Unfortunately, I’ve had to take down all BOC Examination questions because it violated BOC copyright and constituted a violation of the confidentiality pledge. Don’t worry though, these questions were always meant as a supplement to your studies. Study hard and use review and question books and you’re going to do great!

147 Responses to EXAM RECALLS

  1. Rebecca says:

    Thank you everyone for your advice and posting the recall questions! I am taking my test next week and hoping to pass!! I turned some of the recent recall questions and answers into flash cards if anyone is interested. I tried to pick the correct answers or correct ones that I didn’t think might be right after doing some research. So I apologize if some of the answers aren’t totally right- I had to made the best guess since I don’t know what all the test answers were for some of the questions people posted.
    I will add more questions and answers as I study. 🙂

  2. Brooklyn says:


    I am currently preparing to take the ASCP BOC very soon (AHHHH!). I’m using these recalls as a guidance to study in conjunction with the recall notes. I’m going to post the questions below that I’m unsure about, Any help answering them will be a great help! TIA 🙂

    1.) PTH effects on Ca+
    2.) Solution/buffer most ISE use?
    3.) Effect aldosterone has on Na and K?
    4.) What is the purpose of Protein C and S? (choices: act as natural anticoagulant, activates protein coagulants.. etc..)
    5.) What happens if ionized calcium sits out?
    a.change in ph b.evaporation c.consumption of glucose?
    6.) Electrical impedance measures what?
    7.) antacid poisoning,what will you test?
    A)ph B) ammonia C)k
    8.) Enzyme controls resulted in 3SD below the mean and the controls with no enzyme resulted in 2SD below mean. What is causing this?
    a. controls where left at room temperature d. something about they being in deterioration
    9.) amniotic fluid cannot be tested for bilirubin on regular chemistry analyzer as serum bilirubin because???A) they are demanding, B) they are biochemically different, or C) it is just too turbid.
    10.) What does ISE measure?
    11.) what happens to salt glucose and potassium when ADH is increased
    12.) after eating fatty foods what will increase?
    A) chylomicrons B) ldl C) hdl
    12) HDL was 34, Trig was 400, and cholesterol was 235. LDL was directly tested and was 169.
    A) Report out calculated LDL
    B) Retest Triglycerides and recalculate LDL
    C) Retest cholesterol and recalculate LDL
    D) Recollect while fasting
    13) a person overdoses on salicylate and goes to the ER. WHAT WOULD BE TESTED?
    a) pH
    B) Ammonia
    d) BUN

    I know this is a lot of unknown questions, but these are all built up after studying every question here! I appreciate any and all responses!

    • Jordan says:

      1. PTH = normal, and patient elevated Ca+ may caused by Metastasized cancer
      4. what is the purpose of protein C and S? Inactivates F. 5 and F. 8
      8. b. QC being deterioration ( QC enzyme is unstable at RT, but no enzyme also shift below 2SD)
      12. a. Chylomicrons (turbid and milky serum) also called Postprandial Lipemia
      10. ISE measures ionized Ca++, pH dependent
      9. b. they are biochemically different
      3. Effect of increased Aldosterone enzyme: Na= high, K= low, Hypertension, Conn’s disease. For decrease : Na= low, K= High
      11. ADH is increased : Diabetes insipidus Na = high, K = low, Glucose =N
      7. Antacid overdose, test Magnesium
      13. measure pH since needed to know acid-base balance. (Ammonia, BUN, Creatinine all evaluate severe liver disease, kidney failure)
      5. affect pH if ionized Ca++ sit out

