OVERVIEW

During their two-month rotation on the Clinical Chemistry Service, pathology residents attend lectures in the Clinical Pathology (CP) Lecture Series, the Management Lecture Series, and Clinical Chemistry Grand Rounds.  In addition, residents attend weekly Call Notes and Case Review Conferences.  The Call Notes Conference is designed to provide pathology residents with a greater understanding of issues related to chemistry topics, while the Case Review Conference is intended to give them the opportunity to critically review a peer-reviewed scientific publication on a chemistry-related topic or discuss a “real world” case that highlights the application of clinical chemistry principles in aiding the diagnosis of the patient's disease.   To gain an appreciation of different analytical methods/instruments, residents also rotate through all subspecialty areas of the various laboratories constituting UTSWMC under the supervision of a senior medical technologist and/or faculty member in the area of the laboratory where these methods/instruments are located.  Lastly, to strengthen the pathology resident's understanding of the important role of clinical chemistry in a multi-disciplinary medical environment, residents participate in:  1) the planning, execution, and interpretation of results from several unique diagnostic endocrine procedures, including bilateral inferior petrosal sinus sampling (IPSS), selective parathyroid hormone (PTH) sampling, intra-operative PTH testing, and adrenal vein sampling (AVS); 2) providing clinical services to the Obstetrics staff via the interpretation of prenatal serum and amniotic fluid screening and confirmatory test results for identifying fetuses at risk for an ONTD, ventral wall defect, or fetal chromosomal abnormality such as trisomy 18 (Edwards' syndrome) or trisomy 21 (Down syndrome); 3) the unique requirements of pediatric testing during their rotation in the clinical chemistry laboratory at Children's Medical Center of Dallas, including an appreciation of the differences in reference ranges between adult and pediatric populations and tests (e.g., blood ammonia level) performed more routinely on pediatric than adult blood samples, including the analysis by gas chromatography-mass spectrometry (GC-MS) and tandem MS of metabolites found in various body fluids/tissues of neonates or children with a wide variety of inborn errors of metabolism; and, 4) the application of drug pharmacology, pharmacokinetics, and routine (e.g., immunoassay methods for the quantitative determination of serum therapeutic drug levels) and non-routine [e.g., gas chromatography (GC)] methods for the identification and/or quantitation of therapeutic drugs and drugs of abuse in urine (dau) and serum.

FACULTY:

• Patricia M. Jones, Ph.D., DABCC, FACB
• Ibrahim Hashim, Ph.D.
• Susan Hilton, M.D., FACP
• Elizabeth L. Todd, Ph.D.
• Martin H. Kroll, M.D., FACB
• Dr. Paul J. Orsulak, Ph.D.
• Frank H. Wians, Jr., Ph.D., DABCC, FACB

DURATION: 2 months

PREREQUISITES:

There are no prerequisites for the Chemistry Rotation.

OBJECTIVES

Patient Care

Medical Knowledge

Practice-based Learning

Interpersonal and Communications Skills

Professionalism

Systems-based Practice

CONFERENCES

• Daily Sign-out of electrophoretic reports
• Clinical Chemistry Grand Rounds
• Endocrine Grand Rounds
• Update in Pathophysiology
• Clinical Pathology Lecture Series>

BASIC READING

Selected articles in multiple booklets provided to Resident prior to the start of the Chemistry rotation; case specific reading assigned by Clinical Chemistry Faculty