Accessioning (Sir Gams PPT) Flashcards
Anatomic Pathology Laboratory Receiving
- Receiving (Request form, specimen)
- Logging
- Accessioning/ Numbering
T/F: Tissues removed from the body can be fixed within 1 hour of its removal.
FALSE, it should be fixed IMMEDIATELY!
The fixative should be __________ of the volume of the specimen
More than 10x
Process of giving an identifying marker to a
specimen
Accessioning/ Numbering
Accessioning starts in which area of the laboratory?
Receiving area
Specimens are logged based on the time it was?
Received
T/F: The middle name of the patient can be omitted from the request form.
FALSE, it should be included.
T/F: The date and time of request is the same as time of specimen removal.
FALSE, it is different.
Contents of clinical abstract
- Medical history of patient
- Chief complaint
- Details of the patient’s case
T/F: The tissue can be processed even if the information is not complete since it can be followed up.
FALSE, NEVER process samples with INCOMPLETE information
T/F: If the specimen number is S-2018-3IMT-2020, the specimen was received in the year 2020.
FALSE, it was received in the year 2018
Fixative for immunofluorescence
Saline or liquid nitrogen
This is used for renal and skin biopsies
Immunofluorescence
In immunofluorescence, __________ are utilized to detect a specific location in the tissue.
Antibodies
This provides rapid diagnosis
Rush Frozen Section
T/F: The fixative for the Rush Frozen section is formalin.
FALSE, there are no fixatives used in this section.
Specimens in the Rush Frozen section uses?
Liquefied CO2 or Liquid nitrogen
Clinical application of Rush Frozen section
Hirschsprung disease
This provides a high magnification to be able to see the ultramicroscopic details of a cell.
Electron Microscopy
T/F: Specimens are rejected IMMEDIATELY if the criteria is not met.
FALSE. Since specimens in histopathology are difficult to replace, troubleshoot first.
It is grounds for specimen rejection if the tissue has already gone?
Putrefaction
Ratio of tissue to formalin
1:10 or 1:20
Container for specimens
Leak-proof, must fit the specimen
Transport time should be _________________ of collection
Within 1 hour
Specimen Rejection criteria
- Condition of the specimen is not ideal for the test (unfixed/fixed)
- Quantity of fixative not sufficient
- Wrong container
- Long transport time
- Wrongly or incomplete filled request form
- Unlabelled/Mislabeled specimen
Receiving: Logging and Numbering
- Verify information on the request form
- Verification of the specimen label
- Enter all data in the logbook/LIS
- Accession/Number the specimen
Importance of Accessioning
- Avoid mixing/switching of specimen
- Track down specimen/results
- Prevents mismanagement of specimen
- Process the right specimen
- Accurate and Timely results
- Proper Management/treatment at the right time
- Record keeping
- Laboratory Planning
This is the first step in Histopathologic techniques
Accessioning/Numbering
Purpose of Accessioning
Identify specimen without writing the name of the patient
Initial assessment of the specimen
Accessioning/Numbering
All requisition forms must be labeled with correct information of the patient:
- Name of Patient
- Age, DOB, Sex
- Medical Record Number
- Date and Time of Collection
- Type of Specimen (anatomic site)
- Location of the patient
- Clinical History of the Patient
- Pre/post operation diagnosis
- The requesting physician’s name
- Physician or authorized person’s signature on the request form
- Name and address of physician (for referral laboratories)
This is required in the request form if it is intended for referral laboratories
Name and address of physician
Specimen container must be labelled with the correct information:
- Full name of the patient
- Medical record number
- Age and sex of patient
- Type of specimen (Anatomic site)
- Date and time of collection
- Location of the patient
Identity of every specimen is maintained at all time using these two identifiers:
Medical Record Number and Pathology Number
If there are multiple specimens from the same patient, they can be labeled as:
A, B, C, etc.
If the specimen has different blocks, they can be labeled as:
A1, A2, A3, etc.
