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Y2 medical pathophysiology > Cytopathology > Flashcards

Cytopathology Flashcards

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USMLE® Step 1 flashcards
1
Q

What is cytopathology?

A

The morphological study of dissociated cells.

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2
Q

Why wouldn’t histopathology always be used instead of cytopathology?

A
  • Histopathology requires fragments of tissue (biopsies) which are usually obtained through an invasive procedure given that forceps and similar instruments are needed. This can cause bleeding and trauma.
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3
Q

Compare the cell samples needed for cytopathology and histopathology.

A

Cyto - detached cells

Histo - structure and architecture biopsy

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4
Q

Compare the equipment needed for cytopathology and histopathology.

A

Cyto - fine needle, fluid and brushing

Histo- large needed, forceps

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5
Q

Compare the time taken to carry out a cytopatholigcal cell removal compared to that of a histological study.

A

Cyto - 5 mins to 2 hours

Histo- 30 mins to 2 hours

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6
Q

Compare the diagnosis time of cytopathological and histopathological studies.

A

Cyto - mins to 24 hours

Histo - 24 to 48 hours

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7
Q

Describe the stains used in cytopathology and histopathology.

A

Cyto: PAP and H&E
Histo: H&E

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8
Q

What is exfoliative cytology used on?

A

All mucosal surfaces, uterine cervix, oral-pharyngeal mucosa, gastrointestinal mucosa, urinary tract.

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9
Q

What is aspiration cytology used on?

A

All superficial lumps, breast growths, thyroid nodules, enlarged lymph nodes.

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10
Q

Name some potential samples sources for cytology.

A
  • Urine
  • Bladder washes and brushings.
  • Body cavities
  • Fluid from the body cavities.
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11
Q

What body cavities can be used as sample source for cytology?

A

Pleural cavity, Peritoneal cavity, pericardial cavity.

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12
Q

What type of lining lines the body cavities?

A

Mesothelium.

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13
Q

What about fluid from body cavities is analysed during cytopathology?

A

Cytological changes and for the presence of biochemicals.

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14
Q

What influences the type of staining used in cytopathology?

A

The cell type being analysed and the pathology that is being looked for.

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15
Q

What might be targeted during immunocytochemistry?

A

Cytoplasmic targets, nuclear targets, cell membranes, lipids, proteins.

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16
Q

What might affect the immunochemical staining of a sample?

A

Fixation

17
Q

Describe the degeneration of epithelial cells.

A
  • Normal cell
  • Blurring of chromatin, breakdown of nuclear membrane, cytoplasmic vacuolation
  • Nuclear shrinkage and condensation of chromatin by Karyokinesis
  • Nuclear fragmentation and agglutination of chromatin by Karyorrhexis
  • Almost complete dissolution of nucleus by karyolysis
18
Q

Describe the repair of damaged epithelial cells.

A
  • Nuclear enlargement, prominent nuclear border
  • Multinucleation
  • Slight coarsening of chromatin, slight nuclear hyperchromasia, undulations in the nuclear membrane
  • Prominent nucleoli
19
Q

What causes cell death ?

A
  • Unplanned and irreversible damage to the cell (necrosis)

- Regulated processes such as apoptosis - programmed cell death

20
Q

What is a neoplasm?

A

Abnormal growth of cells - tumour

21
Q

What causes cancers to be frequently detected by cytology?

A

Cancer cells lose their cohesive properties early in the disease process. This encourages the shedding of cells from tissue surfaces, thereby increasing the likelihood that cancer cells will be detected.

22
Q

What may cause a tumour to suddenly shrink?

A

The tumour may outstrip its own blood supply.

23
Q

What is metastasis ?

A

The invasion of malignant cells into surrounding tissues.

24
Q

What does the invasiveness of a malignant cell change due to ?

A

o Mechanical pressure of the growing tumour
o Motility of the malignant cells
o Enzymes produced by the malignant cells

25
Q

Wha is Human Papillomavirus?

A

A small DNA virus which infects deeper layers of the skin and internal lining of organs such as the vagina and mouth.

26
Q

What people are likely to get Human Papillomavirus and when?

A
  • Detectable in more than 99% of cervical cancer cases.
  • 75% of women have been infected by the age of 50.
  • Women are likely to be infected in their later teens and early 20s.
  • Rate of HPV increases from the age of 14
27
Q

What are the effects of HPV ?

A

Infects cells and then integrates its DNA to the DNA of the host cell.

Persistent infection leads to cells becoming damaged and pre-cancerous.

Eventually cancer - abnormal uncontrolled growth of tissues occurs after many years.

28
Q

Describe the treatment of HPV

A

Cannot be treated but pre-cancerous changes can be detected by screening and removed.

29
Q

What are the categories of genital HPV infection ? Describe each.

A
  • High risk which causes cervical intraepithelial neoplasia and invasive cancer.
  • Low risk
30
Q

What type of HPV causes genital warts?

A

Mainly 6 and 11

31
Q

What is the vaccine used to treat HPV?

A

Gardasil

32
Q

Who is given the Gardasil vaccine against HPV and what is the purpose of this?

A

School age girls to protect them against cervical cancer.

33
Q

What types of HPV does the Gardasil vaccine protect against?

A

6, 11, 16 and 18

34
Q

What is the aim of the NHS cervical screening programme?

A

To reduce the incidence and mortality of cervical cancer by detecting and treating potentially precancerous lesions of the cervix.

35
Q

What are the major problems with cytological and histological assessment?

A
  • Distinction between non-dysplastic and dysplastic phenotypes.
  • Grading of dysplastic and correlation with cancer risk.
  • Distinction between high-grade dysplasia and early invasive gastric cancer.
36
Q

What is dysplasia?

A

A term used to describe the presence of abnormal cells within a tissue or organ. Dysplasia is not cancer, but it may sometimes become cancer

Y2 medical pathophysiology (12 decks)

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