Laboratory medicine

A.Y. 2019/2020
4
Max ECTS
48
Overall hours
SSD
BIO/12 MED/07
Language
Italian
Learning objectives
The course aims to provide students with the knowledge on:
i) role, purpose, potential, limits of laboratory medicine in health protection;
ii) ability to correctly propose the different laboratory tests in relation to the cost / benefit ratio;
iii) criteria for interpretation of laboratory reports.
Expected learning outcomes
The students:
i) know the intervention levels of the biochemistry, microbiology and clinical pathology laboratory;
ii) are able to request laboratory tests and interpret the reports.
Course syllabus and organization

Single session

Responsible
Prerequisites for admission
No prior knowledge is required
Assessment methods and Criteria
The exam consists in a written test with open questions on the topics covered by the program according to each disciplinary module.
Passing the test will result in a mark expressed in thirtieths as the result of the weighted average of the scores given for each module. No intermediate tests are planned.
Biochimica clinica
Course syllabus
THE RATIONALE OF LABORATORY MEDICINE

Role, purpose, potential, limits of laboratory medicine in health
Levels of laboratory intervention in relation to the cost / benefit ratio
Organizational, technical and economic aspects of a centralized laboratory
Variability of a diagnostic test.
Preanalytical phase
· Rules for patient preparation: methods of requesting examination, sampling and access to diagnostic services. Time for availability of results.
Analytical phase
· Principles on which the common analytical techniques, used in clinical biochemistry, clinical pathology, clinical microbiology, are based.
· Assumptions on which the validity of the laboratory data is based
Post-analytical phase
· Criteria for the interpretation of the laboratory test result, relating it to the patient's clinical history and placing it in the reality of the community

BIOCHEMISTRY AND CLINICAL PATHOLOGY

Definition and purpose
· Rationale for laboratory testing.
· Laboratory intervention level and cost / benefit ratio
· Indication to the laboratory examination and type of examinations
· Concept of analytical profile
· Examination of organ or apparatus functionality
· Monitoring of illness and treatment

Laboratory organization
· Centralized laboratory, satellite laboratories
· Flows of a centralized laboratory

Variability
· intra and extra-individual biological
· analytical:
preanalytic
· request procedure
· patient preparation
· collection, treatment and conservation of the biological sample
analytic
· analytical accuracy, precision, sensitivity and specificity
· notes on quality control
· laboratory errors
post-analytic
· reporting

Data interpretation
· reference values
· decision-making levels and critical values
· principles of diagnostic logic
· concept of critical difference

Laboratory techniques
· Current analytical technologies: indications and fundamentals

Diagnostic examinations for illustrative purposes
· Interpretation of the complete examination of urine in terms of diagnostic use
· Interpretation of the results of the main diagnostic investigations in cardiovascular pathology
· Interpretation of biochemical-clinical alterations in dyslipidemia states
· Interpretation and significance of tumor markers
· Interpretation of haematological profile alterations in anemias due to cellular maturation defect
· Interpretation of biochemical-clinical alterations in renal diseases
· Role of the laboratory in the diagnosis and surveillance of diabetes
· Role of the laboratory in the diagnosis of liver diseases
· Role of the laboratory in the diagnosis of jaundice
Teaching methods
The program will be carried out through lectures (5 CFU) with the help of teaching material (slides and / or videos), including discussion of clinical cases) and professional skills (1 CFU in the laboratory and on simulator dummy)
Teaching Resources
Clinical Biochemistry and Clinical Pathology
· Ciaccio M, Lippi G, Biochimica Clinica e Medicina di Laboratorio, Edises, Napoli 2017
· Panteghini M, Interpretazione degli Esami di Laboratorio. Piccin Nuova Libraria, Torino 2008
· Janson,Tischeler, Curatore: M. Plebani, Biochimica clinica. Il quadro d'insieme. Piccin, Nuova Libraria, Torino 2015
· Laposata M, Medicina di laboratorio - La diagnosi della malattia nel laboratorio clinico, Piccin, Torino
Microbiologia e microbiologia clinica
Course syllabus
THE RATIONALE OF LABORATORY MEDICINE

Role, purpose, potential, limits of laboratory medicine in health
Levels of laboratory intervention in relation to the cost / benefit ratio
Organizational, technical and economic aspects of a centralized laboratory
Variability of a diagnostic test.
Preanalytical phase
· Rules for patient preparation: methods of requesting examination, sampling and access to diagnostic services. Time for availability of results.
Analytical phase
· Principles on which the common analytical techniques, used in clinical biochemistry, clinical pathology, clinical microbiology, are based.
· Assumptions on which the validity of the laboratory data is based
Post-analytical phase
· Criteria for the interpretation of the laboratory test result, relating it to the patient's clinical history and placing it in the reality of the community

CLINICAL MICROBIOLOGY

Diagnosis of infection
· Direct and indirect diagnosis of infection
· The diagnostic suspicion for the request of the microbiological investigation
· How the characteristics of infectious agents influence a correct processing of microbiological samples
· Knowledge of the main methods of direct and indirect microbiological investigations
· Timing of reporting
· Interpretation of the microbiological report in relation to the infection phase (recent, previous or chronic for serological investigations) and therapeutic orientation (sensitivity tests to antimicrobial drugs)

Diagnostic investigations, direct and indirect, and interpretation of the report for:
· Viral hepatitis (HBV, HCV, HAV, HEV, HDV)
· HIV and related opportunistic infections
· Blood cultures for bacterial and fungal systemic or disseminated infections
· Meningitis
· Sexually transmitted infections
· Infections of the respiratory and genitourinary system

Infection control
· Concept of nosocomial infections, related to health and community care
· Main nosocomial infectious agents and related problems
· TORCH complex and preventive methodologies

Professional skills

· Blood sampling (tests on dummy and peripheral vein)
· Diagnostic procedure for urinary and blood infections
· Discussion on the interpretation of the results of routine serological investigations during pregnancy
Teaching methods
The program will be carried out through lectures (5 CFU) with the help of teaching material (slides and / or videos), including discussion of clinical cases) and professional skills (1 CFU in the laboratory and on simulator dummy)
Teaching Resources
Clinical Microbiology
· Antonelli G., M. Clementi, G. Pozzi, G.M. Rossolini - Principi di Microbiologia Medica - Casa Editrice Ambrosiana, Rozzano (MI);
· Murray P.R., K.S. Rosenthal, M.A. Pfaller - Microbiologia Medica, EDRA, Milano).
o in alternativa/alternatively:
· Lanciotti E, Microbiologia Clinica, Casa Editrice Ambrosiana, Rozzano (MI)
Biochimica clinica
BIO/12 - CLINICAL BIOCHEMISTRY AND MOLECULAR BIOLOGY - University credits: 3
Lessons: 36 hours
Microbiologia e microbiologia clinica
MED/07 - MICROBIOLOGY AND CLINICAL MICROBIOLOGY - University credits: 1
Lessons: 12 hours
Professor: Morace Giulia
Professor(s)
Reception:
Monday-Thursday by appointment
San Paolo, Bloc C, 8th floor