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Cellular Pathology CA 1 > CELL PATH 1 > Flashcards

CELL PATH 1 Flashcards

1
Q

time frame for when results are issued depend on?

A

distance needed to travel and workload

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2
Q

what happens in the gross room include workflow

A

specimens are analysed and reviewed -> specimen is received + logged into computer, gross description is made and dissection occurs if necessary- specimens then go to tissue processing

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3
Q

How do labs identify samples

A

samples are logged into the system, a bar code is given, the date and time received is labelled and if more than one sample is received from a patient numerical designation occurs[ A, B, C]

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4
Q

what is the minimal acceptance criteria for a sample

A

full name
other identifier [DOB or hospital number]
Details about the sample type is it a skin or bone
specimen request form must match specimen pot

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5
Q

comment on the importance of clinical details and give examples

A

accurate and complete clinical details provide a rounded picture of the case- clinical history also helps in diagnosis - i.e. if their was a history with a previous cancer and a liver biopsy is being examined metastatic cancer is a probable diagnosis and immunocytochemistry will be performed. or if there was a history with alcoholism - a liver cirrhosis is a likely diagnosis - special stains would be required

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6
Q

Dissection Area Characteristics

A
  • Must be clean organized + ventilated
    • Adjustable dissecting tables [inbuilt downdraught extraction - allows extraction of toxic formalin fumes
    • Spillage kit
    • Cutting board, ruler, scalper, forceps, handled knife and probes, blunt end scissors, balance, digital recording and photography, PPE [aprons], systems for cleaning
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7
Q

Preparation to dissect

A
  • Review cases that need dissection
    • Assign priority cases
    • Assess case complexity
    • Assess if specimen needs opening
    • Adequate formalin levels
    • Label cassettes [tissue type]
    • Decide specimen type and categories
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8
Q

inking defines?

A

margins of resection # where tissue was cut out [indian ink]differential inking can also be done

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9
Q

Specimen Categories [comment on SOPS]

A

Specimens in A = transfer to tissue cassette =bone cores
B = transfer but need sampling, weighing or slicing =abscess
C - dissection + sampling [diagnostic assessment with preparation] [anus]
D - dissection + sampling [adrenal glands]
E- complex dissection + sampling [thymus]

- SOPS in place for dissection of particular specimen type + clinical history is taken into account
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10
Q

Definition of gross descriptions + what does it include

A

anatomic description which portrays macroscopic appearance of the specimen
1. Type + number biopsies received
2. Dimensions
3. Colour + consistency [tan yellow white]
4. Blood clots / foreign materials [soft hard / rubbery]
5. If Whole or part - assessed?
6. Tumour / abnormalities - location, number and gross description of tumour]

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11
Q

types of biopsy list them

A

Aspiration B -breast biopsy
Core biopsy - a type of percutaneous Biopsy - spring loaded gun = used
Cone Biopsy - diagnose cervical cancer
Endoscopic biopsy - Endoscope = used with sampling instruments
Punch Biopsy - skin rashes

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12
Q

LEEP

A

loop electrosurgical excision procedure

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13
Q

comment on paediatric specimens

A
  • Take special care [difficulties diagnosing]
    • Tumours from child usually small [need specialised procedures s- immunohistochemistry, flow cytometry, cytogenetics, electron microscopy and molecular genetics
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14
Q

give examples of gross-only examination samples

A
  • Some samples = examined only grossly - non-tissue samples
    • Bullets, implants and foreign bodies
    • Tissues - teeth, ribs, fat vessels
    • Foetal samples - miscarriages + still birth - strict guidelines
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15
Q

how long are histology samples stored post-final report

A

30 days

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16
Q

how long are fixed liquid cytology stored

A

21 days

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17
Q

definition of cellular pathology

A

alterations in cells + tissues caused by disease - can be infectious [i.e. helicobacter pylori can withstand stomachs acidic pH]

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18
Q

alterations in tissues can include

A

number, size + distribution of cells and molecular alterations [carbs, lipids, proteins + nucleic acids]

