
Clinical biochemistry
Lessons: 10 hours
Professor: Paroni Rita Clara
Clinical biochemistry and molecular biology
Lessons: 10 hours
Professor: Paroni Rita Clara
Educational website(s)
to be defined by email
Palazzo LITA, via Fratelli Cervi 93, Segrate