Clinical Biochemistry Nutrition (SLS141)

10 credits

Aim of this module

This module will provide the trainee with the knowledge and understanding of normal nutrition and clinical disorders associated with malnutrition, malabsorption and obesity. Trainees will understand the normal biochemistry of haem synthesis, haematinics and contribute to the investigation of anaemia. They will be able to describe the role of trace elements and vitamins and clinical conditions associated with deficiency or excess. They will be able to assess energy balance and understand enteral and parenteral nutrition. They will appreciate the importance of clinical and biochemical parameters in diagnosing and managing nutritional disorders. In the work-based module they will be expected to apply this knowledge as they learn to perform assays to assess nutritional status using a range of methods and gain experience of the interpretation of results in a range of clinical conditions.

  1. Perform the range of laboratory and point-of-care techniques used in the workplace to investigate nutritional disorders.
  2. Perform the clinical and laboratory investigation and analysis and management of nutritional status.
  3. Perform the clinical and laboratory investigation and analysis and management of digestion, absorption and pancreatic function.
  4. Perform the clinical and laboratory investigation and analysis and management of disorders of iron metabolism and haem synthesis.
  5. Perform laboratory techniques used in the workplace to investigate trace element and vitamin status.
  6. Work in partnership with other clinical specialisms in the investigation and analysis of nutritional disorders.
  7. Interpret and report on the results of clinical and laboratory investigation of nutrition in the correct clinical context.
Number Work-based learning outcome Title Knowledge
1 1,2,3,4,6

Perform the analyses to laboratory standard operating procedures:

  • tests of malabsorption
  • exocrine pancreatic function tests
  • amylase/lipase.
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2 1,4

Perform the analyses to laboratory standard operating procedures:

  • haematinics (B12, folate)
  • iron
  • ferritin
  • transferrin saturation (iron-binding capacity).
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3 1,4

Perform the analyses to laboratory standard operating procedures:

  • porphobilinogen (PBG)
  • porphyrin screen (qualitative)
  • porphyrins (quantitative).
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4 1,5

Perform at least three of the following analyses (following observation of analysis performed by practitioner):

  • caeruloplasmin
  • copper
  • zinc
  • manganese
  • selenium
  • lead
  • aluminium
  • mercury.
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5 1,5

Perform at least two of the following analyses (following observation of analysis performed by practitioner):

  • vitamin A
  • vitamin E
  • vitamin B1
  • vitamin B2
  • vitamin B6.
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6 1,2,3,4,5

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

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7 7

Interpret biochemical data in light of the clinical details.

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8 7

Draft written reports on patients.

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You must complete
2 Case-based discussion(s)
2 of the following DOPS / OCEs
Assessment Title Type
Perform a quantitative analysis of PBG and interpret results DOPS
Interpret an external quality assurance report for haematinics porphyrins DOPS
Identify samples which require routine referral to an external laboratory for analysis DOPS
Perform tests of exocrine pancreatic function DOPS
Perform laboratory tests for malabsorption DOPS
Prepare an internal QC sample for a haematinics assay perform assay and interpret results including reference to haematological results DOPS
Identify, refer and report samples which require urgent analysis at an external laboratory DOPS
Perform a porphrin screen qualitative DOPS
Perform porphyrin analysis quantitative DOPS
Perform laboratory tests for the investigation of haemochromatosis DOPS
Perform trace element analysis DOPS
Perform vitamin analyses DOPS
Explain to a patient the sample collection requirements for investigation of porphyria OCE
Discuss the laboratory aspects of investigation of nutritional deficiencies with healthcare professionals 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 the need for macro- and micronutrients for normal health, growth, repair and reproduction.
  2. Discuss the role of clinical biochemistry in the assessment of nutritional status (including that of patients requiring enteral and parenteral feeding).
  3. Describe the design, operation and performance of biochemical techniques used to assess digestion and absorption.
  4. Describe the design, operation and performance of biochemical techniques used in the assessment of pancreatic function and the detection of pancreatic disease.
  5. Discuss the need to select appropriate sample and method for the estimation of trace elements and vitamins (including direct and indirect methods).
  6. Discuss the role of clinical biochemistry in the assessment of trace element and vitamin status in health and disease.
  7. Describe the design, operation and performance of biochemical techniques used for the analysis of samples for trace elements and vitamins.
  8. Discuss the partnership of biochemical nutrition to other clinical specialisms in the investigation of nutritional disorders and patient care.

Indicative Content

  • Gastrointestinal disorders: physiology and biochemistry of digestion and absorption; maldigestion and malabsorption; pancreatitis (acute and chronic); coeliac disease; inflammatory bowel disease; anaemias; peptic ulcer disease; pyloric obstruction; carcinoid syndrome
  • Gastrointestinal function testing: amylase; iron, ferritin, vitamin B12 and folate; calprotectin and lactoferrin, elastase; urea breath testing; gut hormones
  • Protein energy balance and malnutrition; markers of nutritional status; assessment of nutritional status in elective, acute and chronic conditions, burns, multiple injury and sepsis; principles and practical nutritional support (enteral, parenteral)
  • Trace elements in health and disease
  • Methods of measurement of trace elements in biological samples; atomic absorption/emission; inductively coupled plasma mass spectrometry (ICP-MS)
  • Vitamins in health and disease; syndromes of vitamin deficiency and excess
  • Methods of measuring vitamins in biological samples
  • Porphyrin metabolism, porphyrin measurement, systematic investigation of the porphyrias