MEDICAL LABORATORY TECHNICIAN (MLT)
EXAMINATION
100 PRACTICE QUESTIONS WITH ANSWERS AND
RATIONALES
2026–2027 TESTING CYCLE
SECTION 1: HEMATOLOGY (Questions 1–18)
Question 1: Which anticoagulant is the preferred choice for a complete blood count (CBC)
because it preserves cellular morphology?
Answer: EDTA (Ethylenediaminetetraacetic acid)
Rationale: EDTA is the standard anticoagulant for hematology testing because it chelates
calcium and preserves cell morphology for up to 24 hours. Sodium citrate is used for
coagulation studies, heparin for chemistry tests, and oxalate for certain specialized procedures.
Question 2: A patient has a hemoglobin of 8.5 g/dL, hematocrit of 25%, and MCV of 72 fL.
This presentation is most consistent with which type of anemia?
Answer: Microcytic anemia
,Rationale: A low MCV (<80 fL) is the hallmark of microcytic anemia. The low hemoglobin and
hematocrit confirm the presence of anemia. Normocytic anemia has a normal MCV, while
macrocytic anemia presents with an elevated MCV (>100 fL).
Question 3: A peripheral blood smear reveals numerous schistocytes. This finding is most
consistent with which condition?
Answer: Microangiopathic hemolytic anemia (MAHA)
Rationale: Schistocytes (fragmented red blood cells) are characteristic of mechanical
destruction of RBCs, as seen in microangiopathic hemolytic anemias such as disseminated
intravascular coagulation (DIC), thrombotic thrombocytopenic purpura (TTP), or hemolytic
uremic syndrome (HUS).
Question 4: Which cell type is the precursor to platelets?
Answer: Megakaryocyte
Rationale: Megakaryocytes are large bone marrow cells that produce platelets through
cytoplasmic fragmentation. Myeloblasts give rise to granulocytes, erythroblasts to red blood
cells, and lymphoblasts to lymphocytes.
,Question 5: A patient's white blood cell count is 25,000/μL with 80% neutrophils, many of
which are band forms. This is most consistent with which condition?
Answer: Acute bacterial infection
Rationale: A "left shift" with an elevated WBC count and increased band neutrophils is
characteristic of an acute bacterial infection. This neutrophilic leukocytosis indicates the bone
marrow is responding to infection by releasing immature neutrophils into circulation.
Question 6: The presence of Howell-Jolly bodies on a peripheral blood smear is associated with
which condition?
Answer: Splenic dysfunction or asplenia
Rationale: Howell-Jolly bodies are nuclear remnants normally removed by the spleen. Their
presence indicates splenic dysfunction or absence (post-splenectomy). They may also appear in
severe hemolytic anemia when the spleen is overwhelmed.
Question 7: A peripheral blood smear from a patient with lead poisoning would most likely
reveal which inclusion?
Answer: Basophilic stippling
, Rationale: Basophilic stippling is a classic finding in lead poisoning due to inhibition of
pyrimidine-5'-nucleotidase. Howell-Jolly bodies suggest splenic dysfunction, Heinz bodies are
seen in G6PD deficiency, and Pappenheimer bodies are observed in sideroblastic anemia.
Question 8: A patient has a platelet count of 40,000/μL. This is classified as:
Answer: Severe thrombocytopenia
Rationale: Mild thrombocytopenia is 100,000–150,000/μL; moderate is 50,000–100,000/μL;
severe is <50,000/μL. A count below 20,000/μL significantly increases the risk of spontaneous
bleeding. Normal platelet counts range from 150,000–450,000/μL.
Question 9: Which cell type would be expected to increase in a patient with a parasitic
infection?
Answer: Eosinophil
Rationale: Eosinophilia is characteristic of parasitic infections and allergic reactions.
Neutrophils increase in bacterial infections, lymphocytes in viral infections, and monocytes in
certain chronic infections like tuberculosis.
Question 10: In a patient with a hemolytic anemia, which laboratory finding would be expected?
