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Exfoliative cytology Flashcards

1
Q

Microscopic study of cells desquamated from epithelial surfaces

A

Exfoliative cytology

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2
Q

Uses of exfoliative cytology

A

Detection of malignant or precancerous conditions, cervical lesions, female hormonal status, genetic sex determination, infectious agents

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3
Q

Genetic sex determination in exfoliative cytology

A

Barr body (inactivated X chromosomes)

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4
Q

Specimens requiring adhesive agents

A

Urinary sediment, bronchial lavage specimens

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5
Q

Specimens processed with proteolytic enzymes (e.g., Trypsin)

A

Concentrated sputum, enzymatic lavage samples from GIT

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6
Q

Characteristics of a good adhesive

A

Permeable to fixative and stain, does not retain the stain

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7
Q

Examples of good adhesives for cytologic methods

A

Pooled human sera/plasma, Celloidin Ether-Alcohol, Leuconostoc culture, APES (3-aminopropyltriethoxysilane)

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8
Q

Fixation time for exfoliative cytology

A

15 minutes

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9
Q

Papanicolaou’s fixative composition

A

Equal parts of 95% EtOH and ether

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10
Q

Routine fixative for cytology

A

95% EtOH

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11
Q

Fixative: saturated aqueous mercuric chloride and acetic acid

A

Schaudinn’s fluid

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12
Q

Fixative for blood films

A

Methanol

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13
Q

Composition of Saccomano preservative

A

50% alcohol and carbowax

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14
Q

Substitute for ethanol in spray fixatives

A

Hair spray (10-12 inches or 1 foot distance)

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15
Q

Screening test for cervical cancer, linked to HPV serotypes 6, 18

A

Papanicolaou smear and stain

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16
Q

Uses of Pap smear

A

Detect infections (STDs), ovarian function (hormonal cytology), infertility testing, malignancy response to therapy, Barr body determination, sexual assault examination

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17
Q

Advantages of Pap stain

A

Alcoholic content, transparent blue cytoplasm staining, excellent nuclear staining, predictable color range

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18
Q

Disadvantages of Pap stain

A

Lengthy and complicated procedure, inaccurate acidophilic index

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19
Q

Pap stain: nuclear stain

A

Harris hematoxylin

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20
Q

Pap stain: stains keratin, mature cells

A

OG-6 stain (Orange Green 6)