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19
Q

characteristic of cancer cells

A

MAPN
Metastasis - move from initial area of infection + replicate more
Apoptosis - cell death
Proliferate - increase in size
Neoplasia - excessive growth which leads to cancer

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20
Q

distinguish between histopathology + histology

A

histology - study of tissues [microscopic]
histopathology- study of changes in tissues caused by disease [microscopic]

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21
Q

what is clinical cytology// cytopathology

A

study of tissues within fluid

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22
Q

history of pathology - links by to

A

middle east during Islamic golden age
western Europe during Italian renaissance

23
Q

What did the physician Avenzoar do

A

performed the first post-mortem

24
Q

rudolf virchow is?

A

father of microscopy

25
what is formalin
A fixative + preservative
26
what are 3 sources of specimens
post-mortems, clinics, theatres
27
clinical cytology is involved in the preparation of what
fluid smears + fine needle aspirates
28
clinical cytology is used in what screening
cancer screening programmes
29
Tissue sample types - SLOBE
Scrappings - prostate Lobe- lung Organ - kidney B- biopsies -kidney E- excision- segment of the colon
30
Analysis of cells + tissue steps
1. Prep for microscopy 2. Histochemical methods are applied [#stains] 3. Immunophenotyping of cells [ antibody detects antigen expression] 4. Molecular analytical methods [changes in gene sequence #allows for early diagnosis] 5. QC + microscopy + maintain chemical + sample materials
31
what happens if tissue is not preserved
autolysis + putrefaction can occur immediately
32
Types of tissue preservation
1. Chemical preservation [most common] fixation in 1. formaldehyde 2. Glutaraldehyde or alcohol 2. Freezing - snap freeze + store in freezer 3. Heating - microwave preservation - Thermal [heating - protein coagulates which are abundant so tissue is held in place - boiling or microwave] - Freezing - water crystalizes solid matrix is formed and tissue is hard - CO2 and liquid nitrogen Chemical types of fixatives [most widely used] - done by coagulation + cross-linking - tissue samples are placed in chemical solutions which must permeate tissue [smaller specimens are permeated quicker + smaller]
33
Histochemistry + 4 e.g.s
study of chemical interactions in visualizing cell and tissue components 1. Dye stains 2. Metals [Gold + Silver staining] 3. Immunocytochemistry [antibody attaches label [binds to antigen] then allows visualization 4. DNA or RNA probe attaches label to nucleic acid - visualization
34
FIXATION definition
use of physical and chemical methods to prevent changes associated with tissue decay
35
Most tissues can be fixed but some can't
1. Muscle biopsies for enzyme histochemistry 2. Skin + mucosal biopsies to investigate inflammatory skin conditions [poor fixed tissues can compromise diagnosis [ will be visible once stained]
36
2 main reasons for fixation
prevents autolysis/putrefaction + maintains morphology + contents of tissue
37
what changes occur naturally to the nucleus
1. KARYOLYSIS - nuclear fading chromosomes become denatured by DNAase and RNAase 2. Pyknosis - DNA condenses - ends up as shrunken basophilic mass 3. Karyorrhexis - pyknotic nuclei membrane ruptures and undergoes fragmentation ALL of above lead to nucleus being dissolved and eventually leads to a dead cell with no nucleus
38
Ideal fixatives should do? give 6 examples
1. Prevent autolysis + bacterial decomp 2. Keep tissue in natural state + components 3. Make tissue insoluble in liquids that'll be used later in tissue processing 4. Preserve tissue volume so it doesn't swell 5. Avoid excessive hardness 6. Non-toxic + no-carcinogenic
39
give examples of cross-linking fixative + how does this cross-link form
Formaldehyde + glutaraldehyde - methylene bridge is formed between side and end groups of proteins
40
Mechanism of formalin
