Exam 5 Flashcards
The lab switches to a xylene substitute in the processor. Which phase of the Total Test Approach is affected
Pre-Analytical
With a new antibody optimization you should first
Consult the antibody specification sheet
Companion diagnostic assay results are essential for all of the following reasons except
Determine the patient’s survival rate
Which of the following antibodies can be included in a panel to identify mast cells
Tryptase
An antibody cocktail used for simultaneous IHC staining may contain
Both rabbit and mouse antibodies
Which Her 2 score indicates the highest response to the drug Herceptin?
3+
An automated IHC instrument would be a desirable addition to the histology laboratory because they:
Offer consistency
The detection of two or more antigens in the same tissue section is defined as
Dual or multi-staining
Digital pathology can be useful for
Improving quality assurance
Which of the following antibodies is a mesenchymal marker which aids in the diagnosis of sarcomas
Vimentin
Testing a panel of tissues or cases to determine consistency and reproducibility in antibody performance is referred to as
Validation
Which of the following is a component of the pre-analytical phase
Fixation
An equivocal Her-2 score of 2+ would result in
Reflex to FISH
In this type of IHC instrument technology, continuous movement of the covertile ensures even distribution of the reagents over the slide
Dynamic Gap Staining
The variability that can occur between histology labs when handling tissue from surgical removal to fixation is a strong hindrance of
Standardization
Which of the following would be a technical challenge of multi-staining
Balancing signal intensities
Which of the following is an advantage of sequential staining
Minimized cross-reactivity
Which of the following is not a protocol parameter for optimization
Fixation
Image analysis aids in
Interpretation
Which of the following antibody regulatory statuses would not require additional documentation in the pathology report
IVD
An automated IHC instrument would be beneficial by
Reducing human error
Determining whether the positive tissue control stained appropriately is part of which phase of the Total Test Approach
Post-analytical
Choosing which antigen retrieval method to use is a component of which phase of the total test approach
Analytical
Which two components are used to score ER and PR results
The proportion of cells positive and the intensity of the signal
A rapid consultation is needed for a patient from another hospital. What would be an optimal application in this instance
Digital pathology
Deciding which antigen retrieval method to use when optimizing a protocol is a component of which phase of the Total Test Approach
Analytical
Which of the following would be an advantage of multi-staining
Conservation of tissue
An open system should only be considered if the laboratory has
Highly skilled histotechs
Which two primary antibodies would be included in a Hodgkin’s lymphoma panel
CD15 and CD30
This type of IHC instrument allows for single slides to be loaded and unloaded independently
Continuous
NordiQC or HistoQIP are examples of which type of quality assurance measure
External
Which of the following is a limitation for multi-staining
All antibodies must be optimized for the same antigen retrieval
Which of the following would not be a CAP recommendation relating to quality assurance
Barcode tracking must be implemented
Simultaneous multi-staining allows for
Quicker turn around times
Reviewing slides after each IHC run for specificity is an example of:
Internal quality assurance
Which of the following antibodies is classified as a prognostic or predictive marker
Her-2
In this type of staining technology, a dispenser applies reagent to slides arranged horizontally
Open individual slide system
A lack of standardization likely results in
Poor reproducibility
You are asked to demonstrate two antigens on the same slide using two mouse monoclonal antibodies. Which staining method would you choose in order to minimize cross-reactivity
Sequential
For initial validation of Class II predictive markers, CAP guidelines suggest
20 positive and 20 negative tissues
An external IHC quality assurance program is important
To compare results between different laboratories
Of the following antibodies, which one is a marker of T-cells only
CD3
HMB45 is typically used in a panel for the diagnosis of
Melanoma
Which instance would require partial re-validation
The fixative was changed
The process of determining the optimal protocol parameters to ensure that the primary antibody reacts specifically with the target antigen is referred to as
Optimization
One of the purposes of image analysis is to
Quantify staining intensity and proportion
CD45 will detect which cell type
Lymphocytes
For initial validation of Class I non-predictive markers, CAP guidelines suggest
10 positive and 10 negative tissues
This type of IHC staining system allows for increased protocol options during optimization
Open
This type of IHC instrument requires that slides to be loaded and off-loaded at the same pre-determined time
Batch
A breast nodule is suspected of having metastasized from a carcinoma of a different organ. Which two antibodies may be used in a panel to determine the complex epithelial origin
CK7 and CK20
An open IHC staining system may be preferred due to
Increased flexibility
Which of the following is an optimization recommendation when selecting the antigen retrieval method
Refer to the antibody specification sheet
Ensuring consistent and reproducible IHC results is referred to as
Standardization
According to CAP guidelines, the initial validation should achieve 90% accordance between the new assay and
Expected results
Which of the following antibodies could be used to differentiate between a B cell or T cell lymphoma
CD3 and CD20
The cytokeratin antibody clone AE1/AE3/PCK26 would demonstrate which tissue type
Epithelium
In order to produce the most consistent results for image analysis, what type of IHC staining system would be recommended
Closed
Which of the following is an antibody used to detect an infectious agent
EBV
A next-generation antibody may be defined as an assay that
Improves upon a previous clone
Which of the following is a key factor hindering IHC standardization
Variability and options offered by manufacturers
An advantage of multi-staining is that
Spatial relationships between antigens can be determined
The lack of universal interpretation standards affects which phase of the total test approach
Post-analytical
An antibody cocktail targeting three different antigens is used. Which method of multi-staining would this be referred to
Simultaneous
Which of the following is a predictive marker for breast cancer
ER
Which protocol parameter is selected dependent on the detection enzyme used
Chromogen
Complementary diagnostic assay results are
Not required for therapy administration
In this IHC staining technology, a proprietary oil-based fluid is applied over the reagent on the slide to inhibit evaporation
Liquid overlay system
One purpose of an antibody panel is to
Determine origin of tumors
A technical challenge of sequential multi-staining would be
Avoiding overrinsing or masking of the first chromogen
In image analysis, images are analyzed using
Algorithms
In sequential staining, inadequate results may occur due to improper
Elution/Rinsing
Which of the following is an example of a common algorithm used in histopathology laboratories
Her-2
The purpose of validation is to
Ensure reliable and consistent results
Which of the following is true: Lung adenocarcinomas are typically
CK7 positive
