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What is the maximum thickness of tissue sections placed in cassettes?
What is the maximum thickness of tissue sections placed in cassettes?
Which of the following is a required safety precaution during the Grossing process?
Which of the following is a required safety precaution during the Grossing process?
What specific treatment is required for bone specimens prior to processing?
What specific treatment is required for bone specimens prior to processing?
What type of hazards should be considered during the Grossing process?
What type of hazards should be considered during the Grossing process?
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What is one of the potential health risks associated with exposure to Neutral Buffered Formalin?
What is one of the potential health risks associated with exposure to Neutral Buffered Formalin?
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What ergonomic risk is associated with standing at a grossing station for extended periods?
What ergonomic risk is associated with standing at a grossing station for extended periods?
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Which of the following is NOT a recommended practice for cleaning the grossing area?
Which of the following is NOT a recommended practice for cleaning the grossing area?
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What personal protective equipment is essential for preventing chemical exposure during Grossing?
What personal protective equipment is essential for preventing chemical exposure during Grossing?
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What is the primary purpose of standard precautions in a laboratory setting?
What is the primary purpose of standard precautions in a laboratory setting?
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Which component is NOT included in the five major components of standard precautions?
Which component is NOT included in the five major components of standard precautions?
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What is a critical action to be taken before leaving any potentially contaminated area?
What is a critical action to be taken before leaving any potentially contaminated area?
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What should all staff members understand regarding their job hazards?
What should all staff members understand regarding their job hazards?
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Which safety measure is specifically mentioned for equipment and instruments in the laboratory?
Which safety measure is specifically mentioned for equipment and instruments in the laboratory?
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What does the safety committee primarily focus on?
What does the safety committee primarily focus on?
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Why is a gross description considered important in diagnosis?
Why is a gross description considered important in diagnosis?
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Which practice contributes to maintaining a safe workplace?
Which practice contributes to maintaining a safe workplace?
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Which of the following best describes the purpose of orientation markers in pathology?
Which of the following best describes the purpose of orientation markers in pathology?
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What is the main purpose of slicing the specimen during gross examination?
What is the main purpose of slicing the specimen during gross examination?
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Which statement correctly describes a technique involved in specimen dissection?
Which statement correctly describes a technique involved in specimen dissection?
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Which of the following is included in the standardization process during grossing?
Which of the following is included in the standardization process during grossing?
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What is the primary responsibility of a pathologist during the gross examination process?
What is the primary responsibility of a pathologist during the gross examination process?
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Which factor is essential for ensuring accurate gross descriptions?
Which factor is essential for ensuring accurate gross descriptions?
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In addition to pathologists, who else may perform gross examinations of tissue specimens?
In addition to pathologists, who else may perform gross examinations of tissue specimens?
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Which of the following best explains why safety protocols are important during grossing?
Which of the following best explains why safety protocols are important during grossing?
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What findings should be recorded when examining the condition of the mucosa in an appendectomy specimen?
What findings should be recorded when examining the condition of the mucosa in an appendectomy specimen?
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Which of the following specimens would require submission of the entire appendix?
Which of the following specimens would require submission of the entire appendix?
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What type of specimen is most commonly produced during a LEEP procedure?
What type of specimen is most commonly produced during a LEEP procedure?
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In processing specimens from a total hysterectomy for malignant conditions, what additional components are typically included?
In processing specimens from a total hysterectomy for malignant conditions, what additional components are typically included?
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Which of the following best describes the condition that commonly necessitates an appendectomy?
Which of the following best describes the condition that commonly necessitates an appendectomy?
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What type of specimen falls under the processing category for benign conditions during a total hysterectomy?
What type of specimen falls under the processing category for benign conditions during a total hysterectomy?
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What is the correct description for a fecalith in the intestinal tract?
What is the correct description for a fecalith in the intestinal tract?
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What specific structures are involved in a salpingo-oophorectomy?
What specific structures are involved in a salpingo-oophorectomy?
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Which section types are required when submitting an appendectomy specimen?
Which section types are required when submitting an appendectomy specimen?
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During the processing of the appendix, what should be recorded about the mesoappendix?
During the processing of the appendix, what should be recorded about the mesoappendix?
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How should the tip of the appendix be prepared for embedding during grossing?
How should the tip of the appendix be prepared for embedding during grossing?
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What does RSS stand for in the context of specimen submission?
What does RSS stand for in the context of specimen submission?
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What is a potential indication of serositis when examining an appendectomy specimen?
What is a potential indication of serositis when examining an appendectomy specimen?
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What diameter of a fecalith is noted in the lumen of the proximal appendix in the sample dictation?
