EXFOLIATIVE CYTOLOGY Prt 1 Flashcards

1
Q

Non-Gynecologic Specimens

A
  1. Respiratory Specimens
  2. Gastrointetinal Speicmens
  3. Peritoneal, Pleural, and Pericardial Smears
  4. Urine
  5. Breast Secretions
  6. CSF
  7. Prostatic Secretion
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2
Q

Cells found in Cervico-Vaginal Smears

A

A. Mature Superficial Cells
B. Intermediate Cells
C. Parabasal Cells
D. Basal Cells
E. Endometrial Cells
F. Endocervical Glandular Cells
G. Doderlein Bacilli
H. Ferning Phenomenon

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3
Q

Histology of exfoliated, abraded, or desquamated cells

A

Cytology

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4
Q

This is the study or histology of the cells that are being removed from the bodv. Cells that was scraped from the body.

A

Cytology

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5
Q

• Study of cells directly taken from surfaces of excised specimens by touching them

A

Imprint/Abraded Cytology

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6
Q

Microscopic study of desquamated cells from epithelial surfaces

A

Exfoliative Cytology

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7
Q

Study of cells that have been shed or physically removed

A

Exfoliative Cytology

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8
Q

EXFOLIATIVE CYTOLOGY PURPOSES

A

• Assessing cancerous conditions (staging)

• Detection of asymptomatic cancers

• Asessment of female hormonal activity (sterilitv & endocrine disorders) - maturity index

• Determination of genetic sex - Barr bodies (conglomeration of chromatin, XX chromosome)

• Detect presence of possible infection

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9
Q

Material from fluids of the body may be examined either by:

A

Preparation of Smears

Preparation of Tissue Blocks (Cell Blocks)

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10
Q

Here are the examples of different body fluids that we might receive that might be subjected for exfoliative cytology:

Various Regions

A

• Vaginal Smear
• Endometrial and Endocervical Smear
• Prostatic and breast secretion
• Gastric or bronchial secretions
• Pleural or peritoneal fluids
• Sputum
• Smears of urine sediment
• Cerebrospinal fluid

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11
Q

SMEAR PREPARATION

• Make smears from fresh and moist material on clean slide; should not have_____

•________ is used to put identifiers on the smear (name, age, date, and type of smear);_______ may also be used.

• Immerse smears immediately in____ by a single uninterrupted motion (exfoliated cells decompose rapidly)

• Spray Fixatives:______

• Avoid_____ in the container to prevent the cells from being dislodged

• Optimal time:______ to allow dehydration, adhesion, and maximal penetration of the fixative

A

clumps

Diamond pen

frosted-end slides

fixative

12 inches or 1 foot away

vibrations

1 hour

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12
Q

• Best (yet flammable) fixative
The best fixative but it is flammable.

A

95% Ethanol-Ether

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13
Q

• Routinely used fixative

A

95% Ethanol

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14
Q

If smears cannot be made immediately, place the collected material in_______ (for all types of effusions) - replaced by_____

A

50% alcohol

Saccamono’s preservative

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15
Q

Saccamono’s preservative

A

50% Ethanol
2% Carbowax

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16
Q

Storage of sample:

A

add ROH and refrigerate

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17
Q

Storage of sample: Alcohol concentration

A

• 50% alcohol - pleural/peritoneal
• 70% alcohol - sputum
• 95% alcohol - urine, bronchial, gastric

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18
Q

Fixation of Mailed Specimen:

A

air-dry for 10-15 minutes after 2 hours of fixation and place it in a container

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19
Q

If specimen is more than a few drops:

A

• Centrifuge at 2,000 rpm for 2 minutes

• After centrifugation, decant the supernatant, and we will get a small portion of the sediment, then smear the sediment directly to glass slide, or cytocentrifuge directly on slide with albumin.

• Extra sediment can be used for cell block technique.

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20
Q

Viscous Specimen

A

Cervical, Vaginal, Prostate Secretion

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21
Q

Mucoid Specimens

A

Sputum
Bronchial
Stomach secretions

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22
Q

Watery Specimens

A

Urine, Exudate, Aspirate

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23
Q

General processing

Viscous Specimen
Cervical, Vaginal, Prostate Secretion

A

Immerse in ROH ASAP

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24
Q

General processing

Mucoid Specimens

• Sputum, Bronchial and Stomach Secretions

A

Dry smear edges before fixing (to avoid runoff)

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25
Q

General processing

Blood Srecimens
RBC can be destroyed by adding___________ of the specimen

A

2-5 mL of concentrated
Acetic Acid per 100 mL

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26
Q

General processing

Watery Specimens
• Urine, Exudate, Aspirate
Specimen is______ first and the sediment is smeared in an _______ glass slide.

In the event that there is excess sediment, it may be subjected to biopsy.

A

centrifuged

albumin-coated

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27
Q

• For adequate adhesion of smeared material.

A

ADHESION

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28
Q

• ADHESION

not recommended because it will retain the OG (Orange Green) of Pap stain.

A

Albumin

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29
Q

Specimens that require adhesives:

A

Urinary sediment
BAL (Bronchial Alveolar Lavage)
Specimens with proteolytic enzymes (saliva)
Concentrated sputum

30
Q

Characteristics of adhesives:

A

• Permeable to both fixative and stain

31
Q

Examples of good adhesives:

A

• Pooled serum/Plasma
• Celloidin Ether Alcohol
• Leuconostoc Culture

32
Q

SPECIMENS
• Generally divided into two major areas. We have

A

non-gynecologic specimens gynecologic specimens

33
Q

NON-GYNECOLOGIC SPECIMENS
1. RESPIRATORY SPECIMENS

A

• Sputum
• Bronchial brushings
• Bronchoalveolar Lavage/Bronchial Washing
• Bronchial Aspirate

34
Q

Demonstrate abnormal cells early in disease

A

Sputum

35
Q

Collection of sputum

A

Fresh, unfixed, atleast 3 consecutive early morning sputum.

