MCCCD Official Course Competencies:

HCE243  2006 Spring – 2011 Summer II

Practicum Clinical Hematology and Hemostasis

1.

Differentiate between the anatomy and physiology of the normal human hematopoietic and hemostatic system. (I, XII)

2.

Determine collection techniques and specimen handling for peripheral blood specimens, bone marrow, and specimens for hemostasis (coagulation) testing. (II)

3.

Calculate and correlate erythrocyte indices and absolute and relative counts. (III)

4.

Evaluate normal and abnormal peripheral blood cells and morphology. (III-V)

5.

Correlate analyzer results with peripheral smears and patient condition. (IV)

6.

Assess anemia categories based on hematologic analysis results. (V)

7.

Appraise various nonmalignant leukocyte disorders. (VI)

8.

Appraise various malignant disorders of leukocytes. (VII)

9.

Appraise various thrombocyte abnormalities. (VIII)

10.

Apply standard laboratory procedures in interpreting, evaluating, and reporting hematology and hemostasis results. (IX)

11.

Manage preventive maintenance and troubleshooting techniques on hematology and hemostasis instruments. (IX)

12.

Assay and evaluate patient samples on hematology and hemostasis analyzers. (IX)

13.

Perform and interpret calibration and quality control on instruments used in hematology and hemostasis testing. (IX)

14.

Evaluate the principles of method analyses in hematologic and hemostasis testing. (IX, XI, XIII)

15.

Evaluate hematology and hemostasis case studies. (X)

16.

Describe and evaluate disorders of hemostasis. (XIV)

17.

Evaluate laboratory tests used to monitor anticoagulant therapy. (XV)

MCCCD Official Course Outline:

HCE243  2006 Spring – 2011 Summer II

Practicum Clinical Hematology and Hemostasis

I. Normal Hematopoiesis and Hemostasis

A. Fetus

B. Infant and Child

C. Adult

D. Reticuloendothelial system

II. Specimen Collection and Handling Techniques

A. Peripheral blood

B. Bone marrow

C. Hemostasis testing

D. Other

III. Erythropoiesis

A. Maturation sequence

B. Regulatory factors

C. Hemoglobin

1. Structure

2. Function

3. Globin synthesis

a. Normal

b. Genetic variants

4. Altered derivatives

5. Methods of analysis

D. Catabolization

1. Extravascular

2. Intravascular

E. Erythrocyte analysis

1. Counts

a. Manual

b. Automated

2. Hematocrits

3. Indices

4. Reticulocytes

a. Manual

b. Automated

5. Peripheral Smear Evaluation

a. Normal morphology

b. Abnormal morphology

6. Reference ranges

a. Neonates

b. Children

c. Adults

IV. Leukopoiesis

A. Maturation sequences

B. Regulatory factors

C. Leukocyte analysis/counts

1. Manual

2. Automated

3. Relative

4. Absolute

D. Peripheral smear evaluation

1. Normal cells

2. Abnormal cells

3. Performing differentials

a. Manual

b. Automated

E. Reference ranges

1. Neonates

2. Children

3. Adults

V. Erythrocyte Disorders

A. Anemia

1. Clinical signs and symptoms

2. Hematologic findings

a. Hypochromic anemias

b. Megaloblastic anemias

c. Hypoproliferative anemias

d. Hemolytic anemias

3. Morphology changes

B. Erythrocytosis

1. Polycythemias

2. Other

VI. Nonmalignant Leukocyte Disorders

A. Quantitative changes

B. Qualitative changes

1. Acquired

2. Inherited

VII. Neoplastic Leukocyte Disorders

A. Leukemia

1. Risk factors

2. Diagnosis

3. Treatment

4. FAB (French-American-British) classification

B. Acute leukemias

C. Myelodysplastic syndromes

D. Chronic myeloproliferative disorders

E. Chronic lymphoproliferative disorders

F. Plasma cell disorders

G. Lymphomas

VIII. Thrombopoiesis

A. Maturation sequence

B. Regulatory factors

C. Thrombocyte analysis

1. Quantitative

a. Manual

b. Automated

2. Qualitative

3. Morphology

IX. Automation for Hematology and Hemostasis

A. Principles of method analyses

B. Calibration

C. Quality control

D. Proficiency testing

E. Preventive maintenance

F. Troubleshooting

G. Assaying patient samples

1. Evaluate results

2. Correlate and interpret results

3. Report results

a. Autoverification

b. Other

H. Documentation

X. Case Studies

A. Hematologic

B. Thrombopoietic

C. Hemostatic

XI. Miscellaneous Hematology Tests

A. Sickle cell screening

B. Hemoglobin electrophoresis

C. Flow cytometry

D. Erythrocyte sedimentation rates (ESR)

E. Osmotic fragility

F. Kleihauer-Betke stain

G. Cytochemical stains

1. Romanowsky - type

2. Enzymes

3. Esterases

4. Dyes

XII. Hemostasis

A. Primary hemostasis

1. Vasculature

2. Platelets

B. Secondary hemostasis

1. Plasma coagulation factors

2. Intrinsic, extrinsic, and common pathways

C. Inhibitors of hemostasis

D. Fibrinolysis

XIII. Coagulation Tests

A. Prothrombin Time (PT) test

B. Activated Partial Thromboplastin Time (APTT)

C. Thrombin clotting time

D. Fibrinogen assay

E. Factor assays

F. D-Dimer

G. Fibrinogen Degradation Products (FDP) Assay

H. Mixing study

I. Activated Clotting Time (ACT)

J. Dilute Russell Viper Venom Time (DRVVT)

K. Protein C and S

L. Other

XIV. Disorders of Hemostasis

A. Primary

B. Secondary

1. Inherited disorders

2. Acquired disorders

C. Fibrinolysis

1. Disseminated intravascular coagulation (DIC)

2. Other

D. Recurrent thrombosis (thrombophilia)

XV. Anticoagulant Therapy

A. Antiplatelet agents

B. Heparin

1. Unfractionated

2. Low molecular weight heparin (LMWH)

C. Warfarin/Coumadin

D. Other drugs