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SYLLABUS

FOR STUDENTS OF THE DENTISTRY FACULTY

Name of the Course: Biochemistry Code of the course: F.02.O.019; F.03.O.024 The type of course: Compulsory discipline The total number of hours – 102 hours

Including: lectures – 34 hours, practical classes – 68 hours Number of credit-tests provided for the course: 5 (3+2) Teaching staff: Tagadiuc Olga, MD, PhD, assoc. prof., head of the Department Rîvneac Elena, PhD, associate prof. Gavriliuc Ludmila, MD, PhD, prof. Bobcova Svetlana, PhD., associate prof. Simionică Eugen, PhD, lecturer

Chişinău 2014

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I. The purpose of the Biochemistry discipline:

structure of chemical compounds of the living matter; of the fundamental metabolic

processes, which ensure the functioning of living organisms; of diseases caused by metabolic disturbances;

methods of laboratory diagnostics. Development of the abilities of analysis and evaluation of the results of laboratory tests;

peculiarities of the composition and metabolism of the stomatognat system in physiological conditions and in major stomatological diseases.

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 major chemical compounds

of medical interest; - to know the fundamental metabolic processes that ensure the functioning and

reproduction of human organism; - to study the specific features of the structure and metabolism of the organs and organ

systems in physiological conditions and in some major inherited and acquired diseases; - to understand the mechanisms of the neuro-endocrine regulation of the metabolism that

maintain the normal functioning of the organism; - to describe the influence of different factors (vitamins, drugs, poisons etc.) on the major

metabolic processes; - to know physiological constants of the major biochemical tests and variations of these

constants in healthy persons; - to know the diagnostical value of the biochemical tests; - to learn the peculiarities of the composition and metabolism of the stomatognat system in

physiological conditions and in major stomatological diseases. b) at the level of application: - to perform diagnostical biochemical tests; - to perform the collection of saliva for biochemical testing; - to learn the technique of usage of main laboratory devices (simple and self-filling transfer

pipette, pH-meter, spectrophotometer, centrifuge etc.); - to evaluate the utility of certain biochemical test in the diagnostics of some major

diseases; - to understand and evaluate the biochemical tests results. c) at the level of integration: - to realize the importance of Biochemistry for medicine, in general, and stomatology,

particularly, - to understand the ways of Biochemistry integration with other fundamental, clinical and

stomatological medical-biological sciences; - to understand the interconnections and interdependence between structural, general and

clinical Biochemistry;

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- to evaluate the dynamic of the metabolic processes in physiological conditions and their

disturbances that lead to pathology; - to demonstrate the mechanisms of regulation of metabolic processes in normal and

pathologic conditions; - to use the knowledge to understand causes of metabolic and functional disorders and

mechanisms of recovering; - promote scientific ideas for biochemical research and support them with data from

scientific literature.

III. Conditioning and preliminary requirements:

Biochemistry is the medical-biological science that provides future doctors with fundamental knowledge about molecular mechanisms of metabolic and physiologic processes, biochemical mechanisms of regulation of vital functions, which will help them to understand the causes and pathogenesis of inherited and acquired diseases, to reason the necessity of the biochemical testing, to assess the results of the biochemical tests and to correlate them with the clinical data and the results of other paraclinical investigations, to chose a correct diet and life style and prescribe treatments adjusted to the molecular mechanism of the disease development.

For better results in studying Biochemistry is necessary solid knowledge in the such subjects as Biology, Chemistry, Molecular biology, Genetics, Anatomy, Histology, Physiology and others sciences.

IV. Basic contents of the course:

A. Theoretical classes: Ist semester № Subject Hours 1. Structure of the proteins. Structure-function relationships in proteins.

Classification of proteins. Protein's properties: molecular mass, thermolability and solubility. Methods of purification and analysis of proteins. Specific features of collagen structure.

2

2. Enzymes - biological role, structure, mechanism of catalysis, classification and nomenclature. Vitamins as coenzymes. Kinetics of the enzymatic reactions. ′ Specificity of enzyme. Regulation of enzymes activity. Isoenzymes. Saliva’s enzymes.

2

3. Importance of nucleic acids. Structural characteristic of DNA and RNA. Replication of DNA. Biosynthesis of RNA. Protein synthesis. The genetic code.

2

4. Metabolism. Anabolism and catabolism. Final common pathway of metabolism. Bioenergetics. High-energy phosphate compounds. ATP-cycle. The energy status of the cell. Oxidative Decarboxylation of pyruvate. Tricarboxylic acid cycle (Krebs).

