LABORATORY MEDICINE
Laboratory medicine is the medical discipline devoted to obtain, explore and employ knowledge
about using various techniques for the analysis of body fluids composition and properties of cells and
tissues, and interpretation of the results in relation to health and disease. It is both the clinical
discipline and the separate medical science. Laboratory tests are used in various stages of the
diagnostic process in all fields of clinical medicine, being along with imaging studies,
electrophysiological and other procedures the main source of information on the health status of the
patient. In addition to routine diagnostics in symptomatic patients, laboratory tests are used for
screening, treatment monitoring and medical jurisprudence. Laboratory medicine combines the
application of theoretical knowledge to perform complex procedures on blood samples, urine, body
fluids and tissue specimens with the use of sophisticated instruments, and techniques. To run
different analysis laboratory medicine uses many methods based on chemistry, biophysics and
immunology rules. Laboratory medicine is also a clinical science of a specific nature resulting from its
location "across" all other clinical disciplines. Laboratory tests are an essential diagnostic tool, or the
subject of numerous experimental, clinical and epidemiological studies. Laboratory medicine by its
nature integrates the basic science, technical performance and clinical context for patient decision
making but as the science provides a general rules of selection of tests for specific research tasks.
Laboratory medicine creates also the rules of analysis and interpretation of the results and for
evaluation of the diagnostic performance of laboratory tests. All clinical practice guidelines
developed for the use of laboratory tests should be based on evidence-based laboratory medicine
(EBLM) rules.
TEACHERS:
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prof. dr hab. n. med. Grażyna Odrowąż-Sypniewska
dr n. med. Magdalena Krintus
dr n. med. Aneta Mańkowska-Cyl
dr Lena Nowak-Łoś
dr n. med. Joanna Pollak
dr n. med. Agnieszka Pater
CONTACT: dr n. med. Joanna Pollak
asiapollak@wp.pl
SYLABUS
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, tutorials
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
hormoneslaboratory
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
hematochromatosis.
of
anemias,
coagulopathies,
myeloproliferative
diseases,
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 prelaboratory 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 1-89088349-2
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
www.labtestonline.uk
Detailed list of required practical skills and confirmation of completing:
Name:
Year of study:
Group:
Academic year:
Third
Date
Confirmation of
completing
Broad knowledge of the use of
laboratory tests for screening,
diagnosis, prognosis and monitoring
of treatment and test results
interpretation. Practical experience
in some of the techniques and
procedures used in medical
laboratory.
Notes
RULES AND REGULATIONS
Credit form of coursework:
1.
The coursework consist of lectures and tutorials from laboratory medicine.
2.
The coursework is ended with the Final Exam .
Credit form of colloquium:
Three colloquiums
Form of exam:
The coursework will be passed according to scores of the Final Test.
Rules of make-up the unjustified classes missed:
Two lectures may be missed, one tutorial may be missed
Deadline to deliver elaboration, reports or different forms required in the unit:
No concern
General and detailed Management of Health and Safety at Work Regulations required during
teaching programme in the unit:
Students are obliged to comply with general Safety regulations in the laboratory (appendix)