By Cindy Atoji Keene
Cytotechnologist Kelly Flora admits that her last name is a bit serendipitous. As a medical laboratory professional who studies cells and cellular anomalies, one of the diagnosis she gives out is bacterial flora, the proliferation of microorganisms in the body. “When I got married and got my husband’s name, everyone got a good laugh,” said Flora, who is supervisor of the cytology department at Winchester Hospital, one of the many small departments that make up the hospital lab. The lab performs about about 275,000 tests a month – of that, about 2,500 are pap smears, a screening test used to detect potentially pre-cancerous and cancer cells in the female reproductive system.
Q: What is Cytology?
A: Cytology is the study of cells for the detection of cancer. In addition to cancer, we look for different organisms that might be present, such as fungal infection. We also look at specimens that are considered non-gynecological, such as biopsies from patients who have an enlarged thyroid.
Q: Take me step-by-step as far as how you conduct a lab test such as a pap smear.
A: If you’re a woman, you’ve experienced the lovely pap smear – I say that tongue-in-cheek of course. The patient goes to the OBY/GYN or regular PCP and has the sample taken. Once the specimen is collected using a special cervical brush, it’s placed in a vial that preserves the specimen. At the lab, it’s registered with a number then goes to processing, where the cytology prep technician makes a slide. We have a machine that removes the specimen cells and sticks them on a slide. Once that slide is made, it’s put through a stainer. The various cells stain certain colors so they can be viewed under the microscope. Then the cytologist views them and signs them out as either negative or abnormal.
Q: How do false negatives or positives occur in a test?
A: Erroneous test results can sometimes occur if there’s an issue with a specific instrument we are using and we don’t catch it in time.
Q: How powerful is the microscope you use?
A: It’s very powerful – we can really zoom into the cells. We use the 10x and 40x objectives most often in our work, so it's 100 and 400 times more powerful than the naked eye respectfully. We also have special microscopes called review scopes. This imager picks up fields of view on slides where there is most likely to be an abnormal cell. This aids in making a clear-cut diagnosis and potentially avoids missing a subtle change in cells.
Q: Is it difficult for medical technologists to work with urine and stools?
A: You need to have a different kind of mindset, and not think, ‘This is feces.’ I separate myself from the unpleasantness, although sometimes it’s hard when a sample smells so bad that you just want to vomit. But then I also realize, yes, this is bodily fluid, and there must be something seriously wrong with the patient when such a terrible odor is present. This brings you back to, ‘I need to find out what’s wrong with this person so they can be cured.’
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