L1 HISTOMTLE Flashcards
Commercial stock formaldehyde solutions contain:
A. 4% formaldehyde
B. 10% formaldehyde
C. 37% to 40% formaldehyde
D. 98% to 100% formaldehyde
C. 37% to 40% formaldehyde
10% formalin contains approximately what percentage of formaldehyde?
A. 4
B. 10
C. 37
D. 100
A. 4
A microwave oven can be used for fixation because it:
A. Causes cross-linking of proteins
B. Induces physical fixation
C. Increases tissue basophilia
D. Inactivates enzymes with beta-radiation
B. Induces physical fixation
This organ is usually suspended whole in 10% buffered formalin for 2 to 3 weeks to ensure fixation and some hardening prior to sectioning.
A. Lungs
B. Liver
C. Brain
D. Amputated foot
C. Brain
Fixatives that give the best results with metachromatic staining and are the routine fixatives of choice for preservation of detail for photography:
A. Formalin fixatives
B. Mercurial fixatives
C. Lead fixatives
D. Chromate fixatives
B. Mercurial fixatives
Airholes found on tissue
A. Incomplete fixation
B. Incomplete dehydration
C. Incomplete clearing
D. Incomplete impregnation
D. Incomplete impregnation
Tissue is opaque, section cutting is difficult due to the presence of alcohol.
A.Incomplete fixation
B.Incomplete dehydration
C.Insufficient clearing
D. Incomplete impregnation
C.Insufficient clearing
Tissue is soft when block is trimmed:
A.Incomplete fixation
B.Incomplete dehydration
C.Incomplete clearing
D.Incomplete impregnation
A.Incomplete fixation
The first and most critical step in histotechnology?
A. Fixation
B. Clearing
C. Infiltration
D. Embedding
A. Fixation
These knives are used to cut block for ELECTRON MICROSCOPY (EM):
A. Disposal blades
B. Steel knives
C. Diamond or glass knives
D. Magnetic blades
C. Diamond or glass knives
Microtome knives for PARAFFIN SECTIONING are usually made of:
A. Carbon steel
B. Diamond
C. Glass
D. Iron
A. Carbon steel
It is considered to be as the best vital dye.
A. Janus green
B. Neutral red
C. Nile blue
D. Toluidine blue
B. Neutral red
It is used for demonstrating mitochondria during vital staining:
A. Janus green
B. Neutral red
C. Nile blue
D. Toluidine blue
A. Janus green
Oldest stain:
A. Orcein
B. Iodine
C. Eosin
D. Hematoxylin
B. Iodine
What is the most sensitive lipid stain?
A. Oil red O
B. Sudan III
C. Sudan IV
D. Sudan Black B
D. Sudan Black B
The phosphotungstic acid hematoxylin (PTAH) is useful for demonstrating:
A. Edema fluid
B. Muscle striations
C. Ground substance
D. Reticulin network
B. Muscle striations
The connective tissue cells actively involved in wound healing are:
A. Plasma cells
B. Mast cells
C. Macrophages
D. Fibroblasts
D. Fibroblasts
Due to chronic trauma induced by ill-fitting dentures:
A. Hypertrophy
B. Hyperplasia
C. Dysplasia
D. Metaplasia
B. Hyperplasia
It is a special form of cell death produced by the TUBERCLE BACILLUS.
A. Coagulation necrosis
B. Liquefaction necrosis
C. Fat necrosis
D. Caseous necrosis
D. Caseous necrosis
Cell death due to ischemia is known as Infarction and is manifested by a characteristic histologic appearance which is:
A. Coagulation necrosis
B. Liquefaction necrosis
C. Fat necrosis
D. Caseous necrosis
A. Coagulation necrosis
Which of the following organs should not be dissected before they are fixed?
