EXAM RECALLS

Many folks have been asking for exam recalls to be emailed to them. Fortunately, your colleagues have previously posted – and continue to post – recall questions from recent exams. These are located throughout the discussion areas. I continue to compile them all in this area. If you have additional questions to contribute, please do so and you will be credited. Pay it forward and be a good human citizen! Thank you!

Many thanks to: King Bego, SS, Zsa, Yohannes, Jord, CloFro, Adrienne Salazar, Kk, Adrienne, Choneng, Oliver A, Aleesha, Yeng, Christian, Caroline, may, Gab, Ipassed, RufioSD619, PassitForward, student in USA, LM, Ergo, Michi, JB, Veronica, Chellezy78, Sniper, CC, Nancy, ariel acaylar, Ginger, ge02015, anna, Nika, Danny Lyons, Kobe, Valen, Yoro, Dee, Jean, Ruby, DeeCee, FM, John, newmt, CG, Forlornd, Diana, Paralumann, K, Charles, Ryan, Nicole, Sekonie, Kbrown, asdfgaill, Itina, Nicole, Klynn, Liv, TB, Jan, Zinnia, Samsam, SueS, Saro, Violeta, Sukhi, Maricel, Jamaica, mllerena, Bernadette, DoraDExplorer, annu, Shiela, RJ Baclagan, Kuki, Kaneulchan, Mr IT, Maria, Violeta, Anonymous, tao tao, Alexis, Krabbypatty, lead, Jordan, miroslavafh, Roela GV, Tazeen5, Rondrae, Sal, Sarah, Sam, Jen, Charita, Daniel, liwa

Here are my recalls:
-Steno maltophilia- multi-drug resistant and maltose fermenter
-Wilson’s Dse- confuse between increase CK and ceruplasmin (my answer) or increase ALT and ceruplasmin. I chose this because of CK-BB and mostly lead affects brain functioning. ALT is mainly for liver dse
-Suspected bioterrorism agent: morphology- satellitism with Staph aureus Gram stain: GNCB. I answered, rule out Francisella and Bordetella because these ar e characteristics of Haemophilus which is a common pathogen
-P antigen deteriorate over time
-Mycoplasma pnuemoniae – pt did not respond to atb due to lack of cell wall
-positive and negative controls of bile esculin, salt tolerance , CAMP and one more test I cannot remember
-FFP thawed at 10.30 am ans stored at 5C. Transfusion is due at 3 pm. Not mentioned if pooled FFP ( expiry is 4 hrs) so I answered keep on the fridge and wait for doctor’s instructions since normal thawed ffp can last for 24 hrs
-Difference between Pseudo putida and aeruginosa
-Plasmodia spp. wherein schizonts and merozoites are hardly seen- P.falciparum
-Picture of stomatocytes- liver dse
-Tabular CBC result of method A and B. In method A, WNBC is increased. In method B, WBC is normal. Beside it is a peripheral smear of target cells and Hb C bar shaped. Error in method A is on the lysing reagent
-Bilirubin metabolism
-Baby is O+ using cord blood sample. Mother is AB neg. I answered repeat blood group from heel stick.
-Ab ID: Ab identified is Lea and Leb, but choices are the description or characteristics of Ab’s so I chose glycolipids adsorb on plasma. I’m thinking it should be adsorb on red cells but since no other answer related to adsorption so I answered this one.
-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. Try to answer all recall questions especially the latest ones, but don’t rely always on the answers. Better check it by yourself. 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. 🙂

 

Thank you for this amazing website, I took Ascpi yesterday and I passed (my 1st attempt). Graduated in 2015 ( medicine and surgery) and 2008 ( Medical Laboratory Science). I passed really not because I graduated as a medical doctor few years back but because of God’s divine and unmerited grace and this amazing website. I was guided thoroughly by those recalls and comments from many people on this site. Over half of the questions on my exam were actually either related to the things already discussed here or directly same questions. To God I give all the praises and to all who contributed here I say thank you and may God bless you, and to Sohail I say may God bless you richly and immensely.

RECALLS
-something seen in primary biliary cirrhosis
-unconjugated bilirubin seen in
-2 year old baby with normocytic and normochromic blood picture
-picture of burr cell and the cause
-picture of stomatocytes and the cause
-picture of acanthocytes and the cause
-know and if possible memorize all the high yield notes and diagrams (microbiology). I got -over 15 to 20 questions related to those diagrams
-how to differentiate strep using laboratory tests (eg. nacl, eschulin,bile, pyp, camp), hemolysis , drugs and grouping system
-how to differentiate staphs using tests and drugs
-how to differentiate mycobacteria
-antibody panels and how to solve thme
-know the phases eg AHG, IS, 37
-characteristics of each especially kell, duffy, mns lewis, and kidd
also anti i and anti I
-urine reagent strip (principles, causes of false positives and false negatives)
-tumor markers (acute pancreatitis, breast cancer, hepatic ca, etc)
-PSA for prostate (I was given a scenario where one month after surgery PSA was high so what happened?)
-so many blood serology questions
-leukemia and markers
-transfusion reactions and causes
-casts, crystals and where they are found
-hepatitis markers
-PT AND PTT studies
-warfarin and heparin
-diabetes and how to diagnose it, Conn’s syndrome, Sushing syndrome and the lab values
I had no textbook so I read polansky flash cards, harr’s review book tho i didn’t finish it b/c I had less than two months to prepare.

 

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

-reasons for falsely dec/inc PT and PTT.
-how is Ca affted by PTH?
-Relevance of sodium and glucose?
-T.mentagrophytes/T.rubrum: Hair shaft
-overdose of salicylate, what chem test is to be tested?
-olive oil: M.furfur
-Degradation of reagent in PT/PTT reason for the qc to fail
-arrange by protein:lipid ratio (hdl, vldl, ldl, idl) i forgot my answer here
-patient is A positive but no A positive is available only O negative what will you do?
-Burr cells is an indicative of?
-what urine cast will appear in patients with nephrotic syndrome?
-Rbc cell seen in patient with mycoplasma pneumoniae?
-BB: remember the abo discrepancies and also the antibody identification.

-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.

 

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

 

Here are some questions I remember:
1. Markers absent in Acute promyelocytic leukemia: CD13, 34 (I picked) – Don’t know if its right
2. Group A, Le (a+b-) person: Lea only in saliva [Because no Leb = no secretor gene = no A & H antigens in saliva]
3. Burr: uremia, Stomatocytes: Liver disease, Acanthocytes: inadequate slide drying. [Picture shown for these so know what these look like under the microscope]
4. ANA pattern that looked smooth but had orange fluroscence along with green. and had mitotic cells that did not stain [“keyhole”]: picked Anti-mitochondrial – [Don’t know if its right]
5. PT, PTT, and Pt. samples all run together were abnormally high – Choices: CaCl2 added, thromboplastin added, controls deterioration, incubation temp. too low (I picked this one because the others didn’t make sense to me)
6. catheter tip – PT and PTT were high: Heparin contamination
7. %saturation = [Fe/(Fe+UIBC)] X 100
8. Antigen that deteriorates: P group
9. Procainmide toxicity, levels within range, what to do next: Repeat test on same sample, Recollect and repeat, Test NAPA levels (What I picked, don’t know if its right), Test phenobarbital levels
10. LF, ODC (+), Lysine (-): Enterobacter cloacae
11. Gram pos. bacilli: Cat (+), Nonmotile: B. antracis, corynebacterium jeikeium (probably right answer), Erysipelothrix
12. Lesions – Tissue: weird description -, microscope: Septate hyaline hyphae with microconidia: I put Sporothrix schenckii. Other options: Coccidiodes, Microsporum, Epidermophyton
13. RBCs on strip but none in microscope: Dilute alkaline urine {I think}
14. Autoabsorption done – ScI & ScII pos: Choices: Repeat autoabsorption, Selected panel cells, Antibody ID of enzyme treated cells (What I picked – I don’t know if its right)
15. PPT abnormal for normal and abnormal controls: I picked replace thromboplastin reagent
16. 18.5% retics, shows pic of pappenheimer bodies: Stain with Prussian blue
17. What happens in “Adrenal” Cushing disease: Increased Cortisol, Decreased ACTH [I picked this because it said adrenal cushing disease so I thought it meant “primary” – dont know if right]
18. Elevated Ca, Normal PTH: Metastasized carcinoma
19. pt. jaundiced with pancreatic mass: AFP, CA-19-9, [Picked AFP but not sure]
20. Deferral: Hospital workers received HB vaccine few days ago (I think)
21. Normo, Normo anemia, WBC & PLT normal, retic 0.1%: Pure red cell aplasia
22. Calibration of blood gad analyzer: 2 buffers and constant temperature
23. Monocytosis: TB
24. 3 LF organisms growing and also staph and micrococcus(?) on MAC, HE, and something else from stool. I put: report No Salmonella & Shigella isolated {Not sure}, Other options: Work up all three gram negative bacilli, report staph and micro
25. What gene is deleted in the Mcleod syndrome: XK

 

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.

The bloodbank questions were mostly product questions. How are platelets prepared? What temp to store cryo after it has been thawed. That was seriously asked 3 times. It is a room temp storage product after thawing so I’m really not sure why they kept asking me that. What blood types would be acceptable for a plasma transfusion? What antigens are affected by enzymes? etc…

I had several chemistry questions about hemolysis, lipemia, and wrong storage temps and their effects on different tests. A few about different methods of testing for HIV were also on there.

Urinalysis gave 2 pictures of casts, and 1 of a crystal. It didn’t ask what the casts and crystal were, instead it asked what diseases you would see these in.

Hematology was 2 questions about differentiating acute, chronic and leukemoid reactions, calculating the MCHC when given the indices, and a bone-marrow slide.

Good luck!

 

I passed the Ascp exam yesterday. I just want to say thank you so much for this site. The questions that I got, 75% of them were from here. God is good, pray before and after the exam! Whatever is meant to happen will happen. Best of luck for future examiners.

Which antigen deteriotes?
P antigen
Lots of pics with fungi
Math questions
Corrected RBC count
Labeled and unlabeled antigen was the correct answer for one of the questions
3 bb panels
Graph about platelet response to collagen, Adp and epinephrine
Glucose impairment

 

Hey guys. Just took the MLS ASCP like20 mins ago and got a pass. Want to say thanks to wordsology and everyone who posted their recall, especially the most recent exam recalls. I got around 15 or more of the questions posted…This is all I can remember:
-Patient showing symptoms of toxicity to primodone. However, measured value was in control range. what should the the next step? a. request new sample. b. napa c. phenobarbital (chose this).
-csf electrophoresis with anodal albumin…what should be done? a. report results b. report as contaminant c. request new sample d. repeat test
-western blot of HIV-1 showing neg cont, weak cont, and strong control. a patient’s test was showing bands for 160,120 and 66. how should the result be interpret. a. reactive (chose this not sure) b. nonreactive c.intermediate d. cannot be determined
-the use of potassium permanganate in the staining of mycobacterium. (not sure but i chose it is a counterstain)
-mycobacterium stained with carbol fuchsin and counterstained with methylene blue. However no acid fast was observed. whats the cause? a. wrong counterstain. b. wrong primary stain…etc
-antibody that deteriorate with storage. I chose P system.
-Got a lot of blood bank related questions minus the antibody panels. more related to discrepancies and screening cells with DAT
-which antibody is most likely not to show dosage? Jka, E, M, or Lea(chose this)
-False positive blood urine reagent strip. a. high level of ascorbic acid. b. dilute alkaline urine
-Got a picture twice of RBC agglutination. a. PCH, b.warm antibodies c.PNH
-Given result: DAT poly = 0, DAT C3= 3+, what should the tech do? Report DAT positive.
-second irreversible step of platelet aggregation. a. Platelet factor 3 b. release of ADP c. platelet shape change.
-Given result of antibody ID, All 11 tubes AHG= Negative, then added Check cells, 4 tubes did not given agglutination. The wash machine did not dispense correctly volume of saline.
– donor deferral
-Blood donation stops at 390 mL. Used as packed red cells.

Review the exam recalls and the high yield notes. I guarantee they will play a great role to your exam as they did for mine.
Good luck.

 

I got so many Exam recalls qestions:
difference between p. aeruginosa and p. putida – growth at 42’C
Ran controls and PT was normal, PTT was abnormal. Replaced controls and got same results. What should you do next?
A) Change out the Recombiplastin
B) Change out the CaCl
C) Rerun controls
D) Run patient tests
Histoplasma capsulatum –tuberculate macroconidia
amniotic fluid cannot be tested for bilirubin on regular chemistry analyzer as serum bilirubin because A) they are demanding, B) they are biochemically different
something about 2 types of bacteria found in agar one was gram + and another one penicillin, kanamycin resistance anaerobe gram neg. bacilli answer was Bacteroides fragilis
eluate had sc one pos., SC two pos., SC three negative…..you would do what…a) repeat eluate b) do a panel on eluate
Burr cells-uremia
Bartonella- cat scratch curved gram neg
cushing syndrome- increased cortisol, decreased acth
I got question about billirubiner ans ass. Disease
I used was U C B U “yoU C(see) Bulls**t”
U- unconjugated billirubin: Elevated in pre hepatic and post hepatic or billary obstruction
C- conjugated billirubin: elevated in hepatic and post hepatic
B- billirubin: elevated in hepatic and post hepatic
U- urobillinogen: Elevated in pre-hep and hepatic. Decreased in billiary obstruction
One question they ask what increase in hemolytic disease I answered Urobillinogen and unconjugated bilirubin.
Know your PT APTT ranges and MIXING STUDIES! and lupus anticoagulant.
ABO DISCREPANCIES and how to remedy them. Anti-a and Anti-b. Both 4+. A and B cells both 2+. How to resolve this discrepancy? But there was no prewarm in the option so I choose room temperature.
Cause of low NA? (Hypoproteinemia,  Diabetes insipidus
Two days old infant glucose strip positive. Clinitest negative. I answered Glucose pos. (not sure) Galactosuria was also an option.
Metabolite of PHENOBARBITAL : PROCAINAMIDE
Cut off absorbance for HBEAG was 0.734 something. Specimen was 0.3. Interpret result (Positive, Indetermine
Stomatocytes associated with Liver disease
urine refrigerated becomes turbid because of: I answered Amoruphous phosphates (not sure)
Monocytosis seen in what? TB
MI patient who was treated with streptokinase. Which of the results sugesst that treatment wasn’t successful. PT 12, PT 25,PTT 200 or D-dimer +
Rotavirus specimen- stool
Blastoconidia: budding b/w mother daughter
Legionella test: testing in urine Ag
What is in the saliva of a Le(a+b-) individual?Le a
What does CO2 electrode measure?PH
what does the hair test confirm : T. rubrum / T menta
spikey cells Acanthocyte = slides not dry yet
Blood comes up positive for HTLV-I/II, what do you do next? I choose western blot
O neg, Rh pos patient now has a positive DAT. What will their typing results look like now? Includes Rh control. – I chose the answer where everything was negative except the Rh control was positive.
ANA – it had things with like 4 colors green yelloow orange and red all over it but one is totally orange so I guessed. Anti mitochondrial antibodies.
Cushing syndrome causes
a. Hyperglycemia
Increase in jaundiced with pancreatic mass: AFP
Normocytic, normochromic, normal WBC, normal platelet, but retics is 0.1%
a. Pure red cell aplasia
Blood smear picture that looks like Howell bodies, the retic is 18%, the technologist should stain with?
a. Stain Heinz- body staining
Rouleux is undetectable at?
a. Room temp??
b. AHG phase
TSI = A/A and oxidase + and gas
a. Aeromonas
Pink colony on Mac, citrate positive, Lysine=neg, Ornithine posiive, Arginine positive
a. Kleb Pnuemonia
b. Kleb oxytoca
c. E. aerogenes
d. E. cloceae
you need to choose micro. ControlBile, nacl. Camp, bacitracin
I choose enterococcus, s.agalactiae and s.pyogenes (I think so)
what is the product of irreversible aggregation Fibrin formation
what causes postprandial lipemia Fatty acid
antibody identification Lewis b answer but choices were the antibodies description
A. Glycolipida adsorb from the plasma
A neg negative for D C I O RH NEG NEGATIVE FOR D C I ANTIGENS
Study ESR increase/decrease 2 question
. Strip RBC (+), microscope (-), this is due to what? Diluted alkaline urine

CSF for culture, MLS only manages to perform Gram stain in his shift, what should the technologist do? Incubate at 35C
Urinalysis result for a child had tubular renal cells 25-30, granular casts: tubular necrosis
Fecal fat methods: extraction and process
Immunology Patient titles EBV>IgG 1:128, IgM1:10, CMV IgG>1:128, IgM1:38, IgG<1:10: I don’t know the answer I think I choose coinfection.
False decreased in ESR: sample more than 8 hours to be tested
Plate with RBC (hyperchromic, anisocitosis), inclusions (1-2/ RBC) in Wright. Patient has 18.5% of retics. What should the technologist do? Use Prussian Blue
What affects HgbA1C: Life span of RBC
Calculate % of Saturation- UIBC 185 Fe 125
TIBC= 185+125=310 %sat (125/310)*100=40% (remember to convert units if they are not same)
PT normal (11s), PTT (56), Mix 1:1plasma (47)
a. factor XII deficiency b. factor VIII deficiency (chose this one)
In what condition do you find abnormally low erythropoietin? Policitemia Vera
Sample taken from indwelling catheter. Patient isn’t on any anticoagulants yet PTT and TT are way elevated: Heparin contamination (from catheter)
Lupus anticoagulant causes: thrombocytosis
Whole blood donation stops at 390ml:PRBC
Antibody that deteriorates in storage: P1
Table. Choose positive controls to test for anti-c and negative control to test anti-Fy(a): C+c+ for the positive control and Fy(a) for the negative control
Detection of ab where 11 tubes resulted negative in AHG, but when added CC 4 of them didn’t agglutinated. Machine didn’t dispense correctly the saline in the wash
Table. IS 37 AHG CC
SCI 0 0 0 2+
SCII +/- +/- 0 2+
Add 4 drops of serum
Baby A+, DAT-, Mother O- before birth: Do rosette test
Which donor should you differ? donor received Hep B immunoglobulin 8 weeks ago
A panel that anti-Fy(a) was present but can’t rule out anti-E, so the answer to the panel was: anti-Fy(a), anti-E
Patient with Hct 62%, the sodium citrate tube was centrifuged and noticed that de blood plasma ratio was low. What should the MLS do? take sample with more anticoagulant.
Coagulation machine, controls and patient where run in duplicate. Controls where normal, patient 1 PT normal PTT abnormal, patient 2 PT abnormal PTT normal
a. CaCl2 b. Thromboplastin c. something about a light (chose this one, check)
Instrument linearity something about comparing means: Paired T-test
Calibration of blood gases analyzer: 2 buffers with known pH and constant temperature
Absorbance formula: 2-log%T
Patient with fasting blood 155mg/dl and random 225mg/dl I choose Repeat FPG
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
Patient with elevated Ca and normal PTH: Metastasized cancer
What increases in Cushing? ACTH and Cortisol
Patient had dyspnea caused by anesthesia, what should be measured? Pseudocholinesterase

 

June 2017 ASCPi RECALLS
Sezary Syndome – T-cell lymphoma
Affected in Coumadin Therapy – II, VII, IX,X
ABO Discrepancies
Donor’s Requirement
RBC panels
5 HIAA- Carcinoid Tumor
A man with elevated BHCG & AFP but normal PSA & CEA – Testis
LDL computation
Anion Gap computation
RBC maturation picture
Proglottid of T. Saginata
Biochem result of P.vulgaris
Hepa A sequence of ag, IgM & IgG
Rh Neg mother pre natal & post natal results
Cold agglutinins
Results of decreasing bilirubin- due to phototherapy
Results of cbc hgb/hgb on the 3rd day increased by 2.0g- due to prolong tourniquet application
Levey jennings chart- what error
Measure precision- SD
Px with lyme disease- False positive with Syphilis

 

Hi!!! I just want to say Thank you, I did on saturday MLS test and i did PASS it… Im so happy it was kind of hard because for me blood bank was my weakest and i got mostly ABO grouping discrepancies and Antibody screen probs, i had about 9 panels, some bacter, Some questions I remember, by now is kind of hard to remember.
1.-Procainamide: NAPA
2.-ABO discrepancie I remember.A4+B0 O0 A0 B0 O0
3.- how differentiate Proteus Mirabilis and P Vulgaris.
4.-cloride shift-HCO3-Cl-
5.- A sample that was collected in gray tube for chemistry. what to expect.
6.- which anticoagulant should I use for coagulation studies.
7.- malaria in blood.
8.- peppenrhimer bodies
9.- Falciparum
10.-AFT as cancer marker
11.-what is increased in Hemolytic anemia? its as Unconjugated billirubin, iron, TIBC
12.-Gram + Bacili, Branching, CATALASE – partially acid fast— that was easy– Nocardia
13.-Oxidase -, Catalase+ Indole – H2S+ i thought it was Salmonella
14.- difference between primary and secondary thyroidism —TSH
15.Cushing sydrome-cortisol increased
16.- ALP increased when
17.-it was a line with for pictures i have to pick if they were in acid or basic urine
there where also some from bilirubin, some parasites, but no calculations for me.
the infective form
the first thing I did was wrote down all the bacter charts just in case. and the antibodies and ABO discrepancies because studied them from here. was easier to remember.
I cannot remember more but if i do i will come back
Thank you for this web site, it really helped me i read every single post and question.

 

Thank you Sohail the owner wordsology, Thank you all friends whom posted the recalls in this website. I passed the MLS exam today, second try. I studied Harr review, A Bottom line approach, BOC. I used LabCE for quiz game. Very important high yield notes here. Now is my turn to help others.

For Micro: I studied high yield notes micro here, then went through micro review section bacteria from Harr book. Don’t forget to study all micro recalls from here.

For Blood Bank: I studied high yield notes from here. Then reviewed all section of BB from Harr. Some questions from BOC very helpful: 18, 20, 30, 175, 228, 231, 244, 246, 247, 248, 250, 252, 259, 272, 274, 283, 289, 293, 301, 306, 315.

For Chemistry: I studied high yield notes from here. all recalls from here. and studied review section from a Bottom line approach.

Hematology and coagulation: I studied high yield notes from here and review section from a Bottom line approach. All recalls from here.

Urinalysis, BF, immunology: I studies high yield notes, recalls from here. Bottom line approach.

I had a lots of BB questions in my exam today.

Here is my recalls:

Blood Bank:
1. a patient is group A Rh negative and anti-Le(a-b+), what antigen patient have:
A, H, Le(b+)

2. What cause of weak D? Missing Epitope

3. A picture of RBC agglutination: 2 questions:
1) what does it associated with: PCH
2) what is this indicate: Cold antibody reacting

4. Given table : anti-A anti-B Rh Weak D Control
0 0 0 3+ 0
IS 37 AHG CC
SC I 0 0 0 2+
SCII 0 0 0 2+
PT 0 0 2+ NT

What does patient has?
patient has auto and alloantibody

5. Given result: DAT poly = 0, DAT C3= 3+, what should the tech do?
Report DAT positive.

6. Given result of antibody ID, All 11 tubes AHG= Negative, then added Check cells, 4 tubes did not given agglutination.
What happened? the wash machine did not dispense correctly volume of saline.

7. What causes this donor defer?
He had HB immunoglobulin injection 6 week ago.

8.The rouleaux can’t detect at what phage? AHG phage.

9. ABO discrepancy:
anti-A anti-B A1 B
4+ a+ 1+ 1+
what should tech do? incubation at room temperature.

10. Given table results:
Screen I and II positive, DAT = 3+, after autocontrol = 4+, after do auto adsorption, auto control = 2+, what should the tech do?
do enzyme treatment; report result; do another auto adsorption
or do panel selected cells. ( I chose do panel selected cells)

11. Whole blood donation stop at volume of 390ml:
What should we use for this?
a. do separated for platelet and plasma
b. use as packed red cell
c. use as whole blood cells ( I picked this one)
d. separated to plasma

12. Given panel: LeA LeB IS 37 AHG
0 + 0 0 0
0 + 0 0 0
+ 0 +/- 0 0
+ 0 +/- 0 0

this patient has what?
a. Glycolipid absorbed from plasma ( I picked this one)
b. patient has antibody.
c. do a panel
d. run auto control

13. Mother: O Negative has anti-D, anti-C, previously known has anti-LeA
Baby: A postive, DAT = 3+

What blood you chose to transfuse to infant?
a. Group A negative, D, C, LeA antigen negative
b. Group O negative, C antigen negative ( I picked this one)
c. Group A positive, D, C LeA antigen negative
d. Group O positive, D, C antigen negative

14. What cells antigen when storage will deteriorate?
a. Kidd
b. Kell
c. C
d. P ( I picked this one)

15. Given table panel red cells: choose positive control for anti-c (little c) and negative control for anti-FyA: C+c+ for positive control for anti-c, and FyA- FyB+ for negative control for anti-FyA.

16. ABO discrepancy: anti-A anti-B A1 B
0 2+MF 4+ 0

what happened? Patient received group O transfusion.

For laboratory:

1. To calibration of blood gas analyzer, you need what?
two buffers with pH and constant temperature.
2. Compare method for control and patient, what method to used?
Paired- T test

For Micro: you must remember diagram of high yield notes, I have about 10 questions and few they are not from high yield notes such as:
1. patient has cat scratch: GNB, low grade fever, enter ED.
a. Pasteurella multocida ( this for cat or dog bite)
b. Bartonella henselae ( I picked this one)
c. Steptobacillus moniliformes
d. toxaplasmo

2. Child suspected has “walking” pneumonia, doctor description penicillin, two weeks later the child still sick, what happened?
the organism mycoplasma doesn’t have cell wall.

I have 4 questions of Mycology, 1 questions of Parasitology:

1. Test using on hair penetration to differentiate of what organisms?
T. mentagrophytes and T. rubrum

2. What dimorphy yeast have description branch like mother and daughter?
Blastomyces dermatitis

3. Description of dimorphy yeast have ” cigar – bodies”
Sporotrix schenkii

4. Description about Histoplasma capsulatum : Tuberculate, Macroconidia

5. What Plasmodium doesn’t have stage of Schizont and Trophozoite in blood smear?
P. falciparum ( have ring and banana shape?)

 

 

Hi Sohail I took the ASCP-MLS last may 16 and passed. Thank you for putting this website up. Also thank you for those who took time to share the recalls I think I have answered around 15 questions based on recalls. So to give back, below are some of the questions I remember. Again thank you and God Bless.