What diameter of a fecalith is noted in the lumen of the proximal appendix in the sample dictation?
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What does a cone biopsy primarily remove from the cervix?
What does a cone biopsy primarily remove from the cervix?
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What specific aspect of the appendix is noted when examining its serosal surface?
What specific aspect of the appendix is noted when examining its serosal surface?
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What is the primary characteristic of a specimen collected during a LEEP procedure?
What is the primary characteristic of a specimen collected during a LEEP procedure?
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During a cone biopsy, what type of tissue is primarily removed?
During a cone biopsy, what type of tissue is primarily removed?
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What is the primary procedure involved in the removal of a fallopian tube and ovary?
What is the primary procedure involved in the removal of a fallopian tube and ovary?
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What is considered a critical part of processing the appendix specimen?
What is considered a critical part of processing the appendix specimen?
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When examining an appendectomy specimen, which feature would indicate potential complications?
When examining an appendectomy specimen, which feature would indicate potential complications?
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Which of the following components is NOT typically recorded for the mesoappendix during the processing of the appendix?
Which of the following components is NOT typically recorded for the mesoappendix during the processing of the appendix?
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What specific finding must be documented regarding the perforation of the appendiceal wall?
What specific finding must be documented regarding the perforation of the appendiceal wall?
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What is the typical cause for the surgical removal of the appendix?
What is the typical cause for the surgical removal of the appendix?
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What is the primary reason for submitting the entire appendix if there are abnormalities present in the lumen?
What is the primary reason for submitting the entire appendix if there are abnormalities present in the lumen?
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In cases of radical hysterectomy for malignant conditions, which additional components are processed?
In cases of radical hysterectomy for malignant conditions, which additional components are processed?
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What type of specimen classification does a total hysterectomy for fibroids fall under?
What type of specimen classification does a total hysterectomy for fibroids fall under?
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Which of the following findings in the lumen would likely indicate acute appendicitis?
Which of the following findings in the lumen would likely indicate acute appendicitis?
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When examining the condition of the mucosa from an appendectomy, which condition is characterized by glistening appearance?
When examining the condition of the mucosa from an appendectomy, which condition is characterized by glistening appearance?
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What does the acronym ESS signify in the context of specimen processing?
What does the acronym ESS signify in the context of specimen processing?
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What type of luminal content is specifically identified as a hard stony mass in the intestinal tract?
What type of luminal content is specifically identified as a hard stony mass in the intestinal tract?
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During gross examination of gynecologic pathology, what is an essential consideration for processing specimens from a total hysterectomy?
During gross examination of gynecologic pathology, what is an essential consideration for processing specimens from a total hysterectomy?
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Study Notes
Specimen Preparation
- Tissue sections should be no more than 3mm thick.
- Sections should fit in the cassette without touching the edges.
- Cassettes containing the sections should be placed back in fixative until they are processed.
- Bone specimens need additional treatment with a decalcification solution to soften the tissue.
### Safety During Grossing
- The laboratory should have a quality management system for all procedures.
- Physical hazards: Risk of cutting while using a scalpel
- Chemical hazards: Exposure to Neutral Buffered Formalin, which is a known carcinogen.
- Ergonomic hazards: Standing for extended periods of time.
- Biohazard materials: Tissue may contain potentially infectious agents.
### Grossing Equipment
- Scalpels, scissors, saws, and trimming blades should be standard quality.
- Equipment should be kept clean and decontaminated regularly.
### Standard Precautions
- Standard Precautions are followed to reduce the risk of exposure and disease transmission.
- The 5 major components of Standard Precautions are:
- Risk Assessment
- Hand Hygiene
- PPE (Personal Protective Equipment)
- Environmental Controls
- Administrative Controls
### Safe Work Practices
- Eliminate hazards whenever possible.
- Remove potential hazards.
- Report unsafe conditions.
- Follow safe work practices.
- Clean up after yourself.
- Keep the workspace safe for everyone.
### Gross Description
- The gross description records all pertinent information about the specimen.
- It provides important diagnostic information for staging and prognosis.
- The gross description should contain the following information: - Naked eye description of the intact specimen - Configuration of specimen - Orientation (Inking) - Slicing the specimen - Sectioning the specimen - Gross examination of the cut surface - Selection of material for microscopic examination - Instructions for embedding and cutting
- Gross examination is conducted by: - Pathologists - Pathology Residents - Pathologists’ Assistants (PA) - Medical Laboratory Technicians trained as a PA
- The role of the Pathologist is essential for patient care as a diagnostician, advocate and clinical leader.
