CET Specimen Handling & Processing 1 — Questions and Answers
Question 1: Which fixative solution is most commonly used to preserve endoscopic biopsy specimens for histological examination?
- Normal saline
- 10% neutral buffered formalin (Correct answer)
- 70% ethanol
- Glutaraldehyde
Correct answer: 10% neutral buffered formalin
10% neutral buffered formalin is the standard fixative for routine histological processing because it preserves tissue architecture and is compatible with most staining techniques.
Question 2: When labeling a biopsy specimen container, which information is MOST critical to include?
- The endoscopist's license number
- Patient name, date of birth, and anatomical site (Correct answer)
- The technician's initials only
- Procedure start time only
Correct answer: Patient name, date of birth, and anatomical site
Patient name, date of birth, and anatomical site are essential identifiers to ensure specimens are correctly matched to the patient and the pathologist knows where tissue was obtained.
Question 3: A gastric biopsy specimen should be placed into formalin within how many minutes of collection to ensure adequate fixation?
- 30 minutes
- 60 minutes
- Within 1 hour, ideally immediately (Correct answer)
- Up to 4 hours is acceptable
Correct answer: Within 1 hour, ideally immediately
Specimens should ideally be placed in fixative immediately after collection; delayed fixation beyond 1 hour risks autolysis and tissue degradation that compromises pathology results.
Question 4: Which type of specimen requires a dry container (no formalin) and must be kept at room temperature for microbiological culture?
- Colon polyp for histology
- Tissue for H. pylori culture (Correct answer)
- Barrett's esophagus biopsy
- Colorectal adenoma
Correct answer: Tissue for H. pylori culture
Tissue submitted for H. pylori or other microbiological culture must be placed in a sterile dry container without formalin, as formalin kills organisms and prevents culture growth.
Question 5: When multiple biopsy specimens are collected from different sites during the same endoscopy, what is the safest handling practice?
- Place all specimens in one container to save time
- Place each site's specimens in a separately labeled container (Correct answer)
- Label containers after the procedure is complete
- Only separate specimens if the physician requests it
Correct answer: Place each site's specimens in a separately labeled container
Each anatomical site must be placed in its own separately labeled container to ensure accurate pathologic correlation and prevent specimen mix-up.
Question 6: What is the correct tissue-to-formalin volume ratio recommended for adequate fixation?
- 1:1 (equal parts)
- 1:5 (tissue to formalin)
- 1:10 (tissue to formalin) (Correct answer)
- 1:20 (tissue to formalin)
Correct answer: 1:10 (tissue to formalin)
A 1:10 ratio of tissue to formalin ensures complete penetration of the fixative into all parts of the specimen for proper preservation.
Question 7: A technician notices a biopsy specimen container is cracked and leaking formalin. What is the FIRST action to take?
- Continue with the procedure and fix later
- Don protective gloves and a mask, contain the spill, and transfer the specimen to a new container (Correct answer)
- Dispose of the container and specimen immediately
- Notify the pathology lab only after the procedure
Correct answer: Don protective gloves and a mask, contain the spill, and transfer the specimen to a new container
Formalin is a hazardous chemical; the technician must don PPE immediately, contain the spill per OSHA guidelines, and safely transfer the specimen to prevent loss and exposure.
CET Specimen Handling & Processing 1
Which fixative solution is most commonly used to preserve endoscopic biopsy specimens for histological examination?