Hematoxylin and Eosin Stain (H and E stain or H&E Stain) 50 FAQs and 30 MCQs

Hematoxylin and Eosin Stain (H and E stain or H&E Stain) 50 FAQs:
What is Hematoxylin and Eosin (H&E) staining used for?
It is used to visualize tissue morphology, especially in cancer diagnosis and histopathology.
Why is H&E staining considered the gold standard in histology?
It provides clear contrast between nuclei and cytoplasm, aiding in tissue structure analysis.
What does hematoxylin stain in tissues?
It stains nucleic acids (DNA/RNA) and acidic structures (basophilic regions) blue-purple.
What does eosin stain in tissues?
It stains proteins, cytoplasm, and extracellular matrix (eosinophilic regions) pink.
What are the main components of H&E staining?
Hematoxylin (basic dye) and eosin (acidic dye).
What is the role of a mordant in hematoxylin staining?
It enhances dye binding (e.g., aluminum salts in Mayer’s hematoxylin).
What are the types of H&E staining methods?
Progressive, modified progressive, and regressive staining.
What is the difference between progressive and regressive H&E staining?
Progressive stains until desired intensity, while regressive overstains and then differentiates.
Why is differentiation necessary in H&E staining?
It removes excess hematoxylin for clearer nuclear detail.
What is “bluing” in H&E staining?
It converts hematein’s red hue to blue using an alkaline solution (e.g., ammonia water).
What is the purpose of dewaxing in H&E staining?
To remove paraffin from tissue sections before staining.
Why is rehydration of tissue sections necessary?
To prepare tissues for aqueous-based staining by replacing xylene/ethanol with water.
How long should slides stay in hematoxylin?
Typically 5–10 minutes (varies by hematoxylin type).
What is acid alcohol used for in H&E staining?
It differentiates hematoxylin by removing excess stain.
Why is Scott’s tap water substitute used?
It accelerates bluing of hematoxylin-stained nuclei.
How long should eosin staining last?
Usually 1–2 minutes.
Why is dehydration needed after eosin staining?
To remove water before mounting with a non-aqueous medium.
What is the purpose of xylene in the final steps?
It clears tissues for better light penetration during microscopy.
What mounting medium is used for H&E slides?
DPX or other resin-based media.
Can H&E staining be automated?
Yes, automated stainers are commonly used in labs.
Why are nuclei too pale after H&E staining?
Under-staining with hematoxylin or over-differentiation with acid alcohol.
Why is the background too blue?
Inadequate differentiation or insufficient rinsing after hematoxylin.
Why is eosin staining too weak?
Short staining time, degraded eosin, or insufficient pH adjustment.
What causes uneven staining in H&E?
Inconsistent reagent application or drying of sections during staining.
How can over-staining with eosin be corrected?
Rinse briefly in water or alcohol to reduce intensity.
Why do tissues appear washed out?
Over-dehydration or excessive clearing in xylene.
How do you prevent fading of H&E stains over time?
Store slides in dark, dry conditions and use proper mounting media.
What is a common control for H&E staining?
A known well-stained tissue section processed alongside test samples.
How often should H&E reagents be replaced?
Based on usage and manufacturer recommendations (e.g., hematoxylin every 1–3 months).
Can H&E-stained slides be restained?
Yes, after removing coverslips and decolorizing with alcohol/xylene.
What tissues are best visualized with H&E?
All tissue types, but especially for cancer, inflammation, and general histology.
Can H&E staining detect specific proteins?
No, it’s nonspecific; immunohistochemistry (IHC) is needed for protein detection.
Is H&E used in frozen sections?
Yes, with modified protocols to avoid ice crystal artifacts.
Why is H&E insufficient for diagnosing some conditions?
It lacks specificity for microorganisms, lipids, or certain biomolecules (requires special stains).
Can H&E distinguish between benign and malignant cells?
Partially, but additional tests (e.g., IHC, molecular tests) may be needed.
Is H&E used in cytology (e.g., Pap smears)?
Yes, but often with modified protocols like Papanicolaou stain.
How does H&E help in surgical pathology?
It provides rapid preliminary diagnosis during intraoperative consultations.
Can H&E stain decalcified bone tissue?
Yes, but decalcification may affect staining quality.
Why is H&E not used for electron microscopy?
EM requires heavy metal stains (e.g., uranyl acetate) for ultrastructure.
What are alternatives to H&E for specific structures?
Periodic acid-Schiff (PAS) for glycogen, Masson’s trichrome for collagen.
What pH should eosin be for optimal staining?
Slightly acidic (pH ~4–5).
Why is tap water used in H&E rinsing?
Its mild alkalinity aids bluing of hematoxylin.
Can distilled water replace tap water for rinsing?
Yes, but bluing may require an alkaline solution (e.g., ammonia water).
Is hematoxylin carcinogenic?
No, but some components (e.g., chemical oxidizers) may be hazardous.
How should waste H&E reagents be disposed of?
Follow lab safety protocols for organic solvents (e.g., xylene, ethanol).
Can H&E be performed on non-paraffin sections?
Yes, but protocol adjustments are needed for frozen or plastic-embedded sections.
What causes eosin to precipitate?
Contamination or improper storage (keep at room temperature, avoid light).
