CCOG for VT 111 archive revision 201704

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Effective Term:
Fall 2017 through Fall 2024

Course Number:
VT 111
Course Title:
Clinical Laboratory Procedures 1
Credit Hours:
4
Lecture Hours:
0
Lecture/Lab Hours:
80
Lab Hours:
0

Course Description

Covers the knowledge and skills necessary to perform hematology and urinalysis. Includes instruction for performing complete blood counts and urinalysis using current technology.

Addendum to Course Description

This course is intended for first-year veterinary technology students and is a graduation requirement for the Associates Degree in Applied Sciences in Veterinary Technology. 

Intended Outcomes for the course

Upon completion of the course students will be able to:

  1. Work safely in a laboratory setting and properly handle diagnostic blood and urine specimens to assure accurate test results.
  2. Use a microscope properly to produce accurate results in a diagnostic laboratory.
  3. Accurately perform a complete blood count, hematocrit, fibrinogen assay and serum protein assay while recognizing the diagnostic value and methodologies used for each test (dog, cat, horse, sheep, cow, and goat blood).
  4. Recognize the function, morphology and pathophysiology of the various blood cells and their differences between the domestic species.
  5. Accurately perform a urinalysis and recognize its components, diagnostic value, and methodologies used (dog, cat, horse, sheep, cow, and goat urine).
  6. Identify and describe the pathophysiology of the common types of uroliths found in domestic animal species from urinalysis. 
  7. Recognize and apply basic statistical analysis and terms as they apply to laboratory testing.

Course Activities and Design

This course is designed to be a lecture-laboratory course.  It is a four-credit-hour course that meets for eight lecture-laboratory hours per week.   Topics include microscope usage, the complete blood count including leukocyte and erythrocyte development and morphology, and urinalysis (which include chemical and morphological analytical methods of assay).   

Outcome Assessment Strategies

Grades will be based on the student’s understanding of the course content as demonstrated by periodic lecture examinations, laboratory proficiency examinations, and one comprehensive final exam, and by attendance. The student must be able to demonstrate proficiency sufficient to be within 10% of the results obtained on a sample evaluated by the instructor in order to receive a passing grade.  Also in order to receive a passing grade, the student must have attended a minimum of 80 percent of each of the lecture and laboratory classes. 

Course Content (Themes, Concepts, Issues and Skills)

1.0   INTRODUCTION TO HEMATOLOGY AND URINALYSIS

INSTRUCTIONAL GOAL:

The goal is for the student to develop a comprehensive knowledge of the following they relate to the collection and handling of blood and urine.

OBJECTIVES:

1.1 Discuss laboratory safety procedures.

1.2 Discuss the following:

    a. Sample collection

    b. Anticoagulants for blood storage

    c. Storage and stability of blood and urine

    d. Effects of hemolysis

    e. Effects of lipemia

    f. Effects of icterus

    g. Proper filling of blood tubes

    h. Effects of refrigeration on samples

    i. Use of centrifuge

    j. Use of microscope

2.0 THE COMPLETE BLOOD COUNT

INSTRUCTIONAL GOAL:

The goal is for the student to develop a comprehensive knowledge of the components of a complete blood count.

OBJECTIVES:

2.1 Discuss the components and function of blood.

2.2 Discuss the steps involved and errors that can occur when preparing a blood film. 

2.3 Discuss the types, procedure for and the source of errors that can occur in routine staining (Wright’s, Diff-Quick and New Methylene Blue of blood    smears).  

2.4 Discuss how to perform and a hematocrit. Be able to discuss common source of errors.

2.5 Discuss the principles of refractometry and how to measure total serum protein.

2.6 Discuss the procedure for measuring fibrinogen in animals.

2.8 Discuss the Unopette system for performing cell counts. Be able  to discuss procedures as well as the source of errors for the following types of cell counts.  

    a. Total white cell count

    b. Total red cell count

    c. Platelet count

2.9 Discuss the following ways to determine hemoglobin concentration.

    a. Spencer hemoglobinometer

    b. Unopette and spectrophotometer

    c. Automated

    d. Mathematical derivation from the hematocrit.