2

5. Mitochondrial electron transport chain and oxidative phosphorylation. Coupling of phosphorylation to respiration (chemiosmotic hypothesis P. Mitchell). Microsomal oxidation chain.

2

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6. Carbohydrates: classification, digestion and absorption. Metabolism of

glycogen. Glucose metabolism: glycolysis (anaerobic and aerobic) and gluconeogenesis.

2

7. Pentozophosphate cycle. Galactose and fructose metabolism. Regulation of carbohydrate. Diseases associated with the disturbances carbohydrate metabolism. Role of carbohydrates in stomatological diseases.

2

8. Classification, biological role of lipids. Digestions, absorption and transport of lipids. Lipolysis of triacilglycerols. Fatty acid oxidation. Ketone body metabolism.

2

9. Biosynthesis of lipids. Cholesterol metabolism. Regulation of lipid metabolism. 2 IInd semester № Subject Hours 1. Protein turnover. Amino acid pool inputs and outputs. Nitrogen balance.

Protein digestion and absorption. Amino acid decarboxylation. Transamination. Deamination. Ammonia detoxification. The fate of the carbon skeletons.

2

2. Individual metabolism of amino acids. Metabolism of nucleoproteins and hemoproteins.

2

3. Hormones. Definition. Mechanisms of action. Regulation of hormones biosynthesis and release. Regulatory interrelations between hypothalamus, pituitary gland and peripheral endocrine glands. Parathyroid hormone and calcitonin – structure, biosynthesis and release, action on target tissues.

2

4. Blood composition. Plasma chemical composition. Biochemical mechanisms of oxygen and CO2 transport, acid-base equilibrium, fluid-coagulation equilibrium.

2

5. Connective tissue – chemical composition, metabolism, regulation, disturbances in different diseases.

2

6. Bone - chemical composition, metabolism. Bone remodeling mechanism. Disturbances of bone remodeling. Osteoporosis.

2

7. Mineralized teeth layers – composition, structural organization, metabolism. Mechanism of caries development.

2

8. Composition and metabolism of periodontium. Saliva – functions, chemical composition, properties, assay.

2

B Practical classes: Ist semester № Subject Hours 1. Introductory conversation. Role of biochemistry in medicine and stomatology.

Amino acids. Fisher's polypeptide theory. 2

2. Structure of the proteins. Levels of protein organization. Structure-function relationships in proteins (hemoglobin, collagen, Ca++- binding proteins).

2

3. Properties of proteins: molecular mass, thermolability and solubility. Protein solutions. The purification and analysis of proteins.

2

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4. Enzyme kinetics. General properties of enzymes – thermolability, specificity.

Regulation of enzymes activity. Isoenzymes. 2

5. Test: Chemical structure and properties of proteins and enzymes. 6. Biological role of nucleic acids. Structure of DNA and RNA. Replication of

DNA. Repair of DNA. Incomplete replication of DNA, telomeres and telomerases.

2

7. RNA biosynthesis – transcription. Specific features of RNAm, RNAr and RNAt processing. Regulation of transcription.

2

8. The genetic code. Protein synthesis. Peculiarities of collagen biosynthesis. 2 9. Test: Structure and biosynthesis of nucleic acids. 2 10. Metabolism. Anabolism and catabolism. Final common pathway of

metabolism. Bioenergetics. High-energy phosphate compounds. ATP cycle. Oxidativ decarboxylation of pyruvate. The tricarboxylic acid cycle (Krebs).

2

11. Electron transport chain and oxidative phosphorylation. Coupling of phosphorilation to respiration (chemiosmotic hypothesis of P. Mitchell). Microsomal oxidation chain. Free radical oxidation.

2

12. Test: Bioenergetics. 13. Carbohydrates: biological role, classification, structure, digestion and

absorption. Starch metabolism. 2

14. Glucose metabolism: glycolysis (anaerobic and aerobic) and Gluconeogenesis.

2

15. Pentozophosphate cycle. Galactose and fructose metabolism. 2 16. Regulation of carbohydrate metabolism. Diseases associated with

carbohydrate metabolism disorders. Role of carbohydrates in teeth diseases. 2

17. Test: Carbohydrates metabolism. 2 IInd semester: № Subject Hours 1. Lipids: biological role, classification, structure, properties. Digestions of

lipids, absorption and transport. Catabolism of triacilglycerols. Fatty acid oxidation. Ketone body metabolism.

