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Quizzes > Health & Medicine

Histopathology Quiz: Sharpen Your Slide Interpretation Skills

Quick, free quiz with histopathology questions. Instant feedback and explanations.

Editorial: Review CompletedCreated By: Tutku KolcuUpdated Aug 26, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration for histopathology quiz on a sky blue background

This histopathology quiz helps you practice slide interpretation, check weak spots, and build exam speed. Work through case-style items with clear explanations after each answer. To deepen tissue ID skills, try the epithelial tissue histology quiz, the interpretive cytopathology quiz, or the histology connective tissue quiz.

Which histological stain is specifically used to detect collagen fibers?
Masson's trichrome
Silver stain
Periodic acid - Schiff
Hematoxylin & Eosin
Masson's trichrome is a three-color staining protocol that highlights collagen fibers in blue, muscle fibers in red, and nuclei in dark purple. It is widely used to assess fibrosis and connective tissue deposition in pathological specimens. Its specificity for collagen makes it a standard in histopathology labs for evaluating tissue scarring and fibrosis.
Hematoxylin, a basic dye, primarily stains which cellular structure?
Cytoplasm
Nuclei
Cell membrane
Mitochondria
Hematoxylin is a basic dye that binds to basophilic structures containing nucleic acids, prominently staining cell nuclei blue to purple. It is paired with eosin, which stains cytoplasmic components pink, forming the classic H&E stain. The affinity of hematoxylin for DNA and RNA makes it valuable for assessing nuclear morphology.
What is the most commonly used fixative in routine histopathology?
Bouin's solution
Glutaraldehyde
Formalin
Ethanol
Neutral buffered formalin (10% formaldehyde) is the standard fixative in histopathology, preserving tissue architecture by cross-linking proteins. It is inexpensive, penetrates tissues well, and maintains both morphological and molecular characteristics. Alternative fixatives may be used for special applications, but formalin remains the workhorse in most labs.
Eosin, an acid dye, stains which component of the tissue?
Cytoplasmic proteins
Lipids
Carbohydrates
Nuclei
Eosin is an acidic dye that binds to and stains basic (eosinophilic) components such as cytoplasmic proteins and extracellular matrix fibers pink to red. It complements hematoxylin, which stains nuclear material. Together, H&E provides contrast that differentiates cellular and extracellular structures with high clarity.
A freeze artifact in cryosections is characterized by which feature?
Excessive shrinkage
Overstaining
Ice crystal formation
Tissue hardening
Cryosection freezing without cryoprotectants leads to ice crystal formation, which disrupts cellular architecture and produces voids or jagged edges in tissue sections. Recognizing ice artifacts is critical to avoid misinterpretation of structural changes. Proper rapid freezing techniques reduce crystal size and preserve morphology.
In paraffin embedding, what reagent is commonly used for dehydration of tissue specimens?
Ethanol
Formalin
Xylene
Bouin's solution
Dehydration prior to paraffin embedding is achieved by passing tissue through increasing concentrations of ethanol, which removes water. Xylene follows dehydration to clear the tissue of alcohol, rendering it miscible with molten paraffin. Skipping proper dehydration can cause poor infiltration and sectioning artifacts.
What term describes unwanted structural changes introduced during histological processing?
Lesion
Translocation
Inclusion
Artifact
Artifacts in histology are alterations or distortions of tissue morphology that arise from fixation, processing, or sectioning. They can mimic or obscure pathology if not recognized. Proper technique and awareness of common artifacts help ensure accurate interpretation.
Which acid is commonly used for decalcification of bone specimens in histopathology?
Nitric acid
Hydrochloric acid
Acetic acid
Formic acid
Formic acid is widely used for decalcifying bone because it effectively removes calcium without excessively damaging tissue proteins or nucleic acids. Stronger acids like hydrochloric may decalcify faster but can impair staining quality. Proper decalcification balances speed with preservation of microscopic detail.
Reticulin stain is used to highlight which type of collagen fibers?
Type IV collagen
Type I collagen
Type III collagen
Type II collagen
Reticulin (silver) stain selectively highlights type III collagen fibers as black networks around cells and capillaries. It is useful in evaluating the architectural framework of organs like liver and bone marrow. Loss or distortion of reticulin fibers can indicate pathological remodeling.
In immunohistochemistry, diaminobenzidine (DAB) yields which color upon reaction?
Red
Blue
Brown
Green
DAB is a chromogen that produces a brown precipitate upon oxidation by peroxidase enzymes in immunohistochemical assays. This brown signal indicates the presence of the target antigen. It is one of the most commonly used detection systems in pathology labs.
Ki-67 is an immunohistochemical marker used to assess:
Apoptosis
Proliferation
Inflammation
Hypoxia
Ki-67 is a nuclear protein expressed during active phases of the cell cycle but absent in resting cells. The Ki-67 labeling index is used to gauge tumor proliferation rates and inform prognosis. Higher Ki-67 indices often correlate with aggressive behavior.
Birbeck granules identified by electron microscopy are characteristic of:
Macrophages
Langerhans cells
T lymphocytes
Plasma cells
Birbeck granules are tennis-racket - shaped organelles seen in Langerhans cells, reflecting their antigen-presenting function in the skin and mucosa. They are pathognomonic for Langerhans cell histiocytosis when identified ultrastructurally. Light microscopy with CD1a or Langerin immunostains can also confirm the diagnosis.