  3. KM says:

    Hi everyone! I just took my ASCP MLS exam and passed on the first try! I can’t thank you enough for this incredible website and thank you so much to everyone who’s posted exam recalls here, they were immensely helpful! I will try to do my best to include what was on my test. I’m sorry this will be kind of all over the place but my brain is fried so I’m just going to add the questions as I remember them. I’ll add more later if I think of any others.
    I had a ton of hemo and coag questions and many blood bank questions. Pretty even on chem and micro. Also quite a few immuno questions.
    I didn’t have any blood bank panels except for one about Lewis and how they can be adsorbed from the serum. Really bummed because I’m great at BB panels. Oh well.
    TONS of questions on DATs with mom and baby. These were a bit confusing.
    O neg, Rh pos patient now has a positive DAT. What will their typing results look like now? Make sure you know what the Rh control is used for and why it would be positive or negative
    I had a few ABO discrepancies. Something about the Bx subgroup.
    Lots of immuno questions.
    Which Hep B marker is a sign of long term infection and acute reinfection?
    Formulas for sensitivity. I wasn’t asked to calculate it, just to choose the correct formula.
    Tons of coag questions! Know the reagents for each and what would happen if you mixed them up and added them to the wrong test.
    Prolonged PT, PTT, and thrombin after collecting from catheter= heparin contamination

    Mixing study that was performed with a prolonged PTT that couldn’t be corrected. What would you do? DRVVT (lupus anticoagulant)

    Two patient’s ran in duplicate (PT and PTT). The PTT seemed to always be prolonged but PT looked ok= I picked check the CaCl/phospholipid reagent delivery

