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RMT by August 20,2025, Histopathology & MT LAWS, CLINICAL MICROSCOPY,…

- - - - PSEUDOSTRATIFIED COLUMNAR
        single layer lang
        may cilia
        (TRACHEA)
      - STRATIFIED SQUAMOUS
        multiple layers
        found sa mga madalas inaabuso o may friction na structures (vagina, mouth)
        
        Keratinized
        
        protein = keratin
        
        skin
        
        ⭐RECALL: major cell sa skin...keratinocytes
        
        Non keratinized
        
        mouth, glans, vagina etc.
        
        mga malambot
        
        STRATIFIED CUBOIDAL
        
        sweat duct, ovarian follicles
        
        STRATIFIED COLUMNAR
        
        tall thin cells
        
        larynx, conjuctiva etc.
      - TRANSITIONAL EPITHELIUM / aka urothelium
        
        Stretchable
        
        organs accomodates fluctuations of volume
        
        urinary bladder
        
        IF NOT STRETCHED - CUBOIDAL
        IF STRETCHED = SQUAMOUS
      - Next topic
        
        SECRETORY/gland
        
        Endocrine - no ducts, secrete sa blood stream
        
        Exocrine - may ducts may labasan, secrete sa surfaces
        
        Pwede maging exocrine at endocrine si PANCREAS, pank na pank
        
        PACREAS
        2 ka bida sa pancreas
        
        Acinar cells
        (exocrine)
        
        for digestion
        
        Lipase - digestion of lipids
        
        Amylase - digestion of poly
        
        Islet of langerhans
        (endocrine)
        
        Alpha = glucagon
        
        Beta = insulin
        
        Delta = Somatostatin (regulator ni insulin, GH, glucagon)
      - Connective tissue
        
        ⭐MESENCHYME = embryonic tissue where all connective tissue originates
        
        components are:
        connective tissue cells
        
        Fibroblast = key cells , most common
        
        Adipocytes = fat cells
        
        Intercellular component
        
        Amorphous/gel type
        
        Formed/ fibrous type
        
        Collagenous fibers (most abundant)
        
        Reticular fibers (called argyrophilic - loves silver - silver stain)
        
        Elastic fibers
        
        Areolar tissue
        
        most abundant
        
        sya nagiging glue sa mga organ dikit2
        
        mukhang di sinuklay
        
        Dense tissue
        
        closely packed fibers
        
        sinuklay na!
        
        rope-like structures
        ligaments BONE TO BONE connect
        tendon MUSCLE TO BONE connect
        
        Myxoid CT
        
        found in umbilical cord
        (whartons jelly = forms rouleaux = wash 6-8x)
        
        Adipose tissue
        
        thermal insulator, protection/cushion
        
        Cartilage
        
        contains collagen
        
        collagen type II (mnemonics = carTWOlage) haha
        TYPES:
        
        Hyaline cartilage = glassy/clear, most abundant, temp bone of fetus
        
        Fibrocartilage - ⭐RECALL: type of cartilage kay intervertebral disc
        
        Elastic cartilage = recoil to original shape (ears,epiglottis etc.)
        
        Bone
        
        mga butas2 = called lacunae
        
        TYPE I collagen (type ONE..bONE)
        
        Osteoblast = bbuin, bone forming
        
        Osteoclast = C...ccrain!
        
        Blood
        
        cells = blood cells
        
        extracellular matrix = plasma
        
        Muscular tissue
        Skeletal muscle
        
        elongated, large
        
        voluntary
        
        striated
        
        Cardiac muscle
        
        elongated, branching
        
        involuntary
        
        striated
        
        intercalated disc (FIXATIVE = hellys/ zenker formol)
        
        Smooth muscle
        
        fusiform
        
        involuntary
        
        no striations
        
        NERVOUS TISSUE
        
        irritability and conductivity (functions)
        
        irri...respond to stimulus
        
        condu....transmit signals
        
        the spine (PNS) and the brain (CNS)
        
        composition:
        
        Nerve cell (neurons)
        
        Glial cells (supporting cell ni nerve cell)
        
        ⭐ BIELSCHOWSKYS stains = NAN
        
        N - neurons
        
        A - axons
        
        N - neurofibrils
        
        ⭐ LUXOL FAST BLUE = Myelin
        
        NEXT TOPIC
        
        ABNORMALITIES IN CELL GROWTH
        
        Retrogressive changes
        (ga gamay)
        Developmental changes = @ birth
        
        Aplasia - wala tumubong organ pero fatty/fibrous tissue lng
        
        Agenesia - non appearance, wala gd
        
        Hypoplasia - tubo ang organ pro gamay
        
        Atresia - (no trespassing sa opening) wala opening
        
        Atrophy = acquired, reduced cell size
        (decrease workload)
        
