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PATH2420 > Week 1 > Flashcards

Week 1 Flashcards

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1
Q

Define pathology

A

the study of disease

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2
Q

Define disease

A

very simply, a change in normal body function/structure that leads to abnormal function

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3
Q

Define sign

A

clinical sign that can be objectively observed or measured by a physician or nurse

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4
Q

Define symptom

A

subjective complaint described by the patient (ex. dizziness, nausea, chest pain)

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5
Q

Define etiology

A

study of the causes of disease

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6
Q

Define pathogenesis

A

mechanism of disease
-The sequence of cellular events that take place from the initial contact with the etiologic agent until the expression of disease

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7
Q

Define pathological and morphological manifestations

A

changes in structure and function of tissues, organs, and systems

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8
Q

Define prognosis

A

anticipated course of the disease and final outcome

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9
Q

Define epidemiology

A

the study of the distribution (pattern) and determinants (causes, risk factors) of health-related states, including disease

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10
Q

Define incidence

A

number of new cases arising in a population over a given time period

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11
Q

Define prevalence

A

total number of cases of the disease in a given population

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12
Q

What are the two main categories of divisions of Pathology at LHSC?

A

Anatomical pathology and clinical pathology

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13
Q

What are the subcategories of anatomical pathology?

A
  1. Surgical pathology
  2. Cytopathology
  3. Forensic pathology
  4. Molecular pathology
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14
Q

What are the subcategories of clinical pathology?

A
  1. Clinical chemistry
  2. Immunology
  3. Blood bank/hematology
  4. Microbiology
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15
Q

Describe surgical pathology

A

Large tissue specimens and their architecture under a microscope for diagnosis; typically removed surgically; steps include:
-Gross (macroscopic) examination of organs and tissues such as biopsies, e.g., skin, cervix, breast
-Histological (microscopic) examination
-Generation of a diagnostic pathology report that’s comprehensive to inform physicians and patients

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16
Q

Describe cytopathology

A

The examination of cells under the microscope in the absence of tissue architecture; several types of samples including:
1. Exfoliative
-Spontaneous (spontaneously produced by the patient) such as urine
-Mechanical such as cervical pap smear or bronchial brushings
2. Interventional
-Fine needle aspiration
a. Lymph node
b. Thyroid

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17
Q

Describe forensic pathology

A

Specializes in forensics and performs autopsies, including in criminally suspicious cases

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18
Q

Describe molecular pathology

A

A department on its own but also an adjunct for surgical and cytopathology

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19
Q

Describe clinical chemistry

A

i.Covers a bunch of different clinical and biochemical tests
ii.Clinical Chemistry Specimens: blood, urine, sputum, stool, other body fluids such as bone marrow

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20
Q

Describe hematology

A

Responsible for the blood products that are distributed in the hospital

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21
Q

Describe microbiology

A

looks at microorganisms, viruses, bacteria

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22
Q

What techniques are used in pathology?

A

-Gross examination – examine specimen with the naked eye
-Microscopic examination – light microscopy is used to look at cellular morphology
-Electron Microscopy (special technique) Looks at organelles within the cells
-Ancillary tests (special technique)

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23
Q

Describe ancillary tests

A

o Immunohistochemistry – selectively identifies proteins in cells to aid with diagnosis
o Special histochemical stains – highlight specific tissues (elastic tissue, collagen); pigment (iron, melanin); microorganisms
o Molecular pathology – the detection and/or analysis of nucleic acid molecules (DNA or RNA) to provide clinical information (Chromosomal analysis, DNA sequencing)
 Type of tests:
* Constitutional Genetic Disorders
* Metabolic Disorders
* Hereditary Cancer Panels – genetic predisposition to developing cancer
* Solid tumour testing – treatment purposes

