MLT ASCP UPDATED 2026 EXAM SCRIPT QUESTIONS AND
ANSWERS RATED A+
✔✔Type 3 hypersensitivity - ✔✔Immune complex
Rheumatoid arthritis
SLE
✔✔Type 4 hyper sensitivity - ✔✔Delayed
Monocytes and lymphocytes
✔✔Ouchterlony - ✔✔Antibodies added to pre-cut wells in center of agar plate and
patient Sera and standards are alternated in wells surrounding the center well
✔✔EIA/ELISA - ✔✔Sandwich technique
HCG
✔✔Nephelometry - ✔✔Insoluble complexes
Why is pass-through suspension scattered light absorbance is proportional to the
number of insoluble complexes compared to standards
Antibody concentration
✔✔Immunofluorescence direct - ✔✔Add florescence labeled anti-body to patient tissue
wash and examined under fluorescent microscope
✔✔Immunofluorescence indirect - ✔✔Add patient serum to reagent wash add
florescence label to anti-globulin wash and examined under microscope
✔✔FPIA (Fluorescence Polarization Immunoassay) - ✔✔Add reagent antibody and
fluorescent tact antigen to patient serum
Increase polarize light as a negative test decrease polarized light as a positive test
✔✔Sensitivity - ✔✔TP/ TP + FN x 100
✔✔Specificity - ✔✔TN / TN + FP x 100
✔✔Non lattice - ✔✔More sensitive immunoassays nephelometry
✔✔Lattice - ✔✔Less sensitive
✔✔C reactive protein - ✔✔Acute phase protein
Inflammation
✔✔Syphilis - ✔✔T palladium
FTA abs
,TPI
Dark field microscopy
✔✔VDRL - ✔✔Syphilis CSF screening but can be positive for malaria
✔✔RPR - ✔✔Charcoal for syphilis
More sensitive but Les specific
✔✔infectious mononucleosis - ✔✔EBV
Lymphocytes
B cells
Burkets disease?
✔✔Autoimmune diseases - ✔✔SLE
Sjögren's syndrome
Scleroderma
RA
✔✔Recent acute hepatitis A infection - ✔✔Anti HaV
✔✔Acute hep B infection - ✔✔Highly infectious
HBsAg
HBeAg
✔✔Chronic hep B - ✔✔Carrier
Anti HBc
✔✔Past infection immunity to hep B - ✔✔Anti HBe
Anti HBc
Anti HBs
✔✔Vaccine immunity to hep B - ✔✔Anti HBs
✔✔Hep c infection - ✔✔Anti HcV
✔✔Graves' disease - ✔✔Hyperthyroidism
Low TSH
Increase production T3 and T4
Weight loss and anxiety
✔✔Hadimotos - ✔✔Hypothyroidism
Increase TSH
Weight gain lethargy intolerance to cold
Thyroglobulins
,✔✔rheumatoid arthritis - ✔✔IgG Fc
RA factor
✔✔CA 125 - ✔✔Ovarian cancer
✔✔CA 19-9 - ✔✔Pancreases cancer
✔✔CEA - ✔✔Colon breast lung cancer
✔✔CA 15-1 - ✔✔Breast cancer
✔✔Transferrin - ✔✔Iron transport
✔✔Ferritin - ✔✔Iron storage
✔✔Hemoglobin F - ✔✔Alpha and gamma globlin chains
✔✔Hemoglobin a - ✔✔Alpha and beta globin chains
✔✔Left shift - ✔✔Decreased CO2,
increased pH with high affinity and
decreased 23DPG
✔✔Right shift - ✔✔Increased CO2
Decreased pH
Increased two, three DPG
✔✔Hemoglobin Reference range - ✔✔Males 14-18
Females 12-16
✔✔Hematocrit reference ranges - ✔✔Males is 42% to53%
Females are 38% of 47%
✔✔MCV - ✔✔800-100
Hct/rbc x 10
✔✔MCH - ✔✔28-32 pg
Hgb/rbc x 10
✔✔MCHC - ✔✔32-36%
Hgb/ hct x 100
✔✔Rule of 3 - ✔✔Hgb x3 = hct
, ✔✔RDW - ✔✔11-14%
✔✔WBC reference range - ✔✔5000-10000
✔✔Neutrophils reference range - ✔✔Relative 45-70%
Bacteria
✔✔RBC RR - ✔✔Males 4.5-6.1 x 10^6
Females 3.8-5.2 x 10^6
✔✔Lymphocyte RR - ✔✔Relative 20-40%
Viral infection
✔✔Monocyte - ✔✔Relative 3-10%
✔✔Basophils - ✔✔Relative 0-2%
Inflammation response mediator
✔✔Eosinophils - ✔✔Relative 0-3%
Allergic response
✔✔Hyper-segmented neutrophils - ✔✔Megaloblastic anemia
B12 and folate deficiency
✔✔BAnd neutrophils (hypo-segmented) - ✔✔PelegerHuey
Aml
Aids
✔✔Uncleared red cell WBC correction - ✔✔Wbc X +NRBC
✔✔Dohle bodies - ✔✔May hagglin
Hazy blue inclusion on NEUTROPHILS
✔✔May hagglin - ✔✔Dohle bodies
Thrombocytopenia with stress platelets
Myeloproliferation
✔✔Chediak higashi disease - ✔✔Giant lysosomal granules in granulocytes monocytes
and lymphocytes
Infections and bleeding
✔✔Alder-Reilly anomaly i - ✔✔Darks large metachromatic cytoplasm is granules
✔✔Anisocytosis - ✔✔Variation in size when RDW is greater than 14.5
