Lecture 1

Question 1

What is a disease?

Answer 1

Consequence of failed homeostasis with consequent morphological and functional disturbances

Question 2

What is pathology?

Answer 2

Study of disease and cellular dysfunction. The opposite of biology

Question 3

What discipline of pathology does autopsies?

Answer 3

Cellular pathology which encompasses histopathology and cytopathology

Question 4

What are the pathology disciplines?

Answer 4

Chemical (errors of metabolism etc)

Haematology

Cellular (histo and cyto)

Immunology

Medical microbiology

Question 5

Importance of microscopic diagnosis?

Answer 5

To remove a lesion in major surgery microscopic diagnosis is required

Question 6

Histology vs cytology

Answer 6

Histology uses solid samples like core biopsies and skin lesions whereas cytology uses individual cells such as urine, cervical smears and effusions

Histology is more expensive and takes longer but is better for making diagnosis. Cytology cheaper and quicker but generally used to confirm or exclude conditions rather than make a diagnosis

Question 7

What is distension?

Answer 7

Enlargement or ballooning effect

Question 8

What is an adrenal mass?

Answer 8

A lump of tissue in the organs close to the uterus eg ovaries

Question 9

What is ascites?

Answer 9

Abnormal fluid accumulation in the abdominal or peritoneal cavity

Question 10

What can you look out for to see if cells are abnormal?

Answer 10

Enlarged nucleus

Multiple nucleoli

Question 11

Histological evidence of a malignant cell?

Answer 11

Enlarged cell

Enlarged nucleus:cytoplasm ratio

Hyperchromatism- increased darkness

Many nuclei- seen as dots

Variability in size and shape of nuclei

Mercedes Benz sign= mitosis figure

Question 12

What is neoplasia?

Answer 12

Abnormal growth of cells

Question 13

How does a histopathology at arrive at a diagnosis?

Answer 13

Is this normal or not?

Is this benign or malignant?

Is this inflammatory or neoplastic?

Is this a primary tumour or a metastasis?

Question 14

What can histopathologists tell us about cancer?

Answer 14

Type eg numerous types of lungs cancers all requiring different treatment

Grade eg poorly, moderately or well differentiated. Poorly differentiated hardest to treat as furthest from parent tissue

Stage- SNM used referring to degree of spread, number of nodes affected and metastasis

Can also provide frozen sections

Question 15

Eneumonic for cancer stage?

Answer 15

T tumour

N nodes

M metastasis

Question 16

What is the function of a fixative in histopathology?

Answer 16

To prevent autolysis (self digestion of the tissue)

Question 17

How big should your tissue sample be?

Answer 17

About the size of a stamp

Question 18

How do you get tissue hard enough to cut thin slices?

Answer 18

Use paraffin wax

Question 19

How are thin sections cut?

Answer 19

Microtome

Question 20

How are tissues stained?

Answer 20

Haemotoxylin and eosin.

Haemotoxylin stains nuclei purple while eosin stains cytoplasm and connective tissue pink

Question 21

How does immunohistochemistry work?

Answer 21

Specimens that are antigenic (have antigens) are targeted with antibodies which label them for viewing. Actin is an example

Question 22

What is molecular pathology?

Answer 22

Studies how diseases are caused by alterations in normal cellular molecular biology eg altered DNA, RNA or protein

Eg FISH fluorescence in situ hybridisation used to identify extra HER 2 gene in breast cancer

Question 23

Frozen sections?

Answer 23

Used during surgery take about 10 mins but artefacts common and so is miss diagnosis