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何刚纽约病理刀客
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6月20日 2019

医网情深:两位病理实习/内科见习同学的笔记——在美国行医之路(29)

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医网情深:两位病理实习/内科见习同学的第一周笔记——在美国行医之路(29) Kitty & Sarah (刀评:两位新同学的第一周病理实习及一位同时进行的胃肠内科见习,颇有成效。实习笔记做的主动、很认真细致。两次冰冻切片练习也越来越显得得心应手,动作细腻协调了。令人欣慰) Pathology Externship by Sarah 6/17/19 (Monday, Newpath) 1. Frozen section talk lecture (Dr. He) 2. Frozen section practice (left-hand and right-hand coordinate, be gentle) and staining (according to the protocol) 3. Cassette label (supervisor: Crystal) 4. Observe gross section (Dr. Tan): prostate, lymph node; Prostate section: orientation: seminal vesicle forward (front, anterior) Use metal stick to go through prostatic urethra to diff right and left side Red side: red color (use swab) Left side: blue color Anterior: green color Cut specimen by different levels, then put the small samples to the labeled cassettes, then use formalin to fix. 6/18/19 (Tuesday, GI clinic long island) 1. Sign out practice 2. Observe neutrophils, lymphocytes, nucleus in IBD (inflammatory bowel disease) Many >3 lobes neutrophils: active inflammation Gland: become less or disappear Nucleus: disorganized Can’t different UC (Ulcerative colitis) or CD (Crohn’s disease) b/c only has mucosal specimen 3. Mitosis: A: physiological: grow fast tissues; such as: skin, bowel epithelium Identical (1 becomes 2) B: pathological: grow so fast, no apoptosis; such as: malignancy Not identical, one big, one small They can like chrysanthemum, but not always. Ki-67 index: can evaluate the proliferation degree 4. Pathology report: a. Order: organ name, location, procedure: Such as: small intestine, 2nd portion, biopsy b. Benign or positive (what kind of dx) Such as: benign. No histopathological findings present. Such as: (stomach antrum) reactive gastropathy - negative for Helicobacter pylori on IHC (immunohistochemistry) -negative for intestinal metaplasia by AB/PAS special stains, and no dysplasia c. microscopic description: such as: antral type mucosa showing reactive gastropathy with foveolar hyperplasia, subluminal fibrosis regenerative change-NAIDs/bile reflux etiology d. Gross description: very important! Site and description (size, weight, showed by naked eyes: hemorrhage, necrosis, ect; ) Such as: Site: small intestinal, bulb, biopsy Gross description: Received in formalin and labeled with the patient’s name and “duodenum bulb” are four irregularly shaped pieces of tan tissue, ranging in size from 0.3x 0.1 X0.2 cm to 0.1x0.1x0.1 cm. submitted entirely in one cassette. The minute tissue fragment(s ) may not survive processing. 5. Use cell phone to take pictures (need practice)

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