Pathology Assistant ASCP Exam Prep 2025/2026 –
Complete Study Guide & Review Questions
1. What is the primary purpose of inking the external surface of a resection specimen?
A) To preserve the tissue
B) To mark the surgical margin for histological evaluation ✓
C) To distinguish between different tissue types
D) To prevent tissue dehydration
2. When grossing a colectomy for adenocarcinoma, what is the most critical initial step?
A) Opening the bowel along the antimesenteric border
B) Measuring the tumor's dimensions
C) Orienting the specimen and identifying proximal, distal, and radial margins ✓
D) Taking photographs for documentation
3. A Whipple procedure (pancreaticoduodenectomy) specimen typically includes all of the
following EXCEPT:
A) Head of the pancreas
B) Duodenum
C) Distal stomach
D) Spleen ✓
4. For a radical prostatectomy, the margins most commonly assessed by ink are:
A) Urethral and bladder neck margins
B) Apical, basal, and radial soft tissue margins ✓
C) Seminal vesicle margins only
D) The entire external surface is inked uniformly
5. The standard protocol for submitting sections from a total hysterectomy for benign disease
(leiomyomas) should include:
A) Representative sections of the largest leiomyoma only
B) One section of cervix and one of endometrium
C) Cervix, lower uterine segment, endometrium, and representative myometrium/leiomyomata
✓
D) The entire endometrium must be submitted
6. In a mastectomy for invasive ductal carcinoma, the primary purpose of serially sectioning
the specimen is to:
A) Identify the largest tumor focus ✓
,B) Assess the nipple-areolar complex
C) Evaluate the axillary lymph nodes
D) Measure the skin ellipse
7. Which fixative is most commonly used for routine light microscopy and provides excellent
nuclear detail?
A) Zenker's fixative
B) Bouin's solution
C) 10% Neutral Buffered Formalin ✓
D) Glutaraldehyde
8. A lumpectomy specimen arrives with a suture marking the superior margin. During
grossing, you should:
A) Remove the suture as it interferes with inking
B) Ink the entire specimen one color, as orientation is not critical
C) Correlate the suture with the surgeon's designation and use a specific color of ink for that
margin ✓
D) Ignore the suture and rely on the pathology report from the surgeon
9. When dissecting a lung lobe with a suspected carcinoid tumor, the best method to locate a
small endobronchial lesion is:
A) Serially sectioning the parenchyma in the parasagittal plane
B) Palpating the bronchial tree for firm areas and then opening the airways with scissors ✓
C) Injecting the bronchial tree with formalin
D) Submitting random sections of the lung parenchyma
10. The minimum number of lymph nodes recommended to be found and examined in a
colectomy for colorectal cancer is:
A) 5 nodes
B) 12 nodes ✓
C) 20 nodes
D) It depends on the tumor size
11. A fresh thyroidectomy specimen for a follicular lesion should be assessed for:
A) The presence of Graves' disease
B) Capsular and vascular invasion ✓
C) Involvement of the parathyroid glands
D) The size of the isthmus
,12. In a nephrectomy specimen for renal cell carcinoma, the most important structure to
identify and sample is the:
A) Adrenal gland (if present)
B) Renal pelvis and ureter
C) Renal vein margin for tumor thrombus ✓
D) Renal capsule
13. For a Morton's neuroma, the most common location is:
A) The carpal tunnel
B) Between the 3rd and 4th metatarsal heads ✓
C) The ulnar nerve at the elbow
D) The brachial plexus
14. When grossing a placenta with a singleton birth, the number of vessels in the umbilical
cord should be:
A) One artery, one vein
B) Two arteries, one vein ✓
C) Two arteries, two veins
D) One artery, two veins
15. The purpose of "bread-loafing" a specimen is to:
A) Assess the internal cut surfaces for lesions ✓
B) Determine the weight of the specimen
C) Improve fixation penetration
D) Measure the external dimensions
