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Short Answer Qs Flashcards

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1
Q

What is the ThinPrep Method?

A

Liquid-based cytology technique for Pap tests

Cells are collected in a preservative fluid and processed to produce a monolayer slide.

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2
Q

What are the benefits of the ThinPrep Method?

A

Improves cell preservation, reduces obscuring material, enhances diagnostic accuracy

Obscuring materials include blood and mucus.

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3
Q

Define dyskaryosis.

A

Abnormal nuclear features including enlarged nuclei, irregular contours, hyperchromasia, coarse chromatin

Seen in pre-cancerous cervical lesions.

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4
Q

What is the correlation between dyskaryosis and Cervical Intraepithelial Neoplasia (CIN)?

A

CIN I: Mild dyskaryosis, CIN II: Moderate, CIN III: Severe dyskaryosis, carcinoma in situ.

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5
Q

What is the aim of histochemistry in disease investigation?

A

Use of special stains to visualize and identify specific tissue components

Components include carbohydrates, lipids, enzymes.

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6
Q

What is the embedding process in histopathology?

A

Enclosing tissue in paraffin wax after dehydration and clearing

Correct orientation ensures optimal sectioning and visibility on slides.

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7
Q

Why is correct orientation important in the embedding process?

A

Ensures that diagnostic areas are optimally sectioned and visible on slides

Critical for accurate histopathological assessment.

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8
Q

What does the Periodic Acid-Schiff (PAS) stain highlight?

A

Glycogen, mucopolysaccharides, fungal walls.

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9
Q

What does Alcian Blue stain?

A

Acidic mucins (pH dependent).

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10
Q

What is mucicarmine selective for?

A

Epithelial mucins.

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11
Q

What is the purpose of staining methods for carbohydrates?

A

Used for diagnosing mucin-secreting tumors, fungal infections.

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12
Q

Define staging of tumors.

A

Extent of tumor spread (TNM system: Tumor size, Nodes, Metastasis).

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13
Q

Define grading of tumors.

A

Degree of differentiation (well, moderate, poor).

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14
Q

What is the difference between progressive and regressive staining?

A

Progressive: stain until desired intensity, no differentiation. Regressive: overstained then differentiated.

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15
Q

Give an example of progressive and regressive staining.

A

Hematoxylin (progressive in Gill’s, regressive in H&E with acid alcohol).

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16
Q

What is the ABC Complex in immunohistochemistry?

A

Enhances signal by linking biotinylated secondary antibodies to avidin-conjugated enzymes.

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17
Q

What does DAB stand for in immunohistochemistry?

A

Diaminobenzidine.

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18
Q

What is the reaction of DAB substrate in immunohistochemistry?

A

Reacts with HRP to produce a brown precipitate marking antigen presence.

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19
Q

What is the role of Hydrogen Peroxide in the ABC method?

A

Blocks endogenous peroxidase activity to prevent non-specific staining.

Preventing non-specific staining is crucial for accurate results in immunohistochemistry.

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20
Q

What does Normal Serum do in the ABC method?

A

Blocks non-specific antibody binding (Fc receptors), reduces background.

This helps to enhance the specificity of the antibody binding.

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21
Q

What is the purpose of In-Situ Hybridisation?

A

Detects specific DNA/RNA sequences in cells/tissue using complementary labelled probes.

This technique is essential for identifying genetic material within the cellular context.

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22
Q

What does FISH stand for?

A

Fluorescence in-situ Hybridisation.

FISH is a specific type of in-situ hybridization used for detecting and localizing the presence or absence of specific DNA sequences.

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23
Q

What can FISH identify in cancer diagnosis?

A

Gene amplifications, deletions (e.g., HER2 in breast cancer).

Identifying these genetic changes can guide treatment decisions.

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24
Q

How does In-Situ Hybridisation aid in cancer management?

A

Aids in diagnosis, prognosis, and targeted therapy decisions.

