HTMLE - PAHABOL NOTES Flashcards by Patricia Baltazar

What happens to blueing agent after staining?
a. becomes colorless
b. becomes dark in color”

b. becomes dark in color

Blueing agent forms an insoluble blue aluminum hematin-tissue-lake.

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What should be done to prevent formation of paraformaldehyde upon prolonged storage?
a. place in a well-ventilated area
b. lower temperature
c. amber glass container

a. place in a well-ventilated area

**Gregorios: to prevent formation of formaldehyde, add 10% methanol or avoid storage in cold temperature.
**From other ref: Storing formalin in a cool, well-ventilated area helps prevent the formation of paraformaldehyde, as this process is more likely to occur at lower temperatures and high formaldehyde concentration.

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Way of agitation used by automatic tissue processor:

vertical oscillation

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Which is not a cause of physical hyperplasia?
a. Gaining muscle from exercise
b. Proliferation of cells from endometrium due to hormones
c. Increase in thickness of endometrium during menstrual cycle
d. Enlargement of breasts when breastfeeding”

a. Gaining muscle from exercise

Gaining of muscle from exercise- HYPERTROPHY

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“venetian blinds”
A. Hard tissue
B. Because of nicks
C. Hard yung contaminants

C. Hard yung contaminants”

**Gregorios: Horizontal or parallel lines or furrows across the sections (chatters) are seen when the knife edge vibrates due to hardness of tissue or tilt of knife is too great.
**“Venetian blinds” artifact, also known as “chatter,” appears as parallel strips of tissue separated by clear spaces, resembling venetian blinds, and is caused by vibration or a poorly assembled microtome.
-Vibration-induced disintegration of fragile cellular aggregates that lack dermal stromal support.
-Hard tissue or wax.
-Steep angle of the cutting knife.
-Presence of calcification in tissues.

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*Feulgen stain is for

identify chromosomal material or DNA in cell specimens

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*Purpose of agitation in histopath
A. For mixing
B. uniform mixing of reagents

B. uniform mixing of reagents

Best answer: increases the flow of fresh fluids in and around the tissues, to also prevent tissues from settling at the
bottom

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SIGNS..COVID-19… EXCEPT
a. Loss of taste
b. Productive cough
c. + test
Loss of taste since it is a symptom

a. Loss of taste
Loss of taste since it is a symptom

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Inflammation except:
a. Pain
b. Increase temp
c. Increase body fats
d. Congestion

c. Increase body fats

Cardinal signs of inflammation: Rubor (redness), calor (heat), tumor (swelling), dolor (pain), functio laesa (loss of function). Congestion results from swelling.

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_____ is seen in carousel-type tissue processors.

Vertical oscillation

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Facilitates penetration of reagents in tissue in automated tissue processor
A. Increase reagent volume
B. Increase immersion time
C. Gentle agitation
D. Gradual clearing

C. Gentle agitation

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Infiltrates tissue then solidifies for easy cutting
A. Beeswax
B. Paraffin wax
C. Ice”

B. Paraffin wax

**Impregnation- Embedding medium fills all tissue cavities and give a form consistency to the specimen, which gives the tissue internal support during cutting
**Embedding- impregnated tissue is placed into a precisely arranged position in a moldcontaining a medium, then allowed to solidify.

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Who appoints the BOE
A. PRC
B. President
C. DOLE
D. CHED

B. President

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Counter top used in Laboratory

In clinical laboratories, epoxy resin, phenolic resin, and stainless steel countertops are commonly used due to their durability, chemical resistance, and ease of cleaning.

Ceramic-2nd choice

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Used to remove excess fixative
* ___used to remove excess chromate, formalin, osmic acid
* ___used to remove excess mercuric fixatives

Tap water

Alcoholic iodine

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Purpose of the vertical oscillation of the baskets in automated tissue processor

facilitate penetration of reagents into tissue

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What is the purpose of mayer’s egg albumin?

Answer: adhesive

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What will you add to preserve the specimen during transport?
a. Formalin
b. NSS
c. Distilled water

a. Formalin

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All of the following describe autopsy except:
a. It is a surgical procedure
b. It is used for diagnosis and treatment

b. It is used for diagnosis and treatment

No, an autopsy is not performed for treatment; it’s a post-mortem examination to determine the cause and manner of death, and it’s not a procedure that can be used to treat a living person

**Autopsy - known as a post-mortem examination, necropsy (particularly as to non-human bodies), autopsia cadaverum, or obduction

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Which of the following is not a violation of the law?

