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HISTOPATHOLOGY (TopnotcherQT) > PAPANICOLAU METHOD (PAP'S SMEAR) > Flashcards

PAPANICOLAU METHOD (PAP'S SMEAR) Flashcards

1
Q

______________ is the SECOND BEST CHOICE for routine cytologic examination, AFTER PAPANICOLAU with a greater possibility for immediate microscopic examination used for hormonal evaluation of gynecologic specimen and for cancer detection

A

PHASE-CONTRASTE MICROSCOPY

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2
Q

APPLICATIONS OF PAPANICOLAU METHOD (PAP’S SMEAR)

A
  • SCREEN CERVICAL CANCER
  • To determine the cause of certain infection
  • Hormonal cytology
  • Medico-legal examination of sexual assault
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3
Q

PAP SMEAR PROCEDURE PREPARATION

A
  • PATIENT SHOULD ABSTAIN FROM COITUS
  • Do not douche the vagina for at least a day
  • Do not apply intravaginal preparations for at least one week before the examination
  • SMEARS SHOULD NOT BE TAKEN DURING MENSTRUAL BLEEDING, because contamination with blood, endometrial and tissue debris can obscure the cells in examination
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4
Q

Pap smear should be done at least _____ days after the last menstrual period

A

at least 10 DAYS AFTER THE LAST MENSTRUAL PERIOD

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5
Q

STAINS FOR PAP’S SMEAR:

A
  1. Harris hematoxylin
  2. Orange green 6 (OG-6) stain
  3. Eosin Azure 50 (EA-50) stain
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6
Q

Pap smear stain that stains the NUCLEUS:

A

Harris hematoxylin

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7
Q

Pap smear stain that stains the CYTOPLASM OF MATURE CELL and stains KERATIN

A

ORANGE GREEN 6 (OG-6) stain

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8
Q

Pap smear stain that sta8ins the CYTOPLASM OF IMMATURE CELL

A

EOSIN AZURE 50 (EA-50) stain

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9
Q

COMPONENTS OF EA-50 STAIN:

A
  • Light green SF
  • Bismarck brown Y
  • Eosin Y
  • Phosphotungstic acid
  • Lithium carbonate
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10
Q

Stains the CYTOPLASM OF OTHER CELLS, including non-keratinized squamous cells.

A

LIGHT GREEN SF

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11
Q

STAINS NOTHING and in contemporary formulants it is often omitted

A

Bismarck Brown Y

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12
Q

Stains the superficial epithelial squamous cells, nucleoli, cilia, and red blood cells

A

EOSIN Y

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13
Q

This method provides OPTIMUM NUCLEAR DETAIL information, which is important for cytologic evaluation of PAP’s smears, non-gynecological and FNA cytologic specimens

A

MODIFIED PAPANICOLAU STAIN

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14
Q

In Modified Papanicolau stain, to produce a more distinct color differentiation:

A

BISMARCK BROWN IS OMOTED from the EA 50 formula

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15
Q

Routine Pap’s procedure staining time

FIRST STAIN:

A

FIRST STAIN:
Stain in Harri’s hematoxylin, 5 minutes

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16
Q

Routine Pap’s procedure staining time

SECOND STAIN:

A

SECOND STAIN:
Stain in OG-6, 2 minutes

OG-6 is the FIRST COUNTERSTAIN in PAP’s smear

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17
Q

Routine Pap’s procedure staining time

THIRD STAIN:

A

THIRD STAIN:
EA-50 is the SECOND COUNTERSTAIN in PAP’s smear

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18
Q

PAP’S SMEAR STAINING REACTION:

Nucleus:
CYTOPLASM, Keratinizing cells:
CYTOPLASM, Non-keratinizing cells:

A

NUCLEUS: BLUE or BLACK

CYTOPLASM, Keratinizing cells: PINK or ORANGE

CYTOPLASM, Non-keratinizing cells: BLUE or GREEN

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19
Q

For vaginal hormonal cytology, smears are best taken from the __________________________ because it is more accessible and less likely to be contaminated by cellular debris and vaginal discharge

A

UPPER LATERAL THIRD OF VAGINAL WALL

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20
Q

Estrogen effect:
Progesterone effect:

A

Estrogen effect: INCREASED SUPERFICIAL CELLS
E—->S

Progesterone effect: INCREASED INTERMEDIATE CELLS
P—->I

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21
Q

In hormonal cytology, slide is checked under the ________________ to assess the quality of the smear and staining; quantitative evaluation is done using the ______

A

Hormonal cytology:

LPO: Quality
HPO: Quantity

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22
Q

Different cytologic samples:

A
  1. Upper lateral third of the vaginal wall
  2. Ectocervix
  3. Endocervix
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23
Q

Cytologic sample ideal for vaginal HORMONAL STATUS:

A

UPPER LATERAL THIRD OF THE VAGINAL WALL

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24
Q

MOST COMMON SITE FOR CANCER SCREENING because this is where malignancies arise

A

ECTOCERVIX

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25
Q

For the detection of ENDOCERVICAL AND INTRAUTERIN LESIONS

A

ENDOCERVIX

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26
Q

Tools for gynecologic specimen collection:

A
  • Glass pipette and bulb
  • Ayre’s spatula
  • Laryngeal cannula
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27
Q

Tool used for vaginal aspiration:

A

Glass pipette and bulb

28
Q

Tool used for swab smears

A

Ayre’s spatula

29
Q

Tool sued for endocervical or endometrial aspiration:

A

Laryngeal cannula

30
Q

Cells found in cervico-vaginal smear:

A
  1. mature superficial cells
  2. Intermediate cells
  3. Parabasal cells
  4. Endometrial cells
  5. Endocervical glandular cells
31
Q

These polyglonal squamous cells measures 45 to 50 um and are identified by the presence of pale, pink-standing cytoplasm and DARK PYKNOTIC NUCLEI

A

MATURE SUPERFICIAL CELLS

32
Q

Medium-sized polyhedral or elongated cells with BASOPHILIC VACUOLATED CYTOPLASM

A

INTERMEDIATE CELLS

33
Q

Boat shaped intermediate cells with strong tendency to fold/curl on edges and its presence suggests a combined estrogen-progesteron effect

A

NAVICULAR CELLS

34
Q

Round/oval boat shaped intermediate cells with translucent basophilic cytoplasm observed greatest at the center of the cell

A

PREGNANCY CELLS

35
Q

Round or oval cells with small dense basophilic cytoplasm; similar to ‘FRIED FRESH EGGS” with sunny-side up 15-30 um

A

PARABASAL CELLS

36
Q

Small cells, slightly cylindrical with less basophilic cytoplasm occurs in a tightly-packed groups of 3 or more; found during 1-10 DAYS AFTER MENSTRUATION

A

ENDOMETRIAL CELLS

Note: Smears taken during menstruation is UNSATIFACTORY because it will yield to a high level of WBCs, RBCs, and endometrial cells

37
Q

Occur in large groups or small sheets; Cytoplasm stains pale blue/gray and finely vacuolated, often with indistinct cell borders and nuclei with finely granular chromatin; “HONEYCOMB” appearance when viewed on end

A

ENDOCERVICAL GLANDULAR CELLS

38
Q

Small, round to slightly oval cells with relatively large nuclei normally found in PUBERTY and AFTER MENOPAUSE:

A

BASAL CELLS

39
Q

Most common organism of the nromal vaginal flora that maintains the ACIDIC pH of the vagina; stains BLUE TO LAVENDER with Pap’s method:

A

DODERLAIN BACILLUS

40
Q

Budding yeast seen in DIABETIC patients, people taking oral contraceptives and immunocompromised patients

A

Candida albicans

41
Q

Pear-shaped organism that stain BLUE-GREEN with a slit-like eccentric nucleus “PING=PONG DISEASE”

A

Trichomonas vaginalis

42
Q

Long thin filamentous bacilli, increased in high vaginal pH

A

Leptothrix spp.

43
Q

Abnormal variation of squamous epithelial cells that suggests the presence of Gardnerella vaginalis

A

CLUE CELLS

44
Q

Contaminant due to gloves (powder in gloves)

A

TALCUM

45
Q

Squamous epithelial cell that show the cytopathic effect of Human Papilloma Virus (HPV)

A

KOILOCYTES

46
Q

Also known as ARBORIZATION and the ferning is due to formation of SALT CRYSTALS in high NaCl concentration in cervical mucus under the influence of estrogen; sign/basis for early detection of EARLY PREGNANCY:

A

FERN or PALM=LEAF PATTERN

47
Q

Manner of reporting Pap’s smear:

A
  1. Class system
  2. Bethesda system
48
Q

Reporting of Pap’s smear based on the presence of malignant cells; obsolette:

A

Class system

49
Q

ABSENCE of atypical or abnormal cells

Class:

A

Class I

50
Q

Atypical cytological picture but NO EVIDENCE of malignancy

Class:

A

Class II

51
Q

Cytologic picture SUGGESTIVE BUT NOT CONCLUSIVE of malignancy

Class:

A

Class III

52
Q

Cytologic picture STRONGLY SUGGESTIVE of malignancy

Class:

A

Class IV

53
Q

Cytologic picture CONCLUSIVE of malignancy

Class:

A

Class V

54
Q

New manner of reporting for cervical and vaginal cytologic diagnosis

A

Bethesda system

55
Q

Format of reporting using Bethesda system:

A

Specimen adequacy,
General categorization,
Descriptive diagnosis

56
Q

In collection of sputum, absence of alveolar macrophages suggest ________ rather than sputum and results an UNSATISFACTORY SPECIMEN

A

SALIVA

57
Q

For respiratory tract specimen, obtain at least _______________ sputum specimen

A

3 CONSECUTIVE MORING SPUTUM SPECIMEN

58
Q

Collect early morning sputum by DEEP COUGH in a wide-mouthed jar containing _______________________

A

SACCOMANO’S FLUID (50% Ethyl alcohol and 2% Carbowax)

59
Q

Respiratory tract specimens:

A
  • SPUTUM
  • Bronchoalveolar lavage (BAL)/ Bronchial washing (BW)
  • Bronchial brushing (BB)
60
Q

For Gastrointestinal specimen, the patient should have fasted for _________ before gastring washing is performed

A

8 hours

61
Q

For peritoneal, pleural and pericardial fluid, jelly-like clots may be prevented by adding ___________ for every _______ of aspirate

A

300 units of heparin for every 100 mL aspirate

62
Q

When breast secretion is BLOODY, a _______________ should be considered clinically

A

BENIGN INTRADUCTAL PAPILLOMA

63
Q

Preferred urinary tract specimen:

A

Second urine

64
Q

Urine specimen volume needed to be centrifuged after collection::

A

at least 50 mL IS NEEDED, which must be CENTRIFUGED

65
Q

For CSF specimens, how much is the minimum volume necessary for cytologic evaluation?

A

1cc

HISTOPATHOLOGY (TopnotcherQT) (26 decks)

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