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2 Pathological Processes > 1 Introduction to Pathology > Flashcards

1 Introduction to Pathology Flashcards

1
Q

Identify the 5 main branches of pathology

A
  • Medical Microbiology
  • Chemical Pathology
  • Haematology
  • Immunology (eg allergies)
  • Cellular Pathology (organ examination, autopsies)
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2
Q

What do haematologists do?

A

Haematologists provide specialised services in:

  • Transfusion
  • Coagulation
  • Haemoglobinopathies
  • Haemato-oncology
  • Bone marrow transplantation
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3
Q

What are the two branches of cellular pathology?

A
  • Histopathology
  • Cytopathology
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4
Q

What is histopathology?

A

Histopathology involves the macroscopic and microscopic assessment of tissue samples and the provision of clinically relevant and useful reports

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5
Q

What is cytopathology?

A

Cytopathology is similar to histopathology but the specimens consist of disaggregated cells rather than tissue

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6
Q

Identify 3 branches of histopathology

A
  • Neuropathology
  • Forensic Pathology
  • Paediatric Pathology
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7
Q

What is neuropathology?

A

Neuropathology is a branch of histopathology that is confined to brain, spinal cord, nerves and muscle

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8
Q

What do forensic pathologists do?

A

Forensic pathologists attend crime scenes and perform autopsies in cases of suspicious death

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9
Q

What do paediatric pathologists do?

A
  • Examine histopathology specimens from children
  • Undertake foetal, perinatal and paediatric autopsies
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10
Q

Why is the examination of tissue microscopically important?

A
  • Needed to ensure whether surgery is required
  • Needed to guide the type and extent of surgery
  • Gives indication about treatment options e.g radiotherapy, chemotherapy, antibiotics, steroids
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11
Q

Histology and cytology are both used to make microscopic diagnoses.

Distinguish between them

A
  • Histology involves viewing microscopic slides prepared from tissue sections
  • Cytology studies cells scraped from / sucked out of an organ, lesion or bodily fluid
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12
Q

List 4 advantages of cytology

A
  • Non-invasive or minimally invasive
  • Fast
  • Cheap
  • Safe
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13
Q

What is the main disadvantage of cytology?

A

Higher inadequacies and error rates than histology

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14
Q

Identify two uses of cytology

A
  • Used as a preliminary test before other investigations are conducted or before histology is taken
  • Used to confirm/exclude cancer or dysplasia rather than to diagnose other conditions with accuracy
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15
Q

Identify 4 advantages of histology

A
  • Assesses cell architecture and cellular atypia
  • Differentiates between in situ and invasive malignancy
  • Determines completeness of excision
  • Allows for grading and staging
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16
Q

What sort of testing is better for histology than cytology?

A

Histological sections are better for immunohistochemical and molecular testing than cytological preparations

17
Q

What does immunohistochemistry involve?

A

Immunohistochemistry demonstrates the presence in or on cells of specific substances, usually proteins, by labelling them with antibodies

18
Q

Outline immunohistochemistry testing

A
  • Antibodies are joined to an enzyme that catalyses a colour-producing reaction
  • Antigenic substances are commonly demonstrated by the presence of a brown colour.
19
Q

Identify 5 antigenic substances which can be detected in immunohistochemistry testing

A
  • Actin
  • Cytokeratins
  • Microorganisms e.g. HPV, herpes simplex
  • Hormone receptors e.g. oestrogen receptor (ER) - Her2 receptor
20
Q

What is the Her2 receptor?

A

Her2 receptor is a growth factor receptor which predicts the response of breast cancer to the drug Herceptin (see neoplasia)

21
Q

What are cytokeratins?

A

Cytokeratins are fibrous proteins which are present in almost all epithelia

22
Q

What is the value of detecting cytokeratins?

A
  • Their presence demonstrates epithelial differentiation and they show tissue-specific distribution
  • They can be used to give information about the primary site of a carcinoma
23
Q

What is molecular pathology?

A

- Molecular pathology is the study of how diseases are caused by alterations in normal cellular molecular biology

  • This can be due to altered DNA, RNA or proteins
24
Q

Identify the steps involved in drawing up a histology report

A
  • Fixation
  • Trimming
  • Embedding
  • Blocking
  • Microtomy
  • Staining
  • Mounting
  • Microscopy
  • Report writing

Mnemonic: Free The Eagles Because My School Makes Me Realise

25
Q

What are frozen sections?

A
  • Frozen sections are histological preparations that involve rapidly freezing a small piece of fresh tissue on a cryostat
  • Used under time restraints (duration = 10 mins)
  • Tissue can then be sliced, stained, mounted and passed to a pathologist for microscopy
26
Q

Provide and example situation of when frozen sections are used

A

Tissue for frozen section is taken during the course of an operation with the aim of establishing the presence and nature of a lesion whilst the patient is still under anaesthetic

27
Q

Define disease

A

Pathological condition- characterised by identifiable group of symtoms

28
Q

Outline the differences between Histology and Cytology

A

SAMPLES:

Histology= Core biopsies, cancer resection specimens

Cytology= fine needle aspirates eg breast, sputum, urine

Cytology=faster and cheaper BUT less accurate/definitive

Histology= provides more info, better for molecular testing, can differetiate between invasive and in situ disease

29
Q

Name and explain some potential problems faced by histopathologists

A
  1. Autolysis (self digestion)- blocked by fixation-formalin
  2. Choosing right bit of tissue
  3. Getting tissue into right format to be examined
  4. Cutting thin sections using microtome
  5. H&E staining
    1. Nuclei=purple
    2. Cytoplasm=pink
30
Q

Why might they sequence some DNA which has been purified from a tumour in the lab?

A

Show if mutation=present in particular gene-determine treatment

31
Q

What does mRNA profiling show?

A

Level of activity of large number of genes simultaneously

2 Pathological Processes (12 decks)

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