LEC6 - INTRO TO HISTOPATHOLOGIC TECHNIQUES Flashcards

1
Q

is defined as the process of preparing the tissue

A

tissue processing

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2
Q

refers to a better and more effective means of studying tissues whether normal or abnormal is by examination of their sections and smears which have been permanently preserved, stained, and mounted on glass slides with cover slips for permanent keeping

A
  • Processing of Tissue
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3
Q
  • Why examine histopathologic specimens?
A
  • Pathology attempts to explain the WHYs and wherefores of the signs and symptoms manifested by patients while providing a sound foundation for rational clinical care and therapy.
  • Determine if the sample is benign or malignant
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4
Q

is the microscopic study of the normal tissues of the body

A

histology

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5
Q

is the microscopic study of tissues affected by disease

A

histopathology

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6
Q

procedures adopted for the preparation of material for such studies

A

histologic or histopathologic technique

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7
Q

the examination of tissue has 2 major type of tissue

A

fresh and preserved

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8
Q

tissue processing is a process, by means of process, it refers to the phases which are

A

pre analytic
analytic
post analytic

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9
Q

the method of tissue examination may vary according to the following

A

the structural and chemical components of the cells to be studied

the nature and amount of the tissue to be evaluated

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10
Q

2 types of tissue to be examined

A

fresh and frozen tissue

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11
Q
  • ___ are usually examined when there is an immediate need for evaluation
A

Fresh Tissues

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12
Q
  • Advantages of fresh tissues
A

o Examined in the living state thereby allowing protoplasmic activities such as: motion, mitosis, phagocytosis and pinocytosis to be observed

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13
Q

again, what are the protoplasmic activities we can observed if we are using fresh tissues

A

motion, mitosis, phagocytosis, and pinocytosis

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14
Q
  • Disadvantages of the use of fresh tissues
A

its use has been limited/ the protoplasmic activities are limited in time only

liable to develop the changes that have been usually been observed after death

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15
Q

advantage of preserve tissue

A

once the cellular activity of tissue has stopped is preserved in life-like manner

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16
Q

METHODS OF FRESH TISSUE EXAMINATION

A

● Teasing or Dissociation
● Squash Preparation (Crushing)
● Smear Preparation
○ Streaking
○ Spreading
○ Pull-apart
○ Touch preparation (Impression smear)
● Frozen Section

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17
Q

A method in fresh tissue examination whereby a selected tissue specimen is immersed in a watch glass containing isotonic salt solution

A

Teasing or Dissociation

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18
Q

hypertonic solution can cause the cell to

A

shrink

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19
Q

hypotonic solution can cause the cell to

A

swell

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20
Q

teasing or dissociation method of fresh tissue is examined using what microscopy

A

unstained and examined using phase contrast and bright field microscope

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21
Q

if we want to stain the specimen by examining it using teasing or dissociation method, we can use ____ dye

A

methylene blue dye

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22
Q

CRUSHING method is also called as

A

squashing preparation

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23
Q

a process whereby a small piece of tissue in is placed in microscopic slide and forcible compressed with another slide or with a cover glass

A

squash preparation (crushing)

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24
Q

how many diameter is the limit for squash preparation

A

not more than 1 mm

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25
Q

can we use stain in squashing preparation? if so, how do we stain it

A

a vital stain may be placed at the junction of the slide and the cover glass, and allowed it to get absorbed by the tissue through capillary attraction

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26
Q
  • The process of examining sections or sediments whereby cellular materials are spread lightly over a slide by means of a wire loop or applicator, or by making an apposition smear with another slide
A

smear preparation for fresh tissue examination

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27
Q

this type of fresh tissue method of examination is useful in cytologic examination particularly for cancer diagnosis

A

smear preparation

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28
Q

techniques in smear preparation

A

streaking
spreading
pull apart
touch preparation

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29
Q

this smear preparation technique that uses an applicator stick or platinum loop, the material is rapidly and gently applied in a direct or zigzag line throughout the slide

A

streaking

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30
Q

what should we avoid in streaking - smear preparation

A

making of too thin or too thick smears, since they make the tissues unsuitable for examination

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31
Q

streaking -smear prep is used for preparing

A

mucoid secretions
vaginal secretions
sputum
gastric content

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32
Q

streaking - smear prep uses what materials

A

spatula,
dissecting needle
applicator stick

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33
Q

this smear prep attempts to obtain a relatively uniform distribution of secretion

A

streaking

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34
Q

smear prep technique

o A selected portion of the material is transferred to a clean slide and gently spread into a moderately thick film by teasing the mucous strands apart with an applicator stick

A

spreading

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35
Q

a smear prep that is A little more tedious but maintains cellular interrelationships of the material to be examined

A

Spreading

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36
Q

the use of spreading technique in smear prep

A

for fresh sputum
bronchial aspirates
thick mucoid secretions

37
Q

o A special method of smear prep whereby the surface of a freshly cut piece of tissue is brought into contact and pressed on to the surface of a clean glass slide,

A

Touch preparation (Impression smear)

38
Q

touch preparation is also called as

A

impression smear

39
Q

a smear prep which it allows the cells to be transferred directly to the slide for examination

A

touch preparation or impression smear

40
Q

 Touch preparation (Impression smear) is examined using

A

phase microscope or stained for light microscope

41
Q

o Cells may be examined without destroying their actual intercellular relationship

A

 Touch preparation (Impression smear)

42
Q

smear prep technique used in csf

A

pull apart

43
Q

smear prep technique used in breast secretion

A

pull apart

44
Q

method of rapid tissue processing

A

frozen section

45
Q

this type of fresh tissue prep recommended for lipids and nervous tissue

A

frozen section

46
Q

thickness of frozen section

A

10-15 um

47
Q

a cold chamber kept at an asmospheric temperature of -10C to -20C

A

cryostat

48
Q
  • Frozen sections are commonly used for:
A

o Rapid pathologic diagnosis during surgery
o Diagnostic and research enzyme histochemistry
o Diagnostic and research demonstration of soluble such as lipids and carbohydrates
o Immunofluorescent and immunohistochemical staining
o Some specialized silver stains, particularly in neuropathology.