2

2. Biosynthesis of fatty acids, triglycerides and phosphoglycerides. 2 3. Cholesterol metabolism. Regulation of lipid metabolism. Diseases associated

with lipid metabolism. 2

4. Test: Metabolism of lipids. 2 5. Protein turnover. Amino acid pool inputs and outputs. Nitrogen balance.

Protein digestion and absorption. Amino acid decarboxylation. 2

6. Amino acid degradation. Removal of nitrogen-transamination, deamination. Ammonia detoxification. The fate of the carbon skeletons.

2

7. Individual metabolism of amino acids. 2 8. Metabolism of nucleoproteins. Metabolism of hemoproteins. Diseases

associated with nucleo- and hemoprotein proteins metabolism. Integration of carbohydrate, lipid and protein metabolism.

2

9. Test: Metabolism of simple and conjugated proteins 2 10. Hormones. Mechanisms of action. Intracellular messengers – cAMP, DAG, 2

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IP, Ca2+. Regulation of hormones biosynthesis and release. Hypothalamic and pituitary hormones – representatives, structure, biosynthesis and releases, influence on target gland and metabolism. Regulatory interrelations between hypothalamus, pituitary gland and peripheral endocrine glands.

11. Thyroid, parathyroid, pancreatic hormones, catecholamines and steroid hormones – representatives, structure, biosynthesis and release, action on target tissues.

2

12. Blood composition. Plasma chemical composition. Plasma proteins, enzymes and biological active peptides. Plasma non-proteic nitrogen compounds. Plasma carbohydrates, lipids and organic acids. Plasma mineral compounds.

2

13. Biochemical mechanisms of oxygen and CO2 transport, acid-base equilibrium, blood fluidity maintenance.

2

14. Test: Hormones. Biochemistry of the blood. 15. Convective tissue and bone – composition, metabolism, structural

organization. 2

16. Mineralized teeth layers – composition, structural organization, metabolism. Mechanism of caries development. Periodontium. Saliva.

2

17. Biochemistry of the dental tissues 2

V. Recommended bibliography: A. compulsory:

1. Nelson D.L., Cox M.M. Lehninger Principles of Biochemistry. Sixth Edition. 2012. 2. Bhagavan N.V., Ha Chung-Eun. Essentials of Medical Biochemistry: With Clinical Cases.

Academic Press; 1st edition, 2011. 3. Campbell P.N. Smith A.D. Biochemistry illustrated. International edition, 2000 4. Murray R.K., Granner D.K., Mayer P.A., Rodwell V.W. Harper’s illustrated

Biochemistry. 26-th international edition, 2003 5. Mardashko O.O., Yasinenko N.Ye. Biochemistry. Texts of lectures. Odessa, 2003. 418 p.

Accesibile în sala de lectura a bibliotecii USMF. 6. Champe Pamela C., Harvey Richard A. Biochemistry. Lippincott’s Illustrated Reviews. 6. Rivneac Elena. Biochemistry. Lectures for students of stomatological department. http://biochimie.usmf.md/index-4.html

B. Supplementary:

1. Lehninger A.L. Principles of Biochemistry The Johns Hopkins University School of Medicine, Worth Publishers Inc., 2007.

2. Metzler D.E. Biochemistry. The chemical reactions of living cells. Second edition, vol.1-2. Academic Press, 2003

3. Marshall W.J. Clinical Chemistry. 4th edition, Mosby press, UK, London, 2000 4. Stryer L. Biochemistry. Freeman and Company, San-Francisco, USA, 2000.

VI. The methods of teaching and learning used:

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Biochemistry is a compulsory subject and it 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. 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. 2: Nucleic acids. Test no. 3: General metabolism. Carbohydrate metabolism. Semester I: Test no. 4: Lipid metabolism. Test no. 5: Simple and combined protein metabolism. Test no. 6: Hormones. Blood. Test no. 7: Biochemistry of connective tissue, bone and dental tissues.

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The test consist 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 30 minutes to do it. A computerized test consists of 30 questions of each version (simple choice and multiple choice). Students are given 30 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 choice and 60 - multiple choice. The students have 2 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 30 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 3 components: the annual average mark (coefficient 0.5), oral test (coefficient 0.3) and multiple-choice test (coefficient 0.2).

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 9,6-10 10

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: English

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