Laboratorial Semiotics

Code:

M323

Acronym:

SL

Keywords
Classification	Keyword
OFICIAL	Medicine

Instance: 2024/2025 - 2S (of 17-02-2025 to 13-06-2025)

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	166	Official Study Plan	3	-	3	28	81

Teaching language

Suitable for English-speaking students

Objectives

Students should be able to:

• Have 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 cost/benefit studies.

• Formulate differential diagnoses and identify the most likely diagnoses.

• Know how to use evidence-based medicine to choose the best test for the clinical situation.

• Know how to use ‘Guidelines’ when stratifying diagnostic test requests.

• Know how to take the patient's situation/perspective into account when deciding on diagnostic investigations.

• Know how to select the tests most likely to produce a useful result at an acceptable cost/risk.

• Understand how the prevalence of the disease affects the predictive value of diagnostic tests.

• Identify the main factors to consider when selecting a particular test, including pre-test probability, test performance characteristics (sensitivity, specificity and predictive value), costs, risks/benefits and patient preferences.

• Carefully select diagnostic tests to limit the possibility of false positives/false negatives.

• Understand how reference values are determined and their implications for interpreting laboratory results.

• Know how to interpret the results, integrating them into the clinical context.

• Recognise the main errors in interpreting results and their impact on medical decisions and clinical evolution.

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

• Understand the predictive value of genetic tests, interpretation challenges and their clinical implications.

Learning outcomes and competences

Students should be able to:

• Apply the concepts of diagnostic sensitivity and 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 reference values are determined and used.

• Explain why 5% of analytical results in healthy individuals fall 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 results and how they can affect healthcare.

• Define critical value and explain why these values should be reported immediately to the doctor for immediate action.

• Describe the use of metabolic balance tests, including electrolytes, acid-base balance, osmolality and blood gases.

• Describe the relevant tests for diagnosing acute coronary syndrome, myocardial infarction and congestive heart failure.

• Describe the relevant tests for diagnosing hyperlipemia and use 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 usefulness of a urine test and list the tests used to assess kidney function.

• Describe the tests used to assess liver function.

• Describe the basic principles of clinical toxicology and therapeutic drug monitoring, including pharmacokinetic study with dose adjustment.

• Distinguish the use of tumour markers for screening, diagnosis, prognosis and therapeutic monitoring.

• Describe the use of laboratory tests in the diagnosis of endocrine diseases.

• Describe the methods for determining the haemogram, including measured and calculated values.

• Describe the laboratory assessment and differential diagnosis of anaemia, leucopenia and leucocytosis, thrombocytopenia and thrombocytosis.

• Describe the most commonly used tests for studying proteins in the context of inflammatory and immunological disease.

• List the tests most commonly used in the assessment of autoimmune disease and allergy.

• Understand the predictive value of genetic tests; genetics applied to the clinic: pharmacogenomics and liquid biopsy.

• Describe the laboratory evaluation of biological fluids, including CSF, pleural and ascitic fluid.

Working method

Presencial

Program

1. Presentation - Presentation of the course
2. Analytical cycle. Fundamental concepts.
3. Diabetes Mellitus; Study of Biological Liquids.
4. Acid-Base Balance; Respiratory Insufficiency - Study of acid-base balance. Assessment of respiratory insufficiency.
5. Biological Markers I - Markers of organ damage and dysfunction - liver. Markers of organ damage and dysfunction - cardiovascular system.
6. Biological Markers II - Markers of organ damage and dysfunction - kidney. Markers of inflammatory syndrome.
7. Tumour Markers; Therapeutic Drug Monitoring - Tumour markers. Therapeutic drug monitoring and toxicology.
8. Endocrinology I - Generalities and particularities of laboratory diagnosis in Endocrinology. Hypothalamic-pituitary function and dysfunction. Thyroid function and dysfunction.
9. Endocrinology II - Adrenal function and dysfunction. Phospho-calcium metabolism.
10. Haematology I - Generalities and particularities of laboratory diagnosis in Haematology. The Red Blood Cell.
11. Haematology II - Leucocytes and Platelets.
12. Immunology I - Generalities and particularities of laboratory diagnosis in Immunology. Autoimmunity and Allergy, Clinical Cases.
13. Genetics - Pharmacogenomics and liquid biopsy, Clinical Cases
14. Water and Electrolytes - Changes in the balance of water and ions.

 

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
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.

Observations