49
Q

3 section of histopath

A

paraffin section
frozen section
Celloidin section

50
Q
  • Commonly used methods of freezing
A

o Liquid nitrogen
o Isopentane cooled by liquid nitrogen
o Carbon dioxide gas
o Aerosol sprays

51
Q

advantage of liquid nitrogen

A

used in histochemistry
most rapid of the commonly available freezing agents

52
Q

disadvantage of liquid nitrogen

A

soft tissue is liable to crack producing ice crystals or freeze artifacts

causes vapor phase

53
Q

advantage of isopentane cooled by liquid nitrogen

A

excellent method for freezing muscle tissue

54
Q

advantage of carbon dioxide gas

A

adapting a conventional freezing microtome

55
Q

advantage of aerosol sprays

A

adequate for freezing small pieces

rapidly freezing blocks of any type of tissue

56
Q

2 method of preparing frozen section

A

cold knife procedure
cryostat procedure

57
Q

a method of preparing frozen section wherein a tissue blocks are frozen by adapting a conventional freezing microtome gas supply of carbon dioxide gas from a CO2 cylinder or by using a specially made piece of equipment known as cryostat

A

cold knife procedure q

58
Q

optimum working temperature of cryostat is

A

-18C to -20C

59
Q

cryostat consist of

A

insulated microtome housed in an electrically driven refrigerated chamber and maintained at a temperature near -20*C where microtone, knife, specimen and atmosphere are kept at the same temperature

60
Q

steps in processing for paraffin section

A

fixation
decalcification(optional)
dehydration
clearing
infiltration (impregnation)
embedding
trimming
section-cutting
staining
mounting
labelling

61
Q

conventional method for freezing section

A

carbon dioxide gas

62
Q

clearing is also called as

A

dealcoholization

63
Q

Criteria for rejection of gross specimen

A
  • Discrepancies between the requisition and specimen label
  • Specimen with no labels, or mislabeled
  • Leaking specimen container
  • Absent clinical data or history
  • Inappropriately identified specimen
64
Q

can Specimens be received fresh (without fixative) or in formalin

A

yes

65
Q

For frozen sections, tissue is received _____ for immediate microscopic evaluation by the Pathologist.

A

fresh

66
Q

. May be received for an OR consultation

A

fresh tissue specimen

67
Q
  1. The Pathologist will look at the specimen and make a gross diagnosis

.what are the roles of PA

A

c. As the PA, you may weigh and measure the specimen.
d. As the PA, you may also ink the specimen, if necessary; however,
always check with the Pathologist before making any of these decisions.

68
Q

Ideally, the specimen should have at least _____times x its volume of formalin

A

20

69
Q

Specimen Accessioning rules

A

A. Each specimen receives an accession number.

B. Each number is unique to that particular case and is NEVER reused.

C. The specimen container(s), the requisition slip and all cassettes are labeled with the case/accession number

70
Q

Grossing, often referred to as “______”, it involves a careful examination and description of the specimen

A

cut-up

71
Q

grossing includes careful examination and description of the specimen such as it’s _______

A

appearance,
number of pieces
dimensions

72
Q
  • the most important processes in which the pathologist arrives at a diagnosis.
A

Gross Examination of Specimens

73
Q
  • Steps in grossing
A
  • Identification of the specimen
  • Patient’s surname, name birthday, hosp. number
  • The spec container must bear the same name and acc. Number in the request form
74
Q

Responsibility of a technician

A
  1. Specimen preservation.
  2. Specimen labeling, logging and identification.
  3. Preparation of the specimen to facilitate their gross and microscopy.
  4. Record keeping
75
Q
  • orientation markers
A

INKS
NICKING
SUTURE ATTACHES (LL and SS)

76
Q

an orientation marker that is to identify and orient the spec component

A

inks

77
Q

orientation marker for indicating laterality

A

nicking

78
Q

suture attaches are represented as

A

LL and SS

long lateral
short superior

79
Q

The specimen is then cut into representative sections and is put in small plastic cassette to hold the tissue

size of cassette

A
  • 3.0x2.5x0.4 cm
80
Q
  • Spec should not be more than _______ mm in thickness.
A

0.3

81
Q

Specimen-types

A

excision-specimens
incisional biopsies
punch biopsies
shave biopsies
curettings
core biopsies

82
Q

where whole organs or affected areas are removed at operation

A
  • Excision specimens (surgical biopsies
83
Q

, where tissue is removed for diagnosis from within an affected area

A

Incisional biopsy specimens,

84
Q

, to remove a small piece of suspicious tissue for examination (often from the skin)

A

Punch biopsies

85
Q

where small fragments of tissue are “shaved” from a
surface (usually skin

A
  • Shave biopsies
86
Q

where tissue is removed in small pieces from the lining of the uterus or cervix

A
  • Curettings
87
Q

where a small tissue sample is removed using a special needle sometimes through the skin (percutaneously

A
  • Core biopsies
88
Q
A