Laboratorial Semiotics

Code:

M323

Acronym:

SL

Keywords
Classification	Keyword
OFICIAL	Medicine

Instance: 2018/2019 - SP

Active?	Yes
Responsible unit:	Medical Teaching
Course/CS Responsible:	Integrated Masters Degree in Medicine

Cycles of Study/Courses

Acronym	No. of Students	Study Plan	Curricular Years	Credits UCN	Credits ECTS	Contact hours	Total Time
MIM	388	Transition Study Plan (2018)	3	-	3	28	81

Teaching language

Portuguese

Objectives

Students should be able to:

• Possess a thorough understanding of the components of the diagnostic process and the role of laboratory medicine.
• Propose the inclusion of new diagnostic tests based on studies of cost / benefit.
• Formulate differential diagnoses and identify the most likely diagnoses.
• Know how to use the evidence-based medicine for choosing the best test for a given clinical situation.
• Know how to use "guidelines" in the stratification of test requests.
• Incorporate the situation / patient perspective in deciding diagnosis.
• Select the exams with the highest probability of getting a useful result, with costs / risks acceptable.
• Understand how disease prevalence affects the predictive value of diagnostic tests.
• Identify key factors to consider when selecting a particular test, including the pretest probability, the performance characteristics of the test (sensitivity, specificity and predictive values), costs, risks / benefits and preferences of the patient as an individual.
• Limit the possibility of false positives / false negatives through a careful selection of tests.
• Understand the way of determination of the reference values and the implications that follow from this to the interpretation of laboratory data.
• Know how to interpret the results, integrating them into clinical.
• Recognize how errors in interpretation may affect decisions and clinical outcome.

• Possess the ability to select, justify and interpret diagnostic tests in the most common clinical situations.

Learning outcomes and competences

Students should be able to:

• Apply the concepts of sensitivity and diagnostic specificity of a laboratory test to a specific clinical problem.
• Define negative and positive predictive value and explain how these values are influenced by the prevalence of the disease.
• Describe how the reference values are determined and used.
• Explain why 5% of the analytical results of healthy subjects are outside the reference range.
• Explain the concept of variability in repeated measurements, as well as what happens in the individual at different times and between individuals.
• Explain the impact of pre and post-analytical variables on laboratory outcomes and how they can affect health care.
• Define critical value and explain why these values should be reported immediately to the physician for immediate action.
• Describe the use of tests on metabolic balance, including electrolytes, acid-base balance, osmolality, and blood gases.
• Describe the tests relevant to the diagnosis of acute coronary syndrome, myocardial infarction, and congestive heart failure.
• Describe the relevant tests for the diagnosis of hyperlipidemia and use the tables to calculate cardiovascular risk.
• List the criteria for laboratory diagnosis of diabetes mellitus and explain how laboratory tests are used to control the disease.
• Describe the utility of urinalysis and list the tests used to evaluate renal function.
• Describe the tests used to evaluate liver function.
• Describe the basic principles of clinical toxicology and monitoring of therapeutic drugs, including the dose-adjusted pharmacokinetic study.
• Distinguish the use of tumor markers for screening, diagnosis, prognosis and monitoring of therapy.
• Describe the use of laboratory tests in the diagnosis of endocrine diseases.
• Describe the methods for determining the blood count, including the measured and calculated values.
• To describe the laboratory evaluation and differential diagnosis of anemia, leukopenia and leukocytosis, thrombocytopenia and thrombocytosis.
• Describe the most commonly used tests for the study of proteins in the context of inflammatory and immune disease.
• List the tests most used in the evaluation of autoimmune disease.
• Describe the laboratory evaluation of biological fluids, including CSF, pleural fluid and ascites.

 

Working method

Presencial

Program

1. Presentation; Fundamental Concepts - Presentation of discipline. Analytical cycle.
2. Diabetes Mellitus; Study of Biological Fluids.
3. Acid-Base Balance; Respiratory Failure - Study of acid-base balance. Evaluation of respiratory failure.
4. Biological Markers I - Markers of injury and organ dysfunction - liver. Markers of injury and organ dysfunction - cardiovascular system.
5. Biological Markers II - Markers of injury and organ dysfunction - kidney. Markers of the inflammatory syndrome
6. Tumor Markers; Therapeutic Drug Monitoring - Tumor markers. Therapeutic drug monitoring and toxicology.
7. Endocrinology I - General and specific laboratory diagnosis in endocrinology. Function and hypothalamic-pituitary dysfunction. Function and thyroid dysfunction.
8. Endocrinology II - Function and adrenal dysfunction. Phosphocalcium metabolism.
9. Hematology I - General and specific laboratory diagnosis in Hematology. General concepts of the methods in Hematology. The Red Blood Cell
10. Hematology II - Leucocytes and Platelets
11. Immunology I - General and specific laboratory diagnosis in Immunology. General concepts of the methods in immunology.
12. Immunology II – Autoimmunity, Clinical Cases.
13. Water and Electrolyte – Disorders of water and electrolyte balance.

 

Mandatory literature

.; Artigos de Revisão; Slides das Aulas; Textos de Apoio

Complementary Bibliography

Hurst, J.W. and Walker, H.K; The problem-oriented system, The Williams & Wilkins Company, 1972
Hanson C. William; Healthcare Informatics, McGraw-Hill Medical, 2006. ISBN: 0-07-144066-6
Straus Sharon E. 070; Evidence-based medicine. ISBN: 0-443-07444-5
Rao Goutham; Rational medical decision making. ISBN: 0-07-146397-6

Teaching methods and learning activities

Theoretical and practical classes.

keywords

Health sciences > Medical sciences > Medicine > Clinical medicine

Evaluation Type

Evaluation with final exam

Assessment Components

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

Amount of time allocated to each course unit

Designation	Time (hours)
Estudo autónomo	53,00
Frequência das aulas	28,00
Total:	81,00

Eligibility for exams

In accordance with the legislation in force.

Calculation formula of final grade

Final exam - 100%

Special assessment (TE, DA, ...)

By means of written examination.

Classification improvement

Upon completion of a new written examination.