- The surgical pathologist examines tissues and foreign objects removed from patients to identify disease processes, document surgical procedures and release tissue for research.
Gross Description Qualities
- A good gross description should be: - Succinct and to the point - Well organized - Adequately dissected - Standardized
Grossing Simple and Complex Specimens
- LEEP (Loop Electrosurgical Excision Procedure) is used to remove abnormal cells from the cervix, often after an abnormal Pap test.
- Cone Biopsy of Cervix involves surgically removing a cone-shaped piece of tissue from the cervix. The cone typically includes tissue from both the upper and lower parts of the cervix.
- Resection refers to the removal of all or part of an organ or body structure by surgery.
- Segmental Resection (Segmentectomy) involves the partial removal of an organ or other body structure.
- Salpingo-Oophorectomy is the removal of the fallopian tube (salpingectomy) and ovary (oophorectomy).
Appendix Processing
- Appendices are typically removed due to acute appendicitis, "incidentally" during other procedures, or as part of a right colectomy.
- Processing an Appendix involves recording dimensions, color, external surface characteristics, such as edema, fibrinous exudate, hyperemia, purulence, perforations, and hemorrhages.
- Mesoappendix should be examined and documented for dimensions, color, and appearance (edema, fibrinous exudate, purulence).
- Longitudinal section of the tip is made to fit a cassette with the serosal side inked for orientation.
- Transverse sections are made at 3 mm intervals.
- Appendiceal Wall Thickness, lumen diameter, mucosal condition, and lumen contents should be documented.
-
Contents of lumen:
- Fecalith (hard stony mass of feces)
- Foreign bodies (seeds, gallstones)
- Purulence or blood (acute appendicitis)
- Parasites (Oxyuris vermicularis)
- Mucin - may be associated with a mucocele (benign, mucus containing cyst) or a mucinous neoplasm.
- Fibrous obliteration
- Cassette #1: Longitudinal section of tip and proximal margin.
- Cassette #2: Cross sections, including the area of perforation.
Complex Specimen Grossing: Hysterectomy and Salpingo-Oophorectomy
- Type of hysterectomy (total or radical) and disease (benign or malignant) determine processing methods.
-
Hysterectomy specimens fall into three categories:
- Total hysterectomies for benign conditions (prolapse or fibroids).
- Total hysterectomies for malignant conditions (endometrial carcinoma).
- Radical hysterectomies for malignant conditions (cervical carcinoma) including vaginal cuff, parametrium, and regional lymph nodes.
- Entire specimen is submitted.
- One level is examined for women with benign conditions.
### Grossing Simple and Complex Specimens
- LEEP is used to remove abnormal cells from the cervix
- Cone biopsy involves surgically removing a cone-shaped piece of tissue from the cervix
- Segmental resection is the partial removal of an organ or body structure
- Salpingo-oophorectomy is the removal of the fallopian tube and ovary
Appendix
- Appendix removal is commonly due to acute appendicitis, but can also be incidental during other surgeries or as part of a right colectomy
-
Appendix Processing:
- Record dimensions, color, and external surface characteristics
- Record dimensions, color, and appearance of the mesoappendix if present
- Make a longitudinal section of the tip
- Record the thickness of the wall, diameter of the lumen, condition of the mucosa, and contents of the lumen
- Submit one longitudinal section of the tip and two transverse sections including any abnormalities
-
Cassettes for appendix:
- Cassette #1: longitudinal section of tip and proximal margin, 2 fragments, RSS.
- Cassette #2: cross sections including area of perforation, 4 fragments, RSS.
Hysterectomy and Salpingo-Oophorectomy
- Total hysterectomy for benign conditions: Specimen falls into one of three categories
- Total hysterectomy for malignant conditions: Specimen falls into one of three categories
- Radical hysterectomy for malignant conditions: Specimen falls into one of three categories
- Entire specimen is submitted for analysis
- One level is examined for women with a total hysterectomy for a benign condition (e.g., prolapse or fibroids)
- Multiple levels are examined for women with a total hysterectomy for a malignant condition
- Multiple levels are examined for women with a radical hysterectomy for malignant conditions (e.g., cervical carcinoma)
Specimen categories
- Benign conditions: Total hysterectomies for prolapse or fibroids
- Malignant conditions: Total hysterectomies for endometrial carcinoma, radical hysterectomies for cervical carcinoma
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Description
This quiz covers key concepts related to specimen preparation and safety protocols in the laboratory. It includes procedures for sectioning tissues, safety precautions during grossing, and the necessary equipment for handling specimens. Understanding these elements is vital for maintaining a safe laboratory environment.
