MLS 214 – Fixation in Histopathology Practice
Exam (50 MCQs)
Section A: Basics of Fixation (1–10)
1. The main purpose of fixation is: a) Enhance staining b) Preserve tissue morphology c) Increase
tissue size d) Remove proteins
2. Which process does fixation prevent? a) Autolysis and putrefaction b) Protein synthesis c)
Antigen retrieval d) Lipid oxidation
3. An ideal fixative should: a) Be toxic and expensive b) Prevent autolysis, preserve tissue, maintain
morphology c) Only work on proteins d) Shrink tissues excessively
4. Fixatives act mainly by: a) Dissolving lipids b) Cross-linking proteins c) Destroying nucleic acids
d) Breaking membranes
5. The first step in histopathology after tissue removal is: a) Embedding b) Fixation c) Staining d)
Sectioning
6. Which factor does NOT affect fixation? a) Temperature b) pH c) Time d) Blood type
7. Optimal pH range for fixation is: a) 2–4 b) 6–8 c) 9–11 d) Neutral only
8. What is the ideal tissue thickness for fixation? a) 1–2 mm b) 3–5 mm c) 10 mm d) 20 mm
9. The recommended fixative to tissue volume ratio is: a) 1:1 b) 5:1 c) 10:1 d) 20:1
10. Fixation artifacts include: a) Hyperchromatic nuclei b) Tissue hardening c) Shrinkage d) All of
the above
Section B: Formalin and Common Fixatives (11–20)
11. Commercial formalin is: a) 10% b) 20% c) 40% d) 100%
12. 10% Neutral Buffered Formalin is prepared from: a) 10% stock solution b) 40% stock solution c)
20% stock solution d) 5% stock solution
13. The penetration rate of formalin is: a) 0.1 mm/h b) 1 mm/h c) 10 mm/h d) Instantaneous
14. Formalin fixation requires at least: a) Equal tissue volume b) 2× tissue volume c) 10–20× tissue
volume d) 50× tissue volume
15. Formalin acts by: a) Dissolving fats b) Forming methylene bridges c) Breaking DNA d)
Removing glycogen
16. A disadvantage of formalin is: a) Slow fixation b) Poor lipid/enzyme preservation c) May form
pigments d) All of the above
17. Which fixative is best for electron microscopy of proteins? a) Formalin b) Glutaraldehyde c)
Osmium tetroxide d) Acetone
18. Which fixative preserves lipids best? a) Formalin b) Osmium tetroxide c) Glutaraldehyde d)
Acetone
19. Osmium tetroxide mainly reacts with: a) Proteins b) Unsaturated lipids c) DNA d) Collagen
20. A toxic and volatile fixative that blackens tissues is: a) Osmium tetroxide b) Bouin’s solution c)
Acetone d) Zenker’s
Section C: Special Fixatives (21–30)
21. Bouin’s solution contains: a) Formaldehyde, picric acid, acetic acid b) Alcohol, acetic acid, water
c) Osmium, acetic acid, ethanol d) Glutaraldehyde, formalin
22. Bouin’s solution is excellent for preserving: a) Lipids b) Glycogen and connective tissue c)
Enzymes d) Nucleic acids
23. A disadvantage of Bouin’s solution is: a) Yellow pigmentation b) Rapid fixation c) Too cheap d)
DNA damage
24. The yellow pigment from Bouin’s can be removed by: a) Water b) Ethanol + lithium carbonate c)
Acetone d) Xylene
25. Alcohol fixatives act by: a) Cross-linking proteins b) Dehydration c) Lipid preservation d)
Enzyme inhibition
26. Alcohol-based fixatives are mainly used in: a) Cytology and frozen sections b) Electron
microscopy c) Lipid preservation d) Collagen studies
27. A major disadvantage of alcohol fixatives: a) Tissue shrinkage and lipid loss b) Preserves
enzymes c) Forms pigments d) Too slow
28. Glutaraldehyde penetrates: a) <0.5 mm b) 2 mm c) 5 mm d) 10 mm
29. Which fixatives contain mercury? a) Bouin’s b) Zenker’s and B-5 c) Acetone d) Osmium
30. Mercury-based fixatives are avoided today because: a) Poor nuclear detail b) Too costly c)
Toxicity d) Weak fixation
Section D: Physical Fixatives & Methods (31–40)
31. Cryofixation is used to preserve: a) Lipids b) Enzymes and ultrastructure c) Pigments d)
Collagen
32. Microwave fixation works by: a) Cooling b) Rapid uniform heating c) Oxidation d) Freezing
33. Microwave fixation advantage: a) Preserves antigens b) Slow c) Causes pigments d) Only for
lipids
34. Perfusion fixation involves: a) Spraying fixative b) Fixative through blood vessels c) Freezing
tissue d) Vapor fixation
35. Immersion fixation means: a) Dipping tissue in fixative b) Freezing tissue c) Injecting fixative d)
Using vapors
36. Vapour fixation is usually performed with: a) Acetone b) Osmium tetroxide/formaldehyde vapors
c) Water d) Bouin’s
37. Coating fixation is commonly used in: a) Tissue blocks b) Cytology smears c) Electron
microscopy d) Fibrosis studies
38. Freeze-drying preserves: a) Enzymes and glycogen b) Lipids c) Pigments d) Collagen
39. Which method is fastest? a) Microwave fixation b) Formalin fixation c) Immersion fixation d)
Perfusion fixation
40. A major limitation of cryofixation is: a) Preserves enzymes b) Requires expensive equipment c)
Very slow d) Causes pigments
Section E: Applied/Clinical (41–50)
41. Which fixative is preferred for routine surgical pathology? a) Osmium tetroxide b) Formalin c)
Acetone d) Glutaraldehyde
42. For electron microscopy of membranes, the best fixative is: a) Bouin’s b) Glutaraldehyde +
Osmium tetroxide c) Alcohol d) Acetone
43. Which factor slows fixation but preserves enzymes? a) High pH b) Cold temperature c) High
temperature d) Strong acid
44. Fixation of large tissue requires: a) Thick blocks b) Thin slices 3–5 mm c) Leaving whole organ
d) No slicing
45. Tissue swelling occurs in: a) Hypotonic fixative b) Hypertonic fixative c) Neutral fixative d)
Strong formalin
46. Tissue shrinkage occurs in: a) Hypotonic fixative b) Hypertonic fixative c) Neutral fixative d)
Acetone only
47. Which is NOT a fixation method? a) Immersion b) Perfusion c) Embedding d) Vapour
48. The main hazard of osmium tetroxide is: a) Carcinogenic gas, eye toxicity b) Too cheap c)
Yellow staining d) Weak fixation
49. Formalin pigment can be removed by: a) Alcohol b) Saturated alcoholic picric acid c) Xylene d)
Bouin’s
50. Fixatives must be labeled properly because: a) They are toxic chemicals b) To avoid mix-ups
and ensure safety c) They may evaporate d) Both a and b
