Examination Of Fresh Tissue

Question 1

What is the definition of histology?

Answer 1

Microscopy study of normal tissue

Histology focuses on the structure and function of normal tissues.

Question 2

What is the purpose of histopathology?

Answer 2

To diagnose diseased tissues and assess pathologic changes

Histopathology examines tissue samples for abnormalities indicative of disease.

Question 3

What does FDCIETSSML stand for?

Answer 3

Fixation, Dehydration, Clearing, Infiltration, Embedding, Trimming, Sectioning, Staining, Mounting, Labelling

This is used for tracking tissue samples.

Question 4

How can tissues be obtained for examination?

Answer 4

• Autopsy – Postmortem (PME)
• Biopsy/Surgical Removal
• Aspiration (Exfoliative)

Different methods are used depending on the clinical scenario.

Question 5

What is an incisional biopsy?

Answer 5

Surgical removal of a portion of the tissue

This may be necessary if the lesion is malignant or if it is large and inaccessible.

Question 6

What is an excisional biopsy?

Answer 6

Removal of the entire organ/tissue of interest

This provides complete diagnostic material.

Question 7

What is a fine needle aspiration biopsy (FNAB)?

Answer 7

Simplest, least invasive method to remove a small amount of tissue/cells

It yields individual cells but may not be adequate for diagnosis.

Question 8

What does core needle biopsy involve?

Answer 8

Removes cells and surrounding tissue using a larger needle

This method provides more structural context regarding a lesion.

Question 9

What is a punch biopsy?

Answer 9

Obtain full thickness of skin specimens using a circular blade

This method allows for sampling of both epidermis and dermis.

Question 10

What is a shave biopsy?

Answer 10

Small fragments of tissue are shaved from a surface

This technique is often used for superficial lesions.

Question 11

What is autolysis?

Answer 11

Self-digestion of cells by their own enzymes after removal from the body

It can be accelerated at room temperature and retarded by cold.

Question 12

What is the difference between fresh tissues and preserved tissues?

Answer 12

• Fresh Tissues: Study of living activities, limited diagnostic value
• Preserved Tissues: Prepared with fixatives, provide more diagnostic clarity

Fresh tissues can show motion and other dynamic processes.

Question 13

What is the method of teasing/dissociation?

Answer 13

Specimen is dissected while immersed in saline/Ringer’s lactate solution

This allows for examination of individual cells.

Question 14

What is squash preparation?

Answer 14

Used to spread cellular material by compressing tissue

It concentrates cellular content for better visibility.

Question 15

What is touch preparation?

Answer 15

A piece of tissue is pressed against the slide to transfer cells

This method maintains the cellular relationship and placement.

Question 16

What is smear preparation?

Answer 16

Streaking applied to slide using an applicator stick or loop

It ensures uniform distribution of cells.

Question 17

What is a frozen section?

Answer 17

Immediate diagnosis and intraoperative pathology within 1 hour

It is performed on nerve, muscle, and tumor biopsies.

Question 18

What are the pros and cons of using liquid nitrogen for freezing tissue?

Answer 18

• Pros: Fastest method
• Cons: Ice crystal artifacts, tissue cracking

Liquid nitrogen offers rapid freezing but can damage tissue.

Question 19

What is the optimal mounting temperature for fatty breast tissue?

Answer 19

-35 deg C

This temperature ensures proper embedding without damaging the tissue.

Question 20

What is the primary advantage of frozen sections compared to paraffin sections?

Answer 20

Rapid processing time

Frozen sections can be prepared in minutes whereas paraffin sections take hours to days.

Question 21

What is formaldehyde-induced fluorescence used for?

Answer 21

To demonstrate biogenic amines like 5-hydroxytryptamine and adrenaline

This technique can highlight certain cellular components in tissue samples.

Question 22

What is the first step in the fixation process for samples?

Answer 22

Centrifuge at 2000 rpm for 2 minutes

This step is essential to separate the sediment for further processing.

Question 23

What is the ideal fixative for bloody specimens?

Answer 23

Carnoy’s fluid

Carnoy’s fluid is a mixture that preserves cellular detail in bloody samples.

Question 24

What are the types of adhesives that can be used for fresh tissue specimens?

Answer 24

• APES
• Leuconostoc culture
• Celloidin-Ether alcohol
• Pooled serum/plasma

These adhesives must be permeable to both fixative and stain.

Question 25

What is the significance of using 95% ethanol in fixation?

Answer 25

Common fixative with ether due to its toxic property ## Footnote Ether enhances the fixation process by providing additional penetration.

Question 26

What is the purpose of exfoliative cytology?

Answer 26

Microscopic study of desquamated cells from epithelium ## Footnote This technique is used to collect cells from various body sites for diagnostic purposes.

Question 27

What are the main categories of specimens in exfoliative cytology?

Answer 27

* Gynecologic * Non-gynecologic ## Footnote Gynecologic specimens include cervicovaginal smears, while non-gynecologic specimens include sputum and cerebrospinal fluid.

