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• Undergraduate study:
• Courses
• Order a prospectus
• How to apply
• Information for applicants
• Why choose Kingston University
• Disability and mental health support
• Accommodation
• Undergraduate fees
• Fees, funding and payments
• Access, participation and inclusion

Clinical Chemistry and Haematology (Blood Sciences)

• Module code: LS6005
• Year: 2018/9
• Level: 6
• Credits: 30
• Pre-requisites: LS4001 or LS4004
• Co-requisites: None

Summary

This is a core module for Biomedical Science, and an option for Biochemistry, Biological Sciences (Medical Biology route), and Nutrition (Human Nutrition). The module evaluates the contribution of laboratory investigations to the diagnosis, treatment and prevention of disease in key areas such as renal disease, diabetes, anaemia, and haematological malignancies. The module also considers the role of the transfusion laboratory in the treatment of selected disorders.

Topics are introduced through a structured lecture series and further explored in practical laboratory sessions. Additional material is provided via Canvas, with tutorials used to support the practical programme and strengthen understanding of key concepts.

Throughout the module, case histories are used to illustrate current best practice in Clinical Chemistry and Haematology, and this is re-enforced by keynote lectures from expert practitioners in the field. The module also places an emphasis on students' acquisition of the knowledge and practical skills required by employers.

Aims

• To enable students to understand and critically evaluate the pathophysiology and investigation of human disease by studying selected topics across the fields of Clinical Chemistry and Haematology.

Learning outcomes

On successful completion of the module, students will be able to:

• identify and evaluate critically the diagnostically useful changes which occur in normal body chemistry in selected examples of disease/trauma.
• demonstrate an in-depth understanding of the regulation of haemopoesis and haemoglobin production, and the interrelationships of the processes involved
• determine the classification and investigation of haematological malignancy.
• assess, select and apply the practical skills involved in the investigation of biochemical and haematological disease
• interpret and evaluate the investigations that can aid the management of key examples of disease
• evaluate the processes involved in the investigation of blood groups, and describe the techniques used in blood transfusion.

Curriculum content

A key learning outcome of the module is to 'identify and evaluate critically the diagnostically useful changes which occur in normal body chemistry in selected examples of disease/trauma', and where ever possible the topics in the curriculum are approached using a standard strategy;

• Acquire an understanding of normal physiological processes and homeostasis related to the system under investigation (eg. normal renal function, and the key areas of body chemistry the kidneys control)
• Identification of common diseases affecting the system under investigation, how they affect normal function, and a prediction of the changes this will produce (eg. acute kidney Injury and its causes, producing changes in glomerular and tubular function, resulting in increased blood urea/creatinine, potassium, urine protein)
• Evaluation of the tests that can be carried out to confirm diagnosis or make a differential diagnosis (eg. estimation of glomerular filtration rate, assay of blood urea and electrolytes, roles of morphology, cytochemistry, immunophenotyping, cytogenetic and molecular genetic analysis in leukaemia diagnosis and classification)

Topics covered may include;

• simple biochemical tests for liver and renal disease
  • (bilirubin, AST, ALP, albumin; urea, creatinine, sodium, potassium, glomerular filtration rate, urinalysis)
• plasma proteins and paraproteinaemias
  • (immunoglobulins, serum and urine protein electrophoresis);
• lipid and carbohydrate metabolism
  • (glucose, cholesterol, triglyceride, HDL & LDL)
• calcium and phosphate homeostasis
  • (calcium, phosphate, PTH, vitamin D; renal, bone, gut and parathyroid glad function) 
• water, electrolyte and acid-base homeostasis
  • ('blood gases'; pH, pO2, pCO2, bicarbonate; metabolic and respiratory disorders of acid/base homeostasis)
• simple examples of endocrine tests
  • (thyroid function; TSH, fT4, fT3. adrenal function; CRH, ACTH, cortisol)
• inherited metabolic disorders
  • (PKU, MSUD, glycogen storage disease, CAH; methods of investigation - TLC, HPLC, mass spectrometry)

• clinically important blood groups (ABO, Rh), introduction to laboratory practice and quality control, transfusion reaction and haemolytic disease of the foetus/newborn.

Teaching and learning strategy

Lectures will provide students with a basic grounding in each subject covered from which they will be expected to supplement their knowledge with reading of suggested reviews and original publications. This direction is provided through the use of Canvas, the University's VLE, with the opportunity for students to obtain feedback on their understanding of the lectures through regular on-line and in class formative assessments.