Congo red staining with apple-green birefringence under polarized light indicates the presence of:
Collagen
Fibrin
Amyloid
Hyaline cartilage
Congo red binds to amyloid fibrils and exhibits apple-green birefringence under polarized light, a hallmark diagnostic feature of amyloidosis. This test distinguishes amyloid from other eosinophilic deposits. It remains a gold standard for confirming amyloid in tissue biopsies.
Villous atrophy with crypt hyperplasia in the small intestine is most typical of:
Whipple's disease
Celiac disease
Ulcerative colitis
Crohn's disease
Celiac disease induces immune-mediated damage to small intestinal villi, leading to villous atrophy and compensatory crypt hyperplasia. Diagnosis is confirmed by serology and duodenal biopsy. Marsh classification describes the histologic spectrum of changes.
Mallory-Denk bodies in hepatocytes consist of aggregates of:
Intermediate filaments
Lipids
DNA
Glycogen
Mallory-Denk bodies are cytoplasmic inclusions composed of misfolded keratin intermediate filaments, seen in alcoholic and non-alcoholic steatohepatitis. They appear as eosinophilic, rope-like aggregates in hepatocytes. Their presence points toward hepatocellular injury and can be highlighted by immunostaining for cytokeratins.
Schiller-Duval bodies are a histological hallmark of which tumor?
Yolk sac tumor
Choriocarcinoma
Teratoma
Embryonal carcinoma
Schiller-Duval bodies are glomeruloid structures with a central vessel surrounded by tumor cells and a space lined by more tumor cells. They are pathognomonic for yolk sac (endodermal sinus) tumors. Recognition of these bodies confirms the diagnosis in germ cell tumor pathology.
CD20 immunostaining in lymphoid tissue confirms lineage of which cell type?
T lymphocytes
Natural killer cells
B lymphocytes
Myeloid cells
CD20 is a membrane antigen expressed on mature B lymphocytes and most B-cell lymphomas. It is absent on plasma cells and T lymphocytes. Immunohistochemistry for CD20 helps classify lymphoid neoplasms and guide targeted therapies.
Ground glass hepatocytes are most characteristic of infection with which virus?
Hepatitis B virus
Hepatitis A virus
Hepatitis C virus
Epstein - Barr virus
Ground glass hepatocytes contain finely granular, homogeneous cytoplasm due to accumulation of hepatitis B surface antigen in the endoplasmic reticulum. This distinctive feature is a hallmark of chronic hepatitis B infection. It helps morphologically differentiate HBV from other viral hepatitis.
Carcinoma in situ is best described as which grade of dysplasia?
High-grade dysplasia
Mild dysplasia
Moderate dysplasia
Low-grade dysplasia
Carcinoma in situ is characterized by full-thickness epithelial atypia without invasion of the basement membrane, corresponding to high-grade dysplasia. It carries significant risk of progression to invasive carcinoma if left untreated. Grading dysplasia guides management and surveillance strategies.
PAX8 immunostaining is most useful for identifying tumors arising from which organ?
Breast
Lung
Kidney
Skin
PAX8 is a transcription factor expressed in tumors of renal, thyroid, and Müllerian origin. Its presence in immunohistochemistry supports a diagnosis of primary renal cell carcinoma, thyroid carcinoma, or Müllerian-origin neoplasm. It helps distinguish these from metastatic lesions of other origins.
Perls' Prussian blue stain is used to detect which element in tissue sections?
Iron
Copper
Calcium
Magnesium
Perls' Prussian blue reaction detects ferric iron by forming an insoluble blue pigment (Prussian blue) in tissues. It is widely used to demonstrate hemosiderin deposits in cases of hemorrhage, hemochromatosis, and transfusion overload. The stain is highly specific for iron.
Psammoma bodies are concentrically laminated calcifications characteristic of which neoplasm?
Medullary carcinoma
Follicular adenoma
Papillary thyroid carcinoma
Anaplastic carcinoma
Psammoma bodies are laminated, concentric calcific spherules commonly seen in papillary thyroid carcinoma, serous ovarian carcinoma, and meningiomas. Their presence supports a papillary architecture in thyroid neoplasms. They form by progressive calcification of necrotic papillary tips.
Onion-skinning of arteriolar walls is characteristic of which condition?
Hyperplastic arteriolosclerosis due to malignant hypertension
Vasculitis
Atherosclerosis
Amyloidosis
Hyperplastic arteriolosclerosis, seen in malignant hypertension, features concentric smooth muscle hyperplasia and basement membrane duplication ('onion-skinning') in arterioles. It leads to luminal narrowing and ischemic organ damage. This change contrasts with hyaline arteriolosclerosis seen in benign hypertension and diabetes.
A spike-and-dome appearance of the glomerular basement membrane on silver stain is diagnostic of which condition?
Focal segmental glomerulosclerosis
IgA nephropathy
Minimal change disease
Membranous glomerulonephritis
In membranous glomerulonephritis, subepithelial immune complex deposits induce new basement membrane formation around deposits, producing a characteristic spike-and-dome pattern on silver (Jones) stain. This feature helps differentiate it from other forms of glomerulopathy. Electron microscopy further confirms the location of deposits.
Which immunohistochemical marker is most specific for mesothelial cells to distinguish mesothelioma from pulmonary adenocarcinoma?
Ber-EP4
Carcinoembryonic antigen (CEA)
Thyroid transcription factor-1 (TTF-1)
Calretinin
Calretinin is a calcium-binding protein highly expressed in mesothelial cells and mesothelioma, with strong nuclear and cytoplasmic staining. It is negative in most pulmonary adenocarcinomas, which frequently express TTF-1 and CEA. A panel of immunostains including calretinin helps accurately distinguish these tumors.
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Study Outcomes

