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频道帖子
| 2 |  +9没有文字... | 179 |
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| 6 | BMLT 2nd Year Pathology – Step.pdf | 217 |
| 7 | There is no single fixed time for all blood cells. The time varies according to the cell type and maturation stage.
For example:
RBC production (erythropoiesis) takes several days, with approximately 5–7 days commonly cited for maturation in the marrow.
Other blood-cell lineages have different maturation times.
Therefore, hematopoiesis is a continuous process throughout life, rather than a process that takes one fixed number of days.
---
(b) Clinical Significance of Rh Blood Group
Definition
The Rh blood group system is an important blood group system after ABO. The most important antigen is D antigen.
A person with D antigen is called Rh-positive, while a person without D antigen is called Rh-negative.
Clinical Significance
1. Blood transfusion
An Rh-negative person can become sensitized after exposure to Rh-positive RBCs.
This may lead to formation of anti-D antibodies.
2. Pregnancy
Rh incompatibility can occur when:
Mother is Rh-negative
Fetus is Rh-positive
The mother may become sensitized to fetal RBCs.
3. Hemolytic disease of the fetus and newborn
Maternal IgG anti-D antibodies can cross the placenta and destroy Rh-positive fetal RBCs.
This can cause:
Fetal/newborn anemia
Jaundice
Hemolytic disease of the fetus and newborn
4. Prevention
Anti-D immunoglobulin is used according to appropriate clinical protocols to prevent Rh-negative mothers from becoming sensitized.
5. Importance in blood banking
Rh typing and antibody screening are important before transfusion to reduce the risk of clinically significant hemolytic reactions.
---
(c) Storage and Preservation of Blood
Definition
Blood storage means keeping collected blood under controlled conditions so that its components remain safe and useful for transfusion.
Anticoagulant-Preservative
Common blood collection solutions include:
CPD
CPDA-1
Other approved additive solutions for red-cell storage
Storage Conditions
Whole blood and red-cell components
Stored in a monitored blood-bank refrigerator at approximately 1–6°C, depending on the component and applicable standards.
Important points
1. Maintain the correct storage temperature.
2. Monitor and record refrigerator temperature.
3. Avoid unnecessary temperature fluctuations.
4. Do not store blood with food or unrelated materials.
5. Check expiry date before issue.
6. Inspect blood bags for leakage, clots, discoloration, or abnormal appearance.
7. Maintain proper identification and documentation.
Changes During Storage
During storage:
RBC metabolism continues.
ATP decreases.
2,3-DPG changes.
Potassium may increase.
Some hemolysis may occur.
WBC and platelet function decreases.
Some coagulation factors decrease.
Components obtained from donated blood
Blood can be separated into:
Packed red blood cells
Fresh frozen plasma
Platelet components
Other components according to the blood-bank facility.
Preservation
Proper preservation requires:
Correct anticoagulant/additive solution
Correct temperature
Proper blood-bank equipment
Regular monitoring
Correct labelling
Proper documentation
Maintenance of the cold chain
Conclusion: Proper storage and preservation maintain the quality, safety, and therapeutic usefulness of blood components until transfusion. | 1 |
| 8 | 4. Ketone bodies – may be present in ketosis or uncontrolled diabetes.
5. Blood/hemoglobin – may indicate bleeding or other urinary tract conditions.
6. Bilirubin – may occur in certain liver or biliary disorders.
7. Urobilinogen – helps in evaluation of liver and hemolytic conditions.
8. Specific gravity – indicates the concentration of urine.
Common methods
Dipstick/reagent strip tests
Benedict's test for reducing substances
Sulfosalicylic acid test for protein
Other specific chemical tests as required
---
(d) Short Note on Absolute Eosinophil Count (AEC)
Definition
Absolute eosinophil count (AEC) is the number of eosinophils present in a specific volume of blood, usually expressed as cells/µL.
Principle
A special diluting fluid is used to dilute blood and selectively stain eosinophils. The eosinophils are then counted using a Neubauer counting chamber.
Specimen
Peripheral blood, usually collected in an EDTA tube.
