MLAB 1235 Immunology/Serology
Syllabus
Fall 2005

I. INTRODUCTION

This course covers the science of immunology and serology through the study of theories and processes related to natural body defenses. Included are basic antigen-antibody reactions, complement action, cellular response, humoral immune response and the basic serological procedures used to aid in the detection of certain diseases.

Throughout this course, special emphasis is placed on correlating of laboratory results with the patient's probable condition.

II. PREREQUISITES

None

III. COURSE GOALS

MLAB 1235 - Immunology/Serology is structured to meet the MLT Program goals addressing, but not limited to:

• developing a working knowledge of the principles and procedures of serology,
• producing accurate, skilled clinical laboratory workers with strong ethical and professional values,
• promoting respect and understanding of allied health professionals through renewed understanding of the clinical laboratory technician's role as a member of the allied health care team.

Upon successful completion of this course, the student should be able to:

1. Demonstrate an understanding of the concepts of nonspecific and specific immunity.
2. Describe the immunologic responses involved in preventing and combating infections.
3. State the principle of the routine serologic procedures performed in the clinical laboratory.
4. Read and correctly follow the instructions in reagent package inserts, as needed, to obtain valid results.
5. Evaluate laboratory test outcomes and determine the validity of the test results obtained.
6. Recognize the limitations of each laboratory procedure performed and describe how these may affect the results of the testing performed.
7. Perform and evaluate quality control results as required by the procedure and use the results to evaluate the patient results obtained.
8. Correlate test results with patient condition(s).
9. Maintain a safe laboratory environment by putting away all reagents/supplies, washing laboratory glassware/slides, disinfecting work area upon completion of duties, and putting full biohazard bags in designated area.
10. Demonstrate improvement in the affective traits of organizational skills, work habits, attitude, interpersonal skills, and problem-solving ability.

SCANS

The U.S. Department of Labor has established the Secretary's Commission on Achieving Necessary Skills (SCANS) to ensure that student's are gaining competencies that are required in the work place. The following competencies will be acquired upon completion of MLAB 1235 Immunology/Serology:

IV. METHODS OF PRESENTATION

A. Lecture
B. Demonstration and discussion
C. Laboratory practice
D. Audiovisual aids such as films and overheads
E. Internet Assignments
F. BlackBoard

V. MATERIALS

A. Required: Stevens, Christine (2003), Clinical Immunology and Serology: A Laboratory Perspective, 2nd ed., FA Davis (ISBN 0803610955)
B. Required: 3-ring binder with dividers and a Sharpie
C. Recommended: Medical Dictionary (Mosby), A Manual of Laboratory & Diagnostic Tests, Fischbach (2000), and a timer. (Instructor will give you specifics on what time of timer to purchase.)

VI. COURSE REQUIREMENTS AND REGULATIONS

A. Attendance Policy

Regular and punctual attendance is required at all lecture and laboratory sessions. Class roll will be taken. Absences must be explained to the instructor on the day of the absence by telephone, email or personal visit. If an absence is anticipated, the student is to make a scheduling arrangement in advance with the instructor. Two or more absences may be cause to withdraw a student from the course. A student who is five (5) minutes late is considered TARDY. Three (3) tardies constitute one absence. It is the student's responsibility to keep track of his/her attendance record and for all assignments, materials, examinations, etc., missed. Out of respect for your instructor and classmates PLEASE be punctual.

B. Out of courtesy for your instructor and classmates please turn pagers and cell phones to mute or off during class.

C. Student Assistance Policy

It is the sincere desire of the program faculty to aid each student in developing his/her professional potential. Academic, clinical, and those personal problems that interfere with the student's development are of concern to the faculty. The program faculty has adopted the following policy:

1. Personal Problems
   
   The MLT student should feel free to make an appointment to discuss problems of a personal nature with a faculty member of his/her choice. In addition, the Health Science counselors are available for student counseling.  
   
   
2. Academic Problems

Problems encountered in the MLT lecture and/or laboratory sections should be brought to the attention of the course instructor. The instructor will work with the student to resolve the problem. If the student feels he/she cannot reach an agreement with the instructor, the student should present the situation to the MLT Program Department Chair. If the instructor is the Program Department Chair they may contact the assistant dean. All discussions with the faculty will remain confidential.

