Today is 19 and on 22 at 9:30am I had biochemistry and nutrition final exam of bsc nursing 2nd sem I want to score good becoz I’m dep in my fon practical that’s why I can’t sit in fon exam although I’m regular for fon exam now only this and health informatics can pass me
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BSc nursing 2nd semester biochemistry nutrition syllabus important topics India university exam
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Here is your complete 3-day crash revision guide for BSc Nursing 2nd Sem - Biochemistry & Nutrition (exam July 22, 9:30 AM).
BSc Nursing 2nd Sem - Biochemistry & Nutrition
3-Day Exam Crash Guide
Sources: Lippincott Illustrated Biochemistry 8e, Basic Medical Biochemistry 6e, Harper's Biochemistry 32e, Robbins Pathology
STUDY PLAN
| Day | Focus |
|---|---|
| Today (Sat) | Carbohydrates + Lipids (metabolism) |
| Sunday | Proteins + Vitamins + Minerals |
| Monday | Nutrition topics + Diseases + Quick revision |
| Tue 9:30 AM | EXAM |
PART A: BIOCHEMISTRY
1. CARBOHYDRATES
Classification (must know)
- Monosaccharides - glucose, fructose, galactose
- Disaccharides - sucrose (glucose + fructose), lactose (glucose + galactose), maltose (glucose + glucose)
- Polysaccharides - starch (dietary), glycogen (storage), cellulose (fiber)
Caloric value: 4 kcal/gram
RDA: 50-60% of total energy intake
Glycolysis (Glucose breakdown)
- Occurs in cytoplasm
- Glucose (6C) → 2 Pyruvate (3C)
- Net ATP yield: 2 ATP (anaerobic) / more in aerobic
- Under anaerobic conditions → pyruvate → lactate (lactic acid, e.g. in intense exercise)
- Key enzyme: Phosphofructokinase (PFK) - rate-limiting step
TCA Cycle (Krebs Cycle)
- Occurs in mitochondria
- Acetyl CoA enters the cycle
- Produces: NADH, FADH2, GTP, CO2
- Each glucose yields: ~38 ATP total (aerobic respiration)
- TCA cycle intermediates: Citrate → Isocitrate → Alpha-ketoglutarate → Succinyl CoA → Succinate → Fumarate → Malate → Oxaloacetate
Blood Glucose Regulation - KEY EXAM TOPIC
| Hormone | Source | Action |
|---|---|---|
| Insulin | Beta cells of pancreas | Lowers blood glucose - promotes glucose uptake, glycogen synthesis |
| Glucagon | Alpha cells of pancreas | Raises blood glucose - promotes glycogenolysis and gluconeogenesis |
| Cortisol | Adrenal cortex | Raises blood glucose |
| Epinephrine | Adrenal medulla | Raises blood glucose (fight/flight) |
Normal fasting blood glucose: 70-100 mg/dL
Diabetes Mellitus: Fasting glucose >126 mg/dL (repeated)
Glycogen Metabolism
- Glycogenesis = glucose → glycogen (storage) - promoted by insulin
- Glycogenolysis = glycogen → glucose (release) - promoted by glucagon/epinephrine
- Main storage sites: Liver (for blood glucose control) and Muscle (for local use)
2. LIPID METABOLISM
Classification
- Simple lipids: Triglycerides (fats and oils)
- Compound lipids: Phospholipids, glycolipids, lipoproteins
- Derived lipids: Cholesterol, steroids, fat-soluble vitamins (A, D, E, K)
Caloric value: 9 kcal/gram
Beta-Oxidation (Fatty Acid Breakdown)
- Occurs in mitochondria
- Fatty acids → Acetyl CoA (enters TCA cycle)
- Long-chain fatty acids need carnitine to cross mitochondrial membrane
Ketone Bodies
- Produced in liver from excess Acetyl CoA (when carbs are limited - fasting/starvation/DM)
- Types: Acetoacetate, Beta-hydroxybutyrate, Acetone
- Used as fuel by brain and muscle during fasting
- Ketoacidosis = dangerous accumulation of ketone bodies (seen in Type 1 DM)
Lipoproteins (very important for exam)
| Lipoprotein | Function |
|---|---|
| Chylomicrons | Carry dietary fat from intestine to tissues |
| VLDL | Carry endogenous triglycerides from liver |
| LDL | "Bad cholesterol" - delivers cholesterol to tissues |
| HDL | "Good cholesterol" - removes cholesterol from tissues |
Cholesterol
- Precursor of: bile salts, steroid hormones, Vitamin D
- Synthesized in liver
- Carried in blood by lipoproteins
3. PROTEIN METABOLISM