Understanding genetic alterations helps in tailoring personalized treatment approaches.

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25
What are common aldehyde fixatives for cells and tissue?
Formaldehyde (formalin), glutaraldehyde
26
What is the primary function of aldehyde fixatives?
Cross-link proteins → preserves tissue architecture
27
Which aldehyde fixative is best for light microscopy?
Formaldehyde
28
Which aldehyde fixative is stronger and used for electron microscopy?
Glutaraldehyde
29
What is a pro of using aldehyde fixatives?
Good preservation of morphology
30
What is a con of using aldehyde fixatives?
May mask antigens for immunostaining
31
What does Fluorescent In-Situ Hybridisation (FISH) detect?
Specific DNA/RNA sequences in cells/tissues
32
What do FISH techniques use to detect sequences?
Fluorescent-labeled probes
33
What are applications of FISH?
* Gene amplifications * Translocations (e.g., HER2, ALK)
34
What microscopy technique is used to visualize FISH results?
Fluorescence microscopy
35
What are characteristics of normal cells?
* Uniform size/shape * Organized * Small nuclei
36
What are characteristics of cancer cells?
* Pleomorphism * Hyperchromasia * High N:C ratio * Mitotic figures * Disorganized architecture
37
What does a loss of normal differentiation indicate?
Cancer
38
What is the purpose of special stains in microbiology?
Differentiation of microorganisms
39
What does the Gram stain differentiate?
Bacteria
40
What does the Ziehl-Neelsen stain identify?
Acid-fast bacilli (e.g., TB)
41
What does PAS stain identify?
Fungi, glycogen
42
What does GMS (Grocott's Methenamine Silver) stain identify?
Fungi
43
What does Warthin-Starry stain identify?
Spirochetes (e.g., H. pylori)
44
What is the purpose of quality control in cellular pathology?
Ensures accuracy & reproducibility
45
What are the two types of quality control?
* Internal QC: Daily checks, control tissues * External QA: Inter-lab comparisons
46
What aspects does quality control cover?
* Staining * Sectioning * Reporting standards
47
What are the principles for effective cancer screening?
* High sensitivity & specificity * Early detection in asymptomatic individuals * Cost-effective, accessible
48
What are examples of cancer screening methods?
* Cervical cytology (Pap smear) * Mammography
49
What should be clear in cancer screening for positives?
Referral pathways
50
What are mucins?
High molecular weight glycoproteins
51
What stains are used to identify mucins?
* PAS stain * Alcian blue * Mucicarmine
52
What do mucins help distinguish in tumors?
Mucin-producing tumors (adenocarcinomas)
53
What is cryotomy?
Rapid sectioning of fresh tissue at -20°C to -30°C
54
What is the primary use of frozen sections?
Used intraoperatively for diagnosis
55
What is a limitation of frozen sections compared to paraffin sections?
Lower quality
56
What are the steps involved in preparing tissue samples for examination?
Dehydration → clearing → infiltration with paraffin wax ## Footnote This process is crucial for preserving tissue morphology for histological examination.
57
Why is tissue orientation important in histology?
Ensures diagnostic areas are sectioned properly ## Footnote Critical for accurately assessing margins and layered structures such as skin and the gastrointestinal tract.
58
What does fluid cytology examine?
Cells in effusions (pleural, peritoneal, CSF) ## Footnote This technique is particularly useful in detecting metastatic cancer and primary malignancies.
59
What are the benefits of fluid cytology in malignancy detection?
Less invasive, useful for diagnosis & staging ## Footnote It allows for the evaluation of cancer with minimal discomfort to the patient.
60
What is the purpose of therapeutic biomarkers testing in lung biopsy?
Markers guide targeted therapy ## Footnote This helps in personalizing treatment for better patient outcomes.
61
Name some common biomarkers tested in lung biopsy.