C. Dress Code

1. The student will be expected to attend class clean and neatly dressed.
2. The provided lab coat must be worn buttoned/snapped during all laboratory sessions.
3. Footwear appropriate for a laboratory setting will be required.
4. Hair that is shoulder length or longer must be worn up or securely tied back.
5. Loose or dangling jewelry will not be permitted.
6. Strong smelling perfumes or after-shave lotion are inappropriate in a laboratory.
7. Latex gloves must be worn when handling body fluids or other potentially biohazardous materials. If the student is allergic to latex or the powder that is normally found on latex gloves, vinyl or powder free gloves will be provided for the student.
8. Nothing that is dangling may be left outside the lab coat, ie, ties, long scarves, etc. These must be tucked in.

VII. STUDENT EVALUATION

A. Measurement, Written

Each student is required to write a report using the Internet for resources and references. The instructor will hand out the instructions and requirements for this project.

Each student will view the film "Gattaca", or a film of your choice, related to ethical/moral issues surrounding the use of blood tests in the real world and the consequences that follow. A two page written summary of the film as well as your thoughts/opinions on the ethical/moral issue will be submitted. The instructor will provide a handout with general guidelines for this assignment.

Four (4) written examinations will be given over lecture materials. The objectives for in each appropriate chapter in the textbook should be reviewed as an aid in preparing for the examinations. All written examinations will be given online through BlackBoard. The highest ethical and moral standards of honesty are expected. Any student caught cheating by looking at notes, textbooks or other study materials during the exam will be given a grade of "0".

A comprehensive final examination will be given in the MLT classroom according to the lecture schedule.

Students are expected to come to class prepared by reading all materials (lecture, textbook, lab exercise) BEFORE COMING TO CLASS. An admission ticket consisting of questions covering the reading assignments will be completed by the student. Each student must submit the "admission ticket" upon entering the classroom. Students who are not prepared for the days' activities may be asked to leave at the discretion of the instructor.

B. Measurement, Practical

Proficiency in the clinical laboratory section will be measured by performance of required skills within specific tolerance and time limits of each procedure.

Laboratory sessions are designed not only to develop proficiency in serology testing, but also to provide additional information on the given topic areas and to develop professional attitudes. Therefore, students are expected to attend each laboratory session. It will not be possible to make up a missed laboratory assignment due to specimen, reagent and/or instructor availability. (See Attendance Policy.)

Points are awarded for the successful completion of laboratory exercises. Students are expected to come to laboratory prepared for the performance of the scheduled exercise. Student laboratory performance is evaluated using the following criteria:

1. Laboratory sessions are designed not only to develop proficiency in serology testing, but also to provide additional information on the given topic areas and to develop professional attitudes. Therefore, students are expected to attend each laboratory session. It will not be possible to make up a missed laboratory assignment due to specimen, reagent and/or instructor availability. (See Attendance Policy.)
2. Develop ability to read and follow instructions from reagent package inserts.
3. Setting up and performing procedure.
4. Appropriate specimens are obtained and utilized.
5. Proper handling, labeling and disposal of specimens, tubes, etc.
6. Proper use of equipment, glassware and pipets.
7. Organization and performance of individual tasks.
8. Completion of tests within a reasonable amount of time.
9. Clean up of work area.
10. Correct calculation and/or interpretation of results with recognition of critical values or discrepancies being brought to the attention of the instructor(s).
11. Results reported in proper format.
12. Results of laboratory quizzes and/or practicals.
    

C. Black Board

1. Introduction
   a. Method presenting course materials via the Internet.
   b. Increases student interaction and critical thinking by participation in discussion forum plus research assignments.
   c. Exposes student to the wealth of information available on the Internet
   d. Each student MUST have an email address. Email is the preferred method of communication in the workplace today.
   
2. Students will be taught to access Black Board and instruction areas within.
   a. Assignments will be posted for each unit of instruction which will involve visiting a web site, researching information on the Internet and posting it to discussion forums.
   b. Grades will be posted
   c. Online review quizzes for each exam
   
   The Black Board activities are NOT optional. Each MLAB course will have a Black Board component.

D Extra Credit

To encourage active involvement in the medical technology community and to promote the development of continuing education, extra credit will be given for various medical technology activities outside the classroom and student laboratory. These activities must be approved by the instructor in advance and must be documented by written report and submitted to the instructor. Activities can include attendance at medical laboratory seminars or participation in health fairs, etc. A maximum of 20 points, to be added to the sum of the major exam scores, can be achieved during the semester.

