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MTAP 2 > FINALS: HISTOPATHOLOGY > Flashcards

FINALS: HISTOPATHOLOGY Flashcards

1
Q

IMMUNOHISTOCHEMISTRY
- X ___, special procedure in ___
- involves ___

A
  • routine
  • disease diagnosis
  • antigen-antibody reactions
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2
Q

PURPOSE OF IHC:

A
  • Most common form of Ab used in IHC
  • For identification of tissue / cellular antigens / phenotypic markers
  • Detection of organisms (microbes: cause diseases) in cytologic procedures (sputum, body fluids, FNA)
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3
Q

ANTIGENS (found in ___)

A
  • cells
  • to be detected
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4
Q

ANTIBODIES (class of ___, ___)
Most common Ig used?

A
  • serum proteins
  • immunoglobulins
  • IgG
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5
Q

TYPES OF ANTIBODIES USED IN IHC
A. ___
- produced by ___
- react w/ ___
- from ___
Main Source:
Other Source:

A
  • POLYCLONAL
  • different cells
  • various isotopes
  • laboratory animal sources
  • RABBITS - immunized to produce Abs
  • GOATS, PIGS, SHEEP
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6
Q

TYPES OF ANTIBODIES USED IN IHC
B. ___
- more ___
- produced from ___
- reacts only w/ ___
Main Animal Source:

A

B. MONOCLONAL
- specific
- individual clone of plasma cell
- 1 specific type of isotope
- MICE

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7
Q

LABELLING OF ANTIBODIES
1. USE OF ___
Most widely used?
Alternative?

A
  • ENZYMES
  • HRP (HORSE RADISH PEROXIDASE)
  • AP (ALKALINE PHOSPHATASE)
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8
Q

Required in use of enzymes to see ___?

Required by chromogens; ___?

A
  • CHROMOGENS -> color developers
  • positive result
  • SUBSTRATE
  • consumed by enzyme
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9
Q

Ab + ___ to react w/ antigen

A

E + C + S

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10
Q

Enzyme: HRP (HORSE RADISH PEROXIDASE)
Substrate: ___

Chromogen:
1. ___
Color:
Suitable Counterstains:

  1. ___
    Color:
    Suitable Counterstains:
A

Enzyme: HRP (HORSE RADISH PEROXIDASE)
Substrate: HYDROGEN PEROXIDASE (H2O2)

Chromogen:
1. DAB (3,3’ DAB diaminobenzidine)
Color: Brown
Suitable Counterstains: Hematoxylin, Methyl green, Methyl blue

  1. AEC (3-amino-9-ethylcarbazole)
    Color: Brick red
    Suitable Counterstains: Hematoxylin, Methyl blue
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11
Q

Enzyme: AP (ALKALINE PHOSPHATASE)
Substrate: ___

Chromogen:
1. ___
Color:
Suitable Counterstains:

  1. ___
    Color:
    Suitable Counterstains:
A

Enzyme: AP (ALKALINE PHOSPHATASE)
Substrate: Phosphate

Chromogen:
1. BCIP (5-Bromo-4-Chloro-3-Indolyl Phosphate) / NBT (Nitro Blue Tetrazolium)
Color: Bluish violet / Black violet
Suitable Counterstains: Nuclear fast red, Brilliant green

  1. FAST TR RED SALT
    Color: Rose color
    Suitable Counterstains: NONE
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12
Q

Used to observe end products?
Fluorochrome dye used?

A
  • LIGHT MICROSCOPE
  • FLUORESCENCE MICROSCOPE
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13
Q

HEMATOXYLIN AS COUNTERSTAIN
- ___; ___

MAYER’S OR HARRIS HEMATOXYLIN - ___
MAYER’S - ___
HARRIS - ___; ___

A
  • traditional counterstain; nuclear stain
  • Immunohistochemistry
  • Reddish violet
  • Red; commonly used bc tissue morphology are well-defined
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14
Q

INCUBATION - ___
Incubation time & temperature to link Ab w/ ___

A
  • required to link Ag to Ab
  • 30-60 MINS AT ROOM TEMPERATURE
  • peroxidase
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15
Q

LABELLING OF ANTIBODIES:
2. USE OF ___
- requires ___
Most common:

