In the SurePath liquid-based method, cells are separated from blood and debris by:

Density gradient centrifugation

Clotting the sediment with thrombin

Cytocentrifugation onto a filter card

Filtration through a polycarbonate membrane

A 58-year-old bidi smoker with haemoptysis sends three sputum samples for cytology. Each Pap-stained smear shows many superficial squamous cells, oral bacteria and food particles, but no alveolar macrophages. What should be reported?

Unsatisfactory: ask for deep-cough morning samples

Negative; repeat only if haemoptysis persists

Satisfactory, with oral contamination noted

Negative for malignancy in all three samples

In human female somatic cells, inactivation of one X chromosome (lyonisation) occurs:

Randomly, in early embryonic life

Afresh at each adult cell division

Always on the paternally derived X

Voided urine for cytology will reach the laboratory only after several hours. A common way to preserve it is to add:

An equal volume of 10% formalin

A few drops of glacial acetic acid

Why is a sputum sample collected in Saccomanno fluid homogenised in a blender before smears are made?

To free cells from mucus and spread them evenly

To kill mycobacteria before the smear is made

To lyse red cells and remove inflammatory cells

To dissolve the carbowax that coats the cells

Non-gynaecological cytology, FNAC and techniques

47 Kerala MSc MLT Entrance practice questions on Non-gynaecological cytology, FNAC and techniques, part of Pathology. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
In the SurePath liquid-based method, cells are separated from blood and debris by:
1. AClotting the sediment with thrombin
2. BDensity gradient centrifugation
3. CCytocentrifugation onto a filter card
4. DFiltration through a polycarbonate membrane
Show answerHide answer
Answer: B · Density gradient centrifugation
SurePath collects cells in an ethanol-based preservative. In the laboratory the sample is layered on a density reagent and centrifuged, so much of the blood, inflammatory debris and mucus is removed, and the cell-rich pellet then settles by gravity onto a slide in a settling chamber. ThinPrep, by contrast, collects cells on a polycarbonate filter under vacuum and transfers them to the slide. Both give a thin layer with less obscuring material than a conventional smear.
- A: Clotting a sediment with thrombin is a way to make a cell block.
- C: A cytocentrifuge spins cells onto a slide; it is not part of SurePath.
- D: Collecting cells on a polycarbonate membrane is the ThinPrep method.
Question 2 · Hard
A 58-year-old bidi smoker with haemoptysis sends three sputum samples for cytology. Each Pap-stained smear shows many superficial squamous cells, oral bacteria and food particles, but no alveolar macrophages. What should be reported?
1. AUnsatisfactory: ask for deep-cough morning samples
2. BNegative; repeat only if haemoptysis persists
3. CSatisfactory, with oral contamination noted
4. DNegative for malignancy in all three samples
Show answerHide answer
Answer: A · Unsatisfactory: ask for deep-cough morning samples
Alveolar macrophages, often containing carbon (dust cells), prove that a sputum sample came from the lower respiratory tract. Smears with only squamous cells, oral bacteria and food are saliva, so they cannot be called negative, however many are sent. The patient should give a deep-cough sample on waking on three consecutive days; if he cannot, sputum can be induced with nebulised hypertonic saline. Reporting saliva as negative gives false reassurance in a smoker with haemoptysis.
- B: A negative report on saliva falsely reassures a high-risk patient.
- C: A sample with no lower-airway cells is unsatisfactory, not satisfactory with a limitation.
- D: Without macrophages the sample is saliva, so a negative report is not valid.
Question 3 · Easy
In human female somatic cells, inactivation of one X chromosome (lyonisation) occurs:
1. AAfresh at each adult cell division
2. BAlways on the paternally derived X
3. COnly in germ cells, at puberty
4. DRandomly, in early embryonic life
Show answerHide answer
Answer: D · Randomly, in early embryonic life
Early in embryonic life, at about the late blastocyst stage, each cell inactivates one of its two X chromosomes at random, either the maternal or the paternal one. The choice is then inherited by all daughter cells, so a woman is a mosaic of two cell populations. The inactive X condenses into the Barr body, which lies against the nuclear membrane. This mosaicism explains why female carriers of X-linked disorders such as G6PD deficiency show variable expression.
