-SQA-SCOTTISH QUALIFICATIONS AUTHORITY. Hanover House 24 Douglas Street GLASGOW G2 7NG NATIONAL CERTIFICATE MODULE DESCRIPTOR

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1 -SQA-SCOTTISH QUALIFICATIONS AUTHORITY Hanover House 24 Douglas Street GLASGOW G2 7NG NATIONAL CERTIFICATE MODULE DESCRIPTOR -Module Number Superclass- PB -Title- CLINICAL CHEMISTRY (x 1 / 2 ) -DESCRIPTION- Type and Purpose A Specialist Module ( 1 / 2 ) which enables the student to acquire a knowledge of clinical chemistry. It is suitable for students in Medical Laboratory Sciences programmes. Preferred Entry Level Chemical and Instrumental Analysis A Human Physiology Learning Outcomes The student should: 1. know the clinical reasons for carrying out chemical tests on body fluids and the clinical significance of levels of components in a range of body fluids; 2. know the principles of collection, safe handling, preservation, biochemical analysis, documentation and quality control when dealing with specimens of body fluids; 3. use methods of biochemical analysis safely. Content/ Corresponding to Learning Outcomes 1-3: Context 1. The main types of body fluids which are routinely tested and the reasons for the tests on: capillary, venous, arterial blood, plasma, serum, urine, cerebro-spinal fluid. The clinical significance of the following in urine: protein, glucose, bilirubin, ketones, blood, urobilinogen.

2 The clinical significance of the following in plasma and urine: urea, sodium and potassium. The clinical significance of the following in plasma: glucose, amylase, total bilirubin, aspartate amino transferase. 2. The principles of collection of the main body fluids and their preservation in relation to the components which are being measured, e.g. sample of plasma or serum, choice of anticoagulant, depending on parameter being measured. Safe use of centrifuge in processing body fluids. Quality control in determining whether results are accurate and precise, i.e. use of replicate analyses, 'within' and 'between' batch precision, known pooled and commercial standards. The distinction between 'trends' and 'shifts'. 3. Safe handling and accurate biochemical analysis of the following body fluids when testing for the following components by a simple biochemical test: urine or substitute; protein, glucose, bilirubin, ketones, blood, urobilinogen, plasma and urine; urea; plasma; glucose, total bilirubin. Safe use of the centrifuge. Use of known standards to make a calibration graph in the estimation of one of the following: protein, glucose, total bilirubin; Use of prepared standard graphs to determine unknown materials. Suggested Relating to Learning Outcomes 1-3: Learning and Teaching 1. Individual learning materials supported by Approaches resource-based information in books, medical journals, etc. Formative assessment at the end of each section of work could be in the form of tutorials/worksheets. -2 -

3 2. The use of resource material such as 35 mm slides, videos, films, manufacturers' literature. Demonstration of suitable specimen containers and collection techniques, e.g. sampling of capillary and venous blood into appropriate container with/without anticoagulant. Demonstration of safe centrifugation of blood samples to yield plasma or serum. Provision of results for students to estimate accuracy, precision, trends, shifts. Individualised learning material to summarise information and aid in understanding. Formative assessment at the end of each section of work could be in the form of oral questioning. 3. Students working individually or in pairs should safely carry out the range of biochemical tests listed in Content 3. Detailed method sheets should be provided. Each student should prepare at least one calibration graph and also interpret prepared standard graphs in simulated case studies. A visit to a clinical chemistry laboratory would be desirable. Assessment Relating to Learning Outcomes 1-3: Procedures 1&2. Short answer tests for each Learning Outcome, held after the work for each Outcome. The performance required will depend on the extent and difficulty of the tests and cannot by fully judged in advance: they will however require a high score. 3. Satisfactory use of methods can be assessed by observation and by inspection of laboratory reports using appropriate checklists to include: use of equipment; observation/measurements; safe working practice; presentation; accurate recording of observations/ measurements; calculations; graphs; valid conclusions. Performance Criteria. The following criteria for each Learning Outcome are for guidance, the standard to be achieved will be a matter for the professional judgement of the tutor aided by the Council's assessor. -3 -

4 Learning Outcome 1: To the satisfaction of the tutor the student should be able to: name the main types of body fluids: capillary, venous, arterial blood, plasma, serum, urine, cerebro-spinal fluid; describe the clinical significance of the following in urine: protein - glucose - bilirubin - ketones - blood - urobilinogen - kidney disease; diabetes mellitus; obstructive jaundice; excessive fat catabolism in the body, e.g. in a diabetic who is not under effective insulin control; kidney disease; lesions of bladder or ureters; breakdown of large numbers of red cells; prehepatic jaundice; describe the clinical significance of the following in plasma or urine: urea sodium and potassium - clearance value for kidney; mineralocorticoid imbalance; describe the clinical significance of the following in plasma: glucose- amylase - total bilirubin - aspartate amino transferase - hyperglycaemia due to diabetes mellitus; hypoglycaemia due to insulin overdosage or certain tumours of the pancreas; pancreatitis; increased breakdown of red cells; bile duct obstruction; severe muscular damage, e.g. muscular dystrophy, heart attack. Learning Outcome 2: To the satisfaction of the tutor, the student should be able to: describe the principles of collection of: capillary blood - surface disinfection of skin; finger, thumb or heel (infants) prick; -4 -

5 venous blood - arterial blood - plasma - serum - urine - cerebrospinal fluid - surface disinfection of skin; venepuncture, usually in arm; surface disinfection of skin; removal by syringe; anticoagulant used to prevent loss of clotting factors; centrifugation of whole blood; centrifugation of clotted blood; single specimen; timed 24 hour sample; lumbar puncture; describe choice of specimen and method of preservation when testing: blood for glucose - plasma sample - fluoride to inhibit red cell metabolism; oxalate to act as anticoagulant; blood for protein - serum sample; blood for sodium and potassium - plasma with Li heparin as anticoagulant; blood for amylase or bilirubin - serum; blood for urea - plasma with Li heparin as anticoagulant; urea - preserved with hydrochloric acid; describe procedures for safe use of: centrifuge in handling potentially pathogenic specimens of body fluids; balancing of specimen tubes; caps on tubes; procedures in the event of spillage in the centrifuge; analyse data to establish accuracy (nearness to correct result), precision (consistency of results), within and between batch precision, trends (gradual, steady change in results over a number of samples) and shifts (sudden change in results); describe use of standards in quality control - known pooled or commercial standards - to establish 'within' and 'between' batch precision. -5 -

6 Learning Outcome 3: To the satisfaction of the tutor, the student should be able to: test for each of the following components by one of the following tests; protein in urine or substitute - boiling test, sulphosalycylic acid test or albustix. glucose in urine - Benedict's test, 'Clinitest', 'Clinistix'; bilirubin - Fouchet's test, Hunters test, 'Bililabstix'; ketones - Rothera's test, 'Ketostix'; blood - 'Haemastix'; urobilinogen - Ehrlich's test; use known standards to make a calibration graph in the estimation of one of the following: protein by Biuret reagent; glucose by Glucose oxidase-peroxidase method; total bilirubin by Van den Bergh reaction; test for urea in plasma and/or urine using diacetyl monoxime method; use prepared standard graphs to determine concentration of substances in unknown samples. Award of the module depends on the satisfactory achievement of all the Learning Outcomes. Copyright SQA