Procedure
1. Collect blood in an EDTA tube.
2. Dilute the blood with appropriate eosinophil diluting fluid.
3. Mix properly.
4. Charge the Neubauer chamber.
5. Allow the cells to settle.
6. Count eosinophils under the microscope.
7. Calculate the absolute count.
Formula
AEC = Number of eosinophils counted × dilution factor × chamber factor
For the commonly used chamber method, the exact calculation depends on the dilution and area/depth counted.
Clinical significance
AEC may be increased in:
Parasitic infections
Allergic conditions
Some skin diseases
Certain hematological disorders
---
(e) Collection and Handling of Urine
Collection
1. Give the patient a clean, dry, properly labelled container.
2. Explain the collection procedure.
3. For routine examination, a fresh midstream urine sample is commonly preferred.
4. Collect an adequate amount.
5. Close the container immediately.
6. Label with patient identification and collection time.
Handling
Send the sample to the laboratory as soon as possible.
Examine promptly.
If there is a delay, store the specimen appropriately, generally under refrigerated conditions according to laboratory policy.
Avoid contamination.
Mix the specimen gently before examination when appropriate.
Important precautions
Use a clean container.
Do not touch the inside of the container.
Avoid contamination with stool, tissue, or other material.
Correct identification and timing are important.
---
(f) Changes in Blood on Storage
Blood undergoes several changes during storage.
1. RBC changes
RBCs become less flexible.
Some RBCs undergo hemolysis.
ATP levels decrease.
2,3-DPG decreases initially.
Potassium may increase in stored blood.
2. WBC changes
WBCs gradually lose viability and function.
3. Platelet changes
Platelet function decreases during storage.
4. Plasma changes
Some labile coagulation factors decrease, especially factor V and factor VIII.
5. pH changes
pH gradually decreases because of metabolic changes.
6. Other changes
Glucose is consumed.
Lactate increases.
Electrolyte changes occur.
These changes are collectively called storage lesions.
---
Q.3 Long Answer Questions
(a) What is Hematopoiesis? How Long Does Hematopoiesis Take?
Definition
Hematopoiesis is the process by which all blood cells are formed, developed, and matured from hematopoietic stem cells.
The major blood cells produced are:
RBCs
WBCs
Platelets
Sites of Hematopoiesis
Before birth
Embryonic yolk sac
Liver
Spleen
Later, bone marrow
After birth
The main site is red bone marrow, particularly in:
Vertebrae
Ribs
Sternum
Pelvis
Skull
Proximal ends of some long bones
Main process
Hematopoietic stem cell → Progenitor cell → Precursor cell → Mature blood cell
Different growth factors and cytokines control this process.
Major Cell Lines
Myeloid stem/progenitor cells →
RBCs
Platelets/megakaryocytes
Neutrophils
Eosinophils
Basophils
Monocytes
Lymphoid progenitor cells →
B lymphocytes
T lymphocytes
NK cells
How long does hematopoiesis take? | 1 |
| 9 | BMLT 2nd Year Pathology – Step-by-Step Answers
Below are the answers in easy English, arranged according to the examination paper.
---
Q.1 Multiple Choice Questions
(a) Human blood group types in the ABO blood group are identified by:
i) Clotting factors in plasma
ii) Microscopic examination of WBCs
iii) Antigen–antibody reactions ✅
iv) Series of enzyme-controlled reactions
Answer: iii) Antigen–antibody reactions
Explanation:
ABO blood grouping is based on the reaction between A/B antigens on RBCs and corresponding antibodies in antisera.
---
(b) How much anticoagulant is required for 450 mL of blood?
i) 49 mL
ii) 63 mL ✅
iii) 50 mL
iv) 36 mL
Answer: ii) 63 mL
Explanation:
For a standard 450 mL blood collection, approximately 63 mL of anticoagulant-preservative solution is used in a standard blood collection bag.
---
(c) In the context of ABO blood group, a transfusion of AB blood may be given to a person who has blood type:
i) A
ii) B
iii) O
iv) AB ✅
Answer: iv) AB
Explanation:
For whole-blood transfusion, ABO compatibility is important. AB blood is generally given to an AB recipient.
---
(d) On which chromosome is the Rh gene located?
i) Chromosome 19
ii) Chromosome 1 ✅
iii) Chromosome 9
iv) Chromosome 8
Answer: ii) Chromosome 1
Explanation:
The major Rh blood group genes, RHD and RHCE, are located on chromosome 1.