Procainamide=NAPA
P.aeroginosa vs. P. putida = choices ; 1. pyoverdin, 2. growth @ 42C (answered #2 not sure)
Growth in olive oil = M. furfur
Picture of stomatocytes= liver disease
Whats in the saliva of Le (a+b-)= answered Lea( not sure) other choices include H and A
Specimen of choice for whopping cough = nasopharangeal swab
Zygomycetes description
Creatinine clearance calculation
ABO typing discrepancies (5 items or more )
Before addition of caffeine bilirubin = 3.2 after addition of caffeine bili = 5.4 = what is the conjugated and unconjugated bilirubin result
Abnormal acetaminophen result ( increased) what other relevant test mus be performed
Choices are 1. bun 2. crea 3. salicylate
Cryoprecipitate storage after thawing
Will you preapare platelet concentrate from wholeblood stored in ref for 24hours?
Picture of hypersegmented neutrophil = condition associated with it
Picture of burr cells = condition associated with it
Antibody panels = identify the unit to be transfused
Patient for coagulation study has 67% hematocrit what would you do.
Choices include 1. recollect with reduced anticoagulant 2. proceed with test 3. recollect with increased anticoagulant

 

Questions recalled:

Procainamide: NAPA
BHCG tumor marker for what? Not sure but I answered chorocarcinoma. Cos the three choices were pancreatic, colon and lungs
MCV calculation
5HIAA carcinoid tumors
I had 5 bb panels (was thinking maybe this was the reason I failed. Although I did understand but the questions were a bit confusing. Not sure with my answers)
Proteus vulgaris and mirabilis indole tests
Bb and Heme Case studies
Hydatid cyst fluid
Rh stuff
ABO descripancies
Antacid overdose? What lab test should you conduct?
Ouchterlony reading

I took the ASCP MLS exam yesterday for the third time and passed. I went through quite a few recalls and did a lot of lab CE (scoring around 80 for the regular 100 question mode and 75 on the adaptive tests) Here is what I can remember:

-coagulation
-Prolonged PT, PTT, and thrombin after collecting from catheter= heparin contamination
– Question with mixing study that was performed with a prolonged PTT that couldn’t be corrected=
DRVVT
-Another question with two pt’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
-Hematology-
-Lot’s of stomatocytes= liver disease
-Burr cells= uremia
-Picture of target cells with hemoglobin C crystals. The white count was high on instrument 1, so a second instrument was used with a stronger lysing agent, and the white count was corrected= I picked anti-lysing target cells are what increased the white count.
-A sodium citrate tube was drawn for a HCT on a pt but the hematocrit was abnormal. Options were recollect in heparin (what I picked), recollect with increased anticoagulant, recollect with decreased anticoagulant, etc.
-Question that gives a red blood cells count, HGB, and HCT. I did the rule of 3 and found that the HGB didn’t meet the rule of 3 because it was too high= I picked check for lipemia (elevates HGB)
-Picture of PBS with an elevated reticulocyte count and howell jolly bodies in the RBC’s.= I picked stain with prussian blue stain in order to see the retic nuclei
-what is composed of DNA?=howell jolly bodies
-what falsely decreases ESR=vibration
-ESR is increased, what is NOT a cause=I picked macrocytes because macrocytes don’t rouleux. Other options were rouleux, increased globulins, inflammation, etc.
-Chemistry-
-Question about lactic acid collection=separate from serum and put on ice
-Question about coefficient of variation
-Carbon dioxide electrode measures what?= pH
-Question about patient that had a random glucose >200 and an FPG >126. What do you do next?= I picked repeat the FPG. Other options were diagnose with diabetes mellitus, perform OGTT, etc.
-Immunology-
-Man tested positive for syphilis 2 years ago but may have again, how would you test him?-RPR
-Question with a graph with 3 peaks related to a bacterial infection= I picked that the first peak was the antigen in the stool, the second peak was IgM (goes up and then down quickly), and the third peak was IgG (goes up and levels off a little).
-Person tested positive for HIV-1 and HIV-2 but western blot was indeterminate. What do you do?= I picked do CD4 count. Other options were repeat western blot, repeat HIV-2, etc.
-Blood Bank- It felt like I had a lot of questions
– 1 small antibody ID panel. The antibodies that matched up were Lewis A Lewis B. Question asked about the characteristics of the antibodies.= I picked that they are lipids absorbed onto RBC from plasma.
– There was a positive DAT on cord blood; mother is Rh pos, baby is Rh neg. What is most likely coating the baby’s red cells?= I picked K (kell). Other options were A&B, D, Lewis, etc.
-Picture of what looks like cold agglutinins (I got this picture 2 different times during the test).= The first time I picked cold reacting antibody. The second time the options were different so I went with Paroxysmal cold hemoglobinuria. Mycoplasma infection was an option but there wasn’t a lot of WBC’s in the picture so I didn’t pick Mycoplasma.
-What phase can rouleux not be detected in?= I picked AHG phase because a positive 37C, negative AHG, and positive auto=rouleux
-Picture of ABO type with mixed field reaction in the forward type= I picked that patient was transfused with O blood
-Picture of AB in forward reaction, and weak reactions in back type= I picked incubate at room temp because probably cold agglutinins
-Question about an adsorption that had been done twice, and antibody screen is positive=I picked perform antibody ID panel
-If a patient is type A with Lewis a+b- what substance will be on their red cells= I picked Lewis a but other options were (A, Lea), (H, A, Lea), (Lea,Leb), etc.
-Micro- no parasite questions, 2 mycology questions
– Only 1 micro picture. Bile esculin +, NaCl-, alpha hemolytic, looked like a strep=Group D strep gallolyticus/bovis
-TSI slant K/A H2S+, PD-,= Salmonella antisera was only organism that fit
-Question with lactose fermenter, ODC+, lysine -, etc.=Enterobacter cloaca but I’m not sure
-Rotavirus= stool
-CSF storage= incubate at 35C
-Hair perforation test= Trichophyton metagrophyte and T. rubrum
-Good way to detect Legionella infection=antigen detection in urine
-Question about a lesion on an arm= I picked sporothrix schenckii but I’m not sure. Other options were cryptosporidium, microsporum, etc.
-Mycoplasma can’t be treated with penicillin= no cell wall

 

I just passed my ASCP so thank wordsology. Your exam recall really helped especially the drugs.Here is a list of things i recall:
1. eosinophils in urine sediments indicates what ? interstitial nephritis
2 calculate creatinine clearance : (Urine creatinine X urine Volume/Plasma creatinine x time in minutes)x (1.73/body surface area)
3. what is measured in procainamide ? NAPA
4. LEARN YOUR IMVIC REACTIONS YOU WILL AT LEAST 5 QUESTIONS AND TRY TO TURN EACH SEGMENT INTO A SENTENCE; THIS REALLY HELPED
5. Glomerulonephritis is found linked to which microorganism? Strep pyogenes
6. disease correlations : basophilic stippling and high lead results. Is this correct
7. what happens to CO2, PCO2, and pH when blood is left around for an extended period of time? low, low, and high
8 make a list of organisms that must be worked on under the hood

 

I just passed my MLT board, I studied for about a month (only 4 months out of school) I used LabCE (1800 questions in total) this site along with some Polansky and one day of Harr. Notes from my clin lab class right before the test
1. Need to pipette .5ml of specimen, what do you use—Volumetric, Erlenmeyer, or Serologic pipette. I picked serologic.
2. When to give Rhogam—Gave various types with moms Anti-X found. I picked Mother Neg with baby pos mother has Anti-C
3. Cold antibody—Anti-I
4. Gave two more ABO discrepancies and how to resolve them—Rouleaux seen microscopically use Saline replacement technique
(Recommend http://www.austincc.edu/mlt/bb/bbLab3ABO_DSpring2012.pdf)
5. ABO discovery: Landsteiner
6. According to Beers law- directly proportional to the amount of light absorbed, or inversely proportional to transmitted light.
7. One question that kind of tripped me up was mom was type BO- and father was OO- the results of the baby appeared AB+ asked what to do… Since this isn’t possible I figured mom messed around and still chose to report it, instead of any type of correction.
8. Dce/dce – R0/r
9. QC +/- of bacteria question- I picked oxidase- E.Coli and pseudomonas
10. Cell line question with multiple listed, anisocytosis and ovalcytes stuck out to me – anemias and myelofibrosis
11. Bile Eschulin and 6.5% NaCL pos– distinguishes Enterococcus species from the group D strep
12. Strep pneumo hemolysis- Alpha
13. Picture of strep pneumo in respiratory found here (http://textbookofbacteriology.net/S.pneumoniae.html)
14. ALP seen in—- Liver and Bone
15. Someone comes in after 4hours of MI symptoms gave results of CK CKMB and troponin- I picked troponin it was most elevated.
16. PT elevated in—Gave various factors I choose VII
17. Intrinsic has which factor- I picked Von Wilebrand(VIII)
18. Enterobacteria broad question- can’t remember the question but I chose Ferments Lactose
19. Someone who expresses immunity and acquired Hep B will have- HbsAg
20. Blood EDTA given to the lab 6hrs after draw will most effect– I chose platelets
21. What tube quantitates the determination of Calcium- Sodium heparin? (Red/Gold was not avail)
22. Electrophoresis question
23. Description of immature cell no picture
24. Differentiation by description no picture of myelocyte and promyelocyte
25. When using a blutterfly for coag study – Discard a blue top then use 2nd blue
26. Description of Football shaped egg with hyaline plugs at each end- Trich Trich
27. 4 nuclei may have chromatoidal bars large, round glycogen vacuole.- E. Histolytica
28. Hypersegmented neutrophils seen in vitamin B12 or folate deficiencies
29. Picture of Triple phos in urine
30. ALP elevation seen in- Hepatic Carcinoma?
31. Colon tumor marker- CEA
32. trough level is the lowest concentration in the patient’s bloodstream, therefore, the specimen should be collected just prior to administration of the drug.
33. Peak Levels drawn 2-3hrs after drug is given
34. bacitracin test can also be used to differentiate the bacitracin-resistant Staphylococcus from the bacitracin-susceptible Micrococcus.
35. Increased bili in urine will appear- Dark yellow color
36. WBC casts seen in pyelonephritis (kidney infection)
37. Waxy Cast- a higher refractive index
38. Metabolic acidosis- Vomiting

 

I just took the exam 4 hours ago and failed. I thought I’ll do just fine considering I read ciulla, Polanski, BOC, Recalls (from your site). I even went to a review class and signed up for the passascp just in case they weren’t enough. Although I had 5 recall questions, the rest were just idk…
1. Role of a supervisor
A. Democratic
B. Autocratic
C. Laissez-faire
2. Colony stimulated factor is composed of?
3. Picture of histoplasma capsulatum
4. Hodgkins cell- I guessed reed stern berg
5. Giant platelets- since there was no Bernard, I chose the may hagglin.
6. What it means to have a high plt count-essential thrombocytopenia
7. Procainamide-NAPA
8. A histogram ?
9. What does it mean if the organism is resistant? (This is the sensitivity)
A. Too little agar
B. Too much organism in the innoculum.
10. Basket cells/smudge cells. Where do you see them in?
11. Low serum ferritin, high tibc, low iron. What disorder?
12. Picture of a tube that had white organism inside. (Thought ithat was the Kansasii one but I was most likely wrong)
13. ABO discrepancies
14. Oligoclonal band-multiple sclerosis
15. Electrophoresis
16. Something about a chromosome. So I assumed t15:17
17. Rotavirus. If the EIA is positive, what do you do next?
18. picture of a cell
A. Dohle bodies
B. Auer rods
19. A graph with something on the left ( I forgot) and on the bottom is time. The question is about enzyme.
A. Enzyme concentration
B. Substrate concentration
20. Another graph with plt, wbc, rbc. 3 different graphs but the question was about the WBC.
21. A/A niacin postive
22. Ionized cal was left to stand for a while. What would happen?
A. Change in pH
B. Evaporation
23. A line graph of glucose and time. Which line would be a normal glucose level.
24. Hepatobilliary test
A. Ast and ALT
B. GGT
25. What enzyme would go up first in myocardial infarction.
A. CK
B. Myoglobin
26. Picture of agglutinated blood. How to disperse the cells.
A. 22% albumin
B. Saline
C. Prewarm
27. Another colony stimulated factor question
28. Anti-Hcv positive, Anti-Hbs positive
A. Hep A
B. Hep B
C. Hep C
D. Hep D

I guess that’s all for now. My eyes are heavy from all the crying. I’m not giving up, I just know it’s not my time yet. I’ll do better next time.

 

Passed the MLS ASCPi exam! I can say it was hard but with good study materials and prayers, inshallah you will pass. I used the Polansky cards then the Betty Theriot book for refresher as it was 8 years ago since i took the national board exam for RMT in my country – Philippines. I highly advice you to avail of Labce and do at least 100 exam daily. Both the computer adaptive and the Review mode. Read the explanations at the end and take note of them. Identify subjects you are weak and concentrate more on them. For subjects you are good at, give lesser time to them. Also, take notes of the recalls in this wordsology site. Try to memorize them, they might appear in your exam just like mine. They are worth points! These could save you. Coagulations, Blood disorders, Leukemia and Mycology and Biochemicals identification are things that appeared in my exam. The subjects i’m very weak at. They come on a situational format – like what will you do? What do you expect? Here are my recalls…

After ingesting moth balls what you see in PBS? Heinz Bodies
AB Rh: POSITIVE patient has reaction on forward A 4+ and B 1+ Rh 4+. What will you report? I answered AB Rh +
Gram negative cocci after a jaw surgey? Veilonella spp
QC on BhCG has weak positive in QC + and negative on QC neg what will you release? Release as positive BhCG.
MCV day 1: 78, MCV day 2: 77 MCV day 3: 76 MCV day 4: 62, what is the probable reason? Wrong patient.
Which leukemia + for Philadelphia?
High LAP score?
Low LAP score?
Smudge cells usually seen in? ALL
A picture of alternaria fungus.
A picture of Candida geothricum.
Olive oil for. M.furfur
calculate precision.
Youre given a list of cv, which of them is best?
Given lab results, which one is suggestive of Lactic acidosis?
Calculate how many units of blood to be taken given the antibodies and their percentages.
Calculate corrected WBC given the retics and WBC count. In this case the differential was only 50. Im not sure but what i did is: WBC Uncorrected x 50 / nucleated RBC x 50. I did the 100 the answere is not on d choices, but when i calculated using 50 as factor, the answer was on the choices.
Study antibodies of HAV.
RPR negative FTABS +? Release positive.
Cryoprecipitate and FFP allowable time of use if Ref. temp is 4 degree celcius. Based on AABB standard.
CK MB normal, Tn I is high? Myocardial infarct.
First to increase in MI? Myoglobin.
Study electrophoresis: Albumin, alpha 1, alpha2, beta, globulin.. Which is high given the disease, or the other way around.
There was a fungal colony which is violet to purple in color on the plate. Im not sure, i chose Fusarium.
Biochemicals of Salmonella typhimurium and Kleb. oxytoca
I had one simple BB panel. it was positive for Anti-Fya and anti-E.
Majority of lymphocytes. T Cells
Premature new born was transfused? why? I answered to compensate to the loss blood becoz of frequent phlebotomy. Not sure though..
Pheochromocytoma : Metanephrines
coccaine metabolite? Benzoylecgonine..

 

Passed my ASCP exam! I would like to thank Sohail for creating this amazing site, and to all the people who commented and shared their thoughts and recalls here. I highly recommend this site to everyone who will be taking their exams soon. I almost shouted at my testing room because i cannot contain my happiness after I saw the word PASS, all other sentences just went out of focus. Haha! Thank you so much, Sohail! 😊
Here are some of the questions i remembered during my exam:
1. Transudates are a. purulent b. has many bacteria c. usually noninflammatory
2. All about DAT and ABO discrepancies. I recommend you study all the discrepancies the cause and solutions of each
3. difference between p. aeruginosa and p. putida – growth at 42’C
4. S. epidermidis in catheterized patients
5. Microccus
6. Pictures of ANA patterns and dse association
7. Picture of Curvularia
8. Geotrichum candidum
9. Levey-Jennings chart
10. Random and systematic error
11. aggregating substances
12. picture of poikilocytes
13. Hbnopathy assoc w naphthalene poisoning
14. Blood pictures and ds associations
15.electrophoresis question.
16.CPDA-1 expiry date
17. coagulation pathways and dse correlations
18. metabolic acidosis
19. pappenheimer bodies
20. CLL, leukemoid reaction
21. Mixing studies
22. graph abt asp, collagen, epinephrine
23. Donor deferrals
24 Hepatitis markers
I also studied Ciulla book and took labce quiz games just for me to practice some questions. I highly recommend that you study the high yield notes created by Sohail especially the bacteriology and hemtology part. the tables and flow charts made it easy for me to familiarize the bacteria and also how to identify them. Big thanks to this site, really! 💞

 

Gosh the exam was hard and I was pretty sure I failed. It was purely blood bank based; wanna say at least 60-70% Q from bb, no parasitology, no UA identification, some heme, some mycology, some bacteriology and some lab management (no specificity or sensitivity 😦 ; which i studied and understood)

Some recalls:
child ate mothball accidentally: Heinz bodies
M. furfur: olive oil
gave 4 different equation with SD & mean; asked which would be more productive CV (So know how to calculate)
something to do with LDL and HDL: heparin manganese solution
5HIAA test: Carcinoid tumors
same effect as Procainamide:NAPA
Zygomycetes (from mycology) (Not sure what were the options or what I chose)
A picture of Histoplasma Capsulatum: identify
A picture of Blastomyces dermatitis: ( i think thats what it was; don’t know for sure)
Cryo was pooled; when is the new expiration?: 4 hrs
FFP was thawed at 11:15 am and left for the OR: came back to blood back at 11:40 and the temp was 11degC; what should the tech do? I chose accept and return to the inventory as it was less than 30 minutes with improper temp
Lots of DAT and Elution question
Lots of panel (please please and super please listen to the ab identification lectures by the BBGUY)
Something about dosage effect of antiE
Lots of ABO discrepancies asking why and what to do? (Please understand Sohal’s BB high yield notes; it is beautifully categorized and explained)
Lots of diagrams with iron, ferritin, TIBC, bilirubin, urobilinogen and then asked what type of disease?
KNOW IMVIC reactions: I have had 2 /3 question from there
K. pneumoniae vs K. Oxi….(See i don’t svn remember the whole name) (As soon as I saw it, I knew indole pos)
How would you differentiate diid Yersinia species: chose motility
know the X factor and V factor H. influenza and how it correlates with S. Aureus.
sensitivity for all the gram (+) organisms ( asked bat Bacitracin, positive camp test,)
Lots of ANA questions(remember the numbers and the patterns)

 

Here are my recalls. credits (to the owners) to those questions that are already posted here:

CDPA-1 how many days?
Which Mycobaterium (pictured) incubated for weeks and exposed tolight become yellow? picture of Kansassi (yellow colonies)

You received a nasopharyngal swab specimen for ROTAVIRUS, what to do? (I choose call for clarification of the request)

Which org requires safety precaution? Choices: Aspergillus, Sporothrix schenckii

Picture of Howell Jolly bodies

Blood from newborn had high PT, high PTT and TT, bleeding from cord also…reason…is a) afibriginogemia b) lupus inhibitor c) factor 8 deficiency d) factor 10 deficiency

FFP is thawed at 8am when is the expiration? Choices: 8pm, 8am etc..

Speckled Pattern is for? Choices: RA, SLE etc..

Question about what antibody causes HDFN when dad was O neg rr, and mom is A pos, R1R1…choices were antibody…. D, c, A, or B

Every other parameter on CBC was ok, (MCV, RDW, RBC, PLT, WBC)..delta failure on HGH is due to what…instrument malfunction, tourniquet too tight, wrong blood was tested….

Lactic acid specimen has to handled how…..a) chilled and separated from cells b) heated c) room temp incubation d) request EDTA sample only

Picture of Strongyloides stercolaris

LDL computation

Picture of Western Blot for HIV, read and interpret the results

Series of results of HGB results for 5 consecutive days, results in Day 3 is high, the others are almost the same. What is the reason? Choices: machine malfunction, collected too early, specimen left standing too long..

S. aureus ferments what? choices: mannitol, sucrose, lactose, fructose
Protein electrophoresis in pH 8.6 what is close to cathode? Choices: albumin & alpha 1, gamma & beta, albumin & alpha 2..

A 70 year old man will donate, what will be the grounds of deferral given the following screening tests: BP 140/90, Pulse 70, Temp 37 degrees the other choice is HBG of 120 or 125 I forget..
Donor will donate plasma. What will be the reason for deferring the donor; choices: Donor received penicillin(I think?) for last week, confirmed Hep B infection last year I forget the other choices..

Pt and ptt controls were abnormal qc repeated ptt was normal what will you do? – replace thromboplastin or replace activator

What process will you do for Weak D? choices: DAT, IAT, elution/adsorbtion etc..

Choriocarcinoma

Picture of P. falciparum (identify)

Biochemical tests identifying Shigella (IMVIC, motility etc)

Question about immunodiffusion arcs: Ouchterlony (identity, partial, non-identity)

First step in agglutination? Choices: flocculation, sensitization, lattice formation

Graph of lag phase micro what are the IgG and IgM?

Elizabethkingia meningoseptica – meningitis is premature NBs

A result of CBC: increase WBC, the rest are normal. Platelets is 20. What is the blood picture? (choices ranged from the normal or abnormal status of the ff PT, PTT, Fibrinogen, D-Dimer)

A picture of bone marrow smear. Is it normal or abnormal blood picture?

A LOT of antibody identification, discrepancies and resolution (3-7 questions)

2mL of blood was filled only for a 5 mL of anticoagulant tube; what would happen for results of apt? (decreased? Increased? Normal?)

O positive man had a strong anti-e, he will be incompatible with what percent of what blood Rh type? (choices; it’s something like: 97% of O positive? 25% of A positive? I forgot the others)

If the PT controls were okay and the aptt controls were okay, what do you do next? Choices were replace thrombin, replace activator, etc.

What is the cv is the 80-100 mmol/L is within 2SDs (choices: 5.5% , 10%, 20%)

What is the purpose of Protein C and S? (choices: act as natural anticoagulant, activates protein coagulants.. etc..)

What bacteria will show positive and negative for the following. Bile esculin, 6.5na, Camp, bacitracin. (choices: S. pyogenes, S. agalactiae, Viridians, Enterococcus)

Slight agglutination only on RPR test. What to do next? (choices: Repost as positive, re-calibrate and re-test, replaced new lot number, repeat testing using same kit)

Effect of increased/decreased aldosterone on Na and K

What’s wrong with this stain? blood smear shows pink buff on rbcs (choices: acid alcohol is too strong, carbolfuchsin is used instead of safranin etc.. I forgot the other choices)

Know common markers for B and T lymphs (CD 19, 20/ CD 2,3,5,7, 4/8 mature

Graph of 650 nm?

What does ISE measures?

How do you differentiate Yersinia enterocolitica vs Yersinia pestis? (I choose motility but not sure)

What is the specific gravity of the 3mL urine diluted with 3mL H2O? Specific gravity is 1.024 before dilution. (choices: 1.024, 1.072, 1.048 etc..)

How do you know if the plasma used for PT has been contaminated with heparin? (choices: test for PT, perform mixing studies.. etc.. I forgot the other choices)

Memorize mnemonics for IMVICs, TSIs, H2S producers, Oxidase and Urease producing bacteria and others etc.

aHCG – Pacreatic CA or testicular?

Where does ALP is increased? (I choose the associated with bone disease; no Obj. Jaundice in the choices)

Bernard Soulier syndrome – The question is long but the main differentiation that caught my eye is “giant platelets”. The rest of the choices are not in sync with the question. (No May-Hegglin in the choices so I choose Bernard S.)

What does 5HIAA in urine mean? (choices: renal disease, carcinoid tumors etc..)

Picture of Ascaris lubricoides ova (Identify)

Given: HDL was 34, Trig was 400, and cholesterol was 235. LDL was directly tested and was 169. What to do next? (choices: repeat Trigly and recalculate LDL?, repeat Chole and recalculated LDL? Recollect after 12 hours of fasting Etc.. I forgot the other choices)

A control blood smear was made that covered 60% of the slide. The red cells stained pink while white cells had their nuclei stain dark blue to light blue. The white cells were clustered at the tail end.
A) Accept
B) Reject – white cells clustered at tail
C) Reject – Red cell color is incorrect

Ran controls and PT was normal, PTT was abnormal. Replaced controls and got same results. What should you do next?
A) Change out the Recombiplastin
B) Change out the CaCl
C) Rerun controls
D) Run patient tests

 

I graduated a couple weeks ago and just passed my exam! I would like to take the time to thank Sohail, the owner of this blog! His high yield notes helped tremendously. I can’t thank you enough! Along with this site, I used LABCE –Did 100 questions a day mix with Adaptive Mode and Review Mode—Scoring about 51-55 % Adaptive—65-75% Review Mode; about 75%-80% subject tests. I also used bottom line approach book, Polansky. I thought I was going to fail as soon as I saw so many blood panels I had. Be positive and don’t second guess your answers! I only changed one answer.

Exam Recalls:

Chemistry/Urinalysis
Transudates
Abnormal urine colors
Cast dealing with strenuous exercise
Difference between traumatic tap; hemorrhage
The difference between primary and secondary thyroidism —TSH
Know your enzymes –ALP AST, LD, etc [Wordsology’s high yield chemistry chart]
Know your Tumor markers –what cancer is associated with it. I got one with hCG—testicular cancer –[Wordsology’s high yield chemistry chart]
Dilution question
Blood Gasses: Metabolic Acidosis/Respiratory Alkalosis etc. [know reference ranges; clinical conditions]
Procainamide and NAPA

Immunology
DiGeorge Syndrome- Regarding T-Cell deficiency—Absence of Thymus
CD4: is it a) inducer b) phagocytic c) cytotoxic d) don’t remember the other choice
ANA patterns

Hematology
Picture of a peripheral blood smear with Plasmodium falciparum
Howell Jolly inclusion picture –what is it composed of? DNA-
One with Pappenheimer Bodies – what do you stain it with? –Confirm with Prussian Blue
Know what anemias are considered normochromic normocytic
Hemoglobin C disease—Target cells
Picture of a peripheral blood smear with Plasmodium falciparum
COAGULATION
APTT; PT – Disseminated intravascular coagulation—Correlating the APTT: PT FIBRINOGEN results [prolonged or not]
Know what factors are in the Intrinsic and Extrinsic Pathway, mixing studies
Blood Bank:
Felt like I had a lot of blood bank questions (my weakest subject) Know how to do panels, DAT/ELUTION/ Subgroups of A
Criteria for Allogenic Donor Selection
CDPA-1 know its advantage

Microbiology/Mycology
Wordsology’s Gram Positive Cocci Chart! Had a question deal with +/- controls for Bile Esculin; CAMP; NACL; Bacitracin
picture of Kansassi
Sterilization – 15 lbs –121C
ESBL
TSI reactions for Enterobacteriaceae –Bottom Line Approach Yellow & Purple book
Ziehl-Neilson—hot stain
Rotavirus – stool
Histoplasma capsulatum –tuberculate macroconidia
Sporothrix schenckii—Cigar bodies

Laboratory management:
One question about quality assurance

 

Here are my exam recalls…..I guessed a few…cannot remember how I answered on a few..but just sharing…
1) 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. I guessed B (not sure if correct).
2)picture of Aued rod
3) picture of sideroblasts.
4) iron deficiency anemia question.
5) I had many electrophoresis questions…HGB C disease picture.
6) Many panels, including enzyme panels, RT, 37 degree reactions,
7) lectins are used in blood bank to…a) find an antigen on rbc b) enhance reactions. there were 2 more choices.
8) blood from newborn had high PT, high PTT and TT, bleeding from cord also…reason…is a) afibriginogemia b) lupus inhibitor c) factor 8 deficiency d) factor 10 deficiency…..I guessed A (not sure if correct)
9) long slender gram neg rods from plueral fluid..tapered ends and long…I chose bacteriodes fragelis (not sure if correct)
10) how would you differentiate morganella and providencia.
11) question about TIBC low, serum iron low…I chose anemia due to chronic inflammation (not sure if correct)
12) question about a discrepancy (subgroup of A) another one about patient had emergency transfusion in past..front type had mixed field reactions.
13) unusual band between gama and beta band on serum electrophoresis is due to what….
14) Spike in gamma region on serum electrophereisis is due to what…
15) If plts are pooled just before transfusion in room temp in open system…when do they expire
16)type I hypersensitivity reactions are due to ….
17) patient is diagnosed with hepatitis B 5 months ago…only thing positive is anti-HBc..what will the med tech do….a) report it as is..b) repeat the negative HBsAG c) report the anti-HBc as false positive d) suggest HCV testing.
18) Donor had anti-Lea, what is the best product for the blood inventory…a) rbc 2) FFP..there were 2 more choices.
19) Myelofibrosis picture.
20) enzymes tests that are needed for muscle dystrophy.
21) ANA detects what…
22) what is chloride shift?
23) what disorder leads to hypertension…when Na is high and K is low…
24)teacher was exposed to Rubella 5 days ago…but she had IgG in her serum…was she immune ?
25) Gram neg coccobacilli grows on chocklate agar and grows around staph aureus colonies on SBA as satellites…does it need a) X and V factor b) X only c) V only d) doesnot need either.
26) presumptive id of Neisseria gonorrhea had be made when it is seen in a) male urethral discharge b) female urine…. there were 2 more choices….
27) question about what method is it when light is emitted and expanded and transmitted at different wavelength..
28)something about mycobacteria…and Kinyoun Stain….
29) wright stain was too pink..what would you do…increase ph…decrease ph…add more wright stain..
30) cat bite wound culture grew gram neg…the choices were pastuerlla multocida, toxoplasma and 2 other..
31) question about what antibody causes HDFN when dad was O neg rr, and mom is A pos, R1R1…choices were antibody…. D, c, A, or B
32) High PT reason…very easy…factor 7
33) every other parameter on CBC was ok, (MCV, RDW, RBC, PLT, WBC)..delta failure on HGH is due to what…instrument malfunction, tourniquet too tight, wrong blood was tested….
34) for OGTT pregnant woman had a FPG of 250 mg/dl…what would you the best thing to do…a) consult physician before proceeding b) redraw and retest c) report it d) give oral glucose dose any way…
35) antigen frequencies were given… how many units would you screen…
36) anion gap values were given…calculate anion gap and choose an answer that explains instrument malfunction.
37) eluate had sc one pos, SC two pos, SC theree negative…..you would do what…a) repeat eluate b) do a panel on eluate c) do an autoabsorption d) do neautraliazation
38) A pos man had no platelet increase after 8 units RH negative were transfused…a) irradiate a unit b) HLA matched unit c) RH pos platelets only d) ABO compatible only.
39) lactic acid specimen has to handled how…..a) chilled and separated from cells b) heated c) room temp incubation d) request EDTA sample only .
40) If urine had many RBC and yeast…how would you add in the urine to differentiate rbc from yeast…a) glacial acetic acid b) saline c) acetic acid…not sure what I chose or what is correct…

 

I passed my MLS yesterday thank you so much. This site was very informative. It helped me a lot. Thank you Sohail and to the other contributors.

