Module - Clinical Disorders of the Major Organs and Cancer (SLS121)

STP

Aim of this module

This module will provide the trainee with detailed knowledge and understanding of the clinical disorders of major organ function, and the clinical and laboratory methods used in diagnosis and management. They will understand the aetiology and biochemical investigation of a range of malignancies. In the work-based module they will be expected to apply this knowledge as they learn to perform and assure a range of manual, semi-automated and automated methods used in the investigation of major organ function and cancer. They will gain extensive experience of the interpretation of patient results in a variety of clinical settings.

Work-based learning outcomes


  1. Perform the range of laboratory and point-of-care testing techniques used in the work-base to investigate major organ function.
  2. Perform clinical and laboratory investigation of homeostatic mechanisms.
  3. Perform clinical and laboratory investigation of kidney function and renal replacement therapy.
  4. Perform clinical and laboratory investigation of liver function.
  5. Perform clinical and laboratory investigation of cardiac function in acute and chronic conditions.
  6. Perform clinical and laboratory investigation of bone metabolism.
  7. Apply Clinical Biochemistry to the screening, diagnosis and treatment of common cancers.
  8. Perform clinical and laboratory investigation of disorders associated with specific protein abnormalities.
  9. Interpret and report clinical and laboratory investigation and analysis in the correct clinical context.

Work-based Competencies


Learning outcome Title Knowledge
1 1,2

Perform the analyses to laboratory standard operating procedures on patients with:

  • fluid balance disorders
  • acid base disorders
  • fluid replacement therapy.
  • The common causes of fluid balance disorders.
  • Acid base disorders.
  • Differential diagnosis and further investigation of the following conditions: 
    • hypo- and hyperkalaemia
    • hypo- and hypernatraemia.

 

2 1,3

Perform the analyses to laboratory standard operating procedures on patients with disorders of:

  • renal pathophysiology.
  • The causes of acute kidney injury.
  • The causes and stages of chronic renal failure.
  • How the following conditions are monitored:
    • renal replacement therapy
    • renal transplantation.
  • Differential diagnosis and further investigation of the following conditions: 
    • renal tubular acidosis
    • renal calculi.
3 1,4

Perform the analyses to laboratory standard operating procedures on specimens for:

  • liver function tests
  • INR (international normalised ratio)
  • tumour markers
  • ferritin and iron saturation
  • copper and caeruloplasmin.
  • The causes of jaundice, acute and chronic hepatitis, cirrhosis, alcohol/drug hepatotoxicity, cholestatic liver disease, fatty liver disease.
  • The inherited causes of liver disease (e.g. haemochromotosis, alpha-1 antitrypsin deficiency, Wilson’s disease).
  • Identification of liver malignancies and monitoring of treatment.
4 1,5

Perform the analyses to laboratory standard operating procedures specimens for:

  • cardiac biomarkers
  • lipids
  • metadrenalines
  • renin and aldosterone.
  • Cardiovascular risk stratification.
  • The causes of primary and secondary cardiovascular disease and treatment strategies.
  • Acute coronary syndromes and chronic heart failure and the efficacy of treatment options.
  • Suitable investigations for hypertension.
5 1,6

Perform the analyses to laboratory standard operating procedures on:

  • bone metabolism (calcium, phosphate, magnesium and alkaline phosphatase)
  • vitamin D and its metabolites
  • parathyroid hormone (PTH)
  • markers of bone turnover.
  • The abnormalities of bone metabolism.
  • The causes of hypo- and hypercalcaemia.
  • Hypo- and hypermagnesaemia.
  • Hypo- and hyperphosphataemia.
6 1,7

Perform the analyses to laboratory standard operating procedures on:

  • tumour markers.
  • The suitability of tumour markers for screening, diagnosis, prognosis and monitoring treatment of the following malignancies:
    • prostate cancer
    • Gastrointestinal (GI) tract cancers
    • pancreatic cancer
    • bladder cancer
    • lung cancer
    • liver cancer
    • ovarian cancer
    • breast cancer
    • choriocarcinoma
    • testicular cancer.

 

 

 

7 1,8

Perform the analyses to laboratory standard operating procedures on:

  • markers of inflammation
  • immunoglobulins and paraproteins
  • cryoglobulins
  • alpha-1 antitrypsin deficiency.
  • The abnormalities of protein metabolism and appropriate investigation of the following conditions:
    • hypo- and hyperalbuminaemia
    • inflammatory disease
    • raised immunoglobulins
    • paraproteinaemia
    • cryoglobulinaemia
    • alpha-1 antitrypsin deficiency.

 

8 2,3,4,5,6,7,8

Identify cases that require urgent intervention and offer clinical advice on the follow-up and/or further management of the patient.

  • Time-critical and grossly abnormal results requiring urgent clinical interventions for the disorders in this module.
9 9

Interpret biochemical data in light of the clinical details.

  • Correct use and interpretation of data in relation to the full range of investigations specified within this module.
10 9

Draft written reports on results of investigations.

  • Report requirements and their importance.
  • Sources of information, including appropriate use of patient records, reference materials and current national/international guidelines.

Work-based assessment


Complete 2 Case-Based Discussion(s)
Complete 2 of the following DOPS and/or OCEs
Type Title
DOPS Perform tests to determine Acid Base disorders
DOPS Perform any necessary maintenance and run Internal Quality Control for Glucose measurement on a point of care analyser
DOPS Prepare a set of lyophilised Internal Quality Control Samples for assay
DOPS Assess performance of a manual pipette
DOPS Prepare appropriate dilutions of an elevated sample for reassay on an automated analyser
DOPS Perform weekly maintenance on an analyser in the automated laboratory
DOPS Perform a manual semiautomated technique in the local laboratory
DOPS Perform tests to determine kidney function
DOPS Perform tests to determine cardiac function and disease
DOPS Review External Quality assessment Chemistry Analytes
DOPS Prepare and analyse samples by HPLC
DOPS Perform tests to determine liver function
DOPS Perform tests to determine bone metabolsim
DOPS Collect a sample for cryoglobulin analysis
OCE Attend a phlebotomy clinic or ward round and explain to a patient what will happen to their blood sample
OCE Explain to a patient how to collect a 24 hour urine sample
OCE Phone and discuss abnormal results with a healthcare professional
OCE Explain to a patient healthcare professional the preparation required to take samples for renin and aldosterone