Chapter 29 HISTO Flashcards
(121 cards)
1
Q
microscopic examination of cells from different body sites for diagnostic purposes.
A
Diagnostic Cytology
2
Q
Diagnostic cytology includes ______ and ______
A
exfoliative cytology; fine needle aspiration
3
Q
For cytologic examination to be of diagnostic value, the sample must include _____ and ______
A
representative material; method used to process the specimen must give rapid results,
4
Q
most important in cytological interpretation.
A
Consistency and reliability
5
Q
Specimen for cytologic examination sources:
A
Exfoliative cytology; Fine needle aspiration; Body fluids
6
Q
deals with the microscopic study of cells that have been desquamated from epithelial surfaces.
A
Exfoliative cytology
7
Q
Exfoliated cells may be found in:
A
spontaneously shed or physically removed from epithelial and mucous membranes.
8
Q
Cytological specimens collected from female genital tract:
A
cervical smear; Vaginal smear; endometrial smear
9
Q
observed in normal cells due to constant growth and replacement with new cells
A
Spontaneous exfoliation
10
Q
Specimen can be collected from the epithelial surfaces by:
A
scraping the surface; by swabbing; aspirating; washing the surfaces
11
Q
Exfoliative cytology is usually recommended for the following:
A
Detection of malignant cells in body fluids
Detection of precancerous cervical lesions in women
Assessment of female hormonal status (sterility and hormonal disorders)
determination of genetic sex -most of the nuclei of females exhibit conglomeration of chromatin
12
Q
representing XX chromosomes (Barr body)
A
detection of infectious agents
13
Q
Smear Preparation (Exfoliative Cytology): Smears should be made from?
A
Fresh material, prepared in doctor’s office/radiology units
14
Q
Smear Preparation (Exfoliative Cytology): Direct Smear Preparation and Labelling
A
- Material is smeared evenly on slide
- Label with name, age, date and type of specimen, identifying number at frosted end
15
Q
Histotechnicians performs:
A
Special stains on cytology smears; Blood films; Cytopreps
16
Q
Most commonly received cytoprep
A
Thin prep
17
Q
Thin prep is wet-fixed in
A
95% ethanol
18
Q
Wet fixation of cytoprep in 95% ethanol is to preserve….
A
Fine structure of chromatin
Evaluation of nuclear changes
19
Q
avoided with smears for cytological detection of neoplasia because it changes the appearances of the cells.
A
Air drying
20
Q
usually air-dried specimens
A
Slides bearing BLOOD or BONE MARROW SMEARS
21
Q
Commonest cancer that can be detected even at the pre-invasive stage
A
uterine cervix cancer
22
Q
Cervical cytology screening involves cell samples from:
A
Ecto- and endocervix
23
Q
Stain used in cervical smear
A
Papanicolaou (Pap) method
24
Q
T/F. Cervical cytology is a screening test, abnormal findings must be confirmed histologically.
A
True
25
PAP Smear Patient Preparation
abstain from coitus
not douche the vagina for at least a day
not apply intravaginal preparations for at least one week before the examination
Smears should not be taken during menstrual bleeding
26
Contaminants that can obscure the cells during examination (PAP smear)
Blood
Endometrial component
Tissue debris
27
Collecting Systems to retrieve gynecology cells:
Cotton swabs
Wooden or plastic spatula
Cervical brushes; “cytobrushes”
28
Collecting system that retrieve more endocervical cells and blood = valuation difficulties
Brush biopsies
29
discouraged because of the drying artifacts and loss of cells that are caused by this method
Cotton swab
30
Preferable to use, with mildly rough surface that can collect more materials
Wooden spatula
31
used strictly for taking materials from endocervix
Endo-cervical brushing
32
Excessively thin or thick smears can result in
false-negative reports
33
often used for ulcerated surface lesions
Impression smear
34
T/F. (Impression Smear): preparations should be quickly air dried and then stained
True
35
Impression smear is indicated in cases of:
TUMOR (especially of lymph nodes)
36
Impression smear retrieval of specimen is done by
touching the cut surface with a clean slide
fixing immediately
37
Sputum smear specimen must be obtain at least ______
3 consecutive morning sputum
38
Sputum specimen must be collected ______
early morning by deep cough
39
Early morning sputum is collected in a wide mouth jar with
Saccomanno fluid
40
Saccomanno fluid is consist of _____ and _____
50% ethyl alcohol
2% carbowax
41
Induced sputum should be collected using _____