- A: Once made, the choice is fixed and passed on to every daughter cell.
- B: Inactivation is random in humans; the paternal X is not singled out.
- C: Inactivation happens in somatic cells in the embryo; germ cells reactivate the X.
Question 4 · Medium
Voided urine for cytology will reach the laboratory only after several hours. A common way to preserve it is to add:
1. AAn equal volume of 10% formalin
2. BAn equal volume of 50% ethanol
3. CA few drops of glacial acetic acid
4. DHeparin, 3 units per mL
Show answerHide answer
Answer: B · An equal volume of 50% ethanol
Urothelial cells degenerate quickly in urine. If processing must wait, the urine is refrigerated or mixed with an equal volume of 50% ethanol as a prefixative, which slows degeneration and keeps the cells suitable for the Pap stain. Formalin hardens cells, makes them adhere poorly to slides and spoils Pap staining. The best sample is still a fresh voided urine (not the first morning sample) processed promptly.
- A: Formalin cross-links the cells, so they stick poorly and stain badly with the Pap method.
- C: Acetic acid lyses red cells and swells nuclei; it is not a preservative.
- D: Heparin stops bloody fluids from clotting but does not preserve cells.
Question 5 · Medium
Why is a sputum sample collected in Saccomanno fluid homogenised in a blender before smears are made?
1. ATo kill mycobacteria before the smear is made
2. BTo free cells from mucus and spread them evenly
3. CTo lyse red cells and remove inflammatory cells
4. DTo dissolve the carbowax that coats the cells
Show answerHide answer
Answer: B · To free cells from mucus and spread them evenly
Saccomanno fluid (50% ethanol with 2% carbowax) fixes sputum as it is collected, and the carbowax protects the cells from drying. Blending breaks up the mucus strands, releasing the cells and distributing them evenly. After centrifugation, smears from the concentrate represent the whole specimen, not only the few strands picked for a direct smear, which raises the yield of malignant cells. Blending is done in a biological safety cabinet.
- A: Blending mixes the sample; it does not kill mycobacteria, hence the safety cabinet.
- C: Blending does not lyse red cells or remove inflammatory cells.
- D: Carbowax is removed later in 95% alcohol, not by blending.
Question 6 · Easy
For rapid on-site assessment of FNAC adequacy, air-dried smears are commonly stained with a Romanowsky-type method such as:
1. ADiff-Quik
2. BHematoxylin and eosin
3. CShorr stain
4. DPapanicolaou
Answer and explanation in LearnFree account
Question 7 · Hard
A 550 mL deeply blood-stained pleural fluid from a 66-year-old man with a lung mass arrives with a large clot in the container. After centrifugation, the deposit shows a thick red cell layer under a thin grey-white layer. Which processing plan gives the best chance of finding malignant cells?
1. ASmear the deepest red cell layer and discard the clot
2. BSmear the buffy coat and make a cell block of the clot
3. CFilter the clear supernatant and discard the clot
4. DBreak up the clot and smear the whole deposit
Answer and explanation in LearnFree account
Question 8 · Medium
Compared with voided urine, a bladder washing (barbotage) for cytology:
1. AIs free of instrumentation artefact
2. BAlso samples the upper tract: ureters and pelvis
3. CGives more, better-preserved urothelial cells
4. DIs best collected as a first-morning sample
Answer and explanation in LearnFree account
Question 9 · Easy
The Y chromosome can be seen in interphase nuclei as a bright fluorescent spot (F body) after staining with:
1. ACresyl violet
2. BAuramine O
3. CAcridine orange
4. DQuinacrine
Answer and explanation in LearnFree account
Question 10 · Medium
Before a CSF with very low protein is cytocentrifuged, a drop of bovine albumin is often added to the sample chamber. Why?
1. ATo stop the CSF from forming a fibrin clot
2. BTo fix the cells before staining
3. CTo lyse contaminating red cells
4. DTo help cells stick and keep their shape
Answer and explanation in LearnFree account
Question 11 · Easy
In a peripheral blood film from a woman, the inactive X chromosome may be seen as a:
1. AAzurophil granule in a lymphocyte
2. BDrumstick on a neutrophil nucleus
3. CDöhle body in a neutrophil
4. DHowell-Jolly body in a red cell
Answer and explanation in LearnFree account
Question 12 · Hard
A 17-year-old girl with primary amenorrhoea has normal breasts, scanty pubic hair and a short, blind vagina. Her buccal smear shows no Barr body in 200 cells, and quinacrine-stained cells show a single bright F body. Which karyotype best fits these findings?
1. A46,XX with Müllerian agenesis
2. B46,XY with androgen insensitivity
