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A study guide for the ascp boc (american society for clinical pathology board of certification) exam, specifically tailored for the 2025/2026 testing cycle. It features a series of multiple-choice questions covering various topics in clinical laboratory science, including hematology, clinical chemistry, microbiology, and immunohematology. Each question is followed by the correct answer, making it a useful tool for self-assessment and exam preparation. The guide also touches on laboratory safety and quality control procedures, providing a comprehensive review for medical laboratory professionals preparing for certification.
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When using an electronic cell counter, which of the following results can occur in the presence of a cold agglutination? a) increased MCV and decreased RBC b) increased MCV and normal RBC c) decreased MCV and increased MCHC d) decreased MCV and RBC ✔✔a) increased MCV and decreased RBC Cerebrospinal fluid for glucose assay should be: a) refrigerated b) analyzed immediately c) heated to 56 degree C d) stored at room temp after centrifugation ✔✔b) analyzed immediately The major crossmatch will detect: a) group A patient mistyped as group O b) unexpected red cell antibody in the donor unit c) Rh-neg donor unit mislabeled as Rh-Pos d) recipient antibody directly against antigens on the donor red cells ✔✔d) recipient antibody directly against antigens on the donor red cells The anion gap is useful for quality control of laboratory reselts for a) amino acids and proteins b) blood gas anaylses c) sodium, potassium, chloride and total C02 d) calcium, phosphorus and magnesium ✔✔c) sodium, potassium, chloride and total C A common cause of respiratory alkalosis is a) vomitting b) starvation c) asthma d) hyperventilation ✔✔d) hyperventilation
Blood is diluted 1:200, and a platelet count is performed. 180 platelets were counted in the center square millimeter on one side of the hemacytometer and 186 on the other side/ The total platelet count is: a) 146 x 10³/μL (146 x 10⁹/L) b)183 x 10³/μL (183 x 10⁹/L) c)366 x 10³/μL (3666 x 10⁹/L) d)732 x 10³/μL (732 x 10⁹/L) ✔✔c)366 x 10³/μL (3666 x 10⁹/L) When staining acid-fast bacilli with Truant auramine-rhodamine stain, potassium permanganate is used a a) decolorizing agent b) quenching agent c) mordant d) dye ✔✔b) quenching agent A first morning sputum is received for culture of acid-fast bacilli. It is digested and concentrated by the N-acetyl-L-cysteine alkali method. Two Sabouraud dextrose slants are incubated in the dark at 35ºC with 5%-10% CO2. The smear reveal acid-fast bacilli, but the slants show no growth after 8 weeks. The explanation is: a) improper media used b) incorrect concentration procedure used c) improper specimen submitted d) exposure to CO2 prevents growth ✔✔a) improper media used MacConkey media for screening suspected cases of hemorrhagic E. coli O157:H7 must contain: a) indole b) citrate c) sorbitol d) lactose ✔✔c) sorbitol A patient with a B-cell deficiency will most likely exhibit: a) decreased phagocytosis b) increased bacterial infections c) decreased complement levels d) increased complement levels ✔✔b) increased bacterial infections
The organism most commonly associated with neonatal purulent mentingitis is: a) Neisseria meningitidis b) Streptococcus pneumoniae c) group B streptococci d) Haemophilus influenzae ✔✔c) group B streptococci The volume of urine excreted in a 24 - hour period by an adult patient was 300mL. This condition would be termed: a) anuria b) oliguria c)polyuria d) dysuria ✔✔b) oliguria Amniotic fluid is tested for the concentration of lamellar bodies. This test determines: a) fetal lung maturity (FLM) b) hemolytic disease of the newborn (HDN) c) alpha-fetoprotein (AFP) d) trisomy 21 ✔✔a) fetal lung maturity The purpose of testing with anti-A,B is to detect: a) anti-A¹ b) anti-A² c) subgroups of A d) subgroups of B ✔✔c) subgroups of A The most important buffer pair in plasma is the a) phosphate/biphosphate pair b) hemoglobin/imidazole pair c) bicarbonate/carbonic acid pair d) sulfate/bisulfate pair ✔✔c) bicarbonate/carbonic acid pair Evidence of active red cell regeneration may be indicated on a blood smear by: a) basophilic stippling, nucleated RBC and polychromasia b) hypochromia, macrocytes and nucleated RBC c) hypochromia, basophilic stippling and nucleated RBC d) Howell-Jolly bodies, Cabot rings and basophilic stippling ✔✔a) basophilic stippling, nucleated RBC and polychromasia
Which of the following is most closely associated with chronic myelogenous leukemia? a) ringed sideroblasts b) disseminated intravascular coagulation c) micromegakaryocytes d) Philadelphia chromosome ✔✔d) Philadelphia chromosome All stages of neutrophils are most likely to be seen in the peripheral blood of a patient with: ✔✔(chronic granulocytic leukemia) CML to be analyzed by gas liquid chromatography a compound must ✔✔be volatile or made volatile Rheumatoid factors are immunoglobulins with specificity for allotypic determinants located on the: ✔✔Fc fragment of IgG. Substances that are ANTIGENIC ONLY when coupled to a protein carrier. ✔✔haptens A technologist splashed a corrosive chemical in his/her eyes. To prevent permanent injury, the first action should be to: ✔✔use the eyewash station to flush eyes with water for 15 minutes Which of the following immunoglobulins is the most efficient at agglutination? ✔✔IgM Use of "standard" (universal) precautions minimizes exposure to: ✔✔bloodborne pathogens