A. Eyes
B. Lungs
C. Heart
D. Liver
A. Eyes
Formalin fixes tissue by:
A. Causing a loss of color
B. Forming crosslinks
C. Forming formic acid
D. Facilitating numerous staining techniques
B. Forming crosslinks
The primary aim of fixation:
A. Preserve the morphologic and chemical integrity of the cell
B. Act as mordant or accentuators
C. Harden and protect the tissue from trauma of further handling
D. Inhibit bacterial decomposition
A. Preserve the morphologic and chemical integrity of the cell
The secondary goal of fixation:
A. Preserve the morphologic and chemical integrity of the cell
B. Act as mordant or accentuators
C. Harden and protect the tissue from trauma of further handling
D. Inhibit bacterial decomposition
C. Harden and protect the tissue from trauma of further handling
To prevent the formation of formalin pigment in tissues, formalin should be:
A. Heated
B. Cooled
C. Buffered
D. Acidified
C. Buffered
The breakdown of tissue due to enzyme activity is called:
A. Polymerization
B. Putrefaction
C. Autolysis
D. Osmosis
C. Autolysis
The breakdown of tissue by bacterial action is called:
A. Autolysis
B. Putrefaction
C. Denaturation
D. Oxidation
B. Putrefaction
A physical agent used in fixation:
A. Stabilization of protein
B. Heat
C. Coagulation
D. Alcohol
B. Heat
For good fixation it is recommended that the tissue be no larger than:
A. 2 cm square and 1 to 2 mm thick
B. 2 cm square and 3 to 4 mm thick
C. 3 cm square and 1 to 2 mm thick
D. 3 cm square and 3 to 4 mm thick
B. 2 cm square and 3 to 4 mm thick
The best fixative for blood smears is:
A. Bouin solution
B. Carnoy fluid
C. B-5
D. Methanol
D. Methanol
A universal fixative used for routine purposes and which allows a broad spectrum of staining procedures is:
A. Zenker fluid
B. Zamboni PAF
C. 10% neutral buffered formalin
D. Carnoy solution
C. 10% neutral buffered formalin
Formalin pigment may be removed from tissue by:
A. Running water
B. Alcoholic picric acid
C. Alcoholic iodine
D. Potassium permanganate
B. Alcoholic picric acid
Precipitate left in tissues that have been fixed in solutions containing mercuric chloride may be removed by immersion in:
A. Running water
B. Weak ammonia water
C. Sodium thiosulfate
D. Iodine
D. Iodine
Carnoy solution contains all of the following, EXCEPT:
A. Absolute alcohol
B. Chloroform
C. Glacial acetic acid
D. Cedarwood oil
D. Cedarwood oil
A small electrical fire occurs in the laboratory. The fire should be extinguished with:
A. Water
B. Soda acid
C. Carbon tetrachloride
D. Carbon dioxide
D. Carbon dioxide
Routine paraffin sections are cut at what micrometer (micron) setting?
A. 1 to 3 um
B. 4 to 6 um
C. 7 to 9 um
D. 10 to 15 um
B. 4 to 6 um
During the morning rush, your laboratory manager comes into the laboratory and starts explaining a new policy regarding vacation requests. Word spreads of the change throughout the day, and the message has changed somewhat. Several in the laboratory are upset and complain to the laboratory manager.
Which of the following actions is the most appropriate way to handle such a situation?
A. Nothing should be changed, it was handled appropriately
B. The manager should have posted the change on the bulletin board in the break room
C. The manager should have announced the policy on each shift
D. The manager should have discussed and distributed the policy at a laboratory meeting, or several laboratory meetings, so that all employees heard the policy from the manager
D. The manager should have discussed and distributed the policy at a laboratory meeting, or several laboratory meetings, so that all employees heard the policy from the manager
You are the lead chemistry MLS. Your laboratory manager has asked you to evaluate two new methods for cholesterol analysis.
In your evaluation, you found that method A was very accurate and precise and that method B was not very accurate and precise. However, the laboratory will make more money by investing in method B.
Which of the following decisions would exhibit professionalism?
A. Recommend method A to your laboratory manager. It is important that the laboratory produce the most accurate and precise results.
B. Recommend method B to your laboratory manager. It is important that the laboratory make as much money as possible.
C. State that you are unable to make a recommendation, because no difference in the methods was noted.
D. Recommend that you need more time to evaluate both methods.
A. Recommend method A to your laboratory manager. It is important that the laboratory produce the most accurate and precise results.
The four essential functions of a manager are:
A. Staffing, decision making, cost analysis, evaluating
B. Directing, leading, forecasting, implementing
C. Planning, organizing, directing, controlling
D. Innovating, designing, coordinating, problem-solving
C. Planning, organizing, directing, controlling
What is the most important role of the manager in charge?
