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100+ Free ASCP PA Practice Questions

Pass your ASCP Pathologists' Assistant (PA) exam on the first try — instant access, no signup required.

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Key Facts: ASCP PA Exam

100

Exam Questions

ASCP PA exam page

2.5 hrs

Exam Time

ASCP PA exam page

400

Minimum Passing Score

ASCP examination procedures

$240

Application Fee

ASCP BOC

~85%

First-Time Pass Rate

ASCP BOC data

30-35%

Surgical Pathology Weight

ASCP PA content guideline

The ASCP PA examination tests pathologists' assistants on surgical pathology (specimen accessioning, fixation, frozen sections), organ-specific grossing protocols (margin assessment, lymph node dissection), autopsy procedures (evisceration methods, organ examination), laboratory management (SOPs, turnaround times), and quality/safety (OSHA compliance, chemical safety). The exam uses CAT format with 100 questions in 2.5 hours.

Sample ASCP PA Practice Questions

Try these sample questions to test your ASCP PA exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1What is the first step a pathologists' assistant should perform when receiving a surgical specimen in the gross room?
A.Begin dissecting the specimen immediately
B.Verify patient identification and compare with the requisition form
C.Place the specimen in formalin
D.Photograph the specimen
Explanation: Patient identification verification is always the first step in specimen accessioning. The pathologists' assistant must confirm that the patient name, medical record number, and specimen site on the container label match the requisition form. This prevents specimen mix-ups, which are among the most serious errors in surgical pathology.
2What is the standard fixative used for routine surgical pathology specimens?
A.Bouin fixative
B.10% neutral buffered formalin
C.Glutaraldehyde
D.95% ethanol
Explanation: 10% neutral buffered formalin (NBF) is the standard fixative in surgical pathology. It preserves tissue architecture, is compatible with H&E staining and immunohistochemistry, and prevents autolysis. The recommended tissue-to-fixative ratio is 1:10, and adequate fixation requires 6-72 hours depending on tissue size. NBF contains approximately 3.7% formaldehyde.
3When grossing a radical mastectomy specimen, which anatomic landmark should be inked first for orientation?
A.The nipple
B.The surgical margins (anterior, posterior, superior, inferior, medial, lateral)
C.The tumor center
D.The axillary tail
Explanation: Inking the surgical margins is the critical first step in orienting a mastectomy specimen. Different colored inks are applied to each margin (anterior, posterior, superior, inferior, medial, lateral) to allow microscopic assessment of margin distance from the tumor. The surgeon typically marks the specimen with sutures or clips to indicate orientation.
4What is the recommended fixation time for breast tissue before performing HER2 immunohistochemistry according to ASCO/CAP guidelines?
A.Less than 1 hour
B.6-72 hours in 10% neutral buffered formalin
C.More than 96 hours
D.No fixation required
Explanation: ASCO/CAP guidelines specify a cold ischemia time of less than 1 hour and a fixation time of 6-72 hours in 10% neutral buffered formalin for breast specimens requiring HER2 and ER/PR testing. Under-fixation can cause false-negative results, while over-fixation can mask epitopes. These pre-analytical factors significantly impact biomarker testing accuracy.
5During a routine autopsy, what is the correct order for removing thoracic and abdominal organs using the Rokitansky method?
A.Each organ is removed individually in anatomic order
B.All organs are removed en bloc as a single mass and then dissected on the table
C.Only diseased organs are removed
D.Thoracic organs are removed first, then abdominal organs are removed separately
Explanation: The Rokitansky method involves en bloc removal of all thoracoabdominal organs as a single evisceration, preserving anatomic relationships. The organ block is then dissected on the cutting table. This contrasts with the Virchow method (individual organ removal) and Ghon method (organ blocks by system). The Rokitansky method is efficient and preserves vascular connections.
6What is the primary purpose of frozen section examination during surgery?
A.To provide a permanent histologic diagnosis
B.To provide a rapid intraoperative diagnosis that guides surgical management
C.To replace the need for routine processing
D.To evaluate specimen fixation quality
Explanation: Frozen section provides a rapid intraoperative diagnosis (usually within 15-20 minutes) that guides surgical decisions such as extent of resection, margin status, or need for lymph node dissection. The tissue is frozen in OCT compound using a cryostat, sectioned, and stained with H&E. Frozen section is a preliminary diagnosis; permanent sections provide the definitive result.
7When grossing a colectomy specimen for colon cancer, what is the minimum number of lymph nodes that should be examined according to CAP/AJCC guidelines?
A.6 lymph nodes
B.12 lymph nodes
C.20 lymph nodes
D.30 lymph nodes
Explanation: CAP and AJCC guidelines recommend examining a minimum of 12 lymph nodes in a colectomy specimen for adequate staging of colorectal carcinoma. Examination of fewer than 12 nodes may result in understaging. If the initial dissection yields fewer than 12 nodes, additional fat clearing techniques or re-examination of the mesentery should be performed.
8What personal protective equipment (PPE) is required when performing an autopsy?
A.Gloves only
B.Scrubs, gown, double gloves, face shield, shoe covers, and N95 or PAPR respirator
C.Lab coat and gloves
D.Surgical mask and single gloves
Explanation: Full PPE for autopsy includes scrubs, fluid-resistant gown or apron, double gloves (with cut-resistant inner glove recommended), face shield or goggles, shoe covers or boots, and respiratory protection (N95 respirator or PAPR). This protects against bloodborne pathogens, airborne agents (M. tuberculosis), and formalin exposure. Enhanced precautions may be needed for known infectious cases.
9What is the purpose of inking surgical margins during gross examination?
A.To improve tissue fixation
B.To identify margin surfaces microscopically and assess the distance of tumor from the margin
C.To prevent tissue shrinkage
D.To mark areas for frozen section
Explanation: Inking surgical margins allows the pathologist to identify the true surgical margin under the microscope and measure the distance between tumor and margin. Multiple colors are used to distinguish different margins (e.g., blue for anterior, black for posterior). Positive margins (tumor at the inked surface) often require re-excision or additional treatment.
10Which tissue processing step replaces water in the tissue with paraffin-miscible clearing agent?
A.Fixation
B.Dehydration
C.Clearing
D.Embedding
Explanation: Clearing is the tissue processing step that replaces the dehydrating agent (alcohol) with a paraffin-miscible substance, typically xylene. The tissue becomes translucent (hence 'clearing'). The sequence is: fixation, dehydration (graded alcohols), clearing (xylene), and infiltration/embedding (paraffin wax). Improper clearing causes poor infiltration and sectioning artifacts.

