MLHG 106 - Introduction to Histology and Cytology: Lesson 4 Q&A Flashcards

100 flashcards covering key concepts in cytology, cytopathology, specimen handling, processing, staining, QA, and safety based on the provided video notes.

What is cytopathology?

A branch of pathology that studies and diagnoses diseases on the cellular level; examines cells shed into body fluids or removed from tissue.

Who is a cytotechnologist and what do they do?

A lab professional who prepares slides, stains, coverslips, and files cytology slides; assists in cytology laboratory work.

What is a Pap test?

A gynecologic cytology test where cervical cells are scraped and examined microscopically for cellular changes.

What is non-gynecologic cytology?

Cytology specimens from non-gynecologic sources used to diagnose or exclude disease, including cancer.

What does accessioning mean in cytology lab workflow?

Receiving specimens and assigning a unique accession number; logging into the LIS.

What is specimen rejection in cytology?

Policy defining when a specimen must be rejected due to quality, labeling, volume, fixative, or other criteria.

What is the standard fixative for cytology and its ratio?

50% ethanol; added at 1:1 volume to the specimen.

What should you do if there is a processing delay for a urine cytology sample?

Preserve by adding an equal volume of 50% ethanol.

What does WHMIS regulate in the cytology lab?

Workplace Hazardous Materials Information System; labeling, safety data sheets, storage and disposal of hazardous solutions.

How should sharps be handled in the cytology lab?

Handled with appropriate safety practices and disposed of in approved sharps containers.

What is spill containment and cleanup in Cytology labs?

Procedures to contain and clean up spills of biological and other hazardous materials.

What does a cytology lab emergency response involve?

Following established safety procedures to protect personnel and contain incidents.

What is an ergonomic principle in cytology?

Applying proper body mechanics to reduce risk of repetitive strain injuries.

What is the process for providing kits and instructions for collecting skin scrapings?

Provide kits and written instructions to guide skin-scraping collection.

Which equipment is mentioned for Cytology labs and their safety/maintenance?

Cytospin (cytocentrifuge), coverslipper, and cryostat (for histology); each has maintenance and safety considerations.

What are Receiving Histology Specimens steps mentioned?

Accessioning samples and specimen rejection policies.

What are the basic principles of processing cytology specimens?

Fixation/preservation, centrifugation, cell block preparation, cytocentrifuge, direct preparation, and liquid-based processors.

Which stains are the main principles of cytology staining?

Papanicolaou stain and Romanowsky stain (Diff Quick).

What should be recorded for a received cytology specimen?

A gross description: material received, fresh or fixed status, processing, and any problems.

What is slide labeling and chain of custody in cytology?

Slides/containers labeled with accession numbers; maintain identity of specimen and patient throughout processing.

What is the difference between exfoliative cytology and FNA?

Exfoliative cytology uses shed or brushed-off cells; FNA uses a fine-needle aspirate from lesions.

What specimens are examined in skin surface cytology techniques?

Skin scrapings and impression smears to detect parasites, bacteria, yeasts, fungi, inflammatory cells, or abnormal skin cells.

What is an impression smear?

A smear made by pressing a clean glass slide against an affected surface to collect material.

What is skin scraping cytology?

Scraping off surface skin cells with a sterile blade and preparing smears on slides.

What is direct preparation in cytology?

Placing material directly on a slide, fixing immediately, and staining.

What is the sputum pick-and-smear technique?

A method using wooden sticks to sample sputum, pooling material on slides, and preparing smears for staining.

What is the sputum collection procedure (early morning preferred)?

Early morning sputum is preferred; collect after deep cough; refrigerate if delayed; deliver to lab promptly.

What is a cytocentrifuge?

A specialized centrifuge (cytospin) used to deposit cells onto a glass slide in a uniform layer.

What is a cell block in cytology?

Cellular material processed like tissue to form a paraffin-embedded block for histology-like evaluation.

What is ThinPrep in cytology?

A liquid-based cytology system that creates a uniform thin layer of cells on a slide by filtration; cells fixed in alcohol before deposition.

What is SurePath in cytology?

A density-gradient, centrifugation-based liquid-based cytology platform; debris removed and diagnostic cells settled onto the slide.

What is a density reagent used for in SurePath processing?

A reagent that enables differential centrifugation to reduce debris and enrich diagnostic cells.

What is the difference between manual and automated staining in cytology labs?

Manual staining is done by hand; automated staining uses instruments to standardize procedures and reduce cross-contamination risk.