A. Independent decision making
B. Communication
C. Informal discussions
D. None of the above
B. Communication
Introduced medical technology practice in the Philippines after World War II:
A. Dr. Pio de Roda
B. Dr. Mariano Icasiano
C. Dr. Prudencia Sta. Ana
D. 26th Medical Laboratory of the 6th US Army
D. 26th Medical Laboratory of the 6th US Army
First clinical laboratory in the Philippines:
A. San Lazaro Hospital
B. Manila Public Health Laboratory
C. Research Institute for Tropical Medicine
D. National Reference Laboratory
B. Manila Public Health Laboratory
When drawing a blood alcohol specimen, it is acceptable to clean the arm with:
A. Benzalkonium chloride
B. Isopropyl alcohol
C. Methanol prep.
D. Tincture of iodine
A. Benzalkonium chloride
A solution used to clean the site before routine venipuncture is:
A. 5.25% sodium hypochlorite.
B. 70% isopropyl alcohol.
C. 70% methanol.
D. Povidone–iodine.
B. 70% isopropyl alcohol.
Active hyperemia:
A. Nose bleeding
B. Gum bleeding
C. Blushing
D. Bruising
C. Blushing
RESPECT the decisions (self-determination) of adults who have decision-making capacity.
Moral rules or obligations:
- Tell the truth
- Respect the privacy of others
- Protect confidential information
- Obtain consent for interventions with patients
A. Autonomy
B. Beneficence
C. Non-maleficence
D. Justice
A. Autonomy
Aspects of this principle:
- Providing benefits
- Balancing benefits and risks/harms
This principle supports the following moral rules or obligations:
- Protect and defend the rights of others
- Prevent harm from occurring to others
- Remove conditions that will cause harm
- Help persons with disabilities
- Rescue persons in danger
A. Autonomy
B. Beneficence
C. Non-maleficence
D. Justice
B. Beneficence
This principle holds that there is an obligation not to inflict harm on others. It is closely associated with the maxim primum non nocere (first do no harm).
This principle supports the following rules:
- Do not kill
- Do not cause pain or suffering
- Do not incapacitate
- Do not cause offense
A. Autonomy
B. Beneficence
C. Non-maleficence
D. Justice
C. Non-maleficence
If the cell or tissue antigen of interest is detected by directly binding a labeled primary antibody specific for that antigen:
A. Direct immunohistochemistry
B. Indirect immunohistochemistry
C. Both of these
D. None of these
A. Direct immunohistochemistry
Uses an unlabeled primary antibody that is detected bound to its antigen with labeled secondary antibodies:
A. Direct immunohistochemistry
B. Indirect immunohistochemistry
C. Both of these
D. None of these
B. Indirect immunohistochemistry
A drug test is valid for _________.
A. Three months
B. Six months
C. One year
D. Two years
C. One year
According to RA 9165, a person who knowingly and willfully consents to the unlawful acts and uses his/her influence, power or position in shielding, harboring, screening or facilitating the escape of any person he/she knows, or has reasonable grounds to believe on or suspects:
A. Practitioner
B. Pusher
C. Protector/coddler
D. Donor
C. Protector/coddler
Methylenedioxymethamphetamine (MDMA) or commonly known as:
A. Cannabis
B. Shabu
C. Meth
D. Ecstasy
D. Ecstasy
Which of the following conducts Proficiency Workshops in HIV and Hepatitis Testing for all medical technologists?
A. LCP
B. NKTI
C. RITM
D. SACCL-SLH
D. SACCL-SLH
Which of the following conducts EQAS on infectious markers for transfusion transmissible diseases as an input to Quality Assurance of all BLOOD SERVICE FACILITIES (BSFs) performing donor blood testing?
A. LCP
B. NKTI
C. RITM
D. SACCL-SLH
C. RITM
Whenever the drug testing laboratory result is challenged, ____ shall make the final decision.
A. Crime laboratory of PNP
B. Crime laboratory of NBI
C. East Avenue Medical Center
D. San Lazaro Hospital
C. East Avenue Medical Center
Assignment of credit unit shall use the Matrix of CPD Activities as provided in Resolution No. 1032, series of 2017 as reference.
Generally, a maximum of ____ credit unit(s) per hour of activity may be given.
