INTRODUCTION TO PATHOLOGY Flashcards
Area of science focusing on all the changes in cells, tissues, and organs that underlie a disease.
Pathology
It is the study of diseases
Pathology
What are the 4 aspects of pathology?
- Etiology
- Pathogenesis
- Molecular and Morphologic Changes
- Functional Derangement & Clinical Manifestations
This refers to the cause: genetic/acquired
Etiology
What are 2 causes based on etiology?
- Genetic
- Acquired
It is the manner/sequence of events on how the disease had developed.
Pathogenesis
This refers to the changes in cells -> tissues -> organs due to disease.
Molecular and Morphologic Changes
Even the normal functioning of organs would be affected, and as a result, the patient will show manifestation of disease.
True or False
TRUE
This refers to the incomplete/defective development of a tissue/organ
Abnormalities of cell growth/developmental defects
Aplasia
Aplasia shows some resemblance to the normal adult structure.
True or False
False
shows no resemblance
What are the paired structures for Aplasia?
kidneys & gland
This is the complete non-appearance/absence of an organ
Abnormalities of cell growth/developmental defects
Agenesia
This is the failure of an organ to reach its normal mature adult size (normal appearance)
Abnormalities of cell growth/developmental defects
Hypoplasia
This is the failure of an organ to form an opening - condition in which an office or passage in the body is closed or absent
Abnormalities of cell growth/developmental defects
Atresia
What is blocked/absent in biliary atresia?
biliary duct
Biliary atresia does not happen in newborns
True or false
FALSE
may happen in newborns
This happens when the anus is missing or doesn’t have a hole.
Imperforate anus
It is a type of birth defect of a baby’s ear where there is an absence of the ear canal
microtia
An injury can be characterized into what?
Reversible or irreversible
In general, what causes an injury?
Injurious Stimuli or Stressful Stimuli —> Normal Cells
all normal cells may be exposed to a lot of injurious stimuli or stressful stimuli and exposure to those stimuli can lead to what?
Injury
What causes adapted Normal Cells?
Reversible Injury —> “cellular adaptations”
In irreversible injury, the unaffected cell can get back to its normal state or condition by using a single cellular adaptation mechanisms
True or False
False
reversible injury; affected cell; multiple cellular adaptations
Reversible Injury using “cellular adaptations” causes what?
Adapted Normal Cells
Irreversible Injury —> “apoptosis (physiologic), necrosis (pathologic)” causes what?
Dead cells
This is the type of injury wherein the affected cell can no longer get back to its normal state. It is considered “the point of no return”
Irreversible injury
This type of injury causes cell death
Irreversible injury
What are the two categories of cell death?
apoptosis and necrosis
Among the two categories of cell death, which among the two are patterns of cell death?
both are patterns of cell death.
Apoptosis is a natural process
True or False
True
This is the type of cell death due to a disease
Necrosis
This is the type of cell death that is physiologic
Apoptosis
This refers to acquired decrease in tissue or organ size
Atrophy
What are the two types of atrophy?
- physiologic
- pathologic
This is the type of atrophy that occurs as a consequence of maturation.
Physiologic
Give an example of a physiologic atrophy
atrophy of thymus during puberty & atrophy of brain and sex organs
At birth the thymus is very big, but as one ages, the thymus gets smaller.
True or False
True
The fact that the thymus decreases in size, as the person ages is what type of atrophy?
physiologic atrophy
In physiologic atrophy, the thymus increases in size, as the person ages
True or False
False
the thymus decreases
the brain and sex organs undergo atrophy at the age of what?
At the age of 50
The decrease in size of the brain and sex organs, at age 50, is normal.
True or False
True
decrease in uterus and breast size after childbirth is an example of physiologic atrophy
True or False
True
this is the type of atrophy wherein there is a decrease in tissue or organ size is due to a disease
Pathologic atrophy
What are the 6 types of pathologic atrophy?
PVEESA
- Pressure atrophy
- Vascular atrophy
- Exhaustion atrophy
- Endocrine atrophy
- starvation/Hunger atrophy
- Atrophy of Disuse
This pathologic atrophy may happen because of the sudden cut off of blood supply
Vascular atrophy
This pathologic atrophy may happen due to lack of nutritional supply; lack of nourishment
starvation/Hunger atrophy
This atrophy may develop due to excessive workload.
Exhaustion atrophy
This type of atrophy may happen because of lack of hormones needed to maintain normal size.
Endocrine atrophy
This is the type of atrophy wherein there is a decrease in tissue or organ size is due to inactivity of diminished function; lack of activity
Atrophy of Disuse
This happens when there is persistent pressure/continuous pressure on an organ or tissue may cause direct injury to the cell causing it to become smaller; too much pressure exerted to an organ or tissue
Pressure atrophy
hyper means what?
increase
In both hypertrophy or hyperplasia there is an increase in tissue or organ size.
true or false
True
This is due to an increase in the size of individual cells comprising an organ.
Hypertrophy
This is the type of atrophy wherein NO NEW CELLS ARE PRODUCED.
