DOH Histopathology Technologist exam questions

The Histopathology Technologist exam in every GCC country

From each regulator's own exam pages; anything a regulator does not publish says so. Assessment mode also depends on your licence title, so confirm your route on your eligibility notice.

12 worked Histopathology Technologist practice questions

Original exam-style questions from the bank, spread across the blueprint domains. They are not real or recalled exam questions. Try each one, then open the answer for the rationale and reference. None of them appear in the free mock exam, so reading them will not spoil it.

1. Question 1 · Immunohistochemistry and Molecular Techniques

   A positive tissue control for an IHC antibody shows no staining, but the patient section shows weak staining. What should the technologist do?

   1. AReport the patient result as negative
   2. BReport the result as positive because the patient stained
   3. CReject the run and investigate the reagents and protocol before repeating
   4. DIncrease the incubation time on the same slide and report it
   Show answer and explanation

   Correct answer: C. Reject the run and investigate the reagents and protocol before repeating

   A failed control invalidates the run, as the result cannot be trusted. Reagents, retrieval and incubation must be reviewed, then the test repeated. Reporting either result is unsafe.

   Reference: Allison KH et al., Estrogen and Progesterone Receptor Testing in Breast Cancer: ASCO/CAP Guideline Update, J Clin Oncol 2020;38:1346-1366

2. Question 2 · Microtomy and Frozen Sections

   What is the usual section thickness for routine H&E paraffin sections?

   1. A3 to 5 micrometers
   2. B20 to 30 micrometers
   3. C0.1 to 0.5 micrometers
   4. D50 to 100 micrometers
   Show answer and explanation

   Correct answer: A. 3 to 5 micrometers

   Routine paraffin sections are cut at 3 to 5 micrometers for light microscopy. Ultrathin sections for EM are far thinner, and thick sections are used for special purposes.

   Reference: Suvarna SK, Layton C, Bancroft JD, Bancroft's Theory and Practice of Histological Techniques, 8th ed. (2019)

3. Question 3 · Microtomy and Frozen Sections

   Sections are placed on a warm water bath after cutting. What is its main purpose?

   1. ATo flatten the sections and remove folds before mounting on a slide
   2. BTo fix the sections permanently so that they do not need later formalin treatment
   3. CTo stain the nuclei lightly before the main hematoxylin step
   4. DTo melt the wax out of the tissue before the slides are dried
   Show answer and explanation

   Correct answer: A. To flatten the sections and remove folds before mounting on a slide

   The warm bath, set slightly below the wax melting point, relaxes and flattens the ribbon. It does not fix, stain or deparaffinize the section.

   Reference: Carson FL, Hladik C, Histotechnology: A Self-Instructional Text, 5th ed. (2021)

4. Question 4 · Microtomy and Frozen Sections

   A technologist notices a section with scratches running across the whole width of the ribbon in the same direction. What should be done?

   1. AIncrease the section thickness to 15 micrometers so that the lines are hidden
   2. BAdd more eosin to the stain so that the scratches are less visible on the slide
   3. CMove to a fresh area of the blade or change the blade
   4. DLower the water bath temperature, because heat makes the lines in the ribbon
   Show answer and explanation

   Correct answer: C. Move to a fresh area of the blade or change the blade

   A nick in the blade makes parallel scratch lines, so a new blade edge is needed. Thickness, staining or bath temperature do not repair a damaged edge.

   Reference: Carson FL, Hladik C, Histotechnology: A Self-Instructional Text, 5th ed. (2021)

5. Question 5 · Quality Control and Troubleshooting

   A laboratory wants to monitor staining quality over time. Which approach is most effective?

   1. ACheck quality only when pathologists complain
   2. BCompare slides by color preference from different staffers
   3. CRun known positive control tissue with each batch and record results against defined acceptance criteria
   4. DChange reagents daily without recording lots
   Show answer and explanation

   Correct answer: C. Run known positive control tissue with each batch and record results against defined acceptance criteria

   Routine controls with documented criteria and lot records detect drift early. Reactive checks, subjective comparison or unrecorded changes do not.

   Reference: Carson FL, Hladik C, Histotechnology: A Self-Instructional Text, 5th ed. (2021)

6. Question 6 · Routine and Special Staining

   Oil Red O is used to demonstrate neutral fat in a liver sample. Why can it not be used on routinely processed paraffin sections?

   1. AProcessing solvents dissolve the lipid out of the tissue
   2. BThe stain works only on decalcified tissue, and decalcification is not done in routine processing
   3. CParaffin makes the dye unstable in water, so the stain fades within minutes
   4. DFormalin converts neutral fat into protein, which then repels the dye
   Show answer and explanation

   Correct answer: A. Processing solvents dissolve the lipid out of the tissue

   Alcohols and xylene extract lipids during processing, so fat stains need frozen sections of fixed or fresh tissue. Decalcification, dye stability and fat conversion are not the reason.

   Reference: Kiernan JA, Histological and Histochemical Methods: Theory and Practice, 5th ed. (2015)

7. Question 7 · Specimen Reception, Fixation and Grossing Support

   Sections of a blood-rich spleen fixed in acidic unbuffered formalin show dark brown granular pigment. How is this pigment removed?