Inhalation of AEROSOL SOLUTION for 20 minutes
42
Number of slides to be prepared for extensive study
Minimum of 2-4 slides
43
Slides prepared for Sputum Smear
One air-dried for Giemsa Staining
at least 2 slides stained by Papanicolaou method
44
Sputum is poured into petri dish and examined first for
Blood-flecked
Solid particles
45
Minimum hours of fixation needed in sputum smear
Minimum of 1 hour
46
The sputum smear should be made without delay due to
Hardening effect of alcohol
47
Sputum collected should have been coughed from _______
Down-deep
48
In sputum smear, present of this substance can preserves the cell constituents
Mucus
49
found on the sputum smears from a deep cough
Alveolar macrophange
50
Absence of alveolar macrophages suggests
Saliva
51
directly smeared onto two labeled slides by pull technique
Bronchial Brushing Specimen
52
Bronchial Brushing specimen is fixed by
Spray fixative
Immersed in 95% alcohol
53
Bronchial Brushing specimen: Failure to fix the slides within a few seconds will produce
unsatisfactory cytologic results due to air drying artifact
54
freshly collected in the bronchoscopy collection container and hand delivered to the laboratory
Bronchial Washing specimens
55
Bronchial Aspirates is collected by
aspiration into a glass suction apparatus
washing the bronchi with 1-2 cc. of saline
56
If the specimen is collected directly from bronchus, then it must contain
Epithelial cells (ciliated bronchial cells) from BRONCHIAL MUCOSA
57
Gastric smear preparations are quite difficult to make due to
inaccessibility of the specimen
presence of gastric juices
58
deleterious effect on the morphology of exfoliated cells due to
presence of gastric juices
59
Smears of Gastric Secretions and Aspirates: Smears are usually collected by simple ____ and ____
irrigation and aspiration technique
60
Smears of Gastric Secretions and Aspirates: Patient Preparation
fasted for at least 8 hours before gastric washing is performed
61
T/F. Esophageal washings are to be examined immediately.
True
62
T/F. Cytologic examination of nipple discharge has an extremely low diagnostic yield for diagnosis of breast carcinoma.
True
63
Spontaneous nipple discharge is usually a result of _____ in young patients
hormonal imbalance
64
Bloody nipple discharge
Benign Intraductal Papilloma
65
T/F. spontaneous nipple discharge should be smeared on a clean glass slide, and immediately placed in fixative
True
66
T/F. During lactation and immediate post-lactation period, nipple discharge is ABNORMAL
FALSE
Nipple discharge is abnormal except During lactation and immediate post-lactation period
67
nipple discharge is usually due to a benign breast lesion such as duct:
Ectasia
Papilloma
Endocrine problems
68
major value of cytologic examination of nipple discharge is potential detection of _______ in a patient with clinically _______.
Malignant cells ; undetected carcinoma
69
Collection Technique (Breast Smear Secretion): Gently strip the ________ and nipple using the __________.
subareolar area ; thumb and forefinger
70
Collection Technique (Breast Smear Secretion): If more than a drop is collected, use another slide to smear with a _______
Pull-up technique
71
Collection Technique (Breast Smear Secretion): Immersed slide in a bottle of _______ or use ______
95% isopropanol ; spray fixative.
72
Collection Technique (Breast Smear Secretion): T/F. If the secretion is scanty in amount, smears should be restricted to a small area of the slide to prevent drying
True
73
Collection Technique (Breast Smear Secretion): T/F. Secretions obtained from both breasts should be properly identified as left or right.
True
74
study of cellular samples obtained from organs that do not shed cells spontaneously, such as breast, thyroid, lymph nodes, liver, lungs, skin, soft tissues and bones
Fine Needle Aspiration
75
organs that do not shed cells spontaneously
breast, thyroid, lymph nodes, liver, lungs, skin, soft tissues and bones
76
T/F. FNA is useful in lesions that are easily palpable
True
77
FNA basic technique uses
25-gauge needle
10-ml syringe
78
Requires larger bore needle and increased suction may be necessary
Tissues composed of MESENCHYMAL CELLS
79
Mesenchymal cells adhere to each other and do not _____
Exfoliate easily
80
FNA that is usually done by Clinicians and pathology
FNA of Superficial masses:
Breast, thyroid, peripheral lymph nodes
81
Deeply seated lesions are
lung
mediastinum
abdominal organs (liver, pancreas, etc.)
