Module code and title 6BM039 Clinical Haematology

Assignment Brief

Module code and title 6BM039 Clinical Haematology

Module leader Assignment name Case report

Assignment type Coursework

Assignment weighting 100%, made up of report 1 (25%) and report 2 (75%)

Assignment size 1500 words for each report

Submission date Submission method Online via canvas

Assignment requirements Assessment criteria 100% of module markLO1, LO2, LO3 and LO4

Additional instructions (If applicable)

Professional Body requirements (If applicable)

University Regulations Support Date by which feedback will be provided Within four weeks of submission

Method by which feedback will be provided Online via canvas

6BM039 Clinical Haematology - coursework task and brief (LO1, LO2, LO3, LO4)

LO1 Demonstrate a critical understanding of the underlying principles of haematological systems.

LO2 Demonstrate an understanding of and the ability to critically evaluate the methods used in the diagnosis and monitoring of a range of haematological disorders.

LO3 Demonstrate practical skills and the ability to follow defined laboratory protocols whilst adhering to health and safety regulations.

LO4 Demonstrate a critical understanding of the clinically significant blood group systems and the implications of these for transfusion practice.

Case report 1: Data analysis and diagnosis

Case report 2: Data analysis and diagnosis

Your assessment task in each case is to write a report on the given patient case study to include an appraisal of the presentation and results from any laboratory tests, a differential diagnosis and any further tests that would be needed to clarify the diagnosis, a brief summary of the disease biology, prognosis and treatment. You should support your report with citations to scientific articles published in peer-reviewed journals using the Harvard referencing system.

The marks will be allocated as follows:

Data interpretation (35 marks)

Marks will be awarded for identifying the relevant parameters in any tests carried out so far rather than woodenly commenting on each one, and for interpreting them together rather than as isolated entities. (Note that relevant parameters may include those in the normal range.)

Differential diagnosis (25 marks)

Credit will be given for logical interpretation of the information and formulation of a differential diagnosis, even where this does not necessarily arrive at the correct answer. If further tests would be likely to resolve the diagnosis these should be suggested, and an indication of how the results would be interpreted. The appropriateness of such tests should be considered expensive and time-consuming tests should not be ordered without due consideration.

Disease biology, prognosis and treatment (35 marks)

A brief summary of the most likely disorder should be given, along with comments on the prognosis and current treatment.

Formatting of references (5 marks)

Guidance on formatting of references can be found in the Biomed-Physiology Departments Guide to Referencing (available on canvas) and in the Librarys guide: https://www.wlv.ac.uk/lib/skills-for-learning/referencing/ Harvard format should be followed.

Note that the marks for the three sections above will include the suitability and use of supporting references. Quality and appropriateness of references will be credited above quantity around 5 10 papers would be considered normal and credit will not be given for citing a surfeit of papers. Guidance on suitability of sources can also be found in the Biomed-Physiology Departments Guide to Referencing (available on canvas) and in the Librarys guide: https://www.wlv.ac.uk/lib/skills-for-learning/referencing/ Peer-reviewed scientific journal articles should be the main source of information, although others may be acceptable in specific circumstances. Online books (e.g. those from StatPearls online publisher or similar), unscientific websites or online public information documents should not be used.

General comments:

The total word count for each report should be 1500, + 20%. The writing should be clear and unambiguous, using correct scientific terms and scientific writing style.

Submission and Grading of your work:

Your work will be submitted and graded on canvas electronically out of a possible 100%. A grade will be calculated using a rubric which is a table of criteria that your work should fulfil to achieve the mark stated. You must look at this closely and use these as essential criteria to structure the work. The use of these marking schemes helps to ensure the objectivity of the marking process and ensures work can be graded efficiently and on time.

Marking rubric for 6BM039 Clinical Haematology

Score/Criteria 70-100%

(21-30 /30;

14-20 / 20)

Excellent Pass 50-70%

(15-21 / 30;

10-14 / 20)

Good pass 40-50%

12-15 / 30;

8-10 / 20)

Borderline pass 20-40%

(6-12 / 30;

4-8 / 20)

Borderline fail 0-20%

(0-6 / 30;

0-4 / 20)

Fail

(1)

Data interpretation

35% Excellently written, picked out the relevant parameters or features of the diagnostic tests and interpreted them together to provide an overall description of the patients condition. Intelligent comments about unusual or conflicting features. Correct style and language used. Well supported by references to suitable journal articles. Well written, most relevant features of the lab tests identified and correctly interpreted, minor errors or omissions, some flaws in language, grammar or style. Reference support is provided by largely suitable journal articles. A correct interpretation overall, but some tendency to regard parameters as distinct entities rather than to build up an overall picture. Some relevant points missed or misinterpreted. Writing quality and style satisfactory rather than good. Referencing is generally good, but some claims are unsupported by references, or to unsuitable sources. A largely incorrect or self-contradictory interpretation, several relevant points missed or misinterpreted. Poor writing or unclear meaning. Referencing is largely to unsuitable sources, or absent. No attempt or an inadequate attempt to interpret the data. Poor writing or unclear meaning. Inadequate referencing or complete lack of reference support.