A. 0.5 c.u.
B. 1 c.u.
C. 2 c.u.
D. 3 c.u.
B. 1 c.u.
Primum non nocere comes from the Hippocratic Oath and means:
A. Do first things first.
B. First do no harm.
C. Quality is foremost.
D. Ready to serve.
B. First do no harm.
Establishing goals & objectives, formulating policies to carry out objectives.
A. Planning
B. Organizing
C. Directing
D. Controlling
A. Planning
Coordinating resources to achieve plans.
Defining working relationships, including line of authority & workflow.
A. Planning
B. Organizing
C. Directing
D. Controlling
B. Organizing
Communicating, motivating, delegating, & coaching. Creating a climate that meets the needs of individuals & the organization.
A. Planning
B. Organizing
C. Directing
D. Controlling
C. Directing
Defining standards of performance, developing a reporting system, & taking corrective action when necessary.
A. Planning
B. Organizing
C. Directing
D. Controlling
D. Controlling
Leadership:
A. Planning
B. Directing
C. Organizing
D. Controlling
B. Directing
Establish the objectives of the system and its processes, obtain the resources needed to deliver results in accordance with customers’ requirements, and identify and address risks and opportunities:
A. Plan
B. Do
C. Check
D. Act
A. Plan
Implement what was planned:
A. Plan
B. Do
C. Check
D. Act
B. Do
Monitor and, where applicable, measure processes and the resulting products and services against policies, objectives, requirements and planned activities and report the results:
A. Plan
B. Do
C. Check
D. Act
C. Check
Take actions to improve performance, as necessary.
A. Plan
B. Do
C. Check
D. Act
D. Act
PRC function:
Administers, implements, and enforce the laws and policies with respect to the regulation and licensing of the various professions and occupations, including the enhancement and maintenance of professional and occupational standards and ethics.
A. Quasi-Legislative
B. Quasi-Judicial
C. Executive
D. None of these
C. Executive
PRC function:
Investigates motu proprio or upon the filing of a verified complaint, any registered professional, any member of the professional regulatory boards, officers and employees under the jurisdiction of the Commission; Issues summons, subpoena and subpoena duces tecum; May hold in contempt erring party or person; May revoke or suspend certificates of registration and professional licenses.
A. Quasi-Legislative
B. Quasi-Judicial
C. Executive
D. None of these
B. Quasi-Judicial
PRC function:
Formulates rules and policies on professional regulation. Reviews, revises and approves resolutions embodying policies promulgated by the Professional Regulatory Boards.
A. Quasi-Legislative
B. Quasi-Judicial
C. Executive
D. None of these
A. Quasi-Legislative
Functions of PRC:
1. Executive
2. Quasi-legislative
3. Quasi-judicial
A. 1 and 2
B. 1 and 3
C. 2 and 3
D. 1, 2 and 3
D. 1, 2 and 3
Biodegradable wastes like leftover food, used cooking oil, fish entrails, scale, fins, fruits, vegetable peelings, rotten fruits, and vegetables:
A. Orange
B. Red
C. Green
D. Black
C. Green
Non-biodegradable wastes like paper or paper products (newspaper, tetra packs, etc.), bottles (glass and plastics), and packaging materials (Styropor, candy wrapper, aluminum cans):
A. Orange
B. Red
C. Green
D. Black
D. Black
Radioactive wastes or medical equipment contaminated or exposed in radioactivity:
A. Orange
B. Red
C. Green
D. Black
A. Orange
Pharmaceutical and chemical wastes:
A. Yellow
B. Yellow with black band
C. Red
D. Orange
B. Yellow with black band
Infectious and pathological wastes such as used test strips, used beads or plates, used reaction pads or foils, used swabs, used gloves, used cord clamp, used plaster, used masks:
A. Yellow
B. Yellow with black band
C. Red
D. Orange
A. Yellow
In the Hierarchy of Controls, which of the following is most effective in preventing exposures:
A. Personal protective equipment
B. Substitution of toxic substances
C. Hazard elimination
D. Engineering controls
C. Hazard elimination
Use of which of the following is a method of substitution of a work-related hazard:
A. Sharp containers
B. Non-latex gloves instead of latex gloves
C. Patient lift equipment
D. Hand sanitizers
B. Non-latex gloves instead of latex gloves
Autonomy is:
A. Providing informed consent
B. Conducting walk-throughs
C. Addressing workplace bullying and violence
D. Not singling out workers/groups for hazardous duties
A. Providing informed consent
In ENTERIC ISOLATION, the technologist is required to wear:
A. Gown and gloves
B. Gown, mask and gloves
C. Gown, mask, gloves and shoe coverings
D. Mask
A. Gown and gloves
Reverse isolation may be used for:
A. A patient with the measles
B. An adult patient with the flu
C. A patient with tuberculosis
D. A patient with severe burns
D. A patient with severe burns
The most important practice in preventing the spread of disease is:
A. Wearing masks during patient contact
B. Proper hand washing
C. Wearing disposable laboratory coats
D. Identifying specimens from known or suspected HIV and HBV-infected patients with a red label
B. Proper hand washing
Primum non nocere comes from the Hippocratic Oath and means:
A. Do first things first
B. First do no harm
C. Quality is foremost
D. Ready to serve
B. First do no harm
What is the proper order for putting on protective clothing?
