Anatomical Pathology

Question 1

What is cytopathology

Answer 1

A branch of pathology that diagnosis diseases on a cellular level

Question 2

Advantages of cytopathology

Answer 2

S simple
A accurate
F fast
E economic

Minimally invasive

Question 3

What does cytopathology look at when observing cells

Answer 3

Patterns
Cell morphology (Sizes, shape, type)
Background

Question 4

Pitfalls of cytopathology

Answer 4

May require histopathology in correlation with cytopathology (can look like malignancy even if it isn’t)

Question 5

How to avoid cytopathology pitfalls

Answer 5

Get detailed clinical radiological data
Adequate specimens
Experienced pathologist
Strict application of cytopatholological criteria for diagnosis

Question 6

What fixatives are used in cytopathology and why are they used?

Answer 6

Most common = ethyl alcohol
Other
>100% methanol
>95% rectified spirit
>alcohol ether

To ensure cells don’t regenerate

Question 7

How can breast samples be obtained (what are the different methods of sample preparation)?

Answer 7

> FNA
Breast secretions

• 6 slide technique ( slide-push technique)
• centrifugation (2ml)

Question 8

How can free fluid samples be obtained (what are the different methods of sample preparation)?

Answer 8

Organ specific
30ml place in contained (100ml even better) with 3units heparin to prevent clotting →fridge until delivered

Centrifuge so that cells are isolated

Question 9

How can resp samples be obtained (what are the different methods of sample preparation)?

Answer 9

Deep cough, early morning specimen 3 days in a row
Bronchial lavage

Question 10

How can CSF samples be obtained (what are the different methods of sample preparation)?

Answer 10

PROMPTLY to lab
1-3ml needed

Question 11

How can urinary tract samples be obtained (what are the different methods of sample preparation)?

Answer 11

Promptly to lab
Indicate if voided/catheter sample
NB refrigerate

Question 12

What are different processing methods in the cytology lab?

Answer 12

> liquid based cytology (LBC)
direct smear
centrifugation
cytocentrifugation
cell block
millipede technique

Question 13

Indications for CSF sample in cytology

Answer 13

MALIGNANCY ONLY (NOT infections, this goes to micro)

Question 14

What are good sites for FNA

Answer 14

Great
Thyroid
Salivary glands
Lungs
Lymph nodes

Question 15

Bad sites for FNA

Answer 15

‘Lumps and Bumps’
Soft tissue (inaccurate analysis, variable tissue) and intra-abdominal organs (needle tract trauma)

Skin
Bone
Cartilage
Bone marrow (haematology)

Question 16

List the specimen audit trail

Answer 16

Registration
Prepared
Screened
Rescreened
Diagnosis entered
Authorisation
Available on lab track

Question 17

Types of staining

Answer 17

Pap
OQ
Ziel Neelsen

Question 18

What do you use for specimen fixation in histology

Answer 18

Formalin at 10:1 ratio with the tissue
Formalin penetration =1mm/hr

Question 19

Frozen section indications

Answer 19

> to confirm it’s histologically viable sample
excision margins
frozen section diagnosis will influence surgical procedure

Question 20

Why are autopsy’s done?

Answer 20

> to establish cause of death
teaching
research
quality control/audit

Question 21

Benefits of post-mortem

Answer 21

> family - definitive answer, remove guilt
public health statistics
medical education
data for insurance claims

Question 22

Documents needed for post-mortem?

Answer 22

Family consent
Clinical summary
Signed permission by hospital superintendent
Application by medical practitioner
Death certificate (natural causes)

Question 23

Documents for cremation

Answer 23

A -application for cremation
B-certificate of medical attendant
C - confirmatory medical certificate
D - certificate after post-mortem
E - authority to cremate
F - register of cremations