Medicine and Surgery "B" - Roma Azienda Policlinico Umberto I

ALESSIO PAONE
ALESSIO PAONE
EUGENIO LENDARO
EUGENIO LENDARO

Understanding the chemical-physical foundations of biological phenomena
Demonstrate a solid understanding of the fundamental principles of chemistry, including concepts of atomic structure, chemical bonding, and properties of molecules.
Explain key biochemical principles such as the structure and function of biomolecules and molecular interactions.
Cognitive Skills

Analyze and interpret experimental data in the fields of chemistry and biochemistry by applying theoretical concepts learned during the course.
Integrate chemical and biochemical knowledge to understand drug mechanisms of action and the molecular basis of diseases.
Practical Skills and Professionalism

Apply acquired knowledge to interpret laboratory data, formulate hypotheses, and draw valid conclusions.
Communicate learned content and concepts clearly and accurately, both verbally and graphically, using appropriate scientific terminology.
Transversal Skills

Work collaboratively in groups to solve problems.
Demonstrate adaptability and autonomous learning skills, continuing to develop their competencies in the fields of chemistry and biochemistry, even after obtaining a degree in Medicine.

General Course Objectives
To provide the basis for understanding the fundamental laws governing matter and its transformations, with particular attention to biological phenomena at the atomic and molecular level, in relation to biomedical applications.
Specific Course Objectives
Knowledge and understanding
At the end of the course, students will be able to: - describe the structure and transformations of matter and interpret the molecular phenomena found in living organisms, with particular regard to acid-base equilibria, physiological buffers, gas laws and solubility in heterogeneous equilibria, osmotic phenomena and the properties of solutions and redox reactions - recognise the main classes of organic compounds and the different functional groups, describing their chemical-physical properties and reactivity, also in relation to the functions of biological macromolecules - recognise the different classes of molecules of biological interest, describing their structures and indicating their functions.
Ability to apply knowledge and understanding
At the end of the course, students will be able to:
- recognise the types of chemical bonds and perform simple reaction balancing - perform simple but fundamental calculations on solution concentrations and osmolarity;
- apply the knowledge acquired in thermodynamics to chemical-physical transformation processes of biomedical interest;
- apply the knowledge acquired to the processes that govern respiration, the maintenance of osmotic balance, and the acid-base equilibria of biological fluids;
- write and recognise the formulas and chemical bonds of the main organic compounds of biological interest;
- apply knowledge of the mechanisms of organic compound reactions to understand biochemical reactions and predict the reactivity of biomolecules based on their functional groups.
Independent judgement
At the end of the course, students will be able to:
1. critically evaluate information
2. form informed opinions
3. make independent decisions
Communication skills:
At the end of the course, students will be able to:
1. express their information and knowledge clearly and effectively
Learning skills
At the end of the course, students will be able to:
1. learn independently and continuously
2. update their skills and knowledge.
3. make independent decisions
Communication skills:
At the end of the course, students will be able to:
1. express their information and knowledge clearly and effectively
Learning skills
At the end of the course, students will be able to:
1. learn independently and continuously
2. update their skills and knowledge.

Knowledge of mathematics, physics, chemistry and biology is required, in line with the curriculum promoted by educational institutions that organise educational and teaching activities consistent with the national guidelines for secondary schools and the guidelines for technical and vocational institutes.

