Reference no: EM133650637
CASE 1
A 47 year old man complains of bloodstaining of toilet paper. There is no pain, no change in bowel habits.
a) At this stage are you able to suggest what body systems are involved in this man's disease?
b) If you were asked to go further, could you suggest a possible diagnosis? Under investigation a polyp is seen and removed endoscopically. It is sent to the laboratory for histopathologic analysis.
c) What features would you like the pathology laboratory to be able to tell you about this polyp? 1d) What other information might the patient want to know about his disease?
CASE 2
A smoker presents with a history of cough and production of bloodstained sputum. He has lost weight.
a) Suggest a few possible diagnoses. Sputum samples are sent to the laboratory for cytological examination.
b) Will cytopathology be able to diagnose the possibilities you have outlined?
c) What additional analysis of the sputum sample might help the pathologist in his/her diagnosis?
d) What are the limitations of sputum cytology?
CASE 3
A 52 year old woman attends for a cervical smear test. Her doctor later contacts her and asks her to return because the smear was abnormal. The doctor recommends colposcopy, that is endoscopic examination of the cervix and vagina, but is unable to say whether the result of the smear showed pre-cancerous changes or not - in fact the concern may be technical. The woman is extremely concerned and not especially reassured that it may be a false alarm.
a) What is the purpose of cancer screening in general?
b) A proposal is put forward for a new screening programme. List as many criteria as possible that should be considered in deciding whether the new screening programme should be implemented. Would expect to see 10 criteria listed.
c) What controls and checks would you wish to see developed for the new screening programme? We would expect to see 4 listed.
d) What medicolegal problems does a screening program raise? We would expect to see 3 listed.
CASE 4
A 67 year old man dies after a routine operation for hernia repair. He was an ex-coalminer. He post-operatively developed pneumonia. Despite intensive treatment and eventually artificial ventilation, he died with major lung problems. An autopsy was requested and the family was keen to know the results of the procedure. The pathologist discussed the case with the intensive care specialists and it was agreed that the crucial question was the presence or absence of significant lung pathology, and whether there was evidence of recent or pre-existing industrial lung disease. The pathologist said it would be best to remove the complete lungs intact and perfuse them with fixative before examination, as this would be the best way of ensuring no significant pathology was missed. He also wanted the examination of the lungs to be done by a different specialist. She worked in another hospital. He estimated that this would take up to three weeks.
a) How should this proceed?
b) Do the lungs really have to be retained? Explain answer
c) If the lungs are retained how would you subsequently dispose of them?