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HISTOPATH- Lec-Gynecological Specimen Flashcards

1
Q

Anatomic Sites for Cytologic Samples

A
  • Upper (Proximal) Third of the Vaginal Wall
  • Ectocervix
  • Endocervix
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2
Q

Anatomic Sites for Cytologic Samples:
Ideal for studying hormonal status, evaluation of inflammatory
conditions, classification of the normal flora and rarely detection of
malignant vaginal lesions

A

Upper (Proximal) Third of the Vaginal Wall

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3
Q

Anatomic Sites for Cytologic Samples:
most common for cancer screening

use of Ayre’s spatula (can reach the T-zone)

Histology: Stratified Squamous Non-Keratinizing

A

Ectocervix

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4
Q

Anatomic Sites for Cytologic Samples:
for detection of endocervical lesions, intrauterine lesions

Histology: Simple Columnar Epithelium

A

Endocervix

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5
Q

Ectocervix histology?

A

Stratified Squamous Non-Keratinizing

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6
Q

Endocervix histology?

A

Simple Columnar Epithelium

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7
Q

Cytologic Collection and Preparation
Materials Used for Conventional Paps Smear:

A

Endocervical Brush
Vaginal Scrape
Lateral Vaginal Scrape
Four Quadrant Vaginal Scrape
Vulvar Scrape

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8
Q

Materials Used for Conventional Paps Smear:
-for endocervical canal

A

Endocervical Brush

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9
Q

Materials Used for Conventional Paps Smear:
- for patients with hysterectomy

A

Vaginal Scrape

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10
Q

Materials Used for Conventional Paps Smear:
-for Hormonal Cytology

A

Lateral Vaginal Scrape

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11
Q

Materials Used for Conventional Paps Smear:
- for localization of vaginal adenosis

A

Four Quadrant Vaginal Scrape

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12
Q

Materials Used for Conventional Paps Smear:
- for detection of herpetic lesions or carcinoma

A

Vulvar Scrape

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13
Q

Equipment for Vaginal, Endocervical and
Endometrial Aspirations

A

Glass Pipet and Rubber Bulb
Ayre’s Spatula
Laryngeal Cannula attached to 10cc syringe

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14
Q

-for vaginal aspiration
6-8 inches x ¼ inches

A

Glass Pipet and Rubber Bulb

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15
Q

Glass Pipet and Rubber Bulb size

A

6-8 inches x ¼ inches

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16
Q

swab smear

A

Ayre’s Spatula

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17
Q

-for endocervical/endometrial aspiration

A

Laryngeal Cannula attached to 10cc syringe

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18
Q

Antiseptic used

A

Zephiran

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19
Q

Papanicolau Smear and Stain
Developed by:

A

George Nicolas Papanicolau

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20
Q

Papanicolau Smear and Stain
Screening Test for:

A

Cervical Cancer

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21
Q

Screening Test for: Cervical Cancer

A

Papanicolau Smear and Stain

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22
Q

Papanicolau Smear and Stain
USES:

A

Determine certain infections (STD)

Determine ovarian function (Hormonal Cytology)

Asses infertility

Medico Legal Examination of Sexual Assault

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23
Q

Pap’s Stain:
nuclear stain (Primary Stain)

A

Harris Hematoxylin

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24
Q

Pap’s Stain ;
stains the cytoplasm of superficial cells (Counterstain)
-strong affinity for mature cells

A

Orange Green-6 (OG 6)