Recalls

Hema (pictures)/STAINS: 8 items mostly pbs
PBS: Burr cells-uremia
What deficiency Teardrop cells? DNA

Stomatocytes:liver disease

Picture of trichuris trichiura

BLOOD BANK
8 questions either interpret or what should you do next….
Anti a Anti b Weak D Rh control A cells B cells
4+ 4+ 2+ 0 0 0

Anti-A Anti-B A cell B cell
4+ 4+ 2+ 2+

• About Micrococcus- (100 ug) Furazolidone resistant
• Favors growth of anaerobic gram negative bacilli- Vitamin K and hemin
• Purpose of potassium permanganate in auramine rhodamine-quenching agent to enhance the color background
• A positive culture of sputum was stained. Carbolfucshin was added, washed, decolorized and malachite blue was used as counter stain. Two entire field was scanned and no acid fast bacilli were found. The most probably reason is: Inadequate scanning of slide
• A patient has “whooping cough”, what specimen?- Nasopharyngeal swab
• RIST – Total IgE
• Graph of the platelet aggregation expressed in % transmittance for ADP, collagen and epinephrine. Result was 0% transmittance ACE. abnormal ADP, Collagen, and Epinephrine)

• Computation: SENSITIVITY AND SPECIFICITY

Positive (100) Negative (100)
Method 1 50 100
Method 2 60 88

• Formula of sensitivity Sensitivity = (TP/TP+FN) 100%

• Lewis Antibody – if Le and Se gene is inherited, one has Leb adsorbed unto RBC Le (a-b+)

• Carbon dioxide ion selective electrode measure?pCO2
• Metabolic acidosis

• Result of lipase increased at Normal amylase (given reference value) saan daw associated ?

Choices : acute AP, colon cancer, Duodenal obstruction etc.

• Why is it that serum bilirubin is preferably measured than amniotic fluid?
Choices: amniotic fluid exceeds linearity of the machine being used , amniotic fluid is more difficult to extract, amniotic fluid has different biological components
• Characteristics of transudates at exudates
The question was clear yellowish peritoneal fluid with results ofRBC,WBC(Lymphocytes 80%)Glucose,Lipase,Amylase,LDH,Potassium
Choices: Viral transudate,Bacterial exudates etc etc etc (super detailed question and I don’t know the answer )
• Hepatitis B marker
• Urolbilinogen :Colorless product of bilirubin metabolism
• HIV: repeat EIA
• Storage of virus: Lyophilized
• Sorage of CSF for culture
• Niacin pos w/ picture M.TB
• CML-diff count result
• Group O isoagglutinins
• Blood to be transfused to a GVHD pxmother to child -irradiated
• Dss association pseudo pelger huet anomaly
• Chronic heap-auto abs- anti smooth muscle
• Picture of teardrop cells:myelofibrosis of the newborn
• Partial D: structure protein altered
• Delta Check:comparison of present data with previous result
• Result increase potassium cause: tourniquet left for more than 10 mins
• Phase contrast microscope : living cells,ustained spx
• Diff morganella and providencia
• Acinetobacter
• Aeromnas
• Differentiate mature and immature blood cells: chromatin clumping
• Light hit, emit power: fluorometry
• Cloudy urine: hematuria
• Picture spherocytes:mild anemia
• Low in serum iron, low tibc, normal ferritin:anemia of chronic disease
• Homogenous pix: ssDNA
• Electrophoresis protein
• Thermistor
• Half life
• Encapsulated yeast seen in DM: C neoformans
• Haptoglobin
• Protein C and Protein S
• Causes thrombosis:C3
• S. aureus ferments: Mannitol
• Heparin-Manganese
• Specimen collection for uine
• Sperm collected for 2 hous-repeat collection
• Hgb electrophoresis
• MCV MCH MCHC
• BB Pannel
• Tap water bacilli- M. gordonae
• Kleihauer Betke Disk
• Ouchterlony

Study materials: Checkpoint notes, BOC, Polansky and Harr LabCE(free quizzes), Ciulla wordsology.org ( high yield notes), for blood bank bbguy.org

Study well but pray harder! Prayers can move mountains seas and skies. Be positive. God will grant the desires of your heart . GOOD Luck

 

Passed the ASCP MLS exam last week. I would like to thank Sohail website, it helped me a lot to pass the exam especially the micro diagrams and recalls, i got like 10 questions from the recalls. Here are the questions that I could remember: mycoplasma pneumoniae 2 weeks titer, RhIg 50 mL fmh what is the dosage? Howel jolly pic, diazo caffeine what is unconjugated and conjugated? 395 glucose, 4.2 K, what is the K after insulin if the glucose is 215? CLL which lymph T cells or B cells? Pagets syndrome pH 9.6, hdl- heparin manganese, which one should be deferred?-hct 37. Bartonella- cat scratch curved gram neg , enhance anaerobes- vitamin k and hemin, what reagent on fecal occult blood? – hydrogen peroxide, chronic myelogenous leukemia, compute coefficient variation which value is more accurate?-choose the lowest value, pic of aggregation test, cushing syndrome- increased cortisol, decreased acth, chronic anemia disease- increased iron, increased tibc, acetaminophen poisoning what to test? – I picked bun and creatinine, 40 ml per min creatinine clearance what is expected? – increased bun. Pt and ptt controls were abnormal qc repeated ptt was normal what will you do? – replace thromboplastin.identify Hep B profile if a person is pos on hep b core, hep b suface ab, hep b e ab, i picked past infection. I had a lot of bloodbank panels, lots of micro questions. I used Harr, lab ce, ciulla, polansky and the yellow book. Good luck to the future examinees:)

I just took my test today. I passed! I studied 4 months for this test. After hearing many people from class saying that thetest was super hard and that they didnt pass I panicked. Maybe I overstudied but I don’t have the money or patience to study twice for the test. I have read every single thing on this forum and website. I cannot emphasize enough how important it is that you utilize this website to the fullest. Even if you don’t manage to study all of BOC HARR or Bottom line. This website and bottom line will have you covered. I am not sure that I can add anything else to what has already been stated by previous posts so I will attempt to make a useful contribution.

Blood Bank:
-Discrepancies, study them. A useful mnemonic device I used for ABO discrepancies was “EMMMA”:
Extra antigen
Missing antigen
Mixed field
Missign antibody
Additional antibody

– Lewis- secretors vs nonsecretors. Know everything about them
– Make sense of who can and can’t donate and why
-Weak D vs Partial D

Bottom line has this section really well summarized. study that plus this site’s section and you should be set. BOC also helped.

Blood bank was the heaviest area for me. If you have a hard time with antibodies use this video :https://www.youtube.com/watch?v=mvGC5M0ICCs it helped me alot on the test.

Micro: This site’s charts. Period. Don’t even bother looking into your micro textbook, along with the recalls the charts summarize it all. Only thing extra is bottom line’s TSI reactions.

Chem: I literally only had recall questions from here. A mnemonic I used was U C B U “yoU C(see) Bulls**t”
U- unconjugated billirubin: Elevated in pre hepatic and post hepatic or billary obstruction
C- conjugated billirubin: elevated in hepatic and post hepatic
B- billirubin: elevated in hepatic and post hepatic
U- urobillinogen: Elevated in pre-hep and hepatic. Decreased in billiary obstruction

Heme: Know your PT APTT ranges and MIXING STUDIES! and lupus anticoagulant.

Immunology: I had alot of HIV, just know that Wetern Blot is used for confirmation.

Urinalysis: know your dipsticks like everyone else said
Immunology: HIV, and ANAs

Finally know basic laboratory procedures. MOST IMPORTANTLY however is that you are able to think critically. A lot of questions are not just based on pure facts, you have to think and act upon your knowledge. This is what would happen in real life, you will somtimes be caught in a situation where you know the theory but have to apply it in another situation. So, relax, breathe and make sure you spend your time on what you know. If you have no idea about a question, PICK B and move on! you could use that time and brain power on things that will require you to think based on knowledge you already have. All in all I used all of the resources: BOC, Lab CE, HARR, this site, Bottoms line, Success, and Polansky cards. If you study enough you should be just fine. If you are scoring between 60 and 70ish on lab CE thats a good indicator, but as alwasy stick to this website and bttom line. Good luck!

 

I took my ASCPi exam and passed! Thank you wordsology for being one of the reasons why I did it!!!!!

Here are my recalls:
1.DAT Interpretation, what to do next if it has 3+ on c3d only
2.night shift reconstituted controls using water from the water purifier. Why? (Expired reagents) and volumetric pipette results were bad – why?  (Improper calibration of pipette)
5.Bx subgroup +mf on anti B
6.ABO DISCREPANCIES and how to remedy them. Anti-a and Anti-b. Both 4+. A and B cells both 2+. How to resolve this discrepancy? (Report? Prewarm? Wash the cells and retype?)
6.medtech performed AUTO ADSORPTION because of 4+ auto control But after adsorption it has still 2+ what to do?
7.Decreased free PSA is associated with?
8.ANA PIC associated with which of the following choices:  were anti ssa anti dsdna anti mitoch anti smooth muscle, the pic was speckled
9.Cause of low NA? (Hypoproteinemia,  Diabetes insipidus)
10.Exchange transfusion.  Mother was AB NEG AND HAS ANTI D, C, I AND LEWIS.  BABY WAS O POS.  What blood to be transfused on baby?
O RH NEG NEGATIVE FOR D C I ANTIGENS forgot other choices
11.if you are testing for MRSA, what to do? (Decrease the level of salt in the media
increase the methicillin conc of the disk, forgot other choices)

12.TIBC computation
13.cause of lack of agglutination after adding check cells on negative results
Two days old infant glucose strip positive. Clinitest negative. Cause? (Galactosuria, Excess ascorbic acid, expired strip)

CA 19 9
Metabolite of PHENOBARBITAL
PROCAINAMIDE
SLEEP APNEA- Associated with pseudocholinesterase
Flurometer
Valinomycin- K
Cut off absorbance for HBEAG was 0.734 something. Specimen was 0.3. Interpret result (Positive, Indetermine, Negative)
Stomatocytes associated with? (Burr cells)

Days before exam focus on how to resolve discrepancies and panel.
Read recalls here. A big help.
I studied harr and polansky and my notes. The high yield notes here were a big help too.
Thanks again, wordsology!

 

Thank you Sohail for creating this site..More blessings to come as you continue sharing your knowledge and experience. I just took my ASCP MLS today and passed!!! This wordsology site, LABCE, Quick review cards by polansky, BOC book and review book by Anna Ciulla are the books that tremendously helped me. 45 days of reviewing for 2 hours in morning and 2 hours in afternoon. Here are my recalls…I will add more- thank you again and good luck to everyone

1.valinomycin-antibiotic use for potasium
2.anion gap calculation (2 question)
3.antibody reaction of kidd,kell,duffy (3 question)
4.what is interferon?
5.Stap.aureus reaction in mannitol and how to report (2 question)
6.antibody panel reaction (situational) 4 question
7. ABO discrepancy and DAT
8.Fletchers media is for???
9.Magnesium test is for??
10.Lactic acid test for ???
11.Study ESR increase/decrease 2 question
12.picture of biochemical reaction
13. how to identify Necator americanus?
14.Prevotella media and identification?
15.Frozen plasma temp. after thawing? and how many hours should be use after thawing (2 question)
16 .releaux formation,spherocytes and cells abnormality(3question)

 

Took my ASCP today and passed. I didn’t think exam was that hard. I took a month post my training (didn’t study every day and studied 4 hrs or so a day)

Here are some of the questions I got! Sorry, didn’t know where I could email you to have them neatly added to the section.

Values of Cl, Na, Co2 and asked which one is not valid based on anion gap

RPR pos, FT-ABS neg, what does that mean?
primary, secondary, false positive

RPR is a good sensitivity test because:
very specific, very sensitive, stays for years after the infection

Catalase pos G+ cocci from (dubircle??) ulcer , slide coag neg, 6.5% NaCl Pos, Bile Neg,
ID as S. bovis, consider normal flora, assume S. aureus and perform tube coag (can’t remember 4th choice)

Important part to ID dermatophytes
macrocondia
chlamydospore
blastoconidia

Purpose of caffeine in diazo reaction for bilirubin?
remove bili bound to albumin
precipitate other compound with negative inference
ppt other compounds with positive interference
increase reaction with unconjugated bili

Low WBC, RBC and PLT, causes?
Folate deficiency of liver disease
Low B12 absorption

Pt 5 day differential result with Hgb slowly dropping, cause of result change (MCV went from 93-92 in 4 days to 72 on 5th day)?
Developing iron def
interference due to lipemic sample
Sample from wrong pt

Calculate LDL from given values

Calculate # of units needed to obtain 4 units that are K and E negative (frequencies were provided)

Calculate # of Rhogam to be given if 95 ml maternal hemorrhage.

 

Hi! I took the exam in September and failed. I regret not searching for tips before the exam. These are the questions I recall….
1. Picture of Fusobacterium
2. A thin, gram-negative bacillus with tapered ends isolated from an empyema specimen grew only on anaerobic sheep blood agar. It was found to be indole positive, lipase negative, and was inhibited by 20% bile. The most probable identification of this isolate would be:
a. Bacteroides
b. Fusobacterium
c. Clostridium
d. Porphyromonas
3. Picture of Taenia proglottid
a. Taenia saginata
b. Taenia solium
c, Dypilidium Caninum
4. Plate of Auer rods, where do you see them
a. AML
b. CML
5. A beta-hemolytic, catalasa positive, gram-positive coccus is coagulase negative by the slide coagulase test. Which of the following es the most appropriate in identification of this organism?
a. Report a coagulase-negative Staphylococcus
b. Report a coagulase-negative Staphylococcus aureus
c. Reconfirm the hemolytic reaction on a fresh 24-hour culture
d. Do a tube coagulase test to confirm the slide test
6. Hairy Cell plate, the picture looked blurry
a. atypic linfocite
b. hairy cell leukimia
c. normal linfocite
7. Plate of toxic granulation
8. During the past month, Staphylococcus epidermidis has been isolated from blood cultures at 2-3 times the rate from the previous year. The most logical explanation for the increase in these isolates is that:
a. The blood culture media are contaminated with this organism
b. The hospital ventilation system is contaminated with Staphylococcus epidermidis
c. There has been a break in proper skin preparation before drawing blood for culture
d. A relatively virulent isolate is being spread from patient to patient
9. Which test differentiates E coli O157:H7
a. Manitol
b. Sorbitol
c. Lactosa
10. A clean catch urine sample was taken:
TSI: acid slant/acid butt; no H2S gas produced
Indole: positive
Motility: positive
Citrate: negative
Lysine decarboxylase: positive
Urea: negative
VP: negative
This organism most likely is:
a. Klebsiella pneumoniae
b. Shigella dysenteriae
c. Escherichia coli
d. Enterobacteria cloacae
11. A gram-negative bacillus has been isolated from feces, and the confirmed biochemical reaction fit those of Shigella. The organism does not agglutinate in Shigella antisera. What should be done next?
a. Test the organism with a new lot of antisera
b. Rest with Vi antigen
c. Repeat the biochemical test
d. Boil the organism and retest with the antisera
12. Asacarolitic organism, DNasa + Oxidasa +- Moraxella catarrhalis
13. Propionibacterium acnés – Blood culture contamination
14. The reverse CAMP test, lecithinase production, double zone hemolysis, and Gram stain morphology are all useful criteria in the identification of:
a. Clostridium perfringens
b. Streptococcus agalactiae
c. Propionibacterium acnes
d. Bacillus anthracis
15. CNA and PEA
16. Case: From a pleural liquid it was recoverd a vancomycin, clindamycin (I think and another antibiotic, can’t remember) susceptible. On sheep blood agar was chewy or sticky and in McK it was pink, they concluded that it was Klebsiella, what do you do next?
a. Report Klebsiella
b. It’s not a common site for klebsiella to grow
c. The plates does not match klebsiella
17. A patient with Meningococci in peniciline treatment. A Gram was made and there where Gram- cocci. It was cultured and at 48 hours there where no organism. What happened?
a. The diagnostic was erroneous
b. Antibiotic inhibit the bacteria
c. Patient created antibodies against the bacteria
d. Bacteria produced Betalactamasa
18. when you prepare sheep blood agar, what do you do next?
19. Urine for culture and routine completely spilled- obtain a new sample
20. add KOH and a fishy odor comes out- clue cells
21. Parasite that migrates to lungs- Ascaris lumbricoides
22. A 47 year old was in antibiotic treatment. She had diarrhea for 4 consecutive days, what should you do next?
23. Mycobacterium process
24. Stool sample question
25. 57% Hematocrit is normal in:
a. Male
b. Female
c. One year old
d. New born
26. Siderotic granules: prussian blue
27. transudate
a. Contains bacterias
b. Something about natural cells
c. Inflamation
28. An alkaline urine refrigerated becomes turbid because of:
a. Amorphous urates
b. Wbc
c. Amoruphous phosphates
d. Bacteria
29. Cristales in sinovial fluid
a. Gota
b. Pseudogota
30. Negative strip, clinitest +
a. Glycosuria
b. Juvenile diabetes
31. Urinalisis and everything was ok except ketones 3+
a. Acetest
b. Ictotest
32. Mean of 140 with 2s and falls in 95% what is the range?
33. 4g of NaCl is added to water until 2500ml is reached. What is the concentration? 4/2500=.16%
34. Absorbance=(abs unk/abs std)x [std]
35. Elevated ALT
36. The best diagnostic for an alcoholic
a. AST
b. ALT
c. GGT
37. In which of the following conditions would a normal level of creatine kinase be found?
a. acute myocardial infarct
b. hepatitis
c. early muscular dystrophy
38. Elevated ALP
a. biliary obstruction
b. hepatitis
39. what should you evaluate in a antacid overload?
40. If the creamy layer of a red tube is discarded and chemistry is done, which result may be affected?
41. cases of acidosis and alkalosis
42. IDA common case
43. Icteric sample
44. A BUN- Creatinine case
45. Histogram, they presented WBC, RBC y platelets. What is the cause of interference in the WBC
a. NRBC-
b. Retics
c. platelet clott
46. Breast cancer marker- CA 15-3
47. Antibodies against TSH
a. Carcinoma-
b. Graves
c. Hashimoto
48. What should you do to a pregnant woman that in the 2hpp had 500mg of glucose in fasting
a. Give glucola
b. Do another fast blood
c. Change to 5 hpp
49. If a particle has the same isolectric point as the pH
a. It moves slowly
b. It moves faster
c. doesn’t move at all
50. Control fall out 3 standard deviations, which rule is broken?
51 Why ANA test is good?
a. Array immuno disease
b. Diagnose of SLE
c. Descartes Sjorgrens
52. Patient with anti-HCV + y anti-HBs +, what does he have?
a. Hep A
b. Hep B
c. Hep C
d. Hep D
53. ELISA was HIV +, What should you do next?
a. Report to the dr HIV +
b. Repeat ELISA with original sample
c. Obtain a new sample
54. Case of a patient that had everything elevated and platelets super high, RBC, Hct
a. Polycythemia vera
b. Polycythemia vera absolute
c. other types of PV that can’t remember
55. Bands of IgG to what their associate?
56. Howell Jolly plate
57. NRBC exercise
58. A plate of a lot of platelets, what do you do?
a. Repeat in the machine
b. Ask for a new sample and process it in the machine
c. Dilute and do a manual count
59. What is RDW
60. 2ml of blood is collected in a .5ml citrate tube, how is affected the pt
a. Decreases because of the inadequate ratio
b. Increases because of the inadequate ratio
c. Normal
61. Aspirin affects?
62. Why RBC in saline are better than those in CPDA-1?
a. Less glucose
b. More donor plasma
63. Girl with menorrhagia and elevated ptt
a. DD
b. Afibrinolemia
c. Ristocetin
64. Mother with mf agglutination
a. do kleihauer to mother’s cell
b. do kleihauer to baby cell
65. Who is the best donor?
a. Patient that received a transfusion 8 months ago
b. Woman that gave birth 4 weeks ago
c. Man that donate blood 10 weeks ago
d. Patient with Hgb in 12
66. To prevent Graft vs Host
Para evitar Host vs Graft que le das
a. Irradiated
b. Leukocyte reduce
67. Temperature for thawing FFP
68. Patient in operating room, intraoperative blood
a. Transfuse the patient in24 hrs if it was maintain at 1-6C
b. Do a crossmatch and then transfuse
c. can give to other patients
69. Lectin use
70. Blood bank panels

 

I just took my ASCP and passed on a first try. I cant thank the creator of this website enough. I used wordsolgy for study tips, exam strategy and high yield notes. I categorized and reviewed almost all the recall questions, the process was time consuming but It paid off. I completed my rotation 5 months ago and so I am not as fresh on the material. I studied for two months: a couple of hours during the first month and about 4 hours a day the second month. The material I used: this website, bottom line approach ( specially tables, graphs, memory aid), the success book for areas that weren’t well covered in the bottom line book. I subscribed to LabCe and completed 5 adaptive exams scoring 52-55% average difficulty 5.5, I also subscribed to PassASCP.org but their questions are all mentioned as recall questions from this website.
My thoughts on the exam: it was a fair exam, most of my questions were blood bank. I strongly encourage anyone to go through the recall questions I have seen about 30-35 questions that were from this website.
Recalls/focus areas
Blood bank: focused on discrepancy and DAT
Micro/Mycology: high yield notes specially enterobacterace chart, I got about 9 questions from both areas mostly were recalls
Urinalysis: strip tests and discrepancy
Chem/Immunology: memorize bilirubin (conjugated and unconjugated), urobiloinogen pre,hepatic and post hepatic results.
1)what causes postprandial lipemia
2)for some measurement (can’t remember exactly) the absorbance cutoff is0.700 and the measured viral antigen is 0.300 what does this mean? +/- or undetermined results.
3)patient fasting glucose is 128 and 2hr level is 200something.What should be done? Repeat test, do glucose tolerance… can’t remember other choices.
4) Cushing syndrome ACTH and Cortisol levels
5)Monocytosis seen in what? TB, mononucleosis, hypersensitivity.
6) young woman with sore throat, malaise and cervical lymphadenopathy then given antigen or antibody levels to CMV and EBV and had to determine if it is coinfection, CMV or EBV.
7) One ANA question with fluorescing speckled and centromere patter and I think it was CREST and scleroderma.
8) patient prostate gland was remove a year ago due to cancer, yet his current PSA is positive? Is the test not specific, is the sample not his, his cancer came back

Heme/ coag
1)There is a picture that I came across in two different questions and I think it was hemagglutinin
2)Reduced EPO is due to what? PV or secondary PV
3)Philadelphia chromosome
4)Megakaryocyte CD marker
5)lupus anti coag what does it do
6)recognize DIC lab results
7)Manual RBC calculation
8)MI patient who was treated with streptokinase. Which of the results sugesst that treatment wasn’t successful. PT 12, PT 25,PTT 200 or D-dimer +

 

I went into test center scared half to death because of “all the situational questions” but frankly, they were all one line questions giving the most minimal information. I am an over thinker, very well versed in what MTs actually do in their labs, what text books say to do, and also in all sorts of far-out alternative theories, so these minimal-info questions drove me crazy. Also, my test gave me definitions as choices in place of the actual organism or condition. Some questions were just so easy that I wondered if there was a hidden meaning. Example of definition: antibody R/O panel showing all reactivity in IS phase nothing at 37/AHG, so choices included cells destroyed by enzymes, sialo (or something like that) antigens, and glycoproteins adsorbed onto RBC. As the panel reviewed perfect reactivity in Lewis and mixed reactivity with M & N, I chose the glycoproteins adsorbed as that is definition of Lewis. Another was exact definition of FV Leiden. But I was getting hard questions toward the end, like figuring out the most likely antibody for a certain Rh phenotype – by then I was just tired, not that I couldn’t figure it out. I had to remember the Rh antigen frequency (D, c E, C e most frequent to least) . Also my test had a good third of questions all from these recalls, I had read the recalls back in August but forgot about them, but they must have sunk in, after all. So my bit of advice, yes yes, do go over the high yield notes on this site’s strategies, do know as much as you can about the highest yielding stuff, be well rested! Write down reminders on your white-board to clear your mind. I got a TP/FN question, wrote down the equation provided just in case and got a similar question later with no equation provided! I had the same slide 2x of cold agglutinin, asking what might this reflect (Mycoplasma) and then again, what condition might lead to this cold agglutinin (PCH as Mycoplasma was not a choice this time). I had at least 6 questions using babies as patients so I had to really know what might affect babies differently from adults, their normal clinical ranges. I’d say, because of all these recalls, the high yield notes, my own note taking, my test was not actually hard, and there were only 5 questions where I had never heard of condition/situation and had to guess. My own problem is I’m used to a ton of information in case studies, and it was hard for me to just look at the question as is.

Dino C: I took my MLS Oct 14,2016 for first time & passed. I agree with you on hard questions persisting toward the end. I found that a good one-third to half of my total questions actually reflected most of the recalls posted on Wordsology. I had read the recalls back in Aug, wrote many of them down figuring I’d double-check their answers but forgot, as I was deep in studying for everything else. So most of the recalls must have sunk in, after all. Anyway, I got a few easy questions toward the end, like the no-brainer: what is the analyte for GFR. But question #100 was analyzing 4 donors for a patient with DCeDCe phenotype, and which antibody most likely causing Rx in 2 of the donors. I had to take time working that out because by then I was tired, not because I didn’t know how to do it. And had run out of space on my white board. My really “hard” questions in hematology, micro & BB were around questions 10 -50. Because of all the recalls occurring in my exam, I never found the MLS to be that hard overall. Not a single leukemia, acid-base or which agar to choose. I was more than prepared for those😦

 

Where are urine crystals formed? Options 1)where distaled tubules, proximal tubules, loop of henle or bladder.
2) 2 questions about someone who had Duffy antibody but no longer has it. They need blood what do you do? Options where cross match only or do pannel are the ones I remember.
3) which is used as control in micro? It was something for ecloi vs something else for indole test. options for urease, lysine?
4) question about adh in chemistry and water
5) questions about sodium and chloride
6) question about Mcv
7) coefficient of variation formula
8) what is Tsh used for? Some of the options were to detect thyroid cancer, something about t4
9) where is lymphocyte from? Not bone marrow but another one I forgot but bone marrow was option.
10) something about Sudan stain and what’s it used for? Options were lipids, fats, proteins and something else
I had a lot of micro and blood bank questions more than anything else.

 

Resources I used to study: this site, labCE, Harr, Polansky review cards, sketchymicro, bottom line approach (highly recommended!!!)

Questions I remember:
1) Transudate definition (is it purulent, high cellular WBC count, etc?)
2) Urine color matching choose which one is correct ( I put port wine- porphyrin)
3) Which is more significant found in urine (pH 8.0, +1 protein, bilirubin +)
4) Know how to read immunodiffusion arcs (identity, partial, non-identity)
5) If you see band at start of serum protein electrophoresis what should you do?
A. report as abnormal
B. perform immunodiffusion
C. check to make sure it’s serum
6) Low serum iron, low TIBC, normal ferritin? anemia of chronic disease
7) beta-hCG
8) picture of enterobius vermicularis egg- use cellophane tape
9) Sensitivity vs specificity
10) several metabolic/respiratory alkalosis and acidosis questions
11) correlate RBC morphology with disease
12) hyaline casts may be confused with? mucus, fats or crystals (I put mucus)
13) semen analysis (abstinence, lubrication?)
14) calcium ion electrode measures what?
15) bronchiolitis in young children and immunocompromised- respiratory syncytial virus
16) Diphtheria- use loeffler and tinsdale tellurite
17) CD definition- antigenic determining characteristics
18) 3-4 antibody panels
19) cross- match unit calculation
For example: How many units of group O RBC units should you phenotype, in order to fulfill the request for two cross-matched units?
K negative 91%, Fya negative 37%
STEP 1: 0.91 x 0.37 = 0.33
STEP 2: Divide 1 by the number you calculated in first step 1/0.33 = 3
Since you need to cross-match 2 units, need to pull 3×2 = 6 units
20) triglyceride calculation ( cholesterol = LDL + HDL + VLDL) ***VLDL = TG/5
21) tumor marker for colon cancer- CEA

 

Passed the ASCP on first try! I want to thank Sohail for creating this website and other people for their recalls. I got maybe 5-10 questions from the recalls. I think my test was very hard… Thought I wasn’t going to pass… It was a mix of everything and there were some surprises that I had absolutely no clue… No questions on metabolic/ respiratory syndromes, no parasitology, no UA cast pic, 1 blood bank panel, 1 calculation, 1 ANA. The questions were pretty random and some came out of no where (unlike some people who had mostly BB or micro) and didn’t cover the topics that I studied the most/ most confident in. Where did the antibody ID, blood components, and Hematology questions go?!