Why is cross-contamination a concern in cytology staining?

Cells from one slide can contaminate another slide via staining solutions or coverslipping; requires QA and proper technique.

What is the recommended staining order to minimize cross-contamination?

Stain less cellular specimens first; gynecologic Pap smears should be stained before endometrial specimens.

What is the purpose of quality assurance in cytology staining?

A program with policies and procedures to prevent cross-contamination and ensure reliable staining results.

What is the purpose of quality control in staining procedures?

Running controls to prove procedures are functioning and producing accurate, reproducible results.

What are Pap smears stained before endometrial specimens to prevent?

Cross-contamination between highly cellular gynecologic specimens and less cellular endometrial specimens.

What are the main colors observed in Pap staining results?

Nuclei are blue-black (purple), cytoplasm is orange-red, red blood cells are bright red; immature cells may appear blue/green.

What are the main steps in Pap staining?

Fixation; nuclear staining with hematoxylin; bluing; cytoplasmic counterstain with OG and EA; clearing; coverslipping.

What is Harris Hematoxylin used for in Pap staining?

Nuclear stain that produces blue-black nuclei.

What are OG-6 and EA-36 in Pap stains?

OG-6 (Orange G) stains cytoplasm; EA-36 (Eosin Azure) provides additional cytoplasmic contrast.

What is the purpose of bluing in Pap staining?

Place slides in mildly alkaline solution to achieve the proper blue-black nuclear color.

What is Scott’s tap water substitute used for in Pap staining?

Sodium bicarbonate solution used as a substitute for tap water during bluing.

What is the purpose of 95% ethanol in Pap staining?

Fixes cells and preserves morphology before staining steps.

What is the sequence of dehydration in Pap staining?

Dehydrate slides through graded ethanols (50%, 70%, 80%, 95%, 100%).

What is the purpose of clearing with xylene in Pap staining?

Removes alcohol and prepares the slide for mounting with xylene-based mounting media.

What is Cytoseal in Pap staining?

A xylene-compatible mounting medium used to coverslip and preserve stained slides.

What is the importance of drying before slide filing?

Slides must be completely dry to prevent sticking; a hot-air oven speeds drying.

What are the retention times for negative and abnormal cytology slides?

Most negative slides stored for 5 years (10 years in some hospital labs); abnormal slides stored for 20 years.

What is Salt solution used for during Pap staining?

Not applicable; the key solutions are hematoxylin, OG, EA, alcohols, xylene, and mounting media.

What is the role of a cytology slide in QA/QC?

Slides are used to verify staining quality, cross-contamination prevention, and documentation of results.

What is the purpose of slide coverslipping technique?

Protects and preserves cells; enables better visualization under the microscope; mountant often contacts the coverslip.

What is meant by 'impression smears are often made twice' when crusts are present?

Two impression smears may be prepared—before and after gentle cleaning—to improve material capture.

What is the purpose of 'picker' or 'pull-apart' technique in Pap prep?

Not a standard Pap step; related to smear preparation in some learning materials—focus on proper smear technique.

What is the role of a 'cell block' in non-gyn cytology?

Allows cytology material to be processed like a tissue biopsy for histology-like examination.

What is 'direct smear fixation' with ethanol?

Unfixed cells are fixed immediately in 95% ethanol to prevent degeneration and artifacts.

What is the purpose of a 'cytospin' vs a 'cytospin prep'?

Cytospin (cytospin) deposits cells onto slides in a thin, even layer to improve visualization.

What is the 'immuno' aspect of cytology in these notes?

Not discussed in these notes; focus is on Pap staining, cytospin, and cytology techniques.

What is the 'gross description' that should be recorded for every cytology specimen?

What material was received; fresh or fixed; processing performed; any problems (e.g., leaks, mislabeling).

What is meant by 'chain of custody' in cytology specimens?

Maintaining specimen identity and patient identity throughout processing with unique labeling.

What is the 'Direct preparation' advantage?

Fastest way to prepare a cytology slide; minimal processing steps.

What is the 'cell block' processing sequence?

Cytology sediment or clot is fixed, processed like tissue, embedded in paraffin, and sectioned.

What is the 'SOP' requirement in cytology QA?

All staff must follow standard operating procedures; deviations must be approved and documented.

What is the 'Quality Assurance' overarching purpose?

To ensure quality results across all aspects of cytology preparation and analysis.

What is the 'QC' requirement for staining procedures?

