|
| |
CLS
2523 HEMATOLOGY I
Fall Semester 2008
8:00 a.m. - 8:50 a.m., MWF
The Class meets in CNHP 502
COURSE DESCRIPTION
Discussion of the formation, morphology, and function of various blood cells and
the principles of hemostasis. Includes the theoretical elements of related
laboratory procedures. Prerequisites: CLS 1512 Principles of
Clinical Laboratory Science and CLS 1511 Laboratory for Principles of Clinical
Laboratory Science. Corequisite: CLS 2521
Laboratory for Hematology I.
SYLLABUS
DATE
CLASSROOM
Textbook
Laboratory
SCHEDULE
Reading
Activities
Assignment
August
25 (M) Introduction, overview Chptr 1,
4
27 (W) QA/QC/Statistics
Chptr 5
29 (F) QA/QC/Statistics
September
01 (M) ☺ ◊ ☺ ◊ ☺ Labor Day Holiday ☺ ◊ ☺ ◊ ☺
03 (W) Statistics/Safety
Chptr 1, 2, 3
05 (F) Phlebotomy Review
Chptr 3
08 (M) Hematology techniques Chptr 3
10 (W) Laboratory techniques
Chptr 14, 15
12 (F) Reagents/Stains
Chptr 14, 30
15 (M) Hematology procedures Chptr 14,
15, 30
17 (W) Bone Marrow
Chptr 6, 7, 16
19 (F) Bone Marrow Chptr 6, 7,
16
22 (M) RBC’s
Chptr 8- 11
24 (W) RBC’s
Chptr 8- 11
26 (F) RBC’s
Chptr 8- 11
29 (M) RBC’s
Chptr 8- 11
October
01 (W) RBC’s
Chptr 8- 11
03 (F) RBC’s
Chptr 8- 11
06 (M) RBC’s
Chptr 8- 11
08 (W) RBC’s
Chptr 8- 11
10 (F) RBC’s
Chptr 18-20
13 (M) RBC’s
Chptr 18-20
15 (W) RBC’s
Chptr 18-20
17 (F) RBC’s
Chptr 18-20
20 (M) WBC’s
Chptr 12, 14, 28
22 (W) WBC’s
Chptr 12, 14, 28
24 (F) WBC’s
Chptr 28, 29
27 (M) WBC’s
Chptr 28, 29
29 (W) WBC’s
Chptr 12, 14
31 (F) WBC’s
Chptr 12, 14
November
03 (M) WBC’s
Chptr 26 - 27
05 (W) WBC’s Chptr
26 - 27
07 (F) WBC’s
Chptr 26 - 27
10 (M) WBC’s
Chptr 26 - 27
12 (W) Instrumentation Chptr 39
14 (F) Instrumentation
Chptr 39
17 (M) Hemostasis
Chptr 13, 40
19 (W) Hemostasis
Chptr 40 - 46
21 (F) Hemostasis
Chptr 42 - 46
24 (M) Hemostasis
Chptr 42-46
25 (T) ☺ ◊ ☺ ◊ ☺ Fall Break / Thanksgiving Holiday ☺ ◊ ☺
◊ ☺
26 (W) ☺ ◊ ☺ ◊ ☺ Fall Break / Thanksgiving Holiday ☺ ◊ ☺
◊ ☺
27 (R) ☺ ◊ ☺ ◊ ☺ Fall Break / Thanksgiving Holiday ☺ ◊ ☺
◊ ☺
28 (F) ☺ ◊ ☺ ◊ ☺ Fall Break / Thanksgiving Holiday ☺ ◊ ☺
◊ ☺
December
01 (M) Hemostasis
Chptr 42 - 46
03(W) Hemostasis
Chptr 47
05 (F) Hemostasis
Chptr 47
08 (M) Final Exams Begin
13 (S) Final Exams End
.
Final exam time for this course: 8:00 am to 10:00 am, (Wednesday). December
5.
TEXTBOOKS
01.
Required. Rodak, B. F. (2007), Hematology:
Clinical Principles and
Applications. Third Edition. W. B. Saunders Company.
02.
Required. Abbott Laboratories' Medical
Atlas. The Morphology of Human
Blood Cells.