A. Gloves first, then gown, mask last
B. Gown first, then gloves, mask last
C. Gown first, then mask, gloves last
d. Mask first, then gown, gloves last
C. Gown first, then mask, gloves last
What is the correct order for removing protective clothing?
A. Gloves, gown, mask
B. Gown, gloves, mask
C. Gown, mask, gloves
D. Mask, gown, gloves
A. Gloves, gown, mask
Which of the following is a disinfectant?
A. Benzalkonium chloride
B. Chlorhexidine gluconate
C. Household bleach
D. Hydrogen peroxide
C. Household bleach
Your patient is not wearing an ID band. You see that the ID band is taped to the nightstand. The information matches your requisition. What do you do?
A. Ask the patient to state her name; if it matches the requisition, continue.
B. Ask the patient’s nurse to attach an ID band and proceed when it is attached.
C. Go to the nurses’ station, get an ID bracelet, attach it, and then proceed.
D. Tell the nurse that you will not collect the specimen and return to the lab.
B. Ask the patient’s nurse to attach an ID band and proceed when it is attached.
Elastic cartilage, except:
a. External ear
b. Walls of Eustachian tubes
c. Epiglottis
d. Intervertebral discs
d. Intervertebral discs
Intervertebral discs - fibrocartilage
Involuntary:
1. Smooth muscle
2. Skeletal muscle
3. Cardiac muscle
a. 1 and 2
b. 2 and 3
c. 1 and 3
d. 1, 2, and 3
c. 1 and 3
Striated:
1. Smooth muscle
2. Skeletal muscle
3. Cardiac muscle
a. 1 and 2
b. 2 and 3
c. 1 and 3
d. 1, 2, and 3
b. 2 and 3
Increased ESR:
a. Sign
b. Symptom
a. Sign
Sign - w/ evidence
Symptoms - w/o evidence
Toothache:
a. Sign
b. Symptom
b. Symptom
Sign - w/ evidence
Symptoms - w/o evidence
Fever:
a. Sign
b. Symptom
a. Sign
Sign - w/ evidence
Symptoms - w/o evidence
Tinnitus:
a. Sign
b. Symptom
b. Symptom
Sign - w/ evidence
Symptoms - w/o evidence
(+) Covid 19 result:
a. Sign
b. Symptom
a. Sign
Sign - w/ evidence
Symptoms - w/o evidence
Ill-fitting dentures:
a. hyperplasia
b. hypertrophy
c. atrophy
d. aplasia
a. hyperplasia
Denture-induced hyperplasia is a reactive lesion arising from excessive and chronical mechanical pressure
Hypertension:
a. hyperplasia
b. hypertrophy
c. atrophy
d. aplasia
b. hypertrophy
a classical example of pathologic hypertrophy is enlargement of the heart in response to pressure overload, usually resulting from either hypertension or valvular disease.
