* NLE * NCLEX * CGFNS * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY *

CLOSED DOOR COACHING IN HISTOPATHOLOGY & MTLAWS (MARCH 2021)

Prepared By: Prof: Ryan Geronimo, RMT, MPH
CLOSED DOOR COACHING NOTES FOR HISTOPATHOLOGY, CYTOPATHOLOGY, MTLAWS AND OTHER RELATED LAWS
rfgeronimo2021

1. Ammoniacal silver stains are most commonly used for reticular fiber and basement membrane staining.
2. Secretary of Department of Health: Sec. Francisco T. Duque
3. The purpose of team building activities is to motivate your people to work together, to develop their strengths, and to address any weaknesses. So, any team
building exercise should encourage collaboration rather than competition. Be sure to incorporate team building into your workplace routines and practices.
* Team building is about providing the skills, training and resources that your people need, so that they can work in harmony.
4. If the fetus had an intra-uterine life of less than seven months, it is not deemed born if it dies within twenty four hours after its complete delivery from the maternal womb
(Article 41, RA 386)
5. Counterstain for Immunohistochemistry (IHC): Hematoxylin, the product of the Haematoxylin Campechianum (Mexican) tree is the most popular dye used in IHC

6. Line authority is the power given to someone in a supervisory position to mandate actions by subordinates
7. Urine tumor marker tests: Most doctors consider CYTOSCOPY a good way to determine whether cancer cells have formed in the bladder
8. Milky tissues in clearing: Incomplete dehydration
9. The sensitivity of the test reflects the probability that the screening test will be positive among those who are diseased. In contrast, the specificity of the test reflects the
probability that the screening test will be negative among those who, in fact, do not have the disease.
10. National External Quality Assurance Scheme (NEQAS)
A. To ensure the accuracy and quality of test results issued by DOH-accredited laboratories, NRLs are mandated to conduct Quality Assurance Program through
the Proficiency Testing (PT) Program.
B. Participation is required by the BHFS–DOH for purposes of renewal of accreditation and continuous maintenance of the accreditation.
C. All accredited laboratories applying for renewal of accreditation must participate and pass satisfactorily.
11. National Reference Laboratory (NRLs)
a. Research Institute for Tropical Medicine (RITM): Dengue, Influenza, TB, and other Mycobacteria, Malaria and other parasites, Bacterial enteric disease. Measles
and other viral Exanthems, Mycology, Enteroviruses, Antimicrobial resistance and engineering diseases
b. San Lazaro Hospital (SACCL): HIV/AIDS, Hepatitis, Syphilis and other STIs
c. East Avenue Medical Center: Environmental and Occupational Health; Toxicology and Micronutrient assay
d. National Kidney and Transplant Institute (NKTI): Hematology, Immunohematology and Immunopathology and Anatomic Pathology
e. Philippine Heart Center: Pathology for Cardiac Disease
f. Lung Cancer of the Philippines: Atomic Pathology for Pulmonary Diseases; Biochemistry

