ASCP: Final Exam Questions and All
Actual Answers 2026-2027 Updated.
the radioactive method used to measure red cell survival uses which of the following isotopes? -
Answer 51Cr
which condition can be associated with macrocytes and large ovalocytes? - Answer
megaloblastic anemia
which alpha thalassemia syndrome has the genotype -a/aa? - Answer silent carrier
alpha thalessemia minor genotype - Answer --/aa, -a/-a
hemoglobin H disease genotype - Answer --/-a
a laboratory test to determine heparin levels in a patient's plasma is? - Answer Anti-factor Xa
assay
a small child has albino characteristics, photophobia, frequent pyogenic infection, and her blood
smear shows giant dark granules in her monocytes and granulocytes. what is the diagnosis? -
Answer chediak hegashi syndrome
pelger heut is associated with bi-lobed neutrophil
alder rielly is associated with genetic mucopoly saccharidoses
You are evaluating a potentially malignant effusion (e.g. peritoneal or pleural fluid) and you note
cells that appear to be some type of tumor cells. How would you follow up/report this? -
Answer Consult a pathologist and confirm that the specimen has been sent to cytology for
analysis
Which of the following represent other hemoglobin gene loci that occur on the same
chromosome As the beta chain loci? - Answer Delta and gamma
MCV normal range: 80-100fl
MCH normal range: 27-31pg
MCHC normal range: 32-36% - Answer Normal ranges
,Which of the following processes does NOT occur during primary hemostasis? - Answer
Fibrin strands added to the newly formed clot
What type of lymphocyte appears as a large cell with abundant cytoplasm and a few azurophilic
granules? - Answer Natural killer lymphocytes
The decreased serum iron levels seen in anemia of chronic disease (also referred to as anemia
of chronic infection or inflammation) is caused by which of the following? - Answer
Decreased iron released from macrophages
The mutational status of Janus kinase 2 (JAK2) is most commonly used for the diagnosis Of
which of the following? - Answer Myeloproliferative neoplasms
A balloon-like bulge filled with blood formed due to a weakness in the wall of a blood vessel is
known as: - Answer Aneurysm
An example of a neoplastic proliferative disease of the plasma cells is: - Answer Multiple
myeloma (also known as plasma cell myeloma)
A peripheral smear demonstrates a population of cells composed of red cells that are mostly 5 -
5.5 um in diameter. The CBC data shows RDW of 13% (reference range 11.5-14.5%). Which of
the following morphologies is consistent with these findings? - Answer Microcytosis, low
variation of cell volume
A few dark blue staining granular inclusions located near the periphery of an erythrocyte are
most likely: - Answer Pappenheimer bodies
Fifty percent blasts are found on a peripheral blood smear. The cells are large (3-5x the size of a
lymphocyte) with a nucleus that contains homogeneous fine chromatin and two to three
nucleoli. There is moderate blue-grey cytoplasm with Auer rods. What leukemia is most likely? -
Answer Acute myelogenous leukemia (AML)
Which ethnic group has the highest incidence of hereditary hemochromatosis in the United
States? - Answer Caucasians
Where is the main site of action for monocytes after diapedesis? - Answer Body tissues
Methylene blue stain works by: - Answer Staining cellular components that have an acidic pH
such as ribosomes, DNA, and RNA
,Which white blood cell population would have the MOST side scatter when analyzed using flow
cytometry? - Answer Granulocytes
All of the following methods are used in the diagnosis and classification of acute leukemia,
EXCEPT? - Answer Reticulocyte count
Complaints of pain from a patient with sickle cell disease are most likely associated with which
of the following conditions/events? - Answer Vaso-occlusive crisis
Which of the following is a valid reason for evaluating red cell morphology as part of the
differential procedure? - Answer May provide diagnostic information to the physician.
All of the following tests are useful in the diagnosis of heparin induced thrombocytopenia (HIT)
EXCEPT: - Answer Dilute partial thromboplastin time (DTT)
The INR (international normalized ratio) is calculated using the following formula: - Answer
INR=(PT patient / PT normal) raised to the ISI.
A 2-year-old girl, who had been treated with upper respiratory tract infection a few weeks ago,
showed multiple bruises and had the following laboratory Findings:
Hgb=13.5 g/dL
RBC= 3.9•10^12/L
WBC=8.0 • 10^9/L
Platelets= 5•10^9/L
Bone Marrow M:E ratio= 3:1
megakaryocytes= increased
these results are most suggestive of which condition? - Answer Immune (idiopathic)
thrombocytopenic purpura
Why is hereditary hemochromatosis (HH) thought to be underdiagnosed? - Answer Its early
symptoms are nonspecific and vague, and generally do not get serious until later in life.
