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Histopathology > Exfoliative cytology > Flashcards

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
Q

Pap stain: bacteria color

A

Dark blue

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26
Q

Pap stain: mycelia color

A

Violet

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27
Q

Pap stain: Trichomonas vaginalis color

A

Pale greenish blue blob of cytoplasm

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28
Q

Steps in Pap stain procedure

A

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
Q

Ideal site for hormonal cytology, evaluation of inflammation, normal flora classification

A

Upper (proximal) third of the vaginal wall

30
Q

Most common site for cancer screening, use of Ayre’s spatula

A

Ectocervix

31
Q

Histology of ectocervix

A

Stratified squamous non-keratinizing epithelium

32
Q

Site for detection of endocervical and intrauterine lesions

A

Endocervix

33
Q

Histology of endocervix

A

Simple columnar epithelium

34
Q

Material used for endocervical canal collection

A

Endocervical brush

35
Q

Material used for patients with hysterectomy

A

Vaginal scrape

36
Q

Material used for hormonal status evaluation

A

Lateral vaginal scrape

37
Q

Material used for localization of vaginal adenosis

A

Four-quadrant vaginal scrape

38
Q

Material used for detecting herpetic lesions or carcinoma (HSV-2)

A

Vulvar scrape

39
Q

Equipment for vaginal aspiration

A

Glass pipet and rubber bulb (6-8 inches x 1/4 inch)

40
Q

Equipment for swab smear collection

A

Ayre’s spatula

41
Q

Equipment for endocervical/endometrial aspiration

A

Laryngeal cannula attached to a 10cc syringe

42
Q

Antiseptic used for alcohol testing

A

Zephiran (benzalkonium chloride)

43
Q

Methods of Pap smear

A

Conventional Pap’s smear, Liquid-based Pap’s (SurePath, ThinPrep)

44
Q

Collection method for liquid-based Pap’s

A

Use of spatula or brush/broom; sample placed in vial with preservative; thin cell layer prepared on slide

45
Q

Steroid hormone acting upon superficial cells, produced by ovarian follicle granulosa-theca cells

46
Q

Steroid hormone acting upon intermediate cells, produced by corpus luteum after ovulation

A

Progesterone

47
Q

Large, polyhedral flat cells with acidophilic or basophilic cytoplasm, small pyknotic nuclei (<6 µm)

A

Superficial cells

48
Q

Medium-large (20-30 µm) polyhedral or elongated cells, basophilic cytoplasm with vacuoles, vesicular nuclei (6-9 µm)

A

Intermediate cells

49
Q

Boat-shaped intermediate cells with folded, curled edges

A

Navicular cells

50
Q

Round or oval cells with translucent basophilic cytoplasm, double cell wall appearance; associated with pregnancy

A

Pregnancy cells

51
Q

Round or oval cells (15-25 µm), thick, ‘fried egg’ appearance, strong basophilic cytoplasm, vesicular nuclei (6-9 µm); found in specific conditions

A

Parabasal cells

52
Q

Small (13-20 µm) round/oval cells, large nucleus occupying ≥50% of cell volume, strongly basophilic cytoplasm; found before pregnancy and after menopause

A

Basal cells

53
Q

Evaluates hormonal status based on the distribution of superficial, intermediate, and parabasal cells

A

Cytohormonal smear

54
Q

Percentage distribution of cell types (superficial, intermediate, parabasal) per 100 cells

A

Cytohormonal Maturation Index (CHMI)

55
Q

Cytohormonal Maturation Index classification

A

Parabasal/Intermediate/Superficial

56
Q

Pregnancy MI due to high progesterone levels CHMI

57
Q

Newborn (up to 8 weeks) MI reflecting maternal progesterone influence CHMI:

58
Q

Infancy (8 weeks to puberty) MI due to increasing estrogen levels CHMI

59
Q

Late menopausal MI reflecting no estrogen production: CHMI

60
Q

75-year-old woman undergoing estrogen therapy MI due to exogenous estrogen CHMI

61
Q

CHMI: 0/10 (progesterone)/90 (estrogen); seen in menopausal women on estrogen therapy

A

Menopausal women on estrogen

62
Q

CHMI: 0/70/30; indicates shift to midzone during pregnancy

A

Midzone pregnancy shift

63
Q

CHMI: 100/0/0; seen in premenarchal or menopausal women

A

Premenarchal/Menopausal

64
Q

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.

A

Endometrial cells/Endometrium

65
Q

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.

A

Endocervical cells

66
Q

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.

A

Döderlein bacilli

67
Q

Seen during traumatic collection or menstruation. Pap smear should be done 10 days after LMP.

68
Q

Long, thin, filamentous bacilli. Increased in high vaginal pH. Indicates a possible infection indirectly.

A

Leptothrix sp.

69
Q

Usually a contaminant. Appears as ovoid bodies.

Histopathology (30 decks)

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