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MTAP 2 FINALS > HISTOPATHOLOGY FINALS > Flashcards

HISTOPATHOLOGY FINALS Flashcards

1
Q

Deals with microscopic study of cells desquamated from epithelial cells

A

Exfoliative cytology

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2
Q

Purpose of exfoliative cytology

A

Detect cancerous /malignant conditions

Detect asymptomatic cancer in women or pre-cancerous cervical lesions

Determination of genetic sex

Detection of possible infection

Evaluate female hormonal status in case of sterility

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3
Q

Specimens for Examination: Non-gynecological

A

Sputum

Smears of urine sediments

Prostatic and breast secretions

Pleural and peritoneal fluids

Gastric and bronchial secretions

CSF

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4
Q

Specimens for Examination: Gynecological

A

Endometrial and Endocervical smears

Cervico vaginal smear a.k.a PAP Smear

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5
Q

Smear to detect HPV, Trichomoniasis, Yeast infection

A

PAP smear (Cervicovaginal smear)

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6
Q

Preparation for NON-GYNECOLOGIC SPECIMENS

A

Smears
Cell blocks
Cytospin preparation

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7
Q

Motion for streaking smear

A

Zigzag

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8
Q

Smear applied at the center and use loop to spread

A

Spreading

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9
Q

Smear technique for thick secretion

A

Pull apart technique

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10
Q

Smear technique for fixation

A

Touch preparation/ Impression smear

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11
Q

Best method to collect cells from body fluids

A

Cell blocks

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12
Q

Cytospin preparation rpm and minutes

A

1000 rpm for 1 minute

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13
Q

Specimen to rule out pneumocystis jirovecci

A

BAL (Bronchoalveolar lavage)

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14
Q

Respiratory tract specimens

A

Bronchial washings

Bronchial brushings

Sputum

Brochoalveolar lavage

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15
Q

Manner of collection for sputum

A

Collected from a deep cough

At least 3 mornings (3 days)

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16
Q

Cells that indicate that the specimen is sputum

A

Alveolar macrophage

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17
Q

Fixative for sputum

A

Saccomano fluid

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18
Q

Fixative for bronchial brushing

A

spray fixative or 95% ethanol

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19
Q

Gastric secretions/aspirates should not be delayed beyond ____ minutes to prevent degradation

A

30 minutes

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20
Q

Requirement for gastric secretion/aspirate collection

A

Fasting for at least 8 hours

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21
Q

Smear preparation for breast secretion

A

pull apart technique

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22
Q

Discharge from nipple is usually benign and may be due to lesion like

A

duct ecstasia
papilloma

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23
Q

Peritoneal-Pleural-Pericardial fluid presence is always —

A

pathologic

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24
Q

Jelly clots in peritoneal-pleural-pericardial fluid is prevented by adding —-

A

300 units of heparin per 100mL of aspirate

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25
Q

Breast secretion fixative:

A

spray fix or 95% Isopropyl alcohol

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26
Q

Used to detect urothelial malignancies

A

Urinary tract sediments

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27
Q

Urinary tract specimens

A

Voided urine

Catheterized urine

Washing from bladder or renal pelvis

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28
Q

Preferred urine collection for urinary tract specimen

A

secondary collection

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29
Q

Urine specimen should be ____ if there is delay in examination

A

refrigerated

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30
Q

Urine specimen volume for best results

A

50 mL

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31
Q

Body cavity effusions- CSF and ascitic fluid should be submitted _____

A

fresh

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32
Q

Amount of CSF should be —-

A

at least 1 mL

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33
Q

Extra sediments are used for —–

A

cell block technique

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34
Q

Methods of Cell block preparation

A

Direct filtration

Plasma thrombin method

Carbowax method

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35
Q

Method of Cell block preparation:

Centri fluid, add 10% formalin to sediment, embed using paraffin

A

Direct filtration

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36
Q

Method of Cell block preparation:

