LABORATORY MEDICINE
cod. 08711

Academic year 2008/09
3° year of course - Second semester
Professor responsible for the course unit
CHEZZI Carlo
integrated course unit
7.5 credits
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course unit
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Learning objectives

<br />AIMS<br />Clinical Microbiology<br />Principles and methods for the laboratory diagnosis of infectious diseases <br />Aetiology, outline of pathogenesis, clinical samples, laboratory diagnostic procedures, interpretation of the results of microbiological and virological investigations to diagnose the infectious diseases.  <br />The determination of susceptibility/resistance of the pathogenic agents to chemotherapeutics<br />Clinical Pathology<br />- to know the most relevant laboratory tests <br />- to understand the role and the importance of the laboratory medicine for a correct diagnosis<br />- to evaluate cost/benefit ratio<br /> <br />Clinical Biochemistry<br />To correctly apply the fit methodologies to notice the functional finds and of laboratory, critically also interpreting them under the physiopathologic profile, to the goals of the diagnosis and the prognosis. The student has to be able to point out for the clinical cases of different typology, brought to his/her observation, the more appropriate investigations of laboratory, to appraise of it critically the diagnostic meaning and to suggest the more effective close examinations of laboratory.

Prerequisites

<br />All the examinations expected to the term of the 4th year <br />It is mandatory to pass the pre-clinic exams before being allowed to take the exam of Laboratory Medicine.

Course unit content

<br />CONTENTS<br />Principles and methods for the laboratory diagnosis of infectious diseases: - Demonstration of the pathogenic agent and its constituents in the pathological material- Demonstration of a recent specific immune response- The medical prescription of microbiological and virological investigations- Collection, transport and preservation of the clinical samples for microbiological and virological investigations.- Aetiology, outline of pathogenesis, clinical samples, laboratory diagnostic procedures, interpretation of the results of microbiological and virological investigations regarding the diagnosis of: - Infections of the respiratory apparatus- Infections of the intestinal apparatus and related glands- Systemic infections- Infections of the cardiovascular apparatus- Infections of the central nervous system- Infections of the genitourinary apparatus and sexually-transmitted infections- Infections of the skin and cutaneous adnexa- Infections of the muscular-skeletal apparatus- Infections of the eye and the ear- prenatal, connatal and perinatal infections.-The nosocomial infections-The determination of susceptibility/resistance of the pathogenic agents to chemotherapeutics:- Methods - Interpretation of the results- The dosage of chemotherapeutics in tissues and biological fluids.<br /><br />Clinical Biochemistry<br />To begin to apply the logical tools in the clinical reasoning and to address the choices of the diagnostic tools according to the decisional criterions of efficiency and effectiveness that keep in mind of the relationships among benefits, risks and costs. <br />- Preanalytical, analytical and postanalytical variability. Condition that can alter the results of the analyses of laboratory; different possibilities of collecting.- Correct application of the techniques for the collecting and the harvest of the materials.-The concept of normality in biology and the functions of risk (normal values on statistic base, normal values on biological base, desirable values and functions of risk, usable decisional values to diagnostic or therapeutic end).-General principles of the most diffused techniques in use near the clinical laboratories. Control of quality.-To appraise critically a report (intervals of reference, sensibility and specificity of a test, predictive value, critical difference). The values of reference of the analyses of the common routine. -Elements of diagnostic molecular.-Investigations for the control of the pregnancy.-Interpretation of the complete examination of the urines in key of diagnostic use.-Interpretation of measures of enzymes and isoenzymes, and of other indicators as diagnostic mean in specific pathologies and of organ.-Alterations biochemical-clinics in the carbohydrate metabolism.-Alterations biochemical-clinics in the lipid metabolism.-Alterations biochemical-clinics in the purine metabolism.-Alterations biochemical-clinics in the electrolytes.-Alterations biochemical-clinics in the mineral metabolism and the connected pathologies.-Interpretation of the variations of the parameters of the equilibrium acid-base in relationship to their pathologies.-To orient on the choice and on the meaning of the principal diagnostic tests in the most common endocrine pathologies.-Interpretation of the alterations of the plasma proteins as suspect diagnostic of the pathologies to them connect.<br />Clinical Pathology<br />Laboratory tests, patient preparation, biological samples-Hematological laboratory test and their interpretation in the diagnosis of hematological diseases-Endocrine and metabolic test and their interpretation-Tumour markers and their interpretation-Diagnostic molecular biology<br />Professionalizing training: Legend: 0: The student has seen the execution, 1: The student has executed at least one time, 2: The student is able to execute autonomously.<br /> CLINICAL MICROBIOLOGY<br /><br />Medical prescription of microbiological and virological investigations   2<br />Interpretation of the report of the microscopic examination for bacteria (Gram staining)    2<br />Interpretation of the report of the microscopic examination for bacteria (Ziehl-Nielsen staining) 2<br />Interpretation of the report of the cultural examination for bacteria 2<br />Interpretation of the report of the antibimicrobial susceptibility tests for bacteria    2<br />Interpretation of the report for the serological diagnosis of syphilis  2<br />Interpretation of the report for the diagnosis of mycobacterial infection    2<br />Interpretation of the report for the detection of bacetrial nucleic acids  2<br />Interpretation of the report of the cultural examination for fungi    2<br />Interpretation of the report of the antibiogram for fungi    2<br />Interpretation of the report for the detection of anti-Toxoplasma gondii antibodies     2<br />Interpretation of the report for the detection of intestinal parasites    2<br />Interpretation of the report for the detection of intestinal parasites     2<br />Interpretation of the report for the detection of Leishmania   2<br />Execution of the thin peripheral blood smear for parasites detection       0<br />Interpretation of the report for the detection of nucleic acids of protozoa     2<br /> Agarose gel Electrophoresis of nucleic acids of protozoa      0<br />Interpretation of the report for the detection of antigens of protozoa      2<br /> Interpretation of the report for the laboratory diagnosis of malaria     2<br /> Detection of arthropods in human samples (macroscopic examination)     1<br />Detection of elmynths (Cestodes, Nematodes) by macroscopic examination    1<br />Interpretation of the report for the diagnosis of viral hepatitis   2<br />Interpretation of the report for the detection of antigens of hepatitis viruses     2<br />Interpretation of the report for the detection of nucleic acids of hepatitis viruses  2<br />Interpretation of the report for the detection of anti-hepatitis viruses antibodies   2<br />Agarose gel Electrophoresis of nucleic acids of viruses      0<br />Interpretation of the report for the detection of viruses by electron microscopy    2<br />Interpretation of the report for the detection of anti-viruses antibodies   2<br />Interpretation of the report of the culture for viruses     2<br />Interpretation of the report for the detection of viral antigens    2<br />Interpretation of the report for the detection of antigens of HIV     2<br />Interpretation of the report for the detection of nucleic acids of HIV    2<br />Interpretation of the report for the detection of anti-HIV antibodies    2<br />CLINICAL PATHOLOGY<br />LEGEND:0¨The student attended a performance; 1¨The student performed at least once; 2¨The student is able to perform independently<br />Blood withdrawal      0<br />To verify whether blood samples are suitable for laboratory examinations        2<br />To prepare and stain a smear of peripheral blood for microscopical study        2<br />To use an optic microscope adjusting its various components            2<br />To perform a differential count of white blood cells on a glass slide of peripheral blood smear at the microscope          1<br />To identify at the microscope morphologic characteristics of erythrocytes, platelets and leukocytes            2<br />Interpretation of hemochromocytometric tests   2<br />Interpretation of tests concerning glucidic metabolism       2<br />Simulation of assays: RIA, ELISA, IRMA          0<br />Interpretation of tests concerning lipidic metabolism         2<br />Interpretation of laboratory data concerning the main neoplastic markers         2<br />Interpretation of urinary tests    2<br />CLINICAL BIOCHEMISTRY<br /> Organization of the clinical laboratory of biochemistry    0<br /> Preparation of the biological samples for routine diagnostic methods of clinical biochemistry         0<br /> Uses of multichannel automatic analysers      0<br /> Haemogasanalysis: execution        1<br /> Managing of the biological samples since their collection        2<br /> Urine stick test    2<br /><br />                                                    <br /> <br /> <br /> <br /> <br /> <br />

