AIMS AND LEARNING OUTCOMES

The aim of the clinical biochemistry part of the course is to allow the student to acquire basic knowledge on the clinical-diagnostic significance of some of the laboratory tests of the so-called “clinical chemistry profile”.

In particular, the student will acquire knowledge regarding the "normal range" of the clinical chemistry values described during the course and how these values can be modified in the tissue and organ diseases exemplified in the lessons. Moreover, the student should be able to apply this knowledge to develop simple diagnostic reasoning, starting from the results of the clinical chemistry parameters described during the course.

TEACHING METHODS

Plenary lessons (provided on the Teams platform) will provide information on the normal values of the basic parameters of the "clinical chemistry profile" and on the dynamic range of some of these values under conditions of tissue or organ disease. Simple clinical cases will be discussed to allow students to understand the role of laboratory medicine in the clinical reasoning underlying a diagnostic process.

SYLLABUS/CONTENT

Haemoglobin: normal values and pathogenetic definition of anemia, blood count parameters, haemoglobinopathies and thalassemias; laboratory indicators of iron metabolism, serum protein electrophoresis and diagnostic significance.

Lipoproteins: classification, function, normal lipidemic values, cardiovascular risk stratification principles, classification of hyperlipoproteinemias; effect of insulin, glucagon, and extra-pancreatic hormones on circulating lipoprotein levels.

Non-protein nitrogen compounds in serum (urea, amino acids, uric acid, creatinine, ammonia): normal concentration, main causes of increase; creatinine as an indicator of glomerular filtration, estimation and calculation of GFR.

Spectrophotometry principles applied to assays of enzymes and metabolites

B12 metabolism and folates: causes of deficit (pernicious anemia and alcoholism) and laboratory diagnosis.

Monoclonal antibodies: generation strategy, main biomedical applications.

Diabetes mellitus: classification, pathogenetic mechanisms, laboratory diagnostic criteria, incretins, ketogenesis in T1D, metabolic acidosis and respiratory compensation (haemogas-analysis), blood glucose, ketonuria and glycosuria tests; biochemical mechanisms of diabetic micro- and macroangiopathy.

Main methods of hormone assay: ELISA, RIA, chemi-luminescence methods.

Markers of hepatocellular function: functional and enzymatic heterogeneity of hepatocytes; localization and function of enzymes of clinical interest in hepatocytes, entity of increase in serum in different liver diseases, laboratory indicators of chronic alcoholism, indicators of cholestasis.

The laboratory in the study of striated muscle function: indicators of myocellular necrosis, skeletal and cardiac muscle as endocrine organs.

Indicators of nutritional status.

The laboratory in the study of respiratory function: haemogas analysis

Main metabolic changes in cancer cells: oncometabolites.

RECOMMENDED READING/BIBLIOGRAPHY

on-line available slides and Biochemistry with clinical aspects, Devlin, Edises