(not usually carried out, expensive) - Centri fluid, add 1 ml of plasma and add thrombin

A

Plasma thrombin method

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37
Q

Disadvantage of direct filtration

A

easily washed out

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38
Q

Advantage of plasma thrombin method

A

reduce washing out

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39
Q

Advantage of carbowax method

A

no dehydration step but is expensive

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40
Q

Smears should be prepared from fresh material and must be prepared and FIX while moist within

A

10 - 15 minutes

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41
Q

Specimens that require adhesives

A

Concentrated Sputum

Urinary sediments

Bronchial labage

Specimens with trypsin

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42
Q

Adhesives for cytology

A

Celloidin ether alcohol

Leuconostoc culture - bacteria, gram positive cocci

APES – 3 aminopropyltriethoxysilane

Pooled serum or plasma

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43
Q

Most common tissue adhesive

A

Mayer’s egg albumin

44
Q

Egg albumin is not used in cell cytology due to —

A

intensely stained by counterstain in PAP’s

45
Q

Best Fixative for Cytology

A

95% ethanol with ether (not commonly used, flammable)

46
Q

Commonly used fixative for cytology

A

95 % ethanol

47
Q

Spray fixative distance from the slide

A

1 foot (12 inches or 30.5 cm)

48
Q

Saccomano Preservative components

A

Combination of 50% alcohol and 20% carbowax

49
Q

Fixation of fluid specimens:

percentage of alcohol is for all types of effusions

50
Q

Fixation of fluid specimens:

peritoneal and pleural fluid

51
Q

Fixation of fluid specimens:

percentage for sputum specimen

52
Q

Fixation of fluid specimens:

percentage for urine, gastric, and bronchial aspirates

53
Q

The gold standard stain for cytology

A

Papanicolau stain

54
Q

Components of PAP’s stain

A

Harris Hematoxylin
OG6
EA 50

55
Q

Component of PAP’s stain for nucleus

A

Harris hematoxylin

56
Q

PAP’s stain:

Counterstain for cytoplasm of superficial cells

57
Q

PAP’s stain:

Counterstain for both parabasal and intermediate cells

58
Q

Best for bloody stains; cytoplasm green

A

Carnoy’s fluid

59
Q

Color result:

Vesicular Nucleus

60
Q

Color result:

Pyknotic nucleus

A

dark blue to black cytoplasm

61
Q

Color result:

OG 6

A

orange with a hint of green

62
Q

Color result:

EA36-50

A

olive green with a hint of brown and red

63
Q

Color result:

Bacteria

64
Q

Color result:

Mycelia

65
Q

Color result:

T. vaginalis

A

pale greenish blue

66
Q

Purpose of PAP smear

A

Screening test for cervical cancer

For hormonal evaluation - steroid hormones, vaginal cells

67
Q

PAP’s smear method:

causes crowded cells, specimen is directly placed on the slide

A

Conventional PAP’s

68
Q

Used to collect PAP smear

A

ayres spatula

69
Q

Pap smear method:

Use of spatula or brush/broom to collect specimen. Placed in a vial containing preservative. A thin layer of cells is placed on a slide

A

Liquid based PAP’s

70
Q

Sites of collection PAP:

For evaluating inflammatory conditions

A

Upper third of the vaginal wall

71
Q

Sites of collection PAP:

Detection of lesions or intrauterine lesions

A

Endocervix

72
Q

Sites of collection PAP:

most common site for cancer screening

A

Ectocervix

73
Q

Ectocervix is lined up with

A

stratified squamous non keratinized

74
Q

Endocervix is lined up with

A

simple columnar epithelium

75
Q

Location for PAP smear preparation; junction between endo and ectocervix

A

Transformation zone (T zone)