3. C47,XXY with Klinefelter syndrome
4. D45,X with Turner syndrome
Answer and explanation in LearnFree account
Question 13 · Hard
Smears from a lymph node FNAC were all labelled first and placed in 95% ethanol about 2 minutes after spreading. The Pap-stained smears show enlarged, pale nuclei with smudged chromatin, and cytoplasm that stains orange-red instead of blue-green. What is the most likely cause?
1. AToo much suction during the aspiration
2. BExhausted hematoxylin in the staining line
3. CLeaving the smears in ethanol too long
4. DAir-drying before the smears were fixed
Answer and explanation in LearnFree account
Question 14 · Medium
Carnoy's fluid is chosen to fix smears from a heavily blood-stained effusion mainly because it:
1. APrevents the effusion from clotting in the tube
2. BDissolves mucus that traps the cells
3. CLyses red cells while fixing nucleated cells
4. DStains the nuclei of tumour cells blue
Answer and explanation in LearnFree account
Question 15 · Medium
Golden-brown beaded rods with knobbed ends are seen in the sputum of a former asbestos mill worker. Their coating stains positively with:
1. AZiehl-Neelsen stain
2. BMucicarmine
3. CPerls Prussian blue
4. DCongo red
Answer and explanation in LearnFree account
Question 16 · Medium
A lymphocyte-rich exudate with very few mesothelial cells (under 1%) in pleural fluid most strongly suggests:
1. ACirrhosis with hepatic hydrothorax
2. BTuberculous pleuritis
3. CCongestive cardiac failure
4. DPulmonary infarction
Answer and explanation in LearnFree account
Question 17 · Medium
In the ThinPrep liquid-based method, a thin layer of cells is produced by:
1. ASmearing the deposit between two slides and fixing at once
2. BCytocentrifuging the cells onto a slide through a filter card
3. CSpinning the sample through a density gradient to remove debris
4. DFiltering cells by vacuum, then pressing the filter on a slide
Answer and explanation in LearnFree account
Question 18 · Medium
In a female blood film, which nuclear appendage is counted as a drumstick (sex chromatin)?
1. AA hollow head that looks like a tennis racket
2. BA knob on the nucleus of a small lymphocyte
3. CA solid round head about 1.5 µm on a thin stalk
4. DA fragment free in the cytoplasm away from the lobes
Answer and explanation in LearnFree account
Question 19 · Medium
A methanol-based haemolytic preservative such as CytoLyt is used for bloody or mucoid non-gynaecological samples because it:
1. AStains nuclei blue for immediate screening
2. BClots the sample into a firm button for blocking
3. CLyses red cells and dissolves mucus while fixing
4. DKeeps cells alive for later culture
Answer and explanation in LearnFree account
Question 20 · Hard
A 15-year-old short girl with delayed puberty has a buccal smear: 200 well-preserved intermediate cells counted, Barr body in 12. The laboratory's ranges: normal female 20-40% of cells, normal male under 2%. Which karyotype fits best?
1. A46,XY with androgen insensitivity
2. B45,X/46,XX mosaicism
3. C47,XXX (triple X)
4. D46,XX, a normal female
Answer and explanation in LearnFree account
Question 21 · Easy
Membrane filters used to collect cells from urine or other body fluids for cytology usually have a pore size of about:
1. A0.22 µm
2. B5 µm
3. C50 µm
4. D0.45 µm
Answer and explanation in LearnFree account
Question 22 · Medium
In The Paris System for urine cytology, a key criterion for high-grade urothelial carcinoma is a nuclear-to-cytoplasmic ratio of at least:
1. A0.7
2. B0.9
3. C0.5
4. D0.3
Answer and explanation in LearnFree account
Question 23 · Easy
In the plasma-thrombin method of making a cell block, the cell button is held together by:
1. AA gelatin film
2. BMolten paraffin wax
3. CA fibrin clot
4. DAn agar gel
Answer and explanation in LearnFree account
Question 24 · Hard
A 66-year-old retired shipyard worker has a large pleural effusion and pleural thickening. The cell block shows atypical cells in papillary clusters. Immunostains: calretinin positive, WT1 positive, D2-40 positive, Ber-EP4 negative, MOC-31 negative, TTF-1 negative; BAP1 nuclear staining is lost in the atypical cells. What is the most likely diagnosis?
1. AMetastatic serous ovarian carcinoma
2. BMalignant mesothelioma
3. CReactive mesothelial hyperplasia
4. DMetastatic lung adenocarcinoma
Answer and explanation in LearnFree account
Question 25 · Medium
A bronchoalveolar lavage from a patient with HIV shows foamy, honeycomb-like alveolar casts on Pap stain. Which stain best shows the organism?
1. APerls Prussian blue
2. BZiehl-Neelsen stain
3. CGrocott methenamine silver
4. DMucicarmine stain
Answer and explanation in LearnFree account

