CLINICAL CHEMISTRY
🔹 Key Terms
Chemistry: Study of substances.
Biochemistry: Chemistry in living things.
Clinical Chemistry: Tests body fluids to diagnose diseases.
🔹 Purpose
Diagnose diabetes, kidney failure, liver problems by testing
blood, urine, etc.
🔹 Samples Used
Blood, serum, plasma, CSF, ascitic fluid, pleural fluid.
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🍞 CARBOHYDRATE METABOLISM
🔹 Definitions
Carbohydrates: Energy-rich molecules (sugars).
Metabolism = All body chemical reactions.
Anabolism = Build up.
Catabolism = Break down.
🔹 Main Pathways
1. Glycolysis: Glucose → Pyruvate + ATP (in cytoplasm,
anaerobic).
2. Krebs Cycle: Pyruvate → CO₂ + NADH/FADH₂ + ATP (in
mitochondria).
3. Glycogenesis: Glucose → Glycogen (storage).
4. Glycogenolysis: Glycogen → Glucose.
5. PPP/HMP Shunt: Makes NADPH & Ribose for DNA.
🔹 Energy Summary
1 glucose = 38 ATP (2 from glycolysis, 2 from Krebs, 34 from
ETC).
🔹 Blood Glucose
Insulin lowers sugar.
Glucagon raises it.
Fasting glucose: 70–99 mg/dL.
Diabetes = >126 mg/dL fasting.
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🧈 LIPID METABOLISM
🔹 What Are Lipids?
Fats that store energy, build membranes, make hormones.
🔹 Important Lipids
Cholesterol: Makes hormones and bile.
Fatty acids: Saturated (bad), unsaturated (good).
Triglycerides: 3 fatty acids + glycerol = energy store.
Sphingolipids: Found in nerves.
🔹 Metabolism
Lipogenesis: Makes fat from glucose.
β-oxidation: Fat → ATP.
Ketone bodies: Made when fat is burned too much (e.g.,
diabetes, starvation).
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💉 LIPOPROTEINS
🔹 Types
Type Function Notes
Chylomicrons Carry fat from food Apo B-48
VLDL Carry liver-made fat Apo B-100
LDL Bad cholesterol Causes atherosclerosis
HDL Good cholesterol Removes cholesterol
🔹 Normal Lipid Levels
Total cholesterol < 200 mg/dL
LDL < 100
HDL > 40 (men), > 50 (women)
Triglycerides < 150
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🍗 PROTEINS
🔹 Protein Structure
Primary: AA chain
Secondary: Helices/sheets
Tertiary: Folded shape
Quaternary: Many chains together (e.g., hemoglobin)
🔹 Functions
Enzymes, hormones, immune defense, transport (e.g.,
hemoglobin), osmotic balance (albumin).
🔹 Important Plasma Proteins
Albumin: Most abundant, keeps fluid in blood.
Transferrin: Carries iron.
Ferritin: Stores iron.
Ceruloplasmin: Carries copper.
🔹 Disorders
Low protein (Hypoproteinemia): Due to liver disease,
malnutrition.
High protein (Hyperproteinemia): Seen in cancer,
inflammation.
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🔄 PROTEIN METABOLISM
🔹 Digestion & Absorption
Stomach: Pepsin starts breakdown.
Intestine: Trypsin, chymotrypsin continue it.
Absorbed in small intestine → liver.
🔹 Amino Acid Breakdown
Deamination: Removes nitrogen.
Transamination: Switches amino group (AST, ALT).
Urea Cycle: Converts toxic ammonia → safe urea (excreted
in urine).
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🍊 VITAMINS
🔹 Fat-Soluble (A, D, E, K)
Vitamin Function Deficiency
A Vision Night blindness
D Calcium, bones Rickets
E Antioxidant Nerve issues
K Blood clotting Bleeding problems
🔹 Water-Soluble (B, C)
Vitamin Function Deficiency
B1 (Thiamine) Energy Beriberi
B2 (Riboflavin) Energy Mouth sores
B3 (Niacin) NAD/NADP Pellagra
B6 (Pyridoxine) Brain, RBCs Anemia
B9 (Folate) DNA Neural tube defects
B12 Blood, nerves Anemia, nerve damage
C Collagen, immunity Scurvy
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💧 NON-PROTEIN NITROGEN (NPN) COMPOUNDS
Compound Source Clinical Use
Urea From ammonia Kidney function
Creatinine From muscle Best kidney marker
Uric Acid From purines Gout, kidney stones
Ammonia From protein breakdown Liver disease, urea
cycle defect
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🎯 HIGH-YIELD FACTS TO REMEMBER
Steps + enzymes of glycolysis and Krebs cycle.
Urea cycle: Enzymes & steps.
LDL = bad, HDL = good.
Albumin = osmotic pressure regulator.
Insulin vs. Glucagon roles in blood sugar.
Normal lab values: glucose, lipids, proteins, etc.
Deficiency diseases linked to vitamins (e.g., scurvy, rickets,
pellagra).