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 12. Standard Precautions:
A. Do not cover all the requirements of the Blood-Borne Pathogens Standard.
B. Consider all body fluids of all patients to be potentially infectious.
C. Require wearing of gloves for dry skin contact with all patients.
D. Are not feasible in settings such as correctional institutions.
13. Work practice controls are intended to reduce the likelihood of exposure by changing the way a task is performed. They include appropriate procedures for handwashing,
sharps disposal, lab specimen handling, laundry handling, and contaminated material cleaning (OSHA, 2019)
EXCEPT: Splash guards
14. Organizing is the establishment of effective authority relationships among selected work, persons and work places in order for the group to work together efficiently.
Directing refers to a process or technique of instructing, guiding, inspiring, counselling, overseeing and leading people for the accomplishment of organizational goals.
15. Fetal death is death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy; the death is
indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or
definite movement of voluntary muscle.
*Miscarriage: Fetal Death Certificate
16. Apart from the substrates, what other considerations are important for the enzyme to work?
*Enzymes work at a particular optimum pH and temperature, so the chromogen solution must be buffered at this pH, and the reaction should take place for the correct amount of time,
at the right temperature
*Different chromogens are used in particular laboratories, but di-amino-benzidine, which deposits a dark brown stain, is very widely used. (Be aware that this reagent is carcinogenic
and requires specific handling and disposal procedures.) It is not usually sufficient to just carry out the IHC step, since the staining must be seen in the context of the rest of the tissue, so
the IHC may be followed by a simple histochemical stain, to allow the cells to be seen
17. Types of microscope for Immunohistochemistry: Brightfield/Light Microscope and Fluorescent Microscope
18. Unexpected weight loss over the 6 months:
*5%: Diet
*10%: Cancer
19. Component of teeth
*Each tooth is made up of the same four components: enamel, dentin, cementum and pulp. Enamel is the substance that covers the anatomic crown of the tooth, is the hardest
substance in the body and is somewhat translucent. It is created by cells known as ameloblasts.
*Calcium fluoride
20. H & E stain:
*Primary Nuclear Stain: Hematoxylin
*Counterstain: Eosin
21. First grade of alcohol used for dehydration: 70% Ethannol
22. The laboratory must have a method for disposal of hazardous wastes
a. Health care facilities processing tissues often contract this to a waste management company
b. Tissues that are collected should be stored in formalin and may be disposed by incineration
c. By putting them through a "tissue grinder" attached to a large sink (similar to a large garbage disposal unit)
23. Green Bin/Container: BIODEGRADABLE, wet, non-infectious wastes
Black Bin/Container: NON-BIODEGRADABLE, dry, non-infectious wastes
24. Fixation: Is initiated after cell death by the action of intracellular enzymes causing the breakdown of protein and eventual liquefaction of the cell
25. Victoria blue: demonstration of neuroglia

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 26. Alcohols are protein denaturants and are not used routinely for tissues because they cause too much brittleness and hardness. However, they are very good for
cytological smears because they act quickly and give good nuclear detail.
27. Act No. 8749 (approved on June 23, 1999): AN ACT PROVIDING FOR A COMPREHENSIVE AIR POLLUTION CONTROL POLICY AND FOR OTHER PURPOSES

*"Philippine Clean Air Act of 1999"