About the ASCP PA Exam

The ASCP PA exam certifies pathologists' assistants in gross examination, surgical pathology, autopsy procedures, grossing techniques, laboratory management, and safety. Passing earns the PA(ASCP) credential.

Questions

100 scored questions

Time Limit

2 hours 30 minutes

Passing Score

Scaled score 400 (100-999)

Exam Fee

$240 (ASCP BOC / Pearson VUE)

ASCP PA Exam Content Outline

30-35%

Surgical Pathology

Specimen accessioning, tissue fixation, frozen sections, processing, biomarker requirements, and tissue triage

25-30%

Grossing Techniques

Specimen orientation, inking, margin assessment, lymph node dissection, and organ-specific grossing protocols

20-25%

Autopsy Procedures

Evisceration methods, organ examination, brain and spinal cord examination, cause of death determination

10-15%

Laboratory Management

SOPs, turnaround times, synoptic reporting, specimen retention, process improvement, biobanking

5-10%

Quality and Safety

OSHA compliance, PPE, formaldehyde safety, infection control, specimen identification, waste disposal

How to Pass the ASCP PA Exam

What You Need to Know

  • Passing score: Scaled score 400 (100-999)
  • Exam length: 100 questions
  • Time limit: 2 hours 30 minutes
  • Exam fee: $240

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

ASCP PA Study Tips from Top Performers

1Master organ-specific grossing protocols — know required sections and margins for each specimen type
2Study AJCC/CAP staging requirements and minimum lymph node counts for common cancers
3Review all autopsy evisceration methods (Virchow, Rokitansky, Letulle, Ghon) and their differences
4Know OSHA formaldehyde exposure limits (0.75 ppm TWA, 2 ppm STEL) and required safety measures
5Practice tissue fixation timing requirements, especially ASCO/CAP guidelines for breast specimens
6Use our AI tutor to work through grossing protocol questions you find challenging

Frequently Asked Questions

How many questions are on the ASCP PA exam?

The ASCP PA exam contains 100 multiple-choice questions delivered in computer adaptive testing (CAT) format with a 2 hour 30 minute time limit.

What score do I need to pass the ASCP PA exam?

ASCP reports scores on a 100-999 scale, and 400 is the minimum passing score for the PA certification exam.

What is the ASCP PA exam fee?

The ASCP PA application fee is $240. This fee is non-refundable and covers one examination attempt.

What topics are covered on the PA exam?

The PA exam covers surgical pathology (fixation, frozen section, processing), grossing techniques (inking, margins, lymph nodes), autopsy procedures (evisceration, organ examination), laboratory management, and quality/safety (OSHA, PPE).

How should I prepare for the ASCP PA exam?

Focus on organ-specific grossing protocols and surgical pathology fundamentals (largest domains), master margin assessment and lymph node dissection guidelines, review autopsy evisceration methods, and study OSHA formaldehyde regulations.

What career does ASCP PA certification lead to?

The PA(ASCP) credential qualifies you to work as a pathologists' assistant performing gross examination of surgical specimens, assisting with autopsies, preparing frozen sections, and managing gross room operations.