07732 - Clinical Pathology

Learning outcomes

At the end of the course, the student acquires the knowledge and the ability to understand the fundamental concepts needed for a critical evaluation and for the interpretation of the results of the main laboratory diagnostic analyses, in particular of those related to pregnancy.

Course contents

PRINCIPLES OF LABORATORY DATA INTERPRETATION

Diagnostic and biological variability, precision and accuracy, sensitivity and specificity, errors and methodology controls in laboratory clinical tests; reference intervals. Validation of diagnostic systems.

PRENATAL DIAGNOSTIC TESTS

Screening tests (Bi and Tri- tests); NIPT (non invasive prenatal testing)

STEM CELLS FROM CORD BLOOD

Stem cells, selection and donation, harvest, fields of use.

NEONATAL SCREENING

Principles and main application for phenylketonuria, congenital hypothyroidism, cystic fibrosis, widened screening.

THE BLOOD

Haematopoiesis; erythrocytes: physiology and pathology (anemias; haemoglobinopathies), platelets and red blood cells; plasmatic proteins; definition and evaluation of: haematocrit, MCV, MCH, MCHC, RDW, reticolocytes count. Lab parameters for the diagnosis of anemias. Lab parameters for the evaluation of iron metabolism, transferrin, siderosis. Deficiency of iron, vitamin B12 and folates during pregnancy.

HAEMOSTASIS AND THROMBOSIS

The coagulation cascade; alterations of coagulation during pregnancy; evaluation of platelet functionality, of the coagulation plasmatic phase and of the fibrinolitic system; lab analyses for the definition of hypercoagulability states; diagnostic tests for polyabortivity. Disseminated Intravascular Coagulation (DIC).

BLOOD GROUPS

Biochemistry and functions; immunohaematological methods for the determination of blood groups and identification of irregular antibodies; mother-fetus incompatibility.

HAEMOLYTIC DISEASE OF THE FOETUS AND THE NEWBORN

History, phisiopathoogy, preventiona and therapy

THE TRANSFUSION PROCESS

Principles of haemovigilance, critical issues of the transfsuion process, tools for haemovigilance.

KIDNEY FUNCTIONALITY

Kidney functionality markers: creatinin, creatinin clearance, azotaemia, uric acid, electrolytes, urine analyses. Lab tests for the diagnosis of pre-eclampsia.

LIVER FUNCTIONALITY

Liver functionality markers: transaminases, gamma GT, ALP, bilirubin, proteins, LDH; lab tests for the diagnosis of intrahepatic cholestasis in pregnancy.

GLUCIDIC METABOLISM

Glucidic metabolism markers. Glucose, glucose tolerance curves; lab exams for the diagnosis of gestational diabetes.

Readings/Bibliography

• Widmann: interpretazione clinica degli esami di laboratorio. Ronald A. Sacher e Richard A. McPherson. 2001 Undicesima edizione. Mc Graw Hill libri Italia (Milano)
• Italo Antonozzi e Elio Gulletta: Medicina di Laboratorio: Logica & Patologia Clinica. 2013, Piccin Nuova Libraria S.p.A. Padova.
• Technical Manual, AABB (edizioni dalla 17°, sia in lingua italiana sia in lingua inglese)
• Gronowski, Ann M. (Ed.): Handbook of Clinical Laboratory Testing During Pregnancy (testo in lingua inglese)
• S.Tura. M.Baccarani. Corso di malattie del sangue e degli organi emolinfopoietici. 2011, Esculapio, Bologna.
• M.Ciaccio Elementi di biochimica clinica e medicina di laboratorio.2020, Edises
• Recent articles published about some contents
  

Teaching methods

Frontal classes, discussion of clinical cases.

Assessment methods

Oral examination. A short text on a topic of the program (optional). The final mark of the integrated course Microbiology and Pathology will be the average of the tests of General Pathology, Microbiology and Clinical Pathology.

Teaching tools

Pdf files and recent articles used in support of teaching will be available online on the Professor's website

Office hours

See the website of Silvia Manfroi