16. A segmental resection of small bowel for Crohn's disease shows "creeping fat." This refers
to:
A) Fat necrosis within the mesentery
B) Mesenteric fat wrapping around the serosal surface of the bowel ✓
C) Atherosclerosis of the mesenteric vessels
D) Metastatic carcinoma to the omentum
17. In a radical neck dissection, the lymph node levels are defined by:
A) The size of the lymph nodes
B) Anatomical landmarks such as muscles and bones ✓
C) The order in which they are removed by the surgeon
D) Their gross appearance (color and consistency)
, 18. The most critical element to document from a bone tumor resection is:
A) The weight of the specimen
B) The status of the surgical margins ✓
C) The color of the marrow
D) The presence of cartilage
19. When submitting tissue for frozen section, the most appropriate action is to:
A) Place the tissue directly on the cryostat chuck
B) Embed the tissue in Optimal Cutting Temperature (O.C.T.) compound ✓
C) Fix the tissue in formalin first for 10 minutes
D) Dry the tissue thoroughly with a paper towel
20. A "shave" margin implies:
A) A deep, perpendicular section of the margin
B) A tangential, en-face section of the epidermal margin ✓
C) A cross-section of a tubular structure
D) A radial soft tissue margin
21. Which specimen requires immediate fresh tissue allocation for flow cytometry?
A) A breast biopsy for fibroadenoma
B) A lymph node suspected for lymphoma ✓
C) A colon resection for diverticulitis
D) A skin lesion for basal cell carcinoma
22. The most appropriate way to handle a lung with suspected emphysema for gross
examination is:
A) Infusion with formalin to inflate the lung ✓
B) Serially sectioning it without inflation
C) Weighing it and submitting one random section
D) Only examining the pleura
23. In a gastrectomy specimen, the location of a tumor in relation to the incisura angularis is
important because it:
A) Determines the type of gastric carcinoma
B) Affects the surgical approach and lymphatic drainage ✓
C) Indicates the tumor grade
D) Is the site of Helicobacter pylori infection
24. A "cone biopsy" of the cervix is performed to:
A) Remove a benign polyp
Complete Study Guide & Review Questions
1. What is the primary purpose of inking the external surface of a resection specimen?
A) To preserve the tissue
B) To mark the surgical margin for histological evaluation ✓
C) To distinguish between different tissue types
D) To prevent tissue dehydration
2. When grossing a colectomy for adenocarcinoma, what is the most critical initial step?
A) Opening the bowel along the antimesenteric border
B) Measuring the tumor's dimensions
C) Orienting the specimen and identifying proximal, distal, and radial margins ✓
D) Taking photographs for documentation
3. A Whipple procedure (pancreaticoduodenectomy) specimen typically includes all of the
following EXCEPT:
A) Head of the pancreas
B) Duodenum
C) Distal stomach
D) Spleen ✓
4. For a radical prostatectomy, the margins most commonly assessed by ink are:
A) Urethral and bladder neck margins
B) Apical, basal, and radial soft tissue margins ✓
C) Seminal vesicle margins only
D) The entire external surface is inked uniformly
5. The standard protocol for submitting sections from a total hysterectomy for benign disease
(leiomyomas) should include:
A) Representative sections of the largest leiomyoma only
B) One section of cervix and one of endometrium
C) Cervix, lower uterine segment, endometrium, and representative myometrium/leiomyomata
✓
D) The entire endometrium must be submitted
6. In a mastectomy for invasive ductal carcinoma, the primary purpose of serially sectioning
the specimen is to:
A) Identify the largest tumor focus ✓
,B) Assess the nipple-areolar complex
C) Evaluate the axillary lymph nodes
D) Measure the skin ellipse
7. Which fixative is most commonly used for routine light microscopy and provides excellent
nuclear detail?
