Free PA(ASCP) Practice Questions

Question 1

A sigmoid colectomy includes a segment of ileum removed en bloc because it was firmly adherent to the tumor. No neoadjuvant therapy was given. Microscopy shows adenocarcinoma extending through the colonic muscularis propria into pericolic fat. Thorough sampling of the adhesion shows fibrosis and inflammation, but no carcinoma in the adhesion or ileal wall. The visceral peritoneal surface is uninvolved. Under AJCC 8 criteria, what is the pathologic T category?

Accepted Answer

pT3

Answer

pT2

Answer

pT4a

Answer

pT4b

Question 2

A fresh 3-cm lymph node arrives for evaluation of suspected lymphoma. The hematopathologist requests both architectural assessment and flow cytometry; sufficient viable tissue is available for both. How should the node be allocated before routine processing?

Accepted Answer

Place viable tissue in RPMI and representative sections in neutral buffered formalin.

Answer

Fix the entire node in formalin, then remove a portion for flow cytometry.

Answer

Disaggregate the entire node for flow cytometry, retaining a cell block for architecture.

Answer

Freeze the intact node, then thaw and divide it for histology and flow cytometry.

Question 3

While orienting a pelvic exenteration specimen, the pathologists' assistant follows the uterine artery toward the cervix. A slender tubular structure passes beneath the artery before entering the bladder. This relationship identifies the:

Accepted Answer

Ureter

Answer

Round ligament of the uterus

Answer

Uterine tube

Answer

Ovarian artery

Question 4

HER2 immunohistochemistry on an invasive breast carcinoma shows complete, moderately intense membrane staining in approximately 60% of invasive tumor cells. Controls are satisfactory, and fixation requirements were met. How should this result be classified and resolved under the ASCO/CAP scoring algorithm?

Accepted Answer

IHC 2+; reflex to in situ hybridization.

Answer

IHC 1+; negative for protein overexpression.

Answer

IHC 3+; positive for protein overexpression.

Answer

Indeterminate; repeat immunohistochemistry on another block.

Question 5

A patient dies after abrupt collapse five days after a transmural myocardial infarction. Before cardiac dissection, the pericardial sac contains 450 mL of blood, and a ventricular free-wall tear communicates with the left ventricular cavity. Which tissue process most directly accounts for the wall's vulnerability to rupture at this stage?

Accepted Answer

Macrophage digestion of necrotic myocardium before substantial collagen deposition

Answer

Dense collagen deposition with contraction of a mature infarct scar

Answer

Early myocyte swelling while the myocardial framework remains largely intact

Answer

Capillary proliferation and fibroblast growth in established granulation tissue

Question 6

Personal air monitoring during representative gross-room work records an eight-hour formaldehyde average of 0.34 ppm. A separate 15-minute sample during a large-specimen task measures 2.6 ppm. Which response follows OSHA's formaldehyde exposure limits?

Accepted Answer

Reduce exposure at that task; the 2-ppm short-term limit was exceeded.

Answer

Continue unchanged; the full-shift value establishes compliance with both limits.

Answer

Use surveillance alone; neither permissible exposure limit has been exceeded.

Answer

Provide N95 respirators; they are sufficient protection against formaldehyde vapor.

Question 7

The dominant tumor nodule in an untreated prostatectomy is acinar adenocarcinoma composed of approximately 65% fused and poorly formed glands and 35% separate, well-formed infiltrative glands. No other architectural pattern is present. Which Gleason score and Grade Group correspond to this distribution?

Accepted Answer

Gleason 4 + 3 = 7; Grade Group 3

Answer

Gleason 3 + 4 = 7; Grade Group 2

Answer

Gleason 4 + 4 = 8; Grade Group 4

Answer

Gleason 3 + 3 = 6; Grade Group 1

Question 8

An oriented breast excision has a firm focus approaching the inked medial surface. The pathologist needs the microscopic clearance in millimeters, and enough tissue remains to preserve the lesion-to-margin relationship. Which block best provides that measurement?

Accepted Answer

A perpendicular section containing the focus and inked edge

Answer

A thin en face shave of the inked medial surface

Answer

A section through the focus that excludes the inked medial surface

Answer

An en face slice taken a measured 2 mm beneath the ink

Question 9

Persistent focal pain accompanies a parotid mass. Histology reveals basaloid cells arranged in cribriform nests containing hyaline, basement-membrane-like material. Tumor also tracks around and along small nerves. Which salivary neoplasm best accounts for the architecture and pattern of spread?

Accepted Answer

Adenoid cystic carcinoma

Answer

Pleomorphic adenoma

Answer

Mucoepidermoid carcinoma

Answer

Warthin tumor

Question 10

Routine sections from a grossly normal gastrointestinal segment show villi and crypts. Pale mucous glands lie beneath the muscularis mucosae. In which location are all of these features normal?

Accepted Answer

Duodenum

Answer

Gastric pylorus

Answer

Jejunum

Answer

Terminal ileum

Free PA(ASCP) Practice Questions

Domain 1: Fundamentals of Pathology (40-50%)

Question 1

Question 2

Question 3

Question 4

Domain 2: Anatomic Pathology Techniques (10-15%)

Question 5

Question 6

Domain 3: Anatomy (10-15%)

Question 7

Question 8

Domain 4: Autopsy Pathology (10-15%)

Question 9

Domain 5: Laboratory Operations (5-10%)

Question 10

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