   1. AIt is melanin, removed by hydrogen peroxide bleaching
   2. BIt is formalin pigment, removed with alcoholic picric acid
   3. CIt is lipofuscin, removed with hot xylene
   4. DIt is mercury pigment, removed with iodine and thiosulphate
   Show answer and explanation

   Correct answer: B. It is formalin pigment, removed with alcoholic picric acid

   Acid formalin reacts with haemoglobin to produce a brown-black pigment, so buffered formalin should be used, and the pigment is removed from sections with alcoholic picric acid. Melanin is bleached with peroxide, mercury pigment needs iodine and thiosulphate, and lipofuscin is not removed by solvents.

   Reference: Suvarna SK, Layton C, Bancroft JD, Bancroft's Theory and Practice of Histological Techniques, 8th edition (2019)

8. Question 8 · Tissue Processing and Embedding

   At what temperature should the paraffin wax bath be kept for infiltration and embedding?

   1. ATwo to four degrees Celsius above the wax melting point
   2. BTen degrees above the wax melting point
   3. CTen degrees below the wax melting point
   4. DAt room temperature, so that the tissue does not shrink during embedding
   Show answer and explanation

   Correct answer: A. Two to four degrees Celsius above the wax melting point

   Wax is held a few degrees above its melting point so that it stays liquid and infiltrates tissue without heat damage. A temperature below the melting point would solidify the wax, and heat well above it shrinks and hardens tissue.

   Reference: Suvarna SK, Layton C, Bancroft JD, Bancroft's Theory and Practice of Histological Techniques, 8th edition (2019)

9. Question 9 · Microtomy and Frozen Sections

   Sections appear compressed and wrinkled as they come off the blade. Which remedy is most appropriate?

   1. ACut faster with a heavier blade clamp
   2. BWarm the block under a lamp
   3. CCool the block on ice and use a fresh area of the blade
   4. DIncrease the section thickness to 10 micrometres to stiffen the ribbon
   Show answer and explanation

   Correct answer: C. Cool the block on ice and use a fresh area of the blade

   Compression comes from a blunt blade or a block that is too soft, so cooling the block and using a sharp area help. Warming softens the block further, and thicker sections or faster cutting do not address the cause.

   Reference: Suvarna SK, Layton C, Bancroft JD, Bancroft's Theory and Practice of Histological Techniques, 8th edition (2019)

10. Question 10 · Routine and Special Staining

    After haematoxylin in a routine H&E, sections are dipped in weakly alkaline water. What is the purpose of this step?

    1. AMordanting, which links the dye to cytoplasm
    2. BFixation, which hardens the nuclear proteins
    3. CDifferentiation, which removes excess eosin
    4. DBluing, which changes the nuclear colour from red-brown to blue
    Show answer and explanation

    Correct answer: D. Bluing, which changes the nuclear colour from red-brown to blue

    Bluing converts the soluble red-brown haematein to the insoluble blue form that is stable in the nucleus, and Scott's tap water substitute is typical. Differentiation uses acid alcohol, and mordanting and fixation are separate processes.

    Reference: Suvarna SK, Layton C, Bancroft JD, Bancroft's Theory and Practice of Histological Techniques, 8th edition (2019)

11. Question 11 · Immunohistochemistry and Molecular Techniques

    An IHC slide shows strong staining at the edges of a tissue piece and weak staining in the centre. What is the most likely cause?

    1. AExcess primary antibody on the slide
    2. BDelayed or inadequate fixation of the centre of the tissue
    3. COver-fixation of the edges of the tissue in neutral buffered formalin
    4. DSection cut too thin on the microtome
    Show answer and explanation

    Correct answer: B. Delayed or inadequate fixation of the centre of the tissue

    Strong edge and weak centre staining is the typical edge pattern of slow fixative penetration in thick tissue, and the centre is poorly preserved. Excess antibody would produce uniform background, and over-fixation and thin sections do not create a gradient.

    Reference: College of American Pathologists, Template for Reporting Results of Biomarker Testing of Specimens from Patients with Invasive Breast Carcinoma (2023)

12. Question 12 · Quality Control and Troubleshooting

    A laboratory changes to a new lot of haematoxylin. What should be done before using it on patient slides?

    1. ATest it on control tissue and record the lot number
    2. BUse it straight away, since reagent lots are made identical
    3. CDilute it by half to stretch the supply
    4. DUse it once a colleague approves the colour of one slide
    Show answer and explanation

    Correct answer: A. Test it on control tissue and record the lot number

    A new reagent lot is checked on known control tissue to confirm staining quality, and the lot number is recorded for traceability. Assuming lots are identical or diluting at random leaves quality unverified.

    Reference: College of American Pathologists, Laboratory Accreditation Checklist: Anatomic Pathology (2023)

Histopathology Technologist reference books and guidelines

Every question in this bank names the textbook or guideline its answer rests on. These are the sources our Histopathology Technologist questions cite most often - the reading list to revise from alongside the bank.

Where your regulator publishes a reading list, use the editions it names. Exam questions are not taken from any one book.