Answer: Increased reticulocyte count
EXAMINATION
100 PRACTICE QUESTIONS WITH ANSWERS AND
RATIONALES
2026–2027 TESTING CYCLE
SECTION 1: HEMATOLOGY (Questions 1–18)
Question 1: Which anticoagulant is the preferred choice for a complete blood count (CBC)
because it preserves cellular morphology?
Answer: EDTA (Ethylenediaminetetraacetic acid)
Rationale: EDTA is the standard anticoagulant for hematology testing because it chelates
calcium and preserves cell morphology for up to 24 hours. Sodium citrate is used for
coagulation studies, heparin for chemistry tests, and oxalate for certain specialized procedures.
Question 2: A patient has a hemoglobin of 8.5 g/dL, hematocrit of 25%, and MCV of 72 fL.
This presentation is most consistent with which type of anemia?
Answer: Microcytic anemia
,Rationale: A low MCV (<80 fL) is the hallmark of microcytic anemia. The low hemoglobin and
hematocrit confirm the presence of anemia. Normocytic anemia has a normal MCV, while
macrocytic anemia presents with an elevated MCV (>100 fL).
Question 3: A peripheral blood smear reveals numerous schistocytes. This finding is most
consistent with which condition?
Answer: Microangiopathic hemolytic anemia (MAHA)
Rationale: Schistocytes (fragmented red blood cells) are characteristic of mechanical
destruction of RBCs, as seen in microangiopathic hemolytic anemias such as disseminated
intravascular coagulation (DIC), thrombotic thrombocytopenic purpura (TTP), or hemolytic
uremic syndrome (HUS).
Question 4: Which cell type is the precursor to platelets?
Answer: Megakaryocyte
Rationale: Megakaryocytes are large bone marrow cells that produce platelets through
cytoplasmic fragmentation. Myeloblasts give rise to granulocytes, erythroblasts to red blood
cells, and lymphoblasts to lymphocytes.
,Question 5: A patient's white blood cell count is 25,000/μL with 80% neutrophils, many of
which are band forms. This is most consistent with which condition?
Answer: Acute bacterial infection
Rationale: A "left shift" with an elevated WBC count and increased band neutrophils is
characteristic of an acute bacterial infection. This neutrophilic leukocytosis indicates the bone
marrow is responding to infection by releasing immature neutrophils into circulation.
Question 6: The presence of Howell-Jolly bodies on a peripheral blood smear is associated with
which condition?
Answer: Splenic dysfunction or asplenia
Rationale: Howell-Jolly bodies are nuclear remnants normally removed by the spleen. Their
presence indicates splenic dysfunction or absence (post-splenectomy). They may also appear in
severe hemolytic anemia when the spleen is overwhelmed.
Question 7: A peripheral blood smear from a patient with lead poisoning would most likely
reveal which inclusion?
Answer: Basophilic stippling
, Rationale: Basophilic stippling is a classic finding in lead poisoning due to inhibition of
pyrimidine-5'-nucleotidase. Howell-Jolly bodies suggest splenic dysfunction, Heinz bodies are
seen in G6PD deficiency, and Pappenheimer bodies are observed in sideroblastic anemia.
Question 8: A patient has a platelet count of 40,000/μL. This is classified as:
Answer: Severe thrombocytopenia
Rationale: Mild thrombocytopenia is 100,000–150,000/μL; moderate is 50,000–100,000/μL;
severe is <50,000/μL. A count below 20,000/μL significantly increases the risk of spontaneous
bleeding. Normal platelet counts range from 150,000–450,000/μL.
Question 9: Which cell type would be expected to increase in a patient with a parasitic
infection?
Answer: Eosinophil
Rationale: Eosinophilia is characteristic of parasitic infections and allergic reactions.
Neutrophils increase in bacterial infections, lymphocytes in viral infections, and monocytes in
certain chronic infections like tuberculosis.
Question 10: In a patient with a hemolytic anemia, which laboratory finding would be expected?
Answer: Increased reticulocyte count