(2)

Differential diagnosis

25% Excellently written, one or more possible diagnoses correctly identified and suitable further tests suggested, with projected interpretations. Correct style and language used. Well supported by references to suitable journal articles. Well written, differential diagnosis largely correct, but one or two relevant points missed. Minor flaws in language, grammar or style. Reference support is provided by largely suitable journal articles. Generally correct diagnosis, but the level of understanding and interpretation is rather basic. Suggested alternative diagnoses and further tests rather weak. Adequately written so the intended meaning is clear, but the style and grammar are poor. Referencing is generally good, but some claims are unsupported by references, or to unsuitable sources. An incorrect or inadequate initial diagnosis, alternative diagnoses not considered or incorrect. Poor or unclear writing, incorrect language or style. Referencing is largely to unsuitable sources, or absent. No attempt or an inadequate attempt to find a differential diagnosis. Poor writing or unclear meaning. Inadequate referencing or complete lack of reference support.

(3)

Disease biology, prognosis and treatment

35% A well-written summary of the disease biology of the most likely disorder with up-to-date information on prognosis and the latest treatment. Correct use of language and writing style. Well supported by references to suitable journal articles. A well-written summary of the disease biology of the most likely disorder or a plausible disorder, some minor errors or omissions in the prognosis or treatment. Minor errors of grammar or writing style. Reference support is provided by largely suitable journal articles. An adequate summary of the disease biology of a plausible disorder and prognosis and treatment, but with significant errors or omissions. Some errors of grammar or writing style. Referencing is generally good, but some claims are unsupported by references, or to unsuitable sources. An inadequate attempt to explain the disease biology of a relevant disorder, or an irrelevant disorder covered. Prognosis and treatment not covered, or inadequately covered. Poor or unclear writing. Referencing is largely to unsuitable sources, or absent. No attempt made to explain the disease biology, or the disease biology is inadequate, or of an irrelevant disorder. No attempt, or a completely incorrect attempt to explain the prognosis and treatment. Inadequate referencing or complete lack of reference support.

(4)

Format of references

5% Flawless use of Harvard style for journal articles in the reference list and citations. Only very minor flaws in Harvard style for journal articles in the reference list and citations. Some flaws in Harvard style for journal articles in the reference list and citations, but overall correct formatting. Referencing format contains substantial errors. No real attempt at Harvard referencing, or absence of references.

6BM039 summative case study 1 (25% of the module mark) - retrieval

A 64 year old female presents to A&E with haematemesis (vomiting blood) and melaena (passing of black stools). The doctor takes a brief medical history and notes a sudden onset of symptoms. The patient has no history of bleeding and has been otherwise fit and well. The patient had been experiencing intermittent nose bleeds for around one month, but the haematemesis and melaena had presented about one week ago. The patient has no history of recreational drug use and admits to consuming one large glass of wine twice a week. She is not on any anticoagulants. The consultant decided to request a blood test on the patient which proved to be abnormal, so the laboratory requested an urgent repeat. Following the repeat specimen, a haematology referral was requested. The results of all three specimens and further investigative tests are shown below, with normal ranges provided.

Parameter Todays Result (11th January) Repeat Result (2nd January) Initial Result (12th December) Normal range

Prothrombin time (PT) 9.5s 9.1s 9.2s 8.7 - 13.1s

INR 0.9 0.8 0.8 0.8 - 1.2

Fibrinogen 5.11 g/L 4.67 g/L 4.88 g/L 1.5 - 4.5 g/L

APTT 100s 96s 87s 25.6 - 38.4s

APTT Control 32.0s 32.0s 32.0s APTT Ratio 3.1 3.0 2.7 0.8 - 1.2

INR 50:50 mix 0 hrs 0.9 0.8 - 1.2

INR 50:50 mix 1 hr 0.9 0.8 - 1.2

INR 50:50 mix 2 hrs 1.0 0.8 - 1.2

APTT 50:50 mix 0 hrs 51.1 s 25.6 - 38.4s

APTT 50:50 mix 1 hr 66.3 s 25.6 - 38.4s

APTT 50:50 mix 2 hrs 78.9s 25.6 - 38.4s

Factor VIII 1.20 IU/dL 50 - 150 I.U/dL

Factor IX 60.60 IU/dL 50 - 150 I.U/dL

Your task:

Give a reasoned interpretation of the patient presentation and data above.

Suggest a differential diagnosis and any further testing that might be useful to resolve it.

Summarize the disease biology and comment on the likely prognosis and current treatment.

Support your answers with relevant academic, peer-reviewed references, cited and listed in proper Harvard style.