Cytopathology

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Cytoplathology
Examines cells from various body sites to determine the cause or nature of disease. Microscopic appearance of cells from anywhere in the body.
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NHS Cervical Screening Program
Not all diseases make good screening models, needs to detect the disease early enough, has to have an effective treatment, not too invasive.
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3 NHS Screening Programs
Bowel, breast and cervical
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Effectiveness of NHS Cervical Screening Programs
Incidence of cervical cancer has been halved, motality rates have dropped by 25%, pre-cancerous changes are very common, Makes up 1% of UK womens cancer rates. Comparied with 22% in Africa.
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NHS Cervical Screening Programs Process
Call: 25 Recall: every 3 years till 50. Database called Open Exeter.
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Abnormalities in Cells
Patient is sent for treatment at colposcopy or tested for the presence of high risk HPV virus
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Future Changes in NHS Cervical Screening Programs
Vaccination aginst HPV, HPV testing and screening,
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Cervical Screening
Check fro abnormal cell changes in your cervix, and signs of HPV
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Processing the sample in the lab
Samples are barcoded, loaded onto the processor, mixes the viral and draws fluid through a filter and applied onto a glass slide.
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CIN
Cervical intraepithelial neoplasia, also known as cervical dysplasis, the abnormal growth of cells on the surface of the cervix. Potentially precanceroustransformation of cells in the cervix.
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HPV
Transfer through intimate skin-skin contact, it doesn't go away, leads to genital warts and cancer. 16.18,45 and 31 are the most common high risk types. Low risk is 6 and 11.
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HPV Virus
dsDNA. Expression of oncogene proteins E6 and E7 required for carcinogenesis. E6 targets p53 action to prevent mutations. E7 targets retinoblastoma which inhibits cell cycle progression.
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Hybrid Capture 2
Non-radioactive signal-amplification method based on hybridization of the target HPV-DNA to labeled RNA probes in solution.
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HPV Detection
Identify single oncogenic HPV types. Regarding risk-straticiation, persistence of infection. HPV 16/18 persist in 10-15% infections.
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Roche COBAS DNA PCR
Amplification by PCR of L1 gene. Indicates HPV 16/18 while concurrently detecting the rest of the high risk types.
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Gen-Probe Aptima mRNA PCR
Aptima HPV assay, developed qualitative nucleic acid amplification test that detects E6/7 mRNA from 14 high risk oncogenic types,
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Treatment of CIN
Colposcopy, biopsies (confirm grade), Large loop excision (transformation zone to excise lesion), hysterectomy.
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Bowel Screening
Every 2 years from 60-74. One off offer at 55. Screens for signs, causes and treatment.
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***** Occult Blood
Blood in feces that are not visibly apparent. Can be done at home.
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Breast Screening
Women aged 50-71 every 3 years. X rays taken of breast (mammograms).
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Sample Process
Tissue scraping, centrifuged cells, brushing, washing, aspiratings lumps or lesions with a blood taking needle.
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Immunocytochemistry
Positive staining with CEA. Lung cancer patient, accumulating fulid in chest cavity. CEA is expressed in adencarcinomas to confirm cancer started in the lungs( CK7+ and CK20- pulmonary lesions. Or a metastatic lesions of the digestive tract.
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Cytopathology of Urine
Simple to collect - routine investigation (haematuria clinic for blood in the urine) - ultrasound. 10-25% of people with blood in the urine have bladder cancer
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Bladder Cancer
Highly sensitive cytology, flat tumours, hidden tumours in tissue folds, follow ups, suitable for follow up 40% of bladder cancers recur.
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Bronchoscope
is a tube fitted with fibreoptics or a tiny camera. Can carry water, aesthetic, or biopsy tools.
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Bronchoscopy
See tumour, pass forceps to obtain an biopsy, pass sampling brush. Further down the tree, bronchoalveolar lavage, washes out distal airways and alveoli.
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Adencarcinoma
Lungs are cushioned and protects by a thin covering called pleura. Non small cell lung cancer starts in glandular cells on outer part of the lung. Flat, thin cells called squamous cells.
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Fine Needle Aspiration of Thyrid
Nodules are lumps which arise within an otherwise normal thyroid gland, very common, less than 10% are malignant. Cheap, quick, safe, high failure rate.
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Thyroid FNAs
70% are benign, 5-10% are malignant
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Breast FNA
Cancer is the most common in UK, Doubled in the last 25 years. Develops in 1 in 9 women. Peak age 55-69
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Cytology of Breast Cancer
Mommagram, clinical examination, wide bore needle for histology, fine needle used for cytology.
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Other cards in this set

Card 2

Front

Not all diseases make good screening models, needs to detect the disease early enough, has to have an effective treatment, not too invasive.

Back

NHS Cervical Screening Program

Card 3

Front

Bowel, breast and cervical

Back

Preview of the back of card 3

Card 4

Front

Incidence of cervical cancer has been halved, motality rates have dropped by 25%, pre-cancerous changes are very common, Makes up 1% of UK womens cancer rates. Comparied with 22% in Africa.

Back

Preview of the back of card 4

Card 5

Front

Call: 25 Recall: every 3 years till 50. Database called Open Exeter.

Back

Preview of the back of card 5
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