12.

Biopsy and surgical material investigation

1. What is a histopathologic analysis and what are the categories of it?

2. Compare histologic and cytologic investigation methods.
3. What is the role of pathology doctor when diagnosing various diseases, organizing the treatment
strategy and evaluating the disease prognosis?
4. What is a biopsy?
5. What endoscopic methods can be used for acquiring the biopsy samples for histopathologic
investigation?
6. What is a core-needle biopsy and when is it performed?
7. What is a fine-needle aspiration biopsy and when is it performed?
8. What is a punch biopsy and when is it performed?
9. How is bone marrow tissue acquired for pathological examination?
10. What is a surgical excision biopsy?
11. What is a surgical incision biopsy and when is it performed?
12. What is an intraoperative histopathologic examination (urgent biopsy)?
13. What biological material is sent for cytology examination and when is it sent?
14. What are the general requirements of biopsy and surgical specimen preparation for sending a sample to
pathology department?
15. What specific features of preparing biopsy and surgical material samples taken from various organs for
sending to pathology department do you know?
16. How are the biological liquids being sent for histopathologic investigation?
17. How a liquid biological specimen is presented on the slide for cytology analysis?
18. What are the characteristic features of filling in the sending form for tissue sample pathological
examination (Sending Surgical Specimen/Biopsy for Pathology Examination, form 014-1-1/a)?
19. Explain, why is it required to present information about fixation material in the sending form? 20. Why is it
required to present information about the dates, locations and registration numbers of previously performed
morphological tests in the sending form?
21. Why is it required to indicate a thorough clinical diagnosis and clinical data?
22. Why is it required to indicate a type of surgery/invasive procedure?
23. How is a sample sent for histopathology examination being characterized?
24. How is a sample being sent for histopathology investigation?
25. How is a sample accession and registration process being performed?
26. When is pathology analysis suspended and what are the further steps of the process? 27. What is an
identification number of tissue sample?
28. What are the specific features of the macroscopic analysis of the tissue sample?
29. What fixative materials do you know and what is the function of them?
30. What is the purpose of sample hardening procedure by paraffin embedding?
31. What is the essence of histological staining and what routine staining methods do you know? 18 32.
Describe the significance of routine histological analysis.
33. When is a histochemistry (special staining) required? Give some examples.
34. What is the essence of immunohistochemical analysis?
35. What is being evaluated in cases of immunohistochemical reaction? Give some examples.
36. What technological equipment does contribute towards unifying and standardizing pathology analysis?
37. What is the essence of molecular pathology tests?
38. What is the essence and purpose of hybridization in situ reaction? Give some examples.
39. What changes are identified in cases of PCR and gene sequencing. Give some examples.
40. What is the essence and pupose of morphological image analysis? Give some examples.
41. What is the purpose of telepathology? Give some examples.
42. What is virtual microscopy?
43. What types of microscopes are used for pathology investigation?
44. What are the specific features of morphological analysis of intraoperative biopsy samples?
45. How is a cytological smear being stained?
46. What is the significance of cytology analysis? Give some examples.
47. What are the major structural components of histopathology report?
48. What are the specific features of preparing a pathology investigation conclusion?
49. Remember what biomarkers of malignant neoplasia diagnosis, treatment strategy choice and prognosis
you know.
50. What is the basis for TNM classification system of malignant tumours and what is a practical
significance of this system?
51. What are the general rules determining the stage of neoplasm? Remember what T, N and M symbols
mean.
52. What symbol is used to indicate the differentiation grade of neoplasms?
53. What is the practical application of TNM classification?
54. What does these classification symbols of pTNM, cTNM, yTNM, rTNM mean?
55. What are the specific rules and regulations for filling in and sending the histopathology report (form
014-1-2/a)?
56. How are the pathological conditions/diseases being encoded by using International Statistical
Classification of Diseases and Health Disorders (10th revised and updated edition, Australian
classification-based modification)“ (abbreviation in lithuanian TLK10-AM), International Classification of
Diseases for Oncology (abbreviation ICD-0-3) and Systemized Nomenclature of Medicine – Clinical Terms
(abbreviation SNOMED CT)?
57. What are the final terms for biopsy and surgical samples analysis?
58. Where are the tissue paraffin blocks and histological slides being stored? What is the required period
of time for tissue paraffin block and histological slide storage according to the regulations?
59. What is the required time for keeping the sending form to perform a pathology examination in the
archive?
60. What is the required time for the histopathology report to be preserved and where is it preserved?
61. Where can a patient get to know his/her histopathology investigation results?

13. Pathological postmortem investigation (clinical autopsy)

1. What is an autopsy?
2. When performing an autopsy is obligatory and when it is only recommended?
3. When do the family members have an opportunity to refuse the autopsy?
4. What is a pathology autopsy?
5. What is a pathology autopsy benefit to the doctors and medicine practice?
6. What is a pathology autopsy benefit to the family members of the deceased?
7. What is a pathology autopsy benefit to the society and public health?
8. What is a pathology autopsy benefit to the study process?
9. What is a pathology autopsy benefit to the basic biomedical and applied clinical research?
10. Who is the one to fill in the Act for Designating a Postmortem Examination (form 0171/A), when a
patient dies in a healthcare institution and elsewhere? Who confirms the decision of postmortem analysis by
signing this form of document?
11. Where is the patient who died at healthcare institution being transported? What is a content of cover
letter of the deceased?
12. How is the patient‘s history being filled in when a patient dies? When is this document transported to
the pathology department, if a decision to perform an autopsy is made? 13. How does a doctor
pathologist prepare for an autopsy?
14. What are the morphological features of macroscopic and microscopic examination at autopsy?
15. What supplementary methods of examination are applied at autopsy?
16. What is a medical death certificate (form 106-1/a) and perinatal medical death certificate (form
106-2-1/a)?
17. What is an accountability of medical death certificate and what are the principles of its numeration?
18. Who is the one to fill in a medical death certificate when the autopsy is not performed?
19. Who is the one to fill in a medical death certificate when the autopsy is performed?
20. What is the structure of medical death certificate?
21. What are the rules and regulations of filling in the medical death certificate?
22. What is a main disease that cause the death of a patient?
23. What is an intermediate cause of death?
24. What is a direct cause of death?
25. Who can receive a medical death certificate and sign in its counterfoil?
26. What procedures are to be performed when a mistake was detected when filling in a medical death
certificate?
27. What is a period of time required to preserve the counterfoil of a medical death certificate?
28. Where are all the pathology examination findings being recorded?
29. What are the general principles of pathology diagnosis construction after autopsy?
30. What are the components of pathology diagnosis after autopsy?
31. What are the main rules and regulations for pathology epicrisis construction?
32. How are the discrepancies between clinical and pathology autopsy diagnosis being described?
33. Where are all the autopsy analysis results being discussed and hearings performed?
34. How are the conferences of patient‘s treatment strategy analysis being organized and conducted at the
healthcare institution?
35. What is a required period of time for preservation and storage for these documents: the act for
designating a postmortem examination, pathology autopsy report and registration journal of the deceased
patients