HEMATOLOGY MODULE STUDY GUIDE Course Title Hematology Module B Course Coordinator: Dr. Irfan Ashraf

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1 HEMATOLOGY MODULE STUDY GUIDE A Course Title Hematology Module B Course Coordinator: Dr. Irfan Ashraf C Course Committee Dr. Irfan Ashraf, Dr. Syeda Zarreen Raza, Dr. Rubia Kashif D Objectives of Study 1. To inform the students how students-learning program has been organized for the course of hematology Guide Module (2 nd Module of semester V). 2. To communicate about the process of implementation of redesign module. 3. To help students to organize and manage their study skills throughout the program. E Introduction Hematology module will introduce to the components of blood and the common disorders affecting them. It will also deal with the principles and techniques of hematology laboratory investigations which are useful in the diagnosis of diseases and monitoring the progress of treatments. In the lab sessions, students will be exposed to some techniques involving handling and processing of blood and blood products for diagnostic purposes in routine clinical laboratories. The aims of this module are to give the students an overview of the disorders affecting blood, investigation techniques employed by the hematology laboratory and blood bank, the rationale behind these tests, and correlation with clinical conditions. F Context This module is designed for 3 rd year 5 th semester MBBS students, which is the beginning of their clinical postings providing initial exposure to real patients. It will be focusing on clinical correlation of basic sciences knowledge. G Target Students semester V third year MBBS H Duration 4 weeks I Rationale This module addresses many aspects associated with hematology. Lecture and clinical postings are incorporated to address the clinical aspects of hematology supported by small group discussions with emphasis on management of blood diseases. The skills and knowledge imparted in this module will help students recognize the signs and symptoms of patients with hematological diseases and will help them manage the patients J Learning Outcomes At the end of the module, the students should be able to: to discuss etiology & clinical presentations of common blood diseases, to take appropriate history, perform clinical examination of patients suffering from hematological disorders, to formulate appropriate plan of investigations to list out differential diagnosis, 1 P a g e

2 to understand basic principles of management of common hematological ailments, to demonstrate appropriate skills for counseling the patients. K Teaching and learning 1. Bed Side Teaching 2. Lectures 3. Problem Based Learning 4. Practical session strategies: 5. Tutorials 6. Seminar 7. Presentations 8. Skills lab 9. Self-study 10. elearning L Departments Clinical Faculty Anatomy Biochemistry Community Medicine Physiology Pathology Pharmacology Forensic Medicine M DEPARTMENT/SUBJ ECTS TOPICS/METHOD OF TEACHING WEEK 1 PHYSIOLOGY LEARNING OBJECTIVES At the end of the week, the studentsshould be able to: enumerate steps of normal haemopoiesis with importance of red cell indices and its correlation physiological review of anemia(nutritional),importance of red cell indices and its correlation(lecture) PATHOLOGY interpret the blood report of patients suffering from microcytic & macrocytic anemia Categorize and discuss laboratory tests used in the diagnosis of anemia, outlining the basic workup of a patient who presents with anemia. discuss pathogenesis and pathological changes in a patient with diminished erythropoeisis and hemolytic anemia Interpretation of CBC report Normal, microcytic, macrocytic anemia(tutorial) Classification of anemia and blood loss anemia(lecture) anemia of diminished erythropoeisis(iron deficiency anemia, megaloblastic anemia, aplastic anemia)(lecture) Hemolytic anemia(hs,g6pd,scd)(lecture) 2 P a g e

3 FORENSIC PHARMACOLOGY CLINICAL FACULTY WEEK 2 PATHOLOGY COMMUNITY Discuss the forensic methods and scientific basis for age estimation by forensic odontology explain indication, dose, effect, adverse affect of hematinics, erythropoietin, colony stimulating factors discuss clinical presentation, d/d and investigation of patients suffering from anemia in different age group and sex. describe pathogenesis & pathological changes in patients suffering from Thalassemia,autoimmune hemolytic anemia,bleeding and coagulation disorders state the recommendations for current vaccines and vaccine schedules Appreciate the role and interdisciplinary methods of cancer control and prevention Describe the principles and concepts of an efficient immunization programme age estimation from teeth(tutorial) Iron,B12 treatment(hematinics,erythropoietin,colony stimulating factors(lecture) Overview of anemia(lecture) Thalassemia syndromes(lecture) Bone marrow Examinations( normal and Abnormal)(LAB) Autoimmune hemolytic anemia(lecture) Bleeding diatheses,platelet disorders(lecture) Coagulation disorder(hemophilia,vwd) (LECTURE) Immunity type,vaccine(lecture) Epidemiology and prevention of Cancers(LECTURE) EPI program (LECTURE) evaluate on the basis of history & examination and enlist the investigation of patient with different types of anemia and bleeding disorders Thalassemia syndromes(lecture) hemolytic anemia,iron deficiency anemia,anemia of chronic disease (LECTURE) Megaloblastic anemia,aplastic anemia(lecture) Approach to a patient with bleeding(lecture) 3 P a g e

4 PEDIATRICS explain signs & symptoms, d/d and integrated management of a neonate/ child suffering from hemoglobinopathies and hemolytic anemias Cong hemolytic anemia (+ Sickle cell anemia) Hereditary spherocytosis, G6PD deficiency, Pyruvate kinase Deficiency, Acquired hemolytic anemia, Autoimmune hemolytic anemia(lecture) FORENSIC Apply the forensic strategies for the personal identification,its types along with parameters of identification in living as well as dead Personal identity I(LECTURE) -Complete and partial identification - Identification in living and dead bodies - Parameters of identification - Determination of race - Sex determination and intersex states Personal identity II(LECTURE) Medico legal importance of age Age estimation in medico legal cases by: - General examination - Forensic Odontology - Radiology Personal identity III(LECTURE) - Third party method of identification - Subjective method of identification - Objective methods of Identification - Osteometric indices - Dactylography - Superimposition photography - Trace evidence - Locard s principle of exchange & its medico legal importance 4 P a g e