E. Determination of Final Grade

1. Lecture: 2/3 of final grade
   a. Examinations and extra credit = 50% Examinations are given online through BlackBoard. YOU ARE EXPECTED TO USE THE HIGHEST LEVEL OF ETHICAL BEHAVIOR WHEN TAKING THE EXAMS. NO STUDY MATERIALS OF ANY TYPE ARE TO BE USED WHEN TAKING THE EXAM. Students who are caught cheating will receive a grade of "0" for the exam and the process of dismissing the student from the MLT program will be initiated. Your Exam average and Final Exam grade must be within plus/minus 5 points of each other.
   b. Final Exam = 35%
   c. Internet Search Project and Movie Report worth 1 exam grade
   d. BlackBoard Posting = 5%
   e. Admission Ticket 10%
2. Laboratory: 1/3 of Final Grade
   a. Lab Evaluation and Procedure Results = 75%
   b. Lab Exams/Practicals = 25%
   
3. Grading System:

   A = 90 -100%
   B = 80 - 89%
   C = 75 - 79%
   D = 60 - 74%
   F = 59% or below
   I = Incomplete: A student must have a passing average (75% or better) and have completed at least 80% of the course work. Registration for MLAB 2431, MLAB 1211 or MLAB 1331 is dependent on the understanding that an "I" (Incomplete) in MLAB 1235 will be completed within the same semester or no credit will be given for the courses.

   W = Withdrawal: Please meet with the MLT Department Chair before making any decision on withdrawal. We will assist you in any way possible with problem areas.

VIII. PROMOTION, FAILURE AND/OR DISMISSAL FROM THE PROGRAM

1. A minimum grade of "C" (75%) is required in both the lecture and laboratory components of all Medical Laboratory Technology courses. Failure to meet the minimum passing score upon retesting may result in termination from the program.
2. Any student may be withdrawn from the program for excessive absences (see Attendance Policy), consistently failing to meet class assignments, disruptive conduct, or for displaying conduct detrimental to the ethics of Medical Laboratory Technology.
3. The MLT faculty understand that learning in group situations can be beneficial. However, students are expected to demonstrate their own competency by doing their own work. Any student caught plagiarizing, cheating on examinations, during lab practicals, or sharing lab results will be subject to disciplinary action outlined in the official ACC Student Handbook. This includes, but is not limited to, academic penalty and possible withdrawal from the program.

4. The student may utilize the "Student Grievance Procedure of Austin Community College" in the disposition of a grievance or complaint without fear of recrimination or retaliation.

IX. SPECIAL LABORATORY REQUIREMENTS

1. It is the responsibility of the student to prepare for each lecture/laboratory session. Each student is responsible for his/her own work and for the cleaning up of the work station
2. Safety Regulations

   1. Proper Handwashing Procedure

   a. Wet hands and apply a small amount of an antiseptic soap (3-5 mL).
   b. Vigorously lather hands and rub together for at least 15 seconds.
   c. Wash well between fingers and up the wrists.
   d. Rinse well with a moderate stream of water in a downward motion.
   e. Dry with a paper towel and use the towel to turn off the faucet. Dry skin adequately to avoid dermatitis.

Alcohol hand rinse or foam products may also be used for decontaminating the hands whenever clean running water is not available.

Frequent hand washing can be very damaging to the skin's normal protective mechanisms by damaging or cracking skin, altering its pH, or changing its normal flora. Recent studies suggest that frequent application of hand lotion may reduce this damage; lab personnel, therefore, are now encouraged to use it. This may be difficult, however, as one should avoid applying hand lotion immediately after washing, right before giving direct patient care, or right before handling of sensitive instruments or equipment. Lotions might interfere with the residual action of the antimicrobial hand washing products.

2. Standard Precautions

The concept of Universal Precautions was first introduced in 1987 by the Centers for Disease Control (CDC) to decrease the occupational risks of blood-borne diseases such as AIDS and hepatitis B to healthcare workers. Due to inconsistent use of Universal Precautions the standards were revised and are now called Standard Precautions and require that all body fluids be handled with the same precautions as blood. Blood, urine, and other biological specimens possibly containing pathogenic organisms will be used in this course; therefore, CDC guidelines will be followed as they apply. Precautions specific for clinical laboratories:

