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LAB MAN > Chapter 29 HISTO > Flashcards

Chapter 29 HISTO Flashcards

1
Q

microscopic examination of cells from different body sites for diagnostic purposes.

A

Diagnostic Cytology

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2
Q

Diagnostic cytology includes ______ and ______

A

exfoliative cytology; fine needle aspiration

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3
Q

For cytologic examination to be of diagnostic value, the sample must include _____ and ______

A

representative material; method used to process the specimen must give rapid results,

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4
Q

most important in cytological interpretation.

A

Consistency and reliability

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5
Q

Specimen for cytologic examination sources:

A

Exfoliative cytology; Fine needle aspiration; Body fluids

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6
Q

deals with the microscopic study of cells that have been desquamated from epithelial surfaces.

A

Exfoliative cytology

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7
Q

Exfoliated cells may be found in:

A

spontaneously shed or physically removed from epithelial and mucous membranes.

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8
Q

Cytological specimens collected from female genital tract:

A

cervical smear; Vaginal smear; endometrial smear

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9
Q

observed in normal cells due to constant growth and replacement with new cells

A

Spontaneous exfoliation

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10
Q

Specimen can be collected from the epithelial surfaces by:

A

scraping the surface; by swabbing; aspirating; washing the surfaces

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11
Q

Exfoliative cytology is usually recommended for the following:

A

Detection of malignant cells in body fluids
Detection of precancerous cervical lesions in women
Assessment of female hormonal status (sterility and hormonal disorders)
determination of genetic sex -most of the nuclei of females exhibit conglomeration of chromatin

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12
Q

representing XX chromosomes (Barr body)

A

detection of infectious agents

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13
Q

Smear Preparation (Exfoliative Cytology): Smears should be made from?

A

Fresh material, prepared in doctor’s office/radiology units

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14
Q

Smear Preparation (Exfoliative Cytology): Direct Smear Preparation and Labelling

A
  • Material is smeared evenly on slide
  • Label with name, age, date and type of specimen, identifying number at frosted end
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15
Q

Histotechnicians performs:

A

Special stains on cytology smears; Blood films; Cytopreps

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16
Q

Most commonly received cytoprep

A

Thin prep

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17
Q

Thin prep is wet-fixed in

A

95% ethanol

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18
Q

Wet fixation of cytoprep in 95% ethanol is to preserve….

A

Fine structure of chromatin
Evaluation of nuclear changes

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19
Q

avoided with smears for cytological detection of neoplasia because it changes the appearances of the cells.

A

Air drying

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20
Q

usually air-dried specimens

A

Slides bearing BLOOD or BONE MARROW SMEARS

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21
Q

Commonest cancer that can be detected even at the pre-invasive stage

A

uterine cervix cancer

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22
Q

Cervical cytology screening involves cell samples from:

A

Ecto- and endocervix

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23
Q

Stain used in cervical smear

A

Papanicolaou (Pap) method

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24
Q

T/F. Cervical cytology is a screening test, abnormal findings must be confirmed histologically.

A

True

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25
Q

PAP Smear Patient Preparation

A

abstain from coitus
not douche the vagina for at least a day
not apply intravaginal preparations for at least one week before the examination
Smears should not be taken during menstrual bleeding

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26
Q

Contaminants that can obscure the cells during examination (PAP smear)

A

Blood
Endometrial component
Tissue debris

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27
Q

Collecting Systems to retrieve gynecology cells:

A

Cotton swabs
Wooden or plastic spatula
Cervical brushes; “cytobrushes”

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28
Q

Collecting system that retrieve more endocervical cells and blood = valuation difficulties

A

Brush biopsies

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29
Q

discouraged because of the drying artifacts and loss of cells that are caused by this method

A

Cotton swab

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30
Q

Preferable to use, with mildly rough surface that can collect more materials

A

Wooden spatula

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31
Q

used strictly for taking materials from endocervix

A

Endo-cervical brushing

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32
Q

Excessively thin or thick smears can result in

A

false-negative reports

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33
Q

often used for ulcerated surface lesions

A

Impression smear

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34
Q

T/F. (Impression Smear): preparations should be quickly air dried and then stained

A

True

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35
Q

Impression smear is indicated in cases of:

A

TUMOR (especially of lymph nodes)

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36
Q

Impression smear retrieval of specimen is done by

A

touching the cut surface with a clean slide
fixing immediately

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37
Q

Sputum smear specimen must be obtain at least ______

A

3 consecutive morning sputum

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38
Q

Sputum specimen must be collected ______

A

early morning by deep cough

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39
Q

Early morning sputum is collected in a wide mouth jar with

A

Saccomanno fluid

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40
Q

Saccomanno fluid is consist of _____ and _____

A

50% ethyl alcohol
2% carbowax

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41
Q

Induced sputum should be collected using _____

A

Inhalation of AEROSOL SOLUTION for 20 minutes

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42
Q

Number of slides to be prepared for extensive study

A

Minimum of 2-4 slides

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43
Q

Slides prepared for Sputum Smear

A

One air-dried for Giemsa Staining
at least 2 slides stained by Papanicolaou method

