Cytology

Question 1

often used for ulcerated surface lesions to allow an immediate assessment of the lesion before fixation and processing of the tissue sample

Answer 1

Impression smear

Question 2

It is also indicated in the case of tumors especially of lymph nodes.

Answer 2

Impression smear

Question 3

Soon after an excision biopsy of lymph node, the specimen is cut using a sharp scalpel blade an imprint of the smear is taken by touching the cut surface with a clean slide and fixing immediately.

Answer 3

Impression smear

Question 4

What is the minimum number of consecutive morning sputum specimens that should be obtained?

Answer 4

At least 3 consecutive morning sputum specimens

This ensures a more accurate diagnosis.

Question 5

How should early morning sputum be collected?

Answer 5

By a deep cough in a wide-mouthed jar containing Saccomanno fluid

Saccomanno fluid consists of 50% ethyl alcohol and 2% carbowax.

Question 6

What should be done if the patient cannot cough up sputum spontaneously?

Answer 6

Induced sputum should be collected using inhalation of an aerosol solution for 20 minutes

This method helps produce a deep cough sample.

Question 7

If a more extensive study is to be made, how many slides should be prepared?

Answer 7

A minimum of 2-4 slides should be prepared

This allows for thorough examination and analysis.

Question 8

What is the purpose of air drying one of the sputum slides?

Answer 8

For Giemsa staining

Giemsa staining helps in identifying cellular components.

Question 9

How many slides should be stained using the Papanicolaou method?

Answer 9

At least two slides should be stained by the Papanicolaou method

This method is used for cytological evaluation.

Question 10

What does Diagnostic Cytology mean?

Answer 10

Microscopic examination of cells from different body sites for diagnostic purposes.

Question 11

What are the two main types of cytology included in Diagnostic Cytology?

Answer 11

• Exfoliative cytology
• Fine needle aspiration

Question 12

What is crucial for cytologic examination to be of diagnostic value?

Answer 12

The sample must include representative material and the processing method must yield rapid results without sacrificing cellular detail.

Question 13

What factors are most important in cytological interpretation?

Answer 13

Consistency and reliability.

Question 14

What do cytologists rely heavily on for their work?

Answer 14

The quality and appearance of the stain.

Question 15

From what sources can specimens for cytologic examination be derived?

Answer 15

• Exfoliative cytology
• Fine needle aspiration
• Body fluids

Question 16

What does Exfoliative Cytology study?

Answer 16

The microscopic study of cells that have been desquamated from epithelial surfaces.

Question 17

How are exfoliated cells typically found?

Answer 17

In smears that have been spontaneously shed or physically removed from epithelial and mucous membranes.

Question 18

What types of cytological specimens are collected from the female genital tract?

Answer 18

• Cervical smear
• Vaginal smear
• Endometrial smear

Question 19

What is spontaneous exfoliation?

Answer 19

The shedding of normal cells due to constant growth and replacement with new cells.

Question 20

What is more readily observed in malignant tumor cells?

Answer 20

Spontaneous exfoliation.

Question 21

How can specimens be collected from epithelial surfaces?

Answer 21

• Lightly scraping the surface
• Swabbing
• Aspirating
• Washing the surfaces

Question 22

For what purposes is Exfoliative Cytology usually recommended?

Answer 22

• Detection of malignant cells in body fluids
• Detection of precancerous cervical lesions (cervicovaginal smear/Pap smear)
• Assessment of female hormonal status in case of sterility and endocrine disorders

Question 23

What is the maturity index (MI) used for in Exfoliative Cytology?

Answer 23

It is based on microscopic evaluation of smears taken from the lateral vaginal walls.

Question 24

What does the conglomeration of chromatin in female nuclei represent?

Answer 24

XX chromosomes (Barr body)

This can be demonstrated in smears from buccal or vaginal mucosa.

Question 25

What is the purpose of smear preparation?

Answer 25

Detection of infectious agents ## Footnote Smears should be made from fresh material in a clinical setting.

Question 26

What information must be indicated on the laboratory requisition form?

Answer 26

Patient's name, age, date, and type of specimen ## Footnote The laboratory identifying number should also be on the slide.

Question 27

What is the recommended fixation method for cytology smears?

Answer 27

Wet-fixed in 95% ethanol ## Footnote This preserves the fine structure of the chromatin.

Question 28

Why should air drying be avoided in smears for cytological detection of neoplasia?

Answer 28

It changes the appearances of the cells ## Footnote Air drying is acceptable for blood or bone marrow smears.

Question 29

What is the commonest cancer that can be detected through cervical cytology screening?

Answer 29

Cancer of the uterine cervix ## Footnote It can be detected even at the pre-invasive stage.

Question 30

What is the Pap smear?

Answer 30

Microscopic examination of cell samples from the cervix ## Footnote The cells are stained by the Papanicolaou method.

Question 31

What must be done if abnormal findings are found in cervical cytology screening?

Answer 31

They must be confirmed histologically ## Footnote Cervical cytology is a screening test.

Question 32

What should patients avoid before a cervical smear examination?

Answer 32

Coitus, douching, and intravaginal preparations ## Footnote Abstain for at least a day or a week before the examination.

Question 33

Why should smears not be taken during menstrual bleeding?

Answer 33

Due to contamination with blood, endometrial components, and tissue debris ## Footnote These can obscure the cells during smear examination.

Question 34

What types of collecting systems are used for cervical smears?