---
(e) Black-coloured stool is called:
i) Hemorrhage
ii) Melena (Melaena) ✅
iii) Hemoptysis
iv) Hemoglobinuria
Answer: ii) Melena
Explanation:
Melena means black, tarry stool usually caused by bleeding in the upper gastrointestinal tract.
---
Q.2 Short Answer Questions
(a) Describe Different Methods of Blood Grouping
Definition
Blood grouping is the identification of a person's blood group according to the antigens present on the surface of RBCs.
Main methods
1. Slide Method
Place a drop of anti-A on one area of a clean slide.
Place a drop of anti-B on another area.
Add the patient's RBC suspension to each.
Mix separately with applicator sticks.
Observe for agglutination.
Agglutination with anti-A → Group A
Agglutination with anti-B → Group B
Agglutination with both → Group AB
No agglutination → Group O
2. Tube Method
Prepare patient's RBC suspension.
Add it separately to tubes containing anti-A and anti-B.
Mix and centrifuge according to the laboratory procedure.
Observe for agglutination.
Record the result.
Tube method is more sensitive and reliable than the slide method.
3. Microplate Method
Uses wells of a microplate.
Patient RBCs and antisera are added to appropriate wells.
After incubation/centrifugation as required, agglutination is observed.
4. Gel/Column Agglutination Method
Uses a gel card containing anti-A, anti-B, and other reagents.
RBCs are added and centrifuged.
Agglutinated cells remain within or above the gel column, while non-agglutinated cells pass to the bottom.
---
(b) Short Note on Semen Analysis
Definition
Semen analysis is the laboratory examination of semen to assess its physical and microscopic characteristics, especially sperm quantity and quality.
Specimen Collection
1. Collect semen in a clean, sterile, wide-mouth container.
2. The specimen is usually collected by masturbation.
3. The entire specimen should be collected.
4. Record the time of collection.
5. Deliver it to the laboratory promptly.
Examination
1. Physical examination
Volume
Colour
Appearance
Liquefaction
Viscosity
pH
2. Microscopic examination
Sperm count/concentration
Sperm motility
Sperm morphology
Pus cells
RBCs
Epithelial cells
Other cells or organisms if present
Importance
Semen analysis is mainly used in the evaluation of male reproductive function and infertility.
---
(c) Short Note on Chemical Examination of Urine
Chemical examination checks different chemical substances in urine.
Common tests
1. pH – shows whether urine is acidic or alkaline.
2. Protein – normally absent or present only in very small amounts.
3. Glucose – normally absent; may occur in conditions such as diabetes mellitus. | 1 |
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| 15 |  Aku patna 10 th convocation | 308 |
| 16 |  Watch free movies and earn real cash on Rigi TV!
Join me using my link: https://app.rigi.club/B1s0/2k9f58gr | 300 |
| 17 | Answer: Mainly cytoplasm and extracellular proteins pink.
10. What are the major steps of tissue processing?
Answer: Fixation → Dehydration → Clearing → Infiltration → Embedding.
---
🧠 ONE-LINE REVISION
Histopathology: Microscopic study of diseased tissues.
Grossing: Macroscopic examination of specimen.
Fixation: Preservation of tissue.
Decalcification: Removal of calcium from bone.
Microtome: Cuts thin tissue sections.
Dehydration: Removes water using alcohol.
Clearing: Replaces alcohol, commonly using xylene.
Embedding: Tissue is placed in paraffin wax.
Hematoxylin: Nucleus → blue/purple.
Eosin: Cytoplasm → pink.
Museum specimen: Preserved specimen for teaching/reference. | 292 |
| 18 | The purpose of tissue processing is to convert fixed tissue into a form suitable for paraffin embedding and section cutting.
Main steps
Fixation → Dehydration → Clearing → Paraffin infiltration → Embedding
1. Dehydration
Water is removed from tissue using increasing concentrations of alcohol.
Example:
70% → 80% → 90% → 95% → Absolute alcohol
2. Clearing
Alcohol is replaced by a substance that is miscible with both alcohol and paraffin.
Common clearing agent: Xylene
3. Paraffin infiltration
The clearing agent is replaced by molten paraffin wax.
4. Embedding
The tissue is oriented correctly in a paraffin block.