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24
Q

List the pathway of a specimen through pathology and laboratory medicine

A
  1. Gross examination – described in gross section of pathology report
  2. Then prepare sample for microscopic examination, steps:
  3. Tissue cut from specimen
  4. Placed in cassette
  5. Processed – any water content removed
  6. Tissue embedded in wax
  7. Cut on microtome
  8. Thin section
  9. Slide and Stained (hematoxylin and eosin stain – pink/purple stain)
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25
Techniques in anatomical pathology include what?
gross examination, microscopic examination, ancillary tests
26
What can be tested by the laboratory?
Most fluids and cells contain biological components that have diagnostic applications
27
In the chemistry laboratory the most common specimens are?
blood and urine
28
For blood tests, the two main collection types used are?
finger prick, or venipuncture
29
To obtain accurate test results, it is important to do what?
collect the proper specimen type in the correct tub and follow the correct order of draw
30
Most laboratory errors occur in which phase of testing?
pre-analytical phase -ensuring the laboratory receives a quality specimen is key to reporting of accurate test results to the clinical team
31
Why are laboratory tests requested (10 reasons)?
- Diagnosing a disease - Screening for a disease - Determine severity of an illness o E.g., serum K needed for nerve transmission in heart and muscle contraction o Normal range of serum K 3.5-5.0 mmol/L - Determine appropriate management o E.g, prostate cancer – prostate specific antigen (PSA) is used to monitor patient for post-surgical recurrence of tumour - Monitor the progress of surgical recovery - Therapeutic drug monitoring - Identify drugs of abuse or poisonings - Assessment of baseline or nutritional status - Protection against legal repercussions - Re-test to verify abnormal results
32
Define accuracy
describes the ability of data, measurements, or results to match the actual ‘true’ value
33
Define precision
is how close these data, measurements, or results are to each other, working as a measure of the spread of data from the average
34
What is often used to confirm (rule in) or exclude (rule out) a disease?
Laboratory tests
35
Define prevalence
defined as the percent of patients who have the disease that is being tested
36
_____ _____ and _____ are important for interpreting test results, they are calculated based on the decision threshold and can change if that moves.
Test sensitivity and specificity
37
Describe laboratory stewardship
Laboratory stewardship refers to the appropriate utilization of laboratory tests which encompasses correctly ordering, retrieving, and interpreting these tests
38
What is Choosing Wisely Canada?
A national organization that is dedicated to the reduction of testing and efficacious resource use
39
Why does unnecessary testing, procedures, and treatments occur?
-Fear of lawsuit -Practice habits are difficult to change -Patient requests without evidence or knowledge of risks/benefits -Lack of time for shared decision making
40
up to what percent of tests, treatments, and procedures performed in Canada are potentially unnecessary?
30%
41
What are the five things physicians and patients should question (not send for testing)?
1. Don’t perform population-based screening for 25-OH-Vitamin D deficiency. 2. Don’t screen with Pap smears if under 21 years of age or over 69 years of age. 3. Avoid routine preoperative laboratory testing for low-risk surgeries without a clinical indication. 4. Avoid standing orders for repeat complete blood count (CBC) on inpatients who are clinically/laboratorily stable. 5. Don’t send urine specimens for culture on asymptomatic patients including the elderly, diabetics, or as a follow up to confirm effective treatment.
42
What are the types of errors in pathology and laboratory medicine?
1. Pre-analytical – everything involving specimen retrieval 2. Analytical – diagnosis 3. Post-analytical – reporting
43
What types of pre-analytical errors could occur?
Collection, Ordering, Specimen labeling, Specimen processing, Correct clinical information provided
44
What precautions should you take to avoid the pre-analytical error involving collection?
-Collection – specimen collected from the correct patient oVerbal and ID band confirmation o2 step verification
45
What precautions should you take to avoid the pre-analytical error involving ordering?
-Ordering – correct test ordered oSample taken from correct location oCorrect tube used (blood test) oCorrectly input into ordering system
46
What precautions should you take to avoid the pre-analytical error involving specimen labeling?
-Specimen labeling – patient and specimen identification oPatient identification on label of specimen oSpecimen correctly identified on label