Answer: a registered medical technologists who is a senior citizen working in the laboratory

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Requirements for filing in boards except:
a. NBI
b. TOR
c. PSA

a. NBI

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All of the following are allowed to take the MTLE except:
a. BSMT
b. BS in Microbiology
c. BS in Public Health
d. BSMLS

b. BS in Microbiology

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Consent is under?
a. Autonomy
b. Beneficence
c. Non-maleficence
d. Justice

a. Autonomy

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In Philippine HIV and AIDS policy, it promotes the following except;

Answer: it promotes mandatory testing of HIV for all individual

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Tissue basket in automatic machine moves up and down, why:

To keep the temp steady, to prevent solidifying of rgt, to ensure proper mixing of rgt" **Best answer: increases the flow of fresh fluids in and around the tissues, to also prevent tissues from settling at the bottom

**common blueing agent in paps

*Ammonia Water

In the Papanicolaou stain, common bluing agents include

-Scott's tap water substitute (STWS) -dilute aqueous solutions of ammonium hydroxide -lithium carbonate.

Alternative fixative:

Spray fixative and hairspray **Also honey, sugar, jaggery, alcohol-based fixatives, and proprietary solutions

All are important equipment in histopath/cytology, except: a. Shaker b. hot plate c. centrifuge"

a. Shaker

Used to determine sufficient amount of FNA sample: a. rapid on-site evaluation (ROSE) b. cytocentrifuge c. cell block

a. rapid on-site evaluation (ROSE)

Who has the authority in PRC A. SENATE OF THE PRESIDENT B. PRESIDENT OF THE PHILIPPINES C. PAMET

B. PRESIDENT OF THE PHILIPPINES Best answer: Chairperson

Latest PRC chairperson:

Charito Zamora

Tissues not transplanted a. Tendons b. Heart valve c. Cord blood d. Nerve

all can be transplanted; accdg to the pathologist, among all, heart valves are not usually transplanted coz porcine source is most commonly used.

In routine H&E staining, ___ is the most commonly used clearing agent, used to remove water and alcohol from tissue sections, allowing for the infiltration of paraffin wax.

xylene

Not a connective tissue: ground substance lymph elastic fiber

All are connective tissues

Stain used to determine the adequacy of fluid aspirate:

Diff-quik stain **For routine diagnosis, the use of Hematoxylin and Eosin (H&E) is by far preferred for viewing cellular and tissue structure detail by pathologists.

How to unstain in H & E staining? To unstain or differentiate H&E stained slides, you can use a weak _____ to remove excess hematoxylin, followed by bluing in a solution like Scott's tap water substitute.

acid alcohol solution (like 0.3% acid alcohol)

Mary is HIV (+) with a HIV (-) partner. What advice can you give to Mary and her partner.

To prevent HIV transmission in a serodiscordant relationship (HIV+ female, HIV-negative male), consistent condom use during all sexual activities, and for the HIV-negative partner, taking pre-exposure prophylaxis (PrEP) medication are crucial.

Cause of immediate separation of tissues to wax once placed in floatation water bath insuff/incomplete paraffinization (?) insuff fixation insufficient dehydration

insufficient dehydration

**color of spirochetes when stained with warthin starry:

Black *Warthin - Starry stain: Spirochetes: Black. *Helicobacter pylori: Black. *Klebsiella: Brown - Black.

**Marker for progressive breast cancer KRAS EGFR Her2neu NOTA

Her2neu **-Breast cancer cells with higher than normal levels of HER2 are called HER2-positive. These cancers tend to grow and spread faster than breast cancers that are HER2-negative, but are much more likely to respond to treatment with drugs that target the HER2 protein.

*one biomarker that physicians look for in non-small cell lung cancer *non-small cell lung cancer.

*KRAS gene *-EGFR-

**The path of the sample from test requisition through result interpretation and reporting:

workflow

**External auditing:

Proficiency Testing and Accreditation.