2.10

   Discuss the physiology and pathophysiology of red cells and how it pertains to the following.  Be able to discuss differences in domestic species.

   a. Red blood cell indices

   b. Normal red cell morphology

   c. Abnormal red cell morphology

   d. Blood parasites (including Hemobartonella) 

   e. Viral inclusions

   f. Anemia’s of various causes

   g. Immune mediated hemolytic anemia

   h. Polycythemia

   I. Reticulocyte counts  

2.11

   Discuss the function, morphology and pathophysiology of the following cells. Discuss differences between the domestic species. 

   a. Neutrophils

   b. Monocytes

   c. Lymphocytes

   d. Eosinophils

   e. Basophils

   f. Heterophils   

   g. Platelets

2.12

   Discuss the following as they pertain normal verses abnormal physiologic response in animals.

   a. Toxic changes in neutrophils

   b. Hypersegmented neutrophils

   c. Corrected total white cell count

   d. Physiologic leukocytosis

   e. Leukocyte response to corticosteriods

   f. Neutrophil response to inflammatory disease

   g. Left shift of neutrophils

   h. Leukomoid response

   i. Neutropenia

   j. Monocyte responses

   k. Eosionophil responses

   l. Basophil responses

   m. Lymphocyte responses

   n. Atypical lymphocytes

   o. Reactive lymphocytes

   p. Thrombocyte responses

       3.0 BONE MARROW EVALUATION

INSTRUCTIONAL GOAL:

The goal is for the student to develop a comprehensive knowledge of bone marrow evaluation as it applies to common veterinary practice.

OBJECTIVES:

3.1 Be able to discuss the sites and preparation of smears for bone marrow aspiration and biopsy. Describe slide staining techniques.

3.2 List the reasons bone marrow evaluations are performed.

3.3 Define the following:

    a. Cellularity of particles

    b. Myeloid to erythroid ratio

    c. Megakaryocyte numbers

    d. Maturation shift

       4.0 HEMATOPOETIC TUMORS

INSTRUCTIONAL GOAL:

The goal is for the student to develop a comprehensive knowledge of common tumors arising from hematopoetic cells.

OBJECTIVES:

4.1 Define the following

    a. Lymphoproliferative disorders

    b. Myeloproliferative disorders

4.2 Define the following and state what cell line is affected and describe what characteristics would be seen on a peripheral blood film.

    a. Canine malignant lymphoma

    b. Feline malignant lymphoma

    c. Bovine malignant lymphoma

    d. Acute lymphocytic leukemia

    e. Chronic lymphocytic leukemia

    f. Plasma cell myeloma

    g. Acute myeloid leukemias

    h. Eythremic myelosis

    i. Myelodysplastic syndrome

    h. Eosinophilic leukemia

    i. Basophilic leukemia

    j. Chronic granulocytic leukemias

    k. Mast cell leukemia

    l. Megakaryocytic leukemia

5.0 DISORDERS OF HEMOSTASIS

INSTRUCTIONAL GOAL:

The goal is for the student to develop a comprehensive knowledge of hemostasis and the diagnostic tests used to evaluate coagulation.

