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Study Guide6 min read2026-02-14

Biochemistry & Clinical Pathology: Key Topics

Glycolysis, Krebs, lipoproteins, LFTs, CBC normal ranges — the clinical correlations that score well in Year 2.

Biochemistry & Clinical Pathology (ER20-23T) bridges basic science and clinical pharmacy practice.

Biochemistry — Important Topics

1. Carbohydrate Metabolism

Glycolysis (Glucose → Pyruvate)

  • Cytoplasm
  • 10-step pathway
  • Net 2 ATP
  • Key enzymes: Hexokinase, Phosphofructokinase, Pyruvate kinase

Krebs Cycle (TCA)

  • Mitochondria
  • 2 ATP + NADH + FADH2
  • Intermediates: Citrate, Isocitrate, α-Ketoglutarate, Succinate

Diabetes Mellitus

  • Type 1: insulin deficiency
  • Type 2: insulin resistance
  • Lab markers: fasting glucose, HbA1c, OGTT

2. Protein Metabolism

  • Transamination
  • Deamination
  • Urea cycle (liver)

Liver Function Tests:

  • ALT (SGPT) — liver damage
  • AST (SGOT) — liver and muscle
  • ALP — biliary obstruction
  • Bilirubin — jaundice

3. Lipid Metabolism

  • LDL — "bad" cholesterol (atherosclerosis)
  • HDL — "good" cholesterol (cardioprotective)
  • VLDL — triglyceride transport
  • Ketone bodies — formed from excess fat metabolism (diabetic ketoacidosis marker)

Clinical Pathology — Lab Tests

Hematology

TestNormal RangeSignificance
HemoglobinM: 13–17 g/dL, F: 12–16 g/dLAnaemia
WBC count4,000 – 11,000 / μLInfection / immunity
Platelets1.5 – 4.5 lakh / μLBleeding disorders
ESRM: 0–15, F: 0–20 mm/hrInflammation

Biochemistry

TestNormalIndicates
Fasting blood glucose70 – 100 mg/dLDiabetes if >126
HbA1c<5.7%Diabetes control
Serum creatinine0.6 – 1.2 mg/dLKidney function
Serum urea (BUN)7 – 20 mg/dLKidney function
Total cholesterol<200 mg/dLCardiovascular risk

Exam Tips

  1. Memorise normal values — MCQs love them
  2. Map which test indicates which disease
  3. Glycolysis & Krebs with key enzymes
  4. Clinical correlations score high

FAQ

Is biochemistry difficult?
Manageable if you focus on clinical correlations. Don't memorise every pathway — understand the logic.
What is HbA1c?
Glycated haemoglobin — reflects average blood glucose over the past 2 – 3 months.
What does elevated ALT indicate?
Liver damage (hepatitis, drug toxicity). More specific than AST.
Normal fasting blood glucose?
70 – 100 mg/dL. Pre-diabetic 100 – 125. Diabetic >126 on two tests.
LDL vs HDL?
LDL carries cholesterol to tissues (bad). HDL removes cholesterol from tissues (good).

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