Clinical analyses are common in the professional practice of pharmacists. These analyses serve for screening, diagnosis, prognosis and monitoring of multiple health conditions and it is important for them to be able to perform and understand these analyses in order to explore and treat multiple health conditions.

Therefore, the general objectives for students in the Clinical Biochemistry class are the following:

1.- To know and to explain the biochemical changes that occur during pathological processes in relation to normal physiological states.

2.- To Know the procedures that are commonly used in the laboratory for the detection of biochemical changes, diagnosis and monitoring of pathological states that pharmacy graduates can find in their professional activity as well as the limitations of such procedures.

Prior knowledge of Biochemistry, Molecular Biology, Physiology, Physiopathology, Analytical Chemistry and Statistics is convenient.

Along the course, students will…

1.- Know how to treat and manipulate biological samples that are analyzed in Clinical Biochemistry laboratories.

2.- Appropriately apply analysis procedures, taking into account their analytical properties and their usefulness for detecting biochemical alterations in pathological situations.

3.- Know how to use the appropriate quality controls for the different components and stages that are part of the analytical processes.

4.- Assess the limitations of each analytical procedure, in order to choose the most appropriate one.

5.- Know how to define the reference values of the biochemical substances present in the biological fluids of apparently healthy populations.

6.- Know the possible causes that influence the deviations from reference values.

7.- Based on the results obtained with the analyses carried out on biological fluids, interpret the biochemical processes of various pathological states and their variations with respect to a situation considered physiologically normal,



LEARNING OUTCOMES

Students will correctly interpret and explain (both orally and in writing) the theoretical contents of the subject. They will be able to carry out the analyses indicated in the practical contents section both individually and in groups and will be able to search for information on the subject.

THEORETICAL CONTENT:

1. Introduction. Usefulness of biochemical tests in clinical medicine. Taking and handling

samples.

2.- Analysis of samples and results. Reference values. Interpretation of results. Quality control.

3.- Physiological electrolytes. Distribution and homeostasis of water, sodium and potassium. Gases in blood: oxygen and carbon dioxide.

4.- Acid-base balance. Buffering systems. Acid-base balance disorders.

5.- Plasma proteins. Immunoglobulins. Proteins in urine and other body fluids.

6.- Clinical enzymology. Isoenzymes. Enzymes with diagnostic utility.

7.- Tumor markers.

8.- Carbohydrates. Regulation of blood glucose. Diabetes mellitus. Hypoglycemia.

9.- Lipids. Lipoprotein metabolism. hyperlipoproteinemias.

10.- Amino acids. Excretion nitrogenous compounds: urea, ammonia and creatinine.

Amino acid derivatives. Purine metabolism: uric acid and gout.

11.- Heme metabolism. Bilirubin formation. Hyperbilirubinemia. Porphyrin biosynthesis. porphyrias.

12.- Iron metabolism and its alterations. Abnormal hemoglobins. Metabolism of erythrocyte

13.- Cardiac function. Cardiac markers.

14.- Liver function. Liver function tests.

15.- Gastrointestinal function. Exocrine pancreatic function. Malabsorption tests.

16.- Renal function. Kidney function tests.

17.- Mineral and bone metabolism. Regulatory hormones of calcium and phosphate homeostasis. Bone function tests.

18.- Hormones: mechanisms of hormonal action. Pituitary hormones and function.

19.- Thyroid hormones. Thyroid function. Thyroid function tests.

20.- Adrenal glands: cortical activity and its alterations. Endocrine function -reproductive: evaluation of gonadal alterations. Biochemical aspects of pregnancy.

Students will have lectures (35 hours), laboratory sessions (15 hours) and classroom practical sessions (10 hours)

• Continuous Assessment System
• Final Assessment System
• Tools and qualification percentages:
  • Written test to be taken (%): 30
  • Multiple-Choice Test (%): 40
  • Realization of Practical Work (exercises, cases or problems) (%): 15
  • Individual works (%): 5
  • Exhibition of works, readings ... (%): 10

Students with continuous or final evaluation system have to pass a final test, which consists of two parts

1.1) Theoretical part of the subject. It will be a multiple-choice test with 40 questions with a single answer out of five possible ones. Score: 1 point for each correct answer; 0.25 negative points for each incorrect answer; 0 points for each blank answer. Students can obtain a maximum of 40 points.