        Physiologic - normal atrophy
        
        Pathologic - abnormal atrophy
        
        2 more items...
      - SIMPLE SQUAMOUS
        Endothelium - lines blood vessels
        Mesothelium - lines cavities
        (KIDNEY , LUNGS)
        SIMPLE CUBOIDAL
        for active transport
        Kidney tubules = PCT, DCT
        SIMPLE COLUMNAR
        daanan ng mga bagay2
        contains goblet cells = produces mucus
        (STOMACH TO ANUS)
- - - - 3 essentials parts
        
        Knife
        
        Block Holder
        
        Pawl, ratchet wheel
        
        MICROTOME KNIVES
        
        Conventional steel knives
        Plane concave
        
        length 25mm⭐
        
        less concave side = for celloidin
        
        more concave side - paraffin lang
        
        base sledge, rotary, rocking
        
        Biconcave
        
        rotary lang
        
        120mm (sa HEMA ,RBC, biconcave, 120days lifespan)
        
        paraffin lang
        
        Plane wedge knife
        
        both sides straight
        
        100mm
        
        base sledge/sliding
        
        for frozen, and very hard
        
        Disposable Knives
        
        more common nowadays
        
        no need hasain na kay disposable
        
        cheaper
        
        Magnetic knives
        
        for cryostat
        
        Glass knives
        
        for electron microscope
        
        semi thin 0.5 to 1um
        
        Diamond knives
        
        electron man
        
        ultrathin, 50-120nm/500-1200 A
        
        Sharpening
        HoNing
        
        remove Nicks
        
        edge first, heel to toe
        
        20-30 double strokes
        
        MGA pang hasa
        Belgium Yellow
        
        give best results!!!!
        
        Arkansas
        
        more polishing effects
        
        Fine Carborundum
        
        for badly nicked knives
        
        StroPPing
        
        remove buRRs
        
        polishing
        
        toe to heel
        
        40-120 double strokes
        
        Horse Leather
        
        Next topic
        
        1 more item...
        
        Angles
        
        Bevel Angle = 27-32°
        
        perfect/optimum angle = 15° (Tagos na tagos!)
        
        Clearance angle = 0-15°
        
        to prevent alternating thick and thin sections = 5-10°
      - Rocking microtome (cambridge)
        
        large block
        
        simplest (mag asawa..dapat simple pero rock parin)
        
        Trefall (rockers, trefallgar law)
        
        Rotary Microtome (Minot)
        
        routine paraffin
        
        most common (umiikot, common ang mga taong pinapaikotikot)
        
        Sliding microtome
        
        celloidin, rubbery sections
        
        most dangerous (kasi para sa makunat, exposed knife)
        
        Adams, inventor (adame levine, nag slide sa stage palong palo)
        
        2 types:
        
        base sledge = knife steady
        
        Standard = knife moving (dangerous)
        
        Freezing microtome
        
        unembedded frozen sections
        
        queckett, inventor (quick freeze)
        
        Ultrathin microtome
        
        for electron microscopy
        
        knives = glass and diamond
        
        semi thin = 0.5 to 1 um
        
        ultra thin = 500-1200 armstrong (50-120nm)
- - - - METHODS of COLLECTION
        Midstream clean catch
        
        for culture and routine
        
        ⭐catheterized/midstream, requested for culture and urinalysis UNAHON CULTURE
        
        Catheterized
        
        for bacterial culture
        
        Suprapubic aspiration
        
        bacterial culture
        
        three glass technique
        
        to detect prostitis
        
        1 glass = first urine passed
        2 glass = midstream (control) dapat negative for bacteria if positive invalid
        3 glass = post massage spx (bacteria and WBCs found)
        pediatric spx
        
        plastic bags with hypoallergenic tapes sa genital
        
        for sterile spx, catheter and suprapubic aspiration pwede
        
        Drug spx collection
        
        dapat 60mL capacity container
        
        30-45mL spx volume
        
        test valid for 1 year
        
        spx test temp within 4 minute, 32.5-37.7C, if not, gn diskartehan
- - - - MICROBIAL IDENTIFICATION
        
