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RMT 2023 active recall > histopathology > Flashcards

histopathology Flashcards

1
Q

Rubor

A

Redness

Blood flow  Injury

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2
Q

Calor

A

Heat
Blood > heat

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3
Q

Tumor

A

Swelling
Capillary > Sensory nerves

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4
Q

Dolor

A

Pain
Pressure > Sensory nerves

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5
Q

Functio laesa

A

Loss of function

Destruction of functional units

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6
Q

Acute inflammation

A

Vascular & exudative

PMNs—(Tissue)—> Microphages

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7
Q

Subchronic inflammation

A

Intergrade between acute & chronic

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8
Q

Chronic inflammation

A

Vascular & fibroblastic

Monocytes—(Tissue)—> Macrophages

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9
Q

Serous inflammation

A

Serum/secretions from serosal mesothelial cells (3P9s)

Pulmonary TB

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10
Q

Fibrinous inflammation

A

Fibrinogen
Diphtheria, rheumatoid pericarditis
Early stage of pneumonia

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11
Q

Catarrhal inflammation

A

Hypersecretion of mucosa

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12
Q

Hemorrhagic inflammation

A

Blood + exudates

Bacterial infections & other infections

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13
Q

Suppurative/purulent
inflammation

A

Pus: creamy fluid component of PMNs and necrotic tissue debris

Abcess : pus
Pustule: pus

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14
Q

Aplasia

A

Incomplete/defective development of a tissue/organ

Ex. amastia (breast aplasia)

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15
Q

Atresia

A

Failure to form an opening

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16
Q

Hypoplasia

A

Failure of an organ to reach its matured size

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17
Q

Agenesia

A

Complete non-appearance of an organ

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18
Q

Physiologic atrophy

A

Natural

Thymus, brain, sex organs

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19
Q

Pathologic atrophy

A

Vascular atrophy
Pressure atrophy
Atrophy of disuse
Exhaustion atrophy
Endocrine atrophy

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20
Q

Brown atrophy

A

Lipofuscin

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21
Q

Hypertrophy

A

Increased tissue size due to increased cell size

Physiologic: ·size of uterus
Pathologic: Systemic hypertension

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22
Q

Hyperplasia

A

Increased tissue size due to increased cell number

Physiologic: Glandular proliferation of the female breast, ·size of uterus (preg.)
Pathologic: Skin warts due to HPV

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23
Q

Compensatory hyperplasia

A

Ex. Enlargement of one kidney

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24
Q

Pathologic hyperplasia

A

Ex. Endometrial hyperplasia

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25
Q

Congenital hypertrophy

A

Phenytoin-induced

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26
Q

Metaplasia

A

Reversible

One adult cell type ́ Another adult cell type

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27
Q

Dysplasia

A

Reversible

One type of adult cell ́ Changes in structural components

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28
Q

Anaplasia/
Dedifferentiation

A

Irreversible
Criterion toward malignancy
Adult cell  More primitive cells (release tumor markers)

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29
Q

Neoplasia/tumor

A

Continuous abnormal proliferation of cells w/o control (no purpose/function)

Ex. Leukemia

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30
Q

Oncology

A

Study of neoplasm

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31
Q

Parts of a tumor

A
  1. Parenchyma = active elements (tumor cells)
  2. Stroma = CT framework
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32
Q

Types of tumor

A
  1. Capacity to produce death:
    - Benign (Ex. mole)
    - Malignant
  2. Histologic characteristics:
    - Medullary = cells (parenchyma) > supporting tissues (stroma)
    - Scirrhous = supporting tissues (stroma) > cells (parenchyma)
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33
Q

Benign

A

“-oma”

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34
Q

Malignant

A

“SaMe CarE”

<-sarcoma= = mesenchymal/CT
<-carcinoma= = epithelial tissues

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35
Q

Leukemia
Lymphoma

A

Malignant

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36
Q

Squamous cell papilloma

A

Benign

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37
Q

Squamous cell carcinoma

A

Malignant

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38
Q

Hepatoma/
hepatocarcinoma

A

Malignant

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39
Q

Melanoma/
melanocarcinoma

A

Malignant

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40
Q

Ectopic pregnancy

A

Fallopian tube pregnancy

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41
Q

Grading

A

Aggressiveness/level of malignancy
Differentiated cells = resemble normal cells
Undifferentiated cells = younger cells