    Patient is on coumadin therapy, what will be affected? Decreased protein C
    Sodium citrate tube has 67% HCT. What do you do?
    Patient is tested for Procainamide and results negative, what other test can you do? NAPA
    Enzyme controls resulted in 3SD below the mean and the controls with no enzyme resulted in 2SD below mean. What is causing this? The controls were left at room temperature
    What causes postprandial lipemia? Fatty acids
    Cause for decreased serum Na? Hyperglycemia
    Patient with elevated Ca and normal PTH: Metastasized cancer
    Values seen in adrenal Cushing’s
    Serum and urine bilirubin and urobinilinogen levels in hemolytic anemia
    Positive strip for glucose, negative clinitest
    pCO2 electrode measures: pH
    Patient had dyspnea caused by anesthesia, what should be measured? Pseudocholinesterase
    Patient fasting 120mg/dl, non-fasting 160mg/dl: impaired fasting
    Lots of hematology pictures. I had 4 in a row that threw me off. Burr cells, one with microcytic hypochromic RBCs and target cells, agglutinated RBCs (I, too, had this picture come up twice and I believe I answered cold antibodies on one and mycoplasma infection on the other), and stomatocytes. I think I had a Heinz body picture too.
    What are blastoconidia?
    Patient comes in with malaise, sore throat, lymphadenopathy symptoms. Given table with IgG and IgM titer values for EBV, CMV and toxoplasma. I think the IgG titers were 1:128 for EBV and CMV. The IgMs were all low. Have to determine if primary infection with just one or coinfection of EBV, CMV.
    What causes glomerulonephritis in a child after a throat infection?
    Bacillus anthracis reactions
    Fungus you can differentiate with the hair test: T.mentagrophytes/ T. rubrum
    The micro questions were long and focused on TSI reactions and IMViC. Definitely memorize the High Yield Notes flowchart on Enterobacteriaceae, I knew it like the back of my hand and it helped so much!
    Question on ESBL susceptibility testing. . .something like which results correlate with an ESBL organism? The answer choices included results of cef and and cef/clavulinic acid. I chose the one with the smallest zones of inhibition for each of them (I believe it was 6mm).
    Differentiate between Aeromonas and Pseudomonas
    How to differentiate between Pseudomonas aeruginosa and Pseudomonas putida.
    I had a lot of questions differentiating Enterococcus from Group D strep so definitely be familiar with those reactions.
    Young boy has walking pneumonia and is prescribed penicillin. He is still sick 2 weeks later. Why?
    Picture: Retic count 18.3% along with Heinz bodies on the stain. What do you do next?
    Hemoglobin A1c values are affected by RBCs with a short lifespan
    TIBC calculation uIBC and transferrin. This was my only calculation and I couldn’t remember the formula!! I remembered every other formula but not this one. Go figure :\
    EPO is abnormally decreased in: PV
    Falsely decreased ESR is due to: I said vibration
    What does lupus anticoagulant do? Increases thrombosis
    UA question about a 3 year old with high protein, small amount of blood, positive nitrite, negative leukocyte esterase, many renal tubular epithelial cells, and more. Question asked what the boy might have: nephrotic syndrome, acute tubular necrosis, pyelonephritis, or glomerulonephritis
    Patient with pancreatic tumor will have which tumor marker?
    I had an ANA picture but there were several different patterns on it and I couldn’t make out what was going on so I guessed on that.
    Rouleaux is undetectable at AHG.
    Rotavirus: stool specimen
    Legionella antigen: urine
    HTLV confirmation is done with Western blot
    Which cardiac enzyme stays elevated the longest?
    RBCs measured on dipstick but not seen in microscopic. Why? Dilute alkaline urine
    Unit of RBCs was checked out at 4:00am and returned at 4:25am at 8C. What would you do? I said return to inventory.
    Individual with Le(a+b-) will have what in their blood?
    Positive control for anti-c and negative control for Fya.
    Irreversible step of coagulation
    Given a table of hemo values with really low RBCs and really high MCV. I think I said agglutination
    Given a table of hemo values with normal hematocrit but low Hgb. The rule of 3 didn’t match so I said lipemia was interfering.
    Med tech on the night shift makes a Gram stain from CSF but isn’t going to culture it right away. How should it be stored?
    K/A with positive H2S, positive indole, and positive urease. Options: Report as Salmonella, report as shigella, call the doctor, report as normal flora.
    I had one question that was about a gram negative lactose fermenter that included citrate and indole reactions (one was positive and one was negative, can’t remember which). They gave results of lysine decarboxylase, arginine, and ornithine. Options were: Kleb pneumo, Kleb oxytoca, Enterobacter cloacae, or Enterobacter aerogenes
    Which Plasmodium species doesn’t show trophs on blood smear?
    Something about a patient with endocarditis given NaCl, Bile esculin, and a photo of gram + chains. Options were Strep bovis, Enterococcus, Strep pneumo
    Question about what’s impaired on the RBCs in PCH.
    I got the anemia question with the 18% retics that has been listed on the other exam recalls. I also got the question with 0.1% retics (pure red cell aplasia).
    What would be seen in a patient with aplastic anemia? I said pancytopenia with fatty bone marrow
    What is the Staph aureus latex reagent detecting? Clumping factor and protein A
    My 100th question was about Klebsiella. It said that a gram – bacilli was seen with a bunch of WBCs on a slide from a respiratory specimen. Organism was mucoid on blood agar and pink on Mac. Then it said presumptive ID was Kleb pneumo and gave susceptibilities for drugs (I think it was susceptible to everything listed). What would you do? A. Report this out because everything makes sense B. Repeat the gram stain because it doesn’t match Kleb pneumo C. Repeat susceptibilites because they don’t match Kleb pneumo. I think I said to just report it out (I was ready to be done at this point and couldn’t handle sitting there thinking about the question any longer).
    One thing I want to point out that really helped me was to correlate the TSI reactions with that giant Enterobacteriaceae flowchart (which I had memorized months ago but I was having a hard time memorizing the TSI reactions). The Enterobacteriaceae already ferment glucose so you know that they’ll all show an acid deep. The lactose fermenters (E. coli, Klebsiella, Enterobacter, and Citrobacter) will have acid slants because there’s lactose in that upper part of the tube so A/A. The nonlactose fermenters will show K/A because they only ferment glucose.