        Medtech identifies by PHENOTYPIC characteristics of bacteria
        
        Bacterial Genetics
        
        read and familiarize
        
        page 1
        
        MAIN TAKEAWAYS
        1.) Mutation
        
        Transformation = free DNA
        
        Transduction = acquiring DNA from BACTERIOPHAGE, most common method
        
        Conjugation = transfer of DNA through sex pilus, F (fimbriae) F(+) ang may sex pilus then tusok kay F(-) after sex both sila F(+) na
        
        2.) Recombination/Homologous Recombination
        
        Rec A protein, requirement for mutation
        
        mec A gene, gene of MRSA, identified by PCR (gold standard for identifying MRSA)
        
        always recall difference of PROKARYOTES and EUKARYOTES
        
        ribosomes
        
        site of enery production
        
        sino yung may organelles
        
        prokaryote without CHO and sterols
        
        Smallest pathogenic bacteria = h. ducreyi = chancroid - "'oid'' looks like
        T. Pallidum subsp pallidum = chancre
        Largest pathogenic bacteria = B. Anthracis - bioterrorism agent
        
        wala cell wall = MYCOPLASMA and UREAPLASMA
        
        SHAPES of Bacteria
        
        cocci, bacilli, coccobacilli, fusiform or pointed, spiral, curved
        
        Put in mind CURVED BACILLI
        
        Vibrio
        comma or C shaped, shooting star, rapid darting, V and L forms
        
        H. Pylori
        urease+ giemsa/silver impregnation
        
        Jejuni
        darting motility
        
        Capnocytophaga
        spindle shape/fusiform, gliding motility
        
        2 more items...
- - - - Entamoeba Coli
        
        Trophozoite
        
        Many pseudopods, sluggish, undirectional
        
        eccentrically located karyosome
        
        unevenly distributed chromatin
        
        DIRTY LOOKING cytoplasm (bacterias, yeast, cell debris)
        
        Cyst
        
        8 nuclei
        
        slightly larger
        
        Chromotoidal bar - witch broom like appearance
        
        Entamoeba dispar
        
        morphologically same kay histolytica
        
        no ingested RBC
        
        diff by molecular analysis (PCR) best way
        
        Entamoeba hartmanni
        
        same morphology kay histo BUT- smaller race of HISTO sya
        
        Junior ni HISTO
        
        Entamoeba polecki
        
        found in pigs and monkeys
        
        uninucleated cyst
        
        chromtoidal bars - angular/pointed ends
        
        Endolimax nana
        
        smallest amoeba (same size sa RBC)
        
        blot-like karyosome
        
        no peripheral chromatin
        
        4 nucleus cyst (cross-eyed cyst)
        
        NO peripheral chromatin
        NO chromotoidal bar
        (wala entamoeba sa ngalan)
        
        Entamoeba gingivalis
        
        no cystic stage
        
        ingested WBCs
        
        MOT: mouth to mouth, utensils, etc.
        
        Diagnosis: mouth scrapings
        
        first ameba recovered
        
        1 more item...
        
        UNINUCLEATED
        
        Iodamoeba butschlii/williamsi
        
        no PC, UNINUCLEATED
        
        nucleus: ''basket of flowers''
        
        glycogen vacuole (stains well w/ iodine)
        
        achromatic granules
        
        mga kapid ni histo
        
        Entamoeba moshkovskii
        
        morphologically same man kay histo
        
        osmotolerrant (able to grow @ room temp 25-30C)
        
        survives @ 0-41C
        
        the main couterpart
      - Next Topic
        
        FREE living amoeba
        
        Naegleria Fowleri
        (brain eating amoeba)
        
        it has 3 stages: Cyst, Trophozoite (Infective stage), Flagellated form
        
        MOT: inhalation (pakadto sa olfactory nerves to brain), contaminated water
        
        recovered sa kahit ano na tubig EXCEPT seawater
        
        causes PAM (primary amoebic meningoencephalitis)
        
        kernigs sign - cant straighten legs
        
        motile TROPHOZOITE can be recovered in the spine fluid (purulent)
        
        Acanthamoeba
        
        two stages: cyst and troph
        
        like acanthocytes may spiny hyaline sa cyst and spiny pseudopods sa troph
        
        remember DOUBLE WALLED cyst with spiny hyaline projections
        
        MOT: inhalation, enter respiratory then to blood to brain
        
        causes GAE
        (granulomatous amebic encephalitis)
        (also Balamuthia madrillaris) in immunocompromised px
        
        acanthamoeba castellani - causes mostly CNS and Eye infections
        
        Both of them cultured in BAP flooded with 24 hr growth Escherichia coli as their food
        
        tracks or trails seen indicates presence of parasites (troph)
        
        always remember free living infects man through inhalation,eyes,skin BUT NOT ingestion
      - Flagellates
        