This may
purchased at the book store or you may order from:
ADD Distribution Center
c/o COMAC, INC
Attn: Medical Atlases
1521 East Wilson
Batavia, IL 60510
To order, the cost is $12.00 and will take up to four weeks for delivery.
Make your check payable to Abbott Laboratories. The atlas cannot be
returned.
03. Optional. O’Connor, Barbara; A Color Atlas
and Instructional Manual of
Peripheral Blood Cell Morphology. Williams and
Wilkins. Optional
05. Class notes for CLS 2523
(these will be available electronically through
Blackboard 6).
NOTE
If you have a disability or need special
accommodations, it is your responsibility to notify the instructor.
GRADING AND EVALUATION STRATEGIES
01. Major exams (100 points
each). A minimum of five exams will be given
during the semester.
02. Journal reports. A minimum of four are required @ 25 points each.
03. Case Studies and/or problem sets
listed as follows:
A. Problem Set 001. Statistics
in the Laboratory.
B. Problem Set 002. Statistics
in the Laboratory
C. Problem
Set 003. Microscope
D. Case Study.
Blood Collection - Phlebotomy
04. Affective Domain grade (100
points). See Affective Domain information
located in Bb6 and the CLS and
CLT Student Handbook.
05. Quizzes (15 points each).
These will be taken per schedule and will have
a time limit. Quizzes
will b announced and administered via Bb6 and use
of your textbook will be
permitted.
A.
A minimum of twelve quizzes will be
required.
B. See end of this syllabus
for quiz schedule and topics.
06. Optional: Final comprehensive exam (100
points) over hematology and
coagulation. Announced at
end of semester.
JOURNAL REPORTS
01. Four journal reports for
hematology and coagulation will be required. They
are located in Blackboard 6 in the
Assignments Section. You will have to
click on the command "CLICK HERE" and
you will see the page listing the
journal assignments. Turn these reports in as instructed on the
instructions.
The journal reports will be due as
follows:
A. First report due 1:00 pm, the
second Friday of September.
B. Second report due 1:00 pm, the
fourth Friday of September.
C. Third report due 1:00 pm, the
second Friday of October.
D. Fourth report due 1:00 pm, the
fourth Friday of October.
02. The journals for these reports
are located on reserve in the library. Read
the journal article and then answer
the questions.
03. These reports will not be called
for. It is your responsibility to submit these
reports by their due date.
Reports may be turned in early. Late reports will
result in penalty points plus loss of affective
domain points.
04. Reports may be turned in
before or after the lecture or lab assignment or
any other time convenient to
you. Reports may be placed in the instructor’s
mail box. Ask the secretary for
assistance.
05.
When required, submit each report
according to the following guidelines:
A. Reports are to
be typewritten reports on a separate sheet of paper.
B. Keep your
answers in numerical order.
C.
Do NOT use color highlighting to indicate
answers, however it
is okay
to use bold, italics, underline, ALL CAPS as ways to
indicate your answer on those questions that require you to
select
the correct answer.
D. At the end of
each report, write a concise statement that describes how
the
information in the journal article will be beneficial to you
professionally.
E. If your
are turning in two or more pages, staple the report together in
the
upper left hand corner and write your name on BOTH pages.
F. Do NOT
enclose your report in any type of binder.
07. Each report has a point value of
25 points.
08. Journal reports are to be
completed in the order listed on the assignment
sheet. The journal reports will
not be returned until all reports for the same
article are turned in and graded.
REPORTING THE SEMESTER GRADE.
Semester grades are posted electronically. Semester grades are posted
as soon as all assignments and exams are evaluated and scored.
GRADE RETENTION POLICY. See the CLS and CLT Student Hanbook.
NOTE
If you have concerns about the grading of any of the exams, quizzes, or other
graded materials in lecture or laboratory; you must address these concerns
within five classroom days following the return of such materials. If you do not
act to express concern, this is your approval of the matter of grade(s) and the grade(s) will stand.
| If you wish to estimate your grade in the course, total your earned
points and divide by the total possible points. Example: If at midterm you
have earned 400 points out of a possible 500, then divide 400 by 500. The
answer is .80. Multiply this by 100 to convert to the percent grade. The
percent grade becomes 80 or “B”. The following scale will be used this
semester: [1] A = 90 to 100, [2] B = 80 to 89, [3] C = 70 to 79, [4] D = 60
to 69, and [5] F = 59 or less. |
ATTENDANCE AND PARTICIPATION
01. Students are expected to attend
every lecture and laboratory session.
