Hemostasis (SLS132)

10 credits

Aim of this module

This module will provide the trainee with the detailed knowledge and understanding of the pathophysiology and clinical presentation of a range of acquired and genetic bleeding disorders and thrombotic disorders. In the work-based module they will be expected to apply this knowledge as they learn to perform relevant laboratory methods and gain experience of the interpretation of patient results in a variety of clinical settings.

  1. Identify appropriate clinical and laboratory investigations for the investigation of haemostasis.
  2. Perform the range of laboratory, molecular and point-of-care testing (POCT) techniques used in the workplace to diagnose and monitor treatment of bleeding disorders and thrombophilia.
  3. Interpret and report results of investigations of haemostasis in the correct clinical context.
Number Work-based learning outcome Title Knowledge
1 1

Identify suitable methods for the investigation of disorders of haemostasis and thrombosis including:

  • platelet number, morphology and aggregation
  • coagulation factor activity assays (FVIII, IX)
  • prothrombin time
  • activated partial thromboplastin time
  • thrombin time
  • fibrinogen
  • d-dimer
  • inhibitor screen
  • anticoagulation therapy monitoring: warfarin, heparin.
View
2 2

Select and perform to specified quality standards methods for investigating and managing thrombosis, including:

  • d-dimer
  • molecular markers of thrombotic risk
  • anticoagulation therapy monitoring
  • International normalised ratio (INR)
  • laboratory methods
  • POCT.
View
3 3

Interpret haematology data in light of clinical details and authorise reports under supervision on patients with thrombophilia. This should include one congenital example and one acquired example:

  • congenital, e.g. factor V Leiden prothrombin mutation, and MTHFR mutation
  • acquired, e.g anti-cardiolipin antibodies
  • lupus anticoagulants
  • heparin-induced thrombocytopenia
  • antithrombin, protein C and protein S.
View
4 3

Interpret haematology data in light of clinical details and authorise reports under supervision on patients’ disorders of the coagulation system including:

  • haemophilia A, B
  • von Willebrand disease
  • disseminated intravascular coagulation (DIC).
View
5 3

Identify cases requiring urgent intervention and be able to offer clinical advice on follow-up and/or further management.

View
You must complete
2 Case-based discussion(s)
2 of the following DOPS / OCEs
Assessment Title Type
Authorise report on haemostasis and thrombosis for platelet number morphology DOPS
Authorise report on haemostasis and thrombosis for aggregation DOPS
Authorise report on haemostasis and thrombosis for coagulation factor activity assays FVIII IX DOPS
Authorise report on haemostasis and thrombosis for prothrombin time DOPS
Authorise report on haemostasis and thrombosis for activated partial thromboplastin time DOPS
Authorise report on haemostasis and thrombosis for thrombin time DOPS
Authorise report on haemostasis and thrombosis of inhibitor screening DOPS
Perform anticoagulation therapy monitoring warfarin heparin DOPS
Authorise reports on patients with thrombophilia for congenital causes example DOPS
Authorise reports on patients with thrombophilia with acquired causes DOPS
Authorise reports on patients disorders of the coagulation system for Haemophilia A B DOPS
Authorise reports on patients disorders of the coagulation system Von Willebrand disease DOPS
Perform disseminated intravascular coagulation DOPS
Authorise report on haemostasis and thrombosis for fibrinogen DOPS
Attend an outpatient clinic for anticoagulation monitoring and observe near patient testing and take consent OCE
Attend an outpatient clinic for patients with congenital and acquired thrombophilia and take a case history OCE

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning Outcomes

  1. Explain congenital and acquired bleeding disorders.
  2. Describe the design, operation and performance of laboratory, molecular and point-of-care techniques used in the investigation of bleeding disorders.
  3. Discuss and justify the diagnosis and management of bleeding disorders.
  4. Describe and evaluate the causes and risks, diagnosis and treatment options of thrombophilia.
  5. Describe the partnership between the haematology laboratory and other clinical specialisms in the investigation of bleeding disorders and patient care.

Indicative Content

  • Hereditary and acquired primary and secondary bleeding disorders, including nature and sites of bleeding; risks associated with severity
  • Hereditary and acquired thrombotic disorders, including structure and aetiology of thrombus formation; relative risk and environmental factors
  • The genetic basis and functional defects of hereditary bleeding and thrombotic disorders
  • Disseminated intravascular coagulation (DIC)
  • Principles, scientific basis, range and selection of analytical procedures applied in the investigation of bleeding and thrombotic disorders
  • Presentation and laboratory investigation of bleeding and thrombotic disorders, and BCSH guidelines relevant to this area
  • Clinical interpretation of diagnostic results, treatment strategies and management (including clotting factor replacement therapy; anticoagulant therapy; prophylaxis); family studies