Portland Community College | Portland, Oregon

This course focuses on the theory of the coagulation system with emphasis on the principles of testing and the correlation of the test results with various abnormal conditions. The basic principles, classification, and application of therapeutic drug monitoring and toxicology test procedures will be presented. Correlation of electrolyte results and instrumentation used in testing will be delineated. Principles of protein electrophoresis, and the application and interpretation of this data will also be introduced. The essentials of laboratory mathematics will be reviewed and expanded.

Upon successful completion students should be able to:

1. Use an understanding of coagulation; nonprotein nitrogenous wastes; thyroid conditions; electrolytes; toxicology and therapeutic drug monitoring; and protein electrophoresis normal and abnormal test results and their correlation with appropriate pathologic conditions to make appropriate and effective on-the-job professional decisions.
2. Apply appropriate laboratory techniques, methodologies, instruments and equipment in the performance of molecular diagnostic tests, therapeutic drug monitoring, thyroid, and coagulation testing to affect quality patient care.
3. Adapt laboratory techniques and procedures in a corrective manner when errors and discrepancies in results are obtained to affect resolution in a professional and timely manner.

The material in this course will be presented in a traditional classroom (Campus program), or distance-learning format (Distance learning program).  Both traditional and distance learning sections include required laboratory activities.  Traditional classroom instruction consists of lecture, discussion, web based instructional media (tutorials, animations, videos, etc.) and other educationally sound practices. Distance learning sections include similar educational practices and are primarily presented in a web based format. Both campus and distance learning sections require periodic campus based laboratory exercises.  In addition, the distance learning section may have hospital based laboratory exercises.  A laboratory manual will be provided.  The laboratory exercises provide an opportunity for students to employ the testing principles and methodologies discussed and allow for discussion, application and correlation of the concepts presented.  The student is expected to perform all laboratory procedures according to the criteria established by the department.

The instructor will outline the methods used to evaluate student progress and the criteria for assigning a grade at the beginning of the course. Assessment methods may include written and practical examinations and laboratory write-ups. Evaluation of problem solving skills, teamwork, attendance, laboratory performance and communication skills may also be included.

• Course Themes
  • Theme 1: Coagulation
    • Terminology and factors involved in the coagulation process
    • Diseases associated with coagulation abnormalities
    • Process and substances influencing thrombosis, fibrinolysis and coagulation inhibition
    • Principles and methods used in the prothrombin time and activated partial thromboplastin time, and results associated with various disease states and in anticoagulation therapy
    • Diseases or conditions, test principles, and patient results associated with the following: thrombin time, fibrinogen levels, factor XIII assays, FDP, D-dimers, mixing studies, heparin assay, platelet function assay, etc.
  • Theme 2: Non-protein nitrogenous waste
    • Urea, creatinine and uric acid testing methodology and disease correlation
    • Creatinine clearance test and its correlation with kidney function
  • Theme 3: Thyroid Function
    • Anatomy and physiology of the thyroid gland
    • Thyroid function tests and testing methodology
    • Diseases associated with thyroid abnormalities and laboratory testing
  • Theme 4: Electrolytes
    • Major electrolytes and electrolyte homeostasis
    • Principles in electrolyte testing and the instrumentation involved
  • Theme 5:  Protein Electrophoresis
    • Principles and application of serum electrophoresis
    • Normal and abnormal serum electrophoresis patterns
  • Theme 6:  Molecular diagnostic techniques
    • Polymerase chain reaction and probe technique principles
    • RT-PCR; LCR; FISH; RFLP; blotting techniques and microarrays

• Laboratory Skills
  • Use a spectrophotometer to perform chemistry procedures, including
    • Correctly setting up the spectrophotometer
    • Proper handling, cleaning, and storage of the spectrophotometer
    • Correct use of the wavelength selector
    • Proper use of cuvettes
    • Recording data from the spectrophotometer
    • Constructing a standard curve
    • Applying absorbency readings to calculate analyte concentrations
  • Properly prepare reagents, standards, quality control material, and patient specimens for chemistry procedures, including
    • Preparing working standards from stock standard solutions
    • Proper selection of appropriate glassware
    • Proper use of glassware and other laboratory equipment
  • Proper performance of chemistry testing, including
    • Selection of appropriate equipment
    • Specimen preparation (preparing protein-free filtrate)
    • Proper performance of laboratory procedures
    • Correct interpretation of color reactions
    • Recording observations and test results
    • Following written and verbal instructions for laboratory procedures
  • Troubleshooting and problem solving
    • Recognizing errors or discrepancies in results during lab procedures
    • Selecting corrective actions for problem solving

• Cognitive Skills
  • Cognitive processes, including
    • Formulating a clear, answerable question
    • Predicting expected results
    • Following written protocols and verbal instructions
  • Analysis skills, including
    • Collecting and organizing data in a systematic fashion
    • Presenting data in an appropriate form
    • Assessing the validity of the data (including integrity and significance)
    • Recognizing errors and developing a corrective course of action
    • Drawing appropriate conclusions based on the results
  • Communication skills, including
    • Discussing and presenting lab results or findings in the laboratory
  • Interpersonal and citizenry skills, including
    • Working effectively in teams or groups so that the task, results, and analysis may be shared
    • Effectively managing time and tasks allowing concurrent and/or overlapping tasks to be done simultaneously, by individuals and/or within a group
    • Integrating knowledge and making informed judgments about chemistry test results in the clinical setting

• Laboratory Safety
  • Laboratory procedures, including
    • Reporting all spills and broken glassware to the instructor and receiving instructions for clean up
    • Minimizing or containing the production of aerosols and describing the hazards associated with aerosols
    • Washing hands prior to and following laboratories and at any time contamination is suspected
    • Using universal precautions with blood and other body fluids and following the requirements of the OSHA Bloodborne Pathogen Standard
    • Disinfecting lab benches and equipment prior to and at the conclusion of each lab session, using an appropriate disinfectant and allowing a suitable contact time
    • Identification and proper disposal of different types of waste
    • Good lab practice, including returning materials to proper locations, proper care and handling of equipment, and keeping the bench top clear of extraneous materials
  • Protective procedures, including
    • Tying long hair back, wearing personal protective equipment (eye protection, coats, gloves, closed shoes), and using such equipment in appropriate situations
    • Always using appropriate pipetting devices and understanding that mouth pipetting is forbidden
    • Never eating or drinking in the laboratory
    • Never applying cosmetics, handling contact lenses, or placing objects (fingers, pencils, etc.) in the mouth or touching the face
  • Emergency procedures, including
    • Locating and properly using emergency equipment (eye wash stations, first aid kits, fire extinguishers, chemical safety showers)
    • Reporting all injuries immediately to the instructor
    • Following proper steps in the event of an emergency