IN T R O D U C T IO N
Often, the medical student will cringe at the “drudgery” of the basic science
courses and see little connection between a field such as biochemistry and clin-
ical problems. Clinicians, however, often wish they knew more about the basic
sciences, because it is through the science that we can begin to understand the
complexities of the human body and thus have rational methods of diagnosis
and treatment.
Mastering the knowledge in a discipline such as biochemistry is a formidable
task. It is even more difficult to retain this information and to recall it when the
clinical setting is encountered. To accomplish this synthesis, biochemistry is
optimally taught in the context of medical situations, and this is reinforced later
during the clinical rotations. The gulf between the basic sciences and the patient
arena is wide. Perhaps one way to bridge this gulf is with carefully constructed
clinical cases that ask basic science-oriented questions. In an attempt to achieve
this goal, we have designed a collection of patient cases to teach biochemistry
related points. More importantly, the explanations for these cases emphasize the
underlying mechanisms and relate the clinical setting to the basic science data.
We explore the principles rather than emphasize rote memorization.
This book is organized for versatility: to allow the student “in a rush” to go
quickly through the scenarios and check the corresponding answers and to
provide more detailed information for the student who wants thought-provoking
explanations. The answers are arranged from simple to complex: a summary
of the pertinent points, the bare answers, a clinical correlation, an approach to
the biochemistry topic, a comprehension test at the end to reinforcement or
emphasis, and a list of references for further reading. The clinical cases are
arranged by system to better reflect the organization within the basic science.
Finally, to encourage thinking about mechanisms and relationships, we inten-
tionally did not primarily use a multiple-choice format. Nevertheless, several
multiple-choice questions are included at the end of each scenario to reinforce
concepts or introduce related topics.
H O W TO G E T T H E M O ST O U T O F T H IS B O O K
Each case is designed to introduce a clinically related issue and includes open-
ended questions usually asking a basic science question, but at times, to break
up the monotony, there will be a clinical question. The answers are organized
into four different parts:
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