SCOPE OF PRACTICE PGY-5
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1 Recognize normal cytomorphology of cells derived from the respiratory, gastrointestinal, and genitourinary tracts, and body fluid (Cerebrospinal fluid, pleural and peritoneal fluid) Recognize normal cytomorphology of cells retrieved by fine-needle aspiration of the organs such as lymph node, thyroid, salivary glands, lung, liver, pancreas, kidney, adrenal gland, and soft tissues Cervical Cytology o Familial with the Bethesda System for reporting cervical cytology o Recognize common cellular components in cervical specimen o Recognize the features of dysplasia and invasive carcinoma of the uterine cervix o Recognize effects of inflammation and repair, radiation, intrauterine devices on cervical cytology o Recognize the cytopathic effects of genital viral infection, including Human Papillomavirus (HPV), Herpes, and Cytomegalovirus (CMV) o Recognize common infectious agents in the female genital tract, Lepothrix, Candida, Trichomonas, and Actinomyces o Recognize common artifacts that may be present in cervical Pap smear (air drying, fungi, cellular degeneration) o Recognize the effects of hormonal stimuli on the cervical/vaginal epithelium. Updated on 01/28/2016 Page 1 of 5
2 Head & Neck Cytology o Recognize cytologic features of squamous cell papilloma and carcinoma of oral cavity o Recognize cytologic features of common salivary gland neoplasm, including pleomorphic adenoma, mucoepidermoid carcinoma, and adenoid cystic carcinoma o Understand cytologic diagnostic category of thyroid cytology o Familiar with diagnostic criteria for benign, follicular neoplasm, and malignant tumors of thyroid Respiratory Cytology o Know the cytology of pulmonary viral (herpes, CMV), and fungal (histoplasmosis, Pneumocystis Carinii blastomycosis, cryptococcosis, coccidiomycosis) infection o Recognize cytologic features of a granulomatous inflammation o Know the cytologic criteria to identify the various types of lung carcinoma o Familiar with immunocytochemical profile of common lung cancers, such as small cell carcinoma, squamous cell carcinoma and adenocarcinoma o Familiar with molecular tests of lung cancers, such as EGFR and Kras mutations o Be aware of components of respiratory specimens that can be confused with malignant cells Updated on 01/28/2016 Page 2 of 5
3 Renal and Urinary Tract Cytology o Recognize cytologic features of renal cell carcinoma and transitional cell carcinoma o Familiar with immunocytochemical profile of renal cell carcinoma o Be aware of the different constituents of voided, catheterized, and irrigated urinary bladder specimens o Recognize decoy cells in urine o Recognize BCG and other treatment related cytologic changes in urine Digestive System Cytology o Recognize cytologic features common benign and malignant neoplasm of stomach o Familiar with the differential diagnosis of spindle cell neoplasm ( nerve sheath tumor, gastrointestinal stromal tumor, benign and malignant smooth muscle tumor) and their immunocytochemical profile o Recognize cytologic features of hepatocellular carcinoma and cholangiocharcinoma o Recognize benign and malignant neoplasms of pancreas and potential pitfalls in Endoscopic guided FNA (especially contamination with gastric and intestinal mucosa) Soft Tissue Cytology o Familiar with common features of sarcomas and their immunocytochemical profiles Updated on 01/28/2016 Page 3 of 5
4 Body Fluid Cytology o Be aware of the method with which CSF is obtained (lumber puncture vs. shunt device) o Know that significant increase of any type of cells in CSF, including inflammatory cells, may constitute an medical emergency and should report to clinician immediately o Know the features of bacterial, viral, fungal meningitis o Know cytologic features and immunoprofile of mesothelial cells and metastatic adenocarcinoma of different origins Cytopreparation AND FNA Skills o Be familiar with major preparatory techniques in the cytology laboratory: conventional smear, routine and special stains, liquid-based thin layer, cytocentrifugation, and cell blocks o Know the cardinal rules and indication of FNA on superficial masses o Master of FNA technique o Be able to critically analyze a clinical situation, weighed against the quantity of the specimen, and select the most appropriate cytopreparatory method Administrative and The Regulatory Issues Updated on 01/28/2016 Page 4 of 5
5 o Familiar and compliant with federal and state regulations, including but not limited to Clia 88, HIPPA, HCFA, ect o Be aware the essential elements of quality control and quality assurance programs in cytology Updated on 01/28/2016 Page 5 of 5
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