U of M Med Students
M2 Sequence Overview
Hematology/Oncology
Sequence Directors
Paula Bockenstedt, M..D
Lloyd Stoolman, M.D.
Sequence Mission Statement & Intended Learning Outcomes

 

GOALS OF THE HEMATOLOGY/ONCOLOGY SEQUENCE

The overall goal of the hematology sequence is for the student to be able to recognize and diagnose anemias, bleeding and clotting disorders, and abnormal white blood cell and lymphocyte disorders. The student will be taught the clinical approach to a patient with a red blood cell, hemostatic or thrombotic, and white blood cell disorder.

There is a required text: Schmaier AH, Petruzzelli LM (eds), Hematology for the Medical Student, Lippincott, Williams & Wilkins, 1st edition, 2003. This textual material is a supplement to the lectures and powerpoint presentations. The student is required to know the context of Chapter 1 which will not be formally presented.

The following are the educational objectives of the Hematology Sequence.

I. Diagnosis of a Presenting Problem

Given a real or simulated patient with one of the following presenting problems, the student will be able to provide a differential diagnosis and appropriate laboratory studies for the following conditions:

  • Anemia: macrocytic, normocytic, or microcytic
  • Leukocytosis
  • Bleeding (Coagulation protein, platelet, or von Willebrand factor defect)
  • Leukopenia
  • Thrombosis
  • Lymphadenopathy

 II. Diagnosis of a Specific Disease

Given a real or simulated patient with one of the following diagnoses, the student will be able to gather the appropriate data, arrive at a diagnosis, and give the evidence (historical, physical, laboratory, radiologic, and special procedural data) to support the diagnosis:

  • Iron deficiency anemia
  • Infectious mononucleosis
  • Pernicious Anemia
  • Lymphoma (any type)
  • Folic acid deficiency
  • Chronic lymphocytic leukemia
  • Thalassemia, Sickle cell anemia
  • Chronic myelocytic leukemia
  • Hereditary spherocytosis
  • Acute leukemia
  • G6PD hemolytic anemia
  • Multiple Myeloma
  • Hemophilia A and B
  • Thrombotic thrombocytopenia purpura
  • Immune thrombocytopenia
  • Disseminated Intravascular Coagulation

III. Assay/Laboratory/Procedural/Interpretive Skills

  1. The student will be able to list the componets and interpretation of and/or indications for:
    • A complete blood count (CBC)
    • Bone marrow aspirate and biopsy
    • Activated partial thromboplastin time
    • Prothrombin time
    • Bleeding time
    • Platelet aggregation and secretion studies
    • Von Willebrand factor studies
    • Lymph node biopsy
  2. The student will be able to examine a peripheral blood smear to:
    • Accurately describe the RBC and platelet morphology of any condition using standard nomenclature.
    • Identify polymorphonuclear neutrophils, mature mononuclear cells (lymphocytes and monocytes), and granulocyte precursors as a group (not individual stages).
    • Perform a WBC differential composed of cells in the line above sufficiently accurately to extract the clinical information relevant to the patient being examined.

IV. Enabling Objectives

The student shall be able to:

  1. Describe the general origin, function, and component parts of the hematopoietic system.
  2. Describe the basic kinetics of red cell, white cell, and platelet formation and life span.
  3. Be able to classify red blood cell disorders based upon the size of the red blood cells.
  4. List the indications for, hazards of, and methods of whole blood, packed red cell, platelet, and plasma component transfusions.
  5. Provide a diagnostic approach to the bleeding patient by completely knowing the differential diagnosis of a long APTT, PT, both APTT and PT, bleeding time, and platelet count.
  6. List the indications for and be able to interpret the following tests: serum iron and iron binding capacity, ferritin level, reticulocyte count, Schilling test, Coombs' test (direct and indirect antiglobulin test), stool guaiac (blood), platelet count, prothrombin time, activated partial thromboplastin time, thrombin clotting time, and bleeding time.
  7. Describe the mode of action of standard heparin, low molecular weight heparin, warfarin (Coumadin?), platelet glycoprotein IIb/IIIa (alpha2Bbeta3 integrin) antagonists, and clopidogrel (PlavixTM).
Resources

Medical School Portal

Digital Microscopy