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42
Q

Staging

A

Size, extent of spread to lymph nodes, +/- metastases

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43
Q

UICC

A

TNM classification

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44
Q

AJCS

A

Grading + staging

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45
Q

TNM system

A

Applicable to all forms of neoplasia

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46
Q

T

A

1’ tumor
#: denotes the size of tumor and its local extent
Tis = carcinoma in situ
Ta = non-invasive
Tx = cannot be evaluated
T0 = free of tumor
T1 = lesion <2 cm (T1a = <0.5 cm | T1b = <1 cm | T1c = <2 cm)
T2 = lesion 2-5 cm (invasion in muscle)
T3 = skin and/or chest wall involved by invasion (T3a = deep muscle | T3b =
through organ)
T4 = tumor invasion/fixation (T4a = adjacent organ | T4b = fixation to bladder or
colonic wall, in breast, edema)

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47
Q

N

A

Regional lymph node involvement

High # denotes increasing extent of involvement
Nx = not evaluable
N0 = no axillary nodes involved
N1 = 1 mobile regional (axillary) node involved
N2 = multiple, mobile regional nodes involved
N3 = fixed regional lymph node involved
N4 = beyond regional lymph node involvement

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48
Q

M

A

Metastasis

M0 = no evidence of metastases
M1 = distant metastases are present
Mx = distant metastases not evaluable

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49
Q

Teratomas

A

Compound tumors
Greek: Monstrous tumors
May contain hair, teeth, bones
w/ heartbeat

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50
Q

Apoptosis

A

Programmed cell death (cellular suicide)

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51
Q

Necrobiosis

A

Physiologic cell death

Ex. normal sloughing off of skin cells

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52
Q

Necrosis

A

Pathologic cell death

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53
Q

Coagulation necrosis

A

Most common
Tombstone formation
<MyLKS=
Myocardium
Lungs
Kidneys
Spleen

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54
Q

Liquefaction/colliquative
necrosis

A

Pus formation
Brain & spinal cord

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55
Q

Caseous/caseation necrosis

A

Yellow, cheesy, crumbly material

TB, syphilis, tularemia, lymphogranuloma inguinale

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56
Q

Gangrenous necrosis

A

Sulfide gas production

a. Dry gangrene = arterial occlusion
b. Wet gangrene = venous occlusion

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57
Q

Fat necrosis

A

Chalky white precipitates
Pancreatic degeneration

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58
Q

Fatty degeneration

A

Liver

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59
Q

1’ changes

A

During somatic death

“CRC” : circulatory, respiratory, CNS failure

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60
Q

2’ changes

A

After somatic death

“ARLP DPA”: Algor mortis, Rigor mortis, Livor mortis, Postmortem clotting,
Dessication, Putrefaction, Autolysis

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61
Q

Algor mortis (1st)

A

Postmortem cooling

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62
Q

Rigor mortis (2nd)

A

Stiffening

1st: neck & head (2-3 hrs)
Persists for 3-4 days

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63
Q

Livor mortis

A

Lividity/suggillations
Purplish discoloration
After 10-12 hrs, it does not blanch on pressure or shift when the body is moved

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64
Q

Disappears on pressure (reappears when pressure is
released)

A

Opposite of postmortem lividity

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65
Q

Oozing of blood (incision)

A

No oozing of blood (incision)

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66
Q

Postmortem Clot

A

Settling of RBCs from plasma
Chicken fat
Currant jelly
Assumes the shape of the vessel
Rubbery consistency
Dessication
Putrefaction
Autolysis

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67
Q

Antemortem Clot

A

Not readily detachable from the blood vessels
No chicken fat
No currant jelly
Seldom assumes the shape of blood vessels
Granular & friable
Drying & wrinkling of the anterior chamber of the eye
Invasion of intestinal microorganisms
Self digestion of cells
Lysosome: suicide sac of the cell, releases lysozyme

68
Q

Exfoliative cytology

A

Desquamated cells

69
Q

Pap smear stain method

A

Method of choice

70
Q

Barr body

A

Females

71
Q

3 anatomical sites

A
  1. Upper lateral third of the vagina
  2. Ectocervix
    (Stratified Squamous Epithelium)
    ——-T zone: detect cervical cancer——-
    (Simple Squamous Epithelium)
  3. Endocervix
72
Q

Fixation

A

♫ 50% alcohol = All types
50% alcohol = pleural & peritoneal
70% alcohol = sputum
95% alcohol = urine, bronchial & gastric
♫ Saccomanno9s fixative = 50% ETOH + 2% carbowax

