BASIC TOPICS OF HEMATOLOGY| COURSE CODE | ΠΘ 0900 |
| | COURSE INSTRUCTOR | GEORGE VASSILOPOULOS, PROFESSOR |
| | CO-INSTRUCTORS | NIKOS GIANNAKOULAS |
| | ECTS: | 2.00 |
| COURSE TYPE | EL | SCIENTIFIC AREA |
| | TEACHING SEMESTER | SPRING SEMESTER |
| | WEEKLY TEACHING HOURS: | 2 HOURS |
| | Total Time (Teaching Hours + Student Workload) | 54 HOURS |
| PREREQUIRED COURSES: | NO |
| | LANGUAGE OF TEACHING AND EXAMS | GREEK |
| | AVAILABLE TO ERASMUS STUDENTS | YES |
| | SEMESTER LECTURES: | DETAILS/LECTURES |
| | TEACHING AND LEARNING METHODS : | Lectures and small group teaching
Tutorials and seminars
Demonstration/Observation
Problem-based learning
Independent self-directed learning (eg reading, including webbased material, journals etc) Podcasts, created presentations (e.g. powerpoints) |
| | STUDENT EVALUATION | Multiple Choice Questions (MCQs) |
| | Objective Objectives/Desired Results: | The course covers the field of Hematology and includes lectures on normal and abnormal hematopoiesis, its laboratory investigation and the interpretation of the diagnostic tests.
All the hematological disorders are presented as patient cases in a problem-based learning process; this aims at the development of critical thinking and of differential diagnosis in complex clinical scenarios. In parallel, it encourages the dialog among small groups and enhances the presentation skills of the students. Finally, the course will enable students to comprehend the position of hematology in Internal Medicine by familiarizing with the hematological manifestations of systemic disorders.
Learning Objectives
1. Diagnose and manage anemia
2. Understand and Construct laboratory diagnosis of hemoglobinopathies and abnormal hemoglobins and manage individuals with hemoglobinopathies
3. Disorders of iron metabolism: recognize and manage iron deficiency and iron overload disorders
4. Diagnose and manage bone marrow failure syndromes
5. Describe the principles of diagnosis and management of the acute leukemias
6. Diagnose and manage Hodgkin and non-Hodgkin lymphoma
7. Diagnose and manage plasma cell and related disorders
8. Diagnose and manage myeloproliferative disorders
9. Diagnose and manage patients with inherited and acquired bleeding disorders
10. Evaluate and diagnose patients with thrombotic disorders
11. Clinical and Blood Transfusion Practice: Outline and direct the safe and appropriate use of blood and blood components and diagnose and manage possible adverse effects related to transfusion
12. Develop and understanding of normal and abnormal hematology in obstetrics and gynecology General Abilities Pursuant to course completion, the students will be in a position to:
• Comprehend the field of hematology
• Have a grip of normal and abnormal hematopoiesis
• Critically interpret all diagnostic tests
• Diagnose all hematological disorders
• Use the microscope, the immunophenotype and the molecular markers for disease diagnosis
• Solve a diagnostic problem in a constructive dialogue with fellow students within the group
• Understand the basic principles of clinical trials |
| | Course URL : | |
| | Course Description: | Learning Objective 1: Diagnose and manage anemia
– Describe the mechanism of erythropoiesis
– Define the less common causes of anemia, such as red cell aplasia, red cell membrane disorders, metabolic enzyme deficiencies etc
– Define the appropriate modalities of treatment
– Explain the pathophysiology of anemia, such as: iron, B12 or folate deficiency
– Define the investigative techniques required for the investigation of anemia
Learning Objective 2. Understand and Construct laboratory diagnosis of hemoglobinopathies and abnormal hemoglobins and manage individuals with hemoglobinopathies
– Describe laboratory diagnosis of hemoglobinopathies and abnormal hemoglobin
– Outline the molecular basis of hemoglobinopathies
– Outline the management of individuals with thalassemia major, including: transfusion, chelation therapy, diagnosis and management of iron overload, management of splenectomized individuals, psychological aspects of chronic illness
– Describe the management of the patient with sickle cell disease
Learning Objective 3. Disorders of iron metabolism: recognize and manage iron deficiency and iron overload disorders
– Describe the iron metabolism and causes of iron overload
– Outline the causes of iron deficiency
Learning Objective 4. Diagnose and manage bone marrow failure syndromes
– Define and explain the causes of pancytopenia
– Define the causes of bone marrow failure, including aplastic anemia
– Describe the myelodysplastic syndromes and their hematological sequel
– Explain the investigations that are required to diagnose the cause of bone marrow failure
Learning Objective 5. Describe the principles of diagnosis and management of the acute leukemias
– Define normal hematopoiesis and stem cell biology
– Classify acute leukemias integrating: morphology, immunophenotyping, cytogenetics and molecular biology
– Outline pathophysiology and natural history of leukemia
– Define the principles of targeted, non-cytotoxic therapies, including retinoic acid, arsenic, imatinib, rituximab etc.
