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ASCP HT Exam: Practice Questions

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ASCP HT Exam: Practice Questions

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250
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About these practice questions

These practice questions will help you prepare for the ASCP HT exam.

This practice test contains 250 practice questions covering the five sections of the ASCP HT exam:

  1. Fixation
  2. Processing
  3. Embedding/Microtomy
  4. Staining
  5. Laboratory operations

All questions have been carefully designed to reflect the questions on the real exam, to help you prepare and get a passing grade.

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Section 1: Fixation

1) Which fixative is used for electron microscopy?
  1. 10% neutral buffered formalin
  2. Glutaraldehyde
    Glutaraldehyde is used as a fixative for electron microscopy because it preserves fragile structures well, such as microtubules and mitotic spindles.
  3. Paraformaldehyde
  4. Zinc formalin
2) Why are bacterial smears heat-fixed before staining?
  1. To ensure the smears can be cut into thin slices
  2. To make the cell walls permeable so the stain can penetrate
  3. To prevent cells from being washed off during staining
    Heat fixation adheres bacteria to the slide, preventing them from washing off the slide when the stain is added.
  4. To provide a warm temperature for the bacteria to grow
3) What is the term for formaldehyde dissolved in water?
  1. Acetone
  2. Cytospray
  3. Ethyl acetate
  4. Formalin
    Formaldehyde dissolved in water is commonly referred to as formalin. Formalin is a commonly used fixative for preserving biological tissues.
4) Smears for cytology must be fixed:
  1. immediately
    Smears for cytology must be fixed immediately to preserve the cellular details and prevent degradation of the cells.
  2. within 2 hours
  3. within 8 hours
  4. within 16 hours
5) Which of these is a fixative?
  1. EDTA
  2. Formalin
    Other common fixatives are ethanol, methanol, and 10% neutral buffered formalin.
  3. Hydrochloric acid
  4. Xylene
6) Which of these is a compound fixative?
  1. Acetic acid
  2. Bouin's fluid
    Compound fixatives are fixatives that consist of a mixture of two or more chemicals that work together. Bouin's fluid is a compound fixative because it is a mixture of picric acid, formaldehyde, and acetic acid.
  3. Formaldehyde
  4. Picric acid
7) Which action prevents the formation of acid formaldehyde hematin?
  1. Adding drops of cytochrome b5 reductase
  2. Keeping the solutions refrigerated
  3. Using buffered formalin
    With formaldehyde solutions, the formaldehyde can break down to form formic acid, which reacts with hemoglobin to produce an artifact pigment (acid formaldehyde hematin). However, this can be prevented by using buffered formalin.
  4. Washing excess fixative overnight with water
8) Which chemical is added to formalin as a stabilizer?
  1. Half-normal saline
  2. Iodine
  3. Methanol
    Formalin contains a small amount of methanol to slow down the conversion of formaldehyde into paraformaldehyde.
  4. Sodium phosphate
9) What are the three components of formalin?
  1. Formaldehyde, ethanol, and acetic acid
  2. Formaldehyde, methanol, and water
    Formalin has three components: formaldehyde, methanol, and water.
  3. Formic acid, ethanol, and acetone
  4. Paraformaldehyde, glycerol, and water
10) Specimens should be placed in a fixative that is ______ times greater than the volume of the tissue.
  1. 10–20
    The volume of fixative should be 10 to 20 times greater than the volume of the tissue. This helps the fixative soak fully into the tissue.
  2. 20–30
  3. 30–40
  4. 40–50
11) Which chemical is added to formalin as a buffer?
  1. Half-normal saline
  2. Iodine
  3. Methanol
  4. Sodium phosphate
    Unbuffered formalin is acidic, with a pH between 3 and 4. The acidity can react with hemoglobin in tissue to form dark brown deposits called acid formaldehyde hematin, making slides harder to interpret. To avoid this, a buffer like sodium phosphate is added to bring the pH to neutral.
12) How is 10% formalin prepared from stock formalin?
  1. 1 part stock formalin with 10 parts water
  2. 1 part stock formalin with 9 parts water
    You need to mix 1 part stock formalin with 9 parts water to make a 10% formalin solution.
  3. 9 parts stock formalin with 1 part water
  4. 10 parts stock formalin with 1 part water
13) During fixation, why is buffered formalin used instead of unbuffered formalin?
  1. To inactivate cellular enzymes
  2. To keep the tissue dehydrated
  3. To maintain a neutral pH
    Formalin is buffered to maintain a neutral pH. This helps prevent acid-related artifacts.
  4. To prevent cells from bursting
14) At approximately what pH is neutral-buffered formalin most effective?
  1. 3
  2. 5
  3. 7
    Most fixatives (e.g. buffered formalin) are most effective at a neutral pH of 7.
  4. 9
15) Which of these fixatives is alcohol-based?
  1. B-5 fixative
  2. Carnoy’s solution
    Carnoy's solution is 60% ethanol, 30% chloroform, and 10% acetic acid. It is alcohol-based because ethanol is its main component.
  3. Formalin
  4. Helly’s fixative
    Helly's fixative is a combination of potassium dichromate, mercuric chloride, formaldehyde, and distilled water. It is not alcohol-based.
16) What color do picric acid fixatives give to tissues?
  1. Blue
  2. Green
  3. Orange
  4. Yellow
    Picric acid gives tissue a yellow color.
17) Which molecule most commonly causes streaming artifacts during fixation?
  1. Cholesterol
  2. Glycogen
    Streaming artifacts are caused by unfixed material changing location in the tissue. This is most commonly seen with glycogen in glutaraldehyde fixation.
  3. Myosin
  4. Phosphatidylglycerol
18) What color is formalin pigment?
  1. Brown
    Formalin pigment, also called acid formaldehyde hematin, is a brown-black artifact seen on tissues fixed in acidic formalin. It results from a reaction between formaldehyde and hemoglobin.
  2. Gray
  3. Red
  4. Yellow
19) What is the preferred fixative for Masson Trichrome?
  1. Acetone
  2. Bouin's solution
    Bouin’s solution is the preferred fixative for Masson Trichrome. 10% formalin or Zenker's solution can also be used.
  3. Formalin
  4. Zenker's fixative
20) What is autolysis?
  1. The decay of tissue by bacteria
  2. The denaturing of proteins by chemical fixation
  3. The destruction of cells by their own enzymes
    Auto means “self” and lysis means “breakdown”. Autolysis is therefore the breakdown of an organism's cells by the organism's own enzymes.
  4. The dissolution of cells by enzymes from another organism

