Module - Disorders of Red and White Blood Cells (SLS124)

STP

Aim of this module

These modules provide the trainee with the knowledge that underpins the specialist module in Haematology and Transfusion Science and provides trainees with the knowledge and understanding that underpins and is applied to work-based learning.

This module will provide the trainee with the knowledge and understanding of the pathophysiology and clinical presentation of a range of disorders associated with abnormalities of red cell, white cell and haemostatic parameters. In the work-based module they will be expected to apply this knowledge as they perform methods related to red cell, white cell and haemostatic function and gain experience of the interpretation of patient results in a variety of clinical settings.

Work-based learning outcomes

  1. Perform a range of laboratory and molecular techniques used in the workplace investigate anaemia, red cell disorders.
  2. Perform a range of laboratory and molecular techniques used in the workplace to investigate white cell disorders.
  3. Identify appropriate clinical and laboratory investigations and outline the management of acquired and hereditary red cell disorders.
  4. Identify appropriate clinical and laboratory investigations and outline the management of non-malignant white cell disorders.
  5. Perform quality assurance and control tasks across the range of investigations associated with the investigation of red and white blood cell disorders.

Work-based Competencies

Learning outcome Title Knowledge
1 1,5

Perform methods for the investigation of anaemia including the following:

  • iron deficiency anaemia
  • anaemia of inflammation
  • megaloblastic anaemia
  • hereditary haemolytic anaemias
  • acquired haemolytic anaemias.
  • The initial, routine screening tests for anaemia, including FBC, reticulocyte count and blood film morphology.
  • How to asses haematinics using representative assays for the investigation of iron, B12 and folate status.
  • The common screening tests for hereditary and acquired red cell disorders, including enzymopathies and red cell membrane defects, haemoglobinopathies and haemoglobin variants.
  • Performance characteristics of methods, internal quality control (IQC) and external quality assurance (EQA).
2 1,5

Perform methods for the investigation of a range of hereditary red cell disorders, including the following:

  • sickle cell disease (SCD)
  • thalassaemias
  • other haemoglobin variants
  • red cell enzymopathies
  • red cell membrane defects.
  • Methods used in the investigation of haemoglobin variants, including:
    • electrophoresis
    • HPLC
    • DNA-based methods
    • mass spectrometry.
  • The operation of the national screening programme for SCD and thalassaemia.
  • Methods for the investigation of red cell enzymopathies and membrane defects including:
    • cell morphology
    • enzymic methods
    • molecular methods.
  • Performance characteristics of methods, IQC and EQA.
3 2,5

Perform methods for the investigation of non-malignant white cell disorders including:

  • automated quantitation of white cells, including white cell differential
  • blood film morphology
  • infectious mononucleosis screen.
  • Principles of automated white cell counting.
  • Normal and abnormal white cell morphology and blood film examination.
  • Morphological features associated with viral illnesses and further testing for infectious mononucleosis.
  • Performance characteristics of methods, IQC and EQA.
  • The clinical significance and the laboratory presentation in relation to the disorder chosen.
4 3

Interpret haematology data in light of clinical details and authorise reports under supervision of patients with anaemia, including:

  • iron deficiency anaemia
  • anaemia of inflammation
  • megaloblastic anaemia
  • hereditary haemolytic anaemias
  • acquired haemolytic anaemias.
  • The clinical significance and the laboratory presentation, in relation to the disorder chosen.
  • BCSH, NICE and other clinical practice guidelines for the investigation of anaemia.
  • Correct timing of patient samples prior to and during investigation.
  • Correct interpretation of haematological results relative to reference data.
  • Requirements of interpretive reports.
  • Responsibility and level of authority for production and authorisation of reports.
5 3

Interpret haematology data in light of clinical details and authorise reports under supervision of patients with a range of hereditary red cell disorders, including the following:

  • SCD
  • thalassaemias
  • other haemoglobin variants,
  • red cell enzymopathies
  • red cell membrane defects.
  • The clinical significance and the laboratory presentation, in relation to the disorder chosen.
  • BCSH, NICE and other clinical practice guidelines for the investigation of red cell disorders.
  • Correct timing of patient samples prior to and during investigation.
  • Correct interpretation of haematological results relative to reference data.
  • Requirements of interpretive reports.
  • Responsibility and level of authority for production and authorisation of reports.
6 3

Interpret laboratory data and reports from the national screening programme for SCD and thalassaemia.
  • The incidence of SCD and thalassaemia as revealed by the national screening programme for SCD and thalassaemia.
  • Reporting methodology for the national screening programme and responsibilities at local level for communication and follow-up.
7 4

Interpret haematology data in light of clinical details and authorise reports under supervision on patients with at least one of the following of white cell disorders:

  • lymphopenia
  • neutropenia
  • leucocytosis
  • The clinical significance and the laboratory presentation, in relation to the disorder chosen.
  • BCSH, NICE and other clinical practice guidelines for the investigation of white cell disorders.
  • Correct timing of patient samples prior to and during investigation.
  • Correct interpretation of haematological results relative to reference data.
  • Requirements of interpretive reports.
  • Responsibility and level of authority for production and authorisation of reports.
8 3,4

Identify cases requiring urgent intervention and be able to offer suggest clinical advice on follow-up and/or further management.
  • Red cell and white cell abnormalities that require urgent intervention, management and further investigation.
  • The need for urgent intervention (e.g. high WBC) and the range of further follow-up tests.

Work-based assessment

Complete 2 Case-Based Discussion(s)
Complete 2 of the following DOPS and/or OCEs
Type Title
DOPS Authorise test report for patients with Lymphocytopenia
DOPS Authorise reports for patients with Neutropenia
DOPS Authorise test reports reports for patients with Leucocytosis
DOPS Authorise reports patients with platelet disorders including at least one of the following Congenital disorders Thrombocytopenia Myeloproliferative disorders rugs eg aspirin
DOPS Perform investigation of Blood film morphology, Infectious mononucleosis screen
DOPS Authorise reports under supervision on patients with a range of anaemias
DOPS Authorise written reports under supervision on patients with a range of hereditary red cell disorders
OCE Attend a haematology outpatient clinic and take a patient history
OCE Attend an out patient clinic and take a patient history from a patient with a red cell disorder
OCE Attend an out patient clinic and take a patient history from a patient with a red cell disorder