OBJECTIVES:

5.1 Review the physiology of hemostasis and define the following.

    a. Primary hemostasis

    b. Secondary hemostasis

    c. Intrinsic system

    d. Extrinsic system

    e. Common pathway

    f. Fibrinolysis

5.2 Describe the following tests, sample preparation and list which ones can be done in a clinic or needs to be sent out to a commercial laboratory.

    a. Mucosal bleeding time

    b. Platelet count

    c. Platelet estimate

    d. One-step prothrombin time

    e. Partial thromboplastin time

    f. Activated clotting time

    g. Whole blood clotting time

    h. Coagulation factor assays

    i. Fibrinogen assay

5.3 For each of the following hemostatic disorders, describe the pathophysiology and appropriate tests needed to diagnose them.

    a. Immune mediated thrombocytopenia

    b. Von Willebrand’s disease

    c. Effects of aspirin

    d. Vitamin K deficiency

    e. Disseminated intravascular coagulation

    f. Hemophilia A

5.0 URINALYSIS

INSTRUCTIONAL GOAL:

The goal is for the student to develop a comprehensive knowledge of the study of urine and urolithiasis as it applies to domestic animals.

OBJECTIVES:

5.1 Review the function of the kidney

5.2 Describe the following methods of urine collection

    a. Voided sample

    b. Bladder expression

    c. Urinary catheterization

    d. Cystocentesis

5.3 Describe the following physical properties of urine

    a. Color

    b. Clarity

    c. Concentration (Specific gravity)

5.4 Describe the pathophysiology of the following chemical properties of urine.

    a. Protein

    b. Glucose

    c. Ketones

    d. Bilirubin

    e. Occult blood

    f. Urobilinogen

    g. Nitrite

    h. pH

    i. Creatinine

5.5 Describe the procedure for evaluating the chemical properties and sediment constituents in urine.

5.6 Describe the pathophysiology and significance of finding increased quantities of the following urine sediment constituents.

   a. Red blood cells

   b. White blood cells

   c. Casts

   d. Crystals

   e. Bacteria 

5.7 Describe the pathophysiology and identification of the following types of uroliths in domestic animal species.

    a. Struvite

    b. Urate

    c. Cystine

    d. Calcium oxalate

    e. Silica

6.0 BASIC CONCEPTS OF LABORATORY TESTING

INSTRUCTIONAL GOAL:

The goal is for the student to develop a comprehensive knowledge of basic statistics and terms as they apply to laboratory testing.

OBJECTIVES:

6.1 Define the following

    a. Sensitivity

    b. Specificity

    c. Predictive value

    d. Probability

    e. Accuracy

    f. Precision

    g. Reliability

    h. Standard deviation

7.0 LABORATORY COMPETANCIES

INSTRUCTIONAL GOAL:

The goal is for the student to develop a perform a complete blood count and urinalysis on dog, cat, horse, sheep, cow, and goat blood and urine.   

OBJECTIVES:

7.1 Be able to demonstrate competency by performing the following procedures on blood.

    a. Hematocrit

    b. Total protein by refractometry

    c. Fibrinogen assay

    d. Hemoglobin

    e. Total white cell count by Unopette and slide estimate method

    f. Total red cell count by PCV and Unopette method

    g. Reticulocyte count (percent and absolute)

    g. Platelet count

    h. Calculate hematologic indices

    i. Prepare a blood film

7.2 Be able to demonstrate competency by performing the following microscopic procedures on blood.

    a. Stain blood films (Diff-Quick and NMB)

    b. Perform leukocyte differential

    c. Identify normal/abnormal morphology of leukocytes

    d. Identify normal/abnormal morphology of erythrocytes

    e. Estimate platelet count

    f. Calculate absolute values

    g. Perform white blood cell correction for nucleated red cells

    i. Identify blood parasites (including Hemobartonella, Anaplasma,

       Babesia, Eperythrozoan and Ehrlichia

7.3 Determine the following physical properties of urine:

    a. Color

    b. Clarity

    c. Specific gravity by refractometer and urometer

7.4 Test the chemical properties of urine using dipstick and/or tablet reagent testing.

    a. Protein

    b. Glucose

    c. Ketones

    d. Bilirubin

    e. Occult blood

    f. Urobilinogen

    g. Nitrite

    h. pH

    i. Creatinine

7.5 Examine, identify and quantify the following found in urine sediment.

   a. Red blood cells

   b. White blood cells

   c. Casts

   d. Crystals

   e. Bacteria