- Introduction
Definition of Physiological Chemistry. Its usefulness in diagnosis. Overview of Nurse-Physician and Nurse-Laboratory interaction. Review of analytical methods and units of measurement. Reasons for testing. Screening. Profiles. Normal and reference values. Introduction to statistics.
Section I - At the end of this section, the student should be able to:
1. Understand the relationships between biochemistry, clinical chemistry and physiology.
2. Appreciate the processes physicians use to arrive at diagnosis.
3. Understand what role a nurse plays in their professional relationships with physicians and the laboratory.
4. Understand how statistics is used to interpret test results as "normal" or "abnormal".
- Water and Electrolyte Balance
Water balance. Measurement of body fluids. Osmotic Pressure. Disorders of water imbalance. Electrolyte depletion and excess. Methods of measurement.
Section II - At the end of this section, the student should be able to:
1. Understand the role of water and electrolytes in the maintenance of health.
2. Understand the condition which may lead to the "imbalance" of these bodily constituents.
3. Understand the conditions arising as a result of their imbalance.
- Acid-Base Regulation
Buffer systems and maintenance of normal blood pH. Acidosis and alkalosis. Blood gases. Methods of measurement.
Section III - At the end of this section, the student should be able to:
1. Understand the concept of pH, strong and weak acids and electrolytes.
2. Understand the composition and function of buffer systems.
3. Understand the nature of buffers controlling the pH of blood.
4. Understand how cells exchange oxygen and carbon dioxide.
5. Understand the conditions leading to disturbances of pH.
6. Understand the procedures to correct such disturbances.
- Enzymes
Nature and mode of action. Nomenclature and classification. Coenzymes. Diseases of enzyme defect. Isoenzymes. Special reference to cardiac, liver and digestive enzymes.
Section IV - At the end of this section, the student should be able to:
1. Understand the need for transformation of foods and metabolites, and relationships between such conversions and energy.
2. Understand the role of enzymes and coenzymes in such transformations.
3. Understand the reversible nature of enzymatic processes.
4. Understand how electrophorsis works.
5. Understand what are isoenzymes.
6. Understand the evaluation of liver-, cardiac-, renal and other bodily functions by utilizing enzyme testing.
- Carbohydrates
Classification. Main metabolic pathways. Digestion and absorption. Metabolic dysfunction and disease. Diabetes mellitus. Diabetic acidosis and ketosis. Laboratory methodologies and interpretation of fasting and post-prandial glucose, glucose tolerance, insulin, amylase, D-xylose absorption, glycosylated hemoglobin, etc.
Section V - At the end of this section, the student should be able to:
1. Know the classification, structure and functions of common carbohydrates.
2. Understand how carbohydrates are used by the body to produce energy.
3. Appreciate the nature of biochemical cycles and pathways.
4. Understand how defects of metabolism lead to conditions and diseases.
5. Know tests for diagnosis of diabetes mellitus.
6. Know the various consequences of uncontrolled diabetes.
7. Know principles of dietary and pharmaceutical interventions in control of diabetes.
- Lipids
Nomenclature. Main metabolic pathways. Digestion and absorption. Ketosis. Laboratory methodologies and interpretation of triglycerides, phospholipids, cholesterol, lipase, carotenoids, etc.
Section VI - At the end of this section, the student should be able to:
1. Understand classification, structures and functions of fatty acids, triglycerides and other lipids.
2. Understand the process of digestion and absorption of lipids, and their various metabolic pathways.
3. Understand factors leading to conditions such as ketosis and acidosis.
4. Understand why risk factors, such as hyperlipidimia, hypercholesterolemia, obesity, etc., should be controlled by modification of life styles and/or pharmacotherapy.
- Proteins, Immunochemistry & Genetic Code.
Amino acids. Structures and properties of proteins, metabolism of proteins. Plasma and erythrocyte proteins. Urea, creatine, creatinine, uric acid. Serum protein-, hemoglobin-, lipoprotein- and immunoelectrophoresis.
Chemical basis of heredity; DNA, RNA and genes.
Section VII - At the end of this section, the student should be able to:
1. Understand structures and functions of some dietary proteins.
2. Understand how proteins are digested and amino acids absorbed.
3. Appreciate metabolic pathways of amino acids, formation of nitrogenous excretary products, and protein biosynthesis.
4. Understand basics of immunochemistry.
5. Understand the structures of nucleic acids and their role in protein biosynthesis and heredity.
- Hormones
Hormonal balance. Assays for hypothalamic, pituitary, thyroid, adrenal, gonadotropic hormones. Estrogens, epinephrine, growth hormone. Pregnancy.
Section VIII - At the end of this section, the student should be able to:
1. Understand basics of endocrinology including: endocrine glands and their secretions, the hormonal action and feedback systems.
2. Understand the basics of endocrine diseases, such as diabetes mellitus, hyper- and hypothyroidism.
3. Understand principles of laboratory testing for diagnosis of hormonal imbalance.
- Liver Function
Role in metabolism and detoxification. Bile, Bilirubin, Liver enzymes, Hepatitis testing.
Section IX - At the end of this section, the student should be able to:
1. Understand how the liver converts normal metabolic products as well as foreign substances (e.g. drugs) into forms that can be excreted.
2. Appreciate methods for assaying levels of hepatic enzymes, and their utilization in evaluating liver functions.
3. Understand the nature of bile, bilirubin and waste products.
4. Understand the effects of drugs and toxins on hepatic parenchyma.
5. Know factors responsible for common diseases related to liver such as, hepatitis and jaundice.
- Renal Functions
Role in acid-base and electrolyte regulation. Creatinine clearance, osmolality, phenolsulfonthalein clearance. Urinalysis.
Section X - At the end of this section, the student should be able to:
1. Understand renal function in the balance and imbalance of acid-base and electrolytes.
2. Understand the nature of renal excretary products, and their measurement in the assessment of kidney function.
- Vitamins and Minerals
Role in metabolism. Hypo- and hypervitaminosis, Assays for Vitamin A, B12 and folic acid, Vitamin K.
Section XI - At the end of this section, the student should be able to:
1. Understand the nature of vitamins, and conditions related to hyper - and hypo - vitaminosis.
2. Understand the need for essential minerals and conditions related to lack of these minerals (e.g. goiter).
- Therapeutic Drug Monitoring
Principles. Testing for antibiotics, anticonvulsants, antiarrhythmic, antiepileptic antiasthmatic drugs, and antibiotics.
Section XII - At the end of this section, the student should be able to:
1. Understand the principles of drug absorption, distribution,
metabolism and excretion.
2. Understand the balance between ineffective, therapeutic and toxic levels of drugs in blood, and the need to monitor these.
3. Understand commonly prescribed drugs for various conditions and their therapeutic levels.
- Toxicology
Common household and industrial poisons. Drug abuse testing.
Section XIII - At the end of this section, the student should be able to:
1. Understand common household and industrial chemicals and their toxicities.
2. Know guidelines for emergency collection of specimens and testing for toxic agents.
3. Know the principles of detoxification.
4. Know methods of drug-abuse testing.
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