Thrombotic disorders

Details

Title

Thrombotic disorders

Type

Stage Two

Module code

HLS158

Requirement

Compulsory

Module objective

By the end of the training period trainees will, in respect of thrombotic disorders, be able to:

• analyse, synthesise, evaluate and apply knowledge
• perform, adapt and master a range of technical and clinical skills and procedures
• demonstrate the attitudes and behaviours necessary for professional practice as a consultant clinical scientist dealing with the complexities, uncertainties and tensions of professional practice at this level.

Knowledge and understanding

By the end of the training period the trainee will be able to demonstrate the ability to analyse, evaluate and synthesise relevant knowledge and its application to their professional practice in relation to

• venous thromboembolism and thrombophilia: clinical features and pathogenesis of hereditary thrombophilia, genetic risk factors and molecular basis (AT deficiency, PC deficiency, PS deficiency, APC resistance/FV Leiden, prothrombin G20210A, ‘other’ risk factors), prevalence and natural history of risk factors, principles and practice of laboratory phenotypic and genotypic assays, diagnosis and classification, quantification of risk and interpretation of test results, understanding of contribution of circumstantial risk factors for VTE (surgery, hospitalisation, immobilisation, pregnancy, oral contraceptives/HRT, obesity), multifactorial nature of thrombophilia
• acquired causes of deficiencies of natural anticoagulants (AT, PC, PS), acquired APC resistance and thrombotic risk, acquired risk factors for thrombosis (lupus anticoagulant, pregnancy, COCP/HRT, malignancy, etc.)
• what laboratory tests and when to test:
  • timing of tests
  • population screening
  • screening in pregnancy
  • thrombophilia screening and OCP/HRT
  • family studies
  • screening to assess risk for recurrent VTE
• thrombophilia and pregnancy: maternal thrombosis, recurrent foetal loss, pre-eclampsia, IUGR, anticoagulant prophylaxis in pregnancy
• arterial thrombosis: pathogenesis, risk factors, laboratory investigation
• thrombosis and thrombotic risk factors in children
• antiphospholipid syndrome:
  • clinical features and pathogenesis, thrombosis, pregnancy failure
• antiphospholipid antibodies
• diagnosis of APS, lupus anticoagulant: laboratory assays (APTT, KCT, DRVVT, platelet neutralisation test, dilute thromboplastin inhibition test, textarin/ecarin ratio, anticardiolipin assays
• management of APS – principles and measures
• disseminated intravascular coagulation (DIC)
• etiology and pathogenesis (infection, trauma/tissue injury, malignancy, obstetric complications, vascular disorders, severe allergic/toxic reaction)
• laboratory investigation and diagnosis
• D-dimer methodology
• treatment principles and measures
• Thrombotic microangiopathies:disseminated intravascular coagulation (DIC)
• TTP and HUS, pathophysiology, laboratory diagnosis, clinical manifestations, clinical management and treatment principles.

Technical and clinical skills

By the end of the training period the trainee will be able to demonstrate a critical understanding of current relevant research, theory and knowledge and its application to the performance, adaptation and mastery of the following technical procedures and laboratory skills:

• knowledge and understanding of the investigation of thrombotic disorders
• appropriate use of laboratory investigations to establish diagnosis
• knowledge of pathogenesis, genetics and clinical and laboratory aspects of acquired risk factors for thrombosis
• advise clinical and laboratory colleagues on the investigation of thrombotic disorders
• knowledge and understanding of thrombotic risk in pregnancy
• knowledge of pathogenesis, clinical and laboratory aspects of acquired risk factors for arterial thrombosis
• knowledge and understanding of clinical scientific aspects of thrombosis in children
• knowledge and understanding of the application of laboratory methods to the investigation and diagnosis of APS
• knowledge and understanding of the pathogenesis of DIC laboratory methods to the investigation, diagnosis and monitoring of DIC
• knowledge and understanding of the pathogenesis of TTP and HUS and application of laboratory methods to the investigation and diagnosis of TTP/HUS.