The NSH QIHC Exam Prep Course is intended to provide participants with an overview of the principles and practices of immunohistochemistry in an effort to comprehensively prepare them for the ASCP’s QIHC examination. The course covers the topic areas outlined by the ASCP’s published exam topic outline and provides a reading guide for the top recommended texts for preparing for the exam. The course contains 10 modules including Exam Overview, Basic Immunology, Laboratory Math, Protocol Development, Antibody Production, Preanalytical Considerations, Staining, CAP Considerations, Common Diagnostic IHC Assays, and an Intro to ISH.
Learning Section Format: The course contains 14 hours of lectures. To ensure this large amount of materials is digestible the course has been split into topic modules.
Knowledge Checks: In each module you will be asked to complete a Knowledge Check(s). Knowledge Checks consist of several questions – asked in a variety of formats - about the section(s) you just completed.
Diagnostic Practice Questions: The course provides a diagnostic question bank based on the ASCP QIHC Content Outline. You can take the diagnostic test as many times as you wish, and each experience will provide a unique testing experience.
CEUs: This histology course is worth 14 continuing education credits. Course is available for 365 days from date of purchase.
Michelle Bell
Service and Applications Manager
Milestone Medical
Michelle Bell has been in the histopathology profession for over 23 years. Michelle has served in many roles in the laboratory, from bench tech to IHC supervisor to manager. She is a very active member of the NSH and the Texas Society for Histotechnology. Michelle is passionate about sharing knowledge and developing community within the histology field. She enjoys teaching and collaborating with other peers to elevate patient care and the profession.
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Jorge E Benavides, BS, HT(ASCP)QIHC cm
Commercial Training Manager
Biocare Medical
Medical and Sales Professional with over 15 years of clinical and research pathology experience. Well versed in the laboratory processes of histology, IHC, Molecular and ISH, as well as their regulatory requirements, reimbursement requirements, and importance for future advancements in medicine and for our patients.
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Elizabeth Chlipala, HTL(ASCP)QIHC
Owner Partner
Premier Lab
Elizabeth Chlipala is an owning partner, at Premier Laboratory, LLC, a contract histology laboratory in Longmont, Colorado, since 2003. She has over thirty-seven years’ experience working in laboratories and hospitals, doing both clinical and research histology, immunohistochemistry and whole slide imaging. She is a member of NSH, ASCP, CSH, and Colorado Bioscience Association. Elizabeth is an accomplished, knowledgeable and sought after speaker, speaking at over 80 conventions, symposiums, annual meetings and teleconferences, since 1986. Her speaking engagements have included topics in histology, pathology, quality assurance immunohistochemistry and digital pathology. Elizabeth has received numerous awards, including Illinois Society for Histotechnology – Technologist of the year (1993), National Society for Histotechnology – Dako Award for Excellence in Standardization of the IHC Techniques (2006), Biogenex Award for Standardization in Immunohistochemistry (2006) and the NSH Presidents Award (2019). Elizabeth’s education includes a BS in Biology from Oakland University in Michigan and the William Beaumont Hospital School of Histotechnology for HTL(ASCP) and QIHC(ASCP) certifications.
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Kimberly Feaster, HTL(ASCP)QIHC
Program Director, Histology
West Virginia University
Kimberly Feaster is a professor at West Virginia University. Ms. Feaster has experience as a bench Histotechnologist and supervisor in research and hospital histology laboratories. She is currently the director of the Histotechnology program at West Virginia University. She holds a masters degree, her HTL, and her QIHC. In addition to running the program at West Virginia – she is an active volunteer with the NSH. She is an active member of the NSH Education Committee. Volunteering her time and expertise for many years to the various projects and programs
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Debra Freeman
Account Manager
Agilent Technologies
Debra Freeman is an account manager with Agilent Technologies. She is regular – and very popular - presenter with NSH and the histology community. Previous to her current role, she worked as a research associate performing IHC in biotech.
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Thomas Isbell, BS, HT(ASCP)QIHC cm
Sr Territory Account Manager
Milestone Medical Technologies
Thomas Isbell has a BS in Biochemistry/Molecular Genetics and is a certified HT(ASCP)QIHC cm. He was an AP Manager for almost 19 years before his current position as Sr Territory Account Manager for Milestone Medical. Tom's hobbies and interests include Star Wars, motorcycles, former punk rock drummer, art (painting and sculpture mostly), my husky, Lucy Vader, and my daughter (who is #1 above the rest).