Classification of Proteins
- Essential amino acids (cannot be made by body, must come from diet): 9 total - His, Ile, Leu, Lys, Met, Phe, Thr, Trp, Val - mnemonic: "PVT TIM HaLL"
- Non-essential: body can synthesize them
Caloric value: 4 kcal/gram
RDA: ~0.8 g/kg body weight/day (adult); higher in pregnancy, growth, illness
Nitrogen Balance
- Positive N balance: Nitrogen intake > output (growing children, pregnancy, recovery)
- Negative N balance: Nitrogen intake < output (starvation, severe illness, burns)
- Equilibrium: Healthy adults
Transamination & Deamination
- Transamination: Transfer of amino group to a keto acid - key enzyme is ALT/AST (transaminases) - elevated in liver disease
- Deamination: Removal of amino group → releases ammonia (NH3)
- Ammonia is toxic → converted to urea in the liver (Urea Cycle) → excreted in urine
4. ENZYMES - KEY CONCEPTS
- Enzyme: Biological catalyst, protein in nature
- Factors affecting enzyme activity: Temperature, pH, substrate concentration, inhibitors
- Coenzymes: Non-protein organic molecules (many vitamins are coenzyme precursors - B vitamins!)
- Isoenzymes (isozymes): Different forms of same enzyme
- LDH-1 → elevated in heart attack (MI)
- AST/ALT → elevated in liver disease
- ALP → elevated in bone/liver disease
- CPK-MB → specific for myocardial infarction
5. ACID-BASE BALANCE
- Normal blood pH: 7.35-7.45 (slightly alkaline)
- Acidosis: pH < 7.35 | Alkalosis: pH > 7.45
- Buffer systems: Bicarbonate (main), Phosphate, Protein
- Respiratory acidosis: CO2 retention (pneumonia, COPD)
- Metabolic acidosis: Diabetic ketoacidosis, renal failure, diarrhea
- Respiratory alkalosis: Hyperventilation (anxiety, high altitude)
- Metabolic alkalosis: Vomiting (lose HCl), diuretics
PART B: VITAMINS & MINERALS
VITAMIN TABLE (Most Important for Exam)
Fat-Soluble Vitamins (A, D, E, K) - stored in body, can cause toxicity
(Source: Robbins & Kumar Basic Pathology)
| Vitamin | Key Function | Deficiency Disease/Sign |
|---|---|---|
| A (Retinol) | Vision (rhodopsin), epithelium integrity, immunity | Night blindness, xerophthalmia, blindness, squamous metaplasia |
| D (Calciferol) | Calcium & phosphorus absorption, bone mineralization | Rickets (children), Osteomalacia (adults) |
| E (Tocopherol) | Antioxidant - scavenges free radicals | Spinocerebellar degeneration, hemolytic anemia in premature infants |
| K (Phylloquinone) | Clotting factors II, VII, IX, X (liver carboxylation) | Bleeding disorder (prolonged PT) |
Water-Soluble Vitamins (B complex + C) - not stored, daily requirement
(Source: Robbins & Kumar Basic Pathology)
| Vitamin | Key Function | Deficiency Disease/Sign |
|---|---|---|
| B1 (Thiamine) | Coenzyme in decarboxylation (pyruvate) | Beriberi (wet = cardiac; dry = peripheral neuropathy), Wernicke-Korsakoff syndrome |
| B2 (Riboflavin) | Coenzyme FMN & FAD in redox reactions | Cheilosis (cracked lips), glossitis, stomatitis, dermatitis, corneal vascularization |
| B3 (Niacin) | Part of NAD and NADP | Pellagra - "3 Ds": Dermatitis, Diarrhea, Dementia (+ Death = 4th D) |
| B6 (Pyridoxine) | Coenzyme in amino acid metabolism | Cheilosis, glossitis, dermatitis, peripheral neuropathy |
| B9 (Folate) | DNA synthesis, one-carbon transfer | Megaloblastic anemia, neural tube defects (spina bifida) |
| B12 (Cobalamin) | Folate metabolism, DNA synthesis, myelin | Pernicious anemia (megaloblastic) + subacute combined degeneration of spinal cord; needs intrinsic factor for absorption |
| C (Ascorbic acid) | Antioxidant, collagen synthesis (hydroxylation) | Scurvy (bleeding gums, perifollicular hemorrhages, poor wound healing) |
MINERALS TABLE
| Mineral | Function | Deficiency |
|---|---|---|
| Calcium | Bone/teeth, nerve conduction, muscle contraction, clotting | Hypocalcemia - tetany, osteoporosis |
| Iron | Hemoglobin, myoglobin, cytochromes | Iron deficiency anemia (microcytic hypochromic) |