The study materials I used were Harr, Bottom Line Approach, BOC, Labce, Polansky cards, high yield notes from here and my class notes. In my opinion, Labce is helpful only to a certain extent. You can get an idea of how well you understand the concepts but the questions do repeat and some were too difficult and irrelevant for the board exam. BOC book is okay because the questions are worded similar to the actual test. Study the recall questions!

What I remember:
1. Differentiate btw Enterobacter- Lysine and Arginine
2. Burr cell- uremia
3. Pre-hepatic/ hepatic/ obstruction and bilirubin levels
4. UA results and correlate to disease
5. Couple questions that provide coag results and ask what is wrong. Controls? Instrument?
6. Lupus anticoagulant
7. Rotavirus specimen- stool
8. Differentiate btw EBV and CMV infection
9. serum Na: SIDAH
10. Staph. aureus ferments mannitol
11. Some ABO discrepancy
12. 1 ANA
13. EPO in what? PV? Aplastic anemia?
14. Heinz body stain
15. Pic of polyagglutionation and asked what is the cause? The same pic actually came up 2x LOL
16. Pseudomonas aeroginosa vs putida
17. Catalase pos bacilli in blood culture. Non beta hemolytic, non motile, Penicillin resistant
18. TSI and some biochemical results and what is the organism?
19. Pasturella- cat bite
20. Blastoconidia
21. Legionella test
22. GN anaerobe in blood culture
23. Calculate transferrin saturation
24. Hepatitis marker
25. HTLV confirmation test
26. Which blood group antigen is not stable in storage?
27. What is in the saliva of a Le(a+b-) individual?
28. PCR erroneous results?
29. What causes postprandial lipemia?
30. Treponemal test
31. High Hct in coag sample. What should you do?
32. What does CO2 electrode measure?
33. BGA pH controls
34. serum Na while other electrolytes are normal. What should you do next?
35. Pic of stomatocytes
36. Enterococcus vs Group D strep
37. Aeromonas is oxidase pos
38. 1 panel but it asked about the characteristics of the antibody and not just antibody ID
39. Cushing- hyperglycemia
40. 1 mycology
41. Mycoplasma has no cell wall so penicillin is not effective
42. Monitor PA and NAPA
43. What affects HgbA1c?
44. What can cause a in ESR?
45. False positive in UA reagent strips

 

I took the M(ASCP) and passed today. I can’t really remember all of the questions, as I zoomed through it pretty fast. All said and done, I only used about an hour of my allotted time.

As far as my recommendations for study: this website, A Concise Review of Clinical Lab Science, labce, and Sketchy Medical. The BOC book is good for reviewing Acid fast bacilli stuff…..but you don’t really get many questions anyway. Probably two of the eight questions of AFB were directly from the BOC book. I’ll try to write what I remember, but they may not be verbatim.

1(Picture of S. haematobium)
From which source are you most likely to see this parasite?
A.Urine
B.Feces
C.Blood
D.Sputum

2 This catalase positive, gram positive bacilli with diptheroid morphology is highly resistant to many antibiotics and is associated with immunocompromised patients.

A.)C. diptheriae
B.)C. jeikeium
C.)L. monocytogenes
D.)E. rhusiopthiae

3 A chart with susceptibilities (of which I can’t remember) for K pneumoniae asking how the results should be reported. I’m pretty sure it was an ESBL producing organism according to the results.

4 Which of the following is most likely to penetrate through unbroken skin?
A. Necator americanus
B. Trichuris trichura
C. Enterobius vermicularis

5. Which is an appropriate specimen to diagnose Dracunculus medinensis?
A.Stool
B. Skin snipping
C.Feces

6. Which is the agent of hand foot and mouth disease?
A. Herpes
B. Coronavirus
C. Coxsackie A
D. Reovirus

7. A flat colony with green metallic sheen grows on blood. What’s the likely TSI reaction?
(A picture with 4 different tubes)
1. A/A
2.K/A
3.K/K
4.K/A +gas +H2S

8. How would you differentiate Group A from Arcanobacterium?
A. PYR
B. Catalase
C.Oxidase
D. Hemolysis studies

9.Most likely species for: Small gray colonies that are gamma hemolytic, bile esculin positive, PYR negative, Gram positive cocci in short chains and small clusters
A. Group A
B. Group B
C. Enterococcus
D. Strep bovis

10. Decontamination choice for Pseudomonas in AFB culture
A. Oxalic acid
B. NALC

11. How would you differentiate Micrococcus and Staphylococcus?
A. Coagulase
B Oxidase
C Novobiocin

12. How would you differentiate V parahaemolyticus from V cholerae?
A. Sucrose
B Glucose
C Some other sugar
D You can’t

13 (Picture of Epidermophyton)
Which species is this organism most likely to be?

14. Gram positive cocci, catalase negative,vancomycin resistant, LAP negative
A. Leuconostoc
B. Pediococcus
C. Group A
D.Staph aureus

There were a couple small math questions about calculating a 3% solution and some weird stuff I havent seen about ocular correlations. There were also about 5 really wordy questions, but if you knew your indole, citrate, H2S organisms it was pretty easy. There were some others, but I don’t really remember enough details to put them on here. It probably wouldn’t be helpful.

 

Questions I remembered
1.only 1 bottle for blood culture was sent to the lab from a baby,what would you do next?
A.gram stain
B.subculture
C.recollect
D.plate in an agar
2.what is the purpose of lectins?
3.8 yr old in er had a alkaline dark brown urine,what do you expect to see in his urine?
A.glitter cells and hyaline cast
B.waxy cast and granular cast
C.red cells and red cells
D.white cells and white cells
4.what is decrease in females who have their menstrual period?
A.transferrin
B.alt
C.haptoglobin
D.ggt
5.what is chloride shift?

1.what is chloride shift?
2.what will increase in gamma globulin?alpha 1 antitrypsin?
3.what is the best specimen for cmv?
4.a picture of tear drop,correlates with a.vit b12 and folate b.acute inflammation
4.specimen for rotavirus?
5.tsh of 1.2 and t4 18 (high t4 and normal tsh)-secondary hyperthyroidism
6.metabolic acidosis know the normal values
7. Disease in target cell
8. At ph 8.6 beta globulin is faster than?
9.dark brown urine in alkaline,what cells will you see?waxy and granular?glitter cells and hyaline?
10.ketone 1+,bili +1,occult trace.which one is the most pathogenic?
11.nitroprusside test in urine for what?
12.increase in potassium affects what?liver lungs or heart?
13 ionized calcium left in room temp for an hour,it will affect result due to a.change in ph b.evaporation c.consumption of glucose?
14 electrical empedance measures what?
15.fibrinolytic assay-thrombin time
16.dic-prolonged pt,Ptt,ddimer,decrease in fibrinogen
17.anti-ss positive specked Ana at 1:340,is it sle sjogensen syndrome?
18.picture of urine amorphous.microscope used is it bright field,polarized or electron?
20.body fluid I think it was pleural exudate has white count of 500 and is turbid,is it because it’s purulent,chylous,lipemic?
21.virulence of strep pneumoniae?
22.graph of lag phase micro what are the igG and IgM?
23.increase results in empedance what is the cause?pinching the tubing reagent,compressor?
24.specimen for t.cruzi?
25.listeria-charcoal yeast
26.vibrio -tcbs seashells
27.picture of fussarium what agar to use?
28.Graph of window,recovery phase of hepatitis,interpret…
29.picture of rbc agglutination,what to do?prewarm sample at 37 degrees
30.menstrual period-decrease in ferritin
31.antacid poisoning,what will you test?ph,ammonia,k?
32.hgb c what test needed?is it hgb electrophoresis?
33.after eating fatty foods what will increase?chylomicrons,ldl hdl no choice of triglycerides
34.hospital is going to buy new equipment how do you know if it is working well?coefficient of variation,sd of difference,regenerating result?
35.gomori agar?
36.cryoptt must contain how many my of fibrinogen?
37.ffp storage
38.enterococcus-peptedoglycan
39.strep pneumoniae-lancet shape-sensitive to what? Bacitracin,Vanco,or penicillin
40.purpose of kbst stain
41.propionibacterium spp-bacterial contamination of the skin while drawing a clot
42.a black clot in a unit of bag means bacterial contamination
43.a picture of an rbc graph,is it normocytic,macrocytic,microcytic
44.treponemal test
45.cfu in immuno is what cell?lymphocyte t,b lymhpocye
46.picture of basophil but the choice was sensitivity to mast cells
48.selective cell
49.blood typing problems
50.antibody identification
51.picture of western blot hiv,how do you report it according to cdc
52.what is the best for hiv test?is it pcr?

 

To add to these recalls, I would definitely know the micro charts. I could get the choices down to two and then just took a guess.
The most common cause of sperm agglutination is presence of sperm antibodies
Swarming; indole negative (proteus mirabilis)
Swarming; indole positive (proteus vulgaris)
Picture of rouleaux; the cause of this can be prom the proliferation of (plasma cells-multiplemyeloma)
Picture of csf electrophoresis; what would the tech do next
Fresh frozen plasma was thawed at 10am and then stored at 4C to be picked up at 3, what should the tech do
2mL of blood and .5 mL ofanticoagulant; what would happen for results of apt
Agar was poured into a 100 mL container instead of the normal 150 mL container. What would happen?
LDL calculation
hCg can be detected in
hemophilia B is a deficiency in factor IX
cell lysis in the classical pathway is caused by___ (know which numbers ex: C8, C5 etc.)
urine was delayed in being refrigerated, what happens; increased pH increased amorphous, casts dissolve
cause of cloudy CSF- crystals
calculate anion gap
calculate LDL
know what the different malarlia looks like in a blood smear
antibody panels
O positive man had a strong anti-e, he will be incompatible with what percent of what blood Rh type
Forward type as A, reverse type as AB; what is the cause
Mom is A dad is O; gave results of baby which ended up being A pos with a positive DAT and a hemoglobin of 8.1. Which one gave a misleading result? I put DAT
If the PT controls were okay and the aptt controls were okay, what do you do next? Choices were replace thrombin, replace activator, etc.
What is used to differentiate primary from secondary hypothyroidism; choices were T3, free T4, TSH, and TBH or something along those lines
Abnormal cells in the bone marrow with a high nucleus to chromatin ratio with few present nucleoli; choices were atypical lymphocytes, monoblasts, lymphoblasts
Pinworm-use the tape prep
Replace fibrinogen in a patient using what product
Mixed field reactions are caused by having; two cellpopulations
Histogram principle
Calcium-ion elective electrode principle
Normal iron and TIBC; pernicious anemia
Significant titer is; 4 fold between acute and convalescent

 

What is increased with mumps ( Amylase, Lipase were options )
I had three urine pictures, one was tyrosine, cystine and x-ray leftover
Definition of a transduate
i had about 6 bloodbank panels
what does the hair test confirm ( I believe it was T. rubrum / T menta but I am not sure )
what is the cv is the 80-100 is within 2SDs (5.5% , 10% )
burr cells = uremia
stomatocytes= liver disease
spikey cells = slides not dry yet
what is blastoconidia
picture of blastomyces
difference between pseudo aer and pseudo putida
Which bacteria is LF , A/A and indole positive ( i put kleb oxytoca )
two questions about CRYO, storage temperature/ time and what needs to be cross matched
Mother is Apos baby is O neg , positive DAT what is the cause ( I put Kell antibodies made by mother , another option was baby made antibodies against mother)
R1R1 mother, R1r father, what genotypes are impossible
person donates blood on jan 1st 2016, glycerol solution is added on jan fifth and frozen , what is exp date ( jan 1st 2017, jan 5th 2017, jan 1st 2026, jan 5th 2026)
Know what happens to salt glucose and potassium when ADH is increased
Hepatitis markers
Syphilis markers for someone in the tertiary phase
GOOD LUCK, Do not panic, They gave me ear buds in case I needed them to concentrate, but I just used them as a mini stress ball anytime my nerves would flair up. I had about 25 recall questions!

 

1)Cystic fibrosis green pigment -?

2)Alkali (that was the exact word )what happens co2, co3, ph?

3)Plt pooled at rt, how long held for ? 2,5,12,24 hrs

4)Pic of crystals in acidic urine

5)Antler hypha what bacteria?

6)Prolonged pt, ptt and tt-?

7)First titer till 120 , second till 50, what is it ? Pnh, mycoplasma …? Something in that nature

8)300 , what gives energy to things? K, copper, calcium ?

9)What grows on chocolate agar?

10)Aldosterone ?

11)Double zone , beta lactase?

12)Viewing crystals or urine under microscope , use 10x or 40 more light, less light . Something like that?

13)All analytes were out of wack, due to water not correct for Chem or reagents , something like that?

14)Mother donating rbc to son , what do you do… Wash, irradiate ect…

15)Where heme c and s found… Extrinsic , intrinsic, warfarin, heparin

 

Which of the following will 1st to increase after MI?
LD
CK-MB
Myoglobin
Trop I

Which of the following parasite cause autoinfection in immunocompromised px?
S.stercoralis
N.americanus
A.lumbricoides
A.duodenale

Which of the following causes antibody against TSH?
SLE
Hashimoto’s Dse
RF
Grave’s Dse

What RBC inclusion can be seen on blood smear of a child who accidentally ingested moth balls?
Heinz bodies
Pappenheimers

Howell Jolly bodies

Which of the following causes decrease HbA1c?
IDA
Hemolytic Anemia
Sickle cell

Which of the following cells releases histamine/heparin?
Neutrophil, Eosinophil
Eosinophil, Basophil
Basophil, Mastcell
Mastcell, Eosinophil

Which of the following Mycobacteria we can acquire from tap water?
M. leprae
M. gordonae
M. bovis
M. tuberculosis

Which of the following analytes is cofactor for most of 300 enzymes?
Zinc
Magnesium
Calcium
Potassium

Which of the following condition is the most common cause of increase anion gap?
Metabolic alkalosis
Respiratory alkalosis
Metabolic acidosis
Respiratory acidosis

 

I just passed my ASCP. This is my 4th time taking the test. I want to thank God 1st,the creator of this site and everyone who submitted recall question more than 50% of my question were questions others mentioned on this site, indeed and BOC book. I took the time and wrote all the recall question down and put then into each category. Study study study. Know the small details. I used labce, Harr review book, bottom line approach, BOC, the Polansky flash card. For microbiology all you need is the height yield note found on this website.
Thank god I only had 2 panels. I was really worried about blood banking. I would say my exam covered all areas. This is what I remember so far… Good luck everyone.
1.What bacteria will show positive and negative for the following. Bile esculin, 6.5na, Camp, bacitracin. I choose s.pyogenes, S. Agalactia, enterococcus . Other option has s. Virdian, S. Aureus…

2. I will bacteria when exposed to light change color m kansasii
3. Contained tap water m.gonada
4. Anti body panel that had anti k. How would the panel show specific or sensitivity can’t remember. I choose run enzyme panel not sure is that correct.
5. Had to calculate LDL
6. A questions which had odd results for glucose, sodium, BUN. What would be affected osmolslity 2na + glucose/20+bun/3
7. Double zone bacteria how to confirmation positive reverse CAMP test.
8. Gram negative anaerobes jaw surgery veillonella
9. A panel that ha anti d and p1
10. Waxy cast or fatty cast I think dye suban o oil.
11. Aeromonas gran negative, beta hemolytic, oxidase positive
12. N meningitis OPNG negative
13. Picture of histoplasma, and one about fluid being drained from the lungs.
14. Picture of aspergillus
15. Zygomycota sporengium
16. Malasezzis furfural- oil or olive oil
17. Auto infection strangyloides
18. Chromogenic agar I think. It was a picture of a agar one side clear organism had different color sheep blood agar all agate looks the same
19. K ISE- valinomycin
20. Person overdose on salicylate decrease ph- I choose metabolic acidosis
21. ALP ph 9.6- pagets
22. Cocaine metabolite- benzoylecgonine
23. Group A pod mother had and miss carriage d neg, weak d beg… Is the patient a candidate for rhig
24. I have to calculate diagnose for rhig twice. Whole blood divide by 30. Rbc by 15
25. Hba1c affected by hemolytic anemia
26. Caffein for diazo rxn why?
27. Bilirubin- 450nm
28. Pituitary gland – increased TSH and T4
29. Increase bilirubin and urobilinogen
30. Release heparin/ histamine – basophils and mast cells
31. Cryo store at RT from 2pm pt scheduled to be transfused at 3pm what would you do?
32. Irradiated blood for pt receiving blood from mother
33. Positive RPR negative FTA for syphilis -false positive
34. Pictur of a waxy cast
35. Alpha thalassemia-hgb Bart and Hgb h
36. Eosinophils in Urine/ intestinal nephritis
37. know the difference CML and AML
38. Questions about multiple myeloma
39. Increase platelet and wbc
40. Issoagglutinin of Type O- anti A, anti B, anti AB
41. Beta and gamma bridge
42. HTLV- confirmatory test- western blot

 

I passed my ASCP exam today. The high yield notes helped! As well as the passing strategy posted. I used Lab Ce did about 1300 questions mainly scoring between 60-70 on the review mode and 52-60 on the adaptive mode.
I got mainly hematology and blood banking and just a few chemistry and about one lab management question.. To those who will be sitting the exam my Recall notes are;

Blood Bank
– make sure you know the antibody panel and how to identify the clinical significant ones I got about 2 panels. Use the one shown here in wordsology.
– make sure you know how to interpret ABO blood typing. I got a question asking if Anti A is pos and Anit B neg and A1 cell Pos and B cells Pos. what should the technologist report. Also I got a question asking what should the technologist do if Anti A is mixed feel and Anti B is Pos and A1 cell Pos how would you interpret it. Also got tuns of questions about ABO discrepancies. If there is a autoantibody reacting only at room temperature which would it be. ect

Clinical Chem
I was asked to calculate
– Molarity -creat clearance- osmolarity- anion gap, coefficient of variation, and I had to know the metabolic syndrome and the conditions that can cause them. LDL calculation as well.

Microbiology
– tons of questions!
know the different in distinguishing K.pnemoniae from K. oxytoca. know about the differential medias. Thanks to the high yield notes most of the questions surrounded them.

Hematology
know how to calculate MVC, MCHC, Manual differentials or wcb, rbc, and one of platelet was there too.know the different leukemia CML, ALL and lymphomas and how to distinguish them.
those are my recall in a nut shell. HIGH YIELD NOTES HELPED

 

Hello everyone! I took my exam yesterday and passed! This website was super helpful, especially the high yield notes for micro and chemistry. I only studied for two weeks after finishing my program and I used the Harr book, Polansky notecards, and LabCE.

BLOOD BANK
1.What antigens are found in the saliva of group A, Le(a+b-) individuals? – Le a (other options included A, H, Le b in different combos)
2. Given a mini panel of antibody reactions. The serum is tested against Group 0 RBCs and cord cells. Reacts with all adult cells, no reaction with cord cells. What antibody? – Anti-I
3. Given panel of antibody reactions, have to determine which ones are causing the reaction and choose the choice that corresponds to them. – In mine, the antibodies were anti-Le a and Le b, but the answer to the question was ‘Is absorbed from the serum onto red cells.’
4. I had 2 questions with the same picture, a cold agglutinin picture. The first question asked what disease/infection it was associated with (Mycoplasma pneumoniae) and the second asked what would cause this blood picture (cold reacting antibodies).
5. Blood comes up positive for HTLV-I/II, what do you do next? – I put repeat the test that was just run. (It said which test in the question, I believe it was EIA, so ‘repeat EIA,’ but I’m not 100% sure. Other options were western blot, etc.)
6. O neg, Rh pos patient now has a positive DAT. What will their typing results look like now? Includes Rh control. – I chose the answer where everything was negative except the Rh control was positive.
7. Which antibody degrades upon standing, making it hard to detect? – I didn’t know the answer. I think I chose Lewis. CW was an option and I don’t remember the rest.
8. Lots of discrepancies, either due to ABO or reagents/technique, but all situational. I don’t know how else to prepare yourself for them other than knowing the basics well and being able to apply them to reason your way through.
9. Given mother blood type (AB-) and baby type (O+), what do you do next? – Since O blood type is impossible from AB mom, get a new heelstick from baby. Other options were get a sample from father, administer RhIg.
10. Mixed field reaction observed. What caused it? – I chose transfusion with O cells.
11. Donor deferral question

IMMUNO
1. ANA pattern, asked what antibody would make that pattern.
2. Patient comes in with mild flu-like symptoms. Given table with IgG and IgM titer values for EBV, CMV and toxoplasma. Have to determine if primary infection with just one or coinfection of EBV, CMV.
3. Biggest problem with PCR? – I chose contamination with nucleotides.
4. What HBV disease marker is found in individuals with a past infection? – HbcAb

MICRO/MYCOLOGY
1. Aeromonas, based on description of reactions.
2. Patient comes in with lesions on arm, given description of what is seen in culture. – I guessed, but I’m pretty sure it was Sporothrix schenkii
3. Blastoconidia – definition. Options included definition of arthroconidia.
4. Enterobacter, given description of reactions – can’t remember if the species was cloacae or aerogenes, both were options. Other options were K. pneumo and oxytoca.
5. Following a throat infection, patient is having kidney problems. What bacteria causing it? – S. pyogenes, other strep species as other options.
6. Patient has walking pneumoniae and is prescribed penicillin. 2 weeks later, still sick. What happened? – Bacteria produces a beta lactamase.
7. Make a gram stain of CSF at night, how do you store until culture the next day?
8. Potassium permanganate in auramine-rhodamine stain for Myco. – Quenching agent
9. Specimen of choice for rotavirus? – Stool
10. Took a swab sample from a wound and incubated on three different medias (including anaerobic media). Nothing grew. What happened? – Swab material inhibited the sample.
11. Latex agglutination for S. aureus – Protein A and clumping factor
12. Given TSI results, what do you report? – The results pointed to Salmonella, so I chose ‘do Salmonella typing’ but another choice was to call the Dr. and immediately report Salmonella type organism. Others were, report normal fecal flora and do Shigella typing.

HEMATOLOGY
1. Burr cells blood picture – Uremia
2. Stomatocytes blood picture – Liver disease
3. Badly discolored blood picture with very spiky cells. What caused this? – Slide not dry
4. Retic count 18.3% along with really messed up blood picture. What do you do next? – Heinz body stain (Supravital stain was also an option)
5. Iatrogenic anemia – due to excessive blood draws.
6. WBC and platelet count normal. Normocytic, normochromic anemia. RBC count very low and retic % is 0.1. – Pure red cell aplasia. Pretty sure I had never heard of this before the exam, but I figured it out. Other options included aplastic anemia.
7. HgbA1C values would be decreased in – hemolysis/hemolytic anemia
8. What is the second, irreversible step in platelet aggregation studies? Or something like that. – I had no idea, guessed change in platelet shape. Upon googling, it seems ‘release of nucleotides’ or something related would be correct.
9. Know about the reagents used for PT and PTT in the automated coag studies. I had 2 questions where the controls were off (and therefore patient results were off) but you needed to know which reagent to replace.
10. What cell type is increased in mononucleosis? – Lymphs
11. What will cause a decreased ESR?
12. Lupus anticoagulant causes what? – Increased risk of thrombosis
13. Sample taken from indwelling catheter. Patient isn’t on any anticoagulants yet PTT and TT are way elevated. – Heparin contamination (from catheter)

CHEMISTRY/UA & BF
1. In which case is Mg monitored? – Eclampsia. Other options were vomiting and diarrhea.
2. I had two UA questions where I was given a list of results and had to choose the disease that correlated with them. – Acute tubular necrosis and renal calculi.
3. 2 or 3 questions on dipstick false positive/negatives. Make sure you know these pretty well. I studied them because other people mentioned it and still had trouble. – Blood and glucose were the two I know for sure were asked about.
4. Hemolytic anemia/prehepatic issue, choose correct results for unconjugated & conjugated bili, urobilinogen, and urine bilirubin.
5. Patient taking primidone showing toxicity, but blood levels normal. What do you do next? – Test phenobarbital level.
6. Sperm count can be done on semen sample when… – Liquefaction is complete
7. Tumor marker seen in pancreatic cancer – CA 19-9
8. Cortisol and ACTH levels in adrenal Cushing’s.
9. Given values for fasting glucose and random glucose. What do you do next to diagnose diabetes? – Both are over diagnostic values, so nothing else needed for diagnosis.
10. Fasting glucose 120. What’s the diagnosis? – Impaired fasting glucose.
11. Pheochromocytoma – Metanephrines

 

Hey guys,
this is what I remember so far…my brain is toast, and yours will be too, but it’ll be worth it..

1. Burr cell – uremia
2. pyr – know POS and NEG orgs
3. BE and NaCl – know orgs POS/neg for them (entero, Grp D, Viridans)
4. KNOW TSI slants blindfolded – if its A/A and gas productio0n wht is it.. entero, serratia, s bovis, grp D strep (my question, I think those were the choices, or close to it)
5. CAMP test POS and NEG ctrls (agalac and pyog)
6. 1 ANA – it had things with like 4 colors green yelloow orange and red all over it looked like a f-ing picasso painting so I totally guessed
7. know the thyroidism chart for inc and dec in TSH, t4 and T3
8. know PTH effects on Ca+
9. Know about aldosterone inc and dec and when it happens, (Conns) and effect on Na and K
10. Cushings is hyperglycemia
11. PTH and Ca+ relationship
12. something about perfringens i think
13. a tough hemoglobin C question
14. rouleaux is undetectable at what phase
15. CMV best to do viral culture (i think, but i guesses)
16. ESRD (1.010 sg and waxy casts predominate)
17. a couple of thrombin/ antithrombin questions
18. no VWF
19. know about heparin contamination and mixing studies and TT/fibrinogen times
20. HBA1C
21. rotavirus – stool
22. HTLV confirmation testing
23. weak D epitope something
24. whats wrong with this stain – acidic so change pH
25. sezary – t cell or congenital t cell (difference)
26. Amylase – mumps
27. something about rubella I forgot
28. enzyme effect on certain Abs (destroy, enhance)
29. about 4 questions about diabetes ( insipidus, mellitus, the ref ranges for cutoffs for diagnjosing)
30. Conn’s sydrome Aldo increases
31. jeikiem quesition about somehing idk
32. know different between glom nephritis. Pyelonephritis, nephrotic disesase, (conj, unconj, urobili)
33. had 1 metabolic acidosis question
34. had the PCR question – denature, anneal, extend
35. had a hypo hashimoto question about tsh inc
36. troponin stays in the system longest
37. 1 syphilis question… just know whats POS and NEG for each of he 3 phases ( the rpr and VDRL)
38. an aeromonas question where it gives you the rx it was something like oxi POS, and some other rxns
39. know the TSI slants ( I have a story for common imvic orgs that helps so if you want it let me know)
40. a really crappy grainy picuture of what looks like rbc agglutination/flocculation/some other crap … that sais what should you do next – I chose heinz body stain (actually got this exact pic twice)
41. intrinsic resistances to common drugs (kleb amp R, Micrococcus R furosamide, stenotrophomonas Bactrim Res , etc)
42. a lot of aldosterone related questions (like 5) and diseases associated with them
43. a couple of coag cascade questions like when to do an F8 assay
44. when to do PT (warfarin therapy)
45. TB testing PPD is T-cell mediated type 4 hypersensitivity rxn
46. know common markers for B and T lymphs (CD 19, 20/ CD 2,3,5,7, 4/8 mature)
47. if pt and ptt are inc what do you do next (exactly waht do you do next)
48. a s-load of bilirubin (like 7) know what happens in prehep, hep, post hepatic and nephrotic syndrome, when you would expect to see jaundice associated with what Bilirubin, etc
49. absolutely no parasitology
50. no myocology
51. almost no hematology
52. no AB/Ag frequencies
53. know (sensitivity = TP/TP +FN) and those others (SPECificity = TN/TN+TP) (PRECISION = TP/TP+FP)
54. a bunch of lab ops questions (3 or 4)
55. no HDL.LDL.VLDL
56. a couple of tiny screen panels like if you have nothing thru iat in screen cells 1 and 2 except patient sample shows up +/- on iat what do you perform next bla bla bla
……..a lot of “what do you perform next questions” related to BB so brush up on panels, DAT, IAT and discrepancies

 

Well I just passed the MLT (ASCP) registry today. I had to cram so I did 1000 questions from LabCE and roughly 300 from the BOC ASCP book. I felt that the BOC practice questions were closer matching to the registry. The reasons given in the BOC guide are poor though so if you need any reasoning for answers then LabCE is definitely superior.