If the specimen blocks have different slides, they can be labeled as
A1-1, A1-2, A1-3, etc.
Slides should be labeled using a:
Permanent marker/pen
T/F: If H&E is the stain used, it should be indicated.
FALSE, all slides other than those stained by H&E will bear the name of the stain
Specimens must be labelled with how many identifiers:
Two
T/F: Sub-optimal specimens should be rejected right away.
FALSE, the physician should be notified first, and resolve the problem
T/F: If the sub-optimal specimen is accepted after the physician has resolved the problem, it is not necessary to document it.
FALSE
All specimens from outside the hospital must have the approval of the hospital administration and consultant on duty before they are accepted for processing. This rule is waived if the specimen is coming from a:
Government hospital
Requests for frozen section require how many hours of notice ahead of the operation?
24 hours
T/F: All In-patients for histopathologic diagnosis must have their laboratory tests entered and collected in the computer by the attending physician.
TRUE
The Histopathology requisition form is also known as
Form Lab 1-A
All specimens must be received fixed with 10% buffered formalin except:
- Frozen section
- Immunofluorescence
- Electron microscopy
Electron microscopy specimens should be fixed in:
2% glutaraldehyde solution in the cold after excision
Renal biopsies should have advance notice before the procedure. Call __________ before the procedure.
15 minutes
T/F: A medical technologist will be available on site to perform renal biopsy.
FALSE, Pathologist
Renal biopsy specimens are examined under which microscope?
Dissecting microscope
What do we look for in Renal biopsy under the dissecting microscope?
Glomeruli
Renal biopsy specimens are divided into 3 parts:
- Frozen (immunofluorescence)
- Immersed in glutaraldehyde (electron microscopy)
- Fixed in formalin (paraffin processing)
T/F: Renal biopsy specimens must be sent to the lab within one hour after the renal biopsy procedure.
TRUE
T/F: The specimen in saline should be immediately snap frozen in liquid nitrogen for further frozen sectioning and immunofluorescence staining.
TRUE
Fixative for Testicular biopsies
Bouin’s fluid
Surgical margins for breast lump
Oriented by sutures; normal tissues surrounding the lesions or lump
Mastectomy apical nodes
Indicated by sutures
T/F: For mastectomy specimens, Superior margin should be indicated by a separate suture in case of simple mastectomy (without axillary dissection).
TRUE
T/F: Perinodal fat should not be included.
FALSE, inclusion of perinodal fat ensures the integrity of the lymph node capsules and assess the tumor spread beyond the lymph node capsule
Infective specimen should be clearly marked with:
Red marker
T/F: The proximal or distal excised margins of bowel resection should be oriented by a suture.
TRUE
T/F: Skin biopsies intended for immunofluorescence are fixed with formalin.
FALSE, it should be received frozen
T/F: Tiny and small biopsies from endoscopies and dermatology are submitted for processing on the same day, if received before the cut-off time and is fixed.
TRUE
Specimens are usually kept at room temperature for at least how many weeks after the release of report?
at least 2 weeks
Referral slides/blocks must be accompanied by the official original pathology report with the following information:
- Patient’s name
- Medical record number
- Hospital/ clinical pathology number
- Number of slides/blocks
Exempted from Pathology Examination:
- Foreign bodies
- Hair, finger nails, toe nails removed for cosmetic purposes
- Teeth, dental appliances
- Eye Lens
- Calculi
- Nasal septum cartilage and bone
- Foreskin from circumcision
“Gross Description Only”
- Torn meniscus
- Varicose veins
- Bone fragments from non-pathologic fracture
- Ear cartilage
- Fetus
T/F: Microscopic examination should be performed whenever there is a request by the attending physician, or at the discretion of the pathologist when indicated by the clinical history or gross findings.
TRUE, irrespective of any exemptions
Small specimens must be sealed in
Biohazard labeled bags
Large specimens must be covered in
Tight, leak-prof containers