*The State shall protect and advance the right of the people to a balanced and healthful ecology in accord with the rhythm and harmony of nature
*Shall promote and protect the global environment to attain sustainable development while recognizing the primary responsibility of local government units to deal with
environmental problems.
28. Use frozen section to:
a. Provide rapid gross or microscopic diagnosis to identify an unknown pathologic process, identify extent of disease/evaluate margins, identify metastases or
simply identify a tissue
b. Process tissue to provide appropriate and accurate diagnosis, prognosis and to adhere to research and special study protocols
c. Confirm that pathological tissue is present for diagnosis on permanent sections
Do not use if:
d. Frozen section diagnosis has no immediate implications for decision making
e. Tissue is needed for permanent processing (is unique or small or requires extensive study for diagnosis)
29. Fatty tissue
*Includes lymph nodes, breast, skin; may be too soft to cut
*Solution: maintain an extremely cold cutting temperature (-20OC)
*Firm lymph nodes, spleen, brain and liver cut better at -10OC; tissue may shatter if sectioning is performed at lower temperature
30. Xylene
*Most rapid clearing agent
*Not suitable for brain and lymph nodes
*Causes hard and brittle tissues
*Can be used for urgent biopsies (RECOMMENDED: BENZENE)
*Can be used to clean microtome knife (or Toluene)
31. Opaque tissues: Re-clear
32. NEQAS for Clinical Chemistry
*Stability: Lyophilized once re-constituted, viable for 2 days
33. Health Hazard (3): Extremely hazardous
34. Current HIV testing algorithm in for a reactive result: 2 parallel screening tests + supplemental confirmatory test
Current National HIV Testing Diagnostic Algorithm in the Philippines
*The current HIV testing diagnostic algorithm in the Philippines include screening test from referring labs
*A reactive result from the screening test will be sent to SACCL for confirmatory testing, where 2 parallel screening tests are performed
*A reactive result on either of these tests will then require Western blot and/or nucleic acid test as supplemental confirmatory tests
35. If PPE is to be used, a PPE program should be implemented. This program should address the hazards present; the selection, maintenance, and use of PPE; the training of
employees; and monitoring of the program to ensure its ongoing effectiveness. Personal protective equipment may include items such as gloves, safety glasses/eye shields
and closed shoes, earplugs or muffs, hard hats/hair nets, respirators, or coveralls, vests and full body suits/laboratory coats.
36. A quality management system can be defined as “coordinated activities to direct and control an organization with regard to quality”
*In a quality management system, all aspects of the laboratory operation, including the organizational structure, processes and procedures, need to be addressed to assure quality.
37. Quality indicators are an objective measure of laboratory practices. Indicators can be developed that look at complaints, timeliness, patient refusals, and lost or delayed
laboratory reports as examples. When these indicators are being monitored, information about customer needs and satisfaction will be acquired.
*When the laboratory conducts internal audits, some aspects of laboratory practice that affect patient satisfaction can be examined. Examples might include turnaround times and
always of great concern to physicians or health care providers.
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 38. Cellular adaptation
*Hyperplasia
*Hypertrophy
*Atrophy
*Metaplasia
39. There is a RMT suffering a chronic disease, how can he renew his PRC license? Apply for exemption
40. Accreditation is a valuable tool to determine the effectiveness of the quality management system. However, it is not the ultimate goal. Once accreditation status is obtained, the
important challenge will be to maintain that status.
The outcomes of accreditation are:
*measurement of the strength and integrity of the quality system
*continual monitoring of the quality system
*recognition for your efforts
41. NOT a trait of a RMT: Religion (form of belief/faith)
42. The principle of beneficence requires doing ethical actions result in obvious and positive benefits to others, while non-maleficence refers to the avoidance of positive harm.
*Respect for Autonomy: recognition of individual rights and the importance of free will. It is the basis of “informed consent” and states that from a healthcare perspective a
patient who is autonomous has the capacity to act with understanding, intentionally, and free from controlling influences when making a decision
*Non-maleficience: requires that professionals never intentionally harm a patient, including harm that results from negligence (“do no harm”). There must be a standard of care
designed to prevent harm to patients under different circumstances
*Beneficence: refers to the duty that healthcare providers have to help their patients (“do good”)
*Justice: considers justice in health care in the form of fairness. It also implies that there should be a fair distribution of benefits and costs across all people affected by a
particular ethical issue
43. The Pap test (or Pap smear) looks for pre-cancer, cell changes on the cervix that might become cervical cancer if they are not treated appropriately. While, the HPV
test looks for the virus (human papillomavirus) that can cause these cell changes. (CDC)
44. Identifiers must AT LEAST be included when labelling tissue samples: Full name of patient, requesting MD, hospital record number
45. TQM= QC + QA
46. The QA program must:
*Assess the effectiveness of the laboratory policies and procedures
*Identify and correct problems
*Assure the accurate, reliable, and prompt reporting of test results
*Assure the adequacy and competency of the staff

Quality Assurance Standards: CLIA 88

*Assessment required for: Patient test management, Quality control, Proficiency testing, Test comparisons, Relate results to clinical data ,Personnel, Communications, Complaints,
Staff review, Records
47. Carnoy’s fluid: Most rapid fixative; Glutaraldehyde: Fixative used for Electron Microscopy and Enzyme Immunohistochemistry
48. Double embedding: Tissue is infiltrated in Celloidin then, Paraffin.
49. Blood Banking Station LTO is valid from January 01- December 31 yearly.
Drug Certificate expires yearly from date of issue.
50. Purchasing and Inventory: Proper management of purchasing and inventory of reagents, media, and supplies can produce cost savings in addition to assuring accurate and
timely reporting of laboratory results. The procedures should be written and implemented to assure that all reagents and supplies are correctly selected, purchased, used, and
stored in a manner that preserves integrity and reliability. The inventory should be kept up to date including information on reception, storage, and issuance. Package inserts and
Material Safety Data Sheets (MSDS) should be archived as part of records keeping
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 *RMTsMARCH2021*

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