Teaching unit 1. The structure of the atom, the periodic table of elements and chemical bonds
(teaching commitment assessed in CFU =0.5)
Describe and interpret:
- The constitution of matter. Fundamentals of atomic theory. Structure of the atomic nucleus,
neutrons and protons. Atomic number and mass number. Atomic mass. Isotopes.
- Overview of the magnetic properties of the nucleus as the basis for the diagnostic tool of Nuclear Magnetic Resonance. - Elements and compounds: mole and molecule. Quantum numbers, orbitals, Pauli's exclusion principle and Heisenberg's uncertainty principle. Hund's rule. The electronic configuration
of elements.
- Radioisotopes and radioactivity. Radioactive decay (α, β, positron, gamma, X radiation): units of measurement also with respect to biological toxicity, correlations of interest for biomedical applications.
- The periodic table of elements. Periodic properties: outer electron configuration, atomic volume, ionisation potential, electron affinity, electronegativity. Chemical elements of biological relevance. The octet rule.
- Concept of molecules and polyatomic ions. Molecular mass.
- Chemical bonding. Bonding orbitals. Covalent bonding: homopolar, heteropolar, dative. Delocalised electron bonding. Ionic bonding. Orbital hybridisation: sp, sp2, sp3. VSEPR theory. Sigma and pi-greek molecular orbitals. Bond angle.
- Nomenclature and structure of the main inorganic compounds of biomedical interest. Examples of the structure of binary and ternary chemical compounds, writing and recognition of structural formulas (oxides, acids, bases, salts). IUPAC and traditional nomenclature. Weak interactions (hydrogen bonding and van der Waals forces) and hydrophobic interactions.
Teaching unit 2. States of matter and principles of thermodynamics (teaching commitment assessed in CFU = 0.5)
Describe and interpret:
- The solid state: ionic, molecular, covalent and metallic solids. - The gaseous state. Absolute temperature. Boyle's, Charles's and Gay Lussac's laws. Equation of state
of ideal gases. Real gases and the Van der Waals equation. Avogadro's law. The concept of the mole and Avogadro's number.
- Introduction to the kinetic theory of gases. Maxwell-Boltzmann law. - Gases and vapours. Gas-liquid equilibrium: vapour pressure.
- The liquid state: boiling, heat of evaporation. Phase diagrams: comparison between water and carbon dioxide. Surface tension. Relevance of changes of state in medicine: sweat evaporation and thermoregulation. Example of application of the gas law to respiration.
- Thermodynamic systems. The principles of thermodynamics. Definitions of state functions. Enthalpy. Exothermic and endothermic transformations (changes of state). Entropy. Gibbs free energy. Reversible and irreversible transformations (exoergic, endoergic). Free energy and chemical equilibrium.
Teaching unit 3. Mixtures and solutions and the colligative properties of solutions (teaching commitment assessed in CFU=1)
Describe and interpret:
- Types of mixtures: homogeneous and heterogeneous (dispersions, suspensions, colloids, aerosols).
- Types of solutions: gaseous solutions, liquid solutions, solid solutions.
- Solubility: water as a solvent. Water and ionic solutes, properties of electrolytes. Electrolytes in biological fluids. Water and molecular solutes. Solubility of gases in liquids: Henry's law. - Units of measurement for solution concentration: weight/weight, weight/volume, volume/volume percentages. Molarity, molar fraction. The concept of equivalent in the biomedical field.
- Concentration in gas mixtures: Dalton's law. Air and its composition, inhaled air and exhaled air. Examples of solutions relevant to biomedical aspects. - Definition of colligative properties. Interactions between solvent and solute. Raoult's law. Lowering of vapour pressure. Raising of boiling point. Lowering of freezing point.
- Electrolytic solutions and van't Hoff's correction factor. Types of membranes and solute passage: diffusion, osmosis and osmolarity. Comparison of the osmotic properties of solutions. - The osmolarity of intracellular and extracellular fluids. Isotonic, hypertonic and hypotonic solutions.
Teaching unit 4. Overview of chemical reactions, cine ca and chemical equilibrium (teaching commitment assessed in CFU=0.5)
Describe and interpret:
- Definitions of chemical reactions.
- Conservation of mass, energy and electric charge. Reversibility. Types of chemical reactions. Neutralisation reactions. Precipitation reactions. Oxidation-reduction reactions. Balancing reactions.
- Definition of reaction kinetics. Multi-stage reactions. Factors influencing the speed of a reaction. Order of a reaction and molecularity. Arrhenius' law and the theory of effective collisions. Activation energy. Transition state theory. Catalysts: homogeneous and heterogeneous catalysts.
- Overview of biological catalysts: enzymes.
- Chemical equilibrium.
- Reversible and irreversible reactions. Equilibrium constant and law of mass action. Homogeneous and heterogeneous chemical equilibrium. Difference between chemical equilibrium and steady state. Principle of mobile equilibrium. The reaction quotient. Effect of temperature on the equilibrium constant. Multiple equilibria. Heterogeneous solid-liquid equilibria. Solubility product, effect of the common ion. Relevance of chemical equilibria in biological processes.
Teaching unit 5. Acids, bases, salts, pH, buffer solutions; oxidation-reduction reactions and electrochemistry (teaching commitment assessed in CFU= 1)
Describe and interpret:
- Arrhenius' theory. Bronsted and Lowry's theory. An overview of Lewis' theory. The autoprotolysis reaction of water. Kw. The concept of pH and pOH. Dissociation constants, Ka and Kb. Strong acids and weak acids, pKa and pKb. pH indicators. The pH of a strong acid/base or weak acid/base solution. Polyprotic acids and polyprotic bases. Relative strength of an acid and a base. Acid-base reactions. Relationship between chemical structure and acid strength. Salts,
acidic or basic behaviour of salts in water, hydrolysis constant. Solubility and pH, examples of biomedical interest: calcium oxalate and calcium phosphate. The topics will be covered with numerical examples to aid understanding of the phenomena described.