Run positive controls (and sometimes negative controls) to verify staining procedures.

What is the role of 'wet vs air-dried slides' in Romanowsky staining?

Romanowsky stains (Diff Quick) are typically performed on air-dried slides.

What is the 'Diff Quick' stain used for?

A rapid Romanowsky stain used for cytology that provides quick visualization of cellular components.

What causes 'air-drying artifact' in cytology slides?

Delay in fixation before staining leading to distorted cellular morphology.

What is the 'cross-contamination risk' in automated slide staining?

Stains are run in batches; cross-contamination can occur if not properly controlled.

What is the 'collection of Pap smears' traditional practice vs modern practice?

Traditionally, slides were prepared by clinicians and stained by the lab; modern practice uses liquid-based processors with slides prepared in the lab.

What is the 'Papanicolaou staining' requirement for Pap tests?

Mandatory; fixation in alcohol before staining; yields detailed nuclear and cytoplasmic features.

What is the 'nuclear staining' color in Pap staining?

Blue-black (purple) nuclei after hematoxylin staining and bluing.

What is the 'cytoplasmic staining' color in Pap staining?

Orange-G and eosin azure give orange/red cytoplasm and contrast with nuclei.

What is 'de-staining' used for in Pap stains?

Removing stain to restain when needed; accomplished with absolute alcohol, 95% ethanol, and acidic alcohol.

What is the 'xylene-based mounting medium' requirement?

Mounting media used in Pap staining; slides must be clear and moisture-free.

What is a 'catch-all' term for lab safety?

PPE, biosafety cabinets, proper handling of fixatives and hazardous materials.

What is the 'Liquid-Based Cytology (LBC)' benefit?

Produces a randomized, representative sample with fewer obscuring factors and debris.

What is the 'PAP stain results' color key for immature cells?

Nuclei blue-purple; cytoplasm blue/green for immature cells.

What is the 'plate' concept of 'cell block' in cytology?

Though cytology blocks are processed like tissue, they originated from cytology specimens.

What is the 'impression smear' collection technique used for?

Collects surface material by pressing a slide against an area to capture cells.

What is the 'sputum collection' guideline for discrete sample quality?

Look for areas with suspicious features; collect from multiple areas; ensure adequate sample.

What is meant by 'representative sampling' in cytology?

The sample should reflect the original material to avoid false negatives.

What is the 'cellularity' concern in cytology sample processing?

Insufficient cells can lead to inconclusive or false-negative results.

What are 'exfoliative cytology specimens' examples?

Urine, sputum, bronchial brushings, biliary tract brushing, etc.

What is the 'cytology staining order for gynecologic vs non-gynecologic specimens' goal?

To minimize cross-contamination by staining order: gynecologic before endometrial or following other less cellular specimens.

What is the 'college lab ' ' chain-of-custody ' ' '?

Not a separate concept; see chain-of-custody.

What is the 'basics of urine cytology' aim?

Detect cancer, CMV, and other infections; use the PAP method on fresh urine samples.

What is the 'gross description' requirement for cytology samples?

Record material received, freshness, processing, and any problems.

What is the 'Slide filing' instruction?

Files slides in an orderly way, usually by numeric case number; ensure dryness and prevent sticking.

What is the 'storage duration policy' for slides?

Most negative slides kept 5 years (10 in some hospital labs); abnormal slides kept 20 years.

What is the 'PAP staining timeline' (what not to do once staining begins)?

Do not let slides dry out after staining begins; proceed to dehydration, clearing, coverslipping.

What is the 'Harris Hematoxylin' color result in Pap staining?

Stains nuclei blue-black.

What is 'Ga' ' Cross contamination risk '

Not applicable.

What does ‘Direct preparation’ vs ‘cytospin’ imply for specimen quality?

Direct prep is quick but may have less uniform distribution; cytospin yields even cell deposition.

What is the 'cites talk about ' ' organ?

Not applicable.

What is the role of the lab in 'Pap smears vs endometrial specimens' staining order?

Pap smears are typically stained before more cellular endometrial specimens to reduce cross-contamination risks.

What is the 'Cross-contamination prevention' during coversliping?

Avoid touching the mounting medium instrument to the specimen; use forceps for handling slides.

What is the 'Quality Assurance' policy on equipment maintenance?

Maintenance and monitoring must be documented; if not documented, it’s considered not done.

What is the 'classification of cytology techniques'?

Direct smears, cytospin, liquid-based processing (ThinPrep, SurePath), and cell blocks.