– Describe the principles of supportive care, including: prevention and management of opportunistic infections, use of blood components, appropriate use of hemostatic agents, anti-emetics and analgesics
– Explain outcomes of leukemia based on classification and prognostic indices
Learning Objective 6. Diagnose and manage Hodgkin and non-Hodgkin lymphoma
– Describe the natural history, classification and molecular biology of Hodgkin’s and non- Hodgkin’s lymphoma and related disorders
– Define current staging and prognostic systems
– Recognise disease specific presentations and complications
– Outline appropriate management principles
Learning Objective 7. Diagnose and manage plasma cell and related disorders
– Outline the natural history, classification and molecular biology of myeloma and the other plasma cell dyscrasias
– Describe the respective clinical manifestations and current staging and prognostic systems
– Identify disease-specific complications
– Explain the distinction between monoclonal gammopathy of uncertain significance, smouldering myeloma and symptomatic myeloma
– Define management principles
Learning Objective 8. Diagnose and manage myeloproliferative disorders
– Outline the criteria for each phase of chronic myeloid leukaemia (CML), i.e. chronic, accelerated, blast crisis
– Explain the pathophysiology of CML on a genetic level
– Describe the diagnostic criteria, major differential diagnosis and treatment plan of polycythemia vera (PV)
– Describe the diagnostic criteria and treatment strategies for essential thrombocythemia (ET)
– Define diagnostic criteria and treatment strategy for myelofibrosis (MF)
– Identify the common and serious complications of PV, ET and MF
Learning Objective 9. Diagnose and manage patients with inherited and acquired bleeding disorders
– Describe the pathophysiology of normal hemostasis
– Describe the natural history, presentation, diagnostic strategies and complications of inherited coagulation disorders, such as deficiency of factor VIII, Factor IX and Von Willebrand factor
– Describe the diagnostic methods used in assessment of inherited coagulation disorders
– Describe the pathophysiology of acquired bleeding disorders, including DIC, renal disease, hepatic disease, obstetric complications etc.
– Describe mechanism of action, indications for use and adverse effects of available haemostatic agents, including blood and coagulation factor products, Desmopressin (DDAVP), anti-fibrinolytics, and other adjunctive agents. Learning Objective 10. Evaluate and diagnose patients with thrombotic disorders
– Describe the pathophysiology of arterial and venous thrombosis
– Explain natural history, presentation, diagnostic strategies, and complications of inherited and acquired thrombophilia
– Outline the changes to hemostasis during pregnancy
– Describe the aetiology, natural history, diagnosis and management of congenital and acquired disorders of platelet number and/or function
Learning Objective 11. Clinical and Blood Transfusion Practice: Outline and direct the safe and appropriate use of blood and blood components and diagnose and manage possible adverse effects related to transfusion
– Outline the main blood components
– Describe the indications for blood components
– Manage complex clinical situations, including: major blood loss, autoimmune hemolytic anemia, fetal alloimmune thrombocytopenia, hemoglobinopathies
– Describe the adverse effects and risks of blood transfusions and the methods by which they can be reduced
– Describe the management of adverse effects of transfusions
Learning Objective 12. Develop and understanding of normal and abnormal hematology in obstetrics and gynecology
– Describe the hematological changes of normal pregnancy, including: physiological anemia of pregnancy, effect on hemostasis and on normal iron, folate and Vitamin B12 stores
– Describe thrombosis in obstetrics and gynecology
– Diagnosis, investigation, treatment and prophylaxis of: thromboembolic disorders in pregnancy and thrombophilia
– Describe the specific issues related to the diagnosis, assessment and management of the following conditions in pregnancy: anemia, thrombocytopenia, massive hemorrhage and DIC, hemoglobinopathies | | | | Recommended reading: | Hoffbrand’s Essential Haematology, 8th Edition A. Victor Hoffbrand, David P. Steensma ISBN: 978-1-119-49590-1 December 2019 Wiley-Blackwell
Relevant online material:
BLOOD (https://ashpublications.org/blood)
HAEMASPHERE (https://journals.lww.com/hemasphere/pages/default.aspx) | | |
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