Universitat Internacional de Catalunya

Hematology

Hematology
3.5
12071
4
First semester
OB
Main language of instruction: Spanish

Teaching staff


Dra. SUBIRÀ CASELLES, Maricel - msubira@uic.es

Students may ask lecturers questions at the end of each class. For enquiries outside of class time, students must make an appointment by email:

Dra Maricel Subirà Caselles: msubira@uic.es

Ramon Salinas Argente: rsalinas@aehh.org

Dra Rosario Lòpez Sánchez: rlopezs@uic.es

Dra Noelia Pérez Muñoz: nperez@uic.es

 

 

 

Introduction

Haematology is a medical discipline in itself, which involves diagnosing and treating patients with haematological diseases, and also provides support to other medical and surgical specialties (blood counts, haemostasis, haematological cytology, molecular haematology and transfusion medicine).

The lecturers of the haematology course do not have the intention of training haematologists, but to provide students with the knowledge of haematology needed to practise medicine. This is their contribution towards achieving the final goal of the degree: training doctors in all technical and human aspects.

However, the lecturers’ ambition goes a little further: we wish to pass on to students our enthusiasm for this specialty, which is sometimes wonderful and sometimes terribly cruel. We hope that students will learn something about haematology, and also acquire an interest in learning more about it throughout their professional career.

 

Pre-course requirements

To have passed the subject: "Structure and function of the blood and immune system".

Objectives

The haematology training course aims to provide students with specific tools that will help them understand the main problems associated with haematological diseases. 

The student should also be able to identify blood disorders secondary to other medical problems.

Additionally, the optimal diagnostic processes to guide diagnosis will be established, using available diagnostic tests and taking into consideration cost-effectiveness variables. 

The treatment bases of haematology and side effects will also be presented. 

Finally, students will reflect on the human problems resulting from haematological diseases and be provided with tools to cope with them psychologically and communicatively.

Competences/Learning outcomes of the degree programme

  • 07 - Understand and recognise normal structure and function of the human body at the molecular, cellular, tissue, and organ and systemetic levels, at different stages of life and in both sexes.
  • 09 - Understand and recognize the effects, mechanisms and manifestations of disease on the structure and function of the human body.
  • 12 - Understanding the foundations for action, the indications and efficacy of therapeutic interventions, based on available scientific evidence.
  • 15 - Ability to formulate an initial diagnosis and establish a rationalised diagnostic strategy.
  • 17 - Establish the diagnosis, prognosis and treatment, applying principles based on the best information possible and safe clinical practice..
  • 18 - To indicate the most appropriate (pharmacological, surgical, psychological, social or other) treatments that are pertinent to the most prevalent procedures, in terms of rehabilitation and also terminally ill patients, including an evaluation of their effectiveness.
  • 19 - Propose preventive measures appropriate to each clinical situation.
  • 23 - Communicate effectively and clearly, both orally and in writing with patients, family members, media and other professionals.
  • 24 - Establish good interpersonal communication skills that enables efficient and empathetic communication with patients, relatives, media and other professionals.
  • 28 - Obtaining and using epidemiological data and assess trends and risks in health related decision-making.
  • 31 - Understand, critically evaluate and know how to use sources of clinical and biomedical information to obtain, organize, interpret and communicate scientific and health care information.
  • 32 - Know how to use information and communication technology in clinical, therapeutic, preventive health care and research.
  • CTP-3 - To develop critical thinking and reasoning as well as self-assessment skills.

Learning outcomes of the subject

At the end of the learning process the student should be able to:

  • Detect abnormal blood count tests and basic haemostasis

  • Guide the diagnosis of anaemia and be able to treat the most prevalent types

  • Differentiate polycythaemia vera from secondary poliglobulias

  • Know the methodology to differentiate between reactive leukocytosis lymphocytic and myeloproliferative neoplasia

  • Identify agranulocytosis and its causes

  • Know the preventive measures to be taken in a neutropenic patient

  • Identify the characteristics of essential thrombocythaemia and learn to distinguish it from reactive thrombocytosis

  • Guide the diagnosis of idiopathic thrombocytopenic purpura and start the treatment protocol and bleeding preventive measures

  • Understand the concepts of bicytopenia and pancytopenia and their causes, and guide diagnosis

  • Know the aetiology, pathophysiology, diagnosis and treatment of major haematological diseases

  • Know how to examine lymphadenopathy and splenomegaly, recognise the warning signs and know the diagnostic process

  • Ability to clinically and analytically treat of haemorrhagic syndrome

  • Know the conditions that predispose thrombosis, the pathologies that cause thrombophilia, preventive measures to be taken and commonly used anticoagulant treatments

