Intro Surg Path Flashcards by Tenzin Dechen

never assume this is left off

Stryker saw

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what two solutions should not mix

bleach and formalin

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what three things should go in biohazard waste

-bloody
-infectious
-patient info

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what two things should go in normal routine waste

-gloves
-miscellaneous waste

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88311

decalcification

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88331

frozen section

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pathology and lab CPT code range

80047-89398

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unexpected events that result in a patient’s death or a serious physical or psychological injury

sentinel event

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any error that would have resulted in a sentinel event but was caught and did not affect the outcome in a negative way; “near miss”

adverse event

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CPT stands for

current procedural terminology

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every specimen must have a minimum of

two patient identifiers

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if there are special requests that the submitting physician notes what must you do

dictate them in the gross description

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what must you always do with the lid as you open each contain

put it upside down so you don’t msis tissue

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where should you discard formalin (2)

small dish/filtered dish

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do not put this type of tissue on sponges, otherwise it will leave an artifact

fresh

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what do you do if there is no tissue in the container

check again and have another PA check

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what do you do if there is mystery tissue

call the attending and put tissue in a separate cassette with a designation and send to them

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what do you do if you missed tissue in the container

report that you found it and rehydrate if necessary

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what do you do if you grossed the wrong case

gather all info and specimen containers for both cases, act calm

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what do you do if you dropped tissue on the ground

dont move, simply look in your area

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you do not want to put through a biopsy greater than ______ cm without bisecting, trisecting, or serially sectioning it

0.4

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always ink this part of a polyp if present

identifiable base

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a term used for multiple colors, usually striated

variegated

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gross dimensions go from ________ to _________

largest to smallest

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range in size goes from _________ to __________

smallest to largest

always give three dimensions for this type of biopsy

polyp

the largest dimension is adequate for specimens consisting of this

small tissue fragments

if all fragments are the same size, use this in the greatest dimension

averages

lymph node core biopsy CPT code

88305

lung core biopsy CPT code

88305

liver core biopsy CPT code

88307

kidney biopsy CPT code

88305

kidney biopsies must be divided into (3)

EM, IF, Light microscopy

the kidney formalin cores are grossed as

core biopsies

kidney biopsy (gross only) CPT code

88300

bone marrow biopsy CPT code

88305

if there is a possible malignancy, a bone marrow biopsy will need

specific decalcification

bone marrow cores must be separated from

blood or other tissue

fixative for electron microscopy

glutaraldehydez

fixative for immunofluorescence

Zeus (Michel's transport medium)

fixative for light microscopy

10% neutral buffered formalin

minimum fixation time for bone biopsies

2 hours

prostate biopsy CPT code

88305

prostate core biopsy dimensions

2 dimensions

how many cores will come from a prostate biopsy

breast biopsy cores are usually separated into what number of cores per cassette

breast biopsy CPT code

88305

what must be documented with breast biopsies

fixation time

fixation time for breast tissue

6-72 hours in 10% neutral buffered formalin

hormone receptor assays for samples have a direct correlation with what

type of chemotherapy the patient will likely respond to

mucosal biopsy CPT code

88305

in HER2 testing guidelines it is recommended that this is short as possible

cold ischemia time

what do you do if you cannot determine what side is which in a mucosal biopsy

use a light and examine it with another PA or pathologist

muscle and nerve biopsies CPT code

88305

usually oriented in a muscle clamp or on a tongue depressor

muscle biopsy

usually sent in saline-soaked gauze on ice

muscle and nerve biopsies

if a specimen comes fresh, these 4 things are possible

-lymphoma work up -frozen and retained -cultures for micro -left out of formalin?

EMC/ECC biopsies CPT code

88305

these biopsies are measured in aggregate

EMC and ECC

mesh biopsy bags are used in these biopsies

EMC and ECC

products of conception CPT code

88305

if the POC specimen comes fresh, determine if this is required

cytogenetics

document these two features for POC specimens

-presence or absence of villi -presence or absence of fetal structures

this occurs PRIOR to decalcification

fixation

10% neutral buffered formalin infiltrates tissue at this rate

0.3 cm / hour

if a fetus is present in POC, measure this

foot length

if there is not a lot of tissue, what should you do

filter formalin through a biopsy paper or mesh bag

nuclei when fixation is incomplete

muddy or smudgy with bubbling and poor tissue morphology

nuclei when there is delayed fixation

loss of chromatin, blue halo, fading, complete disappearance