Blood/Hematology
Total Contact Hours:
36 hours
Course Director:
Julian Gomez-Cambronero, Ph.D., Professor of Cell Biology and Physiology
Course Description:
This course presents the
functional morphology of blood cells (normal and abnormal), how important blood
diseases manifest, and the approaches to diagnosis and treatment of blood and
clotting diseases. Learning
activities include using the microscope with blood samples to make a diagnosis
and problem case discussions.
K=Knowledge and Lifelong Learning
C=Interpersonal and Communication P=Professionalism, Advocacy, and Personal Growth |
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The Blood course has four distinct topics, three related to
the different blood formed elements, and one related to blood banking:
- White
blood cells (K1-4)
- Red
blood cells (K5-8)
- Platelets/coagulation
factors (K9-12)
- Blood
banking (K13)
By the conclusion of this course, the student will
demonstrate substantial knowledge of:
K1 Morphology,
physiology, and biochemistry of blood, marrow, and lymphatic tissues, including
the ability to:
- Define and recognize the components of normal
peripheral blood and bone marrow
- Describe the distribution, functions, lifespan, and
fate of each blood cell, including stem cell
- Compare and contrast erythropoiesis and granulopoiesis,
and distinguish between erythrocytic and granulocytic precursors in bone marrow
films
- Separate the concepts of reactive vs. malignant white
cell disorders
- Explain the major abnormal molecular mechanisms in
leukemia and lymphoma and the diagnostic tools
- Understand the importance of signal transduction in the
development of targeted therapies
K2 Pathology,
staging, and management of a wide variety of neoplastic disorders, including
the ability to:
- Recognize the normal cell counterpart (cell of origin)
for each disease entity listed in WHO classification of tumors and
hematopoietic and lymphoid tissue
- Identify the genetic abnormalities involved in
pathogenesis immunophenotype(s) of neoplastic cells
- Define the morphologic features of neoplastic cells
natural history and prognosis
K3 Pharmacology,
including the ability to:
- Define chemotherapeutic drugs, biologic products, and
growth factors for leukemias and lymphomas
- Define their mechanisms of action, clinical indication,
and limitations, including their effects, toxicity, and interactions
- Understand induction of remission, post-induction and
maintenance pharmacology, evidence-based medicine, and success rates
- Become familiar with current information access using
the CancerNet, the website of the National Cancer Institute (Physicians Data
Query)
K4 How
to integrate previous knowledge (K1-3) and clinical presentation information to
formulate a differential diagnosis and diagnostic strategy, including the
ability to:
- Define the etiology, epidemiology, natural history, and
diagnosis of myeloproliferative disorders, leukemias, and lymphomas.
- Contrast the clinical presentations and prognoses of
the various white blood malignant disorders
- Use prognostic information for therapeutic planning
- Be cognizant of the molecular pathogenesis of white
blood malignant disorders and the relevance to prognostication and treatment
selection
K5 Morphology,
physiology, and biochemistry of red blood cells, including the ability to:
- Explain the normal measurements of red blood cells and
their production
- Understand the fate of iron, vitamin B12 and folate,
and common enzymes involved in red cell metabolism
K6 Pathology
(anemias), including the ability to:
- Describe the body's normal responses to anemia
- Classify the anemias using the red cell indices
- Explain the pathophysiology of the various hemolytic
anemias
- Explain the mechanisms involved in the thalassemias and
megaloblastic anemias
- Describe the etiology and effect of iron deficiency
- Describe other hypoproliferative anemias including
anemia of chronic disease
- For the specific case of Sickle Cell Anemia:
- Describe the genetic defect and its systemic effects
- Identify key medical issues in the diagnosis and
treatment of patients with sickle cell
- Identify major psychosocial experiences and problems of
patients with sickle cell
- Describe the impact of the disease on the families of
patients with sickle cell
- Discuss ethical/professional issues that may arise in
the care of patients with lymphoma and leukemia
K7 Pharmacology,
including the ability to:
- Understand how adverse
effects limit oral iron dosage and affect patient compliance
- Describe indications
for administering parenteral iron and know to treat acute iron toxicity
- Define the agents used
in treating hemolytic anemia
K8 How
to integrate previous knowledge (K5-7) and clinical presentation information to
formulate a differential diagnosis and diagnostic strategy, including the
ability to:
- Correlate the red cell indices with different
pathophysiological mechanisms of disease
- Use the information gathered through the history,
physical exam, and basic lab studies to establish a working diagnosis
- Formulate a therapeutic planning
- Outline the treatment
of a patient with newly discovered megaloblastic anemia
- Know the importance of
properly assessing B12 vs. folic acid deficiency
K9 Morphology,
physiology, and biochemistry of platelets and coagulation factors, including
the ability to:
- Understand the biology of platelets and describe their
role in hemostasis
- Define hemostasis and the fine equilibrium between
hemorrhage and embolism
- Be able to explain the main pathways of coagulation and
anticoagulation
- Be able to explain fibrinolysis and its regulation
- Define the molecular mechanisms of major hemostatic disorders
(Hemophilias and von Willebrand disease)
K10 Pathology,
staging, and management of a wide variety of neoplastic disorders, including
the ability to:
- Describe basic laboratory testing for hemostasis
- Define the major types of disorders associated with
bleeding
- Describe the various heritable coagulopathies.
Specifically discuss hemophilia and von Willebrand disease
- Define disorders associated with thrombophilia
K11 Pharmacology,
including the ability to:
- Describe the mechanism of action and use of antiplatelet
therapy
- Discuss pharmacokinetics of aspirin, warfarin, and
heparin
- Recognize the multiplicity and variability of drug
interactions and antidotes
K12 How
to integrate previous knowledge (K9-11) and clinical presentation information
to formulate a differential diagnosis and diagnostic strategy, including the
ability to:
- Understand the steps in
hemostasis and the coagulation cascade sequence
- Recognize common
bleeding disorders, their mode of inheritance, and clinical features
- Formulate an approach
to the diagnosis of a patient with a bleeding disorder
- Outline an effective
treatment plan for the same
- Recognize the role of
comprehensive treatment centers for the management of these patients
K13 Blood
banking, including the ability to:
- Identify ABO and Rh
antigens and describe how they form
- Recognize ABO and Rh
compatibility and its application in blood transfusion
- Describe how blood is
collected and preserved
- Formulate the basic
indications for transfusion therapy
- Define the side effects
of blood transfusion
- Describe the mechanisms
of transfusion reactions and the symptoms associated with them
- Define the mechanism of
hemolytic disease of the newborn and how to identify it
C1 Interpersonal
communication, including the ability to:
- Solve
complex problems effectively in teams through the team-based learning modules
- Work
effectively with laboratory partners to complete the required assignments
P1 Professionalism, including the ability to:
- Arrive
on time and fully prepared to participate in laboratory exercises and
team-based learning sessions
- Support
one's team in team-based learning through adequate preparation and creation of
a positive, encouraging atmosphere
- Exhibit
ethical behavior in regards to testing in team-based learning sessions and
major examinations
- Treat
fellow students, faculty, teaching assistants, and staff with courtesy and
respect
Learning Activities:
Presentations, Team-Based Learning, lab, case discussions, patient-physician interview.
Syllabi
Assessment:
One MCQ exam, Team-Based Learning. |