Leukocyte-poor red blood cells would most likely be indicated for patients with a history of ✔✔febrile transfusion reactions. In synovial fluid, the most characteristic microscopic finding in pseudogout is ✔✔calcium pyrophosphate dihydrate crystals An index of precision is statistically known as the: ✔✔coefficient of variation AHG coombs control cells : ✔✔are coated with IgG antobody Which laboratory technique is most frequently used to diagnose and follow the course of therapy of a patient with secondary syphilis ✔✔flocculation The disease most often associated with elevations of lactate dehydrogenase isoenzymes 4 and 5 on electrophoresis is: ✔✔liver disease The most appropriate screening test for hemoglobin F is: ✔✔Kleihauer-Betke An enzyme deficiency associated with a moderate to severe hemolytic anemia after the patient is exposed to certain drugs and that is characterized by red cell inclusions formed by denatured hemoglobin is: ✔✔G6P DH deficiency
which one of the following gram-negative bacilli ferments glucose ✔✔Yersinia enterocolitica Photochromogens produce pigment when: ✔✔exposed to light for 1 hour For a patient who has suffered an acute hemolytic transfusion reaction, the primary treatment should be: ✔✔Reverse hypotension and minimize renal damage Which of the following statements most correctly describes the utility of clinical laboratory assays for tumor markers? ✔✔tumor markers are useful in tracking the efficacy of treatment Which of the following is the most reliable test to differentiate Neisseria lactamica from Neisseria meningidis? ✔✔lactose degradation Which of the following may be used a a positive quality control organism for the bile esculin test. ✔✔Enterococcus faecalis The major features by which molds are routinely identified are: ✔✔Macroscopic characteristice and microscopic morphology hemorrhage in polycythemia vera is the result of ✔✔abnormal platelet funtion
A Patient with a coagulopathy was transfused with FP24 (plasma frozen within 24 hours of collection) After infusion of 15mL, the patient experienced hypotension, shock, chest pain and difficulty in breathing. The most likely cause of the reaction is: ✔✔anti-IgA False-positive results can occur for fecal occult blood due to the ingestion of: ✔✔horseradish A consistently and repeatedly negative IFA-ANA is: ✔✔strong evidence against5 untreated SLE What kind of antigen-antibody reaction would be expected if soluble antigen is added to homologous antibody? ✔✔precipitation the Philadelphia chromosome is formed by a translocation between the: ✔✔long arm of chromosome 22 and long arm of chromosome 9 Ten units of group A platelets were transfused to a group AB patient. The pretransfusion platelet count was 12x10^3/uL and the posttransfusion count was 18x10^3/uL. From this information, the technologist would most likely conclude that the patient: a) needs group AB platelets to be effective b) clinical data does not suggest a need for platelets c) has developed antibodies to the transfused platelets d) should receive irradiated platelets ✔✔has developed antibodies to the transfused platelets
A solution contains 20 g of solute dissolved in 0.5 L of water. What is the percentage of this solution? ✔✔4% A technician is asked to clean out the chemical reagent storeroom and discard any reagents not used in the past 5 years. How should the technician proceed? ✔✔consult MSDS sheets for proper disposal in a the clauss fibrinogen method, the time to clot formation in plasma is measured after the addition of: ✔✔thrombin a centrifuge head has a diameter of 60 cm and spins at 3,000 RPM. What is the maximum achievable G force? (G=0,00001 x radius in cm x RPM) ✔✔2,700 G A technologist spilled 10 gallons of formaldehyde on the floor. After determining the chemical poses a significant health hazard, the first action step would be to: ✔✔Evacuate the area A first morning sputum is received for culture of mycobacteria. It is digested and concentrated by the N-acetyl-L-cysteine alkali method. Two Lowenstein-Jensen slants are incubated in the dark at 35C with 5 - 10% CO2. The smears revealed acid-fast bacilli, and after 7 days no growth appears on the slants. The best explanation is: ✔✔Cultures held for insufficient length of time. (mycobacteria are slow growers and may take up to 12 weeks)
For safe operation of a centrifuge: ✔✔ensure proper balance is maintained Which of the following activities is associated with C3b? ✔✔opsonization Which of the following specimen requests is acceptable ✔✔urine for culture of acid-fast bacilli In polycythemia vera, the platelet count is ✔✔elvated A mass spectrometer detects which property of ionized molecules ✔✔mass to charge ration Severe intravascular hemolysis is most likely caused by antibodies of which blood group system? a) ABO b) Rh c) Kell d) Duffy ✔✔ABO urine specific gravity is an index of the ability of the kidney to: ✔✔concentrate the urine When using the turbidity (solubility) method for detecting the presence of hemoglobin S, an incorrect interpretation may be made when there is a(n): ✔✔increased total serum protein