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25
Pap’s Stain: stains the cytoplasm of Parabasal cells and intermediate cells (Counterstain) -strong affinity for immature cells
Eosin Azure-50 (EA-50)
26
Pap's stain: strong affinity for mature cells
Orange Green-6 (OG 6)
27
Pap's stain: -strong affinity for immature cells
Eosin Azure-50 (EA-50)
28
Pap's stain:
Harris Hematoxylin Orange Green-6 (OG 6) Eosin Azure-50 (EA-50)
29
PAP Stain Result: Nucleus: = Vesicular nucleus: = pyknotic nucleus:
Vesicular nucleus: blue Pyknotic nucleus: dark blue to black
30
PAP Stain Result: Cytoplasm: OG-6: EA 36 to 50:
OG-6: Orange with a hint of green EA 36 to 50: Olive Green with a hint of brown and red
31
PAP Stain Result: Bacteria:
dark blue
32
PAP Stain Result: Mycelia:
violet
33
PAP Stain Result: Trichomonas vaginalis:
pale greenish blue blob of cytoplasm
34
PAP Stain Procedure
1. Fix with 95% ethanol 2. Hematoxylin 3. Differentiate with Acid Alcohol the wash with water 4. Ammonia water then wash 5. OG6 6. 95% ethanol (washing) (2 changes) 7. EA 50 or 36 8. Dehydration 9. Xylol 10. Mount 11. Label
35
Cells Found in Cervicovaginal Smears
Superficial Cells (30-60u) Intermediate Cells (20-30um)
36
most mature, polygonal cells with Dark pyknotic nuclei Cells that exhibits “TRUE ACIDOPHILIA” characteristics of vaginal cell under the influence of ESTROGEN
Superficial Cells (30-60u)
37
influence desquamation of Superficial cells
ESTROGEN
38
influence desquamation of intermediate cells
PROGESTERONE
39
most predominant during menopause
ESTRONE (E1)
40
most predominant during reproductive years
ESTRADIOL (E2)
41
plenty but least potent
ESTRIOL (E3)
42
Medium cells, polyhedral with basophilic & vacuolated cytoplasm
Intermediate Cells (20-30um)
43
Intermediate Cells (20-30um)
Navicular Cells Parabasal Cells Pregnancy Cells
44
found in the latter half of menstrual cycle, menopause and during pregnancy (presence suggest Progesterone-Estrogen Effect)
Navicular cells
45
with a tendency to fold or curl on edges
Boat shaped cells
46
-fried egg appearance/ sunny side-up -Round oval nucleus/cells Normally found in: abortion, after menopause, after childbirth, 2 week of Age of puberty
Parabasal Cells (15-25um)
47
Parabasal Cells (15-25um) Normally found in:
abortion, after menopause, after childbirth, 2 week of Age of puberty
48
Small, round slightly oval cells, with relatively large nucleus that occupying half or more of the cell volume
*Basal Cells (13-20um)
49
*Basal Cell's cytoplasm is
strongly basophilic
50
Basal cells are Found in vaginal smears only ______ and _____
before pregnancy and after menopause
51
Nucleus pushed at periphery with double walled boundary appearance
Pregnancy Cells
52
Round oval shaped cell appearing boat cells with translucent basophilic cytoplasm due to glycogen accumulation
Pregnancy Cells
53
-found during menstrual period (in groups)
Endometrial Cells
54
If seen in post- menopausal woman indicate a possible endometrial carcinoma or endometrial hyperplasia
Endometrial Cells
55
Endometrial Cells If seen in post- menopausal woman indicate a possible?
endometrial carcinoma or endometrial hyperplasia
56
Similar to parabasal cells but less basophilic
Endometrial Cells
57
Honey-comb appearance
Endocervical/Glandular Cells
58
Occurs in groups and strips of 3 or more cells
Endocervical/Glandular Cells
59
Slightly cylindrical appearance/ columnar epithelial cells
Endocervical/Glandular Cells
60
Normal vaginal flora
Doderlain Bacillus/Lactobacillus Acidophilus
61
Doderlain Bacillus/Lactobacillus Acidophilus increased in?
L- last trimester of pregnancy I- infection E- estrogen deficiency D- diabetic patients
62
** PAPS smear should be done after______of LMP
10 days
63
yeast cell that is commonly seen in patients with diabetes, taking contraceptive and with immunocompromise state
Candida Albicans
64
STD Pear-shaped organism Greenish blue appearance in PAPs SMEAR Eccentric dark nucleus
Trichomonas vaginalis
65
May appear as cells surrounded by bacilli “CLUE CELLS”
Gardnerella vaginalis
66
Cells that shows cytophatic effect of human papilloma virus Nucleus: appears like “wrinkled prune” that is surrounded by a perinuclear halo
Koilocytes
67
Mucus on drying exhibits a fern or palm leaf pattern
Ferning (Arborization)
68
Basis for the diagnosis of Early Pregnancy
Ferning (Arborization)
69
(+) Ferning: High Persistent ______ Effect in the absence of ______
Estrogen; progesterone
70
-assess the percentage of cells coming from the main layers of the epithelium
Maturation Index (M.I)
71
- Assess the percentage of cells appearance that stains pink-orange to red with Pap’s
Acidophilic/Eosinophilic Index (A.I)
72
-assess percentage of cells with shrunken, dark, small, structureless nucleus
Pyknotic Index (P.I)
73
Reporting Cancer Cytology: Class I
Absence of atypical cytologic picture
74
Reporting Cancer Cytology: CLASS II
Atypical cytologic picture present but no evidence of malignancy
75
Reporting Cancer Cytology: Class III
Cytologic picture suggestive but not conclusive to malignancy
76
Reporting Cancer Cytology: Class IV
Cytologic picture strongly suggestive of malignancy
77
Reporting Cancer Cytology: Class V
Cytologic picture conclusive of malignancy
78
Classification of PAP Test Results
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Finals (20 decks)

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