Chronic smokers:
a. Metaplasia
b. Dysplasia
c. hyperplasia
d. Agenesia
a. Metaplasia
The Certificate of death that we use conforms to the International Form of Medical certificate recommended by the World Health Organization (WHO) with some modifications. This certificate which was revised in January 2007 has a change in color from blue of the January 1993 version to ____ of the current 2007 version.
a. yellow
b. pink
c. white
d. gray
c. white
How may copies of death certificates to be released
a. 2
b. 3
c. 4
d. 5
c. 4
Tissue processor, the tissue transfer type is a machine where specimen is transferred from container to be processed. The entire process take about:
a. 8 hrs
b. 12 hrs
c. 16 hrs
d. 32 hrs
c. 16 hrs
All processes are done in an automatic tissue processor, EXCEPT:
a. Fixation
b. Dehydration
c. Impregnation
d. Embedding
d. Embedding
The Autotechnicon is an automatic tissue processor. The last container through which the surgical tissue section pass through contains:
a. Formalin
b. Alcohol
c. Paraffin
d. Acetone
c. Paraffin
Initial grade of alcohol used in automatic tissue processing:
a. 60%
b. 70%
c. 80%
d. 95%
b. 70%
Primum non nocere comes from the Hippocratic Oath and means:
A. Do first things first
B. First do no harm
C. Quality is foremost
D. Ready to serve
B. First do no harm
What is the proper order for putting on protective clothing?
A. Gloves first, then gown, mask last
B. Gown first, then gloves, mask last
C. Gown first, then mask, gloves last
d. Mask first, then gown, gloves last
C. Gown first, then mask, gloves last
What is the correct order for removing protective clothing?
A. Gloves, gown, mask
B. Gown, gloves, mask
C. Gown, mask, gloves
D. Mask, gown, gloves
A. Gloves, gown, mask
What is the ideal osmolality of a fixative?
a. Slightly hypertonic
b. Slightly hypotonic
c. Isotonic
d. Hypertonic
a. Slightly hypertonic
What is the ideal osmolality of a fixative?
a. hypertonic
b. hypotonic
c. isotonic
c. isotonic
The usual 10% formalin used in fixation of tissues is a 10% solution of formalin, containing about ___ weight to volume of formaldehyde.
a. 2%
b. 4%
c. 6%
d. 8%
b. 4%
All of the following uses aluminum as mordant except:
a. Ehrlich’s
b. Harris
c. Weigert’s
d. Gill
c. Weigert’s
All of the following are natural dyes, except:
a. Saffron
b. Hematoxylin
c. Carmine
d. Aniline
d. Aniline
PAS and tissue chemical bonds:
a. Van der waal forces
b. Ionic bond
c. Covalent bond
d. Coulumbic bond
d. Coulumbic bond
Which of the following is not a basic component of a QA program?
A. Calibration
B. Preventive maintenance
C. Viral marker testing
D. Record keeping
C. Viral marker testing
What is the purpose of competency assessment?
A. Identify employees in need of retraining
B. Evaluate an individual’s level of knowledge during a job interview
C. Identify employees who need to be fired
D. All of the above
A. Identify employees in need of retraining
All blood banks as mandated by law must have a:
A. Water fountain
B. Written laboratory safety program
C. BSC
D. Foot-operated hand wash
B. Written laboratory safety program
One of the best ways to protect employees and keep a safe laboratory environment is to provide employees with:
A. Health insurance
B. Safety education
C. Rest breaks
D. Fluid-repellent laboratory coats
B. Safety education
Components of an information system consist of all of the following except:
A. Hardware
B. Software
C. Validation
D. People
C. Validation
User passwords should be:
A. Shared with others
B. Kept confidential
C. Posted at each terminal
D. Never change
B. Kept confidential
The OSHA hazard communication standard, the “RIGHT-TO-KNOW” rule, is designed:
A. To avoid lawsuits
B. To protect laboratory staff
C. To protect patients
D. To establish safety standards
B. To protect laboratory staff
Routine paraffin sections are cut at what micrometer (micron) setting?
A. 1 to 3 um
B. 4 to 6 um
C. 7 to 9 um
D. 10 to 15 um
B. 4 to 6 um
The process of working with people and resources to accomplish organizational goals:
A. Authority
B. Supervision
C. Management
D. Leadership
C. Management
In an institution, a comprehensive program in which all areas of operation are monitored to ensure quality with the aim of providing the highest quality patient care:
A. Quality assessment
B. Quality assurance
C. Quality control
D. Quality systems
D. Quality systems
A system that verifies the reliability of analytical test results through the use of standards, controls, and statistical analysis
A. Quality assessment
B. Quality assurance
C. Quality control
D. Quality systems
C. Quality control
In the laboratory, a program that monitors the total testing process with the aim of providing the highest quality patient care:
A. Quality assessment
B. Quality control
C. Quality systems
D. All of these
A. Quality assessment