A) Zenker's fixative
B) Bouin's solution
C) 10% Neutral Buffered Formalin ✓
D) Glutaraldehyde
8. A lumpectomy specimen arrives with a suture marking the superior margin. During
grossing, you should:
A) Remove the suture as it interferes with inking
B) Ink the entire specimen one color, as orientation is not critical
C) Correlate the suture with the surgeon's designation and use a specific color of ink for that
margin ✓
D) Ignore the suture and rely on the pathology report from the surgeon
9. When dissecting a lung lobe with a suspected carcinoid tumor, the best method to locate a
small endobronchial lesion is:
A) Serially sectioning the parenchyma in the parasagittal plane
B) Palpating the bronchial tree for firm areas and then opening the airways with scissors ✓
C) Injecting the bronchial tree with formalin
D) Submitting random sections of the lung parenchyma
10. The minimum number of lymph nodes recommended to be found and examined in a
colectomy for colorectal cancer is:
A) 5 nodes
B) 12 nodes ✓
C) 20 nodes
D) It depends on the tumor size
11. A fresh thyroidectomy specimen for a follicular lesion should be assessed for:
A) The presence of Graves' disease
B) Capsular and vascular invasion ✓
C) Involvement of the parathyroid glands
D) The size of the isthmus
,12. In a nephrectomy specimen for renal cell carcinoma, the most important structure to
identify and sample is the:
A) Adrenal gland (if present)
B) Renal pelvis and ureter
C) Renal vein margin for tumor thrombus ✓
D) Renal capsule
13. For a Morton's neuroma, the most common location is:
A) The carpal tunnel
B) Between the 3rd and 4th metatarsal heads ✓
C) The ulnar nerve at the elbow
D) The brachial plexus
14. When grossing a placenta with a singleton birth, the number of vessels in the umbilical
cord should be:
A) One artery, one vein
B) Two arteries, one vein ✓
C) Two arteries, two veins
D) One artery, two veins
15. The purpose of "bread-loafing" a specimen is to:
A) Assess the internal cut surfaces for lesions ✓
B) Determine the weight of the specimen
C) Improve fixation penetration
D) Measure the external dimensions
16. A segmental resection of small bowel for Crohn's disease shows "creeping fat." This refers
to:
A) Fat necrosis within the mesentery
B) Mesenteric fat wrapping around the serosal surface of the bowel ✓
C) Atherosclerosis of the mesenteric vessels
D) Metastatic carcinoma to the omentum
17. In a radical neck dissection, the lymph node levels are defined by:
A) The size of the lymph nodes
B) Anatomical landmarks such as muscles and bones ✓
C) The order in which they are removed by the surgeon
D) Their gross appearance (color and consistency)
, 18. The most critical element to document from a bone tumor resection is:
A) The weight of the specimen
B) The status of the surgical margins ✓
C) The color of the marrow
D) The presence of cartilage
19. When submitting tissue for frozen section, the most appropriate action is to:
A) Place the tissue directly on the cryostat chuck
B) Embed the tissue in Optimal Cutting Temperature (O.C.T.) compound ✓
C) Fix the tissue in formalin first for 10 minutes
D) Dry the tissue thoroughly with a paper towel
20. A "shave" margin implies:
A) A deep, perpendicular section of the margin
B) A tangential, en-face section of the epidermal margin ✓
C) A cross-section of a tubular structure
D) A radial soft tissue margin
21. Which specimen requires immediate fresh tissue allocation for flow cytometry?
A) A breast biopsy for fibroadenoma
B) A lymph node suspected for lymphoma ✓
C) A colon resection for diverticulitis
D) A skin lesion for basal cell carcinoma
22. The most appropriate way to handle a lung with suspected emphysema for gross
examination is:
A) Infusion with formalin to inflate the lung ✓
B) Serially sectioning it without inflation
C) Weighing it and submitting one random section
D) Only examining the pleura
23. In a gastrectomy specimen, the location of a tumor in relation to the incisura angularis is
important because it:
A) Determines the type of gastric carcinoma
B) Affects the surgical approach and lymphatic drainage ✓
C) Indicates the tumor grade
D) Is the site of Helicobacter pylori infection
24. A "cone biopsy" of the cervix is performed to:
A) Remove a benign polyp