    Overall, I’d say to definitely take the time to go through all of these recall questions and the high yield notes. I had at least a third of my questions from here! I took a couple of days to sort out all of the questions and research them then I made flashcards. I’m a micro tech and I asked my supervisors for help on some of the questions but our patient demographics differ from the norm so it wasn’t very helpful. I finished my rotations about 6 weeks ago and got a job right away. I’ve spent every waking minute outside of work studying and I didn’t think the exam was that bad thanks to all of you awesome lovely helpful people and Sohail!!! Last thing, ever since I scheduled my exam date, I kept telling myself “I’m not going in there to take the test, I’m going in there to pass it.” I feel like this really boosted my confidence and made me less anxious on exam day. Not gonna lie, I crammed for the test up until the absolute last minute and I don’t regret it at all. Good luck everyone, stay positive! You can do this!!!

  4. Cherice says:

    congrats to you. can i get your flashcards you made KM my email.com is marriaf@yahoo.com

  5. liwa says:

    hello sohail! can you put also the dates for the recalls so that we can keep track the latest ones, thanks

  6. Sarah says:

    I took my MLS(ASCP) last week and passed with a 512! Thank you so much for this website. I used this, the ASCP practice tests, and the Bottom Line Approach book. I will say, please don’t do what I did as far as taking the exam. I graduated in 2013 and have been too nervous to take it; I should have taken it much sooner because 4 years out of school is too long to remember details! (I have my MLT(ASCP) and have been a tech for 12 years thought so that helped some.)

    My exam was about 50% blood bank, for which I’m very grateful since that has been my only department for the last 9 years, 30% chemistry/urinalysis, 10% hematology, and 10% micro/mycology/parisitology.

    Good luck!

    • wordsology says:

      Excellent review. Thank you so much for helping others out. It’s great to see folks helping each other and giving pointers without asking for something in return. That’s what this website is all about. Congratulations to you and kudos!

  7. HD says:

    I put my recalls but I don’t see them here. what should I do?

  8. kena says:

    Hello I took the MLS exam and passed. LabCE is great. BOC is a waste of time. My suggestion is to review, review, review LabCE and your notes.

    • b says:

      how are you using LabCE? all im doing is grinding the adaptive tests averaging high 60s low 70s with 6.5~ difficulty. but a lot of the time im getting repeated lvl 9 questions. did you get any recent recalls that were posted here?


  9. kena says:

    BTW make sure you know your parasites and the differential tests for the Staphs and Strepts….

  10. cheer says:

    Hi Sohail, thank you so much for this website. I just passed my ASCP ,and I don’t have enough words to thank you and all the contributors of the recall questions. For those preparing for ASCP, please study these questions and answers.

  11. Jen says:

    I remember they asked about Stenotrophomonas maltophilia which are = Rapid oxidizers of maltose
    The asked about the stain used for Cryptosporidium parvum= Modified trichrome stains

  12. Charita says:

    I am so grateful to Sohail because this blog is such a big help for me when I took my exam last July. My scheduled exam was last June but because the system of Pearson was down at that time and I was advised to reschedule my exam which is very hassle.

    Anyway I’m going to share some points. Try to study Harr questions and also BOC for BB. Some of the questions in the BB actual exam were taken from BOC. Try to focus on A bottomline approach by theriot and also the book of ciulla

    -Memorize by heart the high yield notes of Sohail for Enterobacteriaceae and for gram positive cocci and bacilli it can definitely save your life from micro questions.

    I almost forgot the questions. But I hope this might help you.😊😊😊

  13. Andrew says:

    Total pc02 is 40 mm (kpa 5.6) calculted per mol/l ?

    A. 1.2 i picked this
    B. 12
    C. 4.0
    D . 40

    Can some one explain it to me how to do this problem please ?