ANSWERS RATED A+
✔✔Type 3 hypersensitivity - ✔✔Immune complex
Rheumatoid arthritis
SLE
✔✔Type 4 hyper sensitivity - ✔✔Delayed
Monocytes and lymphocytes
✔✔Ouchterlony - ✔✔Antibodies added to pre-cut wells in center of agar plate and
patient Sera and standards are alternated in wells surrounding the center well
✔✔EIA/ELISA - ✔✔Sandwich technique
HCG
✔✔Nephelometry - ✔✔Insoluble complexes
Why is pass-through suspension scattered light absorbance is proportional to the
number of insoluble complexes compared to standards
Antibody concentration
✔✔Immunofluorescence direct - ✔✔Add florescence labeled anti-body to patient tissue
wash and examined under fluorescent microscope
✔✔Immunofluorescence indirect - ✔✔Add patient serum to reagent wash add
florescence label to anti-globulin wash and examined under microscope
✔✔FPIA (Fluorescence Polarization Immunoassay) - ✔✔Add reagent antibody and
fluorescent tact antigen to patient serum
Increase polarize light as a negative test decrease polarized light as a positive test
✔✔Sensitivity - ✔✔TP/ TP + FN x 100
✔✔Specificity - ✔✔TN / TN + FP x 100
✔✔Non lattice - ✔✔More sensitive immunoassays nephelometry
✔✔Lattice - ✔✔Less sensitive
✔✔C reactive protein - ✔✔Acute phase protein
Inflammation
✔✔Syphilis - ✔✔T palladium
FTA abs
,TPI
Dark field microscopy
✔✔VDRL - ✔✔Syphilis CSF screening but can be positive for malaria
✔✔RPR - ✔✔Charcoal for syphilis
More sensitive but Les specific
✔✔infectious mononucleosis - ✔✔EBV
Lymphocytes
B cells
Burkets disease?
✔✔Autoimmune diseases - ✔✔SLE
Sjögren's syndrome
Scleroderma
RA
✔✔Recent acute hepatitis A infection - ✔✔Anti HaV
✔✔Acute hep B infection - ✔✔Highly infectious
HBsAg
HBeAg
✔✔Chronic hep B - ✔✔Carrier
Anti HBc
✔✔Past infection immunity to hep B - ✔✔Anti HBe
Anti HBc
Anti HBs
✔✔Vaccine immunity to hep B - ✔✔Anti HBs
✔✔Hep c infection - ✔✔Anti HcV
✔✔Graves' disease - ✔✔Hyperthyroidism
Low TSH
Increase production T3 and T4
Weight loss and anxiety
✔✔Hadimotos - ✔✔Hypothyroidism
Increase TSH
Weight gain lethargy intolerance to cold
Thyroglobulins
,✔✔rheumatoid arthritis - ✔✔IgG Fc
RA factor
✔✔CA 125 - ✔✔Ovarian cancer
✔✔CA 19-9 - ✔✔Pancreases cancer
✔✔CEA - ✔✔Colon breast lung cancer
✔✔CA 15-1 - ✔✔Breast cancer
✔✔Transferrin - ✔✔Iron transport
✔✔Ferritin - ✔✔Iron storage
✔✔Hemoglobin F - ✔✔Alpha and gamma globlin chains
✔✔Hemoglobin a - ✔✔Alpha and beta globin chains
✔✔Left shift - ✔✔Decreased CO2,
increased pH with high affinity and
decreased 23DPG
✔✔Right shift - ✔✔Increased CO2
Decreased pH
Increased two, three DPG
✔✔Hemoglobin Reference range - ✔✔Males 14-18
Females 12-16
✔✔Hematocrit reference ranges - ✔✔Males is 42% to53%
Females are 38% of 47%
✔✔MCV - ✔✔800-100
Hct/rbc x 10
✔✔MCH - ✔✔28-32 pg
Hgb/rbc x 10
✔✔MCHC - ✔✔32-36%
Hgb/ hct x 100
✔✔Rule of 3 - ✔✔Hgb x3 = hct
, ✔✔RDW - ✔✔11-14%
✔✔WBC reference range - ✔✔5000-10000
✔✔Neutrophils reference range - ✔✔Relative 45-70%
Bacteria
✔✔RBC RR - ✔✔Males 4.5-6.1 x 10^6
Females 3.8-5.2 x 10^6
✔✔Lymphocyte RR - ✔✔Relative 20-40%
Viral infection
✔✔Monocyte - ✔✔Relative 3-10%
✔✔Basophils - ✔✔Relative 0-2%
Inflammation response mediator
✔✔Eosinophils - ✔✔Relative 0-3%
Allergic response
✔✔Hyper-segmented neutrophils - ✔✔Megaloblastic anemia
B12 and folate deficiency
✔✔BAnd neutrophils (hypo-segmented) - ✔✔PelegerHuey
Aml
Aids
✔✔Uncleared red cell WBC correction - ✔✔Wbc X +NRBC
✔✔Dohle bodies - ✔✔May hagglin
Hazy blue inclusion on NEUTROPHILS
✔✔May hagglin - ✔✔Dohle bodies
Thrombocytopenia with stress platelets
Myeloproliferation
✔✔Chediak higashi disease - ✔✔Giant lysosomal granules in granulocytes monocytes
and lymphocytes
Infections and bleeding
✔✔Alder-Reilly anomaly i - ✔✔Darks large metachromatic cytoplasm is granules
✔✔Anisocytosis - ✔✔Variation in size when RDW is greater than 14.5