**Hydrogen peroxide and Potassium periodate are examples of:

ripening agents

**Where should Acknowledgement be placed in a research paper? A. Before title page B. After title page C. Table of contents D. End of the paper

B. After title page

**In the absence of 95% ETOH in cytology, what could be used as a substitute? Corn syrup Hair spray honey Distilled water

Hair spray

** A microwave oven is an essential piece of equipment in the histology laboratory. Microwave ovens are commonly used in the histopathology laboratory to help expedite special staining procedures and improve diagnostic turnaround times. **Microwaves are a form of non-ionizing radiation produced by the magnetron in domestic and scientific microwave ovens. At a____, they have the capacity to generate instantaneous heat when dipolar molecules such as water or polar side chains of proteins are exposed to their alternating magnetic fields at 2.5 billion cycles per second.

frequency of 2.5 GHz

**The foundation for the subsequent stages in the Preparation of tissue sections, up to the making of Diagnosis is ______. A. Fixation B. Impregnation C. Embedding D. Clearing

A. Fixation

**Abnormal Cell growth that is IRREVERSIBLE A. Hyperplasia B. Dysplasia C. Neoplasia D. Metaplasia

C. Neoplasia **Neoplasia is a process of “new growth” in which normal cells undergo irreversible genetic changes, which render them unresponsive to ordinary controls on growth exerted from within the “transformed” cell or by surrounding “normal” cells.

A term used to describe the presence of abnormal cells within a tissue or organ. ___ is not cancer, but it may sometimes become cancer. Dysplasia can be mild, moderate, or severe, depending on how abnormal the cells look under a microscope and how much of the tissue or organ is affected.

Dysplasia

______is increased cell production in a normal tissue or organ. Hyperplasia may be a sign of abnormal or precancerous changes. This is called pathologic hyperplasia. It can also be due to the growth of normal cells

Hyperplasia

____ is defined as the conversion of one cell type to another, and it can include conversions between tissue-specific stem cells.

'Metaplasia'

___ on the other hand, refers to the conversion of one differentiated cell type to another, and should therefore be considered a subset of metaplasia.

'Transdifferentiation,'

**In which substance is paraffin wax Miscible with? A. ETOH B. Acetone C. Water D. Xylene

D. Xylene

Waxes are miscible or dissolved in

clearing agents

**Does not Require Calibration A. Centrifuge B. Pressure Gauge C. Automated (electronic) Pipettes D. Incubator

B. Pressure Gauge **Pressure gauge: To ensure that pressure measuring instruments maintain their accuracy specifications, they require regular calibration.

____monitoring will help maintain the efficiency of your incubator by ensuring it is running at the expected temperature and correcting any inconsistencies.

Regular incubator calibration and temperature

Generally, a new electronic pipette does not need to be calibrated. For special applications (ex: liquids with significantly different specific gravities or temperatures), the pipettes can be calibrated to achieve greater accuracy.

**Typical Paraffin Wax is Liquid At __. A. 80 B. 100 C. 60 D. 50 *Typical wax is liquid at ____ and can be infiltrated into tissue at this temperature then allowed to cool to ___ where it solidifies to a consistency that allows sections to be consistently cut. must be formed into a "block" which can be clamped into a microtome for section cutting.

C. 60 *60°C *20°C

**When staining with Hematoxylin, which reagent is commonly used for slower, more controlled differentiation? A. Acetic Acid B. Nitric Acid C. Hydrochloric acid D. Picric Acid

A. Acetic Acid **In the case of hematoxylin, hydrochloric acid (for rapid differentiation) and acetic acid (for slower, more controlled differentiation) are most commonly used.

**In FISH, Step done before hybridization can occur? A. Labelling of DNA probe B. Mixing of Target and Probe Sequence C. Annealing of Complementary DNA Sequence D. Denaturing of Target and Probe Sequences.

D. Denaturing of Target and Probe Sequences. **Before any hybridization can occur, both the target and the probe sequences must be denatured with heat or chemicals. This denaturation step is necessary in order for new hydrogen bonds to form between the target and the probe during the subsequent hybridization step.

**When 95% ethyl Alcohol is unavailable, the following may be used as alternatives for cytology samples except: A. Distilled Water B. Absolute Alcohol C. Corn Syrup D. Hair-Fixing Spray

B. Absolute Alcohol **100% methanol (absolute) is an acceptable substitute for 95% ethanol. ethanol. water on cells. Hence 80% propanol is a substitute for 95% ethanol.