02. Attendance will be recorded at
each classroom meeting.
03. It is your responsibility to be
on time and to make arrangements for any special assignments missed in the
classroom due to circumstances beyond your control.
04. If you are attending a class
across campus which may affect your timely attendance to this lecture or
laboratory class, advise the instructor of that class so that allowances may be
made. Be prepare to verify your attendance of such classes.
05. Absences and tardiness will
affect your affective domain grade.
06. Excessive absences in CLS 2523
Basic Concepts of Hematology will result in the student receiving a failing
grade for the course. The clinical laboratory profession is a professional
curriculum and attendance is mandatory.
07. If you know in advance that you
have to be absent from a classroom lecture, it is your responsibility to make
arrangement with the instructor to make up that class.
08. If you are ill or involved in an
emergency, where possible, it is professional courtesy to call the Health
Professions Department (870-972-3073) and notify the instructor or secretary of
your absence for that day. If your illness is extended, it is appropriate to
substantiate such illness with documentation from your health care provider.
E-mail address: wwilliam@astate.edu
09. Students who leave the classroom
early without justification will be counted absent and any work turned in for
that classroom period will not be accepted, but will have to be repeated.
You are in a professional environment,
if you know that you have to
leave early, it is professional
courtesy/etiquette to advise the
instructor that you are required to leave
the class early and of the
necessity of leaving. |
10. Make-up work for
any approved absence must be completed within five classroom days after
returning to the campus.
Student Instructions for This Course
These suggestions are given to assist you in doing well in this course and
preparing you for the clinical rotation.
01 Before coming to class or lab, read the assigned chapters in the text
book and review the classroom notes.
02 Bring your notes. The instructor will present case studies and talk
about information in these notes. This is a good time to ask
questions about
areas that are not well understood.
03 After the classroom session, at some point in the same day, review
the
notes.
04 Study your notes thoroughly and read through the textbook
assignments
before the examination.
05 Take time to write out / ask questions over the material. Do this
with
one or more of the students in the class.
06 Remember that when you go to your clinical rotation, you will need
your
classroom notes and textbook. There will be questions to answer
and a final exam
as part of the clinical rotation grade.
N O T E
Circumstances beyond your control are considered to be illness, car trouble on
the way to class, court appearances, death in the immediate family,
medical/dental emergencies, etc. Physician or dental appointment made during the
semester with the intent to miss class is not excused absences. Also. . . . .
wedding rehearsals are not excused absences.
*********************************************************
The Clinical Laboratory Program Policy provides all
students admitted to the Program a copy of the CLS Program Handbook. This
Handbook contains the approved College of Nursing and Health Professions
documents, which includes the following information for which you have
completed the two signature pages and turned in for your files.
01 Standard Precautions for Prevention of Transmission of
Bloodborne Pathogens
in Health-Care Settings.
02 The Safety and Health Statement
03 College Student Code of Honor
04 Board of Trustees Approved Substance Abuse Policy and Procedures
of the ASU
College of Nursing and Health
Professions
05 The Substance Abuse Compliance Contract
06 Wavier of Release of Medical Information of the Substance
and
Abuse Polic
07 Policy and Procedure Guidelines for Infection Control (also
HBV and HIV
and Safety Practices)
08 Policy for Deferring a Clinical Rotation
09 Must have Liability Insurance for Clinical Rotation
10 Policies and Protocol for Safety in the Laboratory
11 Read and Understand the Essential Functions and
Technical Standards
12 Importance of Health Insurance
13 Memorandum of Understanding and Consent.
The Policy and Standards Code page, which affirms that you have read and
understand the above policies, is located at the back of the Student Handbook.
If you have not completed it , it must be removed, signed, and turned in to the CLS office for inclusion in your
file in order to continue in the CLS Program. You need only to complete
this requirement once. If you have not received a copy of the handbook,
see the secretary in CHI 101.