retroperitoneal organs (kidney, adrenal, lymph nodes
82
Deeply seated lesions are performed under
CT scan (Laparoscopy)
Ultrasound (Sonography)
83
sample should be air dried as quickly as possible to ___________
Reduce the effects of shrinkage
84
FNA slide preparation: most diagnostic material for cytologic evaluation
Few drops from Solid lesion
85
FNA slide preparation: Specimen is bloody leads to
Diluted cells
Hard to find on direct smear
86
FNA slide preparation: Maximum slides to be prepared
4 slides
87
FNA slide preparation: How many drops per slide
1-2 drops each slide
88
FNA slide preparation: Smearing technique used
Slide-pull technique
89
FNA slide preparation: Rinse the needle in a preservative solution such as _______
Saccomano fluid
90
FNA slide preparation: Ideal aspirate is ______
creamy consistency with numerous cells suspended in a small amount of tissue fluid
91
FNA slide preparation: In lymph node aspiration, _______ can be prepared in addition to smear.
Cell suspension
92
FNA slide preparation: T/F. Smears obtained by FNA are fixed based on the requirements of the stain to be used.
True
93
FNA slide preparation: Colloid, mucin and smears to be stained with ____
Hematoxylin stain (May-Grunwald-Giemsa)
94
FNA slide preparation: useful in preliminary assessment of adequacy of the sample
Rapid stain (Diff Quik 2-3 mins)
95
FNA slide preparation: Smears to be stained by _________or ______ should be rapidly fixed in alcohol (wet fixation)
Papanicolaou (Pap); hematoxylin and eosin (H&E)
96
FNA slide preparation: Specimen stained by Papanicolaou (Pap) or H&E exhibits
Nuclear details
Better identification of malignant cells
97
FNA slide preparation: In PAP and H&E if the specimen has artefacts it leads to
more eosinophilic cytoplasm
details appear fuzzy
98
FNA slide preparation: smeared by two-slide pull method
Transbronchial Fine needle Aspiration (FNA)
99
Cytological investigation of body fluids such as:
urine samples
cerebrospinal fluid
pleural or peritoneal effusions
100
Body fluids is obtained by
Aspiration
101
Body fluids is useful on the _____ and ______
ORIGIN and TYPE OF PRIMARY TUMOR
102
refers to the fluid accumulated in the three serous cavities namely pleural, pericardial and peritoneal
Serous effusion
103
presence of malignant cells in serous effusions usually indicate metastatic involvement and, therefore, a _______
higher stage of cancer
104
prevented by adding 300 units of Heparin for every 100 ml. of aspirate
Jelly-like clots
105
preferred for cytology
Freshly tapped specimens
106
If immediate processing is not possible, it can be preserved in the
Refrigerator for 24-48 hrs @4 deg cel.
Or 50%. Ethanol
107
should be used to prepare smears from prefixed sample
Albuminized slides
107
best method to collect cells from body fluid
Cytospin
108
no access to a cytospin, can make use of _______ and _______
centrifugation of the preparation and sampling of the centrifuged sediment
109
major objection to the use of cytocentrifuge
distortion of cellular morphology due to air drying artifacts
110
Immediate fixation is done by
using an equal volume of polyethylene glycol
111
received as the result of direct taps of pleural or peritoneal effusions, as well as from cerebrospinal fluid (CSF) and synovial fluid.
Cell suspencions
112
Most cytologists prefer to receive effusions as _____
rapidly as possible in sterile containers without fixative or anticoagulant
113
Optimum amount of Cell suspension
20-30 mL
114
Cells in cell suspension remains viable for up to ________
4 days
115
Cell in the specimen is kept _____
Refrigerated @4deg
116
Preparation of Cytospin slides: The specimen is centrifuged as soon as possible at ________ speed for ______ (our suggested method)
1000 RPM
1 minute
117
Preparation of Cytospin slides: sediment on a glass slide which has been previously coated with a __________
thin layer of egg albumin
118
Preparation of Cytospin slides: When it begins to dry around the edges but is still moist in the center, the smear is fixed in _______
95% alcohol
119
Preparation of Cytospin slides: If smears cannot be prepared immediately, the sediment should be covered with _______ and placed in the refrigerator.
absolute alcohol
120
Preparation of Cytospin slides: When secretions are small in amount, the smear should be prepared and fixed in the _______
operating room/bronchoscopy room
