QUALIFIED MEDICAL LABORATORY TECHNICIAN VIROLOGY SYLLABUS 2014 Copyright Notice All rights reserved; no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without the prior permission of The New Zealand Institute of Medical Laboratory Science, PO Box 505, Rangiora, New Zealand 7440.
Definition of a Medical Laboratory Technician A Qualified Medical Laboratory Technician (QMLT) is a person employed to perform routine tasks by following established protocols under the supervision or direction and control of a Registered Medical Laboratory Scientist. A QMLT may only practise within their area of competence, in a health service that forms part of the medical laboratory science profession. During training, supervision would be direct but after suitable assessment of competency, it may be replaced with direction * by a Registered Medical Laboratory Scientist or another registered health practitioner with an appropriate scope of practice, other than a Medical Laboratory Technician. The QMLT candidate has two syllabi to study: The Common Syllabus which is common to all technician qualifications The Discipline Specific Syllabus which is common only to the discipline in which the candidate is sitting the QMLT exam. The Common Syllabus and Discipline Specific Syllabus are assessed by one examination only Logbook - Virology The Virology Scientists have prepared both a syllabus and logbook for use by Trainee Medical Laboratory Technicians preparing for the QMLT examinations. The logbook found in the following section is compulsory and has been included to aid candidates preparing for the QMLT examinations and to be a record of training or practical competency, accomplished by mastery assessment. NOTE - The logbook is required to be presented as part of the examination process. The Virology Scientists have taken a significant step in the review to limit the theoretical knowledge required, sufficient to perform bench procedures and understand the importance of recognising abnormal or anomalous results for referral to a supervisor. The request for specific numbers of points and the reduction in the number of tests to be performed in the logbook, is an endeavour to limit the quantity of information to learn and examine. This does not preclude employers training their laboratory assistants for their own needs Date Revised: December 2010 Page 2 of 2
1. Role of the Virology Medical Laboratory Technician The candidate will describe the scope and function of a Virology Medical Laboratory Technician. Refer to Common syllabus 2. Anatomy and Physiology The candidate will outline the structure and function of specified human tissues, physiological processes and pathological states. 2.1 Define the term virus. 2.2 List the basic components of viruses. 2.3 Outline the function of these components. 2.4 List the basic components of bacteria and mammalian cells. 2.5 List criteria for classification of viruses into Families, genera and species. 2.6 Virus replication: Outline the life cycle of DNA viruses. Outline the life cycle of RNA viruses. Define: Virus attachment to cell receptors Virus uncoating Transcription of viral nucleic acid Virus assembly Release from cell 2.7 Viral pathogenisis: List types of virus transmission. Define localised viral infection. Define systemic viral infection. Define subclinical infections. Define persistent infections. Date Revised: December 2010 Page 3 of 3
2.8 Host responses to viral infections: List non-specific host defence mechanisms. Define interferon. Define immunity, including antigen and antibody. Define humoral and cellular immune response. Define primary and secondary immune response. Define immunoglobulins IgM, IgA, IgG. 2.9 Prevention of viral infections: List viral vaccines routinely used in New Zealand Define effectiveness and efficacy of viral vaccines Define inactivated vaccine Define live virus vaccine (including attenuated strains) 2.10 Treatment of viral infections: Define antiviral agent. List antiviral agents currently available. 3. Health, Safety and Infection Control The candidate will be able to discuss safety policies, procedures and legislation within the laboratory. 3.1 Identify and manage laboratory hazards. 3.2 Handle store, transport and dispose of hazardous chemical and biological material appropriately. 3.3 List Personal Protective Equipment (PPE) required for PC3 practices. Refer to Common Syllabus Date Revised: December 2010 Page 4 of 4
