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Pathology > Introduction to Pathology > Flashcards

Introduction to Pathology Flashcards

1
Q

what is pathology

A
  • study of disease (pathos - disease; logos - study)
  • study of structure, biochemical and functional changes in cells, tissue, and organs that underlie disease
  • uses molecular, microbiologic, immunologic and morphologic techniques
  • bridges btwn basic science and clinical medicine
  • diagnostic medicine
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2
Q

what do pathologists do

A
  • run laboratory
  • perform anatomic pathology
  • perform clinical pathology
  • does basic/clinical research
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3
Q

What are the Anatomic Pathology Specialties?

A
  • cytology
  • surgical pathology
  • hematopathology
  • autopsy
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4
Q

what do cytologists do

A
  • pap smears
  • FNA
  • fluids
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5
Q

What do surgical pathologist do

A
  • general surgical pathology
  • neuropathology
  • renal pathology
  • dermatopathology
  • GI/Liver
  • transplant pathology
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6
Q

What type of test do anatomic pathologist perform

A
  • primarily morphological
  • gross
  • light microscopy
  • special stains
  • IHC (immunohistochemical)
  • immunofluorescence
  • EM
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7
Q

What type of test do clinical pathologists perform?

A
  • hematology (blood count, coagulation factors)
  • blood bank
  • chemistry
  • immunology/serology (titers)
  • microbiology (culture and test for drug sensitvity)
  • cytogenetics (chromosomes - see translocation)
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8
Q

how is a surgical specimen processed during a gross exam

A
  • describe/dictate specimen
  • photograph
  • ink margins
  • decalcify
  • select tissue for histology
  • select tissue for other studies (ie. flow cytometry, culture, molecular pathology, EM
  • pathologist assistant may do all this
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9
Q

Histrological Processing

A
  • overnight processing
  • embed tissue
  • cut w/ microtome (water bath, dry)
  • stain (usual H&E stain)
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10
Q

after a histological exam of a gross specimen what does the pathologist do?

A
  • may order additional stains
  • dicates or writes report
  • transcription
  • electonic sign out of case
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11
Q

at what elapsed time does te pathologist read slides

A

elapsed time: 24-48 hrs

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12
Q

when does it take more than 24-48 hrs to get diagnosis from gross specimens

A
  • big specimens
  • additional sampling for complicated cases
  • bone/calcium decalcification
  • need for additional stains/studies (usually tumors)
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13
Q

Hematoxylin & Eosin (H&E) used for

A

-nuclear material/nucleus

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14
Q

what is a Giemsa Stain used for

A

-blood smear, bone marrow

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15
Q

what is a Papanicolaou stain used for

A

-cervical pap smears

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16
Q

what is a Diff Quick stain used for

A

-air dried smears

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17
Q

Types of Stains

A
  1. H&E
  2. Giemsa Stain
  3. Papanicolaou Stain
  4. Diff Quik
  5. special histochemical stains
  6. immunohistochemistry
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18
Q

Characteristics of a H&E stain

A

Eosin - red (cytoplasm, acidic proteins)

Hematoxylin - blue (DNA/RNA bases)

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19
Q

what does a Pap stain look like

A

keratin: orange
nuclei: blue black
cytoplasm: blue/green/pink

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20
Q

what are the histochemical stains, “bug stains”

A
  1. gomori silver
  2. acid fast
  3. gram stain
  4. PAS - polysaccharides + mucopolysaccarides
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21
Q

what is a gomori silver stain used for

A

-fungus

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22
Q

what is an acid fast stain used for

A

TB

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23
Q

what is a gram stain used for

A

bacteria

24
Q

what is a PAS (polysaccharides + mucopolysaccarides) stain used for?