Here are my recalls from the test:
Thalassemias
Dimorphic fungi
Enterobacteriaciae biochems
Differentiating non-Lancefield streps
ABO discrepancies
G6PD deficiency
Transfusion testing requirements
Transfusion reactions
Elution, adsorption, absorption
Immunological testing types and methods
Pre, post, and hepatic jaundice (unconjugated, conjugated, bilirubinuria, urobilinogen, etc in each)
Gold standard chemistry tests, methods, and reagents used in them
DIC and MAHA characteristics and complications
Renin angiotensin system
Electrophoretic patterns
Type 1-4 hypersensitivity reactions
Cardiac markers
Coagulation studies and factor deficiencies
Inhibitors and what they inhibit in micro media
Urinary casts and associated conditions
ALL, AML, CML
Which preservatives are best for which stage of parasite and source of specimen.

 

Mycoplasma- why it doesn’t stain
Mycobacterium- kinyon stain, auramine stain sensitivity, fast/ slow growers, scotochtomogen definition.
campylobacter pic, it’s growth condition,
Enterobacteriaceae biochemicals
Parasitology pics
Common urine isolate
Antibiotics
Dimorphic fungi
Pork associated organism
Diff btw Proteus mirabilis& vulgaris
Gram pos cocci pics, other test if not agg pos.
Vitek ms definition, (can’t remember clearly but second question goes like – cannot differentiate btw s. Pneumo and given options)
Fungi pics

**SURE POINTS: Heinz bodies (there were two questions with the exact picture in my exam, I answered G6PD deficiency and anti-malarial drug (now this might be a bit confusing bec the one I had have hypersegmentation, ovalocytes and tear drop cell; focus on the HEINZ BODIES!)
Klebsiella oxytoca (indole + as compared to K. pneumonia which is -) I also recommend Sohail’s notes on Enterobacteriaceae (GNB; all of the high yield notes really, they were all very helpful! memorize them if you can)
Alnernaria microscopic picture
Alkaline ph (9.4) I chose Paget’s disease bec of ALP.
Virus transported for 92 hours or something = Lyophilized (I’ve read this recall here, thank you so much!)
Olive oil = Malassezia furfur
CK (normal), cT (elevated) = Acute myocardial infarction (don’t be confused, since troponins increase faster than CK, this findings can be possible). Order of increase/peak: MTCAL (myoglobin, troponin, CK-MB, AST, LDH)
Bilirubin, Urobilinogen values (what disease association do they inc or dec)
ALP = obstruction
Chronic hepatitis = anti-smooth muscle antibody
Releases heparin/histamine = Basophils/mast cells
If Se and Le genes are both inherited, what phenotype? = Le(a-b+)
Pheochromocytoma = test for METANEPHRINE
Urinalysis results increase RBC (also strongly positive in strip) BUT neg in almost all of it = glomerulonephritis
Another one is almost all were positive in rgt strip and in microscopy, but the highlight was the presence of waxy cast so I chose= Nephrotic syndrome/dse
End stage of degeneration (renal failure) = waxy cast
HgbA1c decrease in = hemolysis (hemolytic anemia)
Lipoprotein that transport the majority of cholesterol=LDL
VLDL (endogenous triglycerides); Chylomicrons (exogenous TAG)
Gram neg cocci present after jaw surgery= Veillonella
Micrococcus = Resistance to Furazolidone
Tap water bacillus=Mycobacterium gordonae
Examination of semen sample, can proceed to sperm count = once the liquefaction is complete
Alpha thalassemia = Hgb Bart/Major (other choices were hgb D, sickle cell, etc)
Aeromonas hydrophila =GNB A/A G(+) on TSI, oxidase +
Procainamide = NAPA
Main metabolite of cocaine = benzoylecgonine
Type 1 hypersensitivity stimulated by = IgE
**Calculations: RhIg, Creatinine Clearance,

**NOT QUITE SURE: Graph of ECA (Epinephrine, Collagen and ADP), two of them changed from 0 (either inc or dec), the other one is just 0. They will ask you which ones are normal/abnormal
They wavelength of the spectro was set to 540 but for some reason the staff keeps getting erroneous (higher than the normal) transmittance, what seemed to be the problem? I chose halogen quartz as being the problem
I’ve read this from some of the recalls posted, about the calculation of potassium? Upon administration of insulin, the glucose decreased, find the value of potassium (given values of insulin and glucose, I don’t know the sol’n, please look for it if you can, I ignored this and then it appeared on my exam, haha tragic)

**other pointers to study/focus : Ab panel/ID, RhIg computation, ABO discrepancies; Bilirubin, Urobilinogen (Pre-hepatic, Hepatic, Post-hepatic), Acid Base Balance (metabolic/resp-acidosis/alkalosis); Sensitivity(TP)/Specificity(TN); ANA patterns. They were generous with the normal values, so you just have to take note of the abnormal results. Don’t be scared with the long questions or results. Just focused on the abnormal ones and also with pt history.

 

hi, I passed my exams last Friday. thanks a lot to this website. I took time to go through all the recalls and I must say it was worth it. saw a lot of the recall questions in my exams. I also used LabCe, BOC book, clinical lab science review book( yellow and purple book) and the one by Elsevier’s and Harr. here are my recall questions. good luck to all those going to sit for the exams. please study and prepare well.
BLOOD BANK
ABO compatibility with blood groups-very important
Blood product that has highest capability of transmitting hepatitis
Temperatures for storage of blood products, how long, ABO compatibility and condition or reason for transfusing product
Platelet temperature and PH- temperature of blood before processing( room temp).
OR schedule- how many units to prepare given blood group and antibody of patient
Kell frequency- 91% negative for antigen
Antigens of ABO system: Le with no Se( Lea+b-), Le with Se ( Lea-b+).
ABO discrepancy- subgroups of A, anti-A1 lectin
Cold antibodies and warm antibodies
Mixed field reactions- check transfusion history first
Controls for D-testing , Du test and AB+ control
Weak D- Missing epitopes, position effect.

IMMUNOLOGY
T-cell, B-cell lymphomas
IgG and IgM- which rises first
Hep A graph: antigen in stool-IgM-IgG
IgE- basophils and mast cells
Classic and alternate pathway complements
RA- IgM produced, autoantibodies to the Fc portion of IgG
FTA, RPR,VDRL, which is for testing reinfection, late stage and early stage
Treponemal antibody agglutination
Infectious mono- reactive lymphs and monocytes
Hepatitis- antigens and antibodies tested for each stage

HEMATOLOGY
Transferring- TIBC
Child swallowed naphthalene ball- Heinz bodies
Heinz bodies- DNA
RBC inclusions and corresponding diseases
Anemias and what to find in RBC- pictures
Sources of error like in ESR and Hb
Stomatocytes- liver disease
Oxidant drugs, anti-malarial drugs effect on RBC
Hemoglobin electrophoresis- cellulose acetate-C S F A and the Hb it migrates with
Hemoglobinopathies- sickle cell solubility test and sources of error
Thalassemia- alpha- Barts and HbH
Beta- cooley’s anemia
Myelodysplastic syndrome- essential thrombocytemia( increase in PLT, splenomegaly).

COAGULATION
Mixing studies
PT & Aptt Factors
Protein C- how aspirin affects test( prolonged, increased or unaffected)
Platelet aggregation_ graph for ADP, epinephrine and collagen
Both PT and Aptt prolonged and then corrected

URINALYSIS
Bilirubin crystals- liver disease
Eosinphils in urine- interstitial nephritis
Monosodium urate- highly birefringent
HCG- pregnancy
Creatnine clearance- (UV/P)*(1.73/A)
Rhabdomyolysis- myoglobin

CHEMISTRY
Glucose levels-nomal and abnormal
ADH- increase water absorption
Iron test
Liver enzymes; hepatobiliary- ALP, GGT, 5NT
Hepatocellular- ALT AST
CK, troponin- MI
Amylase and lipase- pancreatitis, source of error
Solution/buffer for most ISE methods
Blood gases
Bilirubin – conjugated and unconjugated, urobilinogen
Hemolytic, hepatic, biliary obstruction
Immunosuppressant- tacrolimus- use whole blood
Azotemia- increase in BUN
TSH
Pheochromocytoma- VMA
K ISE- valinomycin

MICROBIOLOGY
Anaerobes- chopped meat agar( iron and glycerol)
Micrococcus- resistant to furazilidone
Aeromonas- A/A, oxidase+
Acinetobacter- wounds
Erysipelothrix- H2S+, catalase+
Veillonella(g- cocci) and peptostreptoccus( gram+ cocci) – anaerobes causing jaw abscess
Picture of agar with chromoblastomycosis
Picture of blastomyces dermatitis
Geotrichum- arthroconidia
K. Pneumoniae and K. Oxytoca( indole+)
How to transport viruses after 96 hrs
Malasezzia furfur- oil
Zygomycota- sporangium

 

a person overdoses on salicylate and goes to the ER. WHAT WOULD BE TESTED?
a) pH
B) Ammonia
c)creatinine
d) BUN

A staph like organism is isolated from a wound culture in is resistant to all GPC antibiotics and to Vancomycin, using the automated bichemical method.
what should the tech do.
a. do a gram stain
b. recallibrate the machine
c. report as not Susceptible?

If the stock solution had 9ml of saline and i add 1ml of serum making it 1;10
six test tubes labled Ato F contains 0.5ml saline in each.
i add 0.5ml of the stock solution to tube A and mix and the add 0.5ml to tube B and mix and add 0.5ml to tube C and mix until i reach tube F.
What would be the dilution in tube F?

Passed the MLS Exam. Thank you for this website! I wanted to let everyone know that it is good to know reference ranges. I noticed sometimes they give them to you and sometimes they don’t (HCO3, PCO2, BUN, Ca, etc). I got a ton of blood bank, hardly any micro, about 4 mycology (a recall question about zygomycete = sporangiospore). I also got calculations for Creatinine Clearance, Hemocytometer count (if they show you squares, make sure you take into account both sides of the hemocytometer). Bacillus anthras reactions were on there (non-motile, non hemolytic, catalase positive etc.) I got a picture with pappeinheimer bodies ( poor pictures). I also got a picture that looked like a slide with really prominent burr cells (abnormally sharp looking burr cells) and it asked what could have caused it, I am not sure of the answer but I picked that the slide was not dry. I also got what is TP+TP=FN I had to pick what is was (sensitivity). Another picture that looked like Heinz bodies and asked what stain to use (answer was Heinz body stain). There were a lot of small panels for blood bank. Know what the RBC inclusions are made of (DNA, RNA, Hgb). A question about what fungus you can test with hair ( I picked Microsporum audounii) There was a question about Micrococci (answer Resistant to fluconazol). Rapid latex test for Staphylococcus aureus and what it’s detecting. Something about Sodium dithionate and sickle cell (I chose severe anemia). I had to Identify a picture with Blastomyces Dermatiditis. Know when to do an elution, adsorption, descreptancies like when to test with Anti-A1. Know the difference between in Blood Bank reactions with PCH, Polyagglutinine. Know if HDN is caused by Anti-D or ABO group. Know K antigen frequency and if it will cause a reaction. Asked a question about HIV. Know the different types of electrophoresis, had some situational questions about Multiple Myeloma and whether to test with a different type before confirmation. I also wanted to let you guys know that this was my second attempt and I felt more prepared than the first time. I used Robert Harr and Clinical Lab Science Review Fifth edition plus all recall questions and charts.

Px chem result, you’ll see he has metabolic acidosis, what test are you going to order next, do you test for salicylate or lead poisoning?

Graph which shows the order of serologic markers for hepa a; which is the correct one

Antibody panel answer is the one with anti fya

Picture of tear drop cell, bilirubin crystals, burr cells.

A lot of mycology questions, describe histoplasma, molds that needs olive oil, what is the hair something test use for to differentiate 2 fungi

For those who are preparing to take this exam, please make sure you look at the questions at the back of each chapter of the “Bottom line Approach” . I have got about 20 questions from and many questions from “Actual Question” of this Website

CHEM…analyes elevated…which disease?(ALP-Paget`s bone,bilrubin-obstruction or liver disease,primaryhypothyroidism,skeletal muscle injury etc.)
HDL quantitation,TIBC
HEMATO…smear with cells(H-J bodies,Heinz),which anemia from results?corrected wbc count,mixing studies,RBCindices.thalassemia hbs
Bld.Bank……3,4 abdy panels,storage and life time for cryoppt n ffp
MICRO…reaction given,find organism…(kleb.oxytocca,strep gp A,E.rhusipathiae,Chry.meningosepticum)
veilonella,blas.dermatitidis,micrococci
OTHERS…nephrotic syndrome(fatty cast)aminoaciduria(cysteine)ANAflourscent pattern,CV calculation,PCR components,procainaide assay….

For the ASCP certification the questions I received were mainly Blood Bank (LOTS of DATs, If mother is type A- and baby is B+ what is the most likely cause of a HDFN?, What is the next step to determine if the reaction is due to Rh or ABO discrepancy? Know how to recognize common discrepancies, etc.)
-Lots of Microbiology questions. The flow charts helped me SO much here. Even if I wasn’t sure of the answer, I was able to eliminate wrong answers to reach a conclusion.
-I got 4 questions regarding RPR’s and VDRLs.
-1 question over parasitology
-A question that showed various titers of IgG and IgM for CMV and EBV and you were to determine if it was an active infection of both or just one of the viruses
– 1 or 2 questions regarding Westgard rules and a graph
– Other subjects I remember: Cushing’s Disease, Metabolic/ Respiratory reactions (Bottom line approach makes it easy), Thyroid diseases, ANA, Specificity vs Sensitivity, Bombay phenotype
Most of the questions are phrased differently than LabCE though. They are very situational (Ex. A nurse draws a tube of blood for testing but is left out for 12 hours what tests can be run or do you reject it? Your controls are out of range what could be the cause? Do you continue and process patient samples?) .

i just passed my MLS exam! this site was of big help! i got A LOT of blood bank questions especially about DAT and ABO discrepancies. i also had a bunch of questions where they show you a blood picture and you choose the disease associated with it (ex: burr cells – uremia). i had 2 questions about urinary casts. i had one about platelet aggregation studies. pcs steps. rbc inclusion associated when a toddler ingests a moth ball (naphthalene) — i believe the answer is Heinz bodies. t(15;17) for promyelocytic leukemia or M3. APTT and PT mixing studies. for microbiology i had one question about Erysipelothrix and another about Bacillus anthracis. i didnt get any blood gas and ANA questions at all.

Just took my ascp today for the 3rd time an I passed. I just want to thank you for the charts, they helped me so much I probably had over 40 questions that was all micro an it came right from them charts. An the rest was all bloodbank. I had maybe 2 urine and 5 dilutions and 1 or 2 pic for hematology. Was a really hard exam. I’m just so thankful for the charts they really saved my butt. An anyone else that failed it 2x don’t give up, I wanted to but I had people pushing me and alot of prayers to the man upstairs. Good luck to anyone going 2 sit for the exam.

Here are some of the exam contents that I can remember.. for BLOOD BANKING, most of them were about ABO discrepancies, DAT, HDN and they were all situational hehe. I had some questions about blood component storage and processing (take note of the storage temp and shelf life of each and how they are processed), transfusion rxns and donor deferral. Oh and I had several panels but they were all obvious (there was a pattern). For HEMATOLOGY, they gave me more or less 5 abnormal blood pictures and I had to identify which disease is specific to that corresponding blood picture (example: Burr cells – Uremia) I had one which goes “What red cell inclusion would appear on an infant’s blood smear after accidentally swallowing a mothball?” — I believe the answer is Heinz bodies. I had questions about sickle cell anemia, some leukemias, PT and APTT, mixing studies, and platelet aggregation. I was also asked to calculate for MCV and corrected white cell count. For CLINICAL CHEMISTRY, memorizing the reference values (refer to Polansky on this one) for each analyte especially bulirubin, BUN, glucose, and blood gases would do you great help. Most questions were of case study type. You must be familiar with the enzymes and hormones. Diseases/conditions I repeatedly encountered were Hyperthyroidism, lactic acidosis, respiratory/metabolic acidosis/alkalosis, SIADH, Addison’s and Cushing’s disease, diabetes mellitus and diabetes insipidus to name a few. I was asked to solve for osmolality, anion gap and creatinine clearance too. For MICROBIOLOGY, it is important to memorize or be familiar with the biochemical reactions (the charts in this site helped me a lot) for each bacteria especially Strep (CAMP, PYR, hemolysis, growth on 6.5% NaCl, bile esculin etc) and Enterobacteriaceae (IMVIC, TSIA etc). Also take note of the specific culture media for certain bacteria (ex: Fletcher medium – Leptospira). Some species that I could remember from my exam were Erysipelothrix rhusiopathiae and Bacillus anthracis. I also had questions about Fungi and their biochemical reactions and a few about viruses and parasites (autoinfection – Strongyloides). For URINALYSIS AND BODY FLUIDS, all that I can remember is that I was given a photo of a cast and crystal and I had to identify which types were shown and something about CSF, exudates and transudates. For IMMUNOLOGY/SEROLOGY, they were mostly about immunoglobulins and serial dilution. I had one question about PCR. I was asked to identify one ANA pattern too and the corresponding disease. And last but not the least, I had a few questions about TOXICOLOGY that I was completely clueless of.

My ASCP exam today was not easy…. but my preliminary result is PASS!!! Yay!!!! Thanks for the exam tips. It was helpful.

Questions on my exam were more on Mycology, Bacteriology, and Blood Bank!

Mycology: identification based on descriptions or microscopic view of the organism
Bacteriology: like you said, straight forward- biochem tests, growth on what media, so on… then identify which bacteria.

Blood bank: mostly ABO grouping discrepancies and Antibody screen probs- what u should do if u encounter this and that; and two questions about how many units do u need if you want this antigen-negative blood (given its frequencies in the population)

Hematology: cells in the smear ID; computations- diff count, cell counts; then which stain to use for this type of inclusion, hemoglobin suddenly decreases, platelet aggregation

Chemistry- i was asked to read and interpret HIV-1 immunoblot; questions about Hemolytic anemia (bili, urobili,haptogobin); i was asked about in what condition do you need to monitor Magnessiun, or when does K+ increase.

AUBF- nitrite question, when to suspect presence of contrast dye, reagent strip interferences

Passed my MLS exam yesterday. The first five questions gave me some trouble. Spend almost 30mins answering them. But after that I paced myself towards the rest of the questions. Heres some valuable information I want to share.

Know your GNR flowchart. I got at least 7 questions out of it. Include moraxella and acinetobacter to it because I neglected to include those to my chart.

Sharpen up on your antibody panel screen. I got at least 7 questions from it.

MYCOLOGY!! I got at least 9 questions including pictures. I think I bombed half of it.

I didn’t get lots of chemistry, I can guarantee you that. I braced myself for that subject and end up not getting many.

I got a few questions in hemo that included a couple coagulation questions about mixing studies and lab results for DIC TTP ITP.

Hey everyone took the test today and passssedddddd! I got a lot of questions That others got. Procanimide assay -Napa, picture of burr cells uremia, A lot of ABO discrepancies. That GPR chart is gold! I used this site, Harr, bottom line approach, cards, lab ce, and the SOP for ABO discrepancies from my job. I got only a few calculations, number of units needed and given frequencies, creat. Clearance. Umm Metabolite of cocaine-benzoglyce something or another. Bilirubin a lot of bilirubin. Was shown a picture of two slants grown in dark and pigment in light-M. Kanasii. Albumin fraction decreased, what else is decreased with it. Some other weird ones. Westguard, what day you would reject

Recalled questions that i remembered on my exam:

Hematology:
Picture of RBC inclusions- i think i got HJ Bodies
Lots of Anemias IDA, DIC lab findings
Low RBC Low HGb Elevated MCV MCHC- cause
Stomatocytes picture- what disease
Protein C
Predominant cell type lineage in CLL
Causes of incr & dec ESR
Lots of PT & PTT result disease correlation
Coagulation factors
Platelet Disorder

Chemistry
COV computation
Bilirubin result after caffeine for DB and IB
Inc Gluc dec Na K – disease
findings in SIADH
Cushings
VMA – disease

Blood Bank
Lots of ABO discrepancies and resolution
Cryoppt storage and expiration after pooled
Platelet apheresis
Mixed Field
Antibody screening
Calculation of number of units and frequencies given

Immunology
ANA pictures and diseases

Micro
Aeromonas rxn
Memorize the chart here on high yield very helpful(thank u so much wordsology)
zygomycete
blastoconidia

I took my mls exam today for first time, and I passed, thank you for all your help wordsology… I’ll try to remember questions
What do protein c and s do?
Salmonella enteritidis reaction in TSI
Outcherlony diagram
What is the billirrubin measures before add caffein, and after?
How do yo differenciate Yersinia enterocolitica vs Yersinia pestis?
A dilution in a tube 1:20 and then you took 2 mL of the dilution and add 3 mL of water, if the result is 120 mg/dl, how many would be the original?
Graves disease
Haptoglobin decreased
Enzymes for diagnostic muscle distrophy check ast, alt, ggt, ck, LD, Alkaline phosphatase….
Organism that need fatty acids on medium to grow…
Lupus erythematose, what happen with complement decrease or increased, due to what….

Hello! I took my exam yesterday and luckily, I passed!!!!! Yes! Lots of questions on DAT and the frequency thing , you have to compute to get the total of units to crossmatch whatever. Harr and Ciulla are very useful. And of course, this site!! Thank you very much to the admin of this website. This is gold!

-No ANA questions for me.
-Majority (60%) of the questions are like if there is a blah blah blah, what to do next?
-picture of echinocyte
-picture of blastomyces dermatitidis
-Stomatocyte picture: what disease is related? LIVER DISEASE.
-no bloodbank panel but really lots of DAT. ABO descrepancies. And what are the remedies. (focus more on this)
-chemistry. how to measure hdl. I chose thin-layer but I really dont know. Ultracentrifugation was not on the choices.

I would like to say thank you for helping me pass the exam. i study 6 weeks for MLS. This website really helps A LOT!!! I have to say this… the questions and the study strategy REALLY HELPS. And for questions I was not sure I chose B. Therefore I chose many B’s..LOL..To be honest, I am a grade C student. Nobody would believe I passed the exam.

My exam were mainly balanced of all the subjects.
1. Negative, positive control for CAMP, BILE ESCULIN, 6.5% NaCl, Bacitracin
Choices were mainly Strep family. Study them.
2. Hba1c – 5%, FBS – 155mg/dL
– good long term control but poor recently
3. Caffeine for Diazo reaction
– to measure unconjugated bil
4. Enzyme uses pnp maintained in pH 9.8 increase in what dse
– Pagets
5. Elevated lipase buy normal amylase appearance of plasma
– Lipemic
6. Measurement of iron
– step1: addition of acid
– step 2: addition of reducinh agent
– step 3: add color rgt
7. Estrogen increase in pregnant women
– Estriol
8. Female patient on mesntruation
– I forgot the exact choices but I choice the lab results correlating with IDA
9. TIBC
– Trasferrin
10. Stomatocytes
11. Burr cells
12. Echinocytes
13. Alternaria
14. http://library.med.utah.edu/WebPath/IMMHTML/IMMIDX.html
– study the autoimmune diseases part. Slide 4 was on my test. Exact image.
15. Pheocromocytoma, measure
– Cortisol or Metanephrines : torn between these two hahaha
16. Blastoconidia
17. Definition of Oliguria
18. Measurement of FLM
– phosphatidyl
19. Indole positive, A/A TSI
– K. oxytoca
20. Present after jaw surgery
– if the question was looking for gram neg: Veilonella
– if gram pos: Peptostreptococcus
21. Detextion of Rubella
– IgG 2 weeks interval
22. Zygomycete
– i answered the one with sporangiospore
23. The famous HEINZ BODIES on napthalene something haha

I forgot the others. I need to sleep. Lol. Had 3 hours of sleep only. Id post recall questions when I remembered some

24. SIADH
– decreases Na
25. Case study about urine but the clue was present fat bodies
– Nephrotic
26. Azotemia
– Im really not sure with my answer because the choices have
A. increase bun
B. increase creatinine
But I picked BUN
27. Just remember that in Protein C taking warfarin therapy
– it would decrease
28. The blood glucose was given 390mg/dl, potassium 4.2mmol after insulim administration glucose is 215 potassium is now? Note that this is kot the exact values given
– I really do not know the answer but as insulin increase, potassium would decrease. Just know how to solve this because the choices were values
29. Olive oil
– Malassezia furfur
30. Rotavirus test
– i also dont know the answer but I picked electron microscopy something
31. Sezary cells
– T cells
32. Case study about skin testing blabla
– T cells also
33. Negative and positive control for anti-E
– DcE/DcE, dce/dce
34. Virus specimen was received. What would u do when sending it to other lab or shipment (cant remember exactly)
– I answered lypholized because shipment of viruses are -70, 4C storage
35. Sensitivity formula
36. Aggregation studies that I dont know. They presented me a graph with collagen, adp and epinephrine
37. Latex agglutination in S. Aureus
– protein a and clumping factor
38. Know the antibodies that would react at IS, AHG and 37C
39. Antibodies not enhanced by enzymes
40. Bilirubin
– 450nm
41. About ISE
– KCl

Please know the frequency of anti-K and anti-k. I had a question about these and the freq were not given so I just guess. And also 1 dilution that I do not know. 1 antibody panel for me. Not lots of DATS and ABO discrepancy thank god. No Leukemia and staining for me. Goodluck guys!!! Wish you all the best and happy new year!!

I just took my MLS exam and I passed! I stared at the screen for a while to make sure it really said “pass”.
I want to say thank you to all your wonderful note especially the coagulation note. Although I didn’t get any coagulation question, I’m happy that I finally get the pathway down.
In term of the exam, it was a hard exam for me. I spent all my 150 minutes. My first 40-50 questions were blood bank, micro, and immunology which are my 3 weakest subjects. I was extremely nervous. Break out:
Blood bank
– 5-6 questions about Abo discrepancy ( geeez)
– 2 antibody panels- find the antibody and choose which additional cells are used to rule in and out the antibody.
– 5-6 general questions about blood bank, technique, Dat
-2-3 about blood products

Micro
– I drew my gpc and gnb chart put before I answered any of my micro question. I got 4-5 question about gpc, gnb
– 1 question about micrococcus
– 2 question about plasmodium – which one is not show on the blood smear in troph
-4-5 mycology question( at this point, I was like:” why am I so not lucky”
Immunology:
– Ana positive shows what pattern
– picture and pick what kind of pattern: rim, speckle, ect
– chart of 1st and 2nd expose and tell them which a, b, c, d line are first and second response
– 1-2 hepatitis questions… But not in a traditional form of questions . One question was like : which blood product has a greatest risk transfer hep b( so I guess this is kinda a blood bank questions)
Chem:
I got few easy ones: such as amalyse for mumps, tn/ tp
2-3 blirubin questions
Urine:
3-5 questions
Heme
They were hard too but I can not remember now.
Again, thank you for all wonderful
Note

If you are scoring higher than 70 percent on the LabCe I think you should be fine. As for the questions I received, it was weird because it started off with QA questions and some instrumentation. I even remember them asking questions about how often we need to have CEUs. I had mostly Heme and Bloodbank. Heme was mostly hemagrams with abnormals asking for diagnosis or possible interference and some nrbc/wbc corrections, plt est and rbc inclusions, bloodbank I had tons of RH questions and basic antibody ID from warm and cold. Know your enzymes and effects. DAT IAT screening, donor qualifications. Chem I had some enzyme questions and calculations for GFR, AG, and creat clearance. Coag was basic intrinsic and extrinsic questions, know INR and the discrepancies with the times of pt and ptt. Micro, had about 10 to 15 questions. You should be just fine, stay calm and watch something funny right before to take the stress away prior. Eat some dark chocolate and some black coffee too!!! Thats what I did.

Basically passing the knowledge forward.