A
  • FLUROCHROME LABEL
  • FLUORESCENCE MICROSCOPE
  • FITC (FLUORESCENCE ISOTHIOCYANATE)
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16
Q

LABELLING OF ANTIBODIES:
3. USE OF ___
GOLD - ___ end-product (under ____

A
  • COLLOIDAL METALS
  • pink
  • light microscope
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17
Q

LABELLING OF ANTIBODIES:
4. ___

To detect ___ (traditionally use ___)
- Can bind w/ ___; can also be ___
Source:

A
  • RADIO LABEL
  • LECTINS
  • antigen
  • antibody
  • tissue carbohydrates
  • labeled
  • PLANT / ANIMALS
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18
Q

SPECIMENS FOR IHC:
1. ___
- for ___
- done ___ (while ___)
- tissue prepared as ___ & must be fixed for a few sections using ___ / ___
Preparation: Cut tissue using ___ / ___

A
  • FROZEN SECTION
  • rapid diagnosis
  • intraoperatively
  • patient is in OR
  • cryostat section
  • METHANOL / ACETONE
  • freezer microtome / CRYOSTAT
19
Q

PURPOSE OF FIXATION:

A
  1. To preserve the position of antigens being detected
  2. To prevent destruction of labile antigenic sites
20
Q

SPECIMENS FOR IHC:
2. ___ LIKE ___ & ___

Preferred fixative for IHC?

Required for processed specimens?
Purpose:

A
  • PROCESSED SPECIMENS
  • Formalin fixed, Paraffin embedded
  • FORMALDEHYDE
  • ANTIGEN RETRIEVAL
  • Increase accessibility of Ag to Ab
21
Q

2 GENERAL METHODS OF ANTIGEN RETRIEVAL:
1. ___

  1. ___ / ___
    MOST COMMON ENZYMES USED:
    Both can break ___
    Forms crosslinks?
A
  • HIER (HEAT INDUCED EPITOPE RETRIEVAL)
  • PIER (PROTEASED INDUCED EPITOPE RETRIEVAL) / PROTEOLYTIC ENZYME RETRIEVAL
  • TRYPSIN, PROTEASE
  • formalin crosslinks
  • 10% FORMALIN AS FIXATIVE
22
Q

PRE-TREATMENT
BLOCKING - only for ___, X ___
1. ___
- ___
- uses ___

  1. ___
    - all ___ & reduces ___
    - uses ___
A
  • processed specimen
  • frozen section
  • PEROXIDASE BLOCK
  • endogenous peroxidases
  • 3% H2O2 (HYDROGEN PEROXIDE)
  • PROTEIN BLOCK
  • non-specific sites
  • background
  • 10% NORMAL SERUM
23
Q

PURPOSE OF USE OF CONTROL AS REQUIREMENT IN IHC:

A
  1. To test for specificity of Abs involved
  2. To prevent misinterpretation due to false + & false - results
24
Q

POSITIVE CONTROL - tissue section having the ___

NEGATIVE CONTROL - omit ___ from ___ / replace ___ by an __ directed against an ___

INTERNAL TISSUE CONTROL / BUILT IN CONTROL -contains ___ not only in the ___ but also in ___

A
  • Ag being detected
  • primary Ab
  • staining sched
  • primary Ab
  • Ig
  • unrelated Ig
  • target Ag
  • tissue elements
  • adjacent normal tissue elements
25
Q

DETECTION USING LABELED ENZYME ANTIBODY
1. ___
- use of ___
- Add ___

  1. ___
    - ___ of traditional (direct); ___ of direct
    - involves addition of ___; more ___
  2. ___
    - ___
    - requires use of ___
    PRIMARY Ab -
    SECONDARY Ab - will attach / bind to ___ -> ___ (better ___)
A
  • DIRECT
  • only 1 Ab that is labeled
  • labeled Ab to Ag being detected
  • EPOS (ENHANCED POLYMER ONE-STEP STAINING METHOD)
  • improvement
  • type
  • DEXTRAN POLYMER
  • sensitive
  • INDIRECT
  • two-step
  • 2 Abs
  • specific to Ag being detected
  • Fc portion of primary Ab
  • INCREASING SENSITIVITY
  • signal amplification
26
Q

ENZYMATIC METHOD - ___ are labeled w/ ___ before ___; after reacting w/ ___, ___ is formed

___ - catalyzes ___ to yield a ___ w/c can be analyzed using either ___ / ___

A
  • Abs
  • enzyme
  • reaction
  • targeted Ag
  • Ag-Ab COMPLEX
  • Ag-Ab COMPLEX
  • substrate
  • colored product
  • LM / EM
27
Q

ADVANTAGES OF ENZYMATIC METHOD:

A
  1. Standard samples can be stored for a long time
  2. Hematoxylin can be used as a counterstain
  3. End product can easily be identified using LM / EM
  4. Will not require fluorescence microscope
28
Q

AUTOMATION IN IHC:

A
  1. Greater consistency of staining
  2. Faster & more accurate
  3. Less manpower
  4. Decreased use of reagent
29
Q

TUMOR MARKERS - for ___ & ___ of cancers
- found in ___; markers for ___

A
  • detection & staging
  • tissues
  • malignancies
30
Q

A. EPITHELIAL TUMOR MARKERS
1. KERATIN - for ___; ___
CARCINOMA - ___ in origin
SARCOMA - __ in origin
Ex:
CK 7 (CYTOKERATIN 7) - ___
CK 20 - ___
X all types of carcinoma will be ___

  1. EMA (EPITHELIAL MEMBRANE ANTIGEN) - ___
    - determine ___; ___
  2. CEA (CARCINOEMBRYONIC ANTIGEN) - ___
    - differentiates ___ from ___
    ADENOCARCINOMA - cancer of ___ involving ___
    - elevated: ___
    - monitor ___
  3. TTF-I (THYROID TRANSCRIPTION FACTOR I) - differentiates ___ from ___
    - found in ___
  4. PSA (PROSTATE SPECIFIC ANTIGEN) - highly specific for ___
    - elevated: ___
  5. ER/PR (ESTROGEN-PROGESTERONE RECEPTOR) - normally found in ___ but X in ___
    - prognosis & treatment: ___
    - identification: ___
A

A. EPITHELIAL TUMOR MARKERS
1. KERATIN - for ___; ___
CARCINOMA - ___ in origin
SARCOMA - __ in origin
Ex:
CK 7 (CYTOKERATIN 7) - ___
CK 20 - ___
X all types of carcinoma will be ___

  1. EMA (EPITHELIAL MEMBRANE ANTIGEN) - ___
    - determine ___; ___
  2. CEA (CARCINOEMBRYONIC ANTIGEN) - ___
    - differentiates ___ from ___
    ADENOCARCINOMA - cancer of ___ involving ___
    - elevated: ___
    - monitor ___
  3. TTF-I (THYROID TRANSCRIPTION FACTOR I) - differentiates ___ from ___
    - found in ___
  4. PSA (PROSTATE SPECIFIC ANTIGEN) - highly specific for ___
    - elevated: ___
  5. ER/PR (ESTROGEN-PROGESTERONE RECEPTOR) - normally found in ___ but X in ___
    - prognosis & treatment: ___
    - identification: ___
31
Q

A. EPITHELIAL TUMOR MARKERS
1. KERATIN - for ___; ___
CARCINOMA - ___ in origin
SARCOMA - __ in origin
Ex:
CK 7 (CYTOKERATIN 7) - ___
CK 20 - ___
X all types of carcinoma will be ___

A

A. EPITHELIAL TUMOR MARKERS
1. KERATIN - for epithelial tissue cells; CARCINOMA
CARCINOMA - epithelial in origin
SARCOMA - connective tissue in origin
Ex:
CK 7 (CYTOKERATIN 7) - CANCER OF LUNGS, UTERUS, OVARIES
CK 20 - COLON & STOMACH CANCER
X all types of carcinoma will be (+) for CK

32
Q

A. EPITHELIAL TUMOR MARKERS
2. EMA (EPITHELIAL MEMBRANE ANTIGEN) - ___
- determine ___; ___

A

A. EPITHELIAL TUMOR MARKERS
2. EMA (EPITHELIAL MEMBRANE ANTIGEN) - ADENOCARCINOMA
- determine site of tumor; BREAST, LUNG, KIDNEY CANCER

33
Q

A. EPITHELIAL TUMOR MARKERS
3. CEA (CARCINOEMBRYONIC ANTIGEN) - ___
- differentiates ___ from ___
ADENOCARCINOMA - cancer of ___ involving ___
- elevated: ___
- monitor ___

A

A. EPITHELIAL TUMOR MARKERS
3. CEA (CARCINOEMBRYONIC ANTIGEN) - oncofetal
- differentiates ADENOCARCINOMA from MESOTHELIOMA
ADENOCARCINOMA - cancer of epithelial tissues involving glands
- elevated: CERTAIN CANCERS OF GIT
- monitor COLON, PANCREAS, CERVIX, BREAST CANCER

34
Q

A. EPITHELIAL TUMOR MARKERS
4. TTF-I (THYROID TRANSCRIPTION FACTOR I) - differentiates ___ from ___
- found in ___

A

A. EPITHELIAL TUMOR MARKERS
4. TTF-I (THYROID TRANSCRIPTION FACTOR I) - differentiates LUNG ADENOCARCINOMA from MESOTHELIOMA
- found in thyroid neoplasm

35
Q

A. EPITHELIAL TUMOR MARKERS
5. PSA (PROSTATE SPECIFIC ANTIGEN) - highly specific for ___
- elevated: ___

A

A. EPITHELIAL TUMOR MARKERS
5. PSA (PROSTATE SPECIFIC ANTIGEN) - highly specific for prostate
- elevated: PROSTATE CANCER, PANCREATIC CANCER, SALIVARY TUMORS; PROSTATE INFECTION

36
Q

A. EPITHELIAL TUMOR MARKERS
6. ER/PR (ESTROGEN-PROGESTERONE RECEPTOR) - normally found in ___ but X in ___
- prognosis & treatment: ___
- identification: ___

A

A. EPITHELIAL TUMOR MARKERS
6. ER/PR (ESTROGEN-PROGESTERONE RECEPTOR) - normally found in breast epithelial cells but X in myoepithelial cells
- prognosis & treatment: BREAST CANCER
- identification: METASTATIC BREAST CARCINOMA

37
Q

B. INTERMEDIATE FILAMENT MARKERS
1. ACTIN - tumors derived from ___

A

B. INTERMEDIATE FILAMENT MARKERS
1. ACTIN - tumors derived from SMOOTH, CARDIAC, SKELETAL MUSCLES

38
Q

B. INTERMEDIATE FILAMENT MARKERS
2. VIMENTIN - present in ___ & their counterparts: ___

A

B. INTERMEDIATE FILAMENT MARKERS
2. VIMENTIN - present in normal mesenchymal cells & their counterparts: SARCOMA, MELANOMA, LEUKEMIA, SEMINOMA SCHWANNOMAS

39
Q

B. INTERMEDIATE FILAMENT MARKERS
3. DESMIN - highly specific for ___

A

B. INTERMEDIATE FILAMENT MARKERS
3. DESMIN - highly specific for MYOGENIC TUMORS

40
Q

B. INTERMEDIATE FILAMENT MARKERS
4. GFAP (GLIAL FIBRILLARY ACIDIC PROTEIN) - confirms diagnosis of ___

A

B. INTERMEDIATE FILAMENT MARKERS
4. GFAP (GLIAL FIBRILLARY ACIDIC PROTEIN) - confirms diagnosis of ASTROCYTOMA

41
Q

OTHER MARKERS:
1. HCG (HUMAN CHORIONIC GONADOTROPIN) - ___

A

OTHER MARKERS:
1. HCG (HUMAN CHORIONIC GONADOTROPIN) - CHORIOCARCINOMA

42
Q

OTHER MARKERS:
2. AFP (ALPHA FETOPROTEIN) - ___
TERATOMAS - usually ___, aka ___

A

OTHER MARKERS:
2. AFP (ALPHA FETOPROTEIN) - EMBRYONAL CARCINOMAS & TERATOMAS, HEPATOCELLULAR CARCINOMAS
TERATOMAS - usually benign, aka MONSTROUS TUMORS

43
Q

OTHER MARKERS:
3. LYMPHOMAS / CD 45 - best screening marker for ___

A

OTHER MARKERS:
3. LYMPHOMAS / CD 45 - best screening marker for LYMPHOMA

44
Q

2 MOST COMMON MARKERS TO ASSESS PROLIFERATION OF TUMOR CELLS

A
  1. Ki
  2. MIB-I

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