* EGFR mutations * ALK rearrangements * ROS1 rearrangements * PD-L1 expression * KRAS mutations * BRAF mutations ## Footnote These biomarkers are critical for targeted therapies in lung cancer.
62
What techniques are used for detecting biomarkers in lung biopsies?
* IHC * FISH * PCR * NGS ## Footnote These techniques help in the accurate identification of specific genetic alterations.
63
What is a key consideration when performing biomarker testing?
Sample adequacy critical ## Footnote Ensuring that the biopsy sample is sufficient is essential for reliable test results.
64
What are some reasons for slide recutting or re-staining?
* Incomplete sections * Folds, tears * Weak/uneven staining * Need for deeper sectioning * Identification of specific areas * Poor fixation, artifacts * Additional special stains required ## Footnote These factors can affect the quality of the histological examination and diagnostic accuracy.
65
What is Fine Needle Aspiration (FNA)?
Uses fine needle (22-25G) to aspirate cells ## Footnote This technique is minimally invasive and typically performed in an outpatient setting.
66
What is the purpose of Rapid On-Site Evaluation (ROSE) in FNA?
Immediate assessment of adequacy ## Footnote ROSE guides further sampling and reduces the need for repeat procedures.
67
What is the primary screening method for cervical cancer?
HPV primary screening ## Footnote This method is essential in identifying patients at risk for cervical cancer.
68
What is the triage process for HPV-positive cases in cervical cancer screening?
* High-grade cytology → direct colposcopy * Low-grade cytology → repeat testing, colposcopy if persistent ## Footnote This approach helps ensure appropriate follow-up and reduces overtreatment of patients.
69
What is the processing method for Light Microscopy in renal biopsy?
Formalin-fixed, paraffin-embedded ## Footnote This method is used for structural assessment.
70
Which stains are used in Light Microscopy for renal biopsy?
H&E, PAS, Silver stains ## Footnote These stains help in the structural assessment of the tissue.
71
What type of tissue is used for Immunofluorescence in renal biopsy?
Fresh/frozen tissue ## Footnote This method is used to detect immune complexes.
72
What immune complexes can be detected using Immunofluorescence?
* IgG * IgA * C3 ## Footnote These are important for understanding immune responses in the kidney.
73
What is the fixation method used for Electron Microscopy in renal biopsy?
Glutaraldehyde-fixed ## Footnote This method allows for detailed ultrastructural analysis.
74
What details can Electron Microscopy identify in renal biopsy?
* Ultrastructural details of glomeruli * Deposits * Foot process effacement ## Footnote These details are crucial for diagnosing various kidney diseases.
75
What is the purpose of a liver biopsy?
Assess fibrosis, iron, copper, and underlying causes. ## Footnote The liver biopsy is a diagnostic tool used to evaluate liver conditions.
76
What does the reticulin stain highlight?
Framework of reticulin fibers. ## Footnote It assesses architecture and regenerative nodules in liver tissue.
77
What is the function of Masson’s Trichrome stain?
Stains collagen for fibrosis staging. ## Footnote This helps evaluate the degree of fibrosis present in liver tissue.
78
What does the Periodic Acid-Schiff (PAS) stain detect?
Glycogen and α1-antitrypsin globules. ## Footnote It can be used with or without diastase treatment.
79
What does Perls’ Prussian Blue stain identify?
Iron overload (haemosiderosis, haemochromatosis). ## Footnote This stain is crucial for diagnosing conditions related to iron dysregulation.
80
What does the Orcein stain detect?
Copper-associated protein deposits. ## Footnote It is particularly relevant in diagnosing Wilson's disease.
81
What is the purpose of the Congo Red stain?
Identifies amyloid deposits. ## Footnote Amyloid deposits can indicate various systemic diseases.
82
What are optional special stains in liver biopsy?
Stains for infectious agents (HBV, HCV in situ methods). ## Footnote These stains help identify viral infections in liver tissue.