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Jason Molnar, HT(ASCP), QIHC(ASCP)
Director of Pathology Technical Services
Cellnetix Pathology & Laboratories
Mr. Molnar is seasoned histologist currently serving in the role of Director of Pathology Technical Services at Cellnetix Pathology & Laboratories. He has been working in histology labs since 2003, learning the profession from the ground up. He progressed in roles from lab assistant, bench tech, lead tech, supervisor, manager to director. Mr. Molnar has also had the privilege of working in some great organizations, from small specialty labs with just a few teammates to very large reference labs with more than a hundred on the technical staff. He is passionate about histology, quality improvement methodologies, and leadership.
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Amber Moser, BS, HTL(ASCP)
Principle Investigator
Premier Laboratory
Amber Moser is a Principal Investigator for Premier Laboratory. During Amber's work at Premier she initially started performing routine histology tasks, and is now responsible for all the immunohistochemical and immunofluorescent staining. In addition to the routine IHC work that she performs she has also taken on the responsibility of training and helping new staff as they learn the histology process. She is an excellent teacher and takes great care when teaching and training others in the laboratory.
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Jamie Pert, BS, HTL(ASCP)cm, MBcm, QIHCcm
Education Programs Manager/Lab Director
Corewell Health
Jamie is the Program Director of an HT and HTL programs as well as a Lab Director for the histology and IHC lab in Royal Oak, Michigan. Previous to that she worked as a bench histotechnologist in the immunohistochemistry/molecular lab of anatomic pathology at Beaumont Hospital, and in that time she also worked as a contingent histotechnologist in private GI and Dermatopathology laboratories. Jamie completed her B.S. at Grand Valley State University and she is certified as a histotechnologist (HTL), molecular biologist (MB), and also has her Qualification in Immunohistochemistry (QIHC) through ASCP.
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Dawood Qazzaz, MS, HT(ASCP)
Clinical Laboratory Instructor, School of Histotechnology
Corewell Health William Beaumont University Hospital
I have been in the histology field for over 22 years. I started as a bench teach after graduating from undergrad with a baccalaureate of science degree in Biochemistry. I studied on my own and obtained my registry as an HT(ASCP). Later, I became a lead technical specialist for a few years, and I decided to go back to graduate school where I got my master's of science degree in Biomedical Engineering. I advanced into many different roles in the anatomic pathology laboratory. Currently, I work as a clinical laboratory instructor for the school of histotechnology.
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Brenda Schlosser, HTL(ASCP)QIHC cm
Field Applications Specialist- IHC
Leica Biosystems
I am a seasoned professional in the anatomical pathology field with 17 years of experience. A certified histotechnologist through ASCP for 8 years, I enhanced my skills by obtaining an Immunohistochemistry (IHC) qualification in 2022. Currently, I am a Senior Field Applications Specialist for IHC at Leica Biosystems, where I leverage deep technical knowledge and practical experience to support clinical and research professionals in optimizing IHC assay performance and workflow
While an employee of Leica Biosystems, the opinions and insights in this presentation are based on my professional experience and knowledge. While I strive to provide accurate and unbiased information, it is important to consider my association with Leica Biosystems when evaluating the content of this presentation.
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Diane Sterchi, MS, HTL(ASCP)
Independent Consultant
Indianapolis, IN
My consulting consisted of several laboratories in the United States (US) and several outside of the US. My product is mainly teaching technicians and setting up histology laboratories. I currently have 5 students in the US, 3 in Zambia, and 4 in Tanzania. I completed histotechnology theory and practical on 7 from Eswatini, 5 in Haiti, 7 in China, and 5 in Botswana. I do most of my training in person and that requires traveling to other countries. I also, assist with NSH in any activities when need such as the Histotechnology Training Program (HTP), on Demand presentations.
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Elba G. Vidal, MHA, HTL(ASCP)CM QIHCcm
Anatomic Pathology Manager
University of Maryland Medical Center
Elba G. Vidal is a healthcare leader with over 22 years of experience in clinical laboratory operations, specializing in anatomic pathology, histology supervision, and immunohistochemistry. She excels in laboratory management, safety compliance (CLIA, JCAHO, CAP), and implementing advanced diagnostic processes that enhance patient care. Elba holds a Master's in Healthcare Administration and has successfully led initiatives such as a $5M pathology laboratory upgrade, driving revenue growth and operational excellence. Known for her meticulous recordkeeping and leadership skills, she mentors teams to achieve precision, innovation, and excellence in laboratory testing. Elba is dedicated to advancing diagnostic practices to support timely and life-saving medical interventions.