-I had a lot of mycology question (5) I believe, I’m pretty sure I got all of them wrong. They told me description and showed me a picture and I still got it wrong. I never really studied mycology and the ones I did never showed up.
-Had a picture of a pinworm and needed to know its real name and I didn’t get any more parasite questions after that.
-Chemistry: Effect of hemolysis on chemistry analytes, effect of IV line on chemistry analytes, Diabetes, non-ketoacidosis coma, enzymes for liver, enzymes to help ID muscle problems, cardiac enzymes, what creatinine clearance was (not the formula but what it actually tests–the physiology of it), a weird LDL + HDL methodology that came up twice (how can you separate them–I thought it was ultracentrifugation but that wasn’t even a choice, so if anyone knows please help enlighten me), given a bunch of analytes and their result (without the reference range) and was expected to know which one should be repeated (on it was BUN, osmo, Cl-, Na+, K+, and yeah… wasn’t sure of the answer on this one either). How to tell hepatic from an obstruction and what the test would show
-Urinalysis: what it means if someone has a normal serum glucose but a positive glucose urine test,picture of a cast with refractile circles and they asked you what other tests will help confirm it(?, choices were Sudan black, oil red O, picked oil Red O for some reason)–the almost exact picture can be found on labce
-Immunology: i had a question where it showed a picture of serum IFE and a gamma band and a light chain, and told you that the urine light chain had that light chain as well. Then asked what your next action could be: potential multiple myeloma, redo it again because ULC and S-IFE were not the same.
-Had some trouble shooting question and what would you do if the control you reconstituted were all whacky on all of your analyzers. Check the H2O you used, used new lots, or used fresh control.
-BB: panels are usually straightforward (I mean they do give some choices so that helps), but the tricky ones were the What would you do next if your forward had a positive Anti-B but your serum all came negative (reincubate at 37, report it out, redraw,) or for antibody screen if you wanted to rule out certain things what would you do (requires your knowledge about enzyme and its effect on on the different antigens)–what helped me to remember some were Duffy= gets Destroyed by enzyme
-Micro: the charts given on this site honestly are really helpful. they nitpick, I had one where I had to differentiate between Morganella and Providencia but it gives you a list of three different tests, and if you knew the answer it’s pretty simple because usually there’s one really wrong answer in all the other choices. Some mnemoics: MINOP )mirabilis Indole neg, o(something) positive—sorry my brain is getting fried at the moment, or K-PIN (klebsiella pneumoniae indole neg, E-COP (entero cloceae orthine positive), recommend making sure you memorize the chart on this site.
-what organisms would you look for in a patient with Cystic fibrosis
-Anaerobes Gram negative cocci that causes a disease involving the jaw
-know how to read a TSI slant and ID the organism from it
-know the differences between the Gram negative bacilli (like Enterobactericeae are all oxidase – (except plesimonas) vs the Oxidase+ GNB (like Aeromonas and the others), know the HACEK (the disease associated with them I got a question that told me symptoms and what it looked like and the biochemical and was expected to know it)
-Had two antibiotics question what other antibiotic would used to help ID a mecA gene (or something like that)–choices were vanco, ampicillin, penicillin, methicillin.
-What would you need to know in order to see the effect of a Therapeutic drug
Hematology
-Had two questions where I was told whether serum Iron, ferritin, and TIBC was and had to ID the disease, had two questions on the same picture about what the disease could be and what I would expect the lab values to be
-There’s a labce question where it shows you four different pictures of an abnormal RBC morphology: know those (basically what target cells mean, sphereocytes, teardrops, schitocytes)
-What kind of drug would cause a hypochromic RBC–i answered malarial drug, but who knows..

-the virulence factor of N. gonorrheae,
-which mycobacterium is associated with contaminated H2o.
-glycerol effect on RBC (when will it expire–basically 10 years after the glycerol was added)

-summary: the purple yellow book is god, Do as much practice questions you can with Harr read over the explanation some things are a bit harder in the book though, but definitely read the explanation. DO labce I took 4 CAT and scored around the 50% mark (49-56%) and around a 5.5 hardness level. I did most of the Harr questions minus the end of chemistry and micro (ran out of time). Also look at the question wordsology and other people have put up, it helped me a lot in my preparations.
-The questions on the exam aren’t all that straightforward and that’s the one you know will probably be worth more points because it’s a higher level question.

THANK YOU Sohail, your website helped me a lot. I took the exam in Dec 2014 and failed, just took it a second time today and PASSED!! Hope that what i can share will help someone:

Lots of immunology and mycology.
Chemistry questions
Analyzer questions: flow cytometry how does it count the cells?
Identify a fungi by looking at picture of hyphae: I think it was Alternaria
Identification of anaerobic bacilli based on biochemical tests
2 questions requiring me to identify fungi genus based on description of fungal morphology. I remember “septate, hyaline, basidiomycota, arthroconidia” as keywords. Sorry can’t remember more keywords for this one.
Zygomycota: what are defining characteristics of this fungi
Purpose of check cells in blood banking, and what is a possible reason / lab error that would cause check cells to be negative?
Patient has a soft goiter and low TSH: what is the next lab test that should be done?
How long after whole blood donation should platelets be separated from RBCs?
How long after whole blood donation should plasma be separated from RBCs?
Coagulation mixing study: prolonged PT / PTT that corrects slightly with mixing study. Pt is not on anticoagulants. What could cause this?
Calculate creatinine clearance from pt lab values
Seemed to be lots of iron / transferrin questions. I realized during exam that I don’t understand purpose of transferrin very well.
There was a question on what CBC (iron changes? Transferrin?) a young healthy woman on hormonal birth control would have
CLL usually proliferation of T cells?
Several questions on Heinz bodies and what could cause it (oxidative damage)

Hi! I just wanted to thank you so much for your great work on this website. I just took the ASCP MLS exam this morning and I PASSED!! It was by far the most difficult exam I’ve ever taken, and I doubted every single answer and pretty much everything I knew about my life haha. Your website helped immensely, especially the microbiology section! I also used the Bottom Line Approach and the BOC book. I got a lot of pictures on my exam for some reason…picture of burr cells, what else would you expect to see in lab results? ANA pattern…HgbC, what would you do next. Picture of stomatocytes, related to what disorder. Super red slide, whats wrong with staining? Definitely understand sensitivity/specificity, I had like 4 questions about that. Also bilirubin, at least 5 questions on that too! No acid/base, no parasitology, a few simple mycology questions (hair perforation, cigar bodies), only one TSI. I had lots of Blood Bank discrepancies, Rh, baby DAT+. Every single questions makes you think over everything that you’ve learned, very few were straightforward. I swear there were some answer choices that could have both been correct. Choose the BEST answer. There were nearly always 2 choices that could be immediately ruled out. I reviewed half of my questions at the end, changed one answer, then decided to just submit. I still had 70 minutes leftover. My advice is to not let this test freak you out!! Take a deep breath, you will get through it!!

Some remembered Questions:

Micro
-Atleast 5 Mycology questions (wth), I was clueless on all of them
-No Parasitology for me
-3 Strep questions that can be easily answered by flow chart on this site (add bile solubility for Strep B-hemolytic to it)
-Staph questions – can be answered by flow chart on this site (add Mannitol to it)
-5 Enterobacteriace questions – Knowing IMVICs, TSIs, H2S producers, Lactose Fermenters and I used flow charts from yellow and purple book (Flow chart on this site is good, but I already was committed to bottom line approach)
-Nocardia – branching
-A/A+g what would you expect to see on HE agar – orange

Chem/BF
-Oral Contraceptives – Increase in serum Fe
-ABGs!! – I had 3 acid/base disorders, one with partial compensation
-Calculate Osmolality (2 times), one of them didn’t have the answer (i tried both formulas), picked the closest one to the correct calculated osmolality
-Calculate Anion Gap
-Chylomicrons cause layer at top of tube
-Hashimoto’s – T4 decrease, TSH increase
-Turbid synovial fluid – (I put because of crystals)
-aHCG – Pacreatic CA or testicular? I picked Pacreatic
-4 Routine dipstick discrepancies
-Uroblilinogen false pos = Porphobilinogen
-Atleast 5 Jaundice questions – (know the urobilinogen reference range (along with the bilirubin reference ranges) something like 0.2 EU for urobilinogen) – Table in yellow and purple book made most easy
-caffeine benzoate in bilirubin assay – Accelerator

Blood Bank
-Easy Panels (just identify, you have to use the Pearson Vue dry erase sheet to write out the antigens (not a big deal, but i guess if you are practicing, practice by writing out just the antigens on a sheet of paper.)
-ABO discrepancies (cold agglutinin, Roleux, no reaction on reverse type)
-Most severe HDN – ABO (BOC book)
-2 – RhIG calculation – Calculate vials, calculate feto-maternal hemorrage volume (same as BOC book/Media lab)
-QC for granulocytes (Yellow and purple book)
-Bombay Phenotype – hh
-Avoid allergic rxn something IgA – IgA/Washed RBCs

Hematology
-2 questions – given absolute lymphocyte count, calculate CD56/calculate CD4 (I used 50% CD4, 25% CD8, 15% B, 15% NK – relative to calculate) – numbers came out where there was a clear cut answer
-Calculate LAP score
-Calculate Corrected WBC
-Myeloid Leukemia question that had indices, <10 blasts (thanks wordsology)
-Lots of blood smears, identify disease (look for the hallmark rbc/wbc deformity/inclusion – answers were mostly clear
-2 Histograms (identical to BOC book)

Immunology/Molecular/Other
-Trepanomal highest specificity – FTS
-No ANAs!!…i thought this was going to be huge
-Flourometry – protect yourself from what – excited light or emitted light?
-PCR steps – the one that starts with Denature, Anneal
-Basophil – histamine/heparin
-ASCP CEUs required ?

Had some very specific molecular bio and other related questions that were total greek to me, meant to be answered wrong on the computer adaptive test i guess. I had one (impossible) question in which B and C were the exact same answer (I picked B). Most pics were very pixelated, they looked like resized avatars. Those ASCP questions need to be QC’d.

Anyway just so happy I passed, good luck to everyone!

My ASCP exam has a lot of challenging questions, but fortunately there are many similar questions to the ones that were posted on this website and shared by others. They ask me about specific gravity in urine testing, polycythemia vera, Burr cell, stomatocytes, CLIA requirement in competency, Cushing syndrome, defer donor in blood bank, lipemia interference, a few myco questions related to dimorphic, dermatophytes, blastoconidia, 2 ANA questions, CSF storage temp, diabetes, blood-gas, hemolytic anemia, DIC, Lupus, confirmed test method for HTLV, Pseudomas, Addision, how to detect early renal failure, a few UA case study questions, etc…

I just took my MLT exam tonight! I passed! WOOT WOOT! For my studying I used Clinical Laboratory Science Review – a bottom line approach, and I used the BOC book. I did subscribe to LabCE – I may did about 9 review exams. My scores for those were upper 60s and low 70s. I also used the high yield notes from here and I would totally recommend you know them inside and out! I didn’t get asked everything on them, but those micro flow charts are LIFE savers!

For me, the best resource was the bottom line approach. I am weary of just using LabCE or the BOC book because I feel like I’m just memorizing questions, and from the 9 review exams I took on LabCE, it does repeat questions. Sometimes it would ask me the same question it asked me at the beginning of the exam at the end of it…sooooo. Annnd there are several questions in the BOC book that either a repeat OR they provided the same answer they did for the previous question. For example, see question 215 and 216 on page 197. :/ I really think the key is relearning the material or refreshing your memory on the material so that you can answer any question they throw at you, vs, well I memorized these questions and their answers. Now the BOC and LabCE are great tools to gauge what you know, and I do think that the more questions you see, the better off you are.

As for what I was asked – I was given a panel – these are easy points. Really, they give you the possible antibodies and all you have to do is focus on those. I was asked some very basic things like, B cells produce…. Thrombin time and why it would be increased or affected. I was asked about Beer’s law (yeah… I totally look over that… not). I was asked about absorbance, also I had two hematology histograms – see pages 204/205. It was like those but not those questions. I had several (maybe 4) TSI slants… sometimes I was given the picture, sometimes not. I was given two or three questions about agars and what grows on them, or if they were this color, what did that mean. I had several questions about which of the following would be VP positive, this positive and this positive and I’d have to pick the answer. I think I had three of those. I had a question about keratitis and the answer was Acanthamoeba…The Bottom Line book has a lot of quick and easy ways to remember things, like for keratitis and Acanthamobea… Kerry, aCanthamoeba causes Keratitis; associated with trauma to the eye. I was asked about Enterobius vermicularis… both were a pic to id it from (very similar to the ones in BOC but just had more of them in it), and then a question about what test you’d use to ID it but it still gave you the picture of Enterobius, so make sure you can ID them. I had some questions about glucose ox. converts glucose to gluconic acid …….. I picked and the answer is H2O2.. thank you bottom line! I had two questions that gave you a urinalysis and it would show you a pH and then say they found these crystals… what would you do. There is one like this in the BOC book. All you’re doing is looking at the pH and then thinking, is those crystals acidic or? What should you do? I had several questions about D/fetal/mom… those are to be expected. I had several questions about prehepatic. hepatic and post/obstructive… several, maybe 4 or 5? Sometimes they were easy and sometimes I had to really think about them. There is a wonderful chart in the Bottom line book that is a life saver if you ask me. Also, be prepared to see enzyme questions – liver and heart. I think I had two or three. I had several questions about discrepancies in ABO… like is it an auto, allo, subgroup, rouleaux…. I knew going in that BB was going to be my weakest. Uh, I did not have any questions regarding hep B, but I did have some on hep A. I had several questions on principles of antigen-antibody testing, like immunofixation, agglutination, etc. I had some questions on elutions, adsorption, neutralization so make sure you look over those and understand them.

I did not get any questions on crystals (none that required me to ID them), none on casts at all. I did get asked about the nephron and what is happening where, filtration rate, silly stuff. I did have some questions regarding rbcs and disorders or diseases so be ready for those.

I started the exam with what I thought were super easy questions. I breezed through the first 10-15… then I started to get questions where I had to really think. I started to get easy questions around mid 80s… and the last 10 were pieces of cake (well, I think I might have missed one of the last 10). I felt good in the first ten… about question 30-40 I was thinking I was not going to pass, and kept thinking, ‘ask me about those damn TSI slants! Where are my micro questions!? Urinalysis? Screw these immuno and bb questions”. When I got to question 90 and started seeing super easy ones I felt good. I did review my exam and changed maybe four or five questions, three I had misread and the others I just said what the hell.

My advice is to find a good review book or note cards and refresh your memory. I love the Bottom line because it gave me the cliff notes on everything! Plus it had neat ways of remember stuff, and also wonderful charts. Charts and graphs are a WONDERFUL tool and huge help. I highly recommend you know the high yield notes here. They are a life saver. Good luck to those of you reading this that still have to take the exam. LabCE is great to give you an idea of where you are at and to prepare you for getting a question about micro and then three about this subject… the BOC book is good, too, I just wouldn’t depend on it. I found several errors and I wasn’t really looking that hard and only looking at the MLT questions… who knows how many errors are in the book. So beware if you use it. Good luck! -and thank you to the guy who created this site and supplied us all with those notes!!

After failing the ASCP BOC exam twice I retook the exam and passed! I used the success book for urinalysis, hematology and immunology and serology. I used all the diagrams posted on wordsology and they were all very helpful. I also used labce in different variations using the suggested % (off this site) as the minimum requirement.

As we know the exam is a CAT so no exam is predictable as to what you should focus on. My 1st time taking exam it seemed like a horrible hematology exam, 2nd time it was filled with microbiology and 3rd and final time it was immunohematology based. Meaning that the questions were centered around that subject. So it can be a heme question but indirectly relating to immunohematology.

I had about 20 questions that were direct. The others not so much. Don’t try to guess what they’re asking for. Read the questions thoroughly and answer what they’re asking. That might seem obvious but sometimes seeing familiar terms in an answers throws you off and you might lean towards that answer.

Here’s so concepts that I realized was a major component of the questions.

IMViC system
Many GN Bacilli
Factor deficiencies
Typical Mycology organisms
Renal pathology. (Success urinalysis section was the best study material)
~5 leukemia questions
Although rare I had about 6-8 panels that were no as direct as Labce

*Answer what they’re asking for. Don’t look for a “trick” don’t be paranoid.

Use anything possible to remember any and everything that you have to think twice about while studying.
ie:
IMViC
PEE: IM (+) positive you’ll have to PEE
Proteus Vulgaris
E. coli
Edwardsiella
Are “IM” indole & methyl red positive. Along w/ studying chart off wordsology you will be able to id organisms w/ out a doubt.

Hopefully that was a little helpful to at least one person. Don’t give up!!!

I took the MLS-ASCP exam and passed. I thought that I would fail because I had many case studies (hematology, syphilis, chemistry) and blood bank questions on my first 50 questions. I reviewed my answers 4 times and I always pray every time I changed my answers. Before I finished the exam, I prayed so hard. Here are some of the questions I remembered that I immediately noted after the exam. I do not have all answers but the questions would be helpful in studying the ASCP exam:

1. What enzyme is increase in mumps?
a. Lipase
b. Creatine Kinase
c. Lactate dehydrogenase
d. Amylase (I answered this one because I associate the saliva with amylase)

2. Cushing syndrome causes
a. Hyperglycemia
b. Hypoglycemia
c. Hypercalcemia
d. Hypocalcemia
***(I think high glucose since Cushing syndrome has high cortisol, which increases glucose)

3. Case studies about lactic acidosis, and which patient reflects lactic acidosis.

4. What is (TP x 100)/(TP + FN)
a. Sensitivity (I answered this one)
b. Specificity
c. Precision
d. Reproducibility

5. Questions about two methods showing positive and negative result
Positive Negative
Method 1 50 98
Method 2 100 90

***I could not remember the choices but it is about if Method 1 is more specific than Method 2 or is Method 2 more sensitive than Method 1.

6. Preferred specimen for tacrolimus (but I could not remember the other names of the drugs)
***I think I selected whole blood

7. Preferred testing for Legionella.
***I could not remember the other choices but answered urine antigen testing ( I read this question before).

8. What is the immunity test (I think it was immunity, I could not remember but something like that) for CMV?
a. Latex agglutination
b. Heterophile test
c. Culture
d. Electron microscopy
***I got this one wrong coz I selected latex agglutination but I could not remember the source but it says viral culture. Check this link http://labtestsonline.org/understanding/analytes/cmv/tab/test/

9. Specimen for rotavirus
***I answered stool

10. Specimen for whooping cough
***I answered nasopharyngeal swab

11. Sezary syndrome is:
a. T cell lymphoma
b. B cell lymphoma
***I could not remember the other choices. I think it is T cell

12. Which of the following shows dosage (or does not show dosage, I could not remember) but memorize the antibody that shows dosage
a. M
b. FYa
c. E
d. Leb

13. Questions about appearance of 3 CSF tubes.

14. Question about describing sensitivity of syphilis ( I could not remember the choices)

15. Patient has walking pneumonia but treatment shows penicillin resistance because:
***One of the choices “no cell wall”

16. Magnesium must be monitored in
a. Pre-vomiting
b. Pre-eclampsia (im not sure but I selected this one)
c. Diarrhea

17. Antibody panel to rule out

18. Increase in jaundiced with pancreatic mass (something like that)
a. AFP
b. CA19-9
c. CEA
d. Beta-hcg

19. Normocytic, normochromic, normal WBC, normal platelet, but retics is 0.1%
a. Pure red cell aplasia
b. Fanconi’s anemia
c. Aplastic anemia

20. Blood smear picture that looks like Howell bodies, the retic is 18%, the technologist should stain with?
a. Stain Heinz- body staining
b. Prussian stain
c. Repeat retic
***(it confuses me because Retic was 18% and the blood smear looks Howell bodies but I selected Heinz body staining)

21. What is the problem or effect of dextran sulfate as anticoagulant in blood transfusion (something like that)
a. Destroy D antigen (something like that)
b. Solubility like antigen activity
***Cold not remember otherrchoices

22. Pictures of Stomatocytes, what disease is associated?

23. Pictures of Burr cell, what disease is associated?

24. CBC result, Hct did not match Hgb (Hbg x3), what causes the false increase of Hgb?
***one of the choices is lipemia

25. Rouleux is undetectable at?
a. Room temp
b. AHG phase
c. Could not remember other choises
d. IS

26. Target cell blood smear, what is the effect of target cell on instrument (something like that)

27. Adrenal cushing syndrome causes:
a. ↑ACTH ↑cortisol
b. ↑ACTH ↓cortisol
c. ↓ACTH ↓cortisol
d. ↓ACTH ↑cortisol

28. Pic of blood smear with artifact something like:

29. TSI = A/A and oxidase +
a. Aeromonas
b. Pseudomonas
c. Enterobacteriaceae
d. Serratia

30. Pink colony on Mac, citrate positive, Lysine=neg, Ornithine posiive, Arginine positive
a. Kleb Pnuemonia
b. Kleb oxytoca
c. E. aerogenes
d. E. cloceae

31. Cystic fibrosis associated with P. aeruginosa and organism that is catalase positive, oxidase positive:
a. Acinetobacter
b. B. cepacia
c. Could not remember other choices

32. Disease associated with unconjugated bilirubinemia

33. ANA picture that look like the pic (I answered centromere, be familliar with ANA pattern)

34. Donor deferral questions

35. Acid-fast bacilli, potassium permanganate is used as: (I saw this on ASCP-BOC book)
a. Quenching agent
b. Mordant
c. Dye
d. Decolorizing agent

36. Gram negative tapered ends
a. Fusobacterium
b. I could not remember other choices

37. Pic of coccidiodes

38. Platelet irreversible aggregation
39. Calculation of cell count

i did pass my exam last march 18 =D

lots of question about blood typing, ANA , mixing studies, and some weird bacteriology question…

Lactose fermenter, Oxidase + , A/A… choices are enterobacter, pseudo, hafnia and seratia..
then, picture of red cell inclusion, TP/TP + FN

I wish to thank the creator of this wordpress for providing high yield notes that are practically so helpful. I found your website 5 days before my scheduled ASCPi exam for International Medical Laboratory Scientist in Riyadh, Saudi Arabia. Your flowcharts and tables benefited me a lot not to mention your coagulation pathway tips. I got a confidence booster while reading your general tips in taking the CAT. At 11:30AM (Arabian time) of 21 March 2015, I took and passed the ASCPi exam after less than a month of reading Polansky’s book and the examination simulation of labce.com. Allow me to share some of the items that were given in my exam:
(1) Inappropriate ADH secretion sydrome;
(2) Specifications of FFP refrigerator;
(3) Components of PCR;
(4) Interpretation of blood smear with sickle cells;
(5) Interpretation of blood smear with polychromatophilic cells;
(6) Interpretation of blood smear with tear drop cells, ovalocytes;
(7) Separation and storage temp of FFP;
(8) Temperature requirement after cryoprecipitate thawing;
(9) Biochemical tests in identifying bacteria like Pseudomonas, Erysipelothrix, etc.;
(10) Antibody panel (simpler than what are given in labce;
(11) Urine chemistry (interpretation of results & clinical significance);
(12) Best presumptive test for stool in dx of rotavirus;
(13) Image of a fungus (Aspergillus);
(14) Motility test for Yersinia (I found it in your Enterobacteria flowchart);
(15) Strength of H antigen: O, A2, B, A2B, A1, A1B;
(16) S-s-u rare blood group (100th question in my exam :));
(17) Expiry of blood when 40% glycerol added;
(18) Donor deferment following aspirin intake;
(19) Interpretation of immunodiffusion (with images);
(20) Photometric measurement of iron;
(21) Laboratory picture of hemolytic patient in reference to serum ferritin, iron, transferrin and transferrin saturation;
(22) Secondary hyperthyroidism (increased total T4 and TSH);
(23) Ion affected by Bromide measurement;
(24) Clinical significance of target cells;
(25) Characteristics of Micrococci;
(26) Hallmark feature of chronic hepatitis B;
(27) Indole difference between Klebsiella oxytoca and K. pneumoniae;
(28) Helicobacter pylori for antral gastritis (biochemical tests);
(29) Anaerobic cocci associated with jaw abcess (choices were Peptostreptococcus & Veillonella);
(30) Clostridium perfringens (double zone of hemolysis);
(31) Equivalent color produced with Hektoen if TSI is A/A, gas;
(32) Interpretation of forward/reverse ABO typing, Rh and antibody screen;
(33) Effect of ACTH administration to blood cell count;
(34) Calculation of the number of blood units for compatibility testing given the % of specific blood group antibodies (2 questions);
(35) VLDL as the carrier of endogenous TAG;
(36) Indicator of nutrition (I answered Prealbumin);
(37) AFP as tumor marker (found in this website);
(38) Enzymes to dx skeletal muscle disorder (exactly mentioned in this website) – AST, LD, CK;
(39) The first cardiac biomarker to rise ff AMI (exactly mentioned in this website) – Myoglobin;
(40) Heaprin as circulating anticoagulant (found in this website);
(41) Protein S and C, their role in hemostasis;
(42) APTT and PT questions (the coagulation diagram in this website is amazing);
(43) Factor 5 Leiden mutation;
(44) Pheochromocytoma (VMA) – found also in this website;
(45) Cushing sydrome (cortisol increased) – found in this website “Adrenal gland”;
(46) Anemia classification based on blood indices;
(47) MCV, MCHC values determination based on an image of blood smear showing red blood cells;
(48) Markers for T lymphocyte like CD3 (choices were based on the role of the specific T cell);
(49) May-Hegglin (found exactly in this website) – giant platelets, thrombocytopenia and hemolysis;
(50) Pelger-Huet anomaly – clinical significance; and
(51) Hb H in Alpha Thalassemia.

I just passed my MLS today. This website and the Clinical Science Review book helped a lot. Here’s what I remember from my exam.
Procaine assay-NAPA
Blood unit expiration date when glycerol is added
Apolipoprotein A- HDL
Donor requirements- pick the one that didn’t make the cut. My answer was HCT 37
Lots of antibody panels
What’s indicative of teardrops? Had 2 questions referring to teardrops
Had one on the stain being too blue and what do you do? Decrease ph buffer
Classic Ida pbs
Muscle damage enzymes- ast, ck, ld
Cushings and addisons. Which one has increased glucose and dec
Herease?
Which mycobacteria is in drinking water?
Which parasite can cause auto infection?
What does the rbc morphology look like with hookworm that’s been there for years
How is ldl extracted from HDL? Heparin-manganese
What is creatinine clearance?
What’s the purpose of the caffeine in bilirubin? Take the albumin off
I had no ANA questions
Difference between yersinias? Motility at 25
Acute hepatitis markers
Calculate cv, question gave sd and mean and you had to pick which one had the best cv
One dilution question. It stated off with a 1:2 and made a 1/3 out of that.
Increase urine glucose, what else should correlate with it on a diabetic patient.
No rhizoids- Mucor
I would suggestion writing down the normal ranges whenever they are given to you. Some questions have it and some don’t. It’s helpful for the ones that don’t.
I had a couple acid base questions.
Mixing study questions
Fungal stain- cotton blue

Hello,
I got a good 30% Microbiology.. Dimorphic Fungi. Differentiating characteristics of the Enteros. TSI of E.coli , E. cloacea, P. mirabilis and P vulgaris.
LDC : SEA Salmonella, E. coli, Arizona
ODC: YEP + SMS Y. entercolitica Edwardsiella, P mirabilis and Enteros Salmo, Morganella and Serratia

Get a good grasp of the IMVC AND THE LOA REACTION profiles of the following: YOU WILL BE GIVEN A SET AND ID THE DISCREPANCY…

++–
E coli
Morganella
Edwardsiella
–++
Enterobacter
Serratia
-+–
Salmonella
++-+
Providencia
-+-+
Arizona
Citrobacter

1. Musty basement odor: Nocardia
2. B. anthracis – non motile, non beta hemo
Bacillus spp : motile, beta hemolytic

3. Increased in cathecolamines : Pheochromocytoma
4. Elevated level of aminolevolinic acid in urine is due to presence of : LEAD
5. Order of draw
6. IFA ANA PATTERNS : i got 3
7. Increased platelets, splenomegaly + bleeding is seen in : Essential Thrombocytosis/ Thrombocythemia
8. Branched chain DNA – Signal amplification
9. Purpose of AHG : Detect immunoglobulins present on surface of RBC and serum
10 Picture of PBS.. Too PINK all crenated RBCs and a few WBC all bathe in pink: Acidic
TIBC measure of : FE bound to transferrin
Pseudo Pelger huet anomaly : Myoproliferative disorders
Least reaction with ANTI H : A1
Compute WBC with Hemocytometer
Know all these:
Define: Characteristics of Mucor, Absidia and rhizopus
CV calculation
DILUTION
AB PANEL
RBC morphology and associated disorder : Burr cells and Schistocytes
Obstructive Liver dse.: ALP and GGT
Biliary Obstruction : Conjugated increased

Good luck. Understand the Principle behind all the workings and you will have a good time.. If not sure – confuse.. flag em ..flagging gives you time later after you are done with the 100th item.. to go back to the flagged ones and analyze and be more confident of your choices. Tip: watch your time. Its critical that you are on top of the time element, especially if you are on the last 10 minutes.. and you have flagged a doz. and still stuck on flagged no.1.

Good luck and keep calm. All is good

The Sezary syndrome question, the whooping cough question, and the CMV question specifically. I HIGHLY RECOMMEND looking at ALL of the questions that are one this website. The one’s posted by Sohail are almost verbatim. This is what questions on your test will look like. Also, check out all of the questions posted by other commenters. I’m sorry that my brain dumped all of that information immediately after I saw the word “pass”, but many others did remember, and for that I am forever grateful.