  • Understand the technical characteristics, indications and usefulness of bone marrow cytology, bone marrow biopsy and lymph node biopsy

  • Acquire basic knowledge of highly complex diagnostic techniques (immunophenotype, cytogenetics, molecular biology) and understand the logic of their application in haematological diagnosis

  • Develop a psychological approach to patients and their families, using effective communication tools, individualized for each patient

  • Understand the theoretical basis of pre-transfusion screening and know how to identify and respond to a transfusion reaction

  • Incorporate the use of cytostatics, hematopoietic colony stimulating factors, biological response modifiers, differentiation inducers and radiotherapy as tools in the treatment of haematological diseases

  • Understand the basics of bone marrow transplantation, differentiation of types and indications

Syllabus

Lectures: each lecture lasts for two hours, is for the whole group and is given once.

  • Anaemia. Concept and classification. iron deficiency, associated with chronic diseases, megaloblastic.
  • Congenital and acquired haemolytic anaemia.
  • Lymphoid pathology
  • Lymphocytosis. Lymphopenia. Adenopathy and splenomegaly
  • Chronic lymphoproliferative syndromes: general concepts, incidence, general symptoms, diagnostic tests and stages
  • Lymphomas and lymphoproliferative disorders. Pathology of lymphomas, lymphoproliferative disorders, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, B and T lymphomas associated with immunodeficiency, other glandular pathologies.
  • Other Hemopathies: Histiocytosis, Mastocytosis. Primary immunodeficiencies. Liposomal storage diseases.
  • Bone marrow deficiencies and diseases of the leukocyte system: Aplastic anaemia, bone marrow failure selective neutropenia, genetic defects and disorders of granulocytes functionalism.
  • Myelodysplastic syndromes. Concept, aetiology, epidemiology, pathogenesis, classification and nomenclature. Clinical picture, diagnosis, differential diagnosis, prognosis and treatment.
  • Acute leukaemia. General, acute lymphoblastic leukaemia, acute myeloid leukaemia, treatment
  • Progenitor cell transplantation and Car-t-cells

Case studies: Each session consist of various clinical cases depending on the subject with a duration of two hours. Each session is for 50% of the group.

  • Microangiopathic haemolytic anaemias. Hemochromatosis and porphyria
  • Chronic myeloproliferative syndromes. General, chronic myeloid leukaemia, polycythaemia vera, essential thrombocythaemia, primary myelofibrosis.
  • Platelet disorders and coagulopathies. Semiology and exploration of haemostasis, angiopathic purpura, thrombocytopenia, thrombocytopathies, congenital and acquired coagulation disorders.
  • Thrombosis and thrombophilia. Thrombosis, thrombophilia. Antithrombotic prophylaxis and treatment.
  • Transfusion medicine. Standard procedures in pre-transfusion screening. Indications for transfusion of packed red blood cells, platelets and plasma.

Problem-based learning: Each PBL session will include various clinical problems depending on the subject in two hours. Each session is for 50% of the group.

  • Study of lymphoid pathology.
  • Diagnostic guidance in the face of a haemorrhagic diathesis
  • Diagnostic guidance in the event of a coagulation disorder
  • Diagnostic guidance for pancytopenia
  • Monoclonal gammopathies - Multiple myeloma. Monoclonal gammopathy of undetermined significance, multiple myeloma, Waldenstrom's macroglobulinaemia, heavy chain disease. Primary amyloidosis.

Laboratory Skills. Two hours. There will be classes of two hours each covering the simulation, using specific materials of several cases with typical haematological diseases.

  • Lymphoma Committee. Clinical cases to be presented in groups
  • Haematological morphology
  • Interpretation of the blood count

Teaching and learning activities

In person



We use active teaching methods, which aim for the participation of students in problem solving and knowledge acquisition. To do this we will use various educational resources.

Case studies: In general, focus on clinical cases. The students will have prior case information material to the class, with some questions that will guide the development of the training. It is essential that students read the material that will be given before starting the class to enable active participation and, with this, the generation of knowledge. After the presentation and discussion of the case, based on knowledge, it will try to reach some conclusions for future medical practice of students. It is not necessary for the teacher to teach all the academic concepts of that topic, it goes without saying that the discussion of the cases may occupy the time allocated to the teacher's presentation and that the student may have to develop it on their own.

Problem-based learning: these classes are similar in structure to case studies, focused not on clinical cases but actual diagnostic and therapeutic problems. Educational material will also be provided to students, which they should read before class, so that the session can be more participatory. We will try to reflect on the ideal diagnostic or therapeutic strategy and attempt to lead students to provide criticism or alternative suggestions and generate the discussion.