83
What is the principle behind Fine Needle Aspiration (FNA)?
Uses thin needle to aspirate cells for cytological examination. ## Footnote This technique allows for the analysis of cellular material from lesions.
84
What type of needle is typically used in FNA?
22-25G needle. ## Footnote The gauge indicates the thickness of the needle used for aspiration.
85
What is involved in the technique of FNA?
Multiple passes under palpation/US guidance. ## Footnote This ensures that adequate tissue samples are obtained for analysis.
86
What is the purpose of Rapid On-Site Evaluation (ROSE) in FNA?
Checks adequacy of samples. ## Footnote ROSE allows for immediate assessment of whether sufficient material has been collected.
87
What are the advantages of FNA?
Minimally invasive, quick, cost-effective. ## Footnote FNA is often preferred for its efficiency and lower risk compared to surgical biopsies.
88
What types of lesions is FNA first-line for?
Superficial & deep lesions (thyroid, lymph nodes, breast, lung). ## Footnote FNA is widely used in various clinical settings for diagnostic purposes.
89
What does FNA help differentiate?
Benign vs malignant lesions. ## Footnote This differentiation is crucial for determining further management and treatment options.
90
Is immediate diagnosis possible with FNA?
Yes, in some cases. ## Footnote This can expedite patient management and treatment decisions.
91
What is the principle behind silver stains?
Silver ions reduce to visible metallic silver. ## Footnote Target substances act as reducing agents.
92
How do tissue components interact with silver nitrate in silver staining?
Tissue components reduce silver nitrate to black/brown silver deposits. ## Footnote Often require oxidation, sensitization, and toning steps.
93
What does Grocott’s Methenamine Silver (GMS) stain detect?
Detects fungi (e.g., Pneumocystis, Candida).
94
What is the purpose of the Warthin-Starry stain?
Identifies spirochetes (e.g., H. pylori, T. pallidum).
95
What does the reticulin stain (Gordon & Sweet) highlight?
Highlights reticulin fibers (liver architecture, bone marrow).
96
What are argyrophilic methods used for?
Identify neuroendocrine tumors.
97
What is the diagnostic utility of silver stains?
Infectious agents, fibrosis, neuroendocrine cells.
98
What is the first step in identifying an undifferentiated tumor?
Assess H&E for clues (cell morphology, pattern).
99
What does the immunohistochemistry (IHC) panel Cytokeratins (CK AE1/AE3) indicate?
Epithelial origin (carcinomas).
100
Which marker indicates mesenchymal origin in tumors?
Vimentin.
101
What does LCA (CD45) indicate in tumor identification?
Lymphomas.
102
Which markers are associated with melanoma?
S100, HMB-45, Melan-A.
103
What markers are used for neuroendocrine tumors?
Synaptophysin, Chromogranin, CD56.
104
What are TTF-1, PSA, and PAX8 used for in tumor identification?
Site-specific markers.
105
What molecular tests are used for specific translocations/mutations?
FISH, PCR, NGS.
106
What is the first step when investigating melanoma in a skin ellipse?
Ink deep & peripheral margins.
107
What should be done with the entire lesion during grossing?
Submit entire lesion & margins.
108
What is assessed during H&E examination of melanoma?
Asymmetry, atypical melanocytes, pagetoid spread.
109
What is the significance of Breslow thickness in melanoma?
Prognostic factor.
110
What additional factors are reported in melanoma diagnosis?
Ulceration, mitotic rate, lymphovascular invasion.
111
What is the sensitive melanocytic marker in IHC?
S100.
112
What markers are specific for melanoma in immunohistochemistry?
HMB-45, Melan-A (MART-1).
113
What is the role of SOX10 in melanoma identification?
Nuclear marker for melanocytes.
114
What should be included in the reporting of melanoma?
Confirm diagnosis, measure Breslow thickness, Clark level, comment on margins, ulceration, regression.

Cell Pathology (35 decks)

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