Easy mnemonic
F-D-C-I-E
Fixation
↓
Dehydration
↓
Clearing
↓
Infiltration
↓
Embedding
---
8. H & E Staining
H&E = Hematoxylin and Eosin
It is the most commonly used routine stain in histopathology.
Hematoxylin
Stains nuclei blue to purple/blue-black.
It is considered a basic/nuclear stain in routine H&E interpretation.
Eosin
Stains cytoplasm and many extracellular proteins pink to red.
H&E sequence — simplified
Deparaffinization → Hydration → Hematoxylin → Differentiation/bluing → Eosin → Dehydration → Clearing → Mounting
What H&E demonstrates?
Structure Typical colour
Nucleus Blue/Purple
Cytoplasm Pink
Collagen Pale pink
RBCs Pink/Red
Muscle Pink
Exam point
Hematoxylin → nucleus
Eosin → cytoplasm
---
9. Maintenance of Records and Filing of Slides
Proper record maintenance is important for identification, diagnosis, legal documentation and future reference.
Records may include
Patient identification
Accession number
Specimen type
Clinical details
Gross description
Processing details
Staining details
Final report
Date of examination
Slide filing
Slides should be:
Properly labelled.
Arranged according to accession number.
Stored safely.
Protected from damage and contamination.
Important
The accession number provides a link between the specimen, tissue block, slides and report.
---
10. Biomedical Waste Management
Biomedical waste is waste generated during diagnosis, treatment or laboratory procedures.
Examples
Used gloves
Blood-contaminated materials
Tissue remnants
Used needles
Laboratory waste
Used slides
Important principles
Segregation → Collection → Treatment → Disposal
Waste should be segregated at the point of generation according to applicable biomedical-waste rules.
Why is it important?
Prevents infection.
Protects laboratory staff.
Protects the public.
Prevents environmental contamination.
Reduces occupational hazards.
---
11. Preparation of Museum Specimens
A museum specimen is a preserved pathological specimen maintained for teaching, demonstration and reference.
Common specimens
Tumors
Enlarged organs
Cirrhotic liver
Diseased heart
Tuberculous lesions
Congenital abnormalities
Basic steps
Selection → Fixation → Preparation → Preservation → Labelling → Display
Requirements of a good museum specimen
Properly preserved.
Representative of the disease.
Clear identification.
Appropriate label.
Good appearance.
Suitable container and preservative.
Common preservative
Formalin is commonly used for preservation of gross pathological specimens.
---
⭐ HIGH-YIELD EXAM QUESTIONS
1. Define histopathology.
Answer: Histopathology is the microscopic study of structural and cellular changes in tissues associated with disease.
2. What is grossing?
Answer: Grossing is the macroscopic examination, description and selection of representative tissue from a specimen.
3. What is the common routine fixative?
Answer: 10% Neutral Buffered Formalin.
4. What is decalcification?
Answer: Removal of calcium salts from mineralized tissues such as bone to permit section cutting.
5. Which decalcifying agent preserves morphology best?
Answer: EDTA, although it acts slowly.
6. What is a microtome?
Answer: An instrument used to cut thin tissue sections.
7. What is H&E?
Answer: Hematoxylin and Eosin.
8. What does hematoxylin stain?
Answer: Mainly nuclei blue-purple.
9. What does eosin stain? | 219 |
| 19 | 📚 HISTOPATHOLOGY — EXAM NOTES
Based on the syllabus shown in your image, here are exam-oriented detailed notes covering all important points.
---
1. Introduction to Histopathology
Histopathology is the study of microscopic changes in tissues caused by disease.
Main objectives
Diagnosis of diseases, especially tumors and inflammatory lesions.
Study of tissue architecture and cellular changes.
Determination of benign or malignant lesions.
Providing tissue sections for microscopic examination.
Basic workflow
Specimen collection → Receiving → Grossing → Fixation → Tissue processing → Embedding → Section cutting → Staining → Mounting → Microscopic examination → Reporting
---
2. Receiving of Specimens
When a tissue specimen reaches the histopathology laboratory, it should be properly received and identified.
