LAB1 - Laboratory Safety, Instrumentation, and Quality Management System in Histopathologic Laboratory Flashcards
Art of analyzing and interpreting the shapes, sizes and
architectural patterns of cells and tissues within a given
specific clinical background
Histopathology
3 phases or activities in histopathology
o Pre-analytical
o Analytical
o Post-analytical
The art and science performed by the histotechnologist to
produce a tissue section of good quality
Histotechnology
responsible for the processing of tissue
sections
Histotechnologist
Provide the basic concepts about the principles and
technicalities involved in histopathologic procedures
Histopathologic Techniques
Provide skills in tissue preparation from fresh to properly
mounted specimen
Histopathologic Techniques
what is the purpose of fixation
to preserve the cellular component of the cells and the tissue particularly the nuclear and cytoplasm
Is comprised of a number of glass beakers for filling different
processing chemicals
Automatic Tissue Processor/ Autotechnicon
how many glass beakers are in Autotechnicon
12 beakers
what are the processes that Autotechnicon can handle?
fixation
dehydration
clearing
infiltration
the product of Automatic Tissue Processor is called as
autotechnicon
what are the 11 processes of histopathologic techniques
fixation
***Decalcification(optional)
dehydration
clearing
infiltration
embedding
trimming
sectioning
staining
mounting
labelling
what is the ideal fixative
formalin 10%
ideal agent for dehydration
ethanol - 70% to absolute acetic concentration
ideal clearing agent
xylene
medium used in infiltration
parafilm
medium used in embedding
parafilm, same with infiltration
) a ____ is used for the sectioning of the tissue
microtome
process of cutting into thin sections
Microtomy
An instrument where tissues are cut into sections
Microtome
Embedding media:
paraffin wax
thin sections of tissue are called as
Paraffin ribbons
what is the instrument that is embedded in cryostat
rotary microtome
Used when the specimen is
subjected for the frozen section
Cryostat
The _____ is a refrigerated
apparatus used in fresh tissue
microtomy, for freezing the
tissue into the block holder to
correct degree of hardness to
facilitate easier and faster
sectioning
cryostat
Embedding media/ method of cryostat
frozen tissue
temperature of cryostat, it maintains a temp of
-5 C to -30 C
parafilm is used in what section
parafilm section
if we used cryostat in tissue processing, the section is called as
frozen section
the purpose of embedding is to _____ to make it thinner
sectioning
Used to float paraffin ribbons, to stretch sections and remove
wrinkle
Tissue Water Bath
usually, tissue water bath is coated in black in order for us to _____
easily visualize and see the paraffin ribbons or the sectioning
the tissue water bath temperature
approximately 45 and 50 degrees
Celsius
Used for drying or
dehydrating
of
paraffin
ribbons after the water bath
Laboratory Oven
Optimizes times during STAIN PROCESS to maximize efficiency
(fast and increase accuracy) in obtention of results for a timely
diagnosis
Automated Tissue Stainer
examines the slide under the microscope to identify a disease process or an abnormality that will directly affect the
patient’s treatment
Pathologist
examines the same slide microscopically for
quality control to determine whether all technical processes are
done properly and if a slide of diagnostic quality has been
achieved
Histotechnologist
A microscope must accomplish 3 things:
o It must magnify the object (LPO)
o It must resolve the details of the object (HPO)
o It must make these details visible (IOI)
parts of the framework of microscope
base, arm, stage, substage, mechanical
parts of the lenses
nose piece, objectives, focal Length
Compound Microscope: Viewing Heads
Monocular
Binocular
Trinocular
is the process that increases the size of the
structure under examination
Magnification
The total magnification of a microscope is the product of the
magnifying power of the objective and eyepiece, with a normal
tube length of _____
160 mm
Process of ensuring and maintaining personal as well as
environmental health and safety in the laboratory
Risk Management
Risk Management
The first step is to _____ that can potentially cause harm in the
laboratory
identify all electrical, mechanical and
biological hazards
Types of Hazards in histopathology laboratory
a. Chemical Hazards
b. Physical Hazards
c. Biological Hazards
example of Chemical Hazards
Cleaning agents and disinfectants,
drugs,
anesthetic gases,
solvents,
paints,
compressed gases
Potential exposures to chemical hazards can occur both ‘____ and ____
during use and with poor storage
the “lab standard” applies to the laboratory use of chemicals and
mandates written in the ____that address the particular hazards and precautions required for safe use
Standard Operating Procedures (SOPs)
Are the terms used to define the maximum allowable
airborne concentration of a chemical (vapor, fume or dust)
to which a worker may be expose
Permissible Exposure Limits (PELs),
Threshold Limit Values (TLVs), or
Occupational Exposure Limits (OELs)
Permissible Exposure Limits (PELs), Threshold Limit Values
(TLVs), or Occupational Exposure Limits (OELs) is made up by ___
According to OSHA (Occupational Safety and Health Administration)
maximum allowable
airborne concentration of a chemical is about the 3 components, what are they
vapor, fume, dust
A regulatory limit on the amount or concentration of a
substance in the air
PELs – Permissible Exposure limits
To avoid some occupational exposure diseases that can
develop/ avoid adverse effects
PELs – Permissible Exposure limits
This is usually based on an eight-hour time weighted
average (TWA)
PELs – Permissible Exposure limits
Represents the maximum level of an airborne substance that
a worker can be safely subjected to without being
susceptible to harm or injury
TLVs – Threshold limit values
Indicates the level of admissible exposure, for a length of
time (usually 8 hours), to a chemical or physical hazard that
is not likely to affect the health of a worker
OELs – Occupational Exposure Limits
Every chemical should be labeled with certain basic information,
including:
o Chemical name and, if a mixture, names of all ingredients