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About the ASCP HT exam

What is the ASCP HT exam?

The ASCP Histotechnician (HT) certification exam assesses the knowledge and skills required for entry-level histotechnology positions. The American Society for Clinical Pathology Board of Certification (ASCP BOC) administers the exam.

The exam consists of 100 multiple-choice questions and has a 2.5-hour time limit. It is administered using computer adaptive testing (CAT), with one best answer for each question. The exam covers essential histotechnology topics including tissue fixation, processing, embedding, microtomy, staining, and laboratory operations.

The exam fee is $235.

Exam eligibility

Before applying for the ASCP HT exam, first ensure you're eligible. The exam has three eligibility routes. To take the ASCP HT exam, you must meet the criteria for at least one of these routes.

Route 1: NAACLS Program

To be eligible for this route, you must have completed a NAACLS-accredited Histotechnician program within the last five years.

Route 2: College Education & Experience or Structured Program

To be eligible for this route, you must have either 60 semester hours of academic credit from an accredited college/university OR an associate degree from an accredited college/university, with a combination of 12 semester hours (18 quarter hours) in biology and chemistry, including credit in both subjects.

You must also have completed one of the following within the last five years:

  • one year of full-time acceptable clinical experience in a histopathology laboratory;
  • one year of full-time acceptable veterinary, industry, or research experience in a histopathology laboratory in the U.S. or Canada; or
  • a two-part structured histology program of at least nine months, including classroom training and at least 480 hours of acceptable clinical experience in a histopathology laboratory.