**Which is an example of Medical Technologist obligation to the profession? A. Respect patient rights to freedom of choice B. Recognition of professional Limitation C. Life long Learning D. Compliance with Regulatory Requirements

C. Life long Learning **Obligations to the Profession: Medical laboratory technologists contribute to the profession's development through collaboration, mentorship, self-development, and support of its institutions. MLTs strive for excellence in their professional practice, and professional and personal conduct through life-long learning.

**The acknowledgements are generally included at the very beginning of your thesis, directly after the ____ and before the _____.

title page abstract

what analytical factors are these belong? Test ordering, Sample Collection, Sample Transport, Sample Receipt and Processing.

**Pre-analytic factors:

what analytical factors are these belong? Testing, Results Review and Follow up, Interpretation.

**Analytical factor:

**Categories of quality costs:

* Prevention costs. * Appraisal costs. * Internal failure costs. * External failure costs.

**Outer region of an organ:

CORTEX/CORTICAL REGION

The _____ is a smooth tissue membrane of mesothelium lining the contents and inner walls of body cavities, which secrete serous fluid to allow lubricated sliding movements between opposing surfaces.

serous membrane (or serosa)

**A Drug Test Certificate is valid for: a. 1 year b. 2 years c. 3 years d. 4 years

a. 1 year **A declaration or statement of the result of the drug test issued by accredited drug testing centers. It shall be valid for one-year period from the date of issue.

**Stain for glycogen: ____ **For acid mucopolysaccharides **For fixation:

PAS Alcian blue Lead

**Which of the following components of the Papanicolau stain stains nothing? a. Hematoxylin b. OG-6 c. Eosin Azure d. Bismarck Brown Y

d. Bismarck Brown Y

____stains the superficial epithelial squamous cells, nucleoli, cilia, and red blood cells.[2] ____ confers a blue staining for the cytoplasm of active cells such as columnar cells, parabasal squamous cells, and intermediate squamous cells. ____ are orange to pink, and intermediate and parabasal cells are turquoise green to blue

Eosin Y Light Green SF yellowish Superficial cells

**What is the cause of loss of mass in aged individuals? Apoptosis Dystrophy Atrophy None

Atrophy

**What is used to counterstain keration? OG-6 Eosin Y Bismarck brown NOTA

OG-6 **Solution 2 has OG-6, an acidic cytoplasmic stain, has orange G with phosphotungstic acid (6 denotes the used concentration of phosphotungstic acid). Orange G is an acid dye and stains keratin with a bright intense orange.

what analytical factors are these belong? Result reporting and archiving, Sample management.

post ana

Specific, Measurable, Attainable, Realistic, Time-Framed

**Smart goals-

1-2% aqueous potassium ferrocyanide 2% aqueous hydrochloric acid

**Perls' Prussian blue reaction for Ferric Iron:

**Function of methanol in NBF (neutral buffered formalin): prevents the formation/precipitation of ____

paraformaldehyde ** Methanol is used commercially as a stabilizer in solutions of formaldehyde to prevent its precipitation. ** 2nd choice: formic acid from formaldehyde acidification.

**In Expanded Newborn Screening, which of the following is NOT included? a. CAH b. G6PD deficiency c. Congenital hypothyroidism d. Neonatal diabetes

d. Neonatal diabetes From 6 to 28 disorders.

**Filing for the MTLE opens____ before the board exam starts

3 MONTHS

**Law that mandates the addition of MSUD screening as one of the screening panel for newborns:

Republic Act 9288, otherwise known as the Newborn Screening Act of 2004

*Correct regarding hematoxylin: a. Reduction b. oxidation

b. oxidation **Hematoxylin and eosin (H&E) is the most widely used stain in histology and allows localization of nuclei and extracellular proteins. Hematoxylin, not a dye itself, produces the blue Hematin via an oxidation reaction with nuclear histones causing nuclei to show blue. **This conversion process is called "ripening" and can occur naturally or chemically. The natural oxidation process takes place upon exposure to air and light and can take as long as 3-4 months before ripening is complete.

