INTRODUCTION TO PATHOLOGY Flashcards by RHEMA ENCARNACION

Area of science focusing on all the changes in cells, tissues, and organs that underlie a disease.

Pathology

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It is the study of diseases

Pathology

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What are the 4 aspects of pathology?

Etiology
Pathogenesis
Molecular and Morphologic Changes
Functional Derangement & Clinical Manifestations

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This refers to the cause: genetic/acquired

Etiology

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What are 2 causes based on etiology?

Genetic
Acquired

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It is the manner/sequence of events on how the disease had developed.

Pathogenesis

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This refers to the changes in cells -> tissues -> organs due to disease.

Molecular and Morphologic Changes

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Even the normal functioning of organs would be affected, and as a result, the patient will show manifestation of disease.

True or False

TRUE

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This refers to the incomplete/defective development of a tissue/organ

Abnormalities of cell growth/developmental defects

Aplasia

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Aplasia shows some resemblance to the normal adult structure.

True or False

False

shows no resemblance

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What are the paired structures for Aplasia?

kidneys & gland

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This is the complete non-appearance/absence of an organ

Abnormalities of cell growth/developmental defects

Agenesia

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This is the failure of an organ to reach its normal mature adult size (normal appearance)

Abnormalities of cell growth/developmental defects

Hypoplasia

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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

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What is blocked/absent in biliary atresia?

biliary duct

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Biliary atresia does not happen in newborns

True or false

FALSE

may happen in newborns

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This happens when the anus is missing or doesn’t have a hole.

Imperforate anus

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It is a type of birth defect of a baby’s ear where there is an absence of the ear canal

microtia

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An injury can be characterized into what?

Reversible or irreversible

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In general, what causes an injury?

Injurious Stimuli or Stressful Stimuli —> Normal Cells

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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

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What causes adapted Normal Cells?

Reversible Injury —> “cellular adaptations”

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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

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Reversible Injury using “cellular adaptations” causes what?

Adapted Normal Cells

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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?

1. physiologic 2. 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

1. Pressure atrophy 2. Vascular atrophy 3. Exhaustion atrophy 4. Endocrine atrophy 5. starvation/Hunger atrophy 6. 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?

1. Benign 2. 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?

1. wet gangrene 2. 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)

1. Pain 2. Redness 3. Heat 4. Swelling 5. 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?

1. Primary 2. 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)

1. Putrefaction 2. Postmortem clotting 3. Livor Mortis/Lividity/Postmortem Hemolysis 4. Algor mortis 5. Rigor mortis 6. Desiccation 7. 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

1. Determination of etiology of certain infections 2. Determination of ovarian function 3. One test to assess infertility 4. Medico legal examination of sexual assault 5. Evaluation of response of malignancy to post radiation or chemotherapy 6. 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

1. Fixation with 95% ethanol 2. Hematoxylin 3. Differentiate with acid alcohol then wash with water 4. Ammonia water then wash 5. OG6 6. 95% ethanol –washing , 2 changes 7. EA 50 0r 36 8. Dehydration 9. Xylol 10. 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

1. Descriptive diagnosis 2. General categorization 3. 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?

1. Biopsy specimen 2. Autopsy specimen 3. 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?

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

1. Foreskin removed during circumcision 2. Fats removed from liposuction

What are the types of biopsies? | IBA

1. Incisional 2. Excisional biopsy 3. 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

1. Teasing/ dissociation 2. Squash Preparation or Crushing Technique 3. 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:

1. Streaking 2. Spreading 3. Pull apart 4. 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.

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?

1. Numbering 2. 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

1. By Rudolf Virchow 2. Carl Rokitansky 3. Anton Ghon 4. 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

INTRODUCTION TO PATHOLOGY Flashcards

(445 cards)