  14. liwa says:

    Many blood bank questions especially DAT but I can hardly remember. Review high yield notes and other questionnaires you have. I used this site for review. Other review materials include Polansky, harr, boc and labce. If you are sure of your answer, don’t hesitate to follow your instincts. I never flagged any question since 2 hrs and 30 mins is quite enough. I finish my exam within an hour. Study hard and pray always for guidance. All the best for all takers. 🙂

  15. Cherice says:

    Good day Sohail. Just to let you know l pass my ASCP today. Your high yield notes really helped me. Thanks again.

    • Hi cherice! aside from the high yield notes what other reference
      did you study? Thanks!

    • Kelly Burton says:

      Hi Cherice
      Thank you for posting your exam recall questions, I think it’s amazing that you all can remember so much from the exam. This site, you, and all the contributors are a true blessing! I have a comment about calculations involved in determining how much the insulin given would change the serum potassium levels. I have searched this site for the answer, read my clinical chemistry text, I have read the BOC Study guide and I have looked on line. It seem that it is a dosage question. The BOC book does not mention dosage calculations, and neither does my chemistry text, but I did manage to find a calculation on line that tells how to calculate how much 1 unit of insulin would affect the glucose levels (1unit of insulin will decrease blood glucose by 50 mg/dL). I also found that 10 units of insulin will decrease serum potassium by 1 mmol/L. All these numbers are dependent upon the condition of the patient (Insulin Sensitivity Factor-ISF) and the many other important factors that the ASCP exam question does not provide. I am led to believe that it is a question that only requires the BEST answer (obviously). We know that insulin decreases serum potassium so we would choose the answer that is lower than the one given in the original question. If Potassium is 4.2 before insulin is given, it’s gonna be less after insulin is given. No calculation needed.

  16. Rah says:

    Hello everyone! I took my exam today and passed. I want to say THANK YOU SO MUCH everyone here esp Sohail! Bless you all. Good luck everyone and best of wishes. Don’t give up! No matter what!


    thank you for this amazing website, I took Ascpi yesterday 18th of September 2017 and I passed ( my 1st attempt). graduated in 2015 ( medicine and surgery) and 2008 ( Medical Laboratory Science). I passed really not bcos i gradated as a medical doctor few years back but bcos of God’s divine and unmerited grace and this amazing website. I was guided thoroughly by comments from many people on this site. To God i give all the praises and to all who had contributed here i say thank you and may God bless you, and to Sochil i say may God bless you richly and immensely.

    I had no textbook so I read polansky flash cards, harr’s review book tho i didn’t finish it bcosIi had less than two months to prepare.I actually knew about the exam in June and got registered for the exam in July.

  18. Cherice says:

    Good day Sohail. Just to let you know l pass my ASCP today. Your high yield notes really helped me. Thanks again.

  19. emadberair says:

    Thanks Wordsology for this great info… I am going to take my MLS exam on 10/13/2017…
    my weakest area is biochemical tests for Enterobacteriaceae…I can not memorise them all… : (
    any advice please?
    Thanks all …. for your recall

  20. R says:

    i just took the MLS ASCP exam NOV 9 2017 today and passed on first try!!! i cant thank you enough for this amazing website. i was freaking out during the exam and was so nervous that i almost passed out ……literally !!!!!! use Sucess and LabCE, LabCE is a good practice tool to see if you understand the fundamentals, but the question formats are totally different comparing to the actually exam, for example, LABCE exam gives you the exact values for each test performed and gives hints about whether theres something increased or not so if you understand the fundamental its pretty straight forward and the answer is obvious. but the actual ASCP exam questions are usually one sentenced (very minimal information) and a huge table of results containing relavant and irrevant results, so that could be confusing, so it would consume a lot of your time to figure out those anwsers especially when youre nervous and everything starting not to make sense during the exam and that would be the last thing you want it to happen. i was nervous and i blacked out, so make sure dont get nervous, although ive been trying to convince myself for the pass a few week to not freak out but i didnt work out that well.

  21. carol says:

    OMG what happened to this site, i feel like my only hope to pass just crashed. what happened to all the questions?
    someone help

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