Introduction to Histology Flashcards

1
Q

What is histology?

A

The study of cells and tissues by microscopy

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2
Q

What is histopathology?

A

The study of diseased tissue by microscopy

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3
Q

What is the ABCDE for determining whether a mole is normal or cancerous?

A

Asymmetry

Border

Colour

Diameter

Evolving

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4
Q

What is meant by asymmetry?

A

If you draw a line through the middle of the mole, the halves of a melanoma will not match in size

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5
Q

What is meant by border?

A

The edges of a melanoma tend to be uneven, crusty or notched

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6
Q

What is meant by colour?

A

Healthy moles are uniform in colour

A variety of colours, especially white and/or blue is bad

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7
Q

What is meant by diameter?

A

Melanomas are usually larger in diameter than a pencil eraser

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8
Q

What is meant by evolving?

A

When a mole changes in size, shape or colour or begins to bleed or scab, this is dangerous

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9
Q

What is the extent of the spread of a tumour called?

A

Staging

Determining how far a tumour has spread

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10
Q

What are the 4 stages in the clinical applications of histology?

A
  1. make a diagnosis
  2. determine prognosis
  3. plan and confirm treatment
  4. predict/confirm response to drugs
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11
Q

Why is histology important?

A

It allows ‘normal’ to be defined

This allows comparisons and abnormal characteristics to be identified

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12
Q

What is the first stage in histological preparation?

A

Tissue sampling

This involves taking a tissue sample by surgical excision

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13
Q

What is the second stage in histological preparation?

Why is it needed?

A

Fixation

The tissue is fixed by placing it in a chemical to preserve it

The tissue will begin to degrade if it doesn’t have a blood supply

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14
Q

In which 3 ways does fixation preserve tissues?

A
  1. stopping intrinsic autolytic enzyme action (autolysis) which involves the tissue breaking itself down
  2. prevention of bacterial contamination (putrefaction)
  3. increasing mechanical strength to preserve structure and morphology
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15
Q

How do fixatives work?

A

They link molecules together so that they no longer function

They also kill any bacterial contaminants

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16
Q

What types of bonds are formed by aldehyde and alcohol fixatives?

A

Aldehyde fixatives form protein covalent cross-links

Alcohol fixatives denature proteins and cause aggregation/fixation

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17
Q

What types of bond are formed by oxidising fixatives?

A

Protein covalent cross-links via oxidation

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18
Q

Why is freezing not often used as a method of fixation?

A

It is a quick solution but results in poor morphology

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19
Q

How does formalin (formaldehyde solution) work?

A

It forms protein covalent cross-links

Joining together complex molecules within the tissue means they no longer function and the tissue becomes rigid

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20
Q

What are the pros of using formalin?

A
  1. it has good penetration and mechanical strength

2. good tissue morphology preservation

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21
Q

What are the cons of using formalin?

A
  1. it is poor at preserving DNA and RNA

2. it needs to be quite warm in order to work

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22
Q

How does glutaraldehyde work?

A

It is similar to formalin but is a larger molecule so forms protein covalent cross-links

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23
Q

What are the pros of using glutaraldehyde?

A
  1. it works well at low temperatures

2. it is used for electron microscopy

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24
Q

What are the cons of using glutaraldehyde?

A
  1. it only works on smaller tissue samples
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25
Q

How does ethanol work as a fixative?

A

It fixes by precipitation

It reduces protein solubility so that they form precipitates

26
Q

When is ethanol used as a fixative and why?

A
  1. cytology smears
  2. nucleic acid research

It doesn’t cross-link so it doesn’t damage DNA or RNA

27
Q

What is the third stage in histological preparation?

A

Block selection

This involves slicing the sample and placing areas of interest in a plastic cassette

28
Q

What is the fourth stage in histological preparation?

A

Tissue processing

This involves slicing the tissue thinly, placing it on a slide and staining it to look under a microscope

29
Q

What must the properties of the tissue be like to allow it to be sliced thinly?

How is this overcome?

A

It must be stiff and resistant to mechanical trauma

It is placed in wax to allow thin sections to be cut

30
Q

What are the 4 stages involved in placing a tissue in wax?

A
  1. dehydration - removing water from the tissues using alcohol
  2. clearing - replacing alcohol with xylene
  3. wax infiltration - replacing xylene with paraffin wax
  4. embedding - orientate the tissue to form a paraffin block
31
Q

Why must water be removed from the tissues before they are placed in wax?