I had no calculations, probably 5 parsasitology/mycology questions, and about an equal number of chem/hemo/micro/blood bank. Maybe 5 graphics to ID (blood smear interpretation, urine cast/crystals, microorganism ID. Most of the chemistry was interpreting lab results, and I had 3 panels that had indirect interpretation questions about them.

Hello! First of all, I would like to thank the author of this site. This is a must to read. Very helpful. I took the MLS(ASCP) exam today and I passed. Look at the questions Chellezy78 posted because I had most of those questions too. I wished I scanned all the questions here and it would have been easier for me. I had many Micro questions including about 5 myco (which I just guessed) and Blood Bank. Here are some things I remembered (without answers).
1. Sezary cell
2. 3 questions about Sensitivity vs Specificity (compare 2 methods)
3. Antibodies detected in Speckled pattern of ANA
4.Enzymatic controls were outside 3SD, while the Non-enzymatic controls were within 2SD, What’s the cause? (something like that)
5.Something about blastoconidia (sorry but I suck in Myco, I just guessed)
6.Previous VDRL result of CSF is positive. But the lab ran out of the reagent. The RPR is done but negative, what should the technologist do next?
Some choices: report is as negative. report as positive, inactivate the CSF and do RPR again, plus one more choice.
7. 2 questions about presence/absence of Bilirubin and Urobilinogen in hemolytic anemia. (you need to be familiar with this)
8.Enzymes to diagnose Muscular dystrophy
9.Be familiar with the Enterobacteriaceae reactions.
10.Be familiar with reactions of Strep regarding NaCl, BE, etc. (I had couple of questions)
11.ABO discrepancies
12.Cause of decreased zone of inhibition in Oxacillin disk diffusion
some choices: using 1.0 McFarland suspension; media pH is 7.2, more
13.When should you do sperm count?
choices:As soon as it is received,
Within 3 hours,
Before Liquefaction,
After liquefaction is complete.
14.What is added before doing cell count of Synovial fluid?
15.Pictures of peripheral smear and you have to check the disease associated with it

1. PSA px with prostate gland removed 12 months ago, has a somthing like increase PSA result. so what is the condition?
a. Test sensitivity
b. Test specificity
c. Recurrence of dse
d. i forgot the other choice

2. Blood collected from EDTA for bld typing and antibody screen, shows MF rxn on AHG and IS.
a. report result
b. adsorb somthing like that
c. recollect serum specimen
d. i forgot again sorry

3. What causes weak D?
– i answered missing epitope

4. What enzyme increases in alcoholic px something like that

5. 8 yr old px has osmolality of 297, metabolic acidosis, increase glucose
a. lead poisoning
b. ethyl glyco
c. salicylate

6. What is the effect of target cells in automation

7. Walking pneumonia – no effect using penicillin

8. Positive blood rgt strip and negative RBCs in microscopic exam
a. outdated SG strip
b. Ascorbic acid
c. diluted alkaline urine
d. preoteinemia

9. Rotavirus – stool

10. “adrenal” cushing syndrome

11. Vomiting affects what electrolytes

12. severe normochromic normocytic anemia, normal WBC and platelet hast 0.1% retic count
a. red cell aplasia
b. fanconis anemia
c. aplastic anemia

13. presence of dextran in blood typing something like that, what can be an error

14. ph is 7.0 and SG is >1.050 problem

15. picture of pinkish and crenated RBCs with 1 granulocyte that has pink nucleus, what is the cause?
a. pH buffer
b. ethanol fixing

16. Potassium permanganate – quenching agent

17. i had 3 ana patterns

18. what is the product of irreversible aggregation

19. heparin contamination in sample from catheter

20. i had 2 RBC pictures, identify the morphology and disease

21. how to check if the streptokinase does not function well

22. cushing syndrome
a. hypoglycemia
b. hyperglycemia
c. hypercal
d. hypocal

23. i had 1 antibody panel, it does not only ask for the antibody but it asks for the characteristics of that antibody that causes the reaction, so hard T.T

24. describe bastoconidia

25. Lipemia causes increase or decrease hemoglobin?

26.procaine and procainamide

27. what is the purpose of caffeine in bilirubin assay

28.what is the common error in PCR test

29. Bombay phenotype

30. preferred testing for legionella

31. increased in jaundice with pancreatic mass

32. picture of rouleux formation

33. what rgt deteriorates when in use
a. MN
b. Le
c. Jka
d. Fya

34. lewis antibodies in saliva of Le(a+b-)

35. Hba1c levels result in px with sickle cell disease and hemolytic anemia

I will tell you that the most important thing is to try not to get overwhelmed. I let my nerves get the best of me the first two times that I took the exam. I was a lot more calm and relaxed this time around as far as the questions go here are a few things you should know about: Aquired B, what A1 lectin is, TSI slant reactions ( I had two questions about this), Entomoeba histolytica, normal volume of sperm, sickle cell electropheresis, sickle cell anemia photos, AFP, LDL, rbc indicies, corrected wbc count, anion gap…(I have had this all three times), Hep B stages of infection, passive immunity, aquired immunity, urine casts and where they are formed, CSF fluid, staph questions, strep questions, veionella- not sure if I spelled it correctly, mycobacterium, nocardia, I had a few BB questions on Bombay

I don’t remember most of the questions on my exam, but I will say this – I had 3 questions with ANA florescent slides, and none of my study sources were adequate for those. Know your pre/post hepatic dysfunctions, as I had about 3 or 4 of those. I also had 3 questions about ABO discrepancies, and a couple of DAT questions. Knowing your TSI reactions is also advised. I, like many others, was certain that I had failed the exam, but I didn’t. Hope this helps someone!

Question I remembered from my test : what nutrient is incorpriate in anaerobic ager to aid the growth of anaerobes I choses (glycerol and iron). A bacterial with A TSI A/A or acid over acid meaning the organisming is a fertermnt muciod pink on MacConkey nonmotile but indol positive I chose (klebsiella oxcitical). Omg this question right out of the BOC the question ask what are the characteristics of Microcouse is show they were suscepibal to (Furazolidone) to is question 125 from the BOC. The difference between Yersina entrocolitica and peptis and I chose ( motility). And question 235 from the BOC twisted around a blood culture grew a grew a bacterial that was thought to be a contaminate something of the sought and I chose (propionibactterium) and question from the BOC 330 twisted around.A mycobacterial that cause a water contaminat I chose (mycobacterium Gordonae) and it was right. Anther question BOC 313. The same way when stain acid fast bacilli with truant auramine-rhodamine stain potassium Permanganate is used to I chose ( quenching florencent background) and I was right is a quenching agent. Another similar question from the BOC to 304 to 307 why are first morning sputum needed for mycobacteria I chose (because if septum is held overnight the septum is invaded).
For chermistery I remember the following.
Instead of the whole liver panel they ask similar BOC 144, 145 ezyme do u see most in obstrctive jundiace or hepatoculluar obstruction between ALP and ALT and other ezymes I chose ( ALP) question. A caculation question of creatinine clearance question no the formula C=uv/p know that u always divide the total urine by 1440 and this is = to your volum. What you use to measure and instrument that absorb a flurecent light and transmit it at a large wave light I chose (. Flurometer) another question an instrument that. And an ezyme Usero measure choles something I chose (GGT) beause I thougt of alcohol when I saw the word coholes and didn’t see any thing about the lipid test so I went with that. BOC question 311 in the chermistery section the same question to detect barbiturate abuse when analyzing urine specimen I chose ( gas chromatography and mass spectrometry).

I passed! Questions I came across: PSA reference values and free/total ratio and what 7% free PSA means. HepB “anti-core window”. Free fatty acids to grow what fungus. Lots of blood bank ABO discrepancies. Pos DATs, mf reactions. LOTS of blood bank and quite a few urinalysis on the whole. Lewis antibodies in saliva of Group A Le(a-b+). HUS associated with E. coli. A few questions about Bilirubin and urobiliogen in urine/serum/feces. Direct/Indirect Bili. Know pre/post hepatic jaundice. A question about Erchlich’s test for urobilin/porpho test. Factor V Leiden and what it does. Coumarin therapy and how it affects. Theophylline therapy in babies and test for toxicity of what? HepB ANA homogenous/speckled/anti-smooth muscle/or anti-thyrotropine?…. What does plasmin do. Lots of urine strip test questions, like . CSF standing in room temp for 3 hours affects: immunoglob neutralization, glucose, etc. CSF should be stored for later testing how: -20C, -70C, RT, etc. Cushings shows: hyper/hypoglycemia or hypo/hyper calcium. Question about inappropriate ADH syndrome: decreased serum sodium, increased glucose, etc. Mg needs to be monitored in: severe vomitting, head injury, etc. bHCG level for positive control. Salmonella Paratyphi A. Sickle Cell test interference. Low serum erythropoein levels in what disease. Normocytic/Normochromic severe anemia with 0.1% retics; Fanconi’s anemia? One calculation: corrected WBC count. Pheochromocytoma. Catecholamines in urine. What does 5HIAA in urine mean. Given electrolyte panel and blood gases, what to measure: ethyl glycol, lead, salicylate, etc. Given picture of Auer Rods, confimatory testing (Phili Chromosome?) Absolute/Relative lymphocytosis/lymphopenia. A few questions (at least 3) about precision/sensitivity/specificity with true positives, false pos, true negs and false negs. My question was TP/(TP+FN)=? What are blastoconidia. Stain for cryptosporidium. Mycoplasma and arylsulfatase testing. Seminal fluid volume, motility, abnormal %. Distinguishing characteristic of micrococcus (furazolidone resistant). Non-fluorescing bacteria like Pseudomonas. I hope this helps!! Lot’s of random detailed questions…. These are probably the harder questions since I can remember them. Ex. of an “easy” question I got would be: shape of tyrosine crystals in urine, but not too many of those gimmes. It was hard, not gonna lie.

I failed on my first attempt -MLS(ASCP) exam. I got 381. I needed 400 to pass. I was disappointed because I thought I did good answering most of the questions. I had 4 antibodies panels in BB. I can not remember all the questions but here are a few of them: Tumor marker to monitor breast cancer(CA-15-3). Test for inflammation(CRP). Sweat test ..which of the following is used to clean the skin…70% alcohol, Water, Betadine. Respiratory Alkalosis. Anti Immune disease with an elevated ALP. Clinitest result turns quickly from blue to orange and back to blue….is this test pos or neg? 10ml of chemical sol spilled in the lab…pull the fire alarm, clean the spill, ask everybody to evacuate the lab? test to identify hairy cell? class of leukemia FM1 and FM3. what is a look back test procedure in QC that is more than one times out for a particular test.

I passed my MLS on my first time. I didn’t do LabCE because I was too late when I found it out and beside I already bought a few study guides, but the one that I most spend my time with was the Harr book, ASCP BOC book, and a botton line approach plus my class notes; it can be overwhelming, but I advice to focus brush through the small details and focus on the main stuffs, like really understand prehepatic/posthepatic jaudice in relation with bilirubin and urobilinogen, Hepatitis antigen and antibodies (their window), abnormal protein electrophoresis (each disease it entails), and RBC’s inclusions (howell bodies, peppenheimer, heinz body be able to ID them!). I got few questions on mycology and maybe 0-one on parasite, focus on chemistry, BB, hem, and micro more. BB more on ABO Rh, DAT, IS descrepancies. If you know the basic stuffs on each, you should be fine. Good Luck to future tester!!

I just took my ASCP exam this weekend and passed, and I just want to say thank you for this site. The notes really helped me to recall information. I do want to say that my test included all of the subjects with most of them being blood bank. I actually had more questions than I expected of virology, immunology, QC, instrumentation, and mycology. I would suggest that people planning to take this exam to not brush over those subjects because I probably had 10 questions from these areas. I also had questions about bilirubin, odd organisms in microbiology, pictures of immunodiffusion and what they meant, factor deficiencies/inhibitors, TSI slants, antibodies to various viruses and what they meant, QC question on machine with “no endpoint”, what cocaine is metabolized to, a few questions on liver and cardiac markers, a few questions on endocrine system/steroid hormones, pheochromocytoma, lots of questions on HDN, antibody panels, antibody screens, discrepancies in blood bank, etc. I was very nervous during the test and it was very difficult. I am just so happy to say I passed! Thanks for all your help!

I took my ASCP exam and passed! Thanks Sohail for your website and it’s great for future MLSs to support each other to succeed. My resources (in order of importance) were the Harr book, the review cards, and the LabCe. I must admit I didn’t use the LabCe too much, just a couple of times did the computer adaptive mode, and practiced some questions in my weaker area. I was getting 50% on the computer adaptive mode, so it was a bit discouraging. The exam today had ABO discrepancies, micro (mostly on GPRs & GNRs, mycobacteria), lots of UA/reagent strip case studies (unexpected). It is important to know the main reactions of certain organisms and what they need. ex) malassezia furfur requires olive oil, which org has gliding motility..etc. As long as you’re confident, you may do well, and the review at the end helped me go back and make sure I answered to the best to my ability. I did just graduate last month after a semester-long internship, so that helped.

Here are some questions that came out and remembered. I wont do into detail because I forgot some choices with the question.
– if there is a rouleaux formation on the blood what will you do? (bunch of choices-forgot what the choices was) = saline replacement
– Slide of a smear = it was metamyelocyte
– Slife of immature celles (mye,meta,looks like blasts etc) what test to confirm? a. ph chromosome b. sudan c. oil red d. pas = Not sure with the answer but I choose “a”
– xmatch: DCe/DCe recepient, xmatched with 4 donors, DCE/DCE, dCe/DCE, etc.- anyway there were 4 donors and 2 of them incompatible then asked what Ab is present: Choices: a, C and D b. E and D c. anti c d. anti E ( sorry not perfectly sure what the right choices are but you get the point)
– Some urine strip questions (yup I think I had 4 of them!) = patient came from radiology with urine sg 1.054 done on refractometer and 1.028 on strip what are you going to do or something : a. strip deterioted b. result matched c. calibrate the refractometer d. correlate result with ph
– rgt strip protein negative but SSA 2+ what the cause? cant remember the exact choices the only one I remembered for this is , false neg due to amorphour urates or other protien present,
– I had a pix of electropheresis of SLE: a rim b. centromere c. nucleolar d. diffuse – I think I answered centromere here not sure
– What rgt deteriotes faster when in use a. MN b. Le c. Jka d. Fya
– Jka ruled out but not anti c and anti Kell. tested for Ag Anti Kell = Anti c +? a. comfirmed c but cannot rule out k b. cannot rule out c. confirmed K but not c d. confirmed c but kell can neither be ruledout or confirmed
– nephrotic dse what is seen? a alpha 2 b. albumin, c. gamma d. alpha 1 (not sure with the exact wording on this but you get the point)

Ok that are the only things that I can remember for now. For micro I have maybe 5 of them but honestly I cannot remember them. They are so hard to remember. I had only 1 mycology, no virolgy, no lab operations and no parasitology. I think I had micro, hemo, blood bank and chem equally and yes I had lots of microscopy. And of course as all previous taker here pls study all the desease that correlates with lab results. Like the bilirubins, ABO discrepancies, Coagulation resutls. For biochemical reaction I only had one and it was about a enterobacteriacae. I think my answer was enterbacter. ANyway sorry if this is too long for you guys but I will help other future examinee as best as I can. So hope this helped. Good luck!

Thanks, Sohail! 🙂 Here are the questions I can remember that were just out-of-the-blue and were not in any patterns mentioned in my “PS” below. Hope it helps. God bless!

>For ISE measurements, a ____ membrane is used to selectively bind potassium.
> RIST test detects what?
> Using compensated polarized light, what is positive (blue) for birefringence?
Uric Acid or Calcium pyrophosphate?
> Lab Management questions regarding turn around time and MSDS(?)
> In an exchange transfusion for cases of Rh HDN, whose blood type (mother or baby or father or just Group O negative red cells) do you transfuse?
> Safety precautions you have to take when a lab personnel is electrocuted. What to do when he/she is “stuck” to the electric source itself?

PS- Here are the ‘patterned questions’
(questions that were given in a row referring to the same topic)
-I had ALOT of antibody panels
-Microbiology Enterobacteriaceae identification pictures
(the micro charts on this site were VERY helpful)
-Interpretation of Blood Gas results (NOT “metabolic acidosis/alkalosis”, but what caused it- vomiting, hypokalemia, renal impairment, etc)

Passed. Some of what I got: Antibody least likely to display dosage, Bilirubins in hemolytic anemia, Tumor marker question, calculate RBC count from hemocytomer with given dilution and squares counted, slide with picture of stomatocytes what disease state, diabetes given fasting 128 Glucose tolerance >200, badly stained slide with crenated rbcs what caused, formula given specificity or sensitivity, fluorescence protect yourself from what, slide with blast with auer rods stains most beneficial for diagnosis, slide with RBC agglutination saw twice one time incompatible transfusion other cold agglutinin, RBC H/H given rule of 3 do not correlate lipemia, bile stained “mammillated” (yes BS wording) Ascaris lucky guess, 1+ leukocyte esterase no WBC’s seen why, list of Coag results post surgery indicative of what, an acute hep question (again BS wording) made more difficult than should of been think I got right, unit released brought back within 30 min but “entered” (damnit into what) on floor discard, picture of TSI tube what org. My take I feel like I was tested on reading comprehension more than my ability to not kill someone, would not be surprised if I got exactly 400. I think I changed a couple that I was on the fence on, problem is I think they were right initially. About 4 questions were related in that I had no idea but after seeing the other question I could deduce the answer to the initial question. Had no full Ab panels but some weird mini panels, some discrepancies (not exactly easy), no cardiac enzymes, no thyroids, maybe one blood gas, one or two fungals (probably missed maybe got lucky). Anywho, study hard and you should do fine. Thanks and good luck.

Hi there!

I used your website over the past two months to prepare for the ASCP MLS exam. I took my exam this morning and passed! I just wanted to say thanks to you for putting this site together. It allowed me to organize a study plan that worked.

To those who are preparing to take the exam, study his micro charts! They include everything you need to know to make it through the micro questions on the exam.

Questions I saw on the exam today (July 2013): abnormal PT and APTT results, ANA patterns, RIST vs. RAST, lots and lots of micro biochemical reactions, several antibody panels, abnormal cells on peripheral slides and hematology values, many questions over liver enzymes and bilirubin metabolism, a few over the thalassemias, a couple of parasitology and mycology questions, one question over education objectives, one protein electrophoresis, corrected WBC calculation (nRBC), two dilution calculations

Materials I used to study:
LabCE: I was scoring between 51-55% on computer adaptive setting, 78-80% on the MT 100 question practice exam, and 75-80% on subject tests
Clinical Lab Science Review: A Bottom Line Approach by Patsy Jarreau
Polansky notecards
Wordsology
YouTube videos ( especially over the thalassemias and bilirubin metabolism and associated diseases)

I used this website to organize my study plan. I studied for a little less than two months for a few hours per day. The week before the test, I reviewed the main four subjects and studied several hours per day.

Hope this helps! Good luck.

Hi I took the test today and passed. I have to say it was very hard and like others have mentioned I was pretty sure I had failed around question 50. MY questions certainly didn’t get any easier at the end! There were about 20 I was certain of the answers, kind of straight fact questions. MANY seemed to be the same as John (from March 2013) mentioned above. READ them very very carefully and make sure you know exactly what they are asking. AND some were so vague! I got the one about the unit being “entered” on the floor. Literally the question was ” A unit of blood was issued at 11:15a. After being entered on the floor it was returned at 11:40a. What do you do with the unit?” I am with John-entered into WHAT-the med record? the unit entered?–which now seems like the most logical-but many questions were like that. Minimal information, and what seems to be the correct answer not being there. My favorite (!) was this one: “A med tech sets up QC on new TSI slants using E.coli and P.mirabilis. The results were as follows: E.coli: alkaline slant, acid butt, H2S. P.mirabilis: alkaline slant, acid butt. The answers were: 1. accept QC; 2. Run 2 H2S negative organisms; 3. Run ATCC strain of E. coli, 4. Reincubate. WELL I am a micro tech and first of all most ecoli is not H2S positive, and P. mirablis is H2S positive. And why wouldn’t you have run an ATCC strain in the first place? So the results are screwy to begin with. But out of those choices–What the ????. I picked 2, but who knows!? Looking back I think if you REALLY learn what is on the Polansky cards, and the Clinical Lab Science Review: A Bottom Line Approach by Patsy Jarreau, you will be good. I CANNOT emphasis enough learning bilirubin stuff–urine and blood results for prehepatic, hepatic, post hepatic biliribin and urobilinogen -lots of questions–know the references ranges for total, direct, indirect, conjugated, unconjugated, urine, and blood, know what diseases that elevated values match up to. Maybe because micro is easier for me there seemed to be less of that on there. It seemed like mostly blood banking, chemistry, and hematology. Weird hematology pictures-got the same pictures twice with 2 completely different sets of questions. Know the stains! The only math I had was indices-not just knowing how to calculate them, but using the calculations to diagnose, and a manual RBC count. A few small cell panels. I was really surprised by how minimal and vague some of the questions were. “A known alcoholic comes to the ER. He has cardiac symptoms. His glucose is 180. What test do you run next?” choices; HgBA1C, magnesium, alcohol, glucose tolerance. OMG!! Most of the urine questions were about discrepant dipstick results. A couple mycobacterium questions. I did see the “pass” on the screen but I was so unnerved by the test and shaking, I had to sit in my car for awhile before leaving 🙂.

 

I studied on and off for a few months before taking this exam, which I highly DON’T recommend. Bob Harr was my program director, so I had his book memorized because he and all of my other teachers used questions from his book for our exams. I also used the review book by Patsy Jarrean, along with this site and LABCE. I was very fortunate with my clinical experience and was able to use that knowledge for most of the questions. When I took the LABCE exams, I was scoring in the upper 400’s and lower 500’s. Questions on LABCE repeated themselves semi-often and some of the explanations for correct choices were unhelpful. For example, if I got a question wrong it would say “Answer: 41565 was the correct answer. Description: 41565 is the correct answer.” If you can get a classmate to buy a subscription and share their password with everyone else, I would do that.

The exam wasn’t too bad. For every question I had no idea what to pick, I guessed B (like Harr said). Take your time, I had an hour left when I finished. I went back through and tried to memorize as many questions as I could, mainly for this site. I didn’t change a single answer, it is best not to second guess yourself. You can take a calculator in with you, but you leave everything, even watches and pens, behind. They give you a marker and a dry-erase board so you can write anything down. I immediately wrote all the micro charts from this site, along with a few calculations. You can take a break any time, but time still ticks down. I took a 15 minute break just to clear my head and walk around. They also provide sound-proof headphones, if you would like to use them.

My advice, schedule your exam early because dates can fill up fast. I tried to sign up for a day during the first week of the month, but there was only 1 slot available the whole month. Pearson doesn’t just offer medical related exams, they do stuff for all trades. Also, make sure you send your transcripts in advance to ASCP or they will not send you the certificate. It takes about 3-5 weeks to send your certificate if you have everything submitted.

Because I don’t want to give incorrect answers and steer you wrong, I tried to say most of the choices that I can remember. I scored in the upper 400’s on the ASCP, so I’m no genius. Also, double check all my answers before studying. Answers with a question mark are ones that I am not 100% sure are correct. Also note that if I only list 3 of 4 answers, that’s because I cannot recall the 4th choice. There may be another “better” answer that I cannot remember.

The majority of questions on your exam will probably be on your weakest areas, as confirmed by me and a few classmates. I studied 3/4 of the main areas hard, but got screwed by my weakest.

So…here’s the questions I recall from my exam:
Blood Bank:
1) Mother Le(a-b-), what would cause this? – mother loses lewis antigens while pregnant
2) Mom is A+ baby is B+ elution shows: Acell 2+, Bcell 2+, SC1 0, SC2 0, SC3 0 – what antibody is present?
3) Given a panel, all but one cell reacted at AHG. Asked which cell should be used to rule out Anti-C and gave 4 more possible cells as choices.
5) One ABO discrepancy, asked the cause. Reactions: Anti A 4+, Anti B 0, A cells 0, B cells 0
6) Number of rhogam vials to give mother if fetal blood is 62.
7) Cause of weak D – missing epitope….?
8-12) I had 5 panels. Make sure you know how enzymes affect panels. Half of my panels had an enzyme column.
13) An O positive Patient has a known anti-K. Which of the following is true?
A) 93% of O blood will be compatable
B) 7% of O blood will be compatable
C) 93% of A blood will be compatable
D) 3% of A blood will be compatable

Chemistry:
1) LDL calculation – straight up, no gimmicks
2) HDL was 34, Trig was 400, and cholesterol was 235. LDL was directly tested and was 169. (P.S. if you know the correct answer to this, please tell me. I know that you cannot calculate the LDL if the Trig is above 400, but I keep second guessing myself)
A) Report out calculated LDL
B) Retest Triglycerides and recalculate LDL
C) Retest cholesterol and recalculate LDL
D) Recollect while fasting
3) Gave 4 anion gap equations and asked which one would give an error – one had a negative value
4) Asked the definition of an automated delta check
5) Analyzer is set to delta check sodium at +/-7. Of these results, which would delta check? (and yes, there were 2 that would “technically” delta check”)
Day 1: 137
Day 2: 141
Day 4: 132
Day 5: 137
Day 7: 136
Day 8: 142
Day 10: 134

A) Day 1
B) Day 4
C) Day 8
D) Day 10

6)Patient with HA1C of 5%, glucose is 150. – Patient was following diet for beginning of 3 months and stopped.
7&8)Know your chemistry enzymes from the chart on this site. It is EXTREMELY helpful.
Which of the following is increased in skeletal muscle disorder
ALP is elevated in____
9) Bromide affects which electrolyte?
10) HDL precipitation, what is the use of Heparin-manganase?

Heme:
1) Picture of sickle cells – asked which reagent should be used to diagnose
2) 4 year old has increased N/C ratio with cells containing 2 nucleoli. (no picture) Choices:
A) Lymphoblast
B) Monoblast
C) Reacive Lymph
3) Caused increased ESR
4) Picture of sickle cell and target cells – asked which disease
5) Picture of poly and Macrocytes – asked which anemia
6) Low WBC, low RBC, low Platelet count – asked which lab test would be useful to add on for anemia diagnosis
7) Blood was opened for a long period of time, what would happen to pH, pCO2 and pO2
8) Blood with strong cold antibody will – agglutination on smear
9) Picture of agglutination, asked increase in what causes it?
A) Red blood cells
B) Neutrophils
C) Histamines
D) Platelets
10) Blood smear was staining darker blue – reduce pH buffer
11) A control blood smear was made that covered 60% of the slide. The red cells stained pink while white cells had their nuclei stain dark blue to light blue. The white cells were clustered at the tail end.
A) Accept
B) Reject – white cells clustered at tail
C) Reject – Red cell color is incorrect

Micro:
1) CSF has gram positive beta hemolytic bacilli catalase+, oxidase-. What Should you do?
A) report out normal flora
B) perform indole and…something else
C) perform motility at room temp and 35
2) Hektoen agar, what color would and A/A bacteria change?
A) Yellow
B) Green
C) Black
D) Clear
3) Showed a picture of mycobacterium that was grown in dark. When left in light for 8 hours, it turned yellow and has significantly less growth.
4) Cigar shaped gram positive staining organism – candida
5) Had your Fletcher’s media for Leptospira question
6) Gram stain (can’t remember the site, but I think it was some sort of oral lesion) grew a gram positive cocci and a gram negative bacilli. On the aerobic culture, only the cocci grew. What is the bacteria. – Bacteroides
7) Bacteria with tapered ends – Fusobacterium
8) Showed 4 TSI slants, asked which one would be for Salmonella
9) How to tell Yersinia pestis from other Yersinia species – Motility test
10) Swarming bacteria, which test should you do next – Indole (for Proteus sp.)
11) A beta hemolytic gram positive cocci is growing on a blood plate. It is catalase positive, coag negative, oxidase negative, 6.5% NaCl positive.
A) Report as normal flora
B) Repeat the catalase and report out Enterococcus
C) Repeat the coagulase and report out Staph aureus
D) Repeat the oxidase and report out Micrococcus

Others:
1) Doc sends a throat swab for rotavirus – call for clarification
2) Normal DDMR and abnormal FDP, what disease
A) VWD
B) Fibrinolysis
C) DIC
3) Which factor mediates prothrombin to thrombin
4) Ran controls and PT was normal, PTT was abnormal. Replaced controls and got same results. What should you do next?
A) Change out the Recombiplastin
B) Change out the CaCl
C) Rerun controls
D) Run patient tests
5) 5HIAA – carcinoid tumors
6) Positive RPR but negative FT-ABS. What would cause?
7) Had your pyelonephritis question from your practice questions.
8) Question about coccidioides rapid agglutination test.
9) PT, PTT, and TT were abnormal – Factor 5 inhibitor
10-13) 3-4 questions about PCR, Rotavirus, and viral stools. I wouldn’t be surprised if I missed all of them.
14) Picture of a Renal Epithelial cell

 

Hey guys! Took the exam yesterday for the second time and PASSED!!! Thank you Sohail for this website and thanks to everybody who took from their time and shared they’re recalls. Follow Sohail guideline of study and materials. I strongly recommend the high yield notes specially Micro, LabCE is a super useful tool, don’t be afraid or discourage of the adaptive simulation, at the beginning I was scoring between 50-60% by the last week before the ASCP exam I was scoring 75% up. Read and understand every explanation given even if you got it right. I manage to remember a lot from my exam, I tried to put it in order of subject, hope it comes in handy!

