৪৮তম বিশেষ বিসিএস [স্বাস্থ্য] ⎯ মেডিকেল অংশ [Archived]

Colloids:
          1.size 1-100 nm
          2.Can not pass through semipermeable membrane
          3.osmotically Less active
          4.Forms Heterogenous solution
          5.Glycogen , starch, protein (All are hydrophilic except unconjugated bilirubin)

       Crystalloids :
           1.size < 1nm
           2.Can pass through semipermeable membrane
           3.Osmotically very active
           4. Forms Homogenous solution
           5.Glucose , amino acid , electrolyte, minerals

source : abc of medical biochemistry page 17

ISOTOPE :

Same atomic number (proton) but different atomic weight
(neutron + proton)

Radioactive isotopes :

Carbon – 14

Cobalt- 60

Iodine - 131

Technetium – 99

Chromium - 51

source : abc of medical biochemistry page 28

All monosaccharides, maltose and lactose are reducing sugar

Monosaccharide : glucose, fructose, galactose, mannose , ribose, ribulose

Disaccharide : Maltose , Lactose , Sucrose 

Oligosaccharide :Maltotriose, raffinose , blood group substance

Polysaccharide : Starch, glycogen, cellulose,


source : abc of medical biochemistry page 50

Mucopolysaccharide : (GAG)

1.Hyaluronic acid = Synovial fluid +connective tissue

2.Keratan sulfate = Cornea

3.Heparan sulfate = Basement membrane + cell surface

4. Chondroitin sulfate B : Blood vessel + skin

5. Chondroitin sulfate A, C : cartilage, bone, tendon

source : abc of medical biochemistry page 54

source : abc of medical biochemistry page 64

Lactate dehydrogenase:

1.LDH1 + LDH 2 = RBC, heart

2.LDH 3+ LDH 4 = liver, lung, kidney

3.LDH 5 = skeletal muscle

source : abc of medical biochemistry page 119

Components of bile : ( a digestive juice without enzyme )

1. Bile salt

2. Bile pigment ( bilirubin )

3. Cholesterol ester

4. Phospholipid ( lecithin)





source : abc of medical biochemistry page 139

1.Stimulate gastric juice secretion: gastrin

2.inhibit gastric juice secretion:
somatostatin, secretin, CCK, VIP, GIP

3. Stimulate pancreatic juice secretion:
secretin, CCK, VIP

4.Stimulate insulin secretion:
secretin, CCK, gastrin, GIP, GLP

5. Somatostatin inhibit pancreatic juice and insulin secretion

source : abc of medical biochemistry page 142

Metabolic pathways in mitochondria: ( All other pathways have involvement in cytoplasm )
1. TCA cycle

2. Beta oxidation of fatty acid

3. Respiratory chain

4. Ketogenesis and ketone body oxidation

5. Oxidative deamination

6.oxidation of pyruvate to acetyl Co a

7. carboxylation of pyruvate to oxaloacetic acid

8. oxidation of alcohol

9. steroid hormone synthesis
source : abc of medical biochemistry page 276

source : abc of medical biochemistry page 267

Fate of glucose after absorption:

1. oxidation through glycolysis and HMP shunt

2. storage as glycogen in liver and skeletal muscle

3. synthesis of fatty acid

4. conversion to non-essential amino acid

5. synthesis of structural materials

source : abc of medical biochemistry page 174

UREA CYCLE : 

Energy needed : 04 high energy phosphate provided by  03 ATP 
( 1 ATP provide 2 high energy phosphate and convert to AMP , other 02 ATP provide one high energy phosphate each )


source : abc of medical biochemistry page 210

primary bile acid:
 cholic acid, Chenodeoxycholic acid

secondary bile acid:
deoxycholic acid, lithocholic acid

types of bile salt : 

1.Na⁺ glyco-cholate
2.Na⁺ tauro-cholate
3.K⁺ glyco-cholate
4.K⁺ tauro-cholate

abc of medical biochemistry page 238

abc of medical biochemistry page 245

Macro minerals: (daily requirement >100mg) e.g. sodium, potassium, calcium, magnesium, chloride, sulphur , phosphorus.

Micro minerals (trace elements): (< 100mg daily) e.g. Iodine, zinc, iron, copper, manganese, cobalt, chromium, selenium, fluoride, molybodenum

Iodine, molybodenum and selenium are ultra trace element (RDA <1.0 mg)




abc of medical biochemistry page 494

abc of medical biochemistry page 497

Vitamin A deficiency :
1.Night blindness:  earliest symptom

2.Xerophthalmia: bitot spot, keratinization of cornea

3.keratomalacia: Softening, ulceration, fibrosis and scarring of cornea

4.Vulnerable  to infection

5.Growth retardation and impotency

6.Toad skin

Hypervitaminosis A:
1. Dry and pruritic skin

2. Hepatomegaly and cirrhosis of liver

3.Raised intracranial pressure

4. Teratogenesis

5. Osteoporosis

abc of medical biochemistry page 510

Riboflavin (B2):
 Glossitis, angular stomatitis,  cheilosis, Seborrheic dermatitis

 Niacin (B3): 
 pellagra (diarrhea + dermatitis+ dementia)

Pantothenic acid (B5): peripheral  neuropathy

Pyridoxine (B6): peripheral  neuropathy

Biotin (B7): Dermatitis + glossitis + alopecia+ paresthesia

Folic acid (B9): megaloblastic anemia
neural tube defect in fetus during pregnancy: spina bifida, anencephaly, encephalocele

abc of medical biochemistry page 519

Cobalamin (B12) deficiency :