22 more Non-gynaecological cytology, FNAC and techniques questions

Answer them one by one, keep your score and see your weak topics in Learn. Signed-out visitors try 25 per exam; sign in with Google to see them all.

Study Pathology

Non-gynaecological cytology, FNAC and techniques

In the SurePath liquid-based method, cells are separated from blood and debris by:

A 58-year-old bidi smoker with haemoptysis sends three sputum samples for cytology. Each Pap-stained smear shows many superficial squamous cells, oral bacteria and food particles, but no alveolar macrophages. What should be reported?

In human female somatic cells, inactivation of one X chromosome (lyonisation) occurs:

Voided urine for cytology will reach the laboratory only after several hours. A common way to preserve it is to add:

Why is a sputum sample collected in Saccomanno fluid homogenised in a blender before smears are made?

For rapid on-site assessment of FNAC adequacy, air-dried smears are commonly stained with a Romanowsky-type method such as:

A 550 mL deeply blood-stained pleural fluid from a 66-year-old man with a lung mass arrives with a large clot in the container. After centrifugation, the deposit shows a thick red cell layer under a thin grey-white layer. Which processing plan gives the best chance of finding malignant cells?

Compared with voided urine, a bladder washing (barbotage) for cytology:

The Y chromosome can be seen in interphase nuclei as a bright fluorescent spot (F body) after staining with:

Before a CSF with very low protein is cytocentrifuged, a drop of bovine albumin is often added to the sample chamber. Why?

In a peripheral blood film from a woman, the inactive X chromosome may be seen as a:

A 17-year-old girl with primary amenorrhoea has normal breasts, scanty pubic hair and a short, blind vagina. Her buccal smear shows no Barr body in 200 cells, and quinacrine-stained cells show a single bright F body. Which karyotype best fits these findings?

Smears from a lymph node FNAC were all labelled first and placed in 95% ethanol about 2 minutes after spreading. The Pap-stained smears show enlarged, pale nuclei with smudged chromatin, and cytoplasm that stains orange-red instead of blue-green. What is the most likely cause?

Carnoy's fluid is chosen to fix smears from a heavily blood-stained effusion mainly because it:

Golden-brown beaded rods with knobbed ends are seen in the sputum of a former asbestos mill worker. Their coating stains positively with:

A lymphocyte-rich exudate with very few mesothelial cells (under 1%) in pleural fluid most strongly suggests:

In the ThinPrep liquid-based method, a thin layer of cells is produced by:

In a female blood film, which nuclear appendage is counted as a drumstick (sex chromatin)?

A methanol-based haemolytic preservative such as CytoLyt is used for bloody or mucoid non-gynaecological samples because it:

A 15-year-old short girl with delayed puberty has a buccal smear: 200 well-preserved intermediate cells counted, Barr body in 12. The laboratory's ranges: normal female 20-40% of cells, normal male under 2%. Which karyotype fits best?

Membrane filters used to collect cells from urine or other body fluids for cytology usually have a pore size of about:

In The Paris System for urine cytology, a key criterion for high-grade urothelial carcinoma is a nuclear-to-cytoplasmic ratio of at least:

In the plasma-thrombin method of making a cell block, the cell button is held together by:

A bronchoalveolar lavage from a patient with HIV shows foamy, honeycomb-like alveolar casts on Pap stain. Which stain best shows the organism?