Hypertrophy
this is an increase of [skeletal] muscle due to excessive exercise.
Physiologic hypertrophy
This may happen if one of the paired organs is removed.
Compensatory hypertrophy
Give an example of compensatory hyperplasia
RENAL HYPERPLASIA
When one of your kidneys are removed, the other kidney will increase in size. This is called…
compensatory hypertrophy.
Give an example of Pathologic hypertrophy
hypertrophy of myocardium due to aortic valve disease or hypertension
hypertrophy of myocardium due to aortic valve disease or hypertension is what type of hypertrophy?
Pathologic hypertrophy
This is due to an increase in the number of cells making up the organ.
Hyperplasia
in hypertrophy, new cells are produced.
true or false
false
hyperplasia
Erythroid bone marrow Hyperplasia is what type of hyperplasia?
Physiologic
The increase in breast size during puberty is what type of hyperplasia?
physiologic hyperplasia
The increase in breast and uterus size during pregnancy is what type of hyperplasia?
physiologic hyperplasia
bone marrow hyperplasia (Erythroid bone marrow hyperplasia) may develop in what conditions?
may develop among individuals living in high altitudes.
This type of hyperplasia that may develop among individuals living in high altitudes.
bone marrow hyperplasia (Erythroid bone marrow hyperplasia)
This type of hyperplasia is due to disease
Pathologic
This type of hyperplasia may give rise to neoplasm
Pathologic hyperplasia
This is the type of hyperplasia that may be due to stimulation of growth factors.
Pathologic hyperplasia
This hyperplasia happens with infants from a diabetic mother
PATHOLOGIC HYPERPLASIA
Hyperplasia of pancreatic islet in infants of a diabetic mother (stimulated by high glucose level)
What type of hyperplasia?
PATHOLOGIC HYPERPLASIA
Lymphoid tissue hyperplasia occurring after localized inflammation
What type of hyperplasia?
PATHOLOGIC HYPERPLASIA
Increase in the number of lymph nodules (as noted in TB of cervical lymph nodes)
What type of hyperplasia?
PATHOLOGIC HYPERPLASIA
Hyperplasia of endometrium due to excessive production of estrogen (excess hormonal stimulation)
What type of hyperplasia?
PATHOLOGIC HYPERPLASIA
Diffuse crowding of epithelial cells forming papillary projections
What is this disease called?
Grave’s Disease
Grave’s Disease
What type of hyperplasia?
PATHOLOGIC HYPERPLASIA
This involves transformation of adult cell to another adult cell type
Metaplasia
Metaplasia is considered as an IRREVERSIBLE PROCESS
True or False
False
Reversible process
This refers to the ADULT to ADULT TRANSFORMATION
Metaplasia
Give two examples of metaplasia
E&M
Epithelial metaplasia and Mesenchymal metaplasia
This is the type of metaplasia if the cells involved are EPITHELIAL CELLS
Epithelial metaplasia
This is the type of metaplasia if the cell involved are CONNECTIVE TISSUE CELLS
Mesenchymal metaplasia
Dysplasia is a reversible process
True or false
True
Dysplasia is also known as …
two terms
Pre-neoplastic Lesion or Atypical Metaplasia
Metaplasia and dysplasia are both reversible processes
True or false
TRUE
compared to metaplasia, in dysplasia there is NO CELL TRANSFORMATION
True or false
TRUE
Affected cells in dysplasia shows a change in what?
change in SIZE, SHAPE, and ORIENTATION
De-differentiation is also known as
Anaplasia
Anaplasia is also a reversible process
True or False
False
anaplasia is a irreversible process
Anaplasia is also a reversible process
True or False
False
anaplasia is an irreversible process
This is characterized by transformation of adult cell to PRIMITIVE or EMBRYONIC CELL TYPE
Anaplasia
Anaplasia is characterized by transformation of adult cell to what?
PRIMITIVE or EMBRYONIC CELL TYPE
This is often used as a CRITERION for malignancy
Anaplasia
Anaplasia is often used as a criterion for what?
criterion for malignancy
This refers to the process of TUMOR FORMATION
Neoplasia
Neoplasia is characterized by what?
Abnormal cells
These are cells that serve no purpose/function
Abnormal cells
Continuous proliferation of abnormal cells leads to formation of tumor, formation of new growth
True or False
TRUE
Also called tumor or new growth
Neoplasm
Neoplasm is also called …
Also called tumor or new growth
This is the study of tumors or neoplasm
Oncology
This is a common term for all malignant tumors
Cancer
Cancer is the common term for what?
for all malignant tumors
Oncology is the study of what?
Study of tumors or neoplasm
What are the two types of cancer according to behavior?
- Benign
- Malignant
This type of injury will definitely lead to cell death
Irreversible injury
This refers to programmed cell death
Apoptosis
apoptosis is considered as a physiologic phenomenon while necrosis is said to be pathologic
True ot False
True
When you say pathologic, the death of the cell is due to what?
due to a disease
This happens when the cells’ DNA and proteins are damaged beyond repair.
