Clinical Biochemistry Investigation of Major Organ Function

Module details

Title

Clinical Biochemistry Investigation of Major Organ Function

Type

Rotation

Module code

SLS100

Credits

10

Requirement

Compulsory

Aim of this module

This module will provide the trainee with the knowledge and understanding of the normal physiology of the major organs and the biochemical parameters in common use for the investigation and management of major organ dysfunction. In the work-based module they will be expected to apply this knowledge as they learn to perform common methods used in the investigation of major organ function and gain experience of the interpretation of patient results in a variety of clinical settings.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1	Competency Identify the most appropriate test for at least two example clinical presentations, e.g. diabetes, acute coronary syndrome, acute kidney injury etc.	Action View
# 2	Learning outcome 1,5	Competency Use computer software associated with the LIMS and laboratory equipment.	Action View
# 3	Learning outcome 1,5	Competency Receive, label and store routine clinical biochemistry samples.	Action View
# 4	Learning outcome 2,3	Competency Use automated instrumentation (modular systems, elementary robotics and automated immunoassay analysers) in your training laboratory, which incorporates the following techniques: ion selective electrodes spectrophotometry immunoassay enzymology plus one other from: fluorimetry nephelometry/turbidimetry.	Action View
# 5	Learning outcome 2,3	Competency Use manual and semi-automated techniques to specified standard operating procedures, to include: spectrophotometry osmometers urine analysis (e.g. dipsticks or pregnancy tests) HbA1c analysis.	Action View
# 6	Learning outcome 2,3	Competency Use one of the following POCT methods/devices to specified quality standards: blood gas analysers co-oximetry blood glucose meters.	Action View
# 7	Learning outcome 2,3	Competency Perform analysis of the following analytes: albumin creatinine calcium bilirubin transaminases troponin glucose sodium and potassium	Action View
# 8	Learning outcome 4,5	Competency Produce reports using validated results on common clinical biochemistry investigations.	Action View
# 9	Learning outcome 2,3	Competency Control infection risks in accordance with departmental protocols.	Action View
# 10	Learning outcome 2,3	Competency Minimise risks and hazards in compliance with health and safety policies.	Action View

Assessments

You must complete:

• 1 case-based discussion(s)
• 1 of the following DOPS/ OCEs:

Receive book process and store common clinical biochemistry specimens	DOPS
Perform Serum Osmolality	DOPS
Undertake IQC procedure acceptance criteria	DOPS
Set up a daily analyser and undertake reagent top up	DOPS
Perform daily maintenance procedures	DOPS
An appropriate activity agreed with your Training Officer	OCE

Learning outcomes

1. Interpret routine requests for clinical biochemistry investigations of major organ function in the correct clinical context and process the specimens that accompany those requests.
2. Perform a range of laboratory and point-of-care techniques (POCTs) used in the workplace to investigate major organ function.
3. Apply the principles of internal quality control and external quality assessment and draw conclusions about assay performance.
4. Report the results of commonly performed clinical biochemistry investigations of major organ function.
5. Use laboratory IT systems for handling, processing and storage of patient data.

Learning outcomes

1. Explain normal physiological homeostasis of the major organs.
2. Describe and explain the pathophysiology and cause of common disorders of the major organs.
3. Explain the presentation, diagnosis and management of common biochemical disorders of major organ function.
4. Describe and evaluate the principles of common biochemical measurement techniques used to investigate major organ function.
5. Describe the design, operation and performance of automated analytical platforms used to investigate major organ function.
6. Describe the design, operation and performance of point-of-care testing devices supported by the clinical biochemistry laboratory.
7. Discuss and justify the biochemical investigation of major organ disease in the patient pathway, the correct sampling technique and the use and validity of reference ranges.
8. Explain and justify the principles of internal quality control (IQC) and external quality assessment (EQA).
9. Explain the use of laboratory information technology (IT) systems for handling, processing and storage of patient data.
10. Discuss the partnership of clinical biochemistry to other clinical specialisms in the investigation of disorders of major organs and patient care.

Indicative content

• The normal physiology and function of the following major organs: kidney, liver, heart, lungs, bone and pancreas. To include water homeostasis and acid–base balance
• The clinical and scientific basis of common biochemical markers of function of the kidney, liver, heart, lungs, bone and pancreas
• The application of common biochemical markers of major organ function to a range of frequently encountered clinical disorders
• Presentation, diagnosis and management of common clinical biochemical disorders of major organ function
• The biological and statistical basis of biological variation, reference values and action limits
• Principles and practice of IQC and EQA
• Scientific basis of the following techniques: spectrophotometry, osmometry, ion selective electrodes, enzymology, immunochemical techniques, electrophoresis, chromatography and solid phase chemistry
• Design, operation and performance of automated analytical platforms, including random access, modular, robotics, etc.
• Design, operation and performance of point-of-care testing devices supported by the clinical biochemistry laboratory

Activities

• Attend multidisciplinary review meetings at which biochemical results of major organ function are presented as part of the clinical record. Reflect on these discussions and the impact for patient care and management.
• Reflect on the partnership between clinical biochemistry and other clinical specialisms in the investigation of disorders of major organs.
• Review at least one biochemical investigation of major organ disease in the patient pathway, including the correct sampling technique and the use and validity of reference range.
• Review and discuss at least two examples of the interpretation and reporting of laboratory results in the context of common clinical disorders.
• Attend a clinical unit where POCT for major organ function is performed. Discuss the method(s) with trained users.
• Demonstrate an understanding of the preparation of reports and the reporting process for patients being investigated for major organ function by observing technical and clinical validation. Record case overviews observed and identify key factors that will influence your own future practice.