U2 LAB: ACCESSIONING Flashcards
under Anatomic Pathology Laboratory Receiving
- Receiving
- Logging
- Accessioning/Numbering
under Receiving
- Request form
- Specimen
Specimen must always be accompanied by?
request form
This refers to documenting all steps, all information in request form, and all specimens.
Logging
This is the process of giving an identifying marker to a specimen.
Accessioning / Numbering
Accessioning starts in the?
receiving area
Accessioning is based on?
the time it was received
Request form must include:
- Health facility name
- Hospital number
- Name of patient*
- Date/time of request*
- Age/date of birth*
- Sex*
- Address
- Contact no.
- Clinical abstract
- Laboratory investigation/request
- Specimen
Clinical abstract includes?
- medical history of patient
- chief complaint
- details of the patient’s case
Specimen
Routine Histopath
Tissue/organ
Specimen
Cytology
smears
Specimen
Immunofluorescence
renal and skin biopsies
Specimen
fixative for Immunofluorescence
saline or liquid nitrogen fixative
Specimen
Immunofluorescence uses this to detect specific locations in the tissue
antigens
T/F: Immunofluorescence and Immunostaining uses the same fixative.
True
Specimen
Rush Frozen Section
- unfixed specimen
- specimens for Hirschsprung disease
Specimen
fixative for Rush Frozen Section
liquified carbon dioxide or liquid nitrogen
This is used for very high magnifications or ultramicroscopic details of specimen.
Electron Microscopy
Specimen Rejection Criteria
- condition is not ideal for test
- fixative is not sufficient
- wrong container
- long transport time
- wrong or incomplete filled request
- unlabelled or mislabeled specimen
This refers to decaying processes.
putrefication
Process of Logging and Numbering
- Verify info on request form
- Verify Specimen Label
- Enter data in logbook/LIS
- Accession the specimen
Importance of Accessioning
- avoid mixing/switching
- track down specimen/results
- prevents mismanagement
- process right specimen
- accurate and timely results
- proper management/treatment at right time
- record keeping
- laboratory planning
First step in histopathologic techniques
Accessioning / Numbering
Purpose of Accessioning
identify specimen without writing the name of the patient
initial assessment of specimen
Accessioning
This is to provide criteria for reception, registration and handling of surgical pathological specimens.
Specimen reception, accessioning and handling
All specimens must be delivered to the laboratory within?
1 hour maximum
10% neutral buffer takes how many hours for complete fixation?
12 to 24 hours
If specimen is within the 1 hour range, put in?
automatic tissue processor (to ensure complete fixation)
Patient information in request form
Refers to where the specimen was collected
Type of specimen (anatomic site)
T/F: Location of patient must be seen in request form.
True
Clinical history of patient must include the following:
- laboratory results
- pertinent lab works
- previous biopsies
- treatment done
- gynecologic and menstrual history
This is used for pathologic diagnosis.
Biopsy
T/F: Surgery residents may sign the request form.
True
For send out forms to referral laboratories, what must be included?
- Name
- Address of physician
Specimen container must be labeled with the following:
- Full patient’s name
- Medical record number
- Age and sex of patient
- Type of specimen (Anatomic site)
- Date and time of collection
- Location of patient (ward, patient ID/bed)
If birthday is not written, you may write?
medical record number
Where should the label in specimen containers be placed?
body of container
T/F: The one who collects the specimen will be the one to label the container.
True
Accession Number
S
Surgical specimen
Accession Number
A
Anatomic pathology
Accession Number
H
Histopathology
Accession Number
C
Cytology
The identity of every specimen is maintained at all time with two identifiers:
- MRN
- Pathology number
Used in identifying the case
Case accession number
Used if there are multiple specimens for the same patient case
Case specimen number (A,B,C)
Used if there are multiple blocks on the same specimen
Specimen block number (A1, A2, A3)
Used if there are multiple slides cut from a single block
Block slide number (1,2,3)
Refers to specimens that are cut before the physician is asking for a review
Recuts
All slides other than those stained by H&E will?
bear the name of the stain
Maintains records of blocks, slides, stains prepared, and is capable of demonstrating volumes for any given time
Quadramed
This refers to bacterial contamination or bacteria destroying the specimen cells
Putrefication
Cell is destroyed because of natural process of decomposition or enzymes inside the cell
Autolysis
This is common in specimens for slide reviews.
Damaged specimen or broken slides
T/F: The attending physician must be the one to enter the request on the computer.
True
All specimens from outside the hospital except government must have?
approval of Hospital administration and consultant
Requests for frozen section require ?
24 hours notice ahead of operation (result must be deployed before operation is finished)
Accessioning is carried out where and by who?
laboratory reception area, technologists
Specimen should be immersed in what fixative within 1 hour of biopsy?
10% buffered formalin
Volume of formalin should be at least _________ volume of the specimen.
10 times
All specimens must be fixed in 10% formalin except?
- Frozen section
- Immunofluorescence
- Electron microscopy
unfixed, fresh state
Frozen section
saline or liquid nitrogen
Immunofluorescence
2% glutaraldehyde solution in the cold after excision
Electron Microscopy
Renal biopsies
Before the procedure
call 15 minutes, immerse sample in saline
Renal biopsies
Examined under the dissecting microscope for?
glomeruli
- immunofluorescence
- glutaraldehyde for EM study
- formalin for paraffin processing
fixative for Testicular biopsies
Bouin’s fluid
fixative for Electron microscopy
4% glutaraldehyde solution then refrigerate
surgical margins should be oriented by sutures
Breast Lump
The apical nodes should be indicated by sutures.
Mastectomy
In case of simple mastectomy, this is to be indicated by a separate suture
superior margin
These are closest lymph nodes to the origin of cancer / malignancy (undergoes metastasis)
Sentinel lymph node
Requisition for sentinel lymph nodes includes:
- procedure type
- date and time of injection
- location of lymph node
- tracers used
- radioactivity count
If possible, this should be included to ensure integrity of lymph node capsules and assess tumor spread.
Perinodal fat
Known infective specimen should be clearly marked with?
Red marker
The proximal or distal excised margins should be oriented by suture.
Bowel Resection
Received frozen and stored in deep freezer for immunoflurescence studies
Skin Biopsies
Normally submitted for processing on same day
Tiny and small biopsies (Endoscopy and Dermatology)
Specimens are usually kept at room temp for how many weeks after the official report is released?
2 weeks
Referral slides must be accompanies by the official report with following info:
- Patient’s name
- Medical record number
- Hospital / clinic pathology number
- Number of slides / blocks
Specimens exempt from pathology examination
- foreign bodies
- hair, finger/toe nails (cosmetic reason)
- teeth, dental appliances
- lens
- calculi
- nasal septum cartilage, bone
- foreskin from circumcision (10y.o. and younger)
Specimens accepted for Gross Description only
- torn meniscus
- varicose veins
- bone fragments (non-pathologic fracture)
- ear cartilage
- fetus
This should be performed whenever there is a request by attending physician or at the discretion of the pathologist.
Microscopic examination
T/F: Specimens for Gross Descriptions are embedded in cassettes.
False