A

-fungus

25
Q

special histochemical stains used for Liver panel, bone marrow

A
  1. Prussian Blue
  2. Trichrome
  3. Reticulin
  4. PAS
  5. DPAS
  6. Van Geisen
  7. Mucin or Mucicarmine
26
Q

what is a Prussian blue stain used for

A

-iron (liver)

27
Q

characteristics of trichrome stain

A
  • cells red
  • fibrous tissue blue
28
Q

Characteristics of reticulin stain

A

reticulin black

29
Q

characteristis of PAS (polysaccharides + mucopolysaccarides)

A

magenta

30
Q

characteristics of DPAS stain

A
  • digest glycogen
  • mucopolysaccharides only magenta
31
Q

characteristics of Van Geisen

A

-elastic black

32
Q

characteristics of mucin or mucicarmine

A

-mucin pink

33
Q

when is immunohistochemistry used

A
  • used to identify primary Ab to Ag of interest of membrane/nuclear material/cytoplasmic material
  • second Ab is required to have a chromagen which colors/tags the AB
34
Q

uses of immunohistochemistry

A
  1. identify tumor types
  2. identify normal cells
  3. therapetuic implications
35
Q

how can tumors be identified

A

carcinoma = keratin positive

B cell Lymphoma = CD45 and CD20 positive

36
Q

how do you identify normal cells

A

p63 highlights myoepithelial cells

37
Q

what are the therapetutic implications of using immunohistochemistry

A
  • over expression of genes = susceptibility to specific therapy
  • estrogen receptors & Tamoxifen (ie. is a breast cell estrogen positive)

C Kit (CD117) & Gleevac (if CD117 + use Gleevac)

38
Q

colorectal adenocarcinoma is positive for what CK

A

CK 20+ AND CK7 positive

39
Q

estrogen receptor is what type of stain

A

nuclear staining

40
Q

expression by tumor means sensitivity to

A

estrogen antagonists when using IHC estrogen receptors

41
Q

what type of microscope is used when vieweing kidney specimens

A

electron microscopy

42
Q

when are frozen sections used

A
  • fast results
  • when results will affect procedure
  • intraoperatives

~20 min time frame

43
Q

disadvantage of using frozen sections

A
  • some compromise of quality
  • small eroor rate <5%
  • freezing artifact
  • limited sample
44
Q

how are pap smears performed

A
  • brush/preservative fluid
  • spin fluid on to slide
  • stain
  • screened by cytotechnologist
  • evaluated by pathologist
45
Q

what does a hematophatologist do

A
  • bone marrow biopsy
  • lymph node biopsy
  • biopsy of any tissue involved by lymphoma
  • fine needle aspirate of lymph node
  • flow cytometric analysis
  • molecular analysis
46
Q

autopsy

A

-disection of the body of a deceased patient to determine:

  • cause of death
  • natural course of a disease
  • presence of concurrent disease(s), significant or incidental
  • effect(s) of therapy
  • clinicopathologic correlation
47
Q

a good autopsy required

A
  • knowledge of the clinical details of the case
  • broad general medical knowledge
  • good observational skills
48
Q

medical autopsy is directed by who

A

-a pathologist

49
Q

when is a medical autopsy performed

A

inpatient death: adult, stillborn, newborn

outpatient death for a patient folloed by a staff physician

release of a forensic case by meical examiner

50
Q

forensic autopsy directed by

A

medical examiner or coroner

51
Q

when is a forensic autopsy performed

A
  • criminal, violent, accidental, unattended or suspicious death
  • unclaimed body
52
Q

what are the 4 main reasons that autopsies are declined

A
  1. social
    * family permission required, religious restrictions, lack of understanding by family and physicians
  2. economic
    * cost to hospital, lack of reimbursement through insurance
  3. meidcal
  • Physician overconfidence (imaging, serology)
  • Fear of transmission of infectious disease
  • Failure to use information
  • Pathologist apathy
  • Poor turn-around-time
  1. fear or legal action
53
Q

advantages of autopsies

A
  • unexpected findings
  • valuable teaching and research
  • enhance communication
  • reduce/eliminates suspicions
  • reassurance for family and physician
  • reduces claims/malpractice suit
  • accurate mortality statistics
54
Q

virchow’s node

A

-left supraclavicular node from GI malignancy

55
Q

Virchow autopsy method

A

-one organ at a time

56
Q

Virchow’s Triad

A

thrombosis

57
Q

what was rudolph virchow

A

father of modern pathology

Pathology (18 decks)

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