        Atrial and Intestinal Flagellates
        
        Giardia Lamblia
        
        Old man with eyeglasses, monkey face, old man with mustache
        
        Cyst and troph may 2 ka nuclei
        
        only flagellate na bilaterally symmetrical
        
        resistant to chlorination
        
        CYST
        
        2-4 median bodies and nuclei
        
        excyst in duodenum
        
        TROPHOZOITE
        
        pear shaped, tear drop shape
        
        2 nuclei
        
        4 pairs of flagella
        
        ventral sucker/sucking disk
        
        axostyle - skeleton for structure
        
        median body - energy
        
        MOT
        
        fecal-oral
        
        through sex
        
        Diagnosis
        
        Stool exam, duodenal aspirate, enterotest (pwede si G. lamblia, strongy, cryptosporidium)
        
        Symptoms
        
        malabsoroption, steatorrhea (pwede si G lamblia and capillaria philippenensis)
        
        Gay bowel syndrome
        
        Travellers diarrhea ( like ETEC)
        
        crypts found in duodenum
        
        Treatment
        
        metronidazole
        
        Dientamoeba fragilis
        
        without cystic stage
        
        with cystic stage (new studies)
        
        without external flagella
        
        can be transmitted with helminthic eggs like E. vermicularis and A. lumbricoides
        
        COINFECTION with Enterobius vermicularis
        
        swells and return in water preparation, granules exhibit brownian movement/hakansson phenomenon
        
        Trophozoite
        
        2 nuclei (binucleated)
        
        4-8 chromatin granuels (each nucleus)
        
        Treatment
        
        Iodoquinol
        
        Chilomastix mesniili
        
        CYST
        
        lemon shaped
        
        protrusion in one end
        
        nipple shape
        
        TROPHOZOITE
        
        pear shaped (pwede man si trichomonas and giardia lamblia)
        
        4 flagella, one flagella interior
        
        shephereds crook structure (mesnili - cytosome, tail ni mansonella streptocerca, marburg virus)
        
        TRICHOMONAS
        (pentatrichomonas)
        
        no cystic stage
        
        Trophozoite only
        
        undulating membrane - fin like structure (Trichomonas and trypanosoma)
        
        Trichomonas Hominis
        
        non pathogenic
        
        intestine ga reside
        
        in contaminated milk
        
        milk serves as protective to hominis in stomach
        
        Trichomonas tenax
        
        non pathogenic
        
        sa tartar sa gums sa BABA
        
        MOT: laplap kiss, utensils
        
        smallest
        
        Trichomonas vaginalis
        
        most common non viral STI (pathogenic)
        
        best specimen vaginal secretion, prostatic secretion(males pero carrier lang tana), urine
        
        vertical transmission (pwede sya maadto sa baby)
        
        can cause cervical carcinoma (HPV)
        
        Vaginits - foul smelling greenish yellow discharge, straberry cervix
        
        motility - rapid jerking
        
        reported same as bact. few moderate many/HPF
        
        STAINS: giemsa, papanicolau
        
        Largest
        
        Siderophil granules along axostyle
        
        Treatment
        
        Metronidazole (Histolytica, Giardia same2)
        
        HEMOFLAGELLATES
        
        blood and tissue flagellate
        
        trypanosoma, leishamnias
- - - - ISBT
        
        ABO - 001
        
        Rh - 004
        
        RhAG - 030
        
        Dombrock - not known
        
        next topic
        
        Familiarize history
        (2 points in BOARDS daw)
        
        ABO forward
        (Direct typing)
        ABO reverse
        (serum typing, reverse typing, back typing)
        
        GRADING in agglutination rxn
        
        4+ solid aggregate
        
        3+ Large
        
        2+ medium
        
        1+ small
        
        weak - tiny aggregates
        
        mixed field - mostly free floating cells
        
        Gel technology
        
        Dr. Yves Lapier
        
        Dextran Acrylamide gel
        
        principle = hemagglutination
        
        Incubation = 15 minutes
        
        Centrifugation = 10 minutes
        
        valid for 2-3 DAYS
        
        1 more item...
- - - - THERMOMETER claibration
        
        6-12 months
      - CENTRIFUGE
        
        how to measure RPM? use STROBE light/Tachometer! spin the tacos!!!
        
        calibrate every 3mos.
        
        RPM = 1mo.
        
        1 week = disinfect (sodium hypochlorite)
        
        Lipoproteins = EDTA plasma = gina ultracentrifuge (100,00rpm, the fastest) for 24hrs = it is the reference method