A

Wax is hydrophobic

32
Q

What is the fifth stage in histological preparation?

A

Section cutting and mounting

33
Q

What are the stages involved in section cutting and mounting?

A
  1. making a thin slice of tissue from the wax block
  2. place the block in a slicer to shave off bits of tissue
  3. ribbon of paraffin placed in water
  4. ribbon of paraffin picked up by slide
34
Q

What is the sixth stage in histological preparation?

Why is it needed?

A

Section staining

An unstained tissue section is translucent to light, so dyes are added to make it visible

35
Q

What is the purple component of haemotoxylin and eosin stain?

What does this stain and why?

A

Haemotoxylin is purple

It is a basic dye that is attracted to acidic structures

The nuclei (DNA) are stained purple

36
Q

What is the pink component of haemotoxylin and eosin stain?

What does this stain and why?

A

Eosin is pink

It is an acidic dye that will stain basic structures pink

Proteins in the cytoplasm are dyed pink

37
Q

What is periodic acid schiff (PAS) stain used to detect?

A
  1. mucin and mucopolysaccharides
  2. fungal organisms
  3. visualisation of basement membranes
38
Q

What is a mucin?

A

A high molecular weight, heavily glycosylated protein produced by epithelial tissues

39
Q

What is the drawback of using PAS stain?

A

Glycogen is PAS positive

Glycogen will stain a deep magenta colour

40
Q

What is DPAS and what is it used for?

A

PAS is combined with diastase

Diastase in an enzyme which removes glycogen and helps to distinguish it from other PAS positive elements

41
Q

What is Gram stain used for?

A

To identify bacteria based on the constituents of their cell walls

42
Q

How are Gram positive and Gram negative bacteria distinguished from each other?

A

Gram positive stain blue

Gram negative stain red

43
Q

What is Giesma stain used for detecting?

A

H. pylori bacteria in the stomach which are involved with inflammation

44
Q

What colour will Giesma stain colour the bacteria and human cells?

A

Human cells are purple

Bacterial cells are pink

45
Q

What is Grocott’s methenamine silver stain (GMS) used for?

A

Detecting fungi

It shows fungal cell walls as black

46
Q

What is Oil red O stain used to detect?

A

It is used to stain fat

47
Q

Why can Oil red O only be used on frozen tissue and not processed tissue?

A

Xylene removes all the oil from the tissues

This means there are no fats in processed tissue

48
Q

What is Orcein stain used to detect?

A
  1. copper-associated proteins
  2. elastic fibres
  3. hepatitis B sAg
49
Q

What disease results in abnormal retention of copper?

Which stain can be used to detect this?

A

Wilkinson’s disease leads to an abnormal retention of copper

Orcein stain

50
Q

Which organ is Orcein stain most commonly used in?

A

Liver

51
Q

What is Perl’s stain used for?

A

It is used in lung tissue to look for asbestos bodies

52
Q

What colour will Perl’s stain dye components?

A

it dyes iron blue

It also dyes ferruginous (asbestos) bodies

53
Q

What is Ziehl Neelsen stain used for?

A

Identifying mycobacterium

They contain mycolic acid and large amounts of fatty acids, waxes and complex lipids

54
Q

What is the downside of using tinctorial stains, like H&E?

A

They are not specific

55
Q

What is immunohistochemistry?

A

Using antibodies against a specific protein target

It is not a stain, but a way of locating a specific molecule

56
Q

What is the first stage in immunohistochemistry?

A

A solution containing primary antibody is added to formalin-fixed paraffin embedded tissue

The primary antibody is allowed some time to find the target complementary antigen

57
Q

What happens after the primary antibody is added in immunohistochemistry?

A

Unbound and surplus antibodies are washed away and a secondary antibody is added

58
Q

What happens once the secondary antibody is added in immunohistochemistry?

What is special about the secondary antibody?

A

The secondary antibody is given time to bind to the primary antibody

The secondary antibody carries a linker molecule with HRP enzymes

59
Q

What is added after the secondary antibody in immunohistochemistry and why?

A

DAB is added

HRP enzymes transform DAB into a coloured precipitate

This gives a visual representation of where the primary antibody first bound to its target

60
Q

What is the major benefit of using immunohistochemistry?

A

The antibody stain allows you to see if a specific protein is present in the tissue

This allows it to be used in diagnosis

61
Q

How can immunohistochemistry be used in prognosis?

A

Through mismatch repair

If a tumour has lost expression of its mismatch repair protein, it will no longer be brown