Answer 34

Cotton swabs, wooden or plastic spatula, cervical brushes (cytobrushes) ## Footnote These systems facilitate the collection of cell samples.

Question 35

What type of cells are collected in gynecology?

Answer 35

Endocervical cells and blood ## Footnote Brush biopsies may contain more endocervical cells and blood, leading to evaluation difficulties.

Question 36

What collection method for cervical smears is discouraged?

Answer 36

Cotton swab ## Footnote Cotton swabs cause drying artifacts and loss of cells.

Question 37

Which spatula is preferable for collecting cervical samples?

Answer 37

Wooden spatula ## Footnote Wooden spatula has a mildly rough surface that collects more material than plastic spatula.

Question 38

What is the purpose of endocervical brushing?

Answer 38

To take materials from the endocervix ## Footnote Endocervical brushing is used strictly for this purpose.

Question 39

How should a smear be prepared after collection?

Answer 39

Evenly smeared on the center of a glass slide and fixed immediately ## Footnote Excessively thin or thick smears can result in false-negative reports.

Question 40

What is the function of impression smears?

Answer 40

Immediate assessment of ulcerated surface lesions ## Footnote Impression smears are used before fixation and processing of tissue samples.

Question 41

What is indicated for tumors, especially lymph nodes?

Answer 41

Impression smear ## Footnote This allows for quick assessment after an excision biopsy.

Question 42

What should be done immediately after cutting the lymph node specimen?

Answer 42

Take an imprint smear by touching the cut surface with a clean slide ## Footnote This should be fixed immediately.

Question 43

How many consecutive morning sputum specimens should be obtained?

Answer 43

At least 3 ## Footnote Morning sputum is preferred for accurate analysis.

Question 44

What fluid is used to collect early morning sputum?

Answer 44

Saccomanno fluid ## Footnote Saccomanno fluid contains 50% ethyl alcohol and 2% carbowax.

Question 45

What should be done if a patient cannot cough up sputum spontaneously?

Answer 45

Induced sputum should be collected ## Footnote Induction is done using inhalation of an aerosol solution for 20 minutes.

Question 46

How many slides are recommended for extensive sputum studies?

Answer 46

Minimum of 2-4 slides ## Footnote One slide should be air dried for Giemsa staining.

Question 47

What is the first step after pouring the sputum specimen into a Petri dish?

Answer 47

Examine for blood-flecked or solid particles ## Footnote These particles should be removed and placed on the slide.

Question 48

What should be done with thin and thick portions of sputum?

Answer 48

Secure representative samples from both ## Footnote These samples are then evenly spread on slides.

Question 49

What is the minimum time for fixing specimens in alcohol?

Answer 49

One hour ## Footnote Specimens fixed in alcohol should be sent to the laboratory without delay.

Question 50

yield for diagnosis of breast carcinoma. Spontaneous nipple discharge is usually

Question 51

a result of hormonal imbalance in young patients

Answer 51

and when the secretion is

Question 52

bloody a benign intraductal papilloma should be considered clinically. The

Question 53

spontaneous nipple discharge should be smeared on a clean glass slide

Answer 53

and

Question 54

immediately placed in fixative.

Question 55

In women

Answer 55

except during lactation and the immediate post-lactation period

Question 56

any discharge from the nipple is abnormal .The nipple discharge is usually due to

Question 57

a benign breast lesion such as duct ectasia and papilloma

Answer 57

or due to endocrine

Question 58

problems. However the major value of cytologic examination of nipple discharge

Question 59

is potential detection of malignant cells in a patient with clinically undetected

Question 60

carcinoma.

Question 61

Collection Technique:

Question 62

Gently strip the subareolar area and nipple using the thumb and forefinger.

Question 63

Place the labeled slide upon the nipple and draw it quickly across the nipple. If

Question 64

more than a drop is collected

Answer 64

use another slide to smear with a pull-up

Question 65

technique. Immediately drop slide in a bottle of 95% isopropanol or use spray

Question 66

fixative.

Question 67

If the secretion is scanty in amount

Answer 67

smears should be restricted to a small

Question 68

area of the slide to prevent drying. Secretions obtained from both breasts should

Question 69

be properly identified as left or right. For localized breast lesions producing

Question 70

discharge upon pressure

Answer 70

the secretion may be smeared directly on the slide after

Question 71

expressing material from the breast.

Question 72

Fine Needle Aspiration (FNA)

Question 73

Fine needle aspiration is the study of cellular samples obtained from organs

Question 74

that do not shed cells spontaneously

Answer 74

such as breast

Question 75

lungs

Answer 75

skin

Question 76

like growth of skin

Answer 76

subcutaneous soft tissue tumors

Question 77

salivary glands and breast.

Question 78

The basic technique uses a 25-gauge needle and a 10-ml syringe. The

Question 79

needle is inserted into the lesion and repeatedly redirected to sample a number

Question 80

of areas while applying a small amount of suction on the syringe. Tissues

Question 81

composed of mesenchymal cells (connective tissue) tightly adhere to each

Question 82

other and do not exfoliate easily

Answer 82

requiring a larger bore needle and increased

Question 83

suction may be necessary. The sample should be air dried as quickly as

Question 84

possible to reduce the effects of shrinkage.

Question 85

NA of superficial masses (e.g. breast

Answer 85

thyroid

Question 86

nodes) is usually done by the clinicians

Answer 86

or in some centers by the pathologists.