Laboratory skills: each class will try to focus on a case that incorporates extensive haematology knowledge. We will try to ensure that students themselves make discoveries using innovative teaching materials using the materials offered to the students. They must propose diagnostic or therapeutic measures themselves.

Lecture (CM) are face to face.

Case method (MC), problem-based learning and Laboratory Practice are face to face.

LYMPHOMAS COMMITTEE. Recommended on-line attendance to the General de Catalunya Hospital lymphoma committee, on the assigned date and time. This attendance in no case should interfere with any other activity that the student has programmed. The student must do two jobs related to this activity. The total value of this activity will be 15% of the final mark. As it is an online activity. You can attend those tumour committees that the student considers necessary.

METHODOLOGYCOMPETENCES
09 15 16 17 18 19 21 26

Evaluation systems and criteria

In person



-PARTIAL EXAM of 30 questions type test + three short questions. It will correspond to 20% of the final mark. Partial exam 20% (15% multiple choice question + 5% short question). This exam does not release matter. 

-FINAL EXAM on first call type test (60 questions MIR methodology) around the agenda. Including the matter of the previous examination. It will be up to 60% of the final grade. To pass the course will be essential to obtain a score of at least 50/100 in this test.

-LYMPHOMAS COMMITTEE. Recommended on-line attendance to the HGC lymphoma committee, on the assigned date and time. This attendance in no case should interfere with any other activity that the student has programmed. As an alternative method, you can save the session and view it later. The student must do two jobs related to this activity. The total value of this activity will be 15% of the final mark

  • It is essential to present the informed consent document in moodle on the indicated date. If the overall score of the activity is not presented it will be 0%
  • Individual work 5% to be delivered through Moodle on the indicated date, which will correspond to your participation in the tumour committee, should include the following sections: personal vision of the activity, Evaluation of the discussion that has taken place, analysis of the technologies used, value of group work description of the most relevant data of the patient who has been presented later describe at least three values that have been learned during the course of the activity Other sections that the student considers appropriate
  • Group work and presentation 10% The assigned clinical case must be presented in the laboratory of abilities. Highlight the most relevant data in the case discussion in the tumour committee. Short presentation of the diagnosed pathology. All the students of the group must intervene in the discussion, one of them, at the beginning of the discussion will be designated as an evaluator and will not be able to participate in the exhibition, their peers will have to supplement their exposure

-INDIVIDUAL WORK: it will be related to some work carried out during classes of case method or laboratory of abilities or learning based on projects. Will be delivered through Moodle on the indicated date. The total value of this activity will be 5% of the final mark

TO PASS THE COURSE it is necessary to meet the following 3 requirements:

• Obtain a score of at least 50/100 on the final exam

• Participate in the group presentation of the clinical case of the lymphoma committee

• Deliver via Moodle the individual work related to any of the divided classes.

Students who have already taken the course keep the grade for the two lymphoma committee assignments and the individual assignment for the divided classes. In any case, they can be resubmitted to improve the grade.

 

 FINAL NOTE:  Partial exam 20% (15% multiple choice question + 5% short question) + Final exam 60% + Committee of lymphomas individual work 5% and group presentation 10% + Individual work 5%

 •  The final score to pass the course will be 50% of the total possible score to this point. In all test exams, wrong answers subtract points.

• The partial and final tests will be done by computer. No questions will be answered during the test

• The final exam on second call will include content and skills of all that developed during the course. Therefore, the second call will review 95% of the final grade. + 5% teacher opinion. In this case there will be any improvement in the final grade. On second call, the maximum grade that may be obtained is remarkable.

• On second call, the final score to pass the course will be 50% of the total possible score.

Bibliography and resources

The syllabus of the course will be based on the relevant haematology sections of two textbooks:

  • Farreras - Rozman: Internal Medicine. Elsevier

  • Harrison. Principles of Internal Medicine. McGraw Hill

  • Sanz MA, Carreras E; Manual practico de hematologia clinica. Ed Antares

This content is considered examination material, whether or not it has been covered in lectures.

Teachers may provide students with additional material for the classes they teach, in addition. Any of these materials and any point discussed in class can be included in the examination.

Evaluation period

E: exam date | R: revision date | 1: first session | 2: second session:
  • E1 08/01/2025 I2 17:00h
  • E1 08/01/2025 I1 17:00h
  • E1 08/01/2025 I3 17:00h
  • R1 24/01/2025 A02 16:30h

Teaching and learning material


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