**Reference laboratory for HIV testing a. EAMC b. NKTI c. San Lazaro Hospital/SACCL

c. San Lazaro Hospital/SACCL NRLs were first established through D.O. No. 393-D s. 2000; this Order updates policy and mandate for the six designated host hospitals with NRLs, to institutionalize NRLs’ operations distinct from the host hospitals’ central laboratories * East Avenue Medical Center * Lung Center of the Philippines * National Kidney & Transplant Institute * Philippine Heart Center * Research Institute for Tropical Medicine * San Lazaro Hospital

-provides a one-time comprehensive assessment of key processes in the lab.

Q-PROBES

-evaluates quality of processes both within and beyond the lab that can impact test results and patient outcomes

**Q-TRACKS

**Caused by friction against a rough surface: a. Laceration b. Hematoma c. Contusion d. Abrasion

d. Abrasion

**not an adhesive of choice for tissue ribbons:

pooled serum

**Transition between dehydration and infiltration of embedding medium: a. Clearing b. Impregnation c. Rehydration d. Dehydration

a. Clearing

**A common means of holding tissue sections on the slide during processing is to add what to the water on which sections are floated?

GELATIN

**Number of patients to ESTABLISH a reference range:

120

Number to VALIDATE a reference range:

**What does Z-score represent?

Measures how many standard deviations above or below the mean a data point is

The ____is a way to figure out how far away a piece of data is from the average of a group, measured in standard deviations. It tells us if a data point is typical or unusual compared to the rest of the group, which is useful for spotting unusual values and comparing data between different groups.

Z-score

**Most waxes used for embedding in histologic sectioning melt at approximately.

. 56C

**All of the following are cytoplasmic fixatives, except: Carnoy’s Helly’s Orth’s NOTA

Carnoy’s

**All of the following are components of Bouin's solution, EXCEPT: A. Ethanol B. Glacial Acetic Acid C. Saturated Picric Acid

A. Ethanol

**A stillborn was received by the custodian of a medical museum, what is the required volume of fixative? At least 10X At least 20x At least 30X At least 50X

At least 50X

Bouin solution, or Bouin's solution, is a compound fixative used in histology. It was invented by French biologist Pol Bouin and is composed of ___, ___, ___ in an aqueous solution.

picric acid acetic acid formaldehyde

**It ensures that the entire testing process from pre-analytical through the post-analytical processes are reliable:

Quality assurance (internal auditing)

**Autopsy technique involves en masse removal of all organs within the thoracic, abdominal, and pelvic organs all at the same time:

Letulle

**Key factors for quality of embedding, EXCEPT: a. Thickness of Tissue b. Duration of fixation c. Orientation of tissue d. Composition of embedding medium

b. Duration of fixation ** * Sample Thickness: * Tissue Orientation: * Paraffin Wax Quality/Composition: * Mold Size and Cassette Type: * Availability of Light:

A sheen of oxidized dye on the surface of hematoxylin solution indicates:

stain needs to be filtered

**The following are violationS of RA 5527, EXCEPT: a. Refusal to display COR inside the laboratory b. Release of fraudulent result c. Using expired or invalid COR d. Refusal to identify gender identity

d. Refusal to identify gender identity

*Overall plan to ensure the quality of the organization's product: ***Quality equals lack of____

quality management systems variation

**Best way to communicate patient result to provider? a. Writing b. Telephone c. Verbal d. Electronic

d. Electronic

** In the hematoxylin-eosin (H and E), this stain acts as the basic dye: **acid dye -

hematoxylin Eosin-

**The regressive staining method employs which staining step:

differentiation/decolorization/washing-out

**Formaldehyde fixation temperature. a. 28C b. 32C c. Ambient temperature d. Room temperature

d. Room temperature

**Physical preservation of tissue EXCEPT: a. Heat b. freeze drying c. vapor d. microwave

c. vapor

** Formaldehyde acts as a fixative by:

: cross-linking proteins—best for this function is Glutarladehyde

** The plasma-thrombin method is a technique of preparing:

: Tissue blocks

**Not a stain for CNS:

PAS

*PAP's smear revealed "honeycomb" looking cells:

Endocervical cells

*An organization can measure it's processes against those of recognized leaders in the field to identify areas for improvement.

Benchmarking

*PLUS- STANDS FOR?

- Plan, Lead, Understand, Solve

____ has the greatest influence in laboratory productivity; permitted performance of more procedures in smaller spaces

*Automation:

**Which specimen is most likely to require decalcification before embedding and cutting?

AORTA

** Thymol is added to Meyer's egg albumin to prevent growth of:

FUNGUS