- Buffer solutions, examples of weak acid and weak base buffers. The Henderson-Hasselbalch equation. Efficiency of a buffer system. Acid-base equilibrium in biological fluids: the carbonic acid/bicarbonate buffer, the dihydrogen phosphate/hydrogen phosphate buffer, proteins as buffer systems. Blood pH and blood buffers. The importance and function of buffers in biomedicine.
- Oxidation numbers and redox reactions. Electrochemical systems. Definition of anode and cathode. Types of conductors.
- Half-cells. Standard redox potentials. The Nernst equation. Spontaneous reactions and chemical work: relationship between Gibbs free energy change and potential difference. The relationship between reduction potentials and equilibrium constant. Concentration cells.
- Importance of oxidation-reduction reactions in the biomedical field.
Teaching unit 6. Properties of carbon and reactivity of organic compounds, hydrocarbons, alkyl halides, aromatic hydrocarbons and derivatives (teaching commitment assessed in CFU = 0.5)
Describe and interpret:
- Properties and hybridisation of carbon. Functional groups. Representation of carbon compounds
- General rules of IUPAC nomenclature.
- Oxidations and reductions in organic chemistry. Types of organic reactions. Inductive effect: electron donor, electron acceptor. Delocalisation or mesomeric effect. - Bond breaking: homolytic and heterolytic. Carbocations and carboanions. Stability of carbocations. Nucleophiles and electrophiles. - Acidity and basicity of organic compounds. - Saturated and unsaturated hydrocarbons. - Alkanes and cycloalkanes: IUPAC nomenclature, chemical-physical properties and characteristic reactions. Bond tension in cycloalkanes. Reactions of alkanes: oxidation, radical substitution. - Alkenes: IUPAC nomenclature, chemical-physical properties and main reactions (electrophilic addition,
stability of carbocations). Electron delocalisation and conjugated dienes.
- Cyclic and heterocyclic hydrocarbons. Halogen derivatives of hydrocarbons. Reactions of alkyl halides: nucleophilic substitution with SN2 and SN1 mechanisms, elimination reactions with E1 and E2 mechanisms. - Benzene, aromatic compounds and Hückel's rule. - Nomenclature of aromatic hydrocarbons. Benzene derivatives. Benzene reactions: aromatic electrophilic substitution. Activating and deactivating effect of substituents.
- Toxicity of aromatic compounds.
Teaching unit 7. Functional groups and isomerism: alcohols, phenols, ethers, thiols and thioethers; aldehydes and ketones; carboxylic acids and derivatives, amines and amides (teaching commitment assessed in CFU= 1)
Describe and interpret:
- Chemical-physical properties and nomenclature. Reactions of alcohols: dehydration, oxidation, nucleophilic substitution. Alcohols of biomedical relevance: ethanol. Aromatic alcohols, phenol and derivatives; acidity of phenol. Ethers. Thiols and thioethers. Epoxides.
- Chemical-physical properties and nomenclature of aldehydes and ketones. Reactions of aldehydes and ketones: oxidation, reduction, nucleophilic addition reactions. Hemiacetals and hemiketals, acetals and ketals. - Properties of hydrogen in alpha to carbonyl. Keto-enolic tautomerism and its biological importance. - Aldol condensation reaction. Quinones and hydroquinones. An example of biomedical relevance: ubiquinone.
- Chemical-physical properties and nomenclature. Reactions of carboxylic acids: salification, acyl nucleophilic substitution.
- Carboxylic acid derivatives: acyl halides, anhydrides, esters and thioesters, amides, acyl phosphates. Fisher esterification. Basic and acid hydrolysis of esters. Claisen condensation. Reactions of carboxylic acids containing other functional groups: formation of lactones and decarboxylation of keto acids.
- Organic derivatives of phosphoric acid. The importance of acyl phosphates in biochemistry.
- Chemical-physical properties and nomenclature of amines. Basicity and reactions of amines: nucleophilicity of amines, alkylation. Nitrosamines. Quaternary ammonium: choline. Imines or Schiff bases. - Examples of biomedical importance: urea. - Hydrolysis reactions of amides. - Definition and types of isomerism: constitutional isomers and stereoisomers (conformational and configurational isomers).
- Specific optical rotation. Fischer convention and dextrorotatory/levorotatory convention.
- Diastereomers, epimers, anomers and mesocomposites. Racemic mixtures. Overview of priority rules. E/Z convention and R/S convention. - Significance of enantiomers, diastereoisomers and meso forms in biomedical sciences.
Teaching unit 8. Amino acids and proteins, carbohydrates, lipids, nucleus and polynucleus (teaching commitment assessed in CFU= 1)
Describe and interpret:
- Structure and nomenclature of amino acids, abbreviated names. Classification of amino acids based on the R group. Essential and non-essential amino acids. - Identification and characteristics of the side chains of protein amino acids. Stereochemistry of amino acids and representation according to Fischer's convention. - Acid-base properties of amino acids and isoelectric point.
- The peptide bond and its formation. Characteristics of the peptide bond. Structural levels of proteins: primary, secondary, tertiary and quaternary structure. Weak interactions and disulphide bridges.
- Structure, nomenclature and stereochemistry of carbohydrates. Monosaccharides: isomers, epimers,
anomers and tautomers. Aminosugars. Cyclisation of monosaccharides. Mutarotation. Reactions of monosaccharides: oxidation, reduction, Maillard reaction and Amadori products, condensation. The glycosidic bond. Disaccharides. Oligosaccharides and their derivatives. Polysaccharides: homopolysaccharides (starch, cellulose, glycogen) and heteropolysaccharides (glycosaminoglycans).
- Structure and nomenclature of fatty acids. Saturated and unsaturated fatty acids. Essential fatty acids. Unsaturation and physical and chemical properties. Triglycerides and their functions: oils and fats. Complex lipids: glycerophospholipids, sphingolipids, glycolipids. Cholesterol and steroid derivatives of biomedical interest.
- Nitrogenous bases: definition and structural characteristics of nucleosides and nucleotides. Nucleotides and polynucleotides. Chemical structure and biological importance of ATP and other free nucleotides. Phosphodiester bond.