73
Q

Smear preparation

A

Fix immediately
2-3 slides/patient
a. streaking
b. spreading
c. touch preparation/impression
d. pull-apart
Never touch the bottom of the fixative container

74
Q

Fixing smear

A

Equal parts of ethanol & ether = BEST (but highly flammable)

95% ethanol = commonly used
Spray fixatives = 1 ft away

75
Q

Sputum

A

Saccomanno9s fixative
3 specimen
(+) alveolar macrophage = sputum
(-) alveolar macrophage = saliva

76
Q

BAL

A

P. carinii/P. jiroveci

77
Q

Jelly-like clots

A

Prevent by adding 300U heparin/100mL aspirate

78
Q

GI specimen

A

If >1⁄2 hr delay of fixation  digestion of cells
Fasting: 8 hrs

79
Q

Urine

A

50mL = cytology
10-15mL = UA
2nd urine = preferred

80
Q

Pap smear

A

Dr. George Papanicolau (1940)
Smears: prepared by rotary motion
1. Mailing of specimens
- air drying after 2 hrs fixation
- glycerin technique
2. Egg albumin = not recommended as adhesive agent (intensifies stain by Light
Green)

81
Q

Adhesive agents

A

Pooled human serum/plasma
Celloidin ether alcohol
Leuconostoc culture

82
Q

3 primary materials used
for obtaining specimen for
Pap smear

A
  1. Speculum
  2. Ayer9s spatula = rotate 3600
  3. Cytobrush = Os
83
Q

Strawberry cervix

A

T. vaginalis

84
Q

Shift to the left

A

Parabasal cells

85
Q

Shift to the right

A

Superficial cells

86
Q

Shift to the midzone

A

Intermediate cells

87
Q

Superficial cells

A

45-50μm
Pyknotic nucleus
True acidophilia
Estrogen

88
Q

Intermediate cells

A

Folds/curls on edges
Progesterone
a. Navicular cells = boat-shaped
b.Pregnancy cell = nucleus pushed aside (glycogen)

89
Q

Parabasal cells

A

15-30μm
Fried eggs w/ sunny side up
Menopausal women

90
Q

Endometrial cells

A

Groups of 3 or more
1-10 days after menstruation ( RBCs, WBCs)

91
Q

Endocervical glandular cells

A

Honeycomb appearance

Similar appearance to parabasal cells

92
Q

Doderlein bacillus

A

L. acidophilus

Pap9s stain: blue to lavender

93
Q

C. albicans

A

Diabetic patients
Sish kebab appearance

94
Q

T. vaginalis

A

Pear-shaped, blue-gray to blue-green
Pigs on a scruff appearance

95
Q

Leptothrix

A

Indicates T. vaginalis infection

96
Q

G. vaginalis

A

Clue cells

97
Q

Koilocytes

A

Wrinkled prune appearance
w/ perinuclear halo
HPV (LSIL)

98
Q

Ferning

A

Formation of salt crystals
Estrogen
Early pregnancy

99
Q

3 copies/report

A
  1. Doctor
  2. Patient = original copy
  3. File
100
Q

Reports

A

Surgical pathology report
Cytopathology report
Autopsy report

101
Q

Signatories

A

Request forms = patient9s doctor
Result forms = pathologist

102
Q

Turnover of results

A

Surgical pathology & cytology = 24 hrs
Frozen section = 5-15 mins
Autopsy report = 1 week (Autopsy procedure: 24 hrs)

103
Q

Storage

A

Specimen (tissue) = 1 month to 1 year
Tissue blocks (paraffin) = 3 to 10 years
Slides = indefinite

104
Q

Requisitions

A

2 years

105
Q

QC

A

2 years

106
Q

Instrument maintenance

A

2 years

107
Q

BB QC

A

5 years

108
Q

BB employee signatures

A

10 years

109
Q

BB donor/recipient records

A

Indefinitely

110
Q

Clinical pathology lab
reports

A

2 years

111
Q

Surgical pathology (and
BM) reports

A

10 years

112
Q

Cytogenetics reports

A

20 years

113
Q

Autopsy forensic reports

A

Indefinitely

114
Q

Technique of Virchow

A

Organs removed & dissected individually in the body
Most widely used metohd

115
Q

Technique of Rokitansky

A

In-situ dissection in part combined w/ en bloc technique
♫ En bloc:
- By cavity
- Interrelated to each other
- Systemic dissection
- Ex. thoracic cavity (lungs, heart, diaphragm), respiratory system