  1. Understand Staining Techniques -

    Gain familiarity with common histopathology staining methods and their applications in highlighting cellular structures.

  2. Analyze Tissue Morphology -

    Develop skills to distinguish normal and abnormal tissue features under the microscope.

  3. Identify Disease Markers -

    Recognize key histological markers associated with various pathologies during a histopathology test.

  4. Apply Slide Preparation Best Practices -

    Learn essential protocols for preparing high-quality histopathology slides in laboratory settings.

  5. Evaluate Knowledge Gaps -

    Use targeted histopathology quiz questions to pinpoint areas needing further study and improvement.

  6. Reinforce Pathology Expertise -

    Receive instant feedback to strengthen your understanding and boost confidence in histopathology concepts.

Cheat Sheet

  1. Fundamentals of H&E Staining -

    Hematoxylin stains nuclei blue by binding to DNA's phosphate groups, while eosin highlights cytoplasm and extracellular matrix in varying shades of pink. Remember the mnemonic "Blue Nuclei, Pink Matrix" to quickly recall which structures each dye favors (University of California San Francisco, Histology). Mastering this is key for many histopathology quiz questions.

  2. Key Immunohistochemistry Markers -

    Immunohistochemistry uses antigen - antibody reactions to detect proteins like cytokeratin (CK7/20), HER2, or PSA with chromogens such as DAB for brown staining (Johns Hopkins Medical Institutions). A handy trick: "CD" in CD markers stands for "cluster of differentiation," helping you remember cell-surface targets when you face a histopath test challenge.

  3. Tissue Processing Workflow -

    Fixation (commonly 10% neutral buffered formalin), dehydration through graded alcohols, clearing, paraffin embedding, and microtomy form the backbone of sample prep (College of American Pathologists). Use the acronym "F-D-E-M" (Fix, Dehydrate, Embed, Microtome) to nail these steps on your next histopathology test.

  4. Cellular Inflammation Patterns -

    Acute inflammation features neutrophil - rich infiltrates ("PMNs in ACute") while chronic inflammation is dominated by lymphocytes, macrophages, and plasma cells, often with tissue remodeling (World Health Organization). Spotting these patterns quickly will give you an edge on a histopathology quiz.

  5. Tumor Grading and TNM Staging -

    The TNM system classifies tumors by size (T), nodal involvement (N), and metastasis (M), while grading schemes like Bloom - Richardson assess cell differentiation in breast cancer (AJCC Cancer Staging Manual). Memorize "T1 - T4, N0 - N3, M0 - M1" for rapid recall during histopathology quiz questions.

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