Which of the following is an important technique consideration in order to obtain consistently
high quality bone marrow smears? - Answer Select or concentrate bone marrow spicules,
ensuring they are transferred to the slide.
Which of the following red cell inclusions are often found in peripheral blood smears of patients
with sideroblastic anemia? - Answer Pappenheimer bodies
, A peripheral blood smear with many myeloid cells was presented for morphology review (see
image on the
right). Toxic granulation and vacuoles in the neutrophil most likely represent which of the
following conditions? - Answer Septicemia
The cells which release von Willebrand's Factor (vWF) are: - Answer Platelets and endothelial
cells
An increased reticulocyte count MAY be found in all of the following conditions, EXCEPT? -
Answer Aplastic anemia
Which of the following assays is commonly used to confirm the diagnosis of Activated Protein C
resistance? - Answer Factor V Leiden Mutation Assay
Ristocetin is used in certain von Willebrand Factor (VWF) functional assays. The reason it is used
is because: - Answer Ristocetin enhances binding of vWF to platelet GPIb.
All of the cells listed below function as a phagocyte, EXCEPT? - Answer Eosinophils
Which of the following may result in a platelet count of 230.0 X 10°/L with a bleeding time of 15
minutes. - Answer Defective platelet function
Abnormal platelet function seen in patients with Bernard-Soulier Syndrome is caused by which
of the following platelet components? - Answer Defective glycoprotein Ib/IX
Which of the following factors is known as Hageman factor? - Answer Factor XII
X =Stuart factor
V = proaccelerin
VII = proconvertin or stable factor
A patient has a hypercellular bone marrow and is suspected of having a myeloproliferative
disorder. Laboratory features include: excess megakaryocyte proliferation and atypia, marked
marrow fibrosis, and the JAK2 mutation. The most likely diagnosis is: - Answer Primary
Myelofibrosis (PMF)
Which potent inhibitor of platelet aggregation is released by endothelial cells? - Answer
Prostacyclin
Actual Answers 2026-2027 Updated.
the radioactive method used to measure red cell survival uses which of the following isotopes? -
Answer 51Cr
which condition can be associated with macrocytes and large ovalocytes? - Answer
megaloblastic anemia
which alpha thalassemia syndrome has the genotype -a/aa? - Answer silent carrier
alpha thalessemia minor genotype - Answer --/aa, -a/-a
hemoglobin H disease genotype - Answer --/-a
a laboratory test to determine heparin levels in a patient's plasma is? - Answer Anti-factor Xa
assay
a small child has albino characteristics, photophobia, frequent pyogenic infection, and her blood
smear shows giant dark granules in her monocytes and granulocytes. what is the diagnosis? -
Answer chediak hegashi syndrome
pelger heut is associated with bi-lobed neutrophil
alder rielly is associated with genetic mucopoly saccharidoses
You are evaluating a potentially malignant effusion (e.g. peritoneal or pleural fluid) and you note
cells that appear to be some type of tumor cells. How would you follow up/report this? -
Answer Consult a pathologist and confirm that the specimen has been sent to cytology for
analysis
Which of the following represent other hemoglobin gene loci that occur on the same
chromosome As the beta chain loci? - Answer Delta and gamma
MCV normal range: 80-100fl
MCH normal range: 27-31pg
MCHC normal range: 32-36% - Answer Normal ranges
,Which of the following processes does NOT occur during primary hemostasis? - Answer
Fibrin strands added to the newly formed clot
What type of lymphocyte appears as a large cell with abundant cytoplasm and a few azurophilic
granules? - Answer Natural killer lymphocytes
The decreased serum iron levels seen in anemia of chronic disease (also referred to as anemia
of chronic infection or inflammation) is caused by which of the following? - Answer
Decreased iron released from macrophages
The mutational status of Janus kinase 2 (JAK2) is most commonly used for the diagnosis Of
which of the following? - Answer Myeloproliferative neoplasms
A balloon-like bulge filled with blood formed due to a weakness in the wall of a blood vessel is
known as: - Answer Aneurysm
An example of a neoplastic proliferative disease of the plasma cells is: - Answer Multiple
myeloma (also known as plasma cell myeloma)
A peripheral smear demonstrates a population of cells composed of red cells that are mostly 5 -
