MedInTO Medicine and Surgery

Laboratory Medicine

Laboratory Medicine

Academic year 2023/2024

• Biochemical and Molecular Basis of Metabolism (SCB0314)
• Microbiology (SCB0204)
• Basic pathology and immunology (SCB0205)
• Pathology e pathophysiology (SCB0207)
• Clinical methodology - Module of Clinical Pathology (SCB0426E)

Sommario del corso

• Course objectives
• Results of learning outcomes
• Program
• Course delivery
• Learning assessment methods
• Notes
• Teaching Modules
• Teaching tools
• Course card

Course objectives

Describe the laboratory skills and techniques used in the clinical laboratory, and discuss their application. Recognize and discuss the clinical meaning of laboratory data that characterize non-infectious and infectious diseases. Laboratory medicine, extends across research, clinical (ie, screening, diagnosis, and treatment), and public health settings. Laboratory services have a significant role in informing health care decisions and spending. Appropriate use of laboratory testing is essential for achieving safe, effective, and efficient care to patients.

Results of learning outcomes

The student will demonstrate the ability to integrate laboratory data into the clinical decision-making process for proper diagnosis and optimum patient management.

• Interpret laboratory test results from several of their patients that fall outside the reference range.
• Compare and contrast reference ranges and therapeutic ranges.
• Describe variables in specimen collection, preparation, and processing that may affect the clinical interpretation of a test result.
• Define the terms ‘‘test sensitivity and specificity”, ‘‘test precision and accuracy’’, ‘‘negative and positive predictive value’’ and illustrate their impact on test selection and data interpretation.
• Compare and contrast the attributes of a ‘‘screening test’’ and a ‘‘confirmatory test’’.
• Define ‘‘point of care’’ (POC) testing and appraise its indications and limitations.
• Assess the laboratory test requesting appropriateness
• Illustrate how consultations with pathologists/clinical laboratory scientists may assist in devising the most efficient and cost-effective path to laboratory diagnosis in specific patients or clinical situations
• Describe the importance of appropriately drawing and labeling a blood bank specimen.
• Interpret information generated from a ‘‘type and screen’’ order on one of their patients.
• Compare and contrast blood components available for clinical use and their indications.
• Discuss infectious and noninfectious risks of blood transfusion.
• Describe various clinical presentations of transfusion reactions.
• Describe therapeutic apheresis 

Program

CLINICAL PATHOLOGY

• Organization and principles of the clinical analysis laboratory: the "core lab" and the "point of care testing"
• Analytical methods mainly used in the clinical analysis laboratory
• Appropriateness of laboratory tests
• The basis of clinical pathology (CBC and related disorders, electrolyte blood gas analysis and acid-base balance, renal function parameters, urinalysis, proteinuria, sedimentological aspects, main organ damage markers, laboratory approach to coagulation disorders, principles of immunological diagnostics acute phase proteins, determination of plasma proteins, autoimmunity test)
• Blood group systems and compatibility testing
• Blood donors, blood collection, and donation testing
• Blood processing and components
• Indications for transfusion of blood components
• Transfusion risks and haemovigilance
• Pregnancy immuno-hematological implications

