AIMS AND LEARNING OUTCOMES

Poggi: The student have to  know a) the composition and function of blood b) the methodologies through which the biological parameters of the blood can be evaluated; c)the cellular parameters of  erythrocytes, leucocytes, and platelets; d)on the basis of an altered parameter identify which blood disease and at what may occur.

Rumbullaku: at the end of the integrated course,  the student faces and acquires notions that allow him to know the physio-pathology of the coagulation, the  first, and second level coagulation tests, the dosage methods, the accuracy, the clinical and diagnostic importance and the timeliness of the execution of the coagulation tests. He also acquires knowledge on thrombophilia, second-level laboratory assays for the study of thrombotic risk factors, genetic diagnostics in haemostasis and thrombosis.Also, the student acquires knowledge on the new direct anticoagulant drugs (DOAC), the importance of the laboratory role in the dosage of these drugs.

Visconti: the student acquires notions about the process that leads to the generation of laboratory information, the quality controls and the recognition of pre-analytical, analytical and post-analytical errors competent to a laboratory medicine technician.

TEACHING METHODS

Frontal lessons

SYLLABUS/CONTENT

Clinical Pathology I Dr. Alessandro Poggi (1 CFU) description and analysis in detail:

• the cellular and non-cellular components of the blood and the genesis of the different cell lines and platelets;

• blood functions with reference to the physio-pathological conditions which alter cellular and biochemical parameters;

• methods of laboratory analysis of blood changes;

• main pathogenetic mechanisms of blood diseases such as anaemia, leukaemia in general and alterations of the plasma cell component of the bone marrow and blood.

Clinical Pathology I Dr. Margarita Rumbullaku (1 CFU)

A. Physiopathology of coagulation:

• Primary haemostasis (vasopiastrinal phase)

• Secondary haemostasis: vascular phase, “coagulation cascade”

• Fibrinolysis and physiological coagulation inhibitors

• Thrombophilia and thrombotic risk factors.

B. The Laboratory of Haemostasis and Thrombosis:

• Study of platelets in pathology of haemostasis

• The 1st level laboratory in coagulation

• The dosage of coagulation factors

• Laboratory diagnosis of physiological inhibitors deficiencies

• II level tests for the study of haemostasis and thrombosis

• Genetic diagnostics in haemostasis and thrombosis

C. The new direct oral anticoagulant drugs (DOAC): – Innovative tests for DOAC dosing.

Clinical Pathology I Dr. Valeria Visconti (1 CFU)

• Lundberg scheme: Brain to Brain loop

• Pre-analytical phase: hints on appropriateness of the request, venous withdrawal, check-in, evaluation of unsuitable samples, aliquoting and laboratory safety.

• Analytical phase: precision, repeatability and reproducibility, accuracy of the result, biological and analytical variability, reference and decision-making values, critical values, accuracy and bias, acceptable total error, analytical goals, critical difference. CLSI Guidelines for IQC and EQC Internal Controls (IQC) and external (EQC) of analytical quality.

• Index of tissues sufferance: markers of cardiac, liver, kidney, pancreatic and muscle damage.    

• Post-analytical phase: technical validation, clinical validation, laboratory report signature, sample check-out, telemedicine.

• Example of possible errors in the pre-analytical, analytical and post-analytical phases.

RECOMMENDED READING/BIBLIOGRAPHY

Biochimica clinica e medicina di laboratorio, Autori: Marcello Ciacci, Giuseppe Lippi

 ISBN 8879599585, 9788879599580- Edises, 2017 (acquisto obbligatorio).

Dispense delle lezioni

Manuale di Ematologia, Autori: Corradini - Foa' - Boccadoro - Federici - AAVV  ISBN: 9788877118165, Editore: Minerva Medica; Malattie del Sangue e degli Organi Emolinfopoietici by Sante Tura, VI edizione 2015, DOI: 10.15651/978-88-748-8884-9 Società Editrice Esculapio