FA Bettelheim et al; Chimica e Propedeutica biochimica, Edises.

T Bellini; Chimica Medica e Propedeutica Biochimica, Zanichelli.

L Binaglia & B Giardina; Chimica e Propedeutica Biochimica, McGrawHill.

KJ Denniston et al; Chimica Generale, Chimica Organica, Propedeutica Biochimica, McGrawHill.

- S. Marini et al; Chimica e Propedeutica Biochimica, Piccin.

https://elearning.uniroma1.it/course/view.php?id=19836

The lecturer delivers classroom teaching in the traditional manner, using audiovisual aids and scheduling lessons as indicated on the GOMP Classroom/Timetable System and published on the degree programme and faculty websites.

In accordance with the programme's teaching regulations, students are required to attend all teaching and professional development activities. Attendance is monitored by the University via a computerised system. Students must provide proof of attendance at compulsory teaching activities in order to sit the relevant examination.

The course assessment methods are governed by Ministerial Decree no. 418 of 30/05/2025.
Art. 5, paragraph 1 of Ministerial Decree 418 of 30/05/2025:
‘The examinations for the three courses referred to in Article 4 shall be held on the same date and at the same time in all universities offering the filter semester, even if this is in derogation from the prohibition on taking examinations on the same date provided for in the University's teaching regulations.’

Art. 5, paragraph 3 of Ministerial Decree 418 of 30/05/2025:
‘Each examination consists of thirty-one (31) questions, fifteen (15) of which are multiple choice and sixteen (16) of which are fill-in-the-blank, as provided for in Annex 2, which forms an integral part of this decree... A time limit of 45 minutes is assigned for each examination relating to each course.’

The learning outcomes will be defined according to the guidelines currently being developed by the Ministry of University and Research.