| Iodine | Thyroid hormones (T3, T4) | Goiter, Cretinism (in children) |
| Zinc | Enzyme cofactor (oxidases), wound healing, immunity | Poor wound healing, growth retardation, hypogonadism, dermatitis |
| Fluoride | Tooth enamel hardening | Dental caries |
| Phosphorus | Bone, ATP, DNA/RNA | Hypophosphatemia (rare) |
| Magnesium | Enzyme cofactor, nerve/muscle function | Hypomagnesemia - tetany, arrhythmia |
PART C: NUTRITION
Energy & BMR
- BMR (Basal Metabolic Rate): Energy needed at rest to maintain vital functions
- Factors affecting BMR: Age (decreases with age), sex (males higher), body surface area, thyroid hormones, fever (increases), pregnancy
- Caloric value: Carbohydrates = 4 kcal/g | Proteins = 4 kcal/g | Fats = 9 kcal/g | Alcohol = 7 kcal/g
Balanced Diet - RDA Summary
| Nutrient | Adult RDA |
|---|---|
| Carbohydrates | 55-60% of energy |
| Proteins | 0.8 g/kg/day (adult); 1.2-1.5 in pregnancy/illness |
| Fats | 20-30% of energy |
| Fibre | 25-30 g/day |
| Calories (woman) | ~2000 kcal/day |
| Calories (man) | ~2500 kcal/day |
Special needs: Increased in pregnancy, lactation, growth, fever, burns
Nutritional Deficiency Diseases (India - very likely exam topic)
| Disease | Cause | Population | Signs |
|---|---|---|---|
| PEM (Protein-Energy Malnutrition) | Protein + calorie deficit | Children | Marasmus (starvation, wasting) or Kwashiorkor (protein deficient - edema, fatty liver, moon face) |
| Anemia | Iron/folate/B12 deficiency | Women, children | Fatigue, pallor |
| Rickets | Vitamin D + Ca deficiency | Children | Bow legs, craniotabes |
| Night blindness | Vitamin A deficiency | Children | Poor vision in dim light |
| Goiter | Iodine deficiency | Hilly areas | Enlarged thyroid |
| Scurvy | Vitamin C deficiency | Any age | Bleeding gums |
| Pellagra | Niacin deficiency | Poor diet/maize eaters | 3 Ds |
| Beriberi | B1 (Thiamine) deficiency | Rice-eaters | Nerve/heart problems |
Therapeutic Diets (Diets in Disease)
| Condition | Diet Modification |
|---|---|
| Diabetes | Low simple carbohydrates, high fibre, regular meals |
| Hypertension | Low sodium (DASH diet) |
| Renal failure | Low protein, low potassium, low phosphorus, fluid restriction |
| Liver disease (cirrhosis) | Low protein (if encephalopathy), no alcohol |
| Obesity | Calorie-restricted diet |
| Cardiac disease | Low fat, low sodium, low cholesterol |
| Pre/post surgery | High protein (for wound healing), easily digestible |
| Fever | High calorie, high protein, easily digestible, extra fluids |
Nutritional Programs in India (likely short-answer/MCQ)
- ICDS (Integrated Child Development Services) - supplementary nutrition to children < 6 yrs and pregnant/lactating mothers
- Mid-Day Meal Scheme - school children
- NHM - Iron + Folic Acid tablets for pregnant women
- POSHAN Abhiyaan (National Nutrition Mission) - reduce stunting, wasting, anemia
- Vitamin A prophylaxis program - children 9 months to 5 years
- Universal Iodization of Salt
Food Preservation & Safety
- Methods: Refrigeration, freezing, canning, drying/dehydration, pickling, pasteurization, irradiation
- Pasteurization: Heating milk to 72°C for 15 sec (HTST) to kill pathogens
- PFA Act (Prevention of Food Adulteration Act) - replaced by FSSAI (Food Safety and Standards Authority of India)
- Common adulterants: Starch in milk, metanil yellow in spices, urea in milk, chalk in flour
Nutritional Assessment Methods (ABCD)
- A - Anthropometric: Weight, height, BMI, MUAC (mid-upper arm circumference), skin fold thickness
- B - Biochemical: Serum albumin, hemoglobin, serum iron, Vitamin levels
- C - Clinical: Signs of deficiency (pallor, edema, hair changes, skin lesions)
- D - Dietary: 24-hour recall, food frequency questionnaire, diet history
BMI classification:
- Underweight: < 18.5
- Normal: 18.5-24.9
- Overweight: 25-29.9
- Obese: ≥ 30
QUICK FLASHCARD REVISION
Q: What is the rate-limiting enzyme of glycolysis?