Route 3: College Education & Military Training

To be eligible for this route, you must have completed a 50-week U.S. military histotechnician training course within the last ten years.

You must also have completed one of the following:

  • 60 semester hours of academic credit from an accredited college/university, with a combination of 12 semester hours in biology and chemistry, including credit in both subjects
  • An associate degree from an accredited college/university, with a combination of 12 semester hours in biology and chemistry, including credit in both subjects
[ASCP applying and taking]

Recommended study resources

The ASCP BOC provides a suggested reading list to help candidates prepare for the HT and HTL examinations. The list is intended as a partial reference source and does not mean that examination questions are drawn solely from these publications.

  • ASCP Editorial Board. (2022). BOC study guide: Histotechnology certification examinations (3rd ed.). ASCP Press.
  • Brown, R. W. (Ed.). (2009). Histologic preparations: Common problems and their solutions. College of American Pathologists.
  • Carson, F. L. (2010). HistoDeck flash cards (3rd ed.). ASCP Press.
  • Carson, F., & Cappellano, C. (Eds.). (2020). Histotechnology: A self-instructional text (5th ed.). ASCP Press.
  • Carson, F. L. (2020). Histotechnology: A self-assessment workbook (5th ed.). ASCP Press.
  • Davis, D. L. (2016). Laboratory safety: A self-assessment workbook (2nd ed.). ASCP Press.
  • Eroschenko, V. P. (2017). Atlas of histology with functional correlations (13th ed.). Wolters Kluwer.
  • Lott, R., et al. (2023). Practical guide to specimen handling in surgical pathology. College of American Pathologists and National Society for Histotechnology.
  • O’Dowd, G., Bell, S., & Wright, S. (Eds.). (2023). Wheater’s functional histology: A text and colour atlas (7th ed.). Elsevier.
  • Suvarna, K. S., Layton, C., & Bancroft, J. D. (2019). Bancroft’s theory and practice of histological techniques (8th ed.). Elsevier.
  • Taylor, C. R., & Rudbeck, L. (Eds.). (2013). Dako IHC guidebook: Immunohistochemical staining methods (6th ed.). Dako Denmark A/S.

Exam structure

The questions on the ASCP HT exam encompass five content areas:

  1. Fixation
  2. Processing
  3. Embedding/Microtomy
  4. Staining
  5. Laboratory Operations

1. Fixation

The first content area, Fixation, is worth 15-25% of the exam and covers topics including:

  • tissue morphology and anatomy
  • cell and tissue preservation
  • proper demonstration of cells and tissue components
  • pathology and biochemical principles
  • fixation for light and electron microscopy
  • fixation for special stains and frozen sections
  • fixation for enzyme histochemistry
  • fixation for immunofluorescence and immunohistochemistry
  • fixation for cytologic specimens and in situ hybridization
  • artifacts, precipitates, and pigments
  • quality control
  • specimen and fixative parameters, including size, volume, time, temperature, and pH
  • fixative reagents, their properties, functions, and quality control
  • fixation equipment, including its use, maintenance, troubleshooting, and quality control

2. Processing

The second content area, Processing, is worth 10-20% of the exam and covers topics including:

  • tissue morphology and preservation
  • processing for light microscopy
  • processing of frozen tissues
  • processing for enzyme histochemistry
  • decalcification
  • processing for immunohistochemistry and immunofluorescence
  • processing of cytologic specimens, such as cell blocks and touch preparations
  • processing for in situ hybridization
  • processing for special stains
  • quality control
  • tissue-processing equipment, including conventional tissue processors and microwaves
  • processing reagents, their properties, functions, and quality control

3. Embedding/Microtomy

The third content area, Embedding/Microtomy, is worth 15-25% of the exam and covers topics including:

  • tissue morphology and anatomy
  • proper demonstration and orientation of tissue components
  • paraffin embedding and sectioning
  • frozen sections
  • gelatin and adhesives
  • quality control
  • embedding centers
  • microtomes
  • flotation baths
  • paraffin dispensers
  • slide-drying ovens
  • cryostats
  • equipment use, maintenance, troubleshooting, and quality control

4. Staining

The fourth content area, Staining, is worth 30-40% of the exam and covers topics including:

  • tissue morphology and anatomy
  • cell and tissue component demonstration
  • pathology and biochemical principles
  • staining procedures for:
    • the nucleus and cytoplasm
    • bone marrow
    • carbohydrates
    • connective and supporting tissue
    • lipids
    • microorganisms
    • nerves
    • pigments, minerals, and granules
    • tissues, cells, and components such as fibrin and mast cells
    • cytologic specimens
  • basic immunohistochemistry and immunofluorescence terminology
  • quality control
  • automated and manual staining equipment
  • reagents and dyes, including their properties, functions, and quality control
  • mounting procedures, including:
    • mounting media preparation and selection
    • manual and automated coverslipping

Stains and staining methods that may be encountered on the exam include:

  • Alcian blue
  • Alcian blue-PAS
  • Alcian yellow
  • Bielschowsky stain
  • Bile stain (Hall)
  • Carbol-fuchsin stains, including Kinyoun, Ziehl-Neelsen, Fite, and auramine-rhodamine
  • Colloidal iron stain
  • Congo red stain
  • Crystal violet stain
  • Fontana-Masson stain
  • Giemsa stain
  • Gram stain
  • Grocott/Gomori methenamine-silver (GMS) stain
  • Melanin bleaching
  • Hematoxylin and eosin (H&E) stain
  • Immunohistochemical stains
  • Immunofluorescence
  • Luxol fast blue (LFB/cresyl echt violet)
  • Movat pentachrome stain
  • Mucicarmine stain
  • Oil red O stain
  • Papanicolaou stain
  • PAS-digestion (PASD)
  • PAS-hematoxylin (PASH)
  • Periodic acid-methenamine silver (PAMS/Jones)
  • Periodic acid-Schiff (PAS)
  • Prussian blue stain
  • Reticulin/reticulum stain
  • Rhodanine stain
  • Romanowsky stains
  • Spirochete stains, including Steiner and Warthin-Starry
  • Toluidine blue stain
  • Trichrome stains, including Gomori and Masson
  • Verhoeff-van Gieson (VVG) stain
  • von Kossa stain

The HT exam also includes questions about fixation and processing for enzyme histochemistry and in situ hybridization. However, staining questions on enzyme histochemistry and in situ hybridization are included on the HTL exam only. For immunohistochemistry, the HT exam focuses on basic terminology, fixation, and processing; more advanced staining principles are reserved for the HTL exam.

5. Laboratory Operations

The final content area, Laboratory Operations, is worth 10-15% of the exam and covers topics including:

  • laboratory safety regulations and practices, including:
    • chemical safety
    • safety data sheets (SDS)
    • chemical labeling, storage, and disposal
    • spill response
    • health hazards
    • personal protective equipment (PPE)
    • eyewash stations and safety showers
    • exposure monitoring
    • fire safety
    • ergonomics
    • infection control
    • Standard Precautions
    • disinfection and decontamination
    • hand hygiene
  • laboratory mathematics, including:
    • unit conversions
      • w2e>J>>RfR
    • percent solutions and dilutions
    • molar solutions
  • ancillary equipment and instruments, including microscopes, computers, pH meters, whole-slide imagers, pipettes, balances, and reagent recyclers
  • equipment use, maintenance, troubleshooting, and quality control
  • laboratory regulations, including:
    • quality assurance
    • validation and development of new tests, control tissue, and instrumentation
    • proficiency testing and competency assessment
    • patient confidentiality and HIPAA
    • inventory maintenance and ordering
    • writing, reviewing, and revising laboratory policies and procedures