Why are coverslips used after staining?
To protect tissue and enhance microscopy clarity.
Can H&E slides be digitized?
Yes, for digital pathology and telepathology applications.
How long do H&E-stained slides last?
Decades if stored properly, though fading may occur over time.
Hematoxylin and Eosin Stain (H and E stain or H&E Stain) 30 MCQs:
1. What is the primary purpose of H&E staining?
a) Detecting specific proteins
b) Visualizing tissue morphology✔
c) Identifying bacterial infections
d) Staining lipids
2. Hematoxylin stains which cellular component?
a) Cytoplasm
b) Nuclei✔
c) Extracellular matrix
d) Mitochondria
3. What color does hematoxylin impart to nuclei?
a) Pink
b) Blue-purple✔
c) Red
d) Green
4. Eosin stains which part of the cell?
a) Nuclei
b) Cytoplasm and extracellular proteins✔
c) DNA
d) Ribosomes
5. What is the role of a mordant in hematoxylin staining?
a) To neutralize pH
b) To enhance dye binding to tissues✔
c) To remove excess stain
d) To dehydrate tissues
6. Which of the following is used for differentiation in H&E staining?
a) Xylene
b) Acid alcohol✔
c) Eosin
d) DPX
7. What is the purpose of “bluing” in H&E staining?
a) To remove excess eosin
b) To convert hematein’s red hue to blue✔
c) To dehydrate tissues
d) To clear xylene
8. Which solution is commonly used for bluing?
a) Acid alcohol
b) Scott’s tap water substitute✔
c) Eosin Y
d) Xylene
9. What is the correct sequence in H&E staining?
a) Dewaxing → Hematoxylin → Eosin → Dehydration✔
b) Eosin → Hematoxylin → Mounting → Dewaxing
c) Dehydration → Bluing → Differentiation → Eosin
d) Xylene → Eosin → Hematoxylin → DPX
10. Why is dewaxing necessary before H&E staining?
a) To remove paraffin and allow aqueous stains to penetrate✔
b) To enhance eosin staining
c) To fix the tissue
d) To dehydrate the sample
11. How long are slides typically left in hematoxylin?
a) 1–2 seconds
b) 5–10 minutes✔
c) 30 minutes
d) 1 hour
12. What happens if differentiation with acid alcohol is too long?
a) Nuclei become too dark
b) Nuclei become pale✔
c) Eosin stains better
d) Tissue shrinks
13. What is the final step before mounting H&E slides?
a) Rinsing in water
b) Clearing in xylene✔
c) Staining with eosin
d) Dehydration in ethanol
14. Which of the following is NOT a limitation of H&E staining?
a) Cannot detect specific proteins
b) Cannot stain lipids
c) Provides excellent nuclear and cytoplasmic contrast✔
d) Requires special stains for microorganisms
15. What is the mounting medium used in H&E staining?
a) PBS
b) DPX✔
c) Ethanol
d) Hematoxylin
16. Which tissue structure is NOT stained by eosin?
a) Cytoplasm
b) Collagen
c) Nuclei✔
d) Muscle fibers
17. What causes background staining in H&E?
a) Insufficient hematoxylin
b) Over-differentiation
c) Inadequate rinsing after hematoxylin✔
d) Too much eosin
18. Which of the following is an acidic dye?
a) Hematoxylin
b) Eosin✔
c) Methylene blue
d) Crystal violet
19. What is the purpose of dehydration after eosin staining?
a) To remove water before mounting✔
b) To enhance nuclear staining
c) To fix the tissue
d) To clear xylene
20. Which of the following is a regressive H&E staining method?
a) Staining until desired intensity is reached
b) Overstaining followed by differentiation✔
c) Using only hematoxylin without eosin
d) Skipping bluing step
21. What is the ideal pH for eosin staining?
a) pH 2
b) pH 7
c) pH 4–5✔
d) pH 9
22. Why is tap water used in rinsing after hematoxylin?
a) It is sterile
b) Its alkalinity aids bluing✔
c) It removes eosin
d) It fixes tissues
23. What is the most common fixative before H&E staining?
a) Ethanol
b) Formalin✔
c) Xylene
d) Eosin
24. What happens if eosin staining is too long?
a) Nuclei become darker
b) Cytoplasm becomes overly pink✔
c) Tissue dissolves
d) No effect
25. Which of the following is NOT a step in H&E staining?
a) Dewaxing
b) PCR amplification✔
c) Dehydration
d) Mounting
26. What is the primary use of H&E in cancer diagnosis?
a) Detecting genetic mutations
b) Visualizing tumor morphology✔
c) Identifying bacterial co-infections
d) Measuring protein expression
27. What is the effect of over-dehydration in H&E?
a) Improves staining
b) Causes tissue cracking✔
c) Enhances eosin uptake
d) No effect
28. Which of the following is a basophilic structure?
a) Collagen
b) Cytoplasm
c) Nuclei✔
d) Red blood cells
29. What is the most critical factor for consistent H&E staining?
a) Temperature control
b) Timing of each step✔
c) Use of expensive dyes
d) High-power microscope
30. What is the final step in H&E slide preparation?
a) Staining with eosin
b) Cover-slipping with DPX✔
c) Rinsing in water
d) Fixation in formalin
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