HAEMATOLOGY

Bone marrow structure and function

Haemopoiesis

Ineffective haemopoiesis

Haemoglobin: structure, function, synthesis and breakdown (haemolysis)

Physiological adaptation to anemia: role of 2,3 diphosphoglycerate (DPG).

Factors affecting oxygen dissociation curve.

Normal haematological values

Disparity in some blood counts in normal Nigerians and other black people in relation to Caucasians (whites) (total WBC count, relative neutropenia and eosinophilia).

Definitions and classification of anaemia I.

Polycythemia: definition (including by RBC mass). Primary and secondary.

Abnormal RBC morphology in anaemia.

Systematic plan for the diagnosis of anaemia.

Indication for bone marrow aspiration and biopsy

Quality assurance in haematology

Microcytic anaemia: Iron deficiency, lead poisoning, thalassemia and anaemia of chronic disorders.

Macrocytic anaemia:

·         Megaloblastic anaemia: Folic acid deficiency, vitamin B12 (including Pernicious anaemia).

Anaemia due to bone marrow failure:

·         Myelophthisic anaemia, Aplastic anaemia.

Haemolytic anaemia: due to haemoglobin disorders

·         Sickle cell disorders, sickle cell trait and sickle cell disease; “balanced polymorphism and Sickle cell gene”. Other haemoglobin variants that coexist with sickle cell haemoglobin (Hb-C, Hb-D, Hb-E etc.

·         Other rare abnormal haemoglobin: Unstable haemoglobinopathies: Methaemoglobinaemia and sulfhaemoglobinemia.

Haemolytic anaemia due to RBC enzyme deficiencies:

·         Glucose 6 phosphate dehydrogenase (G6PD) deficiency Protection of G6PD deficiency against malaria. Lyonization theory.

·         Pyruvate kinase deficiency and other RBC enzyme deficiencies.

RBC membrane disorders

·         Spherocytosis and elliptocytosis

Acquired haemolytic anaemia

·         Immune haemolytic anaemia due to antibodies (idiopathic, Evans syndrome, cold agglutinin antibodies, paroxysmal cold haemoglobinuria (PCH) and drug-induced immune haemolytic anaemia. due to defects in RBC membrane (including hereditary).

·         Microangiopathic haemolytic anaemia, prosthesis (cardiac) march haemoglobinuria.

·         Haemolytic anaemia due to parasitic infections (malaria), bacterial pathogens etc

·         ABO blood group system

·         Rhesus blood group system

Blood donor selection and recruitment

·         Types of blood donor

·         Donor eligibility criteria

Blood bank serology

·         Blood grouping: cells and serum grouping, methods of blood grouping

·         Blood crossmatch

·         Antibody screening test: Direct and indirect Coomb’s (antiglobulin) test

Blood transfusion and transfusion reactions including transfusion transmissible infections.

Blood and blood component therapy

·         Preparation and indications for use

·         Rationale blood use

Haemolytic disease of the newborn.

·         Leukopenia

·         Leukocytosis and leukemoid reaction: neutrophilia, lymphocytosis, eosinophilia (including tropical eosinophilia, hypereosinophilic syndrome

·         Diagnostic approach to lymphadenopathy

·         Infectious mononucleosis

·         Acquired immunodeficiency syndrome: HIV/AIDS

·         Structure and function of spleen

·         Disorders of the spleen: Hyposplenism, splenomegaly (including differentials of massive splenomegaly), hypersplenism.

o    Tropical splenomegaly syndrome

Molecular basis of cancers

Diagnostic methods in haematology: Morphology, immunophenotyping, cytogenetics, fluorescent in-situ hybridization and molecular methods.

Haematological malignancies:

·         acute leukaemia (myeloid and lymphoid): definition, epidemiology, aetiology, classification, clinical features, diagnosis, treatment and prognosis.

·         Chronic leukaemia: chronic lymphoid leukaemia, chronic myeloid leukaemia

·         Lymphoma:

o    Non-Hodgkin’s lymphoma: aetiology, classification, epidemiology, clinical features, diagnosis, staging, treatment and prognosis. Burkitt lymphoma, diffuse large B cell lymphoma, mycosis fungoides

o    Hodgkins lymphoma: aetiology, histologic types, epidemiology, clinical features, diagnosis, staging, treatment and prognosis.

·         Myeloproliferative disorders: Polycythaemia rubra vera, essential thrombocythaemia, idiopathic myelofibrosis.

·         Myelodysplastic syndrome (MDS)

·         Plasma cells dyscrasia including multiple myeloma.

·         Haemopoetic stem cell transplantation: introduction, types, conditioning, complications and management of HSCT

·         Human leukocyte antigen (HLA).

Bleeding disorders due to platelets: qualitative and quantitative disorders

Thrombocytopenia: differentials, clinical features, investigation and treatment

Congenital and acquired defects of platelet function

Test for platelet function

Bleeding due to coagulation disorders: genetic (haemophilia, von Willebrand disease) and acquired disorders

Coagulation test: Prothrombin time, Activated Partial Thromboplastin Time, Thrombin time

Defibrination syndrome: Disseminated intravascular coagulopathy (DIC)

Thrombotic disorders

Anticoagulant therapy: heparin, Coumarin, DOACS

Inhibitors and potentiators of anticoagulant

Monitoring of Warfarin therapy: International standardization index (ISI) and international normalized ratio (INR).

Blood film preparation: principles and method of staining.

Identification of common haematologic disorders on peripheral blood films and bone marrow films.

Full blood count – PCV, WBC, platelets.

Hb electrophoresis

Serological tests – blood grouping and crossmatch, Coombs test

Coagulation test – prothrombin time, APTT and correction test; ISI and INR calculation and interpretation.