Identify the most appropriate test for at least two example clinical presentations.
- The repertoire, specimen requirements, referral pattern and storage, ordering, reference ranges and turnaround times of the methods used in Clinical Immunology.
- The major clinical users of the immunology service for protein tests, autoantibody tests and allergy tests.
- The range of investigative techniques used in Clinical Immunology and their application.
Receive, label and store of a wide range of immunological specimens.
- Minimum data set required for identification of samples and the importance of ensuring that this is complete and correct.
- Factors affecting sample integrity and appropriate corrective action.
- Procedures for handling samples which may contain category 2,3 and 4 pathogens.
- Types and implications of hazards and risks associated with handling of specimens and relevant control measures.
- The quality management process that ensures the correct location and storage of documentation and specimens at each stage of process.
- Safe laboratory practices, including principles of decontamination of equipment and work areas.
- Local and national health and safety policies and procedures and their application.
- Relevant records, their importance and how to complete these correctly.
- Correct use of manual and computerised systems for generating labels for the products and components.
- Specimen preservation, distribution, separation, storage and disposal procedures.
Select and apply appropriate control materials.
- Selection and use of suitable and appropriate control materials.
- Use and application of reagents for analysis.
- Correct conditions and locations for storage of test reagents.
Use automated methods, techniques and instrumentation to include at least four of the following:
- protein analysis
- iso-electric focusing
- agglutination assays
- flow cytometry
- allergy testing.
- Capabilities and limitations of methods, techniques and equipment.
- Use, care, monitoring, calibration and routine maintenance of clinical immunology laboratory equipment to include (relevant to automated methods available) from the following list:
- water baths
- pH meters
- radioactive counters,
- sample preparation units
- automated analysers.
Interpret laboratory data in light of clinical details on patients with common disorders where the immune system is dysfunctional, including at least two of the following:
- protein disorders
- autoimmune disorders
- immunodeficiency disorders
- basic allergy testing.
- Organisation and components of the immune system.
- Immunoglobulins, complement and opsonins.
- Inflammatory markers.
- Ranges and values needed for interpretation of results.
- Cellular components (lymphocytes; granulocytes; monocytes/macrophages).
- Humoral components (autoantibodies: the range of autoantibodies and the role they play in autoimmune disease; immunoglobulins: importance of their levels and their absence; complement: importance of their levels and their absence).
- Central molecules of the immune system (major histocompatibility molecules class I & II; CD molecules/cell surface markers; receptor molecules; recognition molecules; adhesion molecules; effector molecules). Majority are used in conjunction with flow cytometry. It will be important to have a basic knowledge of their use in a clinical immunology laboratory and in which diseases their levels and absence is crucial.
- Antigen presentation.
- Innate immune response (endothelial cells; neutrophils; macrophages; natural killer cells; complement). Have a basic working knowledge of which of the components of the innate immune system routine assays can be usefully examined in a clinical immunology laboratory and in which suspected key diseases such assays are performed.
- Adaptive immune response (antigen processing; dendritic cells; T cell responses; B cell responses; primary and secondary responses; vaccination/immunisation). Have a basic working knowledge of which of the components of the adaptive immune system routine assays can be usefully examined in a clinical immunology laboratory and in which suspected key diseases such assays are performed.
- Outcome of immune responses (immunity/immunological memory; direct and indirect functions of antibodies; incidental tissue damage; hypersensitivity and allergy).
- Causes and physiological basis of allergy caused by IgE involvement. Have a good basic working knowledge of the major assay performed in clinical immunology laboratories that aid the diagnosis of suspected allergic reactions.
- Hypersensitivity causes and physiological factors. Have a good basic working knowledge of the major assays performed in a clinical immunology laboratory that will aid in the diagnosis of severe hypersensitivity reactions.
Produce basic interpretative reports on immunological investigations.
- The information to be included in an interpretative report.
- How to construct an interpretative report and the format required for presentation.
- Limits of responsibility in the authorisation and issue of interpretative reports.
- Clinical conditions that may require urgent action and how to instigate such action.
- Normal and abnormal results and their significance to the clinical question or condition.
Control infection risks in accordance with departmental protocols.
- Protocols and requirements for hygiene and infection control related to the relevant range of investigations, including preparation, conduct and completion of investigation.
- Protocol for hand washing and how effective hand washing contributes to control of infection.
Minimise risks and hazards in compliance with health and safety policies.
- The relevant health and safety regulations for laboratory and clinical investigations.
- The specific health and safety regulations for the specialism, type of specimen/sample and investigation.
- The potential hazards and risks and the actions to be taken to minimise these.
- Responsibilities and scope of practice of laboratory personnel involved in performing investigations and reporting those investigations to users.