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PP A > Session 1 Lecture 1 > Flashcards

Session 1 Lecture 1 Flashcards

1
Q

What is disease?

A

A pathological condition of a body part, an organ, or a system characterised by an identifiable group of signs or symptoms.

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2
Q

What is disease a consequence of?

A

Failed homeostasis with consequent morphological and function disturbances.

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3
Q

What is pathology?

A

The study of suffering.

It is the branch of medicine concerned with disease and understanding the process of disease.

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4
Q

What is the importance of the microscopic diagnosis?

A

Provides a definitive diagnosis

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5
Q

In the breast, what can mimic cancer?

A

Fat necrosis

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6
Q

What is the main difference between histology and cytology?

A
  • Histology - look at cells in their architecture

- Cytology - look at individual cell not in their architecture

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7
Q

Give examples of when histology is used?

A

Core biopsies, cancer resection specimens, excised skin lesions, endoscopic biopsies

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8
Q

Give examples of when cytology is used

A

Fine needle aspirates of the breast, thyroid, salivary glands, lungs, effusions, cervical smears, sputum, urine

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9
Q

What does grading of cancer mean?

A

This tells us how nasty the cancer is.

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10
Q

What does staging of cancer tell us?

A

How far spread the cancer is in the body

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11
Q

What is adenocarcinoma?

A

Cancer of the glandular tissue

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12
Q

How does the histopathologist arrive at a diagnosis?

A
  • Pattern recognition
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13
Q

When looking down a microscope, what questions does a histopathologist ask himself?

A
  1. Is it normal or not?
  2. Is it inflammatory or neoplastic?
  3. Is it benign or malignant?
  4. Is this a primary tumour or a metastasis?
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14
Q

When is it cancer, what can a histopathologist tell us?

A
  • Type of cancer
  • Grade of cancer
  • Stage of cancer
  • Completeness of excision and if margins are involved, which ones
  • Likely efficacy of further treatments
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15
Q

What do you use to work out the stage of cancer?

A

TNM model is mostly used

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16
Q

What is the TNM model?

A

The size of the Tumour, whether Nodes are involved and whether the cancer has Metastasised.

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17
Q

What is Moh’s surgery?

A
  • Used to treat skin cancer

- Thin layer of cancer containing skin are progressively removed and examined until only cancer free tissues remain.

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18
Q

What is the goal of Moh’s surgery?

A

Remove as much skin as possible while doing minimal damage to the surrounding healthy tissues.

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19
Q

What can affect the efficacy of cancer treatment?

A

Er and Her2 receptors

20
Q

What are ER?

A

Oestrogen receptor

Group of proteins that are found inside and on cells.

21
Q

What are Her2 receptors?

A

Human epidermal growth factor

Protein that can affect the growth of some cancer cells

22
Q

What is first step to looking at a tissue under a microscope?

A
  • Need to prevent autolysis

- This is done by using fixatives.

23
Q

Fixation

A
  • This process holds the tissue in suspended animation.

- Usually uses formalin.

24
Q

What is the appearance of fresh tissue compared to fixed tissue?

A

Fresh tissue looks like raw meat and fixed tissue looks like cooked meat.

25
After fixation, what is the next process?
The specimen is examined and cut up by a pathologist.t The samples are taken and placed into a cassette.
26
Why do we have to make the tissue hard?
In order to take very thin slices
27
How do we get the tissue hard enough?
- Tissue is surrounded and impregnated with a hardening agent. - This is usually paraffin wax.
28
How do we embed something with paraffin wax?
- Dehydrate sample using alcohol. - Replace the alcohol with xylene. - Replace the xylene with paraffin wax.
29
What is used to cut the samples very thinly?
Microtome cuts the samples to 3-4 microns
30
What procedure is done after the samples are cut thinly?
Thin wax sections are floated on a water bath and picked up on a microscope slide. This process gets rid of all the creases in the tissue.
31
What is used to colour the tissue?
H&E Haemotoxylin stains the nuclei purple Eosin stains the cytoplasm and connective tissue pink.
32
What is the final stage of preparing a slide?
- Preserving and protecting the slice of tissue - This is done by adding a mounting medium to the slide and adding the coverslip. - The mounting medium then dries and hardens.
33
What is immunohistochemistry?
Demonstrates substances in/on cells by labelling them with specific antibodies.
34
How does immunohistochemistry work?
Usually the antibody is joined to an enzyme (e.g. peroxidase) that catalyses a colour-producing reaction.
35
Give some examples of substances that can be seen in immunohistochemistry
- Contractile protein actin - identifies smooth muscle cells - Cadherins - deficient in some carcinomas
36
What are cytokeratins?
Family of intracellular fibrous proteins that are present in almost all epithelia.
37
What are cytokeratins markers for?
Markers for epithelial differentiation.
38
What can cytokeratins give information about?
Give information about the primary site of a carcinoma. Particularly when used in combination CK7+/CK20- and CK7-/CK20+
39
What indicates the presence of carcinoma in lung, breast, endometrium, ovary and thyroid?
CK7+/CK20-
40
When CK7-/CK20+ are present, where is the primary site of carcinoma?
Large bowel, some gastric carcinomas.
41
What type of test can show how DNA is altered in tissues?
In situ microscopy tests. Common example is FISH - this can test for gains in additional copies of the Her2 gene in breast cancer.
42
What can sequencing of DNA purified from tumour tissue show?
It can show us if a certain mutation is present in a particular gene. e.g. if certain mutations are present in EGFR gene, tumour will respond to anti-EGFR treatments.
43
What does mRNA expression profiling methods demonstrate?
The level of activity of a large number of genes simultaneously.
44
What about frozen sections?
- Urgent histopathology - Not routinely used - Commonly used intra-operatively
45
What is the disadvantage of using frozen sections?
Morphology is not as good as in paraffin sections. Accuracy is about 96%.

PP A (13 decks)

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