************************************************************
OVERALL LEARNING OBJECTIVES
The student is responsible for meeting these overall objectives and upon
completion of this course will l be able to will demonstrate their competency
by:
01 explaining the importance of washing one’s hands, list precaution strategies
as a part of laboratory safety awareness to create an understanding of the
importance of safety, and demonstrate the correct hand-washing technique.
02 describing and demonstrating how to correctly collect blood specimens and the
use of blood anticoagulants.
03 explain how to respond in an adverse reaction when collecting blood and when
given an adverse situation, appraise the correctness of the response.
04. describe the different types of blood smears, demonstrate how to correctly
prepare the wedge-shaped smear, and critique previously prepared smears.
05 list a minimum of four stains (excluding the Wright’s stain) used in the
laboratory, then compare and review their role in diagnosis.
06 discuss the Wright’s stain, describe how to evaluate the stained blood smear,
and when given a Wright’s stained smear, correctly “diff” the slide, and
critique its staining properties.
07 explain the Schilling hemogram classification.
08 discuss in general terms bone marrow, it structure and location, its role in
hemopoiesis, and illustrate the anatomy of a bone marrow sinus.
09 describe the formation cells in the RBC line, review the changes that occur
as the cell matures, and when given illustrations, identify the blast,
prorubricyte, rubricyte, metarubricyte, retic cell, and erythrocyte.
10 describe the various RBC morphological variations and inclusions and when
given illustrations, differentiate between the inclusions..
11 discuss hemoglobin and its role in the body, describe the synthesis of
protoporphyrin IX, and state how iron is incorporated to form hemoglobin.
12 review the breakdown of hemoglobin, differentiate between soluble and
insoluble bilirubin, describe how it is eliminated from the body.
13 explain how the indices are calcuated, review purpose of the “rule of three”
and when given data, calculate the indices and evaluate if normal or abnormal.
14 review the formation of the five types of WBC’s, explain their physiological
role, describe distinguishing morphological features of each type, and when
given illustrations differentiate between each type.
15 review the formation of the thrombocyte and
when shown illustrations, differentiate between normal and abnormal forms.
16 review the types of lymphocytes (examples:
reactive, NK-T type, B-cell type), differentiate between normal and reactive
lymphocytes, and compare the roles of each type.
17 review the development of the plasma cell,
describe its morphological features, and when shown illustrations, differentiate
between plasma cells, plasmacytoid lymphocytes and lymphocytes.
18 review the concept of electrical impedance in
automated cell counting.
19 sumarize the principle of light scattering to
characterize blood cells and illustrate the different types of light
scattering..
20 describe the cytogram on an automated cell
counter and when given an illustration, critique the illustration and identify
the location of the cell types..
21 discuss the volume histogram for the WBC, RBC,
and thrombocyte and when given problems sets, compare and interpret each
histogram..
22 discuss the role of the platelet in hemostasis.
23 identify a minimum of fifteen proteins
involved in the total process of hemostasis and compare each one as to its role
in the hemostasis process..
24 review and illustrate the coagulation scheme
schematic, correlating the extrinsic, intrinsic, and common pathways..
25 describe proper collection and handling of the
patient’s specimen for coagulation testing and when given a specimen sample,
correctly evaluate it for testing..
26 summarize the usefulness of routine
coagulation tests (BT, PT, APTT, FDP).
27 discuss fibrinolysis in the context of
hemostasis and the protein factors that affect this process.
28 review the principle of platelet aggregation
testing.
29 summarize the importance of Q. A. and Q. C. in
hematology and coagulation testing.
30 discuss and demonstrate the Gaussian curve and
the Levey-Jennings chart as statistical tools to detect trends and shifts, when
given data, construct a Gaussian curve and/or Levey-Jennings chart, and
interpret the data..
31 describe how to calculate and interpret means
and standard deviations and when given data, correctly calculate the standard
deviation..
32 summarize how the clinical lab scientist
contributes to the diagnosis and treatment of disorders.
33 demonstrate cooperation, interpersonal, and
professional behavior through interaction in the classroom setting.
34 read a journal article and relate how it will
benefit their professional role in the profession.
35 demonstrate problem-solving skills through
classroom participation using case studies and problem sets.
Note: The cognitive and psychomotor objectives
may be downloaded from the Blackboard system. Affective objectives are located
in the student handbook.
There are several sources of information that is
available to assist you in mastering the objectives in this course.