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44
Q

Sputum is poured into petri dish and examined first for

A

Blood-flecked
Solid particles

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45
Q

Minimum hours of fixation needed in sputum smear

A

Minimum of 1 hour

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46
Q

The sputum smear should be made without delay due to

A

Hardening effect of alcohol

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47
Q

Sputum collected should have been coughed from _______

A

Down-deep

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48
Q

In sputum smear, present of this substance can preserves the cell constituents

A

Mucus

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49
Q

found on the sputum smears from a deep cough

A

Alveolar macrophange

50
Q

Absence of alveolar macrophages suggests

51
Q

directly smeared onto two labeled slides by pull technique

A

Bronchial Brushing Specimen

52
Q

Bronchial Brushing specimen is fixed by

A

Spray fixative
Immersed in 95% alcohol

53
Q

Bronchial Brushing specimen: Failure to fix the slides within a few seconds will produce

A

unsatisfactory cytologic results due to air drying artifact

54
Q

freshly collected in the bronchoscopy collection container and hand delivered to the laboratory

A

Bronchial Washing specimens

55
Q

Bronchial Aspirates is collected by

A

aspiration into a glass suction apparatus
washing the bronchi with 1-2 cc. of saline

56
Q

If the specimen is collected directly from bronchus, then it must contain

A

Epithelial cells (ciliated bronchial cells) from BRONCHIAL MUCOSA

57
Q

Gastric smear preparations are quite difficult to make due to

A

inaccessibility of the specimen
presence of gastric juices

58
Q

deleterious effect on the morphology of exfoliated cells due to

A

presence of gastric juices

59
Q

Smears of Gastric Secretions and Aspirates: Smears are usually collected by simple ____ and ____

A

irrigation and aspiration technique

60
Q

Smears of Gastric Secretions and Aspirates: Patient Preparation

A

fasted for at least 8 hours before gastric washing is performed

61
Q

T/F. Esophageal washings are to be examined immediately.

62
Q

T/F. Cytologic examination of nipple discharge has an extremely low diagnostic yield for diagnosis of breast carcinoma.

63
Q

Spontaneous nipple discharge is usually a result of _____ in young patients

A

hormonal imbalance

64
Q

Bloody nipple discharge

A

Benign Intraductal Papilloma

65
Q

T/F. spontaneous nipple discharge should be smeared on a clean glass slide, and immediately placed in fixative

66
Q

T/F. During lactation and immediate post-lactation period, nipple discharge is ABNORMAL

A

FALSE
Nipple discharge is abnormal except During lactation and immediate post-lactation period

67
Q

nipple discharge is usually due to a benign breast lesion such as duct:

A

Ectasia
Papilloma
Endocrine problems

68
Q

major value of cytologic examination of nipple discharge is potential detection of _______ in a patient with clinically _______.

A

Malignant cells ; undetected carcinoma

69
Q

Collection Technique (Breast Smear Secretion): Gently strip the ________ and nipple using the __________.

A

subareolar area ; thumb and forefinger

70
Q

Collection Technique (Breast Smear Secretion): If more than a drop is collected, use another slide to smear with a _______

A

Pull-up technique

71
Q

Collection Technique (Breast Smear Secretion): Immersed slide in a bottle of _______ or use ______

A

95% isopropanol ; spray fixative.

72
Q

Collection Technique (Breast Smear Secretion): T/F. If the secretion is scanty in amount, smears should be restricted to a small area of the slide to prevent drying

73
Q

Collection Technique (Breast Smear Secretion): T/F. Secretions obtained from both breasts should be properly identified as left or right.

74
Q

study of cellular samples obtained from organs that do not shed cells spontaneously, such as breast, thyroid, lymph nodes, liver, lungs, skin, soft tissues and bones

A

Fine Needle Aspiration

75
Q

organs that do not shed cells spontaneously

A

breast, thyroid, lymph nodes, liver, lungs, skin, soft tissues and bones

76
Q

T/F. FNA is useful in lesions that are easily palpable

77
Q

FNA basic technique uses

A

25-gauge needle
10-ml syringe

78
Q

Requires larger bore needle and increased suction may be necessary

A

Tissues composed of MESENCHYMAL CELLS

79
Q

Mesenchymal cells adhere to each other and do not _____

A

Exfoliate easily

80
Q

FNA that is usually done by Clinicians and pathology

A

FNA of Superficial masses:
Breast, thyroid, peripheral lymph nodes

81
Q

Deeply seated lesions are

A

lung
mediastinum
abdominal organs (liver, pancreas, etc.)
retroperitoneal organs (kidney, adrenal, lymph nodes