CLINICAL BIOCHEMISTRY

• Clinical biochemistry and molecular biology of dyslipidemias
• Lipoproteins (classification and composition).
• Apoproteins, Apolipoprotein B. 
• mRNA Editing Catalytic Polypeptide-like (APOBEC) family. 
• Intestinal absorption of cholesterol and phytosterols. 
• Niemann-Pick C1-Like 1 (NPC1L1) transporter and ezetimibe. 
• Clinically relevant ATP binding cassette (ABC) transporters in dyslipidemias.
• ABCG5/G8 and sitosterolemia.
• Secretion of complex lipids into the bile and their intestinal reabsorption.
• Hormonal functions of bile acids.
• CD36 transporter and the intestinal absorption of long-chain fatty acids.
• Chylomicron assembly. 
• Microsomal triglyceride transfer protein (MTP) and abetalipoproteinemia; Sar1 small GTPase and Anderson's disease. 
• Lipoproteinlipase (LPL), apoprotein C2 (ApoC2), chylomicron/VLDL catabolism and hypertriglyceridemia. 
• Hypertriglyceridemia and coronary atherosclerosis: the role of cholesteryl ester transfer protein (CETP)/ApoD, ApoA5, GPI-anchored HDL-binding protein 1 (GPIHBP1), angiopoietin-like (ANGPTL) 4, ANGPTL3/8, SVEP1/Polydom and ApoC3. 
• Cholesterol homeostasis in liver and peripheral tissues: role of LXR/RXR, insulin induced gene (Insig) and Ubc7/gp78/VCP, sterol response element binding protein (SREBP) 2/SBREP cleavage activating protein (Scap) and miR-33a.
• ApoB100, LDL receptor (LDLR) and familial hypercholesterolemia. 
• Clathrin adapters and autosomal recessive hypercholesterolemia.
• Regulation of LDLR degradation by proprotein convertase subtilisin-kexin type 9 (PCSK9) and therapeutic implications.
• ApoE, dysbetalipoproteinemia and familial combined hyperlipidemia.
• NPC1, NPC2 and type C/D Niemann-Pick disease.
• Structure, function and role of HDLs in the control of lipid homeostasis. 
• ABCA1, ABCG1, SR-BI, CETP/ApoD, APOA1 and atherosclerosis; 
• Familial hyperalphalipoproteinemia; causes of HDL deficiency. 
• Correlation between HDL cholesterol levels, cholesterol efflux capacity and atherosclerosis.
• Greaves-Basedow's disease: thyroid stimulating hormone receptor (TSHR), anti-TSHR and anti-IGFR1 antibodies.
• Basedowian ophthalmopathy: TSHR, fibrocytes, and interleukin-6. 
• TSHR mutations and non-autoimmune hyperthyroidism.
• Sodium/iodine symport (Solute Carrier 5A5, SLC5A5) and congenital hypothyroidism.
• SLC26 and Pendred's syndrome.
• The Wolff-Chaikoff effect.
• SLC16A2 and Allan-Herndon-Dudley syndrome. 
• Deiodinase and selenium.
• Peripheral resistance to thyroid hormones.

CLINICAL MICROBIOLOGY

• Elements of diagnostics with particular regard to the collection, storage, transport of biological samples, manual and automated microbiological laboratory tests and their interpretation. 
• Diagnosis of infections of the urinary tract with particular regard to significant bacteriuria, uroculture and its interpretation.
• Diagnosis of infections of the gastrointestinal tract including toxic infections and microbial food poisoning with particular regard to enteric nosocomial infections.
• Diagnosis of the most severe infections of fetus/newborn during/after pregnancy.
• Diagnosis of infections of the central nervous system with particular regard to microbiological investigations on liquor.
• Diagnosis of infections of the blood and cardiovascular system with particular regard to blood culture’s interpretations.
• Diagnosis of respiratory tract infections (upper and lower tract), including Mycobacterium tuberculosis infection, with particular regard to microbiological diagnostics. 
• SARS-CoV-2 infection and its current diagnosis.
• Diagnosis of urethritis and cervicitis.
• Diagnosis of Joint prosthesis infections osteosynthesis implants 
• Discussion of clinical cases of the infections mentioned above referring to microbiological diagnosis and interpretation of results.

Course delivery

Lecture in presence supported/supplemented by recorded lectures that the students can access online through the platform Moodle.

Learning assessment methods

The exam test covers all disciplines included in the course and the final score proportionally takes into account the results of each module. Partial scores are kept valid until the next exam.

EXAMINATION ARRANGEMENTS: written 

• MED/05 - Clinical pathology: 20 questions, brief open answers, 40 min time. No penalties for incorrect answers.
• MED/07 - Clinical microbiology: 4 open questions (two brief and two broad), 40 min time. No penalties for incorrect answers.
• BIO/12 - Clinical biochemistry: multiple-choice test. 16 questions. 20 min time. No penalties for incorrect answers.

Notes

Professors are available upon mail contact.

Partial scores are kept valid until the next exam.

Students with DSA or disabilities are kindly requested to take note of the reception services and support services offered by the University of Turin, and in particular of the procedures required for exam support.

Teaching Modules

• Laboratory Medicine - module of Clinical Biochemistry and Molecular Biology (SCB0226A)
• Laboratory Medicine - module of Clinical Pathology (SCB0226C)
• Laboratory Medicine - module of Microbiology and Clinical Microbiology (SCB0226B)

• Teaching material
• Exams and finals
• Class schedule
• Go to Moodle
• Register for the course
• Enrolled students
• Invia email agli studenti registrati
• Export table