CET Specimen Handling & Processing 2 — Questions and Answers
Question 1: Which of the following is an appropriate step when handling a specimen collected for cytology via brushing?
- Place the brush in formalin
- Smear the brush onto a glass slide and fix immediately with cytology spray or alcohol (Correct answer)
- Rinse the brush in sterile water and submit the water
- Place the entire brush in a dry container and submit
Correct answer: Smear the brush onto a glass slide and fix immediately with cytology spray or alcohol
Brush cytology specimens must be smeared onto a glass slide and immediately fixed with cytology spray or 95% ethanol to prevent air-drying artifact that ruins cellular morphology.
Question 2: What does the chain of custody for a specimen primarily ensure?
- The specimen is processed faster
- Accountability and integrity of the specimen from collection to analysis (Correct answer)
- The physician is billed correctly
- The technician is protected from liability only
Correct answer: Accountability and integrity of the specimen from collection to analysis
Chain of custody documentation ensures that the specimen's integrity is maintained and that there is a clear, accountable record of everyone who handled it from collection through analysis.
Question 3: A patient is having an endoscopic mucosal resection (EMR). How should the resected specimen be handled to preserve orientation for pathology?
- Place freely floating in formalin
- Pin the specimen flat on a cork board with the mucosal side up before placing in formalin (Correct answer)
- Roll the specimen and place in cassette immediately
- Freeze the specimen for cryosection only
Correct answer: Pin the specimen flat on a cork board with the mucosal side up before placing in formalin
EMR specimens must be pinned flat on a cork board mucosal-side up before fixation to preserve margins and orientation, allowing the pathologist to assess resection adequacy.
Question 4: When is it appropriate to use normal saline as a transport medium for an endoscopic specimen?
- For all routine biopsies
- For specimens being sent for flow cytometry or fresh tissue analysis (Correct answer)
- For H. pylori biopsy urease testing only
- Saline is never appropriate for endoscopic specimens
Correct answer: For specimens being sent for flow cytometry or fresh tissue analysis
Saline is used as a transport medium for fresh tissue that requires flow cytometry, lymphoma workup, or other specialized testing that requires viable, unfixed cells.
Question 5: According to standard safety protocols, formalin containers must be stored in which type of environment?
- Any cabinet at room temperature
- A well-ventilated area or designated chemical storage with appropriate labeling (Correct answer)
- Refrigerated at 4°C
- Near heat sources to prevent crystallization
Correct answer: A well-ventilated area or designated chemical storage with appropriate labeling
Formalin (formaldehyde) is a known carcinogen and must be stored in well-ventilated, designated chemical storage areas per OSHA and NFPA standards to prevent exposure and fire hazard.
Question 6: A requisition form must accompany each pathology specimen. Which clinical detail is MOST important to include on this form?
- The cost of the procedure
- Relevant clinical history and the specific anatomical location of the biopsy (Correct answer)
- The patient's insurance provider
- The endoscope model used
Correct answer: Relevant clinical history and the specific anatomical location of the biopsy
Relevant clinical history and the anatomical biopsy site provide the pathologist with context necessary to make an accurate diagnosis and correlate findings with the clinical picture.
Question 7: What is the purpose of the rapid urease test (CLO test) performed on a gastric biopsy?
- To detect colorectal cancer markers
- To detect Helicobacter pylori infection through ammonia production (Correct answer)
- To measure gastric acid output
- To identify Clostridium difficile in the stomach
Correct answer: To detect Helicobacter pylori infection through ammonia production
The rapid urease (CLO) test detects Helicobacter pylori by identifying the ammonia produced when the bacteria's urease enzyme breaks down urea in the test medium, causing a color change.
CET Specimen Handling & Processing 2
Which of the following is an appropriate step when handling a specimen collected for cytology via brushing?