- Protein fixative - Formed when formaldehyde [colourless gas] is mixed with H2O - Is a liquid - 10% formalin = 4% formaldehyde - Commonly used in fixation - Formaldehyde + H2O = made of methylene glycerol which is added to a protein and H2O is removed = METHYLENE BRIDGES = FORMED between 2 proteins bound due to m. glycerol and [protein reaction]
41
Benefits of formalin
- Cheap slow permeation - Quick for small samples larger specimens= done overnight
42
disadvantages of formalin
- Biohazard - Effects other biomolecule cells - Cytoplasmic streaming - carbs moved to side gives uneven staining [glycogen] - not suitable when testing glycogen storage disease
43
Control measure for Formalin// HEALTH + SAFETY ISSUES
- Toxic + carcinogenic - PPE, containment level 2, well ventilation [formalin fumes are extracted when pot is opened]
44
fixation rate is divided into 2 parts
1. Penetration rate [ time taken for chemical to reach innermost surface] 2. Reaction rate [time taken for whole specimen to be fixated FIXATION RATE - 0.75mm per hour = 8 hours for total specimen
45
Glutaraldehyde
- CHO.(CH2)3.CHO - Best morphological preservation - Also cross-linking preservative - Used in 2.5% ph Buffer - Used for specimens undergoing electron microscopy [ not as effective permeation - so can't be used on big specimens]
46
Comment on coagulant fixatives
- Alternative to cross-linking fixatives - Dehydrate tissues [pull water out] - Increased penetration rate - Cause shrinkage [ poor preservation of mitochondria - not suitable for investigating disorders of mitochondria E.G. ethanol, methanol, acetic acid and acetone
47
other fixatives names DPMO-C
- - Osmium tetroxide - oxidising agent, secondary fixative - turns black [fixes lipid] - Mercuric chloride - precipitates proteins - good staining quality - hardens tissue - Picric acid - used in fixative solutions - changes charges of proteins side chain - good glycogen fixative - Dichromate fixatives - secondary fixative - K dicromate = used to show chromaffin reaction [oxidation catecholamines synthesized by tumours - adrenal gland Compound fixatives
48
Problems of fixation
1. Under fixation 2. Over-fixation 3. Antigen masking [ foreign ag = no longer accessible for histochemistry 4. fixated related deposits
49
List factors that affect fixation
1. Buffer + ph [in low ph target groups on proteins = unreactive in formaldehyde] + the cross-linking effects of formaldehyde = reduced 2. Duration of fixation + specimen size - time=distance fixative needs to penetrate through, compound fixatives components fixate @ diff rates. Gross specimens shouldn't be allowed to sit in fixative rather suspended 3. Temperature [ molecules diffuse quicker at an increased temp i.e formaldehyde penetration increases @ higher temp - tissue processors = enclosed @ higher temps 60-65 [but its controlled due to danger of fumes] 4. Concentration of fixative -need to get it right as it varies from fixative -> fixative if formalin conc is greater than 10% = 10% hardening + shrinkage [ineffective fixation] + ethanol concen less than 70% will fail to remove water 5. Osmolarity of fixative [best results when slightly hypertonic [ higher solute concentration] - if hypot-tissue will shrink -too hyper- tissue will swell
50
DECALCIFICATION
calcium must be removed from bone samples after fixation
51
what is decalcification
the removal of calcium from bone samples after fixation
52
Tissues is fixed [list following steps in x4
1. Tissue processing 2. Microtomy [cutting + paraffin wax] 3. Staining 4. Microscopy
53
what is tissue processing + give overview
removal of H2O- which is replaced with a medium - tissue is solidified and can be cut by microtome [done by tissue processor 1. Dehydration - H2O + fixative = removed 2. Clearing - dehydrating fluids = removed - tissue can now receive infiltration medium 3. Infiltrating - tissue is permeated with a support medium [paraffin wax] 4. Embedding - tissue = orientated in medium -> solidifies
54
aims of tissue processing
- Medium used = stable, firm, non-hazardous [i.e. wax] - Helps ability to cut thin section - Allows good preservation of tissue morphology + their contents - Long term preservation

Cellular Pathology CA 1 (1 decks)

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