4 - diagnosis of disease

Question 1

What is histology?

Answer 1

The study of the structure of animal and plant tissues as visualised

Question 2

What is cytology?

Answer 2

The study of the appearance of cells under a microscope

Question 3

How can blood be used to make a diagnosis?

Answer 3

• identify cell abnormalities

- test for certain biochemical markers

Question 4

What is an ultrasound scan?

Answer 4

A low resolution technique that uses sound waves to produce images

Question 5

What is cancer?

Answer 5

Group of diseases caused by abnormal cell division and growth

Question 6

Give some cytological features associated with neoplastic cells

Answer 6

• cellular and nuclear pleomorphism (variation in size and shape of cells and nuclei)
• nuclear hyperchromatism (increase in nuclear staining)
• increase in size of the nucleus relative to the cytoplasm

Question 7

What is the difference between malignant and benign tumours?

Answer 7

Benign tumours have a well defined margins and the tumour remains localised.
Malignant tumours have poorly defined margins and the neoplastic cells invade the surrounding tissues

Question 8

What type of tissue do most cancers originate from?

Answer 8

Epithelial tissue (squamous cells or glandular tissue)

Question 9

How does a tumour metastasise?

Answer 9

• tumours produce blood vessels to promote growth (angiogenesis)
• tumour cells then enter these blood vessels and are transported to other organs via the circulatory system

Question 10

Why is histology used for diagnosing cancer?

Answer 10

• can differentiate between benign and malignant tumours

- can be used to inform treatment

Question 11

What is the purpose of cervical screening?

Answer 11

To indentify people with abnormal cells before the develop into cancer or in the early stages of cancer as it can be cured relatively easily in the early stages

Question 12

What is the most common cause of cervical cancer?

Answer 12

Human papillomavirus (HPV), particularly types 16 and 18

Question 13

How does HPV cause cancer?

Answer 13

They increase proliferation of epithelial cells by integrating it’s viral DNA into the cell genome

Question 14

How is screening for cervical cancer carried out?

Answer 14

Cells are scraped from the ectocervix and lower cervical canal with a spatula or brush.
The cells are then smeared onto a slide and fixed and stained using a pap stain.
You then look for cervical intraepithelial neoplasia.

Question 15

What happens if cervical intraepithelial neoplastic cells are found on a cervical smear?

Answer 15

The cells are tested for HPV DNA and if this is positive, a colposcopy with a biopsy is carried out to examine deeper tissue

Question 16

How are CIN categorised?

Answer 16

The CIN is classified into one of three grades dependant on the proportion of epithelial thickness that contains neoplastic cells

Question 17

How has the cervical cancer screening program been changed since 2020

Answer 17

Cell samples are tested for HPV 16 and 18 DNA testing before being analysed down the microscope

Question 18

Give five techniques that can be used to obtain tissue samples

Answer 18

Needle biopsy, endoscopic biopsy, incisional biopsy, excisions biopsy and resection

Question 19

Give three techniques that can be used to obtain cell samples

Answer 19

Aspiration by needle, exfoliation and extraction of cells from bodily fluids (that have naturally been shed)

Question 20

What are the benefits of an MRI scan over a CT scan?

Answer 20

• gives more detail

- doesn’t use radiation

Question 21

What is a benefit of a CT scan over an MRI scan?

Answer 21

It’s quicker to carry out

Question 22

What is an MRI scan?

Answer 22

An MRI scan (magnetic resonance imaging) is a radiology techniques using magnetism, radio waves, and a computer to produce detailed images of body structures.