A: Phosphofructokinase (PFK)
Q: Where does beta-oxidation occur?
A: Mitochondria
Q: What vitamin deficiency causes Pellagra?
A: Niacin (B3) - "3 Ds: Dermatitis, Diarrhea, Dementia"
Q: What deficiency causes Scurvy?
A: Vitamin C - bleeding gums, poor collagen synthesis
Q: Which vitamin is needed for blood clotting?
A: Vitamin K - required for factors II, VII, IX, X
Q: Rickets is caused by deficiency of?
A: Vitamin D (+ Calcium / Phosphorus)
Q: Normal fasting blood glucose?
A: 70-100 mg/dL
Q: Insulin is secreted by?
A: Beta cells of islets of Langerhans, pancreas
Q: What is Kwashiorkor?
A: Protein deficiency in children - edema, ascites, moon face, hair changes, fatty liver
Q: What is Marasmus?
A: Protein + calorie starvation - severe wasting, no edema
Q: Caloric values?
A: Carbs = 4 kcal/g | Proteins = 4 kcal/g | Fats = 9 kcal/g
Q: BMR is affected by which hormone the most?
A: Thyroid hormones (T3/T4)
Q: What is positive nitrogen balance?
A: N intake > N output; seen in growth, pregnancy, anabolism
Q: What is the role of Vitamin B12?
A: DNA synthesis, myelin maintenance; needs intrinsic factor from stomach for absorption
Q: Difference between water-soluble and fat-soluble vitamins?
A: Fat-soluble (A, D, E, K) = stored in body, can cause toxicity, not needed daily. Water-soluble (B, C) = not stored, needed daily, excess excreted in urine.
Q: What enzyme is elevated in MI (heart attack)?
A: CK-MB (most specific), also LDH-1, Troponin
Q: What is intrinsic factor?
A: Secreted by parietal cells of stomach; required for Vitamin B12 absorption; absent in pernicious anemia
TOP LIKELY EXAM QUESTIONS (Long Answer)
- Describe the metabolism of carbohydrates and its clinical significance in diabetes.
- Explain the classification and functions of lipids. Describe beta-oxidation.
- Explain the role of insulin and glucagon in blood glucose regulation.
- Classify vitamins with their functions, sources, and deficiency diseases.
- Describe PEM (Protein Energy Malnutrition) - types, signs, management.
- What is BMR? List factors affecting it.
- Explain nutritional assessment - ABCD methods.
- Describe the national nutritional programs in India.
- Explain balanced diet for a pregnant woman / school-age child.
- What is acid-base balance? Describe types of acidosis and alkalosis with causes.
- Explain the role of nurse in nutritional assessment and education.
- Describe therapeutic diets in diabetes mellitus / renal failure.
Good luck on the 22nd! Focus your last-day (Monday) revision on vitamins, nutritional deficiency diseases, and national programs - these are the most frequently asked short-answer and MCQ topics in nursing exams. The metabolism sections (glycolysis, TCA, beta-oxidation) are common for 5-10 mark questions. Cover them in that order and you will be well-prepared.
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