Core Adult Internal Medicine Disciplines

Haematology

Topics

• An understanding of haemopoiesis and how the cellular elements of blood are made.
  
• Red cell disorders - mechanisms, investigation and therapy:
  
  • Anaemias.
    
  • Polycythaemias - primary and secondary.
    
  • Thalassaemias.
    
  • Haemoglobinopathies.
• White cell disorders - pathophysiology, investigation and therapy:
  
  • Leukaemias - acute and chronic, myeloid and lymphoid.
    
  • Lymphomas - Hodgkin's disease and the non - Hodgkin lymphomas.
    
  • Myeloproliferative disorders.
    
  • Myeloma and other plasma cell disorders.
• Platelet disorders - pathophysiology, investigation and therapy:
  
  • Thrombocytopenia.
    
  • Thrombocytosis.
• Thrombosis:
  An understanding of the general area of thrombophilia, its prevalence, investigation and management; indications for treatment with heparin, warfarin, thrombolytic therapy and the monitoring of patients receiving these drugs.
  
• Coagulation:
  Diagnosis and management of acquired disorders of haemostasis, including disseminated intravascular coagulation, as well as inherited disorders such as haemophilia and von Willebrand's disease.
  
• Transfusion:
  Indications for transfusion of red cells, platelets, fresh frozen plasma, cryoprecipitate, albumin and immunoglobulin concentrates. The principles of cross-matching and assessment of transfusion reactions and of the obstetric patient.
  
• Transplantation:
  Principles of autologous and allogeneic haemopoietic stem cell tranplantation, including tissue typing, high dose therapy, and graft-versus-host disease.
  
• Interface with general medicine:
  
  • General haematological problems, especially those associated with special units, e.g. intensive care, obstetrics and accident and emergency.
    
  • Assessment and management of haematological emergencies, e.g. neutropenic fever, massive haemorrhage, abnormal bleeding, thromboembolism, hypercalcaemia, nausea, vomiting and pain relief.
    
  • Principles of laboratory haematology: blood counting and morphology, immunophenotyping, cytogenetic analysis, simple tests of haemostasis and blood cross-matching.
    
  • The social and ethical consequences of choosing not to institute or not to continue treatment and understanding the use of ICU severity scoring systems.

Practical Skills for all Trainees

• Blood transfusion and administration of blood products.
  
• Insertion and care of central lines.

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