47
What precautions should you take to avoid the pre-analytical error involving specimen processing?
-Specimen processing oInadequate sample (volume or size) oLost specimen oInadequate or incorrect fixative
48
What precautions should you take to avoid the pre-analytical error involving correct clinical information provided?
-Correct clinical information provided oPertinent information provided to assist with diagnosis
49
List how disease is classified (based on cause)
-Host/Genetic Factors (ex. sickle cell disease) -Environmental Factors (ex. traumatic head injury) -Combination of Factors (ex. heart disease, diabetes, cancer)
50
Not all _____ diseases manifest at birth
inherited (genetic)
51
Not all _____ diseases are genetic
congenital
52
Define congenital anomalies
Structural or functional deficits that occur in utero and are present at birth; may or may not have a genetic cause
53
Define malformation
intrinsically abnormal development process (ex. polydactyly, Spina Bifida, Congenital heart disease)
54
Define disruption
Secondary destruction of an organ or body region that was normal in development, extrinsic disturbance
55
Define deformation
Secondary or extrinsic destruction of the normal development process (ex. localized or generalized compression of growing fetus by biomechanical forces)
56
Genetic or congenital factors are what?
-Alterations in genetic material oSingle mutation in a DNA base pair (ex. Sickle cell disease) oAdditions/Deletions/Rearrangements of whole chromosomes Trisomy 21 (Down Syndrome)
57
Define teratogens
environmental factors causing abnormal development or congenital anomalies
58
List common teratogens
-Infectious agents (ex. rubella, cytomegalovirus, toxoplasma) -Drugs (ex. alcohol, isoretinoin) -Chemical/heavy metals (ex. mercury, lead) -Ionizing radiation -Maternal disease (ex. maternal diabetes, hypertension)
59
What types of environmental factors cause disease?
1. physical agents (ex. mechanical trauma, temp.) 2. chemical agents (ex. poisons) 3. infections - bacteria, virus, etc. 4. drugs - therapeutic, recreational 5. allergens
60
Describe exogenous allergens
originating outside the body
61
Describe endogenous allergens
arising within the body itself, generally proteins
62
How can we classify disease (based on pathology)?
1.Injury – physical, chemical, or biological agent 2.Inflammation – common to many diseases 3.Infection – infectious organisms; local or systemic 4.Immunological reaction – excessive/overactive response by the immune system; hypersensitivity reaction 5.Neoplasia – autonomous proliferation of cells; benign or malignant tumours 6.Metabolic or Endocrine – disorders of enzymes, hormones, secretory products/proteins ex. diabetes 7.Nutritional – deficiency in proteins or calories; decreased absorption, transport, or utilization (celiac disease); specific vitamin or mineral deficiencies (scurvy); psychological factors (anorexia nervosa); excess calories (obesity) 8.Vascular – important cause of death; narrowing of blood vessels (ex. atherosclerosis, heart attack (MI), stroke) 9.Psychological factors – can cause and affect disease processes; mental illness can lead to worsening somatic disease; addiction
63
Define idiopathic
unknown etiology; currently no known cause
64
Define iatrogenic
disease or any adverse condition resulting from treatment by a healthcare professional
65
Describe adverse events
unintended injury or complication resulting in death, disability or prolonged hospital stay (very important causes of morbidity and mortality)
66
Define morbidity
illness or impairment/disability caused by disease -Something that impairs the well-being or normal functioning of a patient
67
Define mortality
something causing the death of patient (death from disease)
68
What are the top 5 reasons for hospital stays in Canada?
1. Giving birth 2. COPD and bronchitis 3. Heart attack 4. Heart failure 5. Osteoarthritis of the knee
69
What are the top 5 causes of death in Canada (2019)?
1.Malignant Neoplasms (all cancers) 2.Heart disease 3.Accidents (unintentional injuries) 4.Cerebrovascular diseases (neurocognitive diseases) 5.Chronic lower respiratory diseases
70
_____ are more likely to be diagnosed with cancer
Males
71
_____ are more likely to survive cancer when compared to males
Females
72
Approx. 90% of cancer diagnoses occur among Canadians who are at least _____ years of age
50 years of age
73
Which type of cancer has the highest mortality in Canada?
Lung
74
Life expectancy has been steadily increasing in Canada; increase of about _____ in life expectancy since 1921.
25 years
75
What are some reasons for improved life expectancy?
Sanitation, medical care, public awareness of good nutrition and the health risks associated with smoking, community advocacy

PATH2420 (12 decks)

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