116
Q

Technique of Ghon

A

En bloc technique

117
Q

Technique of Letulle

A

En masse technique
♫ En masse:
- All organs of thoracic, abdominal, & pelvic are removed at the same time
- Sweeping of all organs

118
Q

Autopsy: Larynx > Rectum

A

Very popular, easy to do, convenient
Part of consent: organs should be retained completely or partially
Organs > set aside later
Body > undertaker of the body

119
Q

Teasing/Dissociation

A

Tissue specimen > Watchglass (isotonic solution) > BF/PC microscope

120
Q

Crushing/squash
preparation

A

Tissue (<1mm) > Sandwich bet. 2 slides/coverslip > Vital stain

121
Q

Smear preparation

A

Spread lightly over a slide (wireloop/applicator)

122
Q

Frozen section

A

(-) Fixative

123
Q

Freezing of unfixed tissue

A

Best frozen section

124
Q

Freezing of fixed tissue

A

To localize hydrolytic enzymes & other antigens

125
Q

Formal (formol) calcium

A

Derivative of formaldehyde
Fix at 49C for 18 hrs

126
Q

Commonly used methods of
freezing

A

Liquid nitrogen = most rapid
Isopentane cooled by liquid nitrogen
CO2 gas
Aerosol sprays

127
Q

Staining methods
(frozen sections)

A

<PATH=
Polychrome methylene blue
Alcoholic pinacyanol
Thionine
H & E = progressive, no decolorizer

128
Q

H & E

A

a. Progressive
- w/o decolorizer
- for frozen sections
b. Regressive
- w/ decolorizer (acid-alcohol)
- for routine histology staining

129
Q

Freeze-drying

A

w/o use of any chemical fixative
♫ Quenching: rapid freezing (-1609C)
♫ Sublimation: removal of H2O in the form of ice (-409C) 3 vacuum

130
Q

Freeze-substitution

A

Similar to freeze drying but:
Frozen tissue  Rossman9s formula/1% acetone
Dehydrated in absolute alcohol

131
Q

Cold knife procedure

A

Any microtome
Uses CO2
Knife: -40 to -609C
Tissue: 5 to -109C
Environment: 0 to -109C

132
Q

Cryostat procedure
(Cold microtome)

A

Temperature: -18 to -209C
Cryostat: refrigerated cabinet w/ rotary microtome

133
Q

O.C.T. (Optimal Cutting
Temperature)

A

Best mounting media for cryostat sections

134
Q

Steps of tissue processing

A

“FDCIETS SMoL”
1. Fixation
(Decalcification)
2. Dehydration
3. Clearing/Dealcoholization
4. Impregnation/Infiltration
5. Embedding/Casting/Blocking
6. Trimming
7. Sectioning/Microtomy
8. Staining
9. Mounting
10. Labeling (slides)

135
Q

Fixation of tissue

A

1st and most critical step
19 aim: preserve cell (life-like)
29 aim: harden & protect tissues
Most important: stabilization of proteins

136
Q

pH of tissue

A

6.0-8.0

137
Q

Microanatomical fixatives

A

General microscopic study of tissues
a. 10% Formol saline
b. 10% NBF
c. Heidenhain9s SuSa
d. Formol sublimate (formol corrosive)
e. Zenker9s solution
f. Zenker-formol (Helly9s)
g. Bouin9s solution
h. Brasil9s solution

138
Q

Cytological Fixatives

A

Specific parts of the cell
a. Nuclear fixatives: w/ glacial acetic acid 3 destroys mitochondria & golgi
bodies (pH f4.6)
b. Cytoplasmic fixatives: w/o glacial acetic acid
c. Histochemical fixatives: preserves chemical constituents

139
Q

Nuclear fixatives

A

<BFNCH=
Bouin9s
Flemming9s w/ acetic acid
Newcomer9s
Carnoy9s
Heidenhain9s SuSa

140
Q

Cytoplasmic fixatives

A

<HORFF=
Helly9s
Orth9s
Regaud9s
Flemming9s w/o acetic acid
Formalin w/ post chroming

141
Q

Histochemical fixatives

A

<FANA=
10% Formol saline
Absolute alcohol
Newcomer9s fluid
Acetone

142
Q

Paraformaldehyde

A
  • White crystalline precipitates
  • Due to prolonged standing
  • Removed by: 10% METOH/filtration
143
Q