Question 28

What is the main advantage of freeze-drying over freeze-substitution?

Answer 28

Excellent enzyme preservation ## Footnote Freeze-drying maintains enzyme activity better than freeze-substitution.

Question 29

What is the freezing temperature used in the quenching process?

Answer 29

-160 deg C ## Footnote This temperature is critical for rapid freezing to preserve cellular structures.

Question 30

What is the main disadvantage of freeze-drying?

Answer 30

Difficult sectioning due to brittle tissue ## Footnote The brittleness can complicate the preparation of thin tissue sections for microscopy.

Question 31

What is the appearance of the nucleus in mature superficial cells?

Answer 31

Vesicular, light blue ## Footnote This indicates they are more mature and have undergone changes in cytoplasmic staining.

Question 32

What does the presence of superficial cells indicate regarding hormonal status?

Answer 32

Associated with estrogen ## Footnote Superficial cells are influenced by estrogen levels, reflecting hormonal changes in the menstrual cycle.

Question 33

What is the significance of the Pap's smear in gynecological health?

Answer 33

Screening test for cervical cancer and infections ## Footnote It helps in early detection of abnormalities in cervical cells.

Question 34

What is the appearance of endocervical cells in a Pap smear?

Answer 34

Honeycomb appearance (large clusters) ## Footnote This morphology is often associated with pregnancy.

Question 35

What is the recommended collection site for gynecological specimens?

Answer 35

Upper lateral third of the vaginal wall ## Footnote This area yields the most representative cells for cytological examination.

Question 36

What is the effect of progesterone on navicular cells?

Answer 36

Boat-shaped appearance ## Footnote Navicular cells are influenced by hormonal changes during the menstrual cycle.

Question 37

What type of cells are associated with endometrial carcinoma?

Answer 37

Endometrial cells ## Footnote These cells can show abnormal features in cases of hyperplasia or malignancy.

Question 38

What is the appearance of bacteria in a Pap smear?

Answer 38

Dark blue ## Footnote This coloration indicates the presence of bacterial infections.

Question 39

What is the key distinguishing feature of parabasal cells?

Answer 39

Thick to round oval cells with strong basophilic cytoplasm ## Footnote They are typically seen in the early menstrual cycle or after childbirth.

Question 40

What is the staining procedure for Pap's smear?

Answer 40

* 95% ethanol * Harris Hematoxylin * Acid alcohol * Ammonia water wash * OG6 * EA 50 or EA 36 * Dehydration with xylol ## Footnote This sequence is crucial for proper cell visualization under the microscope.

Question 41

What is advised before having a pap smear?

Answer 41

Abstaining from sexual activity ## Footnote This is to ensure accurate results during the procedure.

Question 42

What does Cytohormonal Maturation Index (CHMI) evaluate?

Answer 42

Hormonal status and cell distribution ## Footnote It expresses the maturation of cells in terms of parabasal, intermediate, and superficial cells.

Question 43

What are the cell types evaluated in the Maturation Index?

Answer 43

* Parabasal * Intermediate * Superficial

Question 44

What does a shift to the left in vaginal cytology indicate?

Answer 44

Parabasal cells predominance

Question 45

What does a shift to the right in vaginal cytology indicate?

Answer 45

Superficial cells predominance

Question 46

What is the Pyknotic Index?

Answer 46

Cells with shrunken, dark, small, and structureless nucleus

Question 47

What is the criteria for a normal pregnancy in cytologic diagnosis?

Answer 47

* Marked progesterone effect * Presence of L. acidophilus * Less than 30% superficial cells

Question 48

What is the Bethesda System used for?

Answer 48

Reporting pap smear results ## Footnote It categorizes findings to guide patient management.

Question 49

What does Bethesda System Class I indicate?

Answer 49

Negative for malignant cells

Question 50

What does Bethesda System Class II indicate?

Answer 50

Atypical cells present

Question 51

What does Bethesda System Class III indicate?

Answer 51

Suspicious malignant cells

Question 52

What does Bethesda System Class IV indicate?

Answer 52

Strongly suggestive malignant cells

Question 53

What does Bethesda System Class V indicate?

Answer 53

Conclusive of malignant cells

Question 54

What are the three preparations for non-gynecological specimens?

Answer 54

* Smears * Crush technique * Push-pull technique

Question 55

What is the direct filtration process in cell block preparation?

Answer 55

Centrifuge to obtain sediment, then add 10% formalin

Question 56

What is required from urinary tract specimens?

Answer 56

50 mL of urine ## Footnote Voided urine (midstream clean catch) or catheterized specimens are preferred.

Question 57

What should not be used as preservatives for body cavity effusions?

Answer 57

Formalin, alcohol, and other preservatives

Question 58

How should gastric lavage and brush specimens be collected?

Answer 58

Through gastroscopy or endoscopy ## Footnote Fasting for at least 8 hours is required prior to collection.

Question 59

What is essential for the transport of gastric specimens?

Answer 59

Transported in ice packs

Question 60

What can delayed processing of specimens lead to?

Answer 60

Degeneration of cells