82
Q

Deeply seated lesions are performed under

A

CT scan (Laparoscopy)
Ultrasound (Sonography)

83
Q

sample should be air dried as quickly as possible to ___________

A

Reduce the effects of shrinkage

84
Q

FNA slide preparation: most diagnostic material for cytologic evaluation

A

Few drops from Solid lesion

85
Q

FNA slide preparation: Specimen is bloody leads to

A

Diluted cells
Hard to find on direct smear

86
Q

FNA slide preparation: Maximum slides to be prepared

87
Q

FNA slide preparation: How many drops per slide

A

1-2 drops each slide

88
Q

FNA slide preparation: Smearing technique used

A

Slide-pull technique

89
Q

FNA slide preparation: Rinse the needle in a preservative solution such as _______

A

Saccomano fluid

90
Q

FNA slide preparation: Ideal aspirate is ______

A

creamy consistency with numerous cells suspended in a small amount of tissue fluid

91
Q

FNA slide preparation: In lymph node aspiration, _______ can be prepared in addition to smear.

A

Cell suspension

92
Q

FNA slide preparation: T/F. Smears obtained by FNA are fixed based on the requirements of the stain to be used.

93
Q

FNA slide preparation: Colloid, mucin and smears to be stained with ____

A

Hematoxylin stain (May-Grunwald-Giemsa)

94
Q

FNA slide preparation: useful in preliminary assessment of adequacy of the sample

A

Rapid stain (Diff Quik 2-3 mins)

95
Q

FNA slide preparation: Smears to be stained by _________or ______ should be rapidly fixed in alcohol (wet fixation)

A

Papanicolaou (Pap); hematoxylin and eosin (H&E)

96
Q

FNA slide preparation: Specimen stained by Papanicolaou (Pap) or H&E exhibits

A

Nuclear details
Better identification of malignant cells

97
Q

FNA slide preparation: In PAP and H&E if the specimen has artefacts it leads to

A

more eosinophilic cytoplasm
details appear fuzzy

98
Q

FNA slide preparation: smeared by two-slide pull method

A

Transbronchial Fine needle Aspiration (FNA)

99
Q

Cytological investigation of body fluids such as:

A

urine samples
cerebrospinal fluid
pleural or peritoneal effusions

100
Q

Body fluids is obtained by

A

Aspiration

101
Q

Body fluids is useful on the _____ and ______

A

ORIGIN and TYPE OF PRIMARY TUMOR

102
Q

refers to the fluid accumulated in the three serous cavities namely pleural, pericardial and peritoneal

A

Serous effusion

103
Q

presence of malignant cells in serous effusions usually indicate metastatic involvement and, therefore, a _______

A

higher stage of cancer

104
Q

prevented by adding 300 units of Heparin for every 100 ml. of aspirate

A

Jelly-like clots

105
Q

preferred for cytology

A

Freshly tapped specimens

106
Q

If immediate processing is not possible, it can be preserved in the

A

Refrigerator for 24-48 hrs @4 deg cel.
Or 50%. Ethanol

107
Q

should be used to prepare smears from prefixed sample

A

Albuminized slides

107
Q

best method to collect cells from body fluid

108
Q

no access to a cytospin, can make use of _______ and _______

A

centrifugation of the preparation and sampling of the centrifuged sediment

109
Q

major objection to the use of cytocentrifuge

A

distortion of cellular morphology due to air drying artifacts

110
Q

Immediate fixation is done by

A

using an equal volume of polyethylene glycol

111
Q

received as the result of direct taps of pleural or peritoneal effusions, as well as from cerebrospinal fluid (CSF) and synovial fluid.

A

Cell suspencions

112
Q

Most cytologists prefer to receive effusions as _____

A

rapidly as possible in sterile containers without fixative or anticoagulant

113
Q

Optimum amount of Cell suspension

114
Q

Cells in cell suspension remains viable for up to ________

115
Q

Cell in the specimen is kept _____

A

Refrigerated @4deg

116
Q

Preparation of Cytospin slides: The specimen is centrifuged as soon as possible at ________ speed for ______ (our suggested method)

A

1000 RPM
1 minute

117
Q

Preparation of Cytospin slides: sediment on a glass slide which has been previously coated with a __________

A

thin layer of egg albumin

118
Q

Preparation of Cytospin slides: When it begins to dry around the edges but is still moist in the center, the smear is fixed in _______

A

95% alcohol

119
Q

Preparation of Cytospin slides: If smears cannot be prepared immediately, the sediment should be covered with _______ and placed in the refrigerator.

A

absolute alcohol

120
Q

Preparation of Cytospin slides: When secretions are small in amount, the smear should be prepared and fixed in the _______

A

operating room/bronchoscopy room

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