Oncological and Hematologic Disorders

Code:

MI523

Acronym:

DOH

Keywords
Classification	Keyword
OFICIAL	Medicine

Instance: 2017/2018 - 1S (of 11-09-2017 to 02-02-2018)

Active?	Yes
Responsible unit:	Department of Medicine
Course/CS Responsible:	Integrated Master in Medicine

Cycles of Study/Courses

Acronym	No. of Students	Study Plan	Curricular Years	Credits UCN	Credits ECTS	Contact hours	Total Time
MIMED	102	Mestrado Integrado em Medicina- Plano oficial 2013 (Reforma Curricular)	5	-	6	57	162

Modules

Code	Name
MI523_A
MI523_B

Teaching language

Portuguese

Objectives

To obtain the clinical history and to perform the objective physical examination, with special incidence in hematological pathology (theoretical and practical teaching of clinical and laboratory semiotics of the haematopoietic system).
To recognise the most common haematological disorders.
Diagnostic orientation in the most common haematological pathologies. To learn how to interpret peripheral blood counts and other routine haematological tests. To allow the students to gain experience with haemato-oncology pathology (acute and chronic leukaemias, myelodysplastic and myeloproliferative syndromes, Hodgkin and non-Hodgkin lymphomas, multiple myeloma, etc) and with fundamental principles of the cytotoxic chemotherapy and with the medical and psychological support to the oncological patient. To recognise and investigate haematological manifestations of systemic diseases. To know the basis of blood transfusion, its indications and potential problems. To learn the basis of haematopoietic stem cell transplantation.
Approach to the patient with solid tumour. Observation of patients with several types of solid tumour. Discussion of physiopathology, molecular basis and clinical behaviour of brest cancer, colonic cancer, gynaecological cancer, urogenital cancer, gastric cancer. tumours of the central nervous system and tumours of head and neck.
Notions on cytotoxic chemotherapy, biologic agents and targeted agents.
Imagioly aspects of haematopoietic and solid tumours.
Clinico-pathological discussion of cases of leukaemia, lymphoma and solid tumours.

Learning outcomes and competences

At the end of the teaching period the student should be able to:
1) Recognize and guide the diagnosis of the most frequent haematological pathology, referring to specialists in the area if the necessary diagnostic and/or therapeutic means exceeds his/her capacity at the moment;
2) Recognize and guide the diagnosis of the most frequent oncological pathology, referring to specialists in the area if the necessary diagnostic and/or therapeutic means exceeds his/her capacity at the moment;
3) Learn how to interpret the haemogram and some basic haematological exams;
4) Recognize and investigate haematological manifestations of systemic diseases;
5) Recognize what is involved in caring for cancer patients, from the share of bad news to the terminal care;
6) Become familiar with fundamental principles of cytotoxic chemotherapy and medical and psychological support to the neoplastic patient;
7) Know the basis of blood transfusion, its indications and potential problems;
8) Know the basis of haematopoietic stem cell transplantation.

Working method

Presencial

Pre-requirements (prior knowledge) and co-requirements (common knowledge)

Beyond the basis of biomedical science that the students acquired in the 3 first years, students should be able to collect a comprehensive and detailed clinical history and do a thorough and complete physical examination, addressing the patient with humanity, compassion and sympathy and respecting his/her rights and well-being. However both the history and the physical examination shall be done in an organized, structured, methodic and systematised manner and it is absolutely essential that the students acquire these competences in early years mainly in the discipline of Propedeutics.

Program

Review of basic notions on physiopathology of the haematopoietic system; Semiotics of anaemia and  haemolysis; hyporegenerative anaemias and pancytopenia; haemolytic anaemias; Laboratory semiotics (alterations of the blood counts and other tests for haematological diagnosis);  Semiotics  of  adenomegalies and splenomegaly; Leukemogenesis and acute leukaemias; Other haematological cancers  (myeloproliferative  and  myelodysplastic  syndromes, lymphoproliferative syndromes and plasmocellular dyscrasies); The oncological patient; The terminal phase of the disease (palliative care); Semiotics of haemostasis; Thrombocytopenias and thrombocytopathies; Congenital and acquired coagulopathies; Thrombophilia; Blood transfusion. Haematopoietic stem cell transplantation.
Introduction to the patient with solid tumour. Observation of patients with several types of solid tumour. Discussion of physiopathology, molecular basis and clinical behaviour of brest cancer, colonic cancer, gynaecological cancer, urogenital cancer, gastric cancer. tumours of the central nervous system and tumours of head and neck.
Notions on cytotoxic chemotherapy, biologic agents and targeted agents.
Imagiology aspects of haematopoietic and solid tumours.
Clinico-pathological discussion of cases of leukaemia, lymphoma and solid tumours.

 

Mandatory literature

Kasper, Fauci, Hauser, Longo, Jameson, Loscalzo; Harrison's Principles of Internal Medicine

Complementary Bibliography

A. V. Hoffbrand, Paul A. H. Moss; Hoffbrand's Essential Haematology, Wiley-Blackwell, 2015
d. Provan, C. Singer, T. Baglin, I. Dokal; Oxford Handbook of Clinical Haematology, Oxford University Press
G. p. Rodgers, N. S. Young; The Bethesda Handbook of Clinical Hematology, Wolters Kluwer/Lippincott Williams & Wilkins

Teaching methods and learning activities

Theoretical classes (26 = 20h).
Seminars with discussion of clinical cases (13 x 90m):
- 4 of benign haematology;
- 2 of haemato-oncology (haematology + pathology);
- 2 of medical oncology (oncology + pathology);
- 2 of radiology;
- 2 of therapeutics of haemato-oncology;
- 1 of therapeutics of medical oncology.
Practical classes every other week (3 hours) consisting of:
a) observation of inpatients with haematoncological diseases and stem cell transplant;
b) observation of patients with various types of solid tumour in the outpatient clinics;
c) interpretation of full blood counts, coagulation test and protein electrophoresis;
d) semiology and evaluation of adenomegalies and splenomegaly;
e) blood transfusion (blood donation, screening of the donors, fractionation of blood components, preparation and administration of the transfusion, transfusion reactions, cytapheresis, plasmapheresis).

Evaluation Type

Evaluation with final exam

Assessment Components

Designation	Weight (%)
Teste	100,00
Total:	100,00

Amount of time allocated to each course unit

Designation	Time (hours)
Estudo autónomo
Frequência das aulas
Total:	0,00

Eligibility for exams

Compulsory attendance of practical classes and seminars. Gesture notebook completed and validated by the teacher.

Calculation formula of final grade

Multiple choice test (5 options, just one correct) with 50 questions: 25 of Clinical Haematology + 15 of Medical Oncology + 4 of Pathology + 3 of Therapeutics + 3 of Radiology. Weighs 100% in the final classification

Examinations or Special Assignments

Not applicable.

Internship work/project

Not applicable.