CLINICAL BIOCHEMISTRY AND BASIC PATHOLOGY
The course aims to provide the student with the School of Biological Sciences basic elements of the analytical tools and diagnostic laboratory in the evaluation of metabolic functions and organs.
The first part of the course focuses on the general aspects of laboratory tests, such as analytical and diagnostic problems of the pre-analytical phase for the accuracy and completeness of the application of laboratory tests in relation to the diagnostic question and a description of several biological samples and their sampling mode. Knowing the general lines of the imaging techniques more commonly used in the laboratories of Clinical Pathology and Clinical Biochemistry.
The second part of the program focuses on biochemical markers as indicators of pathological processes, on metabolic pathways or organ profiles.
Knowledge and understanding: The student must demonstrate knowledge and understanding of the issues related to the operation of a clinical trial laboratory and the basic analysis of clinical biochemistry.
Ability to Apply Knowledge and Understanding: The student must demonstrate how to use the acquired concepts and the tools necessary to carry out evaluation and execution of clinical biochemistry analysis
Judgment autonomy: Students must be able to independently evaluate situations different from the standard presented by the teacher during the course and to adopt the best solving methodologies.
Communicative Skills: Students must have the ability to express themselves correctly using the appropriate scientific language.
Learning Skills: The student must be able to update continuously through the consultation of texts and publications (also in English) in order to acquire the ability to deepen the topics of the field of clinical biochemistry.
The student must acquire and assimilate the knowledge provided by the Anatomy and Biochemistry courses.
Laboratory Medicine. Meaning, Purpose; biochemical-clinical examinations, basic examinations. Specialist examinations; purpose of screening, diagnostic purposes; urgent samples. The lab staff.
Laboratory use. Sample collection, sampling errors, repeated exams, sample analysis, unnecessary exams.
The variability of the report. Pre-analytic variability, analytical variability, post-analytical variability.
Interpretation of results. How to express the results of analyzes, result variability, reliability, accuracy, accuracy, specificity, sensitivity. Diagnostic logic.
Concepts of Laboratory Medicine. Analytical and statistical concepts of data analysis, interference in laboratory tests, laboratory tests. Guidelines for sample selection, processing and treatment.
Types of analysis. Choice of analysis, analysis, patient, decentralized examinations, methodology, general problems.
The withdrawal. Blood withdrawal, urine withdrawal, other types of withdrawals. Preparing the patient for withdrawal. Pick-up errors, storage errors and sample transport, sample preparation errors.
Urine Analysis Urinary System. Urine formation, urine collection. Urine analysis: macroscopic analysis (direct visual observation). Urine Analysis: Chemical Analysis. Microscopic analysis: urinary sediment analysis. Various types of crystals. Antibiogramma. Urinary parasitology.
Techniques used in clinical biochemistry. Chromatographic systems. Electrophoresis. Western blotting. Spectrophotometry. Colorimetry
Blood count. The blood, the corpusculous part, the plasma. Cell counter. Red blood cells and erythrocyte parameters. Platelets and platelet parameters. Anemia: Mediterranean anemia, sickle cell anemia. Reticulocytes.
Leukocytes. Leukocytes and leukocytogram, microscopic leukocyte formula
Diabetes and blood glucose. Glycemia, such as blood sugar, pancreas, glycemic swelling after a meal. Insulin and glucagon. Type 1 diabetes, type 2 diabetes, gestational diabetes. Glucose load test and glycemic curve. Diabetes monitoring, glycated hemoglobin.
Liver: function and clinical biochemistry. The liver. Examination of liver function. Transaminases, glutamine transferase gamma, alkaline phosphatase, bilirubin, albumin
Myocardial infarction and cardiac markers. Infarction, diagnosis. Cardiac damage markers. Cardiac Enzymes: Transaminase, CPK, CKMB, LDH. Lipoprotein a. Homocysteine. Troponin. Myoglobin.
Atherosclerosis: pathology and clinical biochemistry. Blood vessel anatomy, atherosclerosis. Cholesterol and lipoproteins: LDL, HDL, VLDL. Triglycerides.
TAS-VES. Antistreptolynamic titre (TAS), streptolysin, antistreptolone, diagnostic meaning. Erythrocyte velocity (VES), Rouleaux, diagnostic meaning.
Blood clotting. Primary hemostasis, secondary hemostasis, intrinsic, extrinsic, clotting, fibrinogen, fibrin. Plaster and coagulation. Coagulation test: prothrombin time, thromboplastin time.
Pre-analytical phase. Analytical variability (reliability, accuracy, accuracy and specificity, sensitivity). Interpretation of results. Measurement errors. Patient preparation for withdrawal, factors that influence analytical parameters. Methods for sampling, storage and transport of the sample to be submitted to laboratory tests. Principles of the main analytical techniques used in clinical biochemistry laboratories and, in particular, spectrophotometry and electrophoretic techniques.
Diabetes and clinical biochemistry. Liver function and clinical biochemistry.
Standard urine examination and clinical biochemistry of renal function. Hemocromocytometric examination (leukocyte formula). Anemia: Mediterranean anemia, sickle cell disease. The markers of glucid metabolism (diabetes), lipid (atherosclerosis). Cardiac, renal and hepatic injury markers. Some enzymatic diagnostic relief doses (transaminase, LDH, CPK, alkaline phosphatase). VES and TAS. Coagulation and main analysis.
The course provides a practical lesson that will take place in a University lab, during which students will be explained and then asked to do some simple clinical Biochemistry analysis.
The course includes frontal lessons and practical lessons using the laboratory at the university campus
The didactic material (delivered in pdf format) is provided during the course by the teacher and posted on the University website.
For further information please consult:
Monica Stoppini e Vittorio Bellotti, Biochimica applicata, EdiSES, 2012
Michael Laposata, Medicina di laboratorio, Piccin, 2012
The objective of the exam is to check the level of achievement of the training objectives previously indicated.
The exam is divided into 2 parts that take place on the same day.
1) A written test in which the student is asked to answer questions related to the topics explained during the course.
2) an oral test in which the ability to link and compare different aspects of the course will be evaluated.
The written test is not passed if the score is less than 18, in which case the oral test will not be available.
The final score is given by the average score of the written test and the oral test.