5.5 um in diameter. The CBC data shows RDW of 13% (reference range 11.5-14.5%). Which of
the following morphologies is consistent with these findings? - Answer Microcytosis, low
variation of cell volume
A few dark blue staining granular inclusions located near the periphery of an erythrocyte are
most likely: - Answer Pappenheimer bodies
Fifty percent blasts are found on a peripheral blood smear. The cells are large (3-5x the size of a
lymphocyte) with a nucleus that contains homogeneous fine chromatin and two to three
nucleoli. There is moderate blue-grey cytoplasm with Auer rods. What leukemia is most likely? -
Answer Acute myelogenous leukemia (AML)
Which ethnic group has the highest incidence of hereditary hemochromatosis in the United
States? - Answer Caucasians
Where is the main site of action for monocytes after diapedesis? - Answer Body tissues
Methylene blue stain works by: - Answer Staining cellular components that have an acidic pH
such as ribosomes, DNA, and RNA
,Which white blood cell population would have the MOST side scatter when analyzed using flow
cytometry? - Answer Granulocytes
All of the following methods are used in the diagnosis and classification of acute leukemia,
EXCEPT? - Answer Reticulocyte count
Complaints of pain from a patient with sickle cell disease are most likely associated with which
of the following conditions/events? - Answer Vaso-occlusive crisis
Which of the following is a valid reason for evaluating red cell morphology as part of the
differential procedure? - Answer May provide diagnostic information to the physician.
All of the following tests are useful in the diagnosis of heparin induced thrombocytopenia (HIT)
EXCEPT: - Answer Dilute partial thromboplastin time (DTT)
The INR (international normalized ratio) is calculated using the following formula: - Answer
INR=(PT patient / PT normal) raised to the ISI.
A 2-year-old girl, who had been treated with upper respiratory tract infection a few weeks ago,
showed multiple bruises and had the following laboratory Findings:
Hgb=13.5 g/dL
RBC= 3.9•10^12/L
WBC=8.0 • 10^9/L
Platelets= 5•10^9/L
Bone Marrow M:E ratio= 3:1
megakaryocytes= increased
these results are most suggestive of which condition? - Answer Immune (idiopathic)
thrombocytopenic purpura
Why is hereditary hemochromatosis (HH) thought to be underdiagnosed? - Answer Its early
symptoms are nonspecific and vague, and generally do not get serious until later in life.
Which of the following is an important technique consideration in order to obtain consistently
high quality bone marrow smears? - Answer Select or concentrate bone marrow spicules,
ensuring they are transferred to the slide.
Which of the following red cell inclusions are often found in peripheral blood smears of patients
with sideroblastic anemia? - Answer Pappenheimer bodies
, A peripheral blood smear with many myeloid cells was presented for morphology review (see
image on the
right). Toxic granulation and vacuoles in the neutrophil most likely represent which of the
following conditions? - Answer Septicemia
The cells which release von Willebrand's Factor (vWF) are: - Answer Platelets and endothelial
cells
An increased reticulocyte count MAY be found in all of the following conditions, EXCEPT? -
Answer Aplastic anemia
Which of the following assays is commonly used to confirm the diagnosis of Activated Protein C
resistance? - Answer Factor V Leiden Mutation Assay
Ristocetin is used in certain von Willebrand Factor (VWF) functional assays. The reason it is used
is because: - Answer Ristocetin enhances binding of vWF to platelet GPIb.
All of the cells listed below function as a phagocyte, EXCEPT? - Answer Eosinophils
Which of the following may result in a platelet count of 230.0 X 10°/L with a bleeding time of 15
minutes. - Answer Defective platelet function
Abnormal platelet function seen in patients with Bernard-Soulier Syndrome is caused by which
of the following platelet components? - Answer Defective glycoprotein Ib/IX
Which of the following factors is known as Hageman factor? - Answer Factor XII
X =Stuart factor
V = proaccelerin
VII = proconvertin or stable factor
A patient has a hypercellular bone marrow and is suspected of having a myeloproliferative
disorder. Laboratory features include: excess megakaryocyte proliferation and atypia, marked
marrow fibrosis, and the JAK2 mutation. The most likely diagnosis is: - Answer Primary
Myelofibrosis (PMF)
Which potent inhibitor of platelet aggregation is released by endothelial cells? - Answer
Prostacyclin
