| Grau de Medicina (2009) |
 Assignatures |
| MEDICINA DE LABORATORI |
| Continguts |
| DADES IDENTIFICATIVES | 2014_15 |
| Assignatura | MEDICINA DE LABORATORI | Codi | 14204229 | |||||
| Ensenyament |
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Cicle | 1r | |||||
| Descriptors | Crèd. | Tipus | Curs | Període | ||||
| 3 | Optativa | 2Q |
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| Competències | Resultats d'aprenentage | Continguts |
| Planificació | Metodologies | Atenció personalitzada |
| Avaluació | Fonts d'informació | Recomanacions |
| Tema | Subtema |
| Introduction to the reference intervals | How are reference values established? Inter-laboratory variations: Not all laboratories have the same analytical methods and not all populations are identical. What is normal and abnormal in a specific individual? When a laboratory test should be repeated? Multiple tests to reach the same conclusion? When to do it and when not. When two tests are positive for a disease, the conclusion is strengthened, but when not, the strength of the evidence weakens. To get the sample correctly is crucial for reliable laboratory results. Pre-analytical variability: Endogenous biological variability and exogenous variability due to food intake, pharmacological treatments, age, gender, and physical exercise. Technical errors and administrative errors in the clinical laboratory. |
| How to know the power of a laboratory test | What is diagnostic sensitivity? Differences between diagnostic sensitivity and analytical sensitivity What is diagnostic specificity? Differences between diagnostic specificity and analytical specificity What is positive and negative predictive value? The concept of diagnostic accuracy: How to efficiently discriminate between A and B. How to draw and interpret a ROC curve? |
| Critical values | How to recognize a critical value What the clinician should do when facing a critical value |
| Clinical case 1: Sudden Onset of Severe Anemia | What tests are used to diagnose hemolytic anemia? What laboratory test suggests the hemolytic anemia in this patient is immune mediated? What is unusual about a panreactive pattern on the antibody screen with a negative eluate result? How does cirrhosis of the liver affect the laboratory evaluation of hemolysis? |
| Clinical case 2: Evidences for surgery in a patient with abdominal pain | Why did the endocrinologist specifically look for hyperpigmentation of the skin? In a patient with a greatly increased ACTH, what would be the expected electrolyte disturbance(s)? What are 3 potential problems associated with ACTH measurement? |
| Clinical case 3: Interpretation of HIV Serologic Testing Results | What factors are known to cause false-positive HIV serologic test results? What factors are known to cause an indeterminate WB result? What further testing or clinical history would be of help in evaluating a patient with an indeterminate WB result? |
| Clinical case 4: Persistent Hemolysis in a Patient with Pancreatitis | What are causes of in vivo and in vitro hemolysis and how are they distinguished? How does hemolysis affect test results? What is the likely cause of pancreatitis in this patient? What is the association between hemolysis and pancreatitis? |
| Clinical case 5: Prolonged Activated Partial Thromboplastin Time and atrial fibrillation | Which differential diagnoses should be considered when aPTT prolongation is detected? To what extent do new anticoagulants, such as direct thrombin inhibitors, affect standard coagulation tests? What techniques should be used to evaluate the cause of a prolonged aPTT? |
| Clinical case 6: A Patient with Prolonged Paralysis | What are the pharmacodynamic properties of succinylcholine? What is the role of butyrylcholinesterase in the pharmacokinetics of succinylcholine? What conditions can cause delayed recovery from succinylcholine administration? What additional testing should be used to further evaluate this patient? |
| Clinical case 7: Multiple myeloma | What are the potential causes of a steadily increasing immunoglobulin in an MM patient in remission? What are the criteria for laboratory detection of MM relapse? What tests can be used to determine the clonality of serum immunoglobulins? |
| Clinical case 8: Hemophilia | How do the coagulation studies for this patient differ from those typically seen for patients with hemophilia? What are possible causes of simultaneous prolonged PT and prolonged aPTT? What further coagulation studies would you recommend in evaluating this patient? |
| Clinical case 9: Low Concentration of Human Chorionic Gonadotropin in a Nonpregnant Woman | Which are the sources of hCG to be considered? Which are the potential etiologies? How clinical laboratories may help in diagnosis? |
| Clinical case 10: A Girl with Severe Hand Swelling and Abdominal Cramps | What is the most likely diagnosis? What laboratory tests would you order to confirm the diagnosis? Given the family history, what inheritance pattern would you assume is most likely to explain our patient’s condition? Why does our patient have a low C4? |
| Clinical case 11: Myocardial Infarction in a 72-Year-Old Woman with Low LDL-C and Increased hsCRP: Implications for Statin Therapy | Limitations of risk-prediction algorithms |
| Clinical case 12: Cirrhosis Originally Diagnosed as Nonalcoholic Steatohepatitis | Characteristics of A1AT deficiency |
| Seminar 1: Medical writing for non-native speakers of English. Science (medical) writing is easy because it is conventional; rigidly structured | Interpretation of a conventional model. Why did you do the work? (Or visit a patient) How did you obtain the information? What did you find? What do you conclude? |
| Seminar 2: Medical writing for non-native speakers of English. Structure and purpose of scientific writing | Let’s us respect the work of others. Avoid plagiarism, imprecision, judgmental or gratuitous adjectives. Motivation determines the energy allocated to the reading task. Punctuation: a refueling station for motivation. |
| Seminar 3: Medical writing for non-native speakers of English. Writing results and discussion/conclusion | Revising the research, expanding methodology, general overview of the results, invitation to view results, key results in detail, comparisons with others, possible implications. Revisiting previous sections, summarizing key results, relationship to existing research, contribution, refining implications, limitations, current and future work, applications. |
| Classes pràctiques 1: Obtenció de mostres biològiques | 1)Realització d’una punció venosa. 2)Coneixement pràctic dels diferents tipus de mostres biològiques, la seva obtenció correcte i els diferents tipus de contenidors. . Sèrum . Plasma EDTA . Plasma heparina . Orina de 24 hores . Orina recent . Esperma . Altres líquids biològics |
| Classes pràctiques 2: Laboratori d'Urgències | . Sediment urinari . Estudi bioquímic i hematològic dels líquids cefaloraquidi, articular, pleural i altres. . Espermiograma . Adquisició de coneixements bàsics d’anàlisis bioquímiques automatitzades. . Coneixements bàsics de tècniques microbiològiques: sembrat de cultius, hemocultius. |
| Classes pràctiques 3: Laboratori d'investigació | Cadascun dels alumnes tindrà l'oportunitat d'integrar-se pel temps que vulgui en algun treball específic amb l'ajuda de diversos tutors i podrà usar les seves mans en tècniques que no estan a l'abast d'altres laboratoris. |
