Part I: Processes of Mefabolism and Nurtition 1
Pretace 3
1.Overview of Metabolism 3
Useful definitions 3
Acknowledaements 5
Basic principles of bioenergelics 5
2.carbohydrate and Energy metabolism 7
Glycolysis and its regulation 7
Dedication 8
Central role of acetyl CoA 15
Tricarboxylic acid cycle (TCA Cycle) 18
Generation of ATP 24
Glycogen metabolism 28
Role of 2,3-bisphosphoglycerate 37
Fructose, galactose, ethanol, and sorbitol 39
3.Production of NADPH 45
Pentose phosphate pathway and the pyruvate-malate cycle 45
The roles of NADPH 48
Lipid biosynthesis 51
4.Lipid Metabolism 51
Lipid breakdown 60
Cholesterol metabolism 65
Transporl of Iipids 69
The ketone bodies 74
5.Protein Metabolism 77
Biosynthesis of the non-essential amino acids 77
Protein breakdown and the disposal of nitrogen 82
Gluconeogenesis and the metabolism of amino acids to glucose and fat 89
Amino acid metabolism in individual tissues 94
6.Purines,Pyrimidines, and Haem 99
One-carbon pool 99
Purine metabolism 101
Pyrimidine metabolism 107
Haem metabolism 112
7.Metabolic Integration 117
Glucose homeostasis 117
Basic principles of human nutrition 125
8.Nutrition 125
Energy balance 126
Protein nutrition 130
Vitamins 131
Minerals 141
Part II: Clinical Assessment 148
9.Taking a History 149
Thisngs to remember when taking a history 149
Common presenting complaints 151
General inspection 157
10.Examination of the Patient 157
Limbs 160
Head and neck 162
Thorax 164
The abdomen 166
11.Further Investigations 169
Routine investigations 169
Assessment of nutritional status 175
Part III: Basic Pathology 180
12.Important Metabolic Disorders 181
Disorders of glucose and energy metabolism 181
Disorders of Iipid metabolism 188
Disorders of amino acid metabolism 190
Disorders of purine pyrimidine metabolism 193
Disorders of haem metabolism 194
13.Important Nutritional Disorders 199
Disorders of protein nutrition and energy balance 199
The fat-soluble vitamins:deficiency and excess 202
The water-soluble vitamins: effects of deficiency 205
Disorders of mineral nutrition 210
Part IV: Self-assessment 218
Multipke-choice Questions 219
Short-answer Questions 224
Essay Questions 225
MCQ Answers 226
SAQ Answers 227
Index 232