support@essaywritingexpert.orgThis is an oral Case Based Discussion (CBD) within which you will review the clinical notes provided and prepare to discuss these during a face-to-face discussion with two academic staff.
During the discussion you will be asked to summarise and critically review the data provided, together with answering questions around the following themes:
- The nature of the biomedical investigations undertaken (for example, sample types or examples of analytical methods used).
- Awareness of sources of error and analytical variation, including factors affecting test performance and interpretation.
- The contributions of the tests to disease diagnosis or monitoring.
- Additional, novel or alternative testing strategies, including an awareness of current or emerging practice.
Start by thinking about how you would summarise the case. This should be a quick overview that discusses the testing strategy and how / why specific tests have been used (for example – how do they narrow down the differential diagnosis, what things do they rule in / rule out). You do not need to condense all of the history and tests into this – it is just an overview. Don’t worry if staff move you on – we are capturing a flavour of what you know and how you communicate, and so we can always pick up on other elements as we work through the questions.
After the summary, we will ask you some questions about the diagnostic tests used based upon the themes above – to practice these, the table below pulls out all of the tests used and asks a series of questions about them (obviously we will not be able to cover all of these in the 15 minutes – we will just dip in and out of different elements).
As well, we could extend the questions into the wider themes of the module, for example:
- What do reference ranges represent and how might they be derived?
- Are there different reference ranges for different groups?
- Do you understand the terms sensitivity, specificity, positive and negative predictive values? How do these help in evaluating the value of laboratory tests?
- Are all of the tests appropriate – can you qualify this?
- How does the ‘dip stick’ point of care testing done in the GP surgery compare with laboratory testing? Are there any strengths / weaknesses to point of care testing?
| What does this test measure? | What sample type is used? | Are there any potential sources of error (preanalytical, preservative, time, temperature etc)? | What does this result tell you – what questions does it answer / ask? | How does it help answer the clinical question? | ||
| Clinical Biochemistry | Serum Sodium (part of Urea and Electrolyte profile) | |||||
| Serum Potassium (part of Urea and Electrolyte profile) | ||||||
| Serum Urea (part of Urea and Electrolyte profile) | ||||||
| Serum Creatinine (part of Urea and Electrolyte profile) | ||||||
| Serum Albumin (part of Liver Function Test profile) | ||||||
| Serum Alkaline Phosphatase (part of Liver Function Test profile) | ||||||
| Serum Alanine Transferase (part of Liver Function Test profile) | ||||||
| Serum Gamma Glutamyl Transferase (part of Liver Function Test profile) | ||||||
| Serum Bilirubin (part of Liver Function Test profile) | ||||||
| Serum C Reactive Protein | ||||||
| Plasma Glucose | ||||||
| Serum Paracetamol | ||||||
| Carcinoembryonic Antigen | ||||||
| Alpha Fetoprotein | ||||||
| CA-125 | ||||||
| Haematology | Haemoglobin | |||||
| Red Cell Count | ||||||
| White Cell Count | ||||||
| Mean Cell Volume | ||||||
| Platelet Count | ||||||
| Erythrocyte Sedimentation Rate | ||||||
| Prothrombin Time | ||||||
| Activated Partial Thromboplastin Time | ||||||
| International Normalised Ratio | ||||||
| Blood film | ||||||
| Microbiology | Hepatitis B Surface Antigen | |||||
| Hepatitis C serology | ||||||
| Cellular Pathology | Formalin Fixed, Paraffin Embedded Biopsy Section | |||||
| Haematoxylin and Eosin Stain | ||||||
| Molecular Panel (consider what specific tests this could involve) | ||||||
| Immunohistochemistry (consider what specific tests this could involve) |