MODULE HEMATOLOGY

(SYMPTOMATOLOGY)

OVERVIEW
CONTRIBUTORS TEAM

FACULTY OF MEDICINE UNIVERSITY OF BRAWIJAYA MALANG

MODULE HEMATOLOGY
(SYMPTOMATOLOGY)
AREA OF COMPETENCY 3rd of the Doctor Competencies Standard from Indonesian Medical Council

MODULE CONTENTS
SUB MODULES : 1. Anemia 2. Polycythemia 3. Bleeding Disorders 4. Thrombosis 5. Granulocytes Disorders HISTORY TAKING

LEARNING METHODS
Active learning (3 hrs) Group discussion (2 hrs) Expert lecture (1 hrs)
All sub modules

History taking : check list (last programme)

EVALUATION
1. Middle exams at the end of module programmes multiple choice Final exams at the end of semester OSCE

2.

SUB MODULE 1: ANEMIA

COMPETENCY COMPONENTS To apply concept & principles of anemia as sign or symptom (see outline of lecture contents)

.. ANEMIA (contd)
CLINICAL COMPETENCIES 1. Student can describe : The RBC formation (erythropoiesis) Morphological of RBC Etiology & pathophysiology of anemia Student can diagnose the etiology of anemia based on clinical features & lab. findings

2.

.. ANEMIA (contd)
DEFINITION & OVERVIEW Anemia is a reduction in Hb concentration of the blood accompanied by a fall in RBCs and packed cell volume (PCV) Anemia is not diagnosis but it is only symptom It must be established the etiology of anemia on clinical features & lab. findings based

.. ANEMIA (contd)
OUTLINE OF LECTURE CONTENTS A. ERYTHROPOIESIS : - Erythrocyte differentiation - Regulation of erythropoiesis B. RED BLOOD CELLS (RBCs) : morphology C. ANEMIA : - Definition, classification & etiology - Diagnosis : clinical features & lab.findings D. APPROACH TO DIAGNOSE

SUB MODULE 2: POLYCYTHEMIA

COMPETENCY COMPONENTS To apply concept & principles of definition, classification and clinical approach to diagnose the etiology of polycythemia; (see outline of lecture contents)

.. POLYCYTHEMIA (contd)
CLINICAL COMPETENCIES 1. Student can describe definition, classification and etiology of polycythemia

2.

Student can diagnose polycythemia (rubra) vera, secondary and relative polycythemia

.. POLYCYTHEMIA (contd)
DEFINITION & OVERVIEW Polycythemia (erythrocytosis) is an increase in the Hb concentration above the upper limit of normal for the patients age and sex Classified according to its pathophysiology The major subdivision : - absolute polycythemia: primary & secondary - relative/pseudopolycythemia

.. POLYCYTHEMIA (contd)
OUTLINE OF LECTURE CONTENTS A. DEFINITION B. CLASSIFICATION AND ETIOLOGY C. POLYCYTHEMIA (RUBRA) VERA : - criteria for diagnosis - clinical features and laboratory findings D. SECONDARY POLYCYTHEMIA E. RELATIVE/PSEUDOPOLYCYTHEMIA F. APPROACH TO DIAGNOSE

SUB MODULE 3: BLEEDING DISORDERS

COMPETENCY COMPONENTS To apply concept & mechanism of hemostasis, pathophysiology, and clinical approach to diagnose the etiology of bleeding disorders (see outline of lecture contents)

.. BLEEDING DISORDERS (contd)

CLINICAL COMPETENCIES 1. Student can describe : The mechanism of hemostasis Etiology & pathophysiology of bleeding disorders Student can diagnose the etiology of bleeding disorders based on clinical features & lab. findings

2.

.. BLEEDING DISORDERS (contd)

DEFINITION & OVERVIEW Hemostasis is series of physiological processes which arrest bleeding at the site of injury and initiate repair of the blood vessel An efficient and rapid mechanism for stoping bleeding is clearly essential for survival Bleeding disorders may result from defective of vascular, platelets or coagulation

..BLEEDING DISORDERS (contd)

OUTLINE OF LECTURE CONTENTS A. MECHANISM OF HEMOSTASIS 1. Vascular factor 2. Platelets 3. Coagulation factor B. ETIOLOGY & PATHOPHYSIOLOGY OF BLEEDING DISORDERS C. DIAGNOSIS : clinical features & lab. findings D. APPROACH TO DIAGNOSE

SUB MODULE 4: THROMBOSIS

COMPETENCY COMPONENTS To apply concept & principles of vascular-bed-specific hemostasis, pathophysiology of thrombus formation, pathogenesis & risk factors of thrombosis (see outline of lecture contents)

.. THROMBOSIS (contd)
CLINICAL COMPETENCIES Student can describe : vascular-bed-specific hemostasis pathophysiology of thrombus formation on atherosclerotic lesions pathogenesis & risk factors of arterial & venous thrombosis

.. THROMBOSIS (contd)
DEFINITION & OVERVIEW Thrombi are solid masses or plugs formed in the circulation from blood constituents. Their clinical significance results from ischemia from local vascular obstruction or distant embolization. Thrombi are involved in the pathogenesis of myocardial infarction, cerebrovascular disease, peripheral arterial disease & deep vein occlusion.

..THROMBOSIS (contd)
OUTLINE OF LECTURE CONTENTS A. B. C. VASCULAR-BED-SPECIFIC HEMOSTASIS HYPERCOAGULABILITY STATES PATHOPHYSIOLOGY OF THROMBUS FORMATION ON ATHEROSCLEROTIC LESIONS - The Virchow Triad - Local substrates for thrombosis ARTERIAL & VENOUS TROMBOSIS - Pathogenesis - Risk factors

D.

SUB MODULE 5: GRANULOCYTES DISORDERS

COMPETENCY COMPONENTS To apply concept & principles of granulopoiesis, the morphology and the function of granulocytes, and clinical approach to diagnose granulocytes disorders (see outline of lecture contents)

.. GRANULOCYTES DISORDERS (contd)

CLINICAL COMPETENCIES 1. Student can describe : granulopoiesis the morphology & function of granulocytes causes of granulocytes disorders Student can do clinical approach to diagnose causes of granulocytes disorders

2.

.. GRANULOCYTES DISORDERS (contd)

DEFINITION & OVERVIEW Granulocytes, which include 3 types of cell: neutrophils (polymorphs), eosinophils and basophils, together with monocytes comprise the phagocytes.

The function of phagocytes and immunocytes in protecting the body against infection is closely connected with two soluble protein systems of the body, immunoglobulins and complement. These proteins, which may also be involved in blood cell destruction in a number of diseases.

.. GRANULOCYTES DISORDERS (contd)

OUTLINE OF LECTURE CONTENTS A. GRANULOCYTES - Neutrophils (polymorph) - Neutrophil precursors - Monocytes - Eosinophils - Basophils GRANULOPOIESIS Control of granulopoiesis: myeloid growth factors THE FUNCTION OF GRANULOCYTES: Chemotaxis, Phagocytosis, Killing & Digestion

B. C.

.. GRANULOCYTES DISORDERS (contd)

D. E. DEFECTS OF PHAGOCYTIC CELL FUNCTION Chemotaxis, Phagocytosis, Killing & Digestion LEUCOCYTOSIS AND MONOCYTOSIS - Neutrophil leucocytosis - The leukemoid reaction - Eosinophilic leucocytosis - Basophilic leucocytosis - Monocytosis NEUTROPENIA

F.