5 WEEK 3 PHARMACOLOGY PEDIATRICS PATHOLOGY describe signs & symptoms, d/d, investigation of patients suffering from coagulation disorders as well as for Thrombocytopenia discuss strategies for anticoagulation and its complications. Explain indication, dose, effect, adverse effect and detoxification of Thrombolytics & fibrinolytics drugs. Describe signs & symptoms, d/d, investigation of a child suffering from Rh incompatability. Correlate pathophysiology with the clinical picture of DIC, Hemolytic uremic syndrome, Thrombotic thrombocytopenia discuss causes, signs & symptoms, d/d, investigation and management of patients of DIC List out the tests used to screen bleeding and coagulation disorders Coagulation disorders (hemophilia, vwd) (LECTURE) Thrombocytopenia (LECTURE) Anticoagulation (heparin / warfarin, prophylaxis of venous thrombosis ) (LECTURE) Thrombolytics & fibrinolytics(lecture) Diagnosis of hemolytic disease of new born-rh incompatability(lecture) Disseminated intravascular coagulation: Hemolytic uremic syndrome, Thrombotic thrombocytopenia(lecture) DIC, Thrombotic Thrombo-cyto-penic purpura, Hemolytic Uremic Syndrome(LECTURE) Screening Tests for bleeding and coagulation disorders interpretation(lab) PHYSIOLOGY Explain the physiological pathway of hemostasis Extrinsic and intrinsic pathways of coagulation(lecture) COMMUNITY Understand how community and school policies protect the health, welfare, and safety of students. School Health Service (LECTURE) FORENSIC Apply forensic strategies to determine sex by forensic radiology Determination of sex from bones(tutorial) 5 P a g e

6 interpret and apply knowledge about parameters of identification in dead, decomposed,mutilated, burnt, skeletal and fragmentary remains Personal Identity IV(LECTURE) - Identification of a dead, decomposed body - Mutilated & burnt bodies, - Skeletal & Fragmentary remains. - Hair - Scar - Acquired and congenital deformities - Tattoo marks WEEK 4 PATHOLOGY Recognize and interpret the foundational concepts of thanatology theory and practice Describe the signs and symptoms of DIC And identify management modalities for DIC describe the tools used to establish diagnosis, determine prognosis and clinical management of lymphoma. discuss clinical presentation, d/d, investigation and management of a patients of Leukemia recognize a normal white blood cell morphology,its variations and the underlying clinical conditions Explain the pathological basis for classification of leukemia and lymphoma 5. Thanatology I(LECTURE) - Scientific concepts regarding death - Medico-legal aspect of brain death - Howard s criteria of death - Cause, manner, mode and mechanism of death - Medico-legal aspects of sudden & unexpected deaths DIC(LECTURE) Lymphomas(hodgkin,non hodgkin) (LECTURE) Leukemia Histological Difference b/w normal white cell, leukemoid reaction & Malignant cell(lab) Overview and classification of neoplastic proliferation of white blood cells(lecture) 6 P a g e

7 PHARMACOLOGY FORENSIC Define non-hodgkin s lymphoma and its classes and subtypes. Outline the incidence, prevalence, and risk factors of non-hodgkin s lymphoma. Discuss the immunological basis of transplant rejection Focus on indications for bone marrow transplant, its types and complications Describe the classic peripheral blood findings and bone marrow findings seen in patients with myelodysplasia. Describe laboratory determinants of prognosis in patients with myelodysplasia. Explain the categories of immunomodulating agents and state their general uses Describe the actions and major side effects associated with immunity suppressing medications related to transplant Express the use of Forensic methods for determination of age,sex and race Recognize and articulate the foundational concepts of thanatology theory and practice Non-hodgkins lymphoma(lecture) Immunology of transplant rejection(lecture) Bone marrow transplantation(lecture) Myelodysplastic syndrome,myeloproliferative disorders(lecture) Immunosuppressant,immunemodulators related to transplantation(lecture) Osteometric indices of Bones in determination of Age, Sex, Race-TUTORIAL Thanatology -LECTURE N E-Learning A wealth of learning material in the form of presentations and PDF lectures outline are available at JSMU e- Learning website. Follow the link from JSMU website. O Workshops: Department of medical education will offer optional workshops to improve learning capabilities. P Formative assessment Formative assessment will be available in digital lab as well as online. This will help in self-assessment of students. Q Mode of Internal (Continuous Assessment): Evaluation: Continuous monitoring of attendance and practical assessment in short groups. It will be in the form of BCQs, assignments, stages/sub-stages, projects, quiz or OSPE. Internal evaluation carries 20% weightage in summative semester examination. 7 P a g e

8 R Schedule Of?????????????? Examination/s: S Mode of terminal MCQs + EMQs and OSPE (observed + un observed). Examination: T course monitoring: Through the Department of Medical Education and Quality Enhancement Cell. U Evaluation of the course Through students and faculty feedback and by the analysis of the results. V Course Summary: Special emphasis will be given to diseases involving blood and related systems frequently found in clinical hematology practice such as anemias, benign leukocyte disorders, leukemia and other hematological malignancies W End Note This document is prepared by professional development centre and clinical coordination cell in collaboration with department of medical education. Some parts of the study guide are tentative and may be modified. Any modification will be displayed on website. We need your regular feedback. The hard copies of feedback will be available in your lecture halls. The soft copy is on website X Correspondence m.irfan@jsmu.edu.pk Y Message of Vice??????????? Chancellor Z Published On???????????? 8 P a g e