1.2) Technical and practical part of the subject. It will consist of 6 questions with short answer sub-questions. Each question will score a maximum of 5 points. Student can obtain a maximum of 30 points.

In all cases, students must obtain a minimum of 35 points out of 70 in the final test to pass the class. Of these, it is essential to obtain at least 20 points in the multiple choice test of the theoretical part and 15 points in the questions related to the technical and practical part. Students who do not pass the test in one call must take the full test (both parts, multiple choice and short answer questions) in the next call even if they have passed one of the two parts.

To renounce an evaluation call, it will be sufficient not to take the final exam.

2.- Continuous evaluation.

In addition to the final test, students with continuous evaluation have to ….

2.1.) Solve theoretical-practical exercises in class with the help of their class notes. Maximum score: 15 points.

2.2.) Develop brief written works related to the topics of the subject, which will later be presented orally. Maximum score: 10 points.

2.3.) Assessment of active participation in the classroom and in the laboratory. Maximum score: 5 points.

Students who obtain the minimum score required in the final test will obtain the final grade for the subject by adding the points obtained in the final test to in the continuous evaluation score. A minimum toal of 50 points is required in order to pass the class

The results obtained in the continuous evaluation may be taken into account for the two calls of the same academic year.

Laboratory experience is essential in order to pass the class. That is why there are laboratory sessions. Students who do not carry out these practical sessions will have to demonstrate their experience by completing a practical test in the laboratory.



3.- Final evaluation.

Students have the right to invoke the final evaluation system. Interested students must inform the professor within the first nine weeks of the semester and all of the final score depends on the final test.

In any case, they will have the same obligations as the rest of the students with respect to laboratory sessions. Therefore, students who do not carry out the practical sessions will have to demonstrate their experience by completing a practical test in the laboratory.

Same as the ordinary call (see previous box).

Basic bibliography

“Tietz. Fundamentals of Clinical Chemistry”, C. A. Burtis & E. R. Ashwood, 8th ed. Saunders, 2019.

“Clinical Chemistry”, W. J. Marshall, M. Lapsley & A. Day, 9th ed. Elsevier, 2020.

“Clinical Biochemistry”, W. J. Marshall & S. K. Bangert, 7th ed. Mosby, 2012.

"Clinical Biochemistry and Molecular Pathology", A. González, 3rd ed. Elsevier, 2019

“Clinical biochemistry and molecular pathology”, X. Fuentes Arderiu-eta., 2. ed. I reversed, 1998.

“Clinical biochemistry”, J.M. Gonzalez de Buitrago-eta. McGraw-Hill Inter-American, 1998.

“Clinical Biochemistry”, A. Gaw et al., 5th ed. Elsevier, 2015.

“The clinic and the laboratory”, J.M. Prieto Valtueña-eta, 23. edition. 2019

“Medical Biochemistry”, J. W. Baynes and M. H. Dominiczak, 4th ed. Elsevier, 2015.

“Molecular Pathology”, J. M. González de Buitrago-eta. McGraw-Hill Inter-American, 2001.

“Clinical Chemistry. Theory, Analysis, Correlation”, L.A. Kaplan, A. J. Pesce eta S.C. Kazmierczak, 4th ed. Mosby, 2003.

In-depth bibliography

1.- "Química clínica. Principios, procedimientos y correlaciones", M. L. Bishop y cols., 5ª ed. McGraw-Hill Interamericana, 2007.
2.- "Tietz. Fundamentals of Clinical Chemistry", C. A. Burtis & E. R. Ashwood, 5ª ed. Saunders, 2001.
3.- "Clinical Chemistry", W. J. Marshall & S. K. Bangert, 5ª ed. Mosby, 2004.
4.- "Bioquímica médica", J. W. Baynes y M. H. Dominiczak, 2ª ed. Elsevier, 2006.
5.- "Patología Molecular", J. M. González de Buitrago y cols. McGraw-Hill Interamericana, 2001.

Journals

1.- Clinical Chemistry
2.- Clinica Chimica Acta
3.- Clinical Biochemistry
4.- Annals of Clinical Biochemistry

Web addresses

http://www.seqc.es
http://www.sciencedirect.com
http://www.clinchem.org
http://www.aacc.org
http://www.efcclm.org/