1. Use barrier protection routinely to prevent skin and mucous membrane contamination with blood or other body fluids.
2. Wear gloves:
   1) When cuts, scratches, or other breaks in skin are present.
   2) When performing any type of blood collection.
   3) Whenever blood and body fluid specimens are handled.
   4) Anytime it appears that contamination of the hands may occur.
3. Change gloves after each patient contact or when visibly contaminated with blood.
4. Wear a mask, eye glasses or goggles, or face shield during procedures that are likely to generate droplets of blood or other body fluids to prevent exposure of the mucous membranes of the mouth, nose, and eyes.
5. Wear a fluid-resistant gown, apron, or other covering when there is a potential for splashing or spraying of blood or body fluids onto the body.
6. Wash hands or other skin surfaces thoroughly and immediately if contaminated with blood or other body fluids.
7. Wash hands immediately after gloves have been removed even when no external contamination has occurred. Organisms on the hands multiply rapidly in the warm moist environment within the glove.
8. Handle laboratory instruments, especially needles and scalpel blades, with extreme caution.
9. Place used needles, disposable syringes, skin lancets, scalpel blades, and other sharp items into a puncture-resistant biohazard container for disposal. The container should be located as close as possible to the work area. Phlebotomists should carry puncture-resistant containers with them on their phlebotomy tray.
10. Needles must not be recapped, purposely bent, cut, broken, removed from disposable syringes, or otherwise manipulated by hand. If recapping is unavoidable (blood gas syringes, etc.), do it with one hand and use great caution.
11. Place large-bore reusable needles (bone marrow, biopsy needles, etc.) and other reusable sharp objects into a puncture-resistant container for transport to the reprocessing area.
12. Use mouth pieces, resuscitation bags, or other ventilation devices during emergency resuscitation procedures.
13. Exudative lesions or weeping dermatitis should be covered with an occlusive dressing to prevent contamination.
14. All specimens of blood and body fluids should be put in well-constructed containers with secure lids to prevent leaking during transport. Care should be taken when collecting each specimen to avoid contaminating the outside of the container and the laboratory form accompanying the specimen.
15. Use biological safety hoods (Class 1 or 2) for procedures that have a high potential for generating droplets (e.g., blending, sonicating, and vortexing).
16. Fill evacuation tubes, vials, and bottles by using their internal vacuum only. If a syringe is used, the fluid should be transferred to an evacuation tube by puncturing the diaphragm of the rubber stopper and allowing the correct amount of fluid to flow slowly into the tube along the wall. The tube should not be hand held when puncturing the top. Never force fluid into an evacuation tube by exerting pressure on the syringe plunger.
17. Use mechanical pipettes for manipulating all liquids (including body fluids, chemicals, or reagents) in the laboratory.
18. Decontaminate all laboratory work areas with an appropriate chemical germicide after a spill of blood or other body fluids and when work activities are completed. Laboratory counter tops should be disinfected at least once per shift.
19. Rinse off all body fluids from reusable contaminated equipment prior to reprocessing according to your institution policies.
20. Clean and decontaminate scientific equipment that has been contaminated with blood or other body fluids before being repaired in the laboratory or transported to the manufacturer. Always follow manufacture's recommendations.
21. Pregnant laboratory workers are not thought to be at greater risk of infection than others in the laboratory. However, if an infection does develop during pregnancy or the mother is a carrier prior to the pregnancy, the infant is at risk of infection by perinatal transmission. Therefore, pregnant laboratory workers should be especially aware of universal precautions.

3. Do not wear gloves/lab coats in the student classroom. Gloves must be removed and hands washed before leaving the laboratory area.

4. All accidents are to be reported immediately to the laboratory supervisor/ instructor. Failure to do so on the DATE OF THE OCCURRENCE may result in non-coverage of expenses through our insurance carrier.

X. MATERIALS OF INSTRUCTION

A. References

1. Bryant, N. J. (1992). Laboratory immunology and serology, 3rd ed. W. B. Saunders Company.
2. Turgeon, M. L. (2003). Immunology and serology in laboratory medicine, 3rd ed. St. Louis, MO: C. V. Mosby Company.
3. Stanley, Jacqueline (2002), Essentials of Immunology and Serology, Thomson/Delmar Learning.
4. Roitt, Brostoff and Male (1998), Immunology 5th ed, Mosby
5. Sheehan, Catherine (1997) Clinical Immunology, 2cnd ed, Lippincott
6. Widmann & Itatani (1998), An Introduction to Clinical Immunology and Serology, 2cnd ed, F A Davis.

B. Audio-Visual Aids

1. Selected films/video tapes
2. Overhead transparencies
3. Immunology software
   

C. Black Board

Updated October 21, 2005