76
Q

Hormone that influence desquamation of superficial cells

77
Q

Estrogen most predominant in menopausal

A

E1 - Estrone

78
Q

Estrogen predominant in reproductive years

A

E2 - Estradiol

79
Q

Estrogen most plentiful, least potent

A

E3 - Estriol

80
Q

Hormone that influence desquamation of intermediate cells

A

Progesterone

81
Q

Smears for hormonal cytology should be taken from the

for PAP smear

A

upper lateral third of vaginal wall

82
Q

Cells in PAP’s:

Largest and most mature with pyknotic nuclei (smallest)

30-60u

Polyhedral flat cells and cytoplasm may be acidophilic or basophilic

Pink cytoplasm

A

Superficial cells

83
Q

Cells in PAP’s:

Medium sized cells 20-30 u

Polyhedral cells with basophilic cytoplasm with vacuoles

A

Intermediate cells

84
Q

Intermediate cell, boat shaped cells with a tendency to fold or curl on edges.

A

Navicular cells

85
Q

Cells in PAP’s:

Found in the latter half of menstrual cycle, during pregnancy or menopause

May suggest progesterone-estrogen effect

May be found as a result of abnormal androgen stimulation

A

Intermediate cells

86
Q

Cells in PAP’s:

Round to oval (15-30 u)

With strongly basophilic cytoplasm

Found from 2 wks of age to puberty, after childbirth, abortion and after menopause

A

Parabasal cells

87
Q

Cells in PAP’s:

Smallest and not normally shed

13-20 u

Round to slightly oval cells with large nucleus occupying half or more of the cell volume, with strongly basophilic cytoplasm

Found only before pregnancy and ff> menopause

A

Basal cells

88
Q

Cells in PAP’s:

Found during and 1-4 days after menstruation

Occurring in groups of 3 or more shed in response to ovarian hormone

If seen in post menopausal women it may indicate possible endometrial carcinoma or endometrial hyperplasia

A

Endometrial cells

89
Q

Cells normally shed in vagina:

A

Superficial cells

Intermediate cells

Basal cells

90
Q

Occurring in large groups or sheets

Forms the characteristic honey comb appearance

A

ENDOCERVICAL GLANDULAR CELL CARCINOMA

91
Q

Abnormal Cellular Components in PAP’s:

seen in diabetic patients, in those taking oral contraceptives, patients under prolonged steroid therapy and among immunocompromised patients

A

Candida albicans (yeast)

92
Q

Abnormal Cellular Components in PAP’s:

Pear shaped parasite

A

T. Vaginalis (trophozoite)

93
Q

Abnormal Cellular Components in PAP’s:

Indicative of bacterial vaginosis

A

Clue cells (squamous cells with attached bacilli)

94
Q

Abnormal Cellular Components in PAP’s:

Abnormal squamous with atypical nucleus surrounded by non-staining halo, indicative of HPV infection

A

Koilocytes

95
Q

Abnormal Cellular Components in PAP’s:

Doderlain bacillus is increasedly seen in

A

Last trimester of prengancy

Infection

Estrogen deficiency

Diabetes Mellitus

96
Q

Involves evaluation of hormonal status based on the distribution of cells

A

Cytohormonal Maturation Index (CHMI)

97
Q

CHMI: Parabasal, Intermediate and Superficial cells result

0 / 90 / 10

98
Q

CHMI: Parabasal, Intermediate and Superficial cells result:

0 /80 / 20

99
Q

CHMI: Parabasal, Intermediate and Superficial cells result:

0 / 70 / 30

A

Post ovulatory

100
Q

Old method, obsolete manner of reporting PAP’s

A

Class system

101
Q

Class system result:

Class I

A

Negative malignancy

102
Q

Class system result:

Class V

A

Conclusive of malignancy

103
Q

New system of reporting cervical, vaginal cytologic smears

A

Bethesda system

104
Q

Bethesda system is developed at

A

National Cancer Institute December 1988

105
Q

Report format for specimen adequacy:

A

satisfactory

limited

unsatisfactory

106
Q

Detect cause of death

107
Q

method to detect cancerous condition

MTAP 2 FINALS (4 decks)

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