Acid formaldehyde hematin

A
  • Brown/black granular deposits that may obscure microscopic details
144
Q

10% Formol saline

A

CNS

145
Q

10% NBF

A

Best general tissue fixative
Best fixative for tissue containing iron granules
w/ double phosphate buffer
1 mm/hr = rate of tissue penetration

146
Q

Formol-Corrosive
(formol sublimate)

A

w/ HgCl2

147
Q

Glutaraldehyde

A

EM

148
Q

Karnovsky’s
paraformaldehyde-
glutaraldehyde

A

EM: electron histochemistry & electron immunocytochemistry

149
Q

Acrolein

A

Mixture w/ formaldehyde

150
Q

Fixative that has composition of Mercuric Chloride

A

Tissue photography
For Trichrome stain (excellent)
Produce black granular deposits except SuSa
<BOSCHZZ=
a. B5 = for BM biopsies
b. Ohlmacher9s
c. Schaudinn9s
d. Carnoy-Lebrun
e. Heidenhain9s SuSa = (-) black pigments
f. Zenker9s = recommended for trichrome staining
g. Zenker-formol (Helly9s) = pituitary gland, BM, & blood containing organs

151
Q

De-zenkerization

A

Removal of mercuric deposits
H2O > I2 > H2O > Sodium thiosulfate > H2O

152
Q

Chromate fixatives

A

<ROCK=
a. Regaud9s (Moller9s) = chromatin, mitochondria, mitotic figures&
b. Orth9s = for Rickettsia, tissue necrosis
c. Chromic acid = preserves CHO
d. K2CrO4 = mitochondria (if acidified, fixes chromatin bodies & chromosomes
but destroys mitochondria)

153
Q

Chromate pigments

A

Fine, yellow

154
Q

Picric acid fixatives

A

Highly explosive when dry
Excessive yellow staining of tissues
Picrates  Protein  Ppt. (H2O soluble)  Add 70% ETOH  Insoluble
Never wash in H2O before dehydration
For glycogen (excellent)
a. Bouin9s = for embryos, Masson9s trichrome stain, glycogen
b. Brasil’s alcoholic picroformol = less messy than Bouin’s, glycogen (excellent)

155
Q

Glacial acetic acid

A

Solidifies at 179C
Fixes & precipitates nucleoproteins, chromosomes, & chromatin material
Most commonly combined w/ other fixatives

156
Q

Alcoholic fixatives

A

Disadvantage: polarization (glycogen granules > poles/ends of the cells)
<MEICAN=
a. Methanol = BM & blood smears
b. Ethanol = preserves but does not fix glycogen (Disadv: polarization)
c. Isopropanol = for touch preparations
d. Carnoy’s = most rapid (1-3 hrs) | for chromosomes | Dx: rabies (acetone)
e. Alcoholic formalin (Gendre’s) = sputum
f. Newcomer’s = for MPS | nuclear & histochemical fixative

157
Q

Osmium tetroxide
(Osmic acid)

A

Inhibits hematoxylin
Produce black precipitate crystals (osmium oxide)
For lipids
a. Flemming9s = permanently fixes fat, for nuclear structures (excellent)
- Fixative & decalcifying agent (chromic acid)
b. Flemming9s w/o acetic acid = for mitochondria

158
Q

Trichloroacetic acid

A

Precipitates proteins

Swelling effect  counteract shrinkage by other fixatives
Weak decalcifying agent (softening effect)

159
Q

Acetone

A

Recommended for H2O-diffusible enzymes (phosphatases, lipases)
Rabies

160
Q

Heat fixation

A

Bacteriologic smears
Microwave: 45-559C
Underheating: poor sectioning
Overheating (>659C): vacuolation, overstained cytoplasm

161
Q

2’ fixation

A

Placing an already fixed tissue in a 2nd fixative

162
Q

Post-chromatization

A

Primarily fixed tissue  2.5-3% K2CrO4 (mordant)

163
Q

Washing out

A

Removing excess fixative

a. Tap H2O = remove excess chromates, formalin, osmic acid (NOT Bouin9s)
b. 50-70% alcohol = wash out excess picric acid (Bouin9s)
c. Alcoholic I2 = remove excess mercuric fixatives

164
Q

EM fixatives

A

Glutaraldehyde
PtCl3
PtCl3 3 formalin (Zamboni9s)
AuCl
Osmium tetroxide
10% NBF = acceptable but not recommended

165
Q

Stains (EM)

A
  1. PTA = 1st general stain
  2. Uranyl acetate = Best
  3. Lead

RMT 2023 active recall (4 decks)

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