o Manufacturer’s name and address if purchased
commercially, or name of person making the reagent
o Date purchased or made
o Expiration date, if known
o Hazard warnings and safety procedures
Different Types of Chemicals
Irritants
corrosive
sensitizers
Carcinogens
Toxic materials
Are chemicals that cause reversible inflammatory effects at
the site of contact with living tissue, especially the skin, eyes
and respiratory passages
Irritants
Irritants
* Are chemicals that cause reversible inflammatory effects at
the site of contact with living tissue, especially the ___
skin, eyes and respiratory passages
Cause destruction or irreversible alterations when exposed to
living tissue, or destroy certain inanimate surfaces (generally
metal)
Corrosive chemicals
Are capable of causing death by ingestion, skin contact or
inhalation at certain specified concentrations
Toxic materials
Toxic materials are can be acquired and cause death in what way
ingestion, skin contact or
inhalation
Toxic materials examples
methanol (causes aplastic anemia),
chromic acid,
osmium tetroxide
uranyl nitrate
Toxic materials that can cause aplastic anemia
methanol
Cause allergic reactions in some exposed workers, not just in
hypersensitive individuals
Sensitizers
Are substances that induce tumors, not only in experimental
animals but also in human
Carcinogens
Carcinogenic chemicals:
o Chloroform, chromic acid, formaldehyde, nickel chloride
and potassium dichromate
Carcinogenic dye
Include auramine, basic fuchsin, and any dye derived from
benzidine (including Congo red and diamino- benzidine)
Slips and falls from working in wet locations and the ergonomic
hazards of lifting, pushing, pulling, and repetitive tasks
Physical Hazards
flashpoint in OSHA is
100* or 38* C
flash point in DOT dep of transportation
141 * or 60.6 *C
-Substances that ignite a certain
temperature
combustible
substances whose vapors will ignite at or
above a certain temperature (or flash point)
or in the presence of an ignition source
Combustibles
silent chemicals
oxidizers
initiate or promote combustion and
present a serious fire risk when in
contact with certain substancess
oxidizer
example of oxidizers
sodium iodate,
mercuric oxide
chromic acid
Picric acid
refer to anything that can cause
disease in humans, regardless of their
source
Biological Hazards
___, are one of the most
important health hazards,
Allergens
Common Histological
Chemicals
Hydrogen peroxide
Methanol
Nitric acid
Xylene
Cryogens
osmium tetroxide
odium hypochlorite
(liquid chlorine bleach)
sulfuric acid
Hydrogen peroxide
Essentially harmless if used in
concentrations less than ____
5%
toxic by ingestion and inhalation
Methanol
Moderate skin and eye irritant
Methanol
nitric acid is Corrosive to ___
skin, mucous
membranes
Xylene is ___and _____ irritant, and is toxic
by _____
Skin and eye; ingestion, inhalation or skin
contact
cryogens
temperatures below ____, such as liquid nitrogen and a
boiling point of _____
-153°C (-243°F);
-196oC (-321°F)
Osmium tetroxide
Corrosive to ___ and ___
eyes and mucous
membranes
A strong oxidant, eye irritant and
corrosive to most metals
sodium hypochlorite
(liquid chlorine bleach)
sulfuric acid
Strong irritant to ____
skin,
eyes and
respiratory system
degree to which healthcare services strive
to provide accurate desired outcomes for
patients and are consistent with current
professional knowledge
Quality
“freedom from accidental injury”
Safety
system of routine technical
activities
Quality control
provides routine and consistent
checks to identify, address errors
and omissions, ensures data
integrity, correctness and
completeness and also records all
quality control activities
Quality control
Quality control provides
routine and consistent checks to identify, address errors and omissions,
ensures data
integrity, correctness and
completeness and also records all
quality control activities
planned system of review procedures conducted by personnel not directly
involved in the laboratory process
Quality Assurance
Quality assessment programs are handled internationally by
- College of American Pathologists (CAP)
- United Kingdom National External Quality Assessment Service (UK NEQAS)
data of QC provides the data for Q
- Getting the right _____
test at the right time on the right specimen from the right
patient with right diagnosis and the right price
2 selective system of quality assurance
selective and distributive
a system of QA which stained preparations from departmental archival records are used to assess the quality of staining
selective system
a qa system in which the participating laboratories are asked to stain sections that have been
submitted by the scheme organizer
distributive system
means that the report generated by
the lab are accurate.
Laboratory Quality Management System
QMS (quality management system) components
*concerns with good sampling
* Tissue processing with quality reagents
* Providing supplies and equipment
* Receiving
* Documenting
* Validating results
Goal of QMS
improve potential care and safety
through recognition of potential
problems/errors before they can occur
needed to have an Effective QMS
- Skilled histotechnologist/nicians
- Proper specimen collection
- Proper processing of
specimen - Efficient processing of
results - High quality of reagents
and equipment - Preventive Maintenance of
equipment - Continuous professional
education of staff - Documentation and
control - Proper coordination
- Timely customer’s
feedback
pre-analytical phase
- Collection of the right specimen
- The proper fixation of the specimen
- The correct identification of the spec
- The timely transportation of the specimen
this phase Can endanger quality of histopathology report
pre ana
Analytical phase
- Grossing
- Processing
- Procedure reliability using technical manual
- Reagent integrity and efficiency
- Cutting of paraffin sections
- Staining
- Slide labeling
Post-analytical aspects
- Diagnosis (hard copy) free of clerical errors.
- Reports reaches the appropriate
clinicians/surgeons. - Filing of paraffin blocks
- Slides storage
to have a proper fixation we must have
- proper concentration of the fixative
- ratio of the fixative 20:1
- types of fixative according to the tissue (10% formalin) (95% alcohol for pap smear )