When cleaning up a small (5 mL) blood spill on the counter-top, the first step after donning appropriate personal protective equipment is to: ✔✔absorb the spill with disposable absorbent material A serum sample was assayed for bilirubin at 10 AM, and the result was 12 mg/dL (205. μmol/L). The same sample was retested at 3 PM. The result now is 8 mg/dL (136.0 μmol/L). The most likely explanation for this discrepancy is ✔✔the sample was exposed to light After receiving a 24 - hour urine for quantitative total protein analysis, the technician must first: ✔✔measure the total volume The causative agent of cysticercosis is: ✔✔Taenia solium which of the following is a characteristic of polyagglutinable red cells ✔✔are agglutinated by most adult sera The purpose of a low-dose irradiation of blood components is to: a) prevent posttransfusion purpura b) prevent GVHD c) sterilize components d) prevent noncardiogenic pulmonary edema ✔✔prevent graft-vs-host GVHD
A blood gas sample was sent to the lab on ice, and a bubble was present in the syringe. The blood has been exposed to room air for at least 30 minutes. The following change in blood gases will occur ✔✔PO2 increased/HCO3 decreased A technologist spilled concentrated hydrochloric acid on his/her clothing and skin, affecting a large portion of the body. After removing involved clothing, the next first aid treatment step would be to: ✔✔use emergency safety shower and flush body with water. If present, a characteristic that is helpful in separating Pseudomonas aeruginosa from other members of Pseudomonas family is: ✔✔growth at 42ºC A patient with uncontrolled diabetes mellitus will most likely have: ✔✔a pale urine with a high specific gravity a blood donor has the genotype: hh, AB. What is his red blood cell phenotype? ✔✔O Darkfield microscopy is can be used to visualize? ✔✔Treponema palidum an organism from a peritoneal abscess is isolated on kanamycin-vancomycin laked blood agar and grows black colonies on BBE agar. It is nonpigmented, catalase positive and indole negative. The genus of this organism is: ✔✔Bacteroides
.A 25 year old woman is seen by a physician because of Raynaud's phenomenon, myalgias, arthralgias, and difficulty in swallowing. There is no evidence of renal disease. An ANA titer is 1:5120 with a speckled pattern with mitotic. Which of the following is also likely to be found in this patient? ✔✔high-level ribonucleoprotein (RNP) antibody The direction in which albumin migrates (ie. toward anode or cathode) during electrophoretic separation os serum proteins, at pH 8.6, is determined by: ✔✔the ionization of the carboxyl groups, yielding a net negative charge A urine culture had the following culture results:
100,000 CFU/mL nonlactose-fermenter with red pigment The isolates from Mac had the following biochemical reactions TEST ISO 1 ISO TSI alk/acid alk/acid urea pos neg TDA pos neg H2S pos neg ✔✔Proteus mirabilis and Serratia marcescens The tau isoform of transferrin is a carbohydrate deficient protein found only in:
The following data were calculated on a series of 30 determinations of serum uric acid control: mean=5.8 mg/dL, 1 standard deviation=0.15 mg/dL. If the confidence limits are set at +or- 2 SD, which of the following represents the allowable limits for the control? ✔✔5.50-6.10 mg/dL A fluid sample waas collected by throcentesis. A serum sample was collected immediately afterward. The LD fluid to serum ratio was 0.9. there were 5,000 WBC/uL, with 75% PMNs Which of the following describes this fluid. ✔✔Plural effusion exudate What is the MCV if the hematocrit is 20%, the RBC is 2.4 x 10^6/uL and the hemoglobin is 5 g/dL? ✔✔83 pg which of the following mediators are released during t-cell activation ✔✔cytokines cerebrospinal fluid for glucose assay should be ✔✔analyzed immediately The automated platelet count on an EDTA specimen is 58 x 103/pL. The platelet estimate on the blood smear appears normal, but it was noted that the platelets were surrounding th neutrophils. The next step should be to: ✔✔recollect specimen using different anticoagulant The biuret reaction for the analysis of serum protein depends on the number of: ✔✔peptide bonds
which of the following genera include anaerobic gram-negative nonsporulating bacilli? ✔✔bacteroides An antibiotic used to suppress or kill contaminating fungi in media is: ✔✔cycloheximide Higher levels of employees motivation occur when the supervisor: ✔✔collaborates to set goals to be accomplished Which stain is used to used to measure sperm viability> ✔✔eosin nigrosin The most important use of a nontreponemal antibody (NTA) test alone is in: ✔✔evaluate the success of theropy A nonchromogen that grows best at 42 degree C and is highly resistant to antibiotics is: ✔✔Mycobaterium xenopi Microscope analysis of a urine specimen yields a moderate amount of red blood cells in spite of a negative result for occult blood using a reagent strip. The technologist should determine if this patient has taken: ✔✔vitamine C Nephelometers measure light: ✔✔a scattered at a right angle to the light path