Apoptosis
In apoptosis, what happens when the cells’ DNA and proteins are damaged?
The cell kills itself by apoptosis
In apoptosis, the affected cell becomes bigger.
True or False
False
becomes smaller
In apoptosis, the affected cell becomes bigger.
True or False
False
becomes smaller
In this pattern of cell death, there is a reduction in cell size.
Apoptosis
there is cell shrinkage in necrosis
True or False
False
apoptosis
The plasma membrane remains intact and since the plasma membrane remains intact, the cellular contents do not leak out.
True or False
True
What is the reason why in apoptosis there is no inflammation?
no inflammation since there is no leakage of cellular contents
why is there no leakage of cellular contents in apoptosis?
because the plasma membrane remains intact
This pattern of cell death is considered accidental and unregulated
Necrosis
Apoptosis; cell shrinkage - necrosis;
cell swelling
In necrosis, what is enlarged?
affected cells are usually enlarged
In necrosis, what happens to the plasma membrane?
The plasma membrane is disrupted
In necrosis, what happens when there is a leakage?
there is inflammation
Inflammation ocurs because of what?
Because of a leakage of cellular contents in the plasma membrane
Give one example of Dysplasia
cervical intraepithelial neoplasia
This is a stage in the cellular evolution to
cancer
a pre-neoplastic lesion
In Dysplasia, there is normal growth and differentiation ; variation of size and shape
True or False
False
Abnormal growth… ; variation of size and shape and orientation
What is another term for Dysplasia?
PA
Pre-neoplastic Lesion or Atypical Metaplasia
This cellular adaptation may lead to cancer but not necessarily
Dysplasia
This is a type of necrosis due to sudden cutoff of blood supply.
Coagulative necrosis
This type of necrosis usually happens in solid organs like the heart kidneys and adrenal glands but definitely not in the brain.
Coagulative necrosis
Coagulative necrosis is a type of necrosis usually happens in solid organs like the heart kidneys, adrenal glands, and the brain.
True or False
False
Definitely not in the brain
Coagulative necrosis usually happens in solid organs like what?
- heart
- kidneys
- adrenal glands
In coagulative necrosis, the affected organ on gross inspection, appears like what?
Appears like a boiled material
This type of necrosis may happen due to complete digestion of dead cells.
Liquefactive necrosis
This type of necrosis is characterized by softening of necrotic material due to the action of hydrolytic enzymes
Liqufactive necrosis
Liquefactive necrosis is characterized by softening of necrotic material due to the action of what?
due to the action of hydrolytic enzymes
In liquefactive necrosis, affected organs appear …
appears liquidy and creamy yellow
Affected organs in liquefactive necrosis appears liquidy and creamy yellow because of what?
because of pus
Affected organs in liquefactive necrosis appears liquidy and creamy yellow because of what?
because of pus
This type of necrosis is a combination of coagulative and liquefactive necrosis.
Caseous necrosis
The affected organs of this type or necrosis appears soft and greasy resembling cottage cheese.
Caseous necrosis
Affected organs of caseous necrosis appears as what?
appears soft and greasy resembling cottage cheese.
Caseous necrosis is usually seen in what?
in tuberculosis
This type of necrosis is usually seen in tuberculosis
Caseous necrosis
This type of necrosis is due to immune reactions in the blood vessels.
Fibrinoid necrosis
In this type of necrosis, the changes are too small to see grossly.
Fibrinoid necrosis
In fibrinoid necrosis, the affected vessel appears thickened macroscropically.
True or False
False
Microscropically
This type of necrosis is seen in acute pancreatitis
Fat necrosis
Fat necrosis is seen in acute pancreatitis
True or False
True
In fat necrosis, the necrotic material appears like what?
Necrotic material appears like chalky white precipitate.
In this type of necrosis, the necrotic material appears like a chalky white precipitate
Fat necrosis
This type of necrosis is not actually a specific pattern of cell death.
Gangrenous necrosis
This type of necrosis is usually applied to a limb generally to the lower leg that has lost its blood supply.
Gangrenous necrosis
Gangrenous necrosis is a type of necrosis that is usually applied where? that has lost its blood supply.
to a limb generally to the lower leg that has lost its blood supply
refers to a leg to a lower extremity that has lost its blood supply.
Gangrenous
What are the two types of gangrenous necrosis?
- wet gangrene
- dry gangrene
Wet gangrene is due to what?
Due to venous occlusion
Dry gangrene is due to what?
Due to arterial occlusion
This type of gangrene is due to venous occlusion
Wet gangrene
This type of gangrene is due to arterial occlusion
Dry gangrene
This is actually a tissue reaction to an injury.
Inflammation
It is a vascular response to an injury.
Inflammation
what are the five cardinal signs of inflammation?
Ouch! Red Hot Tumor FuntionLaes (functionless)
- Pain
- Redness
- Heat
- Swelling
- Loss of function
Dolor is …
Pain
Rubor is …
Redness
Tumor is …
Swelling
Loss of function is …
Functio laesa
This is s due to increased dilation of blood vessels resulting in an increase rate of blood flow at the site of injury.
Rubor
Rubor is due to decreased dilation of blood vessels resulting in an increased rate of blood flow at the site of injury.
True or False
False
increased dilation
In rubor, increased dilation of blood vessels results to what?
Results to an increased rate of blood flow at the site of injury.
What causes redness?
the increased dilatation of blood vessels in the rate of blood flow.
This is due to the release of chemical substances like bradykinin that stimulates nerve endings for pain.
Dolor/Pain
Dolor is due to the release of chemical substances like what?
due to substances like bradykinin
What does chemical substances like bradykinin do?
they stimulate nerve endings for pain.
What causes dolor?
the release of chemical substances like bradykinin causing stimulation of nerve endings for pain.
This is due to the transfer of internal heat to the surface or to the site of injury
Calor/Heat
This is due to the extravascular accumulation of fluid.
Tumor/swelling
Tumor is due to the intravascular accumulation of fluid.
True or False
False
extravascular accumulation of fluid
Functio laesa is due to the destruction of what?
destruction of the functioning unit of the tissue.
This is due to the destruction of the functioning unit of the tissue.
Functio laesa/loss of function
This is the type of cell death that is a programmed/physiologic type of cell death.
Apoptosis
This refers to the death of the entire body.
Somatic death
In Somatic death, there are no changes that can be noted in the body.
True or False
False
there are changes noted in the body
Changes in somatic death may be classified into what?
- Primary
- Secondary
This is the change in somatic death wherein the changes can be noted immediately after that.
Primary changes
Primary changes are changes can be observed immediately after death.
True or False
True
These are the changes that can be noted a few hours after death.
Secondary changes
What are the SEVEN secondary changes in somatic death?
PPLARDA (sounds like legarda)
- Putrefaction
- Postmortem clotting
- Livor Mortis/Lividity/Postmortem Hemolysis
- Algor mortis
- Rigor mortis
- Desiccation
- Autolysis
What are the two terms of Livor mortis?
Lividity/Postmortem Hemolysis
This refers to the cooling of the body.
Algor mortis
This is the FIRST secondary change to appear in somatic death
Algor mortis
This secondary change is important in establishing time of death.
Algor mortis
Why is algor mortis important in establishing time of death?
Because this happens at a rate of 7°F.
At what temperature rate does algor mortis happen?
7°F
In short, why is algor mortis important in estalishing the time of death?
because the body temperature decreases every hour.
In algor mortis, the rate of decerase in temperature is faster in what conditions?
- faster in cold weather
- Faster in malnourished individuals
In algor mortis, the decrease in temperature is usually hastened if the cause of death is infection.
True
False
usually delayed
Why is there usually a delay if the cause of death is infection?
If there is infection, there is an increase in temperature.
For instance, at the time of death, the patient had fever, will the cooling of the dead person be faster or slower than it should be?
slower
This refers to the purplish discoloration of the skin.
Livor Mortis/Lividity/Postmortem Hemolysis
In livor mortis, the purplish discoloration of the skin is due to what?
Due to sinking of fluid blood into capillaries of the dependent parts of the body.
The purplish discoloration of the skin due to sinking of fluid blood into veins of the independent parts of the body.
True or False
False
into the capillaries of the dependent parts
Rigor mortis is lso called …
Rigidity
This refers to the stiffening of muscles
Rigor mortis
Rigor mortis occurs how many hours after death?
6-12 hours
Rigor mortis persists for how many day/s?
3-4 days
This is the secondary change in somatic death wherein the blood inside the body will clot.
Postmortem clotting
This is the clotting of blood in somatic death.
Postmortem clotting
This is the drying & wrinkling of the anterior chamber of the eye and cornea.
Desiccation
Dessication is the drying and wrinkling of what?
of the anterior chamber of the eye and cornea.
This is the examination of cells desquamated/shed from epithelial surfaces
EXFOLIATIVE CYTOLOGY
these are leftovers used in cell block technique
Sediments
what are examples of gynecological specimens?
GCN
- Cervicoginal smears (PAP smear)
- Nipple discharge
- Gastric or bronchial secretions
What are the types of non-gynecological specimens?
CUPS
- Pleural and peritoneal fluid
- Sputum
- Urine sediment
- CSF
PAP smear
Gynecological or non-gynecological
Gynecological specimens
Sputum
Gynecological or non-gynecological
Non-gynecological
Nipple discharge
Gynecological or non-gynecological
Gynecological
Pleural and peritoneal fluid
Gynecological or non-gynecological
Non-gynecological
Urine sediment
Gynecological or non-gynecological
Non-gynecological
CSF
gynecological or non-gynecological
non-gynecological
Gastric or bronchial secretions
Gynecological or non-gynecological
Gynecological
What are the advantages of exfoliative cytology?
- Cost effective
- Simple
- Low application rate
- High diagnostic accuracy
Smears are usually made from preserved material
True or False
False
Fresh material
Requisition form must contain the following:
Preparation of Smear
Patient’s ID, name, age, date, and type of specimen
What are some methods of smear preparation?
- Streaking
- Spreading
- Pull-apart
- Touch or impression smear/abraded cytology
PAP smears are not centrifuged
True or False
True
Why are PAP smears not centrifuged?
because they are received as smeared slides already
As soon as we receive the non-gyne and gyne specimens, we do centrifugation except for pap smears.
True or False
True
Centrifugation -> sediments -> smear prep
True
after centrifugation we use the sediments for smear preparation.
True or False
True
Specimen with decreased proteins do not require the addition of adhesives.
True or False
FALSE
specimens with increased protein
specimens with increased proteins which means they do not require the addition of WHAT?
adhesives.
Enumerate the specimens that require addition of adhesive
CUBE
- Concentrated sputum
- Urinary sediments
- Broncho Alveolar Lavage (BAL)
- Enzymatic lavage from GIT
Enumerate the types of adhesives used for specimens with increased proteins
PLACe
- Pure serum or plasma
- Leuconostoc culture
- APES
- Celloidin ether alcohol
If the protein content is very high it will require addition of adhesives but if protein content is low it will not require addition of adhesives
True or false
high; not require - low; require
What is the routine tissue adhesive?
Mayer’s egg albumin
In cytology, we only seldom use Mayer’s egg albumin
True or False
False
we NEVER use Mayer’s egg albumin for cytology
Adhesive must be permeable to both fixative and stain; Must not retain the stain
True or False
True
Why don’t we use Mayer’s egg albumin in cytology?
Because Mayer’s egg albumin is intensely stained by the counterstain used in paps/kapag ginamit mo during staining it will take up the color/dye makukulayan yung Mayer’s egg albumin.
FIXATION
Smears must be prepared and immediately immersed in fixative while still moist and before drying occurs
true or false
True
Why must we FIX exfoliated cells ASAP?
since exfoliated cells decompose rapidly which may destroy cellular and nuclear details
What happens if cellular and nuclear details are destroyed?
it will give inadequate results for diagnosis
How long and how many rotations per minute must centrifugation be?
Centrifuge at 2000 rpm for 2 minutes
After centrifugation, what happens to the supernatant and sediment?
supernatant must be decanted; use sediment for smear preparation
Extra sediment uses what technique?
Cell block technique
Since cells decompose rapidly, what must be done?
fix asap
If the sepcimen is not a smear (i.e., urine sample, CSF), what must be done first?
centrifuge
For specimens that are not a smear (i.e., urine sample, CSF), what must be done after centrifugation?
Remove the supernatant fluid, and use the sediments for smear preparation.
Common 7 Fixatives for Cytologic smears
- 95% ethyl alcohol
- Equal parts of 95% ethyl alcohol & ether
- Equal parts of tertiary butyl alcohol and 1 part 95% ethanol
- Carnoy’s fluid
- Spraycyte or cyto spray
- Schaudinn’s Fluid
- Saccomano preservative
Common Fixatives for Cytologic smears
This is considered the best but not commonly used because it is flammable.
Equal parts of 95% ethyl alcohol & ether
Why is Equal parts of 95% ethyl alcohol & ether considered the best but not commonly used?
because it is flammable.
This is the fixative commonly used for cytology.
95% ethyl alcohol
The tissue fixative is how many percent formalin?
10%
The routine cytological fixative is how many percent ethanol?
95% ethanol
This fixative is used for bloody specimens
Carnoy’s fluid
Carnoy’s fluid is used for what?
used for blood specimens
Spraycyte or cyto spray is a combinaion of what?
Combination of Polyethylene glycol and isopropyl alcohol
This fixative is a combination of Polyethylene glycol and isopropyl alcohol
Spraycyte or cyto spray
Spraycyte or cyto spray must be kept how many feet away from the slide?
1 foot
Spraycyte must be kept 2 feet distance from the slide.
True or False
False
This is the type of fixative that must be kept 1 foot away from the slide
Spraycyte or cyto spray
This is actually a combination of 50% ethanol and 20% carbo wax.
Saccomano preservative
Saccomano preservative is a combination of what?
combination of 50% ethanol and 20% carbo wax.
What does PAP smear stand for?
Papanicolau smear and stain
This is a screening test for cervical cancer.
PAP smear
PAP smears are a screening test for what?
Screening test for cervical cancer.
What are the 6 uses of PAP smear?
DDOMBE
- Determination of etiology of certain infections
- Determination of ovarian function
- One test to assess infertility
- Medico legal examination of sexual assault
- Evaluation of response of malignancy to post radiation or chemotherapy
- Barr Body determination
He is the father of cytopathology
George Papanicolaou
This is a stain that consists of 3 stains, developed by George Papanicolaou
Pap stain
What is the reason why it is called PAP Smear?
because we use the PAPANICOLAOU STAIN
What are the 3 stains used in PAP stain?
- Harris hematoxylin
- OG 6
- EA 50
What is H&E stain?
HEMATOXYLIN and EOSIN
This is used in Papanicolaou stain in order to stain the NUCLEUS
Harris Hematoxylin/NUCLEAR STAIN
This is the first dye to be applied
Primary dye
This is the FIRST counter stain
OG 6
Harris hematoxylin is used to stain what?
to stain the nucleus
This is the FIRST counterstain
OG 6
OG 6 is used to stain the what?
To stain the CYTOPLASM of MATURE superficial cells
This is used to stain the CYTOPLASM of MATURE superficial cells
OG 6 (Orange green 6)
OG 6 is made up of …
Orange green, 0.5 solution in 95% alcohol & phosphotungstic acid
This is the second counter stain
EA 50
This stains the CYTOPLASM of IMMATURE cells
EA 50
EA 50 is used to stain what?
Stain the CYTOPLASM of IMMATURE cells
What are examples of immature cells?
intermediate cells and parabasal cells
This is a polychrome mixture of Eosin Y, Light green SF and Bismarck brown.
EA 50
Light green SF, yellowish 0.1 % solution in 95% alcohol
True or False
True
Bismarck brown 0.5 in 93% alcohol
True or False
False
95% alcohol
Bismarck brown 0.5 in 93% alcohol
True or False
False
95% alcohol
Eosin Y 0.1% in 95% alcohol Phosphotungstic acid, lithium carbonate
True or False
False
Eosin Y 0.5%
EA 50 is comparable to EA 36
True or False
True
Procedure for PAP smear
10 steps
- Fixation with 95% ethanol
- Hematoxylin
- Differentiate with acid alcohol then wash with water
- Ammonia water then wash
- OG6
- 95% ethanol –washing , 2 changes
- EA 50 0r 36
- Dehydration
- Xylol
- Mount and label
Upon receiving the smear, the first step is to …
Fix it with ethanol
After fixing the smear with ethanol, what must be applied next?
apply hematoxylin
After applying hematoxylin, decolorize the smear using what?
Acid alcohol
After decolorizing the smear, place it in a bluing agent which is …
Ammonia water
Fix with ethanol > hematoxylin > acid alcohol > ammonia water > OG 6> ETHANOL > EA 50
True or False
True
In papanicolaou staining the nucleus will definitely appear as what color?
blue
in papanicolaou staining, cytoplasm of superficial cells usually have a color with a hint of …
green
In PAP staining, the cytoplasm of intermediate and parabasal will appear color what with a hint of color what and what
olive green ; hint of brown and red
A smear is will now only be ready for microscopy after what?
Afte pap staining
Normal Cells seen in PAP SMEARS
as to size, this is considered as the largest, but this is the smallest as for its nucleus
Superficial Cells
This normal cell seen in pap smears is the most mature
Superficial cells
large 30-6 u
These are cells with small dark pyknotic nuclei (less than 6u)
Polyhedral flat cells
These are cells that show TRUE ACIDOPHILIA
Superficial cells
For superficial cells, cytoplasm may be acidophilic or basophilic
True or False
True
characteristic of the vaginal cells under the influence of estrogen.
True acidophilia
This is the primary female hormone.
Estrogen
These are medium sized; slightly small than superficial cells
Intermediate cells
Intermediate cells have what characteristic in their cytoplasm?
basophilic with vacuoles, vesicular nuclei (6-9u)
These are boat-Shaped cells with a tendency to fold or curl on edges
Navicular cells
Navicular cells are found where?
Found in the latter half of menstrual cycle, menopause and during pregnancy
The presence of these cells suggest Progesterone-Estrogen effect
Navicular cells
These cells may also be found as a result of abnormal androgen stimulation, either endogenous or exogenous
Navicular cells
These cells are round to oval shaped cells with translucent basophilic cytoplasm due to glycogen accumulation
Pregnancy cells
These round to oval shaped cells with translucent basophilic cytoplasm due to what?
glycogen accumulation
With pregnancy cells, the nucleus is pushed to the center with a single walled boundary appearance
True or False
False
nucleus is pushed at periphery with double walled boundary
Cytoplasm of pregnancy cells stain with what color?
stains deep blue or blue green + cell membrane
Cytoplasm of pregnancy cells stain with what color?
stains deep blue or blue green + cell membrane
These are cells that are smaller than intermediate cells
parabasal cells
These are those said to assume a fried egg appearance
Parabasal cells
Usually parabasal cells may be found in increased number where?
after childbirth/after abortion/after menopause/ and 2 weeks of age to puberty
When does it happen that there are more parabasal cells compared to superficial?
Parabasal cells are more/after childbirth/after abortion/after menopause/ and 2 weeks of age to puberty
These are thick round to oval cells (15-25 u), with strong basophilic cytoplasm and vesicular nuclei (6-9u)
Parabasal cells
What cells are shed off from vaginal surfaces?
superficial, intermediate, and parabasal cells
What are the first cells being shed off?
superficial cells
These are the cells at the very bottom?
Parabasal cells
These are the smallest, but it is the one with a very big nucleus
Basal cells
basal cells are shed off naturally.
True or false
False
not shed off naturally, but are shed TRAUMATICALLY
these are small (13-20u) round, slightly oval cells, with relatively large nucleus occupying half or more of the cell volume
Basal cells
Cytoplasm of parabasal cells are strongly basophilic
True or false
True
These are cells found only in vaginal smears only before pregnancy and after menopause
Basal cells
How were pap smears previously recorded?
How are the results of Pap Smear recorded?
class system
What system is currently adapted or used to report the results of Pap smear?
Bethesda system
When was the class system last used?
December 1988
This class is Negative for malignant cells
Class I
These are atypical cells present, but negative for malignant cells
Class II
Suspicious for Malignant cells
Class III
strongly suggestive of malignant cells
Class IV
conclusive for malignant cells
Class V
The Bethesda System was developed where? when?
National Cancer Institute; December 1988
What are the 3 ways to format reporting?
DGS
- Descriptive diagnosis
- General categorization
- Specimen adequacy
it deals with the study of normal tissues and in the examination of tissues we use microscopes.
Histology
What is the other term for histology?
microscopic anatomy
Why is microscopic anatomy another term for histology?
because the study of tissues is carried out using a microscope.
this is the study of diseases
Pathology
What are the three specimens processed in histopath?
- Biopsy specimen
- Autopsy specimen
- Specimen for cytology
What is the difference between biopsy and biopsy speimen?
Biopsy is the process while biopsy speimen is the specimen coming from a living thing
lahat ba ng ipinapatanggal sa katawan will recquire mandatory submission to the lab?
No
What is the purpose of doing a biopsy?
Biopsy is carried out primarily to detect malignancy/detect cancerous conditions.
What are the exceptions of those specimens not submitted for biopsy?
Fat foreskin
- Foreskin removed during circumcision
- Fats removed from liposuction
What are the types of biopsies?
IBA
- Incisional
- Excisional biopsy
- Aspiration biopsy
Removal from the body is done by who?
surgeons
Processing of the removed specimen is done by who?
medtechs
Processing of the removed specimen done by who?
pathologists
It is the type of biopsy where we remove only part of the mass or part of the organ.
Incisional
It is the type of biopsy where we remove the entire mass or the entire organ.
Excisional Biopsy
Aspiration Biopsy is now called …
FNAB
Fine Needle Aspiration Biopsy
What are the disadvantages with FNAB?
problematic cells might be missed
This is the procedure carried out for palpable masses
fnab
Between incisional and excisional alin ang nakakapagbigay ng greater chances na ma-detect yung cancer?
Excisional, kasi mas malaki as it will provide a greater picture nung itsura.
Bakit hindi masyadong uso yung incisional and excisional biopsy?
Kasi ito mas mahal and will entail surgery
Purpose of doing biopsy:
to detect cancerous conditions
What is another term for autopsy?
necropsy
What is the most important requirement to do an autopsy?
The most important thing is to have consent from the nearest kin.
Hindi lahat ng patay naga-undergo ng autopsy as it is not a mandatory procedure.
True or false
True
What is the purpose of autopsies?
Purpose is to determine the cause of death
as to completeness of the procedure, what are two types of autopsy?
- Complete autopsy
- Partial autopsy
involves the examination of a dead body for the purpose of determining cause of death.
autopsy
This is the type of autopsy as to completeness of the procedure wherein the cadaver is examined from head to foot
Complete autopsy
This is the type of autopsy as to completeness of the procedure wherein the cadaver is only examined for specific parts
Partial autopsy
Autopsy can also classified as to the type of incision. What are these types?
- Straight cut incision
- Y-shaped incision
- T-shaped incision
This is the type of autopsy incision that is the most common
Straight cut incision
This type of autopsy incision is done for adult cadavers.
Y-shaped incision
How is a Y-shaped incision done?
The cadaver will be opened from bone shoulders down to the xiphoid, then from the xiphoid, down to the pubis.
What is the perfect example of Specimens for cytology?
pap smears
In the collection of pap smears, the doctor will ask the Px to lie down in what position?
in a lithotomy position.
What is the site of collection for pap smears?
T-zone / Transformation Zone
This the junction between endo and ectocervix
T-zone / Transformation Zone
Most of the time preserved specimen ang ating pinaprocess dahil pag dating satin nito ay nakababad na sa formalin. Pero we can also examine a fresh specimen.
True or False
True
What is an advantage of examining fresh tissue specimen?
allow us to detect protoplasmic activities
What do we mean by able to detect protoplasmic activities?
We can detect motility, mitosis, phagocytosis & pinocytosis.
What is a disadvantage of examining fresh specimens?
we cannot keep the specimen for a long time and keep it for future references..
What are advantages of examining preserved specimens?
- We can keep it for future reference
- We can do staining to provide better visualization.
What are the methods of examination?
TCS
- Teasing/ dissociation
- Squash Preparation or Crushing Technique
- Smear preparation
This is the method of examination where we get a watch glass, place small pieces of tissues then add NSS.
Teasing/dissociation
This is a method of examination wherein we use a loop, needle or even applicator to dissociate tissues
Teasing/dissociation
What type of microscope is used in dissociated tissues?
Brightfield or phase contrast microscope.
on a slide, place the small pieces of tissues on the slide then get another slide to compress the tissue in between the 2 slides. What method of examination is this?
Squash Preparation or Crushing Technique
The squash preparation or crushing technique is not suited for large tissues, only for small tissues with a size of 1 mm or more
True or false
false
1 mm or less
The squash preparation or crushing technique is not suited for large tissues, only for small tissues with a size of 1 mm or more
True or false
false
1 mm or less
vital dyes are used for what method of examination?
Squash Preparation or Crushing Technique
This vital dye is the best vital dye
neutral red
This is the most recommended method if you are dealing with cells (method for cytology)
Smear preparation
What are 4 ways in preparing a smear:
- Streaking
- Spreading
- Pull apart
- Touch preparation
This is a way to prepare a smear wherein you place the specimen on a slide w/ a loop needle or applicator stick, spread the specimen in a ZIGZAG manner.
This is a way to prepare a smear wherein you place the specimen on a slide w/ a loop needle or applicator stick, spread the specimen in a ZIGZAG manner.
Streaking
this way of preparing a smear is recommended for viscous specimens
Streaking
it is preparing a smear for AFB staining and measuring it by 2 by 3
Spreading
An advantage of streaking is that it preserves the intercellular relationship
True or False
FALSE
SPREADING
THIS IS ALSO A WAY TO REPARE A SMEAR THAT IS also suited for viscous specimen
PULL APART
It is done by spreading the specimen with the use of another slide and not with the loop or applicator stick, this is done by using 2 slides that overlap one another by pulling the slides towards opposite ends in order to spread the specimen
Pull apart
Touch preparation is also called …
impression smear, and also called abraded cytology
It is usually done with specimens for lymph nodes.
Touch preparation
In this method it is allowed for the slide to come in contact with the cut surface of an organ/tissue. If it is allowed to come in contact it will leave its own mark, and that mark is called imprint.
Touch preparation
This is a method of examination for rapid diagnosis
Frozen Section
This method of examination is Done INTRAOPERATIVELY
Frozen section
Fixation involves placing the specimen in formalin for how many hours?
22-48
After dehydration, what do we use for clearing?
xylene or chloroform
Within how many minutes, will it be determined whether it is benign or malignant?
within 15 mins
Previously a freezing microtome, but now, what i used?
cryostat/cold microtome
To prepare frozen, what is used?
CRYOSTAT
To prepare paraffin, what is used?
ROTARY
What is the purpose of frozen section?
- rapid diagnosis when the tissue is in the operating room
- if we process specimens with heat sensitive structures.
Infiltration is also known as …
impregnation
For specimens with heat sensitive structure, we prepare frozen sections.
True or False
tRUE
Frozen section is the section recommended if you want to demonstrate nervous tissues like peripheral nerve, myelin fibers.
True or False
True
For us to cut it faster, we need to have it frozen.
TRUE or False
True
Examples of freezing agents?
- Commonly used is carbon dioxide.
- liquid nitrogen
- isopentane.
What is the average temperature of a cryostat or cold microtome?
The average temperature is -20 degrees celsius
What do we do once we receive a specimen in histopath?
- Numbering
- Enter the details of the patient in the logbook.
What is numbering called if it is computerized?
Accessing
In histopath, we use a marker not only to take down the gross description but to also label the slide.
True or false
FALSE
PENCIL
what is the size of the specimen?
3x2cm.
what is the size of the specimen?
3x2cm.
What must the thickness of the specimen be?
Thickness: 3-5
What is the size for lung specimens?
1-2cm.
What is the size of the tissue cassette?
2.5 x 4 cm
What is the depth of a tissue cassette?
5 mm
it is an automatic tissue processor that can do fixation, dehydration, clearing, and infiltration.
autotech
It consists of 10 beakers. 1 L capacity beaker.
autotech
It consists of 10 beakers. 1 L capacity beaker.
autotech
Beaker arrangement:
first 2 beakers contain formalin for fixation
True or false
TRUE
BEAKER ARRANGEMENT
beakers 3-6 are for for clearing (containing: saline or chloroform)
True or false
FALSE
Beakers 7-8
beaker arrangement
beakers 3-6 contain ascending concentration of the alcohol (dehydration)
True or false
true
beaker arrangement
the last 2 beakers contain what for what?
contains paraffin wax for infiltration
What are the 4 autopsy techniques?
Autopsy techniques
- By Rudolf Virchow
- Carl Rokitansky
- Anton Ghon
- Maurice Letulle
Who is the Father of Modern Pathology?
Rudolf Virchow
Organs are removed one by one
R. Virchow
involves “EN-BLOC” removal of organs
Anton Ghon
involves in situ dissection (walang tatanggalin)
Carl Rokitansky
What does EN BLOC mean?
organs na magkakasystem ay tatanggalin sabay-sabay
involves removal of organs “EN MASSE”
M. Letulle
what does EN MASSE mean?
all organs are removed at the same time
