ASCP BOARD OF CERTIFICATION MLS
COMPUTER ADAPTIVE TESTING EXAM REVIEW
WITH QUESTIONS AND CORRECT ANSWERS
GRADED A+
A peripheral blood smear demonstrates an abundance of
teardrop-shaped red blood cells (dacryocytes) Which clinical
condition is most strongly associated with this finding?
A) Megaloblastic anemia
B) Primary myelofibrosis
C) Hereditary spherocytosis
D) Glucose-6-phosphate dehydrogenase deficiency
Correct Answer: B
Rationale: Teardrop cells (dacryocytes) typically form when
erythrocytes are squeezed through fibrotic bone marrow or
an enlarged spleen, making primary myelofibrosis the classic
associated condition
Which enzyme assay is specifically utilized to evaluate and
monitor clinical conditions involving skeletal muscle damage or
disease?
A) Lipase
B) Aldolase
C) Gamma-glutamyl transferase (GGT)
D) Amylase
,Correct Answer: