HTMLE (RECALLS)

Death due to bacterial or fungal colonization and overgrowth:

A. Putrefaction

B. Autolysis

C. Karyolysis

D. Apoptosis

Putrefaction

Post-mortem decomposition occurs due to the action of these hydrolytic enzymes.

A. Putrefaction

B. Autolysis

C. Karyolysis

D. Apoptosis

Autolysis

The tissue should be dissected to ______ in thickness

A. 1 to 2 mm

B. 2 to 3 mm

C. 2 to 4 mm

D. 3 to 5 mm

2 to 4 mm

NOTE: Care must be taken NOT to overfill the cassettes, as this would impede the flow of the reagents around the tissue.

The embedding medium used exclusively for electron microscopy:

A. Paraffin

B. Celloidin

C. Resin

D. Gelatin

Resin

Increase in the number of cells in an organ or tissue in response to a stimulus.

A. Hyperplasia

B. Hypertrophy

C. Atrophy

D. Dystrophy

Hyperplasia

Fixation for electron microscopy should be performed at what temperature?

A. - 4°C

B. 37°C

C. 4°C

D. - 20°C

4°C

Natural tissue colors may be restored by immers- ing tissues in ________ after fixation.

A. 100% alcohol

B. 95% alcohol

C. 80% alcohol

D. 70% alcohol

70% alcohol

The amount of fixative must be adequate, approximately ______ the volume of the tissue.

A. 5 to 10 times

B. 10 to 20 times

C. 20 to 50 times

D. 50 to 100 times

10 to 20 times

For prolonged fixation (ex. Museum preparation) volume of fixative should not be less than _____ that of the tissue.

A. 10 times

B. 20 times

C. 50 times

D. 100 times

50 times

The epidemiologic triad of disease causation con- sists of:

A. exposure, susceptibility, duration

B. risk, predisposing and environment factors

C. component, sufficient and necessary causes

D. agent, host, environment

agent, host, environment

The paraffin block of a breast specimen with a large central area appears oily and only a rim of fragmented tissue can be transferred to the slide. What is the possible cause?

A. Fatty tissue

B. Wrong processing time

C. Improper concentration of reagents

D. Old microtome blade

Fatty tissue

What could be the problem when the tissue sections present with tearing artefacts and holes?

A. Over fixation

B. Insufficient dehydration

C. Over hydration

D. Inadequate clearing

Insufficient dehydration

Prolonged storage of formaldehyde at very low temperature may induce:

1. Turbidity

2. Formation of white precipitate

3. Paraformaldehyde deposits

4. Neutralization

A. 1 and 2

B. 3 and 4

C. 1, 2, and 3

D. 1,2,3 and 4

1, 2, and 3

Natural tissue colors may be restored by immersing tissues in ________ after fixation.

A. 100% alcohol

B. 95% alcohol

C. 80% alcohol

D. 70% alcohol

70% alcohol

The amount of fixative must be adequate, approximately ______ the volume of the tissue.

A. 5 to 10 times

B. 10 to 20 times

C. 20 to 50 times

D. 50 to 100 times

10 to 20 times

For prolonged fixation (ex. Museum preparation) volume of fixative should not be less than _____ that of the tissue.

A. 10 times

B. 20 times

C. 50 times

D. 100 times

50 times

The epidemiologic triad of disease causation consists of:

A. exposure, susceptibility, duration

B. risk, predisposing and environment factors

C. component, sufficient and necessary causes

D. agent, host, environment

agent, host, environment

The paraffin block of a breast specimen with a large central area appears oily and only a rim of fragmented tissue can be transferred to the slide. What is the possible cause?

A. Fatty tissue

B. Wrong processing time

C. Improper concentration of reagents

D. Old microtome blade

FATTY TISSUE

What could be the problem when the tissue section present with tearing artefacts and holes?

a. Over fixation

b. Over hydration

c. Insufficient hydration

d. Inadequate clearing

INSUFFICIENT DEHYDRATION

RATIO: When tissue is NOT completely dehydrated, the paraffin will not infiltrate properly, and the block is difficult to cut resulting in tearing artifacts and holes. When this occurs, rehydrate the tissue section, and repeat the processing.

Prolonged storage of formaldehyde at very low temperature may induce:

1. Turbidity

2. Formation of white precipitate

3. Paraformaldehyde deposits

4. Neutralization

A. 1 and 2

B. 3 and 4

C. 1, 2, and 3

D. 1,2,3 and 4

1, 2, and 3

Used to fix brain tissue for the diagnosis of rabies

A. Methanol

B. 10% Neutral Buffered Formalin

C. Glutaraldehyde

D. Carnoy's fixative

Carnoy's fixative

Nuclear fixatives usually contain ______ to enhance nuclear structures.

A. Glacial acetic acid

B. Sulfuric acid

C. Nitric acid

D. Picric acid

Glacial acetic acid

NOTE: pH of nuclear fixatives should be maintained at pH 4.

Defined as the ratio of the velocity of light in air to the velocity of light in a liquid or solid medium.

A. Density

B. Refractive index

C. Viscosity index

D. Buoyancy

Refractive index

NOTE: To avoid distortion of the image, the refractive index of the mountant should be near as possible to that of glass which is 1.518.

Density-The ratio of mass to volume.

Viscosity - Resistance of fluid (liquid or gas) to a change in shape.

In PHYSICS, it is the quantity that describes a fluid's resistance to flow.

Buoyancy - Ability of an object to float in water or air

A monoclonal antibody specifically designed to target HER2 receptors.

A. Avastin

C. Vernezio

B. Talzenna

D. Herceptin

Herceptin

NOTE: Herceptin (Chemical name: Trastuzumab) can be used to treat HER2-positive breast cancer that is either early-staged or advanced-stage/metastatic.

Fixative recommended to preserve the intercalated disk of the heart.

A. Bouin's fluid

B. Carnoy's fluid

C. Helly's fluid

D. Picric acid

Helly's fluid

Precipitant fixatives for RNA:

1. Acetone

2. Methanol

3. Ethanol

4. Isopropanol

A. 1 and 2

B. 2 and 3

C. 1 and 3

D. 3 and 4

1 and 3

NOTE: Ethanol and Acetone give the best quantitative results using frozen tissues

The first amino acid inserted in the N-terminal position of all proteins. It initiates translation of messenger RNA (mRNA).

A. Methionine

B. Tyrosine

C. Phenylalanine

D. Lysine

Methionine

Methionine — An important amino acid that helps to initiate translation of mRNA by being the first amino acid incorporated into the N-terminal position of all proteins.

Tyrosine —Precursor of adrenal hormones epinephrine, norepinephrine, and dopamine and thyroid hormones including thyroxine.

Phenylalanine —The direct metabolic precursor of tyrosine. It promotes alertness and vitality, elevates mood, decreases pain, aids in memory and learning, and it is used to treat anxiety and depression.

Lysine —Plays a role in the production of antibodies and lowering TAG levels

Sections are cut between _____ in thickness for routine histologic procedures.

A. 2 to 3 micra

B. 3 to 5 micra

C. 4 to 6 micra

D. 5 to 7 micra

4 to 6 micra

The cellular adaptation to stress seen in the respiratory tract of a habitual cigarette smoker.

A. Anaplasia

B. Metaplasia

C. Dysplasia

D. Hyperplasia

Metaplasia

METAPLASIA Reversible change in which one differentiated cell type (epithelial or mesenchymal) is replaced by another cell type. It often represents an adaptive response in which one cell type that is sensitive to a particular stress is replaced by another cell type that is better able to withstand the adverse environment.

ANAPLASIA means "to form backward," implying a reversal of differentiation to a more primitive level. NOTE: Lack of differentiation, or anaplasia, is considered a hallmark of malignancy.

DYSPLASIA A term that literally means "disordered growth." It is encountered principally in epithelia and is characterized by a constellation of changes that include a loss in the uniformity of the individual cells as well as a loss in their architectural orientation.

HYPERPLASIA The result of growth factor-driven proliferation of mature cells and, in some cases, by increased output of new cells from tissue stem cells

The most widely used fixative for routine histology.

A. 10% Neutral Buffered Formalin

B. Formol-Saline

C. Osmium tetroxide

D. Glutaraldehyde

10% Neutral Buffered Formalin

Excellent cytologic fixative recommended mainly for tumor biopsies especially of the skin: ___________.

A. Helly's solution

B. Heidenhain's Susa solution

C. Flemming's solution

D. Zenker's solution

Heidenhain's Susa solution

The recommended tissue size for adequate fixation is ______.

A. 4 cm2

B. 3 cm2

C. 2 cm2

D. 1 cm2

2 cm2

The process of removing excess fixative from the tissue after fixation to improve staining and remove artefacts from the tissue.

A. Decolorization n

B. Post-chromatization

C. Dehydratio

D. Washing out

Washing out

Preservative added to formaldehyde which will prevent its decomposition to formic acid or precipitation to paraformaldehyde.

A. Methanol

B. Ethanol

C. Isopropanol

D. Butanol

Methanol

A form of cell death which is often physiologic. It serves as a mean of eliminating unwanted cells.

A. Necrosis

B. Apoptosis

C. Necroptosis

D. Pyroptosis

Apoptosis

Apoptosis

Regulated mechanism of cell death that serves to eliminate unwanted and irreparably damaged cells, with the least possible host reaction

Necrosis

external cellular injury (toxin, ischemia, trauma) can damage mitochondria, inducing the formation of mitochondrial permeability transition pores in the outer membrane.

Necroptosis

Resembles necrosis morphologically and apoptosis mechanistically as a form of programmed cell death.

Pyroptosis

Occurs in cells infected by microbes. It involves activation of caspase-1 which cleaves the precursor form of IL-1 to generate biologically active IL-1. Caspase-1 along with closely related caspase-11 also cause death of the infected cell.

The active coloring agent of Hematoxylin dye.

A. Hematein

B. Hematin

C. Hemozoin

D. Hemosiderin

Hematein

Hematein

The major oxidation product of hematoxylin. The natural dye that is responsible for the color properties.

Hematin

Hemoglobin minus the globin molecule, found in old blood clots.

Hemozoin

A black granule formed by malarial parasites living in red blood cells and may be removed by alcoholic picric acid method.

Hemosiderin

The most common hemoglobin derivative and the iron-containing pigment of hemoglobin. It is seen as yellow to brown granule and is normally found inside the cells (macrophages) that have phagocytized and degraded hemoglobin.

Most widely used histological stain:

A. Hematoxylin and Eosin

B. Papanicolau's stain

C. Giemsa stain

D. Alcian blue stain

Hematoxylin and Eosin

Cells responsible for production of collagenic fibers:

A. Chondrocytes

B. Fibroblast

C. Astrocytes

D. Lymphocytes

Fibroblast

The lipids stored in adipose cells are chiefly ______________.

A. Cholesterol

B. Phospholipids

C. Triglycerides

D. Fatty acids

Triglycerides

The most sensitive lipid stain known:

A. Oil Red O

B. Sudan Black

C. Congo red

D. Periodic acid Schif

Sudan Black

Not a Romanowsky stain

A. Giemsa

B. Wright's

C. Silver stain

D. May-Grunwald

Silver stain

The most abundant protein in the body.

A. Albumin

B. Collagen

C. Immunoglobulin

D. Myoglobin

Collagen

Fixation for electron microscopy should be performed at what temperature?

A. - 4°C

B. 37°C

C. 4°C

D. - 20°C

4°C

The connective tissues originate from which embryonic tissue?

A. Ectoderm

B. Endoderm

C. Mesoderm

D. All the above

Mesoderm

An example of a natural dye.

A. Coal tar

B. Napthylamine

C. Hematoxylin

D. Aniline

Hematoxylin

Stain for Helicobacter pylori:

A. Luxol fast blue

B. Toluidine blue

C. Levaditi stain

D. Van Gieson stain

Toluidine blue

Which is NOT a factor on which Quality Assurance depends on?

A. Pre-analytical

B. Analytical

C. Post-analytical

D. Accuracy

Accuracy

The total testing process (TTP) serves as the primary point of reference for focusing on quality in the clinical laboratory. TTP is defined by activities in three distinct phases related to workflow outside and inside the laboratory:

1. Preanalytical, (Preexamination)

2. Analytical, (Examination)

3. Postanalytical, (Postexamination)

When a pathologist looks at a tissue biopsy, the histologic section is most often stained with ______.

A. Hematoxylin and Eosin

B. Periodic acid Schiff

C. Eosin

D. Hematoxylin

Hematoxylin and Eosin

Which concentration of ethyl alcohol is first employed during the dehydration step in tissue processing?

A. 50%

B. 60%

C. 70%

D. 80%

70%

Monocytes, giant cells, fibroblasts, and lymphocytes are characteristic features of _______.

A. Wound healing

B. Chronic inflammation

C. Suppuration

D. Granuloma

Granuloma

5-panel drug test does NOT include _______.

A. Cocaine

B. Alcohol

C. Phencyclidine

D. Opiates

Alcohol

The ideal fixative for most cytological evaluation is _________.

A. 95% Ethanol

B. Hairspray

C. 95% Isopropyl alcohol

D. Absolute alcohol

95% Ethanol

Fever is the most prominent manifestations of the acute-phase response which is produced is response to _________ and _________.

1. Interleukin 1

2. Interleukin 6

3. Tumor necrosis factor

4. Interferon alpha

A. 1 and 2

B. 1 and 3

C. 2 and 4

1 and 3

Most infectious bloodborne pathogen

A. HIV

B. HPV

C. HBV

D. EBV

HBV

Which piece of histology equipment is NOT temperature dependent?

A. Embedding center

B. Water bath

C. Microtome

D. Tissue processor

Microtome

Recommended retention time for paraffin blocks in Histopathology laboratory.

A. 2 years

B. 5 years

C. 10 years

D. 20 years

10 years

All the following are proper histological techniques of a Histotechnologists except:

A. High quality, sharp blades are always used for cutting.

B. Specimens are carefully oriented. Staff performing embedding have ready access to each specimen description and are appropriately trained.

C. The same mold size is used for every specimen.

D. The final sections from each block are cut gently with a uniform, slow rotation.

The same mold size is used for every specimen.

RATIO: A mold of suitable size is always chosen for each specimen.

NOTE: A margin of at least 2 mm of paraffin surrounding all sides of the tissue gives best cutting support.

The ability of tissues to recoil and recover their shape after physical deformation is conferred by _________.

A. Elastin

B. Collagen

C. Proteoglycans

D. Integrins

Elastin

It serves as a critical "life or death" switch following genotoxic stress.

A. TNF

B. p53

C. IL-1

D. TGF

p53

NOTE: p53 protein accumulates in cells when DNA is damaged, and it arrests the cell cycle (at the G1 phase) to allow time for repair. However, if the damage is too great to be repaired successfully, p53 triggers apoptosis. When TP53 is mutated or absent (as it is in many cancers), cells with damaged DNA fail to undergo p53-mediated apoptosis

Microtome used for cutting section for Electron Microscopy.

A. Sliding microtome

B. Rotary microtome

C. Ultrathin microtome

D. Rocking microtome

Ultrathin microtome

It is the most dangerous type of microtome due to the movable exposed knife.

A. Sliding microtome

B. Rotary microtome

C. Ultrathin microtome

D. Rocking microtome

Sliding microtome

Diseases of unknown origin are _______.

A. Idiopathic

B. Iatrogenic

C. Virulent

D. Toxic

Idiopathic

What is the REQUIRED age of an applicant for the issuance of certificate of registration as a registered medical technologist?

A. 18 years old

B. 21 years old

C. 25 years old

D. 22 years old

21 years old

Which is a characteristic of an enclosed type of automated tissue processor?

A. mechanical

B. "dip & dunk"

C. Tissue transfer

D. Fluid transfer

Fluid transfer

RATIO: There are two main types of processors, the tissue-transfer (or "dip and dunk") machines where specimens are transferred from container to container to be processed, or the fluid-transfer (or "enclosed") types where specimens are held in a single process chamber or retort and fluids are pumped in and out as required. (LEICA biosystems)

Which cells provide a structural framework in wound healing?

A. Plasma cells

B. Fibroblasts

C. Lymphocytes

D. Macrophages

Fibroblasts

An ideal fixative used for electron microscopy is ______.

A. Zenker's formol

B. Bouin's solution

C. Glutaraldehyde

D. 10% Formalin

Glutaraldehyde

Most widely used technique for demonstration of carbohydrates:

A. Alkaline fast blue

B. Hematoxylin and Eosin

C. Periodic acid Schiff

D. Congo red

Periodic acid Schiff

It is a process in which a cell eats its own contents.

A. Autolysis

B. Autophagy

C. Apoptosis

D. Necrosis

Autophagy

NOTES:

• Autophagy involves sequestration of cellular organelles into cytoplasmic autophagic vacuoles (autophagosomes) that fuse with lysosomes and digest the enclosed material.

• Autophagy is an adaptive response that is enhanced during nutrient deprivation, allowing the cell to cannibalize itself to survive.

• Autophagosome formation is regulated by more than a dozen proteins that act in a coordinated and sequential manner.

• Dysregulation of autophagy occurs in many disease states including cancers, inflammatory bowel diseases, and neurodegenerative disorders. Autophagy plays a role in host defense against certain microbes.

He discovered the process of phagocytosis by observing the ingestion of rose thorns by amebocytes of starfish larvae and of bacteria by mammalian leukocytes.

A. Gregor Mendel

B. Elie Metchnikoff

C. George Kohler

D. Susumo Tonegawa

Elie Metchnikof

Demonstrates presence of DNA:

A. Feulgen stain

B. Supravital stain

C. Romanowsky stain

D. Negative stain

Feulgen stain

Most widely used incision technique for autopsy procedures. The incision is from near acromion processes extending downwards below the breast and across the xiphoid process to the symphysis pubis.

A. "I"-shaped incision

B. "Y"-shaped incision

C. Modified "Y"-shaped

D. None of the above

"Y"-shaped incision

Factors that retard the fixation process except:

A. Presence of blood

B. Cold temperature

C. Presence of fats

D. Agitation

Agitation

Cytoplasmic fixatives must never contain __________ which destroys the mitochondria and golgi bodies.

A. Nitric acid

B. Formic acid

C. Glacial acetic acid

D. Hydrochloric acid

Glacial acetic acid

An AFB staining modification that uses Hematoxylin as counterstain instead of Methylene blue.

A. Ziehl-Neelsen

B. Kinyoun

C. Fite-Faraco

D. Auramine-Rhodamine

Fite-Faraco

Decalcification should be done after ________ and before _________ to ensure and facilitate normal cutting of sections.

1. Fixation

2. Dehydration

3. Impregnation

4. Clearing

A. 1 and 2

B. 1 and 3

C. 3 and 4

D. 2 and 4

1 and 3

Cell death due to ischemia

A. Infarction

B. Angina pectoris

C. Putrefaction

D. Tuberculosis

Infarction

Lining of the urinary bladder is composed of this type of epithelial tissue:

A. Stratified cuboidal epithelium

B. Stratified transitional epithelium

C. Pseudostratified epithelium

D. Stratified squamous epithelium

Stratified transitional epithelium

Must be fixed prior to grossing or sectioning, its recommended fixation time is 2 to 3 weeks prior to grossing.

A. Heart

B. Brain

C. Lungs

D. Breast

Brain

Inclusion found in the brain of a patient infected with rabies.

A. Guarneri bodies

B. Aschoff bodies

C. Psammoma bodies

D. Negri bodies

Negri bodies

Aschoff bodies-Nodules found in the heart of a person with Acute Rheumatic Fever

Creola bodies-Cluster of columnar cells seen in bronchial asthma

Elementary bodies-Infectious particles of Chlamydia sp.

Sclerotic bodies-Dark brown-black organisms; seen in Chromoblastomycosis

Asteroid bodies-Concentric radiating Eosinophilic material (from antigen-antibody reaction) seen in Sporotrichosis.

Negri bodies-Inclusion seen in Rabies

Guarneri bodies-Inclusion seen in Poxvirus

Owl's eye inclusion-Seen in Cytomegalovirus (CMV) or HHV5

Reduction in size and condensation of nuclear material:

A. Pyknosis

B. Karyorrhexis

C. Karyolysis

D. Autolysis

Pyknosis

Segmentation and fragmentation of nucleus:

A. Pyknosis

B. Karyorrhexis

C. Karyolysis

D. Autolysis

Karyorrhexis

Dissolution of the nucleus where all basophilism is lost and the nucleus disappears.

A. Pyknosis

B. Karyorrhexis

C. Karyolysis

D. Autolysis

Karyolysis

Gomori's Silver Impregnation stains the reticulin fibers _______.

A. Brown

B. Black

C. Silver

D. Gold

Black

Warmth at the site of inflammation is under what cardinal sign of inflammation:

A. Rubor

B. Calor

C. Tumor

D. Dolor

Calor

Extensive deposition of collagen in internal organs because of chronic inflammation

A. Necrosis

B. Fibrosis

C. Apoptosis

D. Keloid

Fibrosis

Commonly used fixative for bone marrow biopsies

A. 10% Neutral buffered formalin

B. Orth's fluid

C. B-5 fixative

D. Bouin's solution

B-5 fixative

The most important step in embedding:

A. Specimen labelling

B. Specimen orientation

C. Paraffin composition

D. Specimen hardening

Specimen orientation

NOTE: Incorrect placement of tissues may result in diagnostically important tissue elements being missed or damaged during microtomy. Usually, tissues are embedded with the surface to be cut facing down in the mold.

Embedding medium recommended for processing neurological tissues.

A. Paraffin

B. Carbowax

C. Celloidin

D. Bioloid

Celloidin

Most rapid freezing agent used in frozen section.

A. Liquid nitrogen

B. Isopentane

C. Carbon dioxide gas

D. Dry ice

Liquid nitrogen

Which type of H & E staining is employed in processing Frozen sections?

A. Regressive staining

B. Progressive staining

C. Both staining techniques

D. None of the above

Progressive staining

After exiting the circulation, leukocytes move in the tissues toward the site of injury by a process called _________.

A. Diapedesis

B. Adhesion

C. Chemotaxis

D. Engulfment

Chemotaxis

Predominant cell seen in acute inflammation

A. Monocytes

B. Lymphocytes

C. Eosinophils

D. Neutrophils

Neutrophils

How long should tissue sections be allowed to remain in the water bath?

A. 10 seconds

B. 20 seconds

C. 30 seconds

D. 45 seconds

30 seconds

Stain used for demonstrating mitochondria during intravital staining.

A. Giemsa stain

B. Crystal violet

C. Neutral red

D. Janus Green B

Janus Green B

Primary application of frozen section

A. Enzyme immunohistochemistry

B. Immunohistochemical staining

C. Rapid diagnosis during surgery

D. Immunofluorescent staining

Rapid diagnosis during surgery

It is often used as a marker for apoptosis in cells populations and to locate bands of DNA in gel electrophoresis.

A. Ethidium bromide

B. Crystal violet

C. Feulgen stain

D. Iodine

Ethidium bromide

An excellent stain for elastic fibers and is especially recommended in dermatological studies due to its ability to demonstrate the finest and most delicate fibers in the skin.

A. Orcein

B. Oil red O

C. Toluidine blue

D. Congo red

Orcein

A local defect, or excavation, of the surface of an organ or tissue that is produced by the sloughing (shedding) of inflamed necrotic tissue.

A. Fibrinous inflammation

B. Purulent inflammation

C. Serous inflammation

D. Ulcer

Ulcer

Largest internal organ that has a remarkable capacity to regenerate.

A. Kidneys

B. Liver

C. Lungs

D. Brain

Liver

Continuous abnormal proliferation of cells

A. Anaplasia

B. Metaplasia

C. Neoplasia

D. Dysplasia

Neoplasia