Practical work will demonstrate some of the principles covered in the lectures and introduce the students to basic diagnostic practices. Practical report writing will test students' written communication skills and their application of knowledge to solving theoretical clinical case studies and students will also be expected to demonstrate competence in basic laboratory techniques.

Tutorials will be structured, student-centred discussions. These will be aimed at enhancing students' understanding of the subject matter and also encouraging their critical thinking and debating skills, particularly through analysis of aspects of experimental design and conclusions drawn. Tutorials will use peer assessment of written work to give students feedback on their understanding of the topics studied.

Independent learning skills are developed through directed reading and are necessary to achieve the learning outcomes. Throughout the module emphasis is placed on 'continuous assessment' (see below), which guides students' preparation for future work ('feed forward'), and also allows students to regularly check their progress. 

Breakdown of Teaching and Learning Hours

Assessment strategy

An essay portfolio will be comprised of:

• Three short, in-class essays/case studies of no more than 800 words each; these may be comprised of seen topics, questions or open book questions. Each essay contributes 10% towards the module mark.
• Feedback will be provided on completed essays prior to commencement of subsequent essays, feeding forward to students and allowing for the developmet of their approach to examination type assessment at this level of study.

(This will be worth 30% of the module mark)

A portfolio of in-class tests will be comprised of:

• Five short tests (typically 15 to 20 minutes); these may be electronic or in class, MCQ, EMQs or 'short answer' tests.

 (This will be worth 20% of the module mark)

Continuous assessment will run across the full taught programme, and is designed to guide students' preparation for future work (feed forward), and also to allow students to regularly check their progress in the module.

• A practical competency exam involving a written laboratory report on investigations carried out in order to make a diagnosis of clinical case histories. Students will work on their own and will carry out a practical assay analysing patient results. Students will report on their laboratory findings, and marks will be awarded based on their accuracy, presentation of results, and conclusions. Within the report, additional patient information will be provided to students, and there will be questions relating directly to the clinical case histories. Students will also be assessed on their ability to interpret this data and answer the questions set. This laboratory assessment will be three hours long and the report will be completed within the laboratory class. The topic of the report and protocol will be released in advance of the practical exam.. Previous formative practicals in this module will be used to allow students to practice the required laboratory and data analysis skills.

(This will be worth 50% of the module)

Mapping of Learning Outcomes to Assessment Strategy (Indicative)

Elements of Assessment

Achieving a pass

It IS NOT a requirement that any major element of assessment is passed separately in order to achieve an overall pass for the module.

Bibliography core texts

The latest versions of the texts are recommended.

(Most recent edition of):

• Andrew Blann and Nessar Ahmed. Blood Science; Principles and Pathology. Wiley-Blackwell.

or

• Gary Moore, Gavin Knight & Andrew Blann. Haematology; Fundamentals of Biomedical Science. Oxford University Press.

and

• Nessar Ahmed. Clinical Biochemistry; Fundamentals of Biomedical Science. Oxford University Press.

Bibliography recommended reading

(Most recent edition of):

• Hoffbrand, A. & Moss P. Essential Haematology. Wiley-Blackwell.
• Hoffbrand, V. et al. Postgraduate Haematology. Wiley-Blackwell.
• Gaw, A. et al. Clinical Biochemistry (An Illustrated Textbook), Churchill Livingstone
• Marshall, W. J. Clinical Chemistry, Mosby or Crook, M. Clinical Chemistry and Metabolic Medicine, Hodder Arnold
• Burtis, C.A. et. al. Tietz Fundamentals of Clinical Chemistry, Saunders Elsevier
• Bain, B.J. et. al. Dacie and Lewis Practical Haematology, Churchill Livingstone.
• Pallister,C. and Watson, M. Haematology (Biomedical Sciences Explained), Scion Publishing Ltd,.
• Rodak B. et al. Hematology, Clinical Principles and Applications, Elsevier-Saunders
• Journals: Annals of Clinical Biochemistry; Blood - New York; British Journal of Haematology; Clinical Chemistry.

Employability/society resources:

• Institute of Biomedical Science http://www.ibms.org/
• The Association for Clinical Biochemistry and Laboratory Medicine http://www.acb.org.uk/home.aspx
• NHS blood and transplant http://www.nhsbt.nhs.uk/
• British Society for Haematology http://www.b-s-h.org.uk/
• NHS Employers http://www.nhsemployers.org/Pages/home.aspx