Full programme

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Bibliography

<br />SUGGESTED REFERENCES<br /> <br />MICROBIOLOGIA CLINICA<br />ANNA M. M0LINA ROMANZI <br />Microbiologia Clinica<br />Gli aspetti microbiologici delle malattie infettive<br />UTET Periodici<br /> <br />BIOCHIMICA CLINICA<br />W.J.MARSHALI AND S.K. BANGERT <br />'Biochimica in. Medicina Clinica'<br />Mc Graw-Hill <br />J.B.HENRY<br />'Clinical Diagnosis and Management by laboratory Methods' <br />W.B. Sanders Company, Philadelphia.<br /> <br />PATOLOGIA CLINICA<br />G. FEDERICI, P. CIPRIANI, C. CORTESE, A. FUSCO, P. IALONGO, C. MILANI <br />“Medicina di laboratorio” McGraw – Hill, (ultima edizione)<br />        WIDMANN <br />“Interpretazione clinica degli esami di laboratorio” – McGraw – Hill, (ultima edizione)<br />

Teaching methods

<br />Oral examination<br />The practical laboratory activity includes the professionalizing training.<br />Clinical Biochemistry<br />Teaching activity: frontal lessons, interactive activity for small groups, seminars, learning by solving problems <br />Kind of exam: oral test   <br /> <br /><br />Teachers:<br />SSD MED/07: Prof.Carlo Chezzi (Coordinator), Prof.Adriana Calderaro<br />SSD BIO/12: Prof.Amos Casti<br />SSD MED/05: Prof.Gloria Saccani, Prof.Maria Cristina Baroni<br />SSD MED/46: Prof.Carlo Chezzi, Prof.Vittorio Coiro

Assessment methods and criteria

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Other information

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