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Course Introduction
Open to view video. | 2 minutes
Open to view video. | 2 minutes
A brief overview of the course and its resources.
Review of QIHC Exam Process
Open to view video. | 28 minutes
Open to view video. | 28 minutes
Upon completion of this lecture, participants will be responsible to:
Discuss the process of applying for the QIHC exam.
Discuss topics covered and resources available for studying for the QIHC exam.
Discuss computer adaptive testing and test taking strategies.
Module 2: Basic Immunology
Module 2.1: Basic Overview of Immunology Process
Open to view video. | 22 minutes
Open to view video. | 22 minutes
Learning Objectives:
1. Basic Overview of Immunology Process
2. List the 2 types of immunity and explain the differences
3. Understand the functions of T-cells and B-cells in immune response
Module 2.2: Detection Methods
Open to view video. | 13 minutes
Open to view video. | 13 minutes
Learning Objectives:
1. Name the basic parts of a cell and their functions
2. Describe the various parts of cell structure and the functions associated
Module 2.3: Antibody Structure and Production
Open to view video. | 28 minutes
Open to view video. | 28 minutes
Learning Objectives:
1. Review of general immunology basics
2. Understand the general structure of antibodies/Immunoglobulins
3. Define what antigens are
4. Identify the different kinds of antibodies produced: Monoclonal, Polyclonal
5. Explain how antibodies bind to antigens
Module 2 Knowledge Check
5 Questions | Unlimited attempts | 0/5 points to pass
5 Questions | Unlimited attempts | 0/5 points to pass
It's time for a knowledge check! Your answers (correct or incorrect) do not prevent you from moving on to the next module however these questions provide you opportunity to see how much you have absorbed from the module so we recommend you take a minute to review your answers before proceeding to the next module.
Module 3: Laboratory Math
Module 3.1 Dilutions and Concentrations
Open to view video. | 42 minutes
Open to view video. | 42 minutes
Learning Objectives:
1. Understand how to properly receive, store and dilute antibodies.
2. Lyophilized antibodies and how to manage them.
3. Learn and practice how to calculate dilutions.
4. Understand the basics of titrating an antibody.
Module 3.2 Concentrations - Weight to Volume
Open to view video. | 15 minutes
Open to view video. | 15 minutes
Learning Objectives:
1. Understand the common concentrations used to describe antibodies (e.g. mg/ml, µg/ml).
2. Become comfortable converting between units.
3. Practice conversions and calculating reagent concentrations
Module 3.3 Solutions
Open to view video. | 33 minutes
Open to view video. | 33 minutes
Learning Objectives:
1. Discuss common solutions in a typical IHC procedure and how to prepare them
2. Learn how to prepare percent solutions
3. Learn how to prepare molar and normal concentration solutions.
4. pH solutions and proper pH Meter usage
Module 4: Intro to IHC and Protocol Development
Module 4.1: Introduction to IHC
Open to view video. | 26 minutes
Open to view video. | 26 minutes
Learning Objectives:
1. Define basic terminology associated with IHC.
2. Recognize different techniques used in IHC.
3. Identify commonly used fluorochromes, enzymes and chromogens.
Module 4.2: Antibody Selection
Open to view video. | 30 minutes
Open to view video. | 30 minutes
Learning Objectives:
1.Classification of antibodies
*IVD and RTU
*ASR
*RUO
2. Selection of the proper antibody
3.Discuss how to use manufacturers data sheets to aid in selecting an appropriate antibody
Module 4.3 Positive and Negative Controls
Open to view video. | 24 minutes
Open to view video. | 24 minutes
Learning Objectives:
1. Discuss the purpose for using positive and negative reagent controls.
2. Discuss the purpose for using positive and negative tissue controls.
3. Discuss how to choose appropriate control tissue.
Module 4.4: Antigen Retrieval
Open to view video. | 16 minutes
Open to view video. | 16 minutes
Learning Objectives:
1. Understand the history of antigen retrieval.
2. When and Why is antigen retrieval necessary
3. What are the most widely used methods.
4. Understand the different Types and Mechanisms.
Module 4.5 Blocking
Open to view video. | 30 minutes
Open to view video. | 30 minutes
Learning Objectives:
1. Discuss how to choose an appropriate blocking reagent.
2. Discuss tissue types that commonly require protein blockers.
Module 4.6: Detection Methods Part 1
Open to view video. | 28 minutes
Open to view video. | 28 minutes
Learning Objectives
1. Discuss direct vs indirect labeling.
2. Explain the chemistry of detection methods.
3. Discuss commonly used fluorochromes and chromogens.
Module 4.6: Detection Methods Part 2
Open to view video. | 21 minutes
Open to view video. | 21 minutes
Learning Objectives
1. Discuss direct vs indirect labeling.
2. Explain the chemistry of detection methods.
3. Discuss commonly used fluorochromes and chromogens.
Module 4.7 Antibody Titration Studies
Open to view video. | 32 minutes
Open to view video. | 32 minutes
Learning Objectives
1. Discuss how to determine the optimal primary antibody dilution.
2. Describe how to perform a titration study.
Module 4 Knowledge Check
6 Questions | Unlimited attempts | 0/6 points to pass
6 Questions | Unlimited attempts | 0/6 points to pass
Module 5: Antibody Production
Module 5.1 Primary Antibody Production
Open to view video. | 38 minutes
Open to view video. | 38 minutes
Learning Objectives:
1. History
2. Polyclonal vs Monoclonal Antibodies
3. Mouse Monoclonal Antibodies vs Rabbit Monoclonal Antibodies
4. Assessing New Antibodies
Module 5.2 Antibody Selection Process
Open to view video. | 15 minutes
Open to view video. | 15 minutes
Learning Objectives:
1. Understanding the antibody assessment process
2. Learning to read and interpret antibody spec sheets
3. Procedures for assessing new antibodies
Module 5.3 Primary Antibody Classification
Open to view video. | 15 minutes
Open to view video. | 15 minutes
Learning Objectives:
1. Understanding Antibody Classification Systems (IVD: In Vitro Diagnostics, ASR: Analyte Specific Reagent, RUO: Research Use Only, FDA: FDA Approved Antibodies)
2. Antibody Variations (RTU, Concentrates, Conjugated)
Module 5 Knowledge Check
8 Questions | Unlimited attempts | 8/8 points to pass
8 Questions | Unlimited attempts | 8/8 points to pass
Module 6: Pre Analytical Considerations
Module 6.1 Tissue Fixation
Open to view video. | 34 minutes
Open to view video. | 34 minutes
Learning Objectives
1. Understand the impact of fixation/pre-analytics on IHC
2. Understand why is fixation so critical to IHC procedures and staining results
3. Understand how other preanalytical factors (grossing/processing) impact fixation and IHC
4. Understand the basics of Antigen Masking and Antigen Retrieval
Module 6.2: Tissue Processing
Open to view video. | 37 minutes
Open to view video. | 37 minutes
Learning Objectives:
1. Quick basic review of processing
2. Understand how processing impacts IHC/ISH staining
3. Understand key factors in processing that can impact IHC/ISH staining
4. Understand IHC/ISH protocols and how they differ with FFPE tissue and frozen tissue
Module 6.3 Recommendations
Open to view video. | 30 minutes
Open to view video. | 30 minutes
Learning Objectives:
1. Understand the basic pre-analytical recommendations for optimal Immunohistochemistry (IHC) (e.g., fixative, processing, ischemic time, etc.).
2. Introduce methods that can be used to compensate for non-optimal pre-analytical factors outside of your control.
Module 6 Knowledge Check
8 Questions | Unlimited attempts | 8/8 points to pass
8 Questions | Unlimited attempts | 8/8 points to pass
It's time for a knowledge check! Your answers (correct or incorrect) do not prevent you from moving on to the next module however these questions provide you opportunity to see how much you have absorbed from the module so we recommend you take a minute to review your answers before proceeding to the next module.