36
Q

3 consecutive collection of early morning sputum must have what time interval?

A

1 hour

37
Q

Collection of sputum

Patients unable to produce sputum:
INDUCED SPUTUM by inhalation of____ for _____

A

aerosol solution for 20 minutes

38
Q

Why is aerosol used to induce sputum

A

Because it can trigger asthma. There will be sputum formation.

39
Q

Collection of sputum: CONTAINER

A

Wide mouthed bottle with Saccomano’s Fluid

40
Q

Sputum

After collection:
• Pour specimen in petri dish, examine for_______ particles
• Remove particles, place on slide,_____ with another slide. Evenly distribute.
• Fix for a minimum of_____.

A

solid or blood flecked

crush

1 hour

41
Q

Collection of sputum

Absence of_____ and _____ indicates that only saliva was collected.

A

histiocytes and alveolar macrophages

42
Q

Collection of Bronchial Brushing

• Directly smear on two slides using_____ technique
• Fix immediately to avoid production of_____ artifacts

A

pull-apart

air drying

43
Q

• Bronchoalveolar Lavage/Bronchial Washing

Performed in patients with_____ to rule out________ infection
Also the causative agent of_____

A

AIDS

Pneumocystis jirovecci

pneumonia

44
Q

Performed in patients with AIDS to rule out Pneumocystis jirovecci infection
Also the causative agent of pneumonia

A

• Bronchoalveolar Lavage/Bronchial Washing

45
Q

• Bronchial Aspirate

Collection:

A

• aspiration (with glass suction apparatus) or
• washing (with saline)

46
Q

Show evidences of malignancy in advanced stage of the disease

A

Bronchial aspirate

47
Q

Bronchial Aspirate

  • Centrifuge specimen for______, medium speed
  • Smear must contain…
  • If specimen is scanty, prepare smear in OR to prevent drying
A

20-30 mins

epithelial cells (ciliated bronchial cells) + RBC and WBC

48
Q

Among the four respiratory specimen

What is the only one collected by the patient?

A

Sputum

49
Q
  1. GASTROINTESTINAL SPECIMENS
    • 2 methods
A

• Through the mouth
• Levine method - through nasogastric

50
Q

Gastrointestinal specimen

Collection:

A

Irrigation
Aspiration

51
Q

Gastrointestinal specimen

Difficult due to_____ and presence of____

A

inaccessibility

gastric fluid

52
Q

Gastrointestinal specimen

• Examine ASAP
• Sample must be processed as soon as possible
•_______ before gastric washing
Even_____ is prohibited

A

8 hours fasting

water

53
Q
  1. PERITONEAL, PLEURAL AND PERICARDIAL SMEARS

For the extraction of peritoneal, pleural, pericardial fluid

A

Paracentesis

54
Q

Collection of PERITONEAL, PLEURAL AND PERICARDIAL SMEARS

A

Same as bronchial specimens

55
Q

• Increased fluid indicates vatholoaic process
• Presence of malignant cells usually indicate metastasis

A

PERITONEAL, PLEURAL AND PERICARDIAL SMEARS

56
Q

Since peritoneal, pleural, and
pericardial samples are prone to clotting, ADD

A

300 units of heparin per 100 mL of aspirate to avoid clots

57
Q
  1. URINE
    • Collection:
    • Male -
A

second-voided urine

58
Q

• Male - second-voided urine

______is not recommended for cytologic evaluation because the cells may degenerate after spending extended period in acid environment in the bladder

A

First morning

59
Q

URINE

Collection

Female -

A

catheterized

60
Q

Because the vagina is prone to bacterial contamination
In order to have a sterile sample, it should be…

A

catheterized

61
Q

Urine collection

• Atleast_____ is needed

A

50 mL

62
Q

URINE

For more reliable evaluation, urine may be collected and examined twice

A

Early morning and later in the day

63
Q

T OR F

URINE

• Use of preservative is not recommended

A

True

64
Q

• For diagnosis of urothelial malignancy and not for prostatic carcinomas

A

Urine

65
Q

BREAST SECRETION
• Collection:

A

Spontaneous nipple discharge

66
Q

Breast secretion
Materials

A

Cotton swab or touch prep
( Touch the nipple directly during discharge using the slide or cotton swab)

67
Q

For hormonal imbalance testing
• Not an indication or phase of cancer

A

Breast secretion

68
Q

• Benign breast lesion or endocrine problems
• Extremely low diagnostic yield for breast carcinoma diagnosis

A

Breast secretion

69
Q

Breast secretion

• If bloody =

A

benign intraductal papilloma

70
Q
  1. CEREBROSPINAL FLUID
    _______performed to obtain cerebrospinal fluid or CSF

Fluid is_____

Minimum of____ is necessary

A

Lumbar puncture

colorless

1 mL

71
Q
  1. PROSTATIC SECRETION

3 specimens required:

A

• Voided urine before massage
• Smear of prostatic secretion by massage
• Urine after massage

72
Q

Prostatic secretion

• Cytologic examination of_____ specimen after unproductive massage is recommended

A

3rd