01 Lectures: These emphasize important concepts in hematology and
coagulation and to correlate between laboratory data and disease. Be
actively involved and if there are points that you are not clear on,
ask questions.
02 Textbook: This book is used in both the basic and advanced
classes. Read it as it supplements the information in the classroom
notes. The information learned from the textbook will enhance your
understanding of the classroom material and prepare you for the
exams and quizzes.
03 Laboratory: The exercises are designed to assist the student
to develop their laboratory skills and increase their success in the
clinical practicums.
04 Instructor: The instructor is available to help the student
achieve learning success in hematology and coagulation. Do not
hesitate to ask questions and if you need extra help, the instructor
will be available to answer questions.
05 Colleagues: These are the students in the lecture and
laboratory classes. Those who are doing well in the class and lab
can be an excellent source of information.
06 Library: There are a number of books and journals that address
the topics of hematology and hemostasis. Check out a book (written
by a different author). It may be beneficial to read the material
with a slightly different approach.
07 Yourself: Unless you put in a reasonable amount of effort into this
course, you will not learn nor retain the information. Be willing to put in up
to six hours a week in studying the material.
The following are topics that that are found in the CLS and CLT
Student Handbook that pertain to this course of study.
01. Critical behavior.
02. Affective
Domain Objectives to assist you in developing
professional skills
and attitudes.
03. Career entry competencies.
04. Students rights and grievance procedures.
05. Helpful learning hints.
06. Student evaluation and testing.
07. Safety and security in a classroom or laboratory
building. See this
section
regarding the lost and found policy.
08. Confidentiality
N O T E
There is in the profession a phenomenon known
as “sink testing” or “dry-labbing”. This is where the laboratorian reports out
lab data without performing the required laboratory test procedure. This is a
very serious infraction and subjects the individual to immediate discipline. If
a professional laboratory employee is found guilty of such offenses, they are
immediately dismissed without recourse. In the student classroom or laboratory,
to turn in data, reports, or other required work without performing the
procedure or doing the work is deemed to be as serious as “sink testing” and
will be subject to immediate discipline.
| Words of caution are in order. If a
student appears to be acting in such a way that demonstrates the appearance
of sleeping in the classroom, that student will be awakened.
Additionally, if work is turned in that strongly appears to be copied from
another student’s paper, that work for both students will not be graded and
a zero will be entered in the grade book. |
NOTES
If you plan on studying/working in any building on campus into the
evening hours and you are ready to leave, it is recommended that you walk to
your car or dorm using the buddy system.
Watch your books and other personal possessions when
you are in any building on campus. Theft is a fact of life. If you have
something stolen, report it to the campus security office (972-2093). In the
hallway, adjacent to the door entry to lab 115, there are 20 lockers that are
available to you. The CLS Program has also provisioned the bottom drawers
on the student lab desks (rooms 109 and 115) with locking capabilities. You may
use a drawer for those items you wish to leave on campus. You will have to
provide your own lock for either locker and it MUST be a combination lock. You
may have to share the drawer or locker with a colleague. The combination to the
lock must be written on a sheet of paper and placed in an a sealed envelope and
turned in to the instructor with your name on the envelope.
If you find you have difficulty learning the material, talk to the instructor,
visit the campus disability office, ask about tutorial services, or seek help
from the student support services.
QUIZZES
The quiz will be scheduled on a weekly basis and will require you to access it
through Bb6. Each week, you will have a three day window to complete the quiz
according to the following rules. The quiz will be posted at
7:00 a.m. on the first day and removed at 11:00 p.m. on the third day. The
quizzes will be taken from the third edition of Hematology: Clinical
Principles and Applications by Rodak, Fritsma and Doig.
01 You will need to check the announcement section of
Bb6weekly for
instructions.
02 Do not attempt to print the quiz as you will have
only one chance at
each question.
You will NOT be allowed to go back to any previous
question.
03 Warning. If the Bb6 exam system closes
you out and stops you from
completing the quiz,
contact the instructor for your next course of action
03 The quiz will be timed and if you exceed the
allowable time, you will NOT
be able to see your
score.
04 The instructor will review each quiz and make grade
adjustments for minor
spelling errors, spacing,
etc.