Module 7.1: Dual Staining
Open to view video. | 27 minutes
Open to view video. | 27 minutes
Learning Objectives:
1. Benefits of multi-staining
2. Different ways double staining can be done in the lab
3. Determine when you should do a multi-stain
4. Determine antibodies, detection and chromogens to use in your multi-stain
5. Understand how cocktails for double staining work and how to make them
Module 7.2 Multiplex Part 1
Open to view video. | 13 minutes
Open to view video. | 13 minutes
Learning Objectives:
1. Understand what Multiplex is and why it can be beneficial
Module 7.2 Multiplex Part 2
Open to view video. | 17 minutes
Open to view video. | 17 minutes
Learning Objectives:
1. Understand what to identify when developing a Multiplex Protocol including:
*Cellular location of antigens
*Pretreatment considerations
*Choosing our primary antibodies
*Choice of secondary antibodies/detection systems to be used
2. Summarize the Importance of Drop-Out Controls When developing a Multiplex Protocol
Module 7.2 Multiplex Part 3
Open to view video. | 18 minutes
Open to view video. | 18 minutes
Learning Objectives:
1. Understand what to identify when developing a Multiplex Protocol
*Sequential vs Simultaneous Multiplex
Module 7.2 Multiplex Part 4
Open to view video. | 7 minutes
Open to view video. | 7 minutes
Learning Objectives:
1. Understand what to identify when developing a Multiplex Protocol
*Chromogenic vs Fluorescence
Module 7.2 Multiplex Part 5
Open to view video. | 6 minutes
Open to view video. | 6 minutes
Learning Objectives:
1. Discuss potential future Multiplex applications
2. Summary and conclusion
Module 7 Knowledge Check
5 Questions | Unlimited attempts | 0/5 points to pass
5 Questions | Unlimited attempts | 0/5 points to pass
Module 8: CAP Considerations
Module 8.1 CAP Considerations
Open to view video. | 42 minutes
Open to view video. | 42 minutes
Learning Objectives:
1. Understand the designations Class I and Class II IHC Assays
2. Understand CAP guidelines and recommendations for IHC assays
3. Understand the meaning of concordance between tests
4. Differentiate between initial analytical validation of non-predictive assays and validation of all laboratory-developed predictive marker assays
5. Understand the types of positive and negative tissues and how many should be used for validation
6. Understand CAP IHC quality control requirements
Module 8.2 CAP Regulated Antibodies
Open to view video. | 29 minutes
Open to view video. | 29 minutes
Learning Objectives:
1. Understand the concept of regulated kit markers
2. Understand and identify from photo IHC markers used for positive and negative controls for tumors of unknown primary
3. Review useful markers for identifying tumor origin
4. Review and identify staining patterns
Module 8 Knowledge Check
7 Questions | Unlimited attempts | 0/7 points to pass
7 Questions | Unlimited attempts | 0/7 points to pass
Module 9: Common Diagnostic IHC Assays, Antibodies, and Control Tissues
Module 9.1 Common Diagnostic Antibodies
Open to view video. | 30 minutes
Open to view video. | 30 minutes
Learning Objectives:
1. Recognize the most common diagnostic IHC assays and what they identify.
Module 9.2 CAP Considerations of Specific Kits
Open to view video. | 30 minutes
Open to view video. | 30 minutes
Learning Objectives:
1. Discuss what kits are currently available
2. Learn how these kits are validated in the laboratory
3. Review how the kits are regulated in the laboratory
Module 9 Knowledge Check
5 Questions | Unlimited attempts | 0/5 points to pass
5 Questions | Unlimited attempts | 0/5 points to pass
Module 10: Introduction to ISH
Module 10.1 ISH Basics and Terminology
Open to view video. | 38 minutes
Open to view video. | 38 minutes
Learning Objectives:
1. Gain a basic understanding and vocabulary around the concept of In Situ Hybridization
Module 10.2 ISH Procedures and Automation Availability
Open to view video. | 42 minutes
Open to view video. | 42 minutes
Learning Objectives:
1. Basic steps to procedure
2. Automation available
3. Resources on-line
Module 10 Knowledge Check
7 Questions | Unlimited attempts | 7/7 points to pass
7 Questions | Unlimited attempts | 7/7 points to pass
It's time for a knowledge check! Your answers (correct or incorrect) do not prevent you from moving on to the next module however these questions provide you opportunity to see how much you have absorbed from the module so we recommend you take a minute to review your answers before proceeding to the next module.
Continuing Education Credits
Participant Survey
6 Questions
6 Questions
Please complete the survey to receive your CEU certificate.
Certificate
14.00 CE Credits credits | Certificate available
14.00 CE Credits credits | Certificate available
Once you have completed the required elements you can print your CEU certificate.
Diagnostic Practice Questions
Diagnostic Practice Questions Introduction
Open to view video. | 2 minutes
Open to view video. | 2 minutes
This module contains questions that represent each of the primary areas from the ASCP Content Outline (see handouts tab for downloadable copy). At the end of the exam, use your results to help guide you as you outline a study plan. This can be retaken an unlimited number of times. Please note, each time you take this assessment you will experience a new combination of questions. The number of questions from each category is based on the published percentages in the content outline.
Diagnostic Practice Test Questions
50 Questions | Unlimited attempts | 90 minute limit | 0/50 points to pass | Graded as Pass/Fail
50 Questions | Unlimited attempts | 90 minute limit | 0/50 points to pass | Graded as Pass/Fail
Complete the following 50 question practice test. You have 90 minutes to complete this diagnostic assessment (the same as the QIHC exam).
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