4. Laboratory Equipment Demonstrate the correct operation of laboratory equipment and understand principles of the equipment as required. Handle store, transport and dispose of hazardous chemical and biological material appropriately. 4.1 Outline the use and maintenance of the following: Microscopes. Biohazard Class I & II cabinets. 4.2 Microscopy: 4.2.1 Outline the basic components of the standard light microscope. 4.2.2 Define the following: Focal and mechanical tube length (definition and resolution). Chromatic and spherical aberration (numerical aperture). Critical and Kohler illumination (transmitted and incident light, dark field illumination, fluorescent microscopy). 4.2.3 Outline the principle of electron microscopy. Date Revised: December 2010 Page 5 of 5
5. Analytical and Practical Techniques To be able to demonstrate competence in laboratory analytical and practical techniques. 5.1 Cell culture: Outline the principle of cell culture. Outline the preparation of primary cell cultures. List common cell lines for the culture of human viruses. List requirements for cell growth. Outline preparation of media for growth and maintenance of cell cultures. Outline the control of bacterial and mycoplasma contamination of cell cultures. Outline cell dispersement techniques. 5.2 Viral culture: Outline growth and cytopathic effect of viruses in cell culture. Outline haemadsorption and haemagglutination. Outline haemagglutination inhibition assay. Outline virus titration and calculation of TCID50 endpoint. Outline virus neutralisation assay. Outline direct and indirect antigen detection by immunofluorescence, including direct and indirect. Outline centrifugation enhanced shell vial and multiwell culture. Outline the recognition of virus morphology under electron microscopy. 5.3 Serology methods: Outline the following methods used to determine antigen/antibody levels: Complement fixation test. Immunofluorescence (as used in serology assays). Enzyme-linked-immunosorbent assay (ELISA). Automated methods. Rapid methods (e.g. immunochromatographic tests). 5.4 Molecular amplification methods Outline the principles of the polymerase chain reaction (PCR). Explain contamination control and work flow in PCR. Date Revised: December 2010 Page 6 of 6
5.5 Describe the methods used for serological and/or virological investigations of the following organisms: Herpes Simplex Virus type one and two. Varicella Zoster Virus. Cytomegalovirus. Epstein Barr Virus. Influenza type A and B. Parainfluenza type 1, 2 and 3. Adenovirus. Respiratory Syncytial Virus. Rhinovirus. Enterovirus. Rubella. Measles. Mumps. HIV. Enterovirus. Rotavirus. Hepatitis B and C. Chlamydia trachomatis. Note Methods should be described under the following headings: Principle. Appropriate specimen collection. Equipment. Reagents. Method. Controls. Clinical application. Date Revised: December 2010 Page 7 of 7
6. Analysis of Samples and Requests Be able to process and analyse requests and samples received by the laboratory as prescribed in the candidate s workplace protocols. 6.1 Outline procedures for the selection, preparation and storage of specimens listed below: Faeces. Swabs: respiratory, cutaneous, eye, genital, etc. Urine. Blood. Tissue biopsies. Fluids and exudates including CSF, sputum, aspirates. Vesicle scrapings. 6.2 Pre-analytical process: Collection & transport - impact on test result. Sample integrity. Sample preparation. 6.3 Analytical process: Testing methods. Quality control. Analysis of result. Result entry. 7. Analysis of Samples and Requests Be able to interpret causes for results obtained from processes and analytical testing within the laboratory. 7.1 Sample storage / documentation. 7.2 Reports sent to clinician - accurately reflects parameters of results (i.e. negative" vs. "not detected"). 7.3 Outline of cytopathic effect (CPE): Inclusion body formation. Cell damage caused by cyticidal viruses. Alterations to the cell membrane. Cell transformation. Date Revised: December 2010 Page 8 of 8
8. Quality Management To be able to outline quality control processes. 8.1 Describe the term Accredited Laboratory and how this relates to diagnostic testing. 8.2 Outline Quality control of laboratory equipment. 8.3 Outline quality control in cell culture. 8.4 Outline quality control in immunofluorescence. 8.5 Outline quality control in viral culture. 8.6 Outline quality control in PCR. 9. Reference Texts Lennette EH, Schmidt NJ, Diagnostic Procedures for Viral, Rickettsial and Chlamydial Infections. 5 th Edition. American Public Health Association, New York 1979 Murray Patrick R, et al. Manual of Clinical Microbiology, 6 th Edition 1995. American Society of Microbiology, Washington DC Roitt IM, Brostoff J, Male DK, Immunology Third Edition, 1993 Mosby-Year Book Europe Ltd ISBN 0-397-44765-5 Tizard Ian R, Immunology: An introduction Second revised edition, 1988 Saunders College Publishing Weir Donald M, Stewart John. Immunology Eight edition 1997 Churchill Livingstone Immunisation Handbook, Ministry of Health Date Revised: December 2010 Page 9 of 9