Important points
1. Check patient name/ID.
2. Check specimen type and site.
3. Verify request form.
4. Check date and time of collection.
5. Ensure specimen is placed in an appropriate fixative.
6. Assign a laboratory accession/registration number.
7. Record all relevant details.
Common specimens
Biopsy
Excision specimen
Organ specimen
Curettings
Endoscopic biopsy
Lymph node
Bone specimens
Exam point: Correct identification of the specimen is essential to prevent diagnostic errors.
---
3. Grossing
Grossing means the macroscopic examination and description of a specimen before tissue processing.
Steps
Examine size, shape and colour.
Measure the specimen.
Identify abnormal areas.
Describe consistency and external surface.
Cut the specimen appropriately.
Select representative tissue pieces.
Place selected tissue in cassettes.
Important principle
The tissue pieces should generally be small enough for proper penetration of fixative and processing reagents.
---
4. Mounting and Section Cutting
After processing and embedding, the tissue is cut into thin sections using a microtome.
Microtome
A microtome is an instrument used to cut thin sections of tissue.
Routine paraffin section
Usually approximately 3–5 µm thick.
Steps
Paraffin block → Trim → Section cutting → Float sections on warm water bath → Pick up on glass slide → Dry → Stain
Common problems
Wrinkles
Chatter
Compression
Knife marks
Sections not forming ribbons
---
5. Fixatives
A fixative is a chemical substance used to preserve tissue and prevent decomposition.
Functions of fixation
Prevents autolysis.
Prevents putrefaction.
Preserves tissue architecture.
Hardens tissue sufficiently for processing.
Preserves cellular details.
Common fixatives
Fixative Important use
10% Neutral Buffered Formalin (NBF) Routine histopathology
Bouin's fluid Testis, delicate tissues
Carnoy's fluid Nucleic-acid-rich tissues/cytology applications
Glutaraldehyde Electron microscopy
Alcohol Cytological preparations
10% Neutral Buffered Formalin
It is the most commonly used routine fixative in histopathology.
Exam point: Adequate fixation is necessary before tissue processing.
---
6. Decalcification of Tissues
Decalcification is the process of removing calcium salts from mineralized tissues, especially bone, so that sections can be cut.
Indications
Bone biopsy
Bone marrow biopsy containing bone
Teeth
Calcified pathological specimens
Common decalcifying agents
1. Nitric acid
2. Hydrochloric acid
3. EDTA
4. Formic acid
Types
A. Acid decalcification
Uses mineral acids or weak organic acids.
Advantages: Fast.
Disadvantages: Over-decalcification can damage:
Nuclear morphology
Cytoplasmic details
Some tissue components
B. EDTA decalcification
EDTA removes calcium by chelating calcium ions.
Advantage: Better preservation of morphology and antigenicity.
Disadvantage: Slow.
End point
The decalcification process should be stopped when adequate calcium removal has occurred.
Exam question:
Best method for preservation of tissue morphology during decalcification? → EDTA method.
---
7. Tissue Processing for Routine Paraffin Section | 186 |
| 20 | Blood Collection Vials – Order of Draw (Series के अनुसार)
Blood collection करते समय vials को सामान्यतः इस क्रम (Order of Draw) में लिया जाता है:
1️⃣ Blood Culture Bottle
🩸 Use: Blood culture / microorganism detection
2️⃣ Light Blue Vial
🔵 Additive: Sodium Citrate
🧪 Use: PT, INR, APTT, Coagulation profile
3️⃣ Red / Yellow Vial
🔴🟡 Additive: Plain / Clot Activator / Gel
🧪 Use: Serum tests, LFT, KFT, Lipid profile, Serology
4️⃣ Green Vial
🟢 Additive: Heparin
🧪 Use: Plasma chemistry, Electrolytes
5️⃣ Purple / Pink Vial
🟣🩷 Additive: EDTA
🧪 Use: CBC, HbA1c, Blood grouping
6️⃣ Grey Vial
⚪ Additive: Sodium Fluoride + Potassium Oxalate
🧪 Use: Blood Glucose, GTT, Lactate
7️⃣ Black Vial
⚫ Additive: Sodium Citrate
🧪 Use: ESR
याद रखने का आसान क्रम:
Culture → Blue → Red/Yellow → Green → Purple/Pink → Grey
> इसे Blood Collection Order of Draw कहा जाता है। यह क्रम additive carryover को कम करने के लिए उपयोग किया जाता है। | 202 |