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21
Q

Pap stain: stains immature cells, light green cytoplasm

A

EA 50 stain

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22
Q

EA 50 compared to EA 36

A

Comparable; EA 65 differs in light green concentration

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23
Q

Pap stain: nucleus colors

A

Vesicular nucleus: blue; pyknotic nucleus: dark blue to black

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24
Q

Pap stain: cytoplasm colors

A

OG-6: Orange with green hint; EA 36/50: Olive green with brown/red hint

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25
Pap stain: bacteria color
Dark blue
26
Pap stain: mycelia color
Violet
27
Pap stain: Trichomonas vaginalis color
Pale greenish blue blob of cytoplasm
28
Steps in Pap stain procedure
Fixation with 95% EtOH, Hematoxylin, Acid alcohol differentiation, Wash, Ammonia water, OG-6, 95% EtOH wash (2x), EA 50/36, Dehydration, Xylol, Mount, Label
29
Ideal site for hormonal cytology, evaluation of inflammation, normal flora classification
Upper (proximal) third of the vaginal wall
30
Most common site for cancer screening, use of Ayre's spatula
Ectocervix
31
Histology of ectocervix
Stratified squamous non-keratinizing epithelium
32
Site for detection of endocervical and intrauterine lesions
Endocervix
33
Histology of endocervix
Simple columnar epithelium
34
Material used for endocervical canal collection
Endocervical brush
35
Material used for patients with hysterectomy
Vaginal scrape
36
Material used for hormonal status evaluation
Lateral vaginal scrape
37
Material used for localization of vaginal adenosis
Four-quadrant vaginal scrape
38
Material used for detecting herpetic lesions or carcinoma (HSV-2)
Vulvar scrape
39
Equipment for vaginal aspiration
Glass pipet and rubber bulb (6-8 inches x 1/4 inch)
40
Equipment for swab smear collection
Ayre's spatula
41
Equipment for endocervical/endometrial aspiration
Laryngeal cannula attached to a 10cc syringe
42
Antiseptic used for alcohol testing
Zephiran (benzalkonium chloride)
43
Methods of Pap smear
Conventional Pap's smear, Liquid-based Pap's (SurePath, ThinPrep)
44
Collection method for liquid-based Pap's
Use of spatula or brush/broom; sample placed in vial with preservative; thin cell layer prepared on slide
45
Steroid hormone acting upon superficial cells, produced by ovarian follicle granulosa-theca cells
Estrogen
46
Steroid hormone acting upon intermediate cells, produced by corpus luteum after ovulation
Progesterone
47
Large, polyhedral flat cells with acidophilic or basophilic cytoplasm, small pyknotic nuclei (<6 µm)
Superficial cells
48
Medium-large (20-30 µm) polyhedral or elongated cells, basophilic cytoplasm with vacuoles, vesicular nuclei (6-9 µm)
Intermediate cells
49
Boat-shaped intermediate cells with folded, curled edges
Navicular cells
50
Round or oval cells with translucent basophilic cytoplasm, double cell wall appearance; associated with pregnancy
Pregnancy cells
51
Round or oval cells (15-25 µm), thick, 'fried egg' appearance, strong basophilic cytoplasm, vesicular nuclei (6-9 µm); found in specific conditions
Parabasal cells
52
Small (13-20 µm) round/oval cells, large nucleus occupying ≥50% of cell volume, strongly basophilic cytoplasm; found before pregnancy and after menopause
Basal cells
53
Evaluates hormonal status based on the distribution of superficial, intermediate, and parabasal cells
Cytohormonal smear
54
Percentage distribution of cell types (superficial, intermediate, parabasal) per 100 cells
Cytohormonal Maturation Index (CHMI)
55
Cytohormonal Maturation Index classification
Parabasal/Intermediate/Superficial
56
Pregnancy MI due to high progesterone levels CHMI
0/90/10
57
Newborn (up to 8 weeks) MI reflecting maternal progesterone influence CHMI:
0/90/10
58
Infancy (8 weeks to puberty) MI due to increasing estrogen levels CHMI
80/20/10
59
Late menopausal MI reflecting no estrogen production: CHMI
100/0/0
60
75-year-old woman undergoing estrogen therapy MI due to exogenous estrogen CHMI
0/20/80
61
CHMI: 0/10 (progesterone)/90 (estrogen); seen in menopausal women on estrogen therapy
Menopausal women on estrogen
62
CHMI: 0/70/30; indicates shift to midzone during pregnancy
Midzone pregnancy shift
63
CHMI: 100/0/0; seen in premenarchal or menopausal women
Premenarchal/Menopausal
64
Found during menstruation (in groups) and 1-4 days after cessation of the period (single). Endometrial stromal cells: tight clusters of small, oval dark cells, slightly larger glandular cells. Nucleus: small, moderately dark. Cytoplasm: basophilic, may be vacuolated. Postmenopausal presence indicates possible carcinoma or hyperplasia.
Endometrial cells/Endometrium
65
Slightly cylindrical, columnar epithelial cells. Occurs in groups or strips of three or more cells. Nuclei: basally oriented, vacuolated. Cytoplasm: deeply basophilic, mucin-filled. Denotes satisfactory sample collection; honeycomb appearance.
Endocervical cells
66
Also known as Lactobacillus acidophilus. Gram-positive slender rod bacteria. Predominant organism in vaginal normal flora. Stains pale blue to lavender in Pap smear. Ferments glycogen from disintegrating epithelial cells to maintain low pH, inhibiting pathogens. Numerous during luteal phase and pregnancy.
Döderlein bacilli
67
Seen during traumatic collection or menstruation. Pap smear should be done 10 days after LMP.
RBCs
68
Long, thin, filamentous bacilli. Increased in high vaginal pH. Indicates a possible infection indirectly.
Leptothrix sp.
69
Usually a contaminant. Appears as ovoid bodies.
Talcum

Histopathology (30 decks)

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