05 The quiz will consist of up to 15 questions
(multiple choice, true-false,
multiple answer, fill-in-the-blank,
short essay (which requires the instructor
to grade).
06 The amount of allowable time to complete the quiz
will be stated in the Bb6
announcement.
ABOUT EXAMS AND A FEW SAMPLE EXAM QUESTIONS
Most questions on exams in CLS 2523 will be multiple choice with a few of the
true and false type. One or more written questions may be included
at the end of these exams. Multiple choice questions require
responding to the single most correct answer. In the
following questions, the correct answer is underlined.
Note that some of the content of these questions has been used in national
certification exams.
01 Which of the following is NOT a usual characteristic
of a reactive lymphocyte?
a. abundant cytoplasm d.
larger size than the normal large lymphocytes
b. irregular nucleus
e. absence of vacuoles
c. visible nucleolus
02 The normal range for the mean platelet volume (MPV)
is:
a. 2 to 4 µm
d. 2 to 20 fL
b. 5 to 28 pG
e. 7 to 10 fL
c. 10,000 to 40,000 µL
03 Calculate the MCV (fL) if the hemoglobin = 13 g/dL, RBC
count = 3.9 × 106/µL, and the hematocrit = 41%.
a. 89.9
d. 100.1
b. 97.3
e. 94.5
c. 105.1
04 A RDW value of 17.4% represents an abnormal value
and the laboratorian knows that there be many target cells on the stained blood
film.
a. True
b. False
05 Which of the following is the immediate precursor
cell for the rubricyte?
a. prorubricyte
d. metarubricyte
b. rubriblast
e. erythrocyte
c. shift-cell
06 The lab manager asked you to use a stain that would
detect the presence of hemosiderin granules in the peripheral blood smear. What
stain did you use?
a. Giemsa stain
d. Prussian blue stain
b. Myeloperoxidase stain
e. Wright’s stain
c. PAS stain
07 The phlebotomist prepped the patient’s arm for a
venipuncture. The needle was inserted and the red stoppered tube placed in the
vacutainer holder and the blood collected. What anticoagulant is found in this
tube?
a. EDTA
d. Heparin (sodium salt)
b. sodium citrate
e. thrombin
c. There is no anticoagulant in this tube.
08 As a quality control measure, which of the following
sources of error represents a preanalytical factor?
a. failure to refrigerate the hematology reagent
b. failure to correct the platelet count after using the
automated cell counter
c. failure to invert and mix the blood specimen
d. failure to perform the daily maintenance procedure at the
specified time.
e. actually none of these are preanalytical factors.
09 You performed a delta check using a specimen used in
the morning run. What source of error are you looking for?
a. insufficient reagent in the bottle
b. a random error such as a mislabeled tube
c. deteriorating light source
d. incorrect instrument calibration
e. correct function of the surge protector
10 Hemostasis is which of the following?
a. the process by which a hematoma forms
b. maintenance of body temperature
c. regulation of kidney function
d. stoppage of bleeding following an injury
e. it could be any of these
11 The children’s hospital has several wards arranged
according to age groups. Which of the following wards would have the higher
hemoglobin, hematocrit, and RBC count test values?
a. ages 6 to 12 years
d. 13 to 18 years
b. ages 1 to 5 years
e. newborn and 6 to 12 years
c. newborn
12 As a cell undergoes mitosis, in which of the following
phases does the condensation of chromosomes takes place?
a. anaphase
c. prophase
b. metaphase
d. telophase
13 The patient underwent a splenectomy. Which of the
following cell types will the lab expect to see which of the following in future
lab tests?
a. RBC’s with granular inclusions
d. shift cells
b. pitting of erythrocytes
e. target cells
c. spherocytes
14 A ‘diff’ was performed on a 5 y/o child and the
following relative count was reported.
Neutrophils =
51% Monocytes =
8%
Bands = 4%
Eosinophils = 7%
Lymphs = 30%
Basophils = 0%
Which of the above cells is out of the correct reference range?
a. monocyte
d. basophil
b. neutrophil
e. eosinophil
c. lymphocyte
15 Quality Assurance
looks at the factors that may affect the treatment of a patient. Which of
the following is an analytical variable?
a. QC Data
d. Specimen collection
b. Transport of specimen
e. Preservative used
c. Reporting lab results
|