Bacteriology
1. Bacteria isolated from a wound TSI A/A, oxidase (+), The most likely organism is: Aeromonas
2. Plate cocci in chains. Patient with endocarditis, alpha hemolysis, bile esculin (+), NaCl (no growth). The most likely organism is: Strep. Galloliticus (bovis)
3. Patient with pharyngitis complicates to glomerulonephritis. The most likely organism is: Strep. Pyogenes
4. Preferred rapid test for Legionella pneumophilia Ag: Ag in urine
5. Bacteria LAP(-), Bile esculin (+), NaCl (growth), PYR(-): Leuconostoc
6. Organism isolated in Hecktoen: TSI K/A, H2S (+), PAD (-), Lysine decarboxylase (-), Urea (+), citrate (+). What should the technologist do? Report as normal flora
7. Child with walking pneumonia due to Mycoplasma and is prescribed penicillin. 2 weeks later, still sick. What happened? The microorganism doesn’t have cellular wall
8. Latex agglutination for S. aureus – Protein A and coagulase
9. Child with cat scratch, BGN, catalase (-), oxidase (-), motile. The most likely organism is: Bartonella henselae
10. Difference between P. aeruginosa and P. putida? Growth on 42C
11. Bacteria grows pink on McConkey, Indol(-), citrate (+), Lysine decarboxylase (-), ONPG (+): Enterobacter cloacae

Virology
12. Rotavirus specimen: stool

Parasitology
13. Parasite that doesn’t present schizont and trophozoite: P. falciparum

Mycology
14. Test of hair penetration allows to differentiate: T.mentagrophytes/ T. rubrum
15. Patient comes in with lesion on arm, the organism presents delicate hyphae with microconidias: Sporotrix schenki
16. What are blastoconidias? Something about budding between mother and daughter (check)

Urinalysis
17. Urine with pH 4.5: diet high in proteins
18. Urine at 10C measured in a refractometer SG 1.024, 1000 mg of glucose. What should the technologist do? Correction of the refractometer due to glucose
19. Strip RBC (+), microscope (-), this is due to what? Diluted alkaline urine

20. Patient that physically appears to be pregnant but the HCG is negative. U/A decreased SG and proteins: trace, why the test result in negative? A. low SG B. False negative because of the protein trace C. There’s no HCG detectable because it’s produce 6-8 days after conception.

21. CSF for culture, MLS only manages to perform Gram stain in his shift, what should the technologist do? Incubate at 35C
22. Urinalysis result for a child had tubular renal cells 25-30, granular casts: tubular necrosis
23. Fecal fat methods: extraction and process

Immunology
24. ANA pattern with fluorescing speckled or nucleolar (check every pattern)
25. Pancreas cancer marker: CA 19-9
26. Long term marker of hepatitis that is also in acute infection: Anti-HBc
27. Screening test for HTLV-I (+), HTLV-II (-): Report HTLV-I by Western Blot
28. Patient titles EBV>IgG 1:128, IgM1:10, CMV IgG>1:128, IgM1:38, IgG<1:10: Acute infection with Toxoplasma
29. HbeAg Abs cutoff 0.700, patient 0.300: indeterminate
30. IgE RIST: measures Total IgE

Hematology and coagulation
31. CBC with RBC: 2.46 Hgb: 14 Hct: 36%- Lipemic sample
32. Plate of peripheral slide, RBC’s and WBC’s looked pinkish- Inadequate pH
33. False decreased in ESR: sample more than 8 hours to be tested
34. Plate RBC all agglutinated (not rouleaux), what’s causing this? Mycoplasma
35. The same plate of agglutinated RBC, with witch condition is associated? Cold autoantibody
36. Plate with Burr cells: Uremia (HUS)
37. Plate with stomatocytes: Liver disease
38. 2-year old girl with anemia Normo-Normo, Retics 0.1%, WBC and Platelets normal: Pure Red Cell Aplasia
39. Table of CBC results. Two methods to measure Hgb (method 1: 14g/dL, method 2: 13g/dL), the second method utilized Lyse. What happen? HgbC cristals are Lyse resistant
40. Plate with RBC (hyperchromic, anisocitosis), inclusions (1-2/ RBC) in Wright. Patient has 18.5% of retics. What should the technologist do? Use Prussian Blue
41. Reactive Monocitosis: Tuberculosis
42. MI patient who was treated with streptokinase. Which of the results suggests that treatment wasn’t successful? PT 25
43. What affects HgbA1C: Life span of RBC
44. Calculate % of Saturation- UIBC 185 Fe 125
TIBC= 185+125=310 %sat (125/310)*100=40%
45. A patient is tested for primidone, what other test can you perform? Phenobarbital
46. PT normal (11s), PTT (56), Mix 1:1plasma (47)
a. factor XII deficiency b. factor VIII deficiency (chose this one) c. fibrinolysis d. something about stypven
47. In what condition do you find abnormally low erythropoietin? Policitemia Vera
48. Patient whit autoimmune condition presents infection with S. pyones, S. aureus and (__) what is the possible deficiency? Neutrophils
49. Sample taken from indwelling catheter. Patient isn’t on any anticoagulants yet PTT and TT are way elevated: Heparin contamination (from catheter)
50. In the second phase of platelet aggregation what is irreversible? Fibrin formation
51. Lupus anticoagulant causes: thrombocytosis
52. Controls and patient PTT elevated, control and patient PT elevated: thromboplastin was added by error
53. Rouleaux are undetectable at what phase? AHG

Blood Bank
54. Patient with DAT (+)
Rh patient Rh control
IS 0 IS 0
AHG + AHG +

55. EDTA tube: report DAT+
Polyspecific IgG Complement
IS 0 0 0
AHG 1+ 0 1+

56. Anti-A Anti-B A B
4+ 4+ 2+ 2+
What would the technologist do? Test with cell panel

57. Anti-A Anti-B A B
0 2mf+ 4+ 0
Discrepancy due to Bx-subgroup

58. Whole blood donation stops at 390ml: PRBC (low volume unit)
59. Le(a) Le(b) IS 37 AHG
0 + 1+ 0 0
0 + 1+ 0 0
+ 0 0 +/-2w +/-2w
+ 0 0 +/-2w +/-2w
Glycolipid absorbed from plasma
60. Patient A+, Le (a+b-): has Le(a)
61. Antibody that deteriorates in storage: P1
62. Pregnant woman O-, anti-D, anti-C, anti-I, previously she had anti-Le(a), baby is A+ with DAT (+), anti-D and anti-C are identified, which blood would you give? O- without C
63. Table. Choose positive controls to test for anti-c and negative control to test anti-Fy(a): C+c+ for the positive control and Fy(a) for the negative control
64. Detection of ab where 11 tubes resulted negative in AHG, but when added CC 4 of them didn’t agglutinated. Machine didn’t dispense correctly the saline in the wash

65. Table. IS 37 AHG CC
SCI 0 0 0 2+
SCII +/- +/- 0 2+
Add 4 drops of serum

66. Baby A+, DAT-, Mother O- before birth: Do rosette test
67. Patient DAT (4+), IAT(+), did eluate and the results are DAT(2+) they auto absorb serum and keeps reacting to SC-I and SC-II in AHG, what should you do? Panel cells (there was also enzyme panel cells, report DAT or make another auto absorption)

68. Anti-A Anti-B Rh Du Control D
0 0 3+ + –
IS 37 AHG CC
SC I 0 0 0 2+
SC II 0 0 0 2+
Patient cells 0 0 2+ not tested
Presents auto-allo ab

69. A panel that anti-Fy(a) was present but can’t rule out anti-E, so the answer to the panel was: anti-Fy(a), anti-E
70. There was a small case to choose which component is the best to give for the deficiency
71. Which donor should you differ? donor received Hep B immunoglobulin 8 weeks ago

Instrumentation and quality
72. Patient with Hct 62%, the sodium citrate tube was centrifuged and noticed that de blood plasma ratio was low. What should the MLS do?
a. take sample with more anticoagulant b. take sample with less anticoagulant c. take sample in heparin d. report
I chose report, the high Hct can be from a new born sample or it can be a dehydrated patient
73. Coagulation machine, controls and patient where run in duplicate. Controls where normal, patient 1 PT normal PTT abnormal, patient 2 PT abnormal PTT normal
a. CaCl2 b. Thromboplastin c. something about a light (chose this one, check) d. controls
74. Instrument linearity something about comparing means: Paired T-test
75. Calibration of blood gases analyzer: 2 buffers with known pH and constant temperature
Chemistry
76. Formula TP/(TP +FN): Sensitivity
77. Absorbance formula: 2-log%T
78. Patient is tested for Procainamide and results negative, what other test can you do? NAPA
79. Patient with fasting blood 155mg/dl and random 225mg/dl: Do OGTT
80. 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
81. What causes postprandial lipemia? Fatty acids
82. Cause for decreased serum Na? Hyperglycemia
83. Patient with elevated Ca and normal PTH: Metastasized cancer
84. What increases in Cushing? ACTH and Cortisol
85. Positive strip for glucose, negative clinitest: presence of Glucose
86. Patient with hyponatremia, all the other electrolytes were normal: hyperglycemia
87. pCO2 electrode measures: pH
88. Patient had dyspnea caused by anesthesia, what should be measured? Pseudocholinesterase
89. Patient fasting 120mg/dl, non-fasting 160mg/dl: impaired

138 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.
    https://quizlet.com/_3huynm
    I will add more questions and answers as I study. 🙂

  2. Brooklyn says:

    Hi,

    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
    c)creatinine
    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. tazeen5 says:

    I got so many Exam recalls qestions:
    difference between p. aeruginosa and p. putida – growth at 42’C
    Ran controls and PT was normal, PTT was abnormal. Replaced controls and got same results. What should you do next?
    A) Change out the Recombiplastin
    B) Change out the CaCl
    C) Rerun controls
    D) Run patient tests
    Histoplasma capsulatum –tuberculate macroconidia
    amniotic fluid cannot be tested for bilirubin on regular chemistry analyzer as serum bilirubin because A) they are demanding, B) they are biochemically different
    something about 2 types of bacteria found in agar one was gram + and another one penicillin, kanamycin resistance anaerobe gram neg. bacilli answer was Bacteroides fragilis
    eluate had sc one pos., SC two pos., SC three negative…..you would do what…a) repeat eluate b) do a panel on eluate
    Burr cells-uremia
    Bartonella- cat scratch curved gram neg
    cushing syndrome- increased cortisol, decreased acth
    I got question about billirubiner ans ass. Disease
    I used was U C B U “yoU C(see) Bulls**t”
    U- unconjugated billirubin: Elevated in pre hepatic and post hepatic or billary obstruction
    C- conjugated billirubin: elevated in hepatic and post hepatic
    B- billirubin: elevated in hepatic and post hepatic
    U- urobillinogen: Elevated in pre-hep and hepatic. Decreased in billiary obstruction
    One question they ask what increase in hemolytic disease I answered Urobillinogen and unconjugated bilirubin.
    Know your PT APTT ranges and MIXING STUDIES! and lupus anticoagulant.
    ABO DISCREPANCIES and how to remedy them. Anti-a and Anti-b. Both 4+. A and B cells both 2+. How to resolve this discrepancy? But there was no prewarm in the option so I choose room temperature.
    Cause of low NA? (Hypoproteinemia,  Diabetes insipidus
    Two days old infant glucose strip positive. Clinitest negative. I answered Glucose pos. (not sure) Galactosuria was also an option.
    Metabolite of PHENOBARBITAL : PROCAINAMIDE
    Cut off absorbance for HBEAG was 0.734 something. Specimen was 0.3. Interpret result (Positive, Indetermine
    Stomatocytes associated with Liver disease
    urine refrigerated becomes turbid because of: I answered Amoruphous phosphates (not sure)
    Monocytosis seen in what? TB
    MI patient who was treated with streptokinase. Which of the results sugesst that treatment wasn’t successful. PT 12, PT 25,PTT 200 or D-dimer +
     Rotavirus specimen- stool
    Blastoconidia: budding b/w mother daughter
    Legionella test: testing in urine Ag
    What is in the saliva of a Le(a+b-) individual?Le a
    What does CO2 electrode measure?PH
    what does the hair test confirm : T. rubrum / T menta
    spikey cells Acanthocyte = slides not dry yet
    Blood comes up positive for HTLV-I/II, what do you do next? I choose western blot
    O neg, Rh pos patient now has a positive DAT. What will their typing results look like now? Includes Rh control. – I chose the answer where everything was negative except the Rh control was positive.
    ANA – it had things with like 4 colors green yelloow orange and red all over it but one is totally orange so I guessed. Anti mitochondrial antibodies.
    Cushing syndrome causes
    a. Hyperglycemia
    Increase in jaundiced with pancreatic mass: AFP
    Normocytic, normochromic, normal WBC, normal platelet, but retics is 0.1%
    a. Pure red cell aplasia
    Blood smear picture that looks like Howell bodies, the retic is 18%, the technologist should stain with?
    a. Stain Heinz- body staining
    Rouleux is undetectable at?
    a. Room temp??
    b. AHG phase
    TSI = A/A and oxidase + and gas
    a. Aeromonas
    Pink colony on Mac, citrate positive, Lysine=neg, Ornithine posiive, Arginine positive
    a. Kleb Pnuemonia
    b. Kleb oxytoca
    c. E. aerogenes
    d. E. cloceae
    you need to choose micro. ControlBile, nacl. Camp, bacitracin
    I choose enterococcus, s.agalactiae and s.pyogenes (I think so)
    what is the product of irreversible aggregation Fibrin formation
    what causes postprandial lipemia Fatty acid
    antibody identification Lewis b answer but choices were the antibodies description
    A. Glycolipida adsorb from the plasma
    A neg negative for D C I O RH NEG NEGATIVE FOR D C I ANTIGENS
    Study ESR increase/decrease 2 question
    . Strip RBC (+), microscope (-), this is due to what? Diluted alkaline urine

    CSF for culture, MLS only manages to perform Gram stain in his shift, what should the technologist do? Incubate at 35C
    Urinalysis result for a child had tubular renal cells 25-30, granular casts: tubular necrosis
    Fecal fat methods: extraction and process
    Immunology Patient titles EBV>IgG 1:128, IgM1:10, CMV IgG>1:128, IgM1:38, IgG<1:10: I don’t know the answer I think I choose coinfection.
    False decreased in ESR: sample more than 8 hours to be tested
    Plate with RBC (hyperchromic, anisocitosis), inclusions (1-2/ RBC) in Wright. Patient has 18.5% of retics. What should the technologist do? Use Prussian Blue
    What affects HgbA1C: Life span of RBC
    Calculate % of Saturation- UIBC 185 Fe 125
    TIBC= 185+125=310 %sat (125/310)*100=40% (remember to convert units if they are not same)
    PT normal (11s), PTT (56), Mix 1:1plasma (47)
    a. factor XII deficiency b. factor VIII deficiency (chose this one)
    In what condition do you find abnormally low erythropoietin? Policitemia Vera
    Sample taken from indwelling catheter. Patient isn’t on any anticoagulants yet PTT and TT are way elevated: Heparin contamination (from catheter)
    Lupus anticoagulant causes: thrombocytosis
    Whole blood donation stops at 390ml:PRBC
    Antibody that deteriorates in storage: P1
    Table. Choose positive controls to test for anti-c and negative control to test anti-Fy(a): C+c+ for the positive control and Fy(a) for the negative control
    Detection of ab where 11 tubes resulted negative in AHG, but when added CC 4 of them didn’t agglutinated. Machine didn’t dispense correctly the saline in the wash
    Table. IS 37 AHG CC
    SCI 0 0 0 2+
    SCII +/- +/- 0 2+
    Add 4 drops of serum
    Baby A+, DAT-, Mother O- before birth: Do rosette test
    Which donor should you differ? donor received Hep B immunoglobulin 8 weeks ago
    A panel that anti-Fy(a) was present but can’t rule out anti-E, so the answer to the panel was: anti-Fy(a), anti-E
    Patient with Hct 62%, the sodium citrate tube was centrifuged and noticed that de blood plasma ratio was low. What should the MLS do? take sample with more anticoagulant.
    Coagulation machine, controls and patient where run in duplicate. Controls where normal, patient 1 PT normal PTT abnormal, patient 2 PT abnormal PTT normal
    a. CaCl2 b. Thromboplastin c. something about a light (chose this one, check)
    Instrument linearity something about comparing means: Paired T-test
    Calibration of blood gases analyzer: 2 buffers with known pH and constant temperature
    Absorbance formula: 2-log%T
    Patient with fasting blood 155mg/dl and random 225mg/dl I choose Repeat FPG
    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
    Patient with elevated Ca and normal PTH: Metastasized cancer
    What increases in Cushing? ACTH and Cortisol
    Patient had dyspnea caused by anesthesia, what should be measured? Pseudocholinesterase

  7. 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.

    The bloodbank questions were mostly product questions. How are platelets prepared? What temp to store cryo after it has been thawed. That was seriously asked 3 times. It is a room temp storage product after thawing so I’m really not sure why they kept asking me that. What blood types would be acceptable for a plasma transfusion? What antigens are affected by enzymes? etc…

    I had several chemistry questions about hemolysis, lipemia, and wrong storage temps and their effects on different tests. A few about different methods of testing for HIV were also on there.

    Urinalysis gave 2 pictures of casts, and 1 of a crystal. It didn’t ask what the casts and crystal were, instead it asked what diseases you would see these in.

    Hematology was 2 questions about differentiating acute, chronic and leukemoid reactions, calculating the MCHC when given the indices, and a bone-marrow slide.

    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!

  8. HD says:

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

  9. 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?

      thanks.

  10. kena says:

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

  11. Sam says:

    Here are some questions I remember:
    1. Markers absent in Acute promyelocytic leukemia: CD13, 34 (I picked) – Don’t know if its right
    2. Group A, Le (a+b-) person: Lea only in saliva [Because no Leb = no secretor gene = no A & H antigens in saliva]
    3. Burr: uremia, Stomatocytes: Liver disease, Acanthocytes: inadequate slide drying. [Picture shown for these so know what these look like under the microscope]
    4. ANA pattern that looked smooth but had orange fluroscence along with green. and had mitotic cells that did not stain [“keyhole”]: picked Anti-mitochondrial – [Don’t know if its right]
    5. PT, PTT, and Pt. samples all run together were abnormally high – Choices: CaCl2 added, thromboplastin added, controls deterioration, incubation temp. too low (I picked this one because the others didn’t make sense to me)
    6. catheter tip – PT and PTT were high: Heparin contamination
    7. %saturation = [Fe/(Fe+UIBC)] X 100
    8. Antigen that deteriorates: P group
    9. Procainmide toxicity, levels within range, what to do next: Repeat test on same sample, Recollect and repeat, Test NAPA levels (What I picked, don’t know if its right), Test phenobarbital levels
    10. LF, ODC (+), Lysine (-): Enterobacter cloacae
    11. Gram pos. bacilli: Cat (+), Nonmotile: B. antracis, corynebacterium jeikeium (probably right answer), Erysipelothrix
    12. Lesions – Tissue: weird description -, microscope: Septate hyaline hyphae with microconidia: I put Sporothrix schenckii. Other options: Coccidiodes, Microsporum, Epidermophyton
    13. RBCs on strip but none in microscope: Dilute alkaline urine {I think}
    14. Autoabsorption done – ScI & ScII pos: Choices: Repeat autoabsorption, Selected panel cells, Antibody ID of enzyme treated cells (What I picked – I don’t know if its right)
    15. PPT abnormal for normal and abnormal controls: I picked replace thromboplastin reagent
    16. 18.5% retics, shows pic of pappenheimer bodies: Stain with Prussian blue
    17. What happens in “Adrenal” Cushing disease: Increased Cortisol, Decreased ACTH [I picked this because it said adrenal cushing disease so I thought it meant “primary” – dont know if right]
    18. Elevated Ca, Normal PTH: Metastasized carcinoma
    19. pt. jaundiced with pancreatic mass: AFP, CA-19-9, [Picked AFP but not sure]
    20. Deferral: Hospital workers received HB vaccine few days ago (I think)
    21. Normo, Normo anemia, WBC & PLT normal, retic 0.1%: Pure red cell aplasia
    22. Calibration of blood gad analyzer: 2 buffers and constant temperature
    23. Monocytosis: TB
    24. 3 LF organisms growing and also staph and micrococcus(?) on MAC, HE, and something else from stool. I put: report No Salmonella & Shigella isolated {Not sure}, Other options: Work up all three gram negative bacilli, report staph and micro
    25. What gene is deleted in the Mcleod syndrome: XK

    • Sam says:

      26. Increased sensitivity (or decreased metabolism) to succinylcholine due to: Pseudocholinesterase deficiency (pretty sure this is right – looked it up)
      27. Previously Group O negative pt. Now with DAT pos. What will the results look like: Weak D and Rh control positive at AHG (Not sure)

    • wordsology says:

      An incredible review. Thank you so much Sam. Congratulations to you sir!

  12. 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.

  13. 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

  14. Charita says:

    I am so grateful with the people who posted their exam recalls and also 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

    -reasons for falsely dec/inc PT and PTT.
    -how is Ca affted by PTH?
    -Relevance of sodium and glucose?
    -T.mentagrophytes/T.rubrum: Hair shaft
    -overdose of salicylate, what chem test is to be tested?
    -olive oil: M.furfur
    -Degradation of reagent in PT/PTT reason for the qc to fail
    -arrange by protein:lipid ratio (hdl, vldl, ldl, idl) i forgot my answer here
    -patient is A positive but no A positive is available only O negative what will you do?
    -Burr cells is an indicative of?
    -what urine cast will appear in patients with nephrotic syndrome?
    -Rbc cell seen in patient with mycoplasma pneumoniae?
    -BB: remember the abo discrepancies and also the antibody identification.

    -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.😊😊😊

  15. 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 ?

  16. liwa says:

    Here are my recalls:
    -Steno maltophilia- multi-drug resistant and maltose fermenter
    -Wilson’s Dse- confuse between increase CK and ceruplasmin (my answer) or increase ALT and ceruplasmin. I chose this because of CK-BB and mostly lead affects brain functioning. ALT is mainly for liver dse
    -Suspected bioterrorism agent: morphology- satellitism with Staph aureus Gram stain: GNCB. I answered, rule out Francisella and Bordetella because these ar e characteristics of Haemophilus which is a common pathogen
    -P antigen deteriorate over time
    -Mycoplasma pnuemoniae – pt did not respond to atb due to lack of cell wall
    -positive and negative controls of bile esculin, salt tolerance , CAMP and one more test I cannot remember
    -FFP thawed at 10.30 am ans stored at 5C. Transfusion is due at 3 pm. Not mentioned if pooled FFP ( expiry is 4 hrs) so I answered keep on the fridge and wait for doctor’s instructions since normal thawed ffp can last for 24 hrs
    -Difference between Pseudo putida and aeruginosa
    -Plasmodia spp. wherein schizonts and merozoites are hardly seen- P.falciparum
    -Picture of stomatocytes- liver dse
    -Tabular CBC result of method A and B. In method A, WNBC is increased. In method B, WBC is normal. Beside it is a peripheral smear of target cells and Hb C bar shaped. Error in method A is on the lysing reagent
    -Bilirubin metabolism
    -Baby is O+ using cord blood sample. Mother is AB neg. I answered repeat blood group from heel stick.
    -Ab ID: Ab identified is Lea and Leb, but choices are the description or characteristics of Ab’s so I chose glycolipids adsorb on plasma. I’m thinking it should be adsorb on red cells but since no other answer related to adsorption so I answered this one.
    -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. Try to answer all recall questions especially the latest ones, but don’t rely always on the answers. Better check it by yourself. 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. 🙂

  17. Cherice says:

    Good day Sohail. Just to let you know l pass my ASCP today. Your high yield notes really helped me. Here are some of my recalls
    1. Sugar ferment by staph.aureus
    Excessively blue stain in red cells what to do
    Mother A Pos father Onegative what causes HDN
    heparin manganese is used in HD L determination to? Precipitate non HDL
    False decrease ESR
    Pooled platelets expiration date
    Teardrop cells is seen in what decease condition
    clumping of RBC due to cold agglutinin
    Which blood to give to new Borns for exchange transfusion
    Delta check
    Cushing syndrome
    Rhogam calculation
    What is decrease in hemolytic anaemia
    Increased basophils is seen in?
    Tumor marker for pancreatic mass
    Temperature for FFP
    Something about decrease K and increase NA
    Creatinine clearance evaluates what
    Which of the following analyte is a cofactors for most of 300 enzymes
    Blood glucose 390mg/do K 4.2mmol after administration of insulin glucose is 215 K is now
    First step in agglutination
    PT and PTT controls were abnormal qc repeated PTT was normal what to do?
    FTA RPR VDRL which is for testing reinfection
    What is the presumptive test for G. Vaginosis something like that . That’s all l can remember from the exam. Thanks again

  18. 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.

    Basically 80% of my exam was from questions posted here, the notes were so helpful. I even got most questions from an exam posted here. Thank you everyone I can’t thank you enough. My questions in the exam were nothing new to add to what already been posted here. I can only add the gene for Ft(a-b-) is GATA and thankfully I guess it right 🙂

    Good luck everyone and best of wishes. Don’t give up! No matter what!

  19. DANIEL OKECHI ONWUKA says:

    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 those recalls and comments from many people on this site. over half of the questions i had on my exam were actually either related to the things already discussed here or directly same questions as discussed here . 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.

    recall
    something seen in primary biliary cirrhosis
    unconjugated bil seen in
    2 year old baby with normocytic and normochromic blood picture
    picture of burr cell and the cause
    picture of stomatocytes and the cause
    picture of acanthocytes and the cause
    know and if possible memorize all the high yield notes and diagrams ( microbiology ) i got over 15 to 20 questions related to those diagrams
    how to differentiate strepts using laboratory tests ( eg nacl, eschulin,bile, pyp, camp ),heamolysis , drugs and grouping system
    how to differentiate staphs using tests and drugs
    how to differentiate mycobacteria
    antibody panels , how to solve it
    know the phases eg AHG,IS,37
    characteristics of each especially kell, duffy, mns lewis, and kidd
    also anti i and anti I
    urine reagent strip ( principles , causes of false positives n false negatives)
    tumor markers ( acute pancreatitis, breast cancer, hepatic ca, etc )
    PSA for prostate ( i think i was given a scenario where surgery was done and after one month the test came came high so what happened )
    so many blood serology questions
    leukemia and markers
    transfusion reactions and causes
    casts, crystals and where they are found
    hepatitis markers
    PT AND PTT studies
    warfarin and heparin
    diabetes and how to diagnose it , Conn’s syndrome, cushing syndrome and the lab values
    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.

  20. Cherice says:

    Good day Sohail. Just to let you know l pass my ASCP today. Your high yield notes really helped me. Here are some of my recalls
    1. Sugar ferment by staph.aureus
    Excessively blue stain in red cells what to do
    Mother A Pos father Onegative what causes HDN
    heparin manganese is used in HD L determination to? Precipitate non HDL
    False decrease ESR
    Pooled platelets expiration date
    Teardrop cells is seen in what decease condition
    clumping of RBC due to cold agglutinin
    Which blood to give to new Borns for exchange transfusion
    Delta check
    Cushing syndrome
    Rhogam calculation
    What is decrease in hemolytic anaemia
    Increased basophils is seen in?
    Tumor marker for pancreatic mass
    Temperature for FFP
    Something about decrease K and increase NA
    Creatinine clearance evaluates what
    Which of the following analyte is a cofactors for most of 300 enzymes
    Blood glucose 390mg/do K 4.2mmol after administration of insulin glucose is 215 K is now
    First step in agglutination
    PT and PTT controls were abnormal qc repeated PTT was normal what to do?
    FTA RPR VDRL which is for testing reinfection
    What is the presumptive test for G. Vaginosis something like that . That’s all l can remember from the exam. Thanks again

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