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LABORATORY MEDICINE I. Name of the unit offering the course: Department of Laboratory Medicine II. Head of the unit/course coordinator: Prof. dr hab.Grażyna Odrowąż-Sypniewska III. 2nd year, number of hours: 40 IV. Form of classes: lectures: 20, tutorials: 20 V. Form of crediting: Exam VI. Number of ECTS points: 2 VII. Aim of the course: Lectures To give the students a comprehensive introduction of basic application of chemical, molecular and cellular concepts and techniques to the understanding and evaluation of human health and disease, a comprehensive understanding of those elements of biochemistry, immunology and hematology which are important to the role of a medical doctor, to disseminate information on ”best practice” at various levels of technology, and the quality of diagnosis and therapy for patients. Tutorials Students should get familiar with the influence of pre-laboratory and preanalytical phase on the laboratory test result, present technologies available for biochemistry, immunochemistry, hematology, coagulation, therapeutic drug monitoring and urinanalysis as well as with some practical skills using point-of-care devices and tests. Interpreation of laboratory test results will be disscussed. Organization and management of medical laboratory will be presented. General learning outcomes To be aware of the laboratory methods available to examine deviations in the biological systems and to be able to interpret the data obtained. To appreciate the common disorders of each of the systems in the human. Topics of lectures / tutorials Lectures: Cardiovascular diseases : laboratory investigation (dyslipidemia, metabolic syndrome, acute coronary syndromes -current guidelines). 1. Laboratory diagnosis of hypertension and kidney diseases (kidney stones), consequences of vitamin D deficiency. 2. Diabetes (type 1, type 2, diabetic complications, gestational diabetes, hypoglycemia, current guidelines). 3. Pathology of endocrine organs- thyroid (laboratory investigation), adrenals (HPA axis – laboratory investigation), pituitary (acromegaly and prolactinoma, IGF, hypopituitarism), gut including endocrinology (gut hormones- laboratory investigation, coeliac disease/malabsorption) 4. Laboratory diagnosis of metabolic bone diseases (osteoporosis) and some systemic connective tissue diseases (rheumatoid arthritis). Autoimmune diseases. 5. Laboratory diagnosis of liver diseases : dysproteinemia, enzymology (current guidelines), hepatitis etc. 6. Laboratory diagnosis of disorders of the respiratory system (laboratory tests in the investigation of chest disease), allergic diseases. 7. Biochemical diagnosis/ monitoring of different cancer diseases 8. Laboratory diagnosis of anemias, coagulopathies, myeloproliferative diseases, hematochromatosis. 9. Laboratory diagnosis of body fluids and electrolytes. Tutorials: 1. Organization of modern medical laboratory (analytical platforms, LIS, internal and external QC). Communication between laboratory staff and medical staff. Introduction into the pre-laboratory and preanalytical phase . Screening tests (neonatal and adult screening). 2. Laboratory diagnosis of dyslipidemia (lipids, apolipoproteins, hsCRP). Interpretation of lab tests results (hyperlipoproteinemias, metabolic syndrome). Biomarkers of acute coronary syndromes; interpretation of results. 3. Markers of liver diseases : (hepatitis etc). Determination of enzyme activity (current guidelines). 4. Laboratory diagnosis of diabetes and pancreas function. Interpretation of lab tests results. Glucometers and other POCT devices. 5. Laboratory markers of hypertension (BNP etc.) and kidney diseases. Interpretation of results. 6. Laboratory diagnosis of metabolic bone diseases and some systemic connective tissue diseases (inflammatory markers, autoantibodies). Autoimmune diseases. Interpretation of results. 7. Laboratory diagnosis of disorders of the respiratory system, allergic diseases. 8. Tumour markers and their clinical utility. 9. Laboratory diagnosis of thyroid disorders, hormonal disorders. 10. Hematology : red and white cell development, blood cell count and blood smears. Laboratory diagnosis of anemias and leukemias. 11. Blood coagulation parameters. 12. Laboratory diagnosis of body fluids. 13. Intensive care (acid-base equilibrium etc). Disorders of water-electrolyte balance. 14. Blood serology. 15. New technologies : capillary electrophoresis, HPLC, biochips Self-study topics: Laboratory diagnosis of inborn metabolic disorders (amino acids, lysosomal storage, mitochondrial disorders, carbohydrates), porfirias, Wilson’s disease. Booklist: Essential reading: 1. Marshall WJ. Bangert SK. Clinical chemistry, 6th edition 2008. Mosby. ISBN 9780723434559 2. Fraser CG. Biological variation: from principles to practice. 2001, AACC press. ISBN 1-890-88349-2 3. Fischbach F, Dunning MB . A manual of laboratory and diagnostics tests. Lippincott Williams &Wilkins 8th edition, 2010. ISBN 9781451108743 4. Guder w. Samples:from the patient to the laboratory. 2nd edition 2001. GIT Verlag ISBN 3-92886531-5 * 5. Gaw A et al Clinical biochemistry: An illustrated colour text 4th edition 2008, Churchill Livingstone. ISBN 0-443-06932-8 6. Kellerman GM. Abnormal laboratory tests results. 2nd edition 2006, McGraw Hill Medical ISBN 9780074715864 7. Anderson SC, Poulsen KB. Anderson’s electronic atlas of hematologic disorders. Lippincott Williams &Wilkins 2003. ISBN 9780781726450 8. Anderson SC, Poulsen KB. Anderson’s atlas of hematologic disorders. Lippincott Williams &Wilkins 2003. ISBN 9780781726627 9. Brunzel Nancy A. Fundamentals of urine and body fluid analysis.Second Edition, Elsevier 2004 ISBN 10. Bayes-Genis A, Januzzi JL. NT-proBNP as a biomarker in cardiovascular diseases. Prous science 2008. * Additional: Students should read any relevant recent review articles from : Annals of Clinical Biochemistry Clinical Chemistry Clinical Biochemistry Eur J Clin Investigationq