1.Megaloblastic anemia

2.Subacute combined degeneration of spinal cord

3.Dementia & optic atrophy

4.Peripheral neuropathy & autonomic neuropathy

5. Hyperhomocystinemia

abc of medical biochemistry page 523

ADH is the only hormone for regulation of water balance . Renin also plays a role but via ADH secretion.


abc of medical biochemistry page 346

Hyponatremia :

1.Hypovolemic hyponatremia: ( sodium loss with relatively smaller water loss)

diuresis, vomiting, diarrhea, burn, sweating, salt losing nephropathy 

2. Hypervolemic hyponatremia: ( water retention with relatively smaller sodium retention)

congestive cardiac failure, nephrotic syndrome,  liver cirrhosis, protein losing enteropathy

3. Euvolemic hyponatremia: ( water retention alone)

SIADH, psychogenic polydipsia, hypothyroidism


abc of medical biochemistry page 363

Calcium Homeostasis : 

Three hormone:

1. Vitamin D (calcitriol)= Bone and intestine: hypercalcemia & hyperphosphatemia

2. PTH (bone and kidney): hypercalcemia & hypophosphatemia

3. Calcitonin (bone and kidney): protect against hypercalcemia by reducing serum calcium


abc of medical biochemistry page 372

abc of medical biochemistry page 384

Respiratory acidosis: 

1.gain of CO2
2. pH is Low
3. HCO₃  is Normal/High
4. pCO₂  is high
5. Renal (HCO3  generation) compensation
6. Anion gap is Normal
7. Base excess is positive , ( to compensate respiratory acidosis, HCO₃^- is increased. this extra amount of HCO₃^-  causes positive base excess)
8. cause : asthma, COPD,  respiratory depression

BE = Actual HCO3 – standard HCO3
Positive base excess :
1. Metabolic alkalosis
2. Respiratory acidosis

Negative base excess: 
1. Metabolic acidosis
2. Respiratory alkalosis

abc of medical biochemistry page 411,  page 392

Important causes of metabolic alkalosis are : 
1. vomiting
2. nasogastric suction
3. diuretic abuse
4. hypokalemia
5. hypochloremia
6. hyperaldosteronism

causes of hyperchloremic metabolic acidosis :

1. diarrhea, intestinal fistula, pancreatic fistula , biliary fistula, ileostomy, colostomy
2. hypoaldosteronism
3. K ⁺ sparing diuretic abuse
4. renal tubular acidosis

causes of normochloremic metabolic acidosis: 
lactic acidosis, ketoacidosis , renal failure

remember : diarrhea = acidosis
                   chloride losing diarrhoe = alkalosis

diuretic abuse = alkalosis
K + sparing diuretic abuse = acidosis

abc of medical biochemistry page 409, 410

causes of hyperchloremic metabolic acidosis ( normal anion gap ) :

1. diarrhea, intestinal fistula, pancreatic fistula , biliary fistula, ileostomy, colostomy
2. hypoaldosteronism
3. K + sparing diuretic abuse
4. renal tubular acidosis

causes of normochloremic metabolic acidosis( increased anion gap ): 
lactic acidosis, ketoacidosis , renal failure


abc of medical biochemistry page 409

Liver function test :
Test for synthetic function:
1.Serum albumin (3-4 g/dl)
2.Albumin globulin ratio (2:1)
3.Serum total protein (6-8 g/dl)
4.Prothrombin time (12-14 sec)

Test for Cholestasis: ALP, gamma-GT

Test for hepatocellular damage: ALT, AST, gamma-GT

Taste for excretory function: Serum bilirubin

Test for metabolic function: Galactose tolerance test


abc of medical biochemistry page 576

abc of medical biochemistry page 580

abc of medical biochemistry page 590

abc of medical biochemistry page 599

Chemical classification of hormone:

1. Protein (>100 AA): GH, Prolactin, Human Placental Lactogen

2. Polypeptide (10 – 100 AA): CRH, GHRH, GHIH, ACTH, PTH, MSH, insulin, Glucagon, calcitonin

3. Glycoprotein : FSH, LH, TSH, hCG

4.Peptide (2 –10 AA): TRH, GnRH, ADH, Oxytocin,

5.Amino acid derivatives: T3, T4, catecholamine, dopamine

6. Steroid (from cholesterol): androgen, estrogen, progesterone, cortisol, aldosterone, calcitriol


abc of medical biochemistry page 527

abc of medical biochemistry page 546

abc of medical biochemistry page 561

abc of medical biochemistry page 422

Cell cycle :

S phase (DNA synthetic phase)

G2 phase (Premitotic phase)

M phase (mitotic phase): nuclear division

G1 phase (Presynthetic phase)

abc of medical biochemistry page 436

Replication = DNA polymerase

Transcription = RNA polymerase

abc of medical biochemistry page 445

Codons are categorized into two groups :


1. Sense Codon: 61 sense codon

2. Nonsense codon (stop codon): 03 = UAA, UAG, UGA


abc of medical biochemistry page 440

In CML, reciprocal translocation occurs between chromosome 9 and chromosome 22; which is a type of chromosomal mutation


Cystic fibrosis = frameshift mutation

DOWN Syndrome = Genomic mutation ( as chromosome NUMBER is altered )

Fragile X syndrome = trineucleotide repeat expansion disorder


abc of medical biochemistry page 456, 457, 458

BLOTS:

Southern blot = DNA

Northern blot = RNA

Western blot = protein

abc of medical biochemistry page 473