Anatomical Pathology

• Preparation of specimens for light microscopy including fixation and tissue processing, and routine staining for formalin fixed paraffin embedded tissue (FFPE)

• Knowledge of anatomy and physiology with application for specimen triage

• Basic knowledge of normal tissue morphology

• Histochemical methods as applied to light microscopy including special stains and immunohistochemistry

• Fixation, preparation and staining of cytological specimens

• Knowledge of cytology preparations with reference to a range of normal and abnormal presentations.

Chemical Pathology

An understanding of the underlying techniques utilised and methodology behind the measurement of common chemistry analytes and their clinical utility including:

• Basic physiology and pathophysiology of disorders of chemical pathology

• Reagent preparation, concentration and dilution

• Electrolytes, anion gap and osmolarity

• Pre-analytical, analytical and post-analytical causes of error

• Urea, creatinine, and creatinine clearance, uric acid, eGFR

• Glucose, glucose tolerance, HbA1c and use in diabetic and pre-diabetic screening and monitoring

• Liver function tests

• Lipid analysis

• Iron studies and anaemia studies currently undertaken in the core laboratory

• Plasma proteins, protein electrophoresis, and immunofixation

• Specific plasma proteins e.g., CRP, beta 2 microglobulin

• Principles of enzymatic analysis

• Enzyme tests e.g. amylase, creatine kinase

• Calcium, phosphates, magnesium and hormonal control

• Bilirubin including neonatal bilirubin measurement

• Myocardial function tests in relation to the acute coronary syndromes

• Common tumour markers e.g., Prostatic specific antigen, CEA

• Basic serology testing now performed in core laboratory settings such as Hepatitis B, C, and HIV

• Endocrinology such as Thyroid and Adrenal function tests

• Dynamic function testing

• Bioinstrumentation including immunoassays, spectrophotometric assays and Point of Care Testing

• Quality Control concepts as they apply to an automated biochemistry laboratory

• Therapeutic drug monitoring (TDM) and toxicology

• Vitamin assays including Vitamin B12, folate, and Vitamin D.

Molecular Pathology

• Basic understanding of patterns of inheritance

• Structure of DNA and RNA

• Define terms, including but not limited to; genotype, phenotype, allele, single nucleotide polymorphism, haploinsufficiency, loss of function, gain of function, truncating and non-truncating mutations

• Transcription and translation

• Epigenetics - basic principles of methylation

• Common mutations in constitutional haematological disorders such as alpha and beta thalassaemia, sickle cell anaemia and other haemoglobinopathies, iron overload disorders, haemophilia A and B

• Genetic basis of cancer, including common lymphoid malignancies and myeloproliferative disorders, including but not limited to, Bcr-Abl, BRAF V600E, JAK2 V617F

• Principles of PCR techniques including sample preparation and use of controls

• Principles of PCR; including reverse transcriptase PCR, real-time PCR, multiplex PCR and QPCR

• Sample integrity for DNA and RNA based techniques

• Awareness of the basis of sequencing technologies:

o Sanger sequencing

o Massively Parallel sequencing or Next Generation Sequencing (NGS)

o Long Read Sequencing

• Understanding of the Human Genomic Variation Society (HGVS) and the International System for Human Cytogenomic Nomenclature (ISCN) international standards for nomenclature

Haematology

• Principles of automated cell counting

• Causes and diagnosis of anaemias

• Benign white cell disorders

• Myeloproliferative disorders

• Lymphoproliferative disorders

• Production of erythrocytes, leucocytes and platelets

• Intrinsic and extrinsic coagulation pathways and methods of testing

• Bleeding and thrombotic disorders

• Anticoagulant therapy and methods of monitoring this therapy

• Natural anticoagulants

• Fibrinolysis

• Malaria testing and species

• Quality control in haematology and coagulation

• Pre-analytical factors in haematology and coagulation.

Immunopathology

• Basic understanding of the structure and function of the immune system, including primary and secondary immune organs and cells of the immune system

• Adaptive and acquired immune mechanisms

• Cellular and humoral immune responses

• Immunoglobulin properties and functions

• Monoclonal antibodies, their properties and their uses in diagnostics

• Monoclonal gammopathy and its laboratory investigation

• Mechanisms of hypersensitivity and their laboratory investigation

• Acquired and inherited immune deficiency conditions, major autoimmune conditions and their laboratory investigation

• Principles of immunology-based assays e.g., immunophenotyping using flow cytometry, protein electrophoresis and immunofixation, ELISA, nephelometry/turbidimetry, immunofluorescence, chemiluminescence, and enzyme immunoassay.

Medical Microbiology

• A basic knowledge of infectious diseases (and associated organisms) commonly diagnosed by analysis of specimens in a routine microbiology laboratory. There will be a greater emphasis on bacterial diseases, but some knowledge of parasitic, fungal and viral disease is also expected.

• Collection, handling and processing of samples including the minimum criteria for acceptance of samples

• Knowledge of normal flora (indigenous flora) of major body sites or absence of normal flora in sterile body sites

• Presumptive identification of major groups of bacteria based on microscopic and colonial morphology on a variety of common media including non-selective, selective / differential and chromogenic media and the use of key basic identification tests such as catalase, oxidase and atmospheric growth requirements

• Principles of major methods of susceptibility testing i.e., disc diffusion, agar dilution and broth dilution and the relationship between breakpoints, MIC and susceptible / resistant categories

• Microscopy: Function and maintenance of a modern binocular microscope, including setting up and using for bright-field, phase-contrast and dark-field microscopy

• Staining techniques: Gram stain and Ziehl-Neelsen stain

• Application of basic molecular techniques for detection, identification of microorganisms / disease markers and detection of important resistance mechanisms

• Basic knowledge of common automation / instrumentation used in routine diagnostic microbiology

• General principles of quality control and quality assurance as it applies to microbiology

• Safety in the microbiology laboratory, Biosafety Cabinets, Biosafety levels.

Transfusion Science

• Antibody structure and function

• Antigen / antibody interaction

• Antibody production

• Blood donation testing

• Blood components

• Blood group systems

• Antibody detection and identification

• Pre transfusion testing and product selection

• Resolving blood grouping discrepancies

• Haemolytic disease of the foetus and newborn

• Antenatal testing

• Quality assurance in the blood bank laboratory

• Internal quality control and external quality assurance in the blood bank.

Laboratory Safety and Quality Control

• Safe handling of biological specimens

• Safe handling of hazardous chemicals

• Sterilisation and disinfection procedures

• Handling of infectious specimens

Principles of Quality Assurance and Quality Control

• Basic charting and rules for rejection of results

• Simple statistical evaluation, Reference ranges methodology – parametric and non-parametric

• The role of internal quality control and external quality assurance

• Uncertainty of measurement.

Basic Laboratory Procedures and Equipment

• Normal and molar solutions

• Basic laboratory calculations

• Basic laboratory equipment and its appropriate use

• Spectrophotometry.

AIMS EXAM