Intro Surg Path Flashcards
never assume this is left off
Stryker saw
what two solutions should not mix
bleach and formalin
what three things should go in biohazard waste
-bloody
-infectious
-patient info
what two things should go in normal routine waste
-gloves
-miscellaneous waste
88311
decalcification
88331
frozen section
pathology and lab CPT code range
80047-89398
unexpected events that result in a patient’s death or a serious physical or psychological injury
sentinel event
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
CPT stands for
current procedural terminology
every specimen must have a minimum of
two patient identifiers
if there are special requests that the submitting physician notes what must you do
dictate them in the gross description
what must you always do with the lid as you open each contain
put it upside down so you don’t msis tissue
where should you discard formalin (2)
small dish/filtered dish
do not put this type of tissue on sponges, otherwise it will leave an artifact
fresh
what do you do if there is no tissue in the container
check again and have another PA check
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
what do you do if you missed tissue in the container
report that you found it and rehydrate if necessary
what do you do if you grossed the wrong case
gather all info and specimen containers for both cases, act calm
what do you do if you dropped tissue on the ground
dont move, simply look in your area
you do not want to put through a biopsy greater than ______ cm without bisecting, trisecting, or serially sectioning it
0.4
always ink this part of a polyp if present
identifiable base
a term used for multiple colors, usually striated
variegated
gross dimensions go from ________ to _________
largest to smallest
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
12
breast biopsy cores are usually separated into what number of cores per cassette
4
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
