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350 > frozen section and decalcification > Flashcards

frozen section and decalcification Flashcards

1
Q

what is the CAP accreditation standard time for frozen section

A

20 mins

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2
Q

4 application for frozen section

A

Intra-operative consultations
Enzyme histochemistry
Immunofluorescent techniques
Lipid stains

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3
Q

benefits for enzymes in frozen sections

A

Enzymes are labile and rapidly degrade when removed from blood and fixed

Freezing tissue = best to preserve enzymes (especially in muscles)

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4
Q

benefits from immunofluorescnt techniques in frozen sections

A

Fixation will degrade Ab

Aldehyde fixatives create autofluorescence

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5
Q

benefits from lipid stains in frozen sections

A

Fixations will dissolve lipids

Neutral lipids (fat) can be visualized

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6
Q

what is freezing artifact

A

ice crystals in muscle that leaves holes in tissue

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7
Q

how to minimize freezing artifact

A

freeze rapidly using heat extractors, dry ice, or liquid nitrogen

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8
Q

what temp for sectioning at -7C to -13C

A

brain
liver
thyroid

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9
Q

what temp for sectioning at -13 to -16C

A

skin
liver
muscle

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10
Q

what temp for sectioning at -20 to -30C

A

breast
fatty tissue

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11
Q

what is used to freeze tissue in place

A

FSC

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12
Q

T/F frozen sections form ribbons

A

F

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13
Q

when tissue is on slide, what is used to fix

A

formalin or alcohol before staining with H&E

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14
Q

how is quality assurance demonstrated in frozen sectioning

A

comparison of frozen slide and paraffin slide to confirm

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15
Q

cause and resolution of chatter

A

Block being too cold or loose component

All levers tight and increase temperature of cryostat / warm block

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16
Q

cause and resolution of shattering

A

Cryostat is too cold (seen most in lymph nodes)

Increase temperature or heat from gloves

17
Q

cause and resolution to compression

A

Block is too warm or Blade is too dull

Cool the block or new blade

18
Q

cause and resolution to lines/scores

A

Defect in blade or Calcification (notify path)

New blade

19
Q

cause and resolution to debris in cryostat

A

Static electricity

Humidify room or wipe down cryotome with alcohol

20
Q

what disinfectant used at end of day

A

70% ethanol

21
Q

how should Oxivir/Cavicide be used

A

when cryostat is defrosted and decontaminated

22
Q

what method of disinfectant is dangerous for cryostat

A

heating chambers to vaporize formalin or gluteraldehyde

23
Q

cons of UV light disinfectant

A

cannot pentrate dirt so it has to be clear before use

24
Q

what causes the cryostat to overheat

A

dusty coils

25
Q

what pH is calcium soluble at

A

4.5 or less

26
Q

what solutions are used to routinly used to decal

A

formic acid with formalin (3-10 days)

HCL or nitric acid when more rapid is needed (<2 days)

27
Q

T/F tissues can be decalcified whenever

A

F - tissues must be fixed before decal

28
Q

what hazard can occur when decal with HCl

A

must be washed after HCl as mixing with formalin = bis-chloromethyl ether (carcinogen)

29
Q

what 3 methods are used in decal

A

simple acid
ion exchange resins
EDTA

30
Q

how does simple acid decal work

A

submerge in solution with agitation to prevent calcium ion surrounding the tissue, then replace solution

31
Q

how does ion exchange resins decal work

A

resins exchange ammonium for calcium ions to prevent saturating solution = quicker decal and less replacement

32
Q

how does EDTA decal work

A

binding metal ions without affecting other tissue components = good to use where acids may destroy labile tissue.

BUT takes weeks to complete

33
Q

what 3 methods are used to detect endpoint

A

chemical
radiography
physical

34
Q

how does chemical endpoint detection work

A

decal solution is neutralized with ammonium hydroxide then ammonium oxalate to form calcium oxalate (white precipitate)

white precipitate = calcium present and more decal needed

35
Q

how does radiography endpoint detection work

A

Ca2+ is solid white on X rays

36
Q

how does physical endpoint detection work

A

bending the tissue to determine if fully decal (unreliable and not recommended as bending creates artifacts)

37
Q

after decal, what is used to neutralize the residual acid

A

lithium carbonate

38
Q

how is overdecal recognized

A

poor nuclear staining

pale red nuclei = loss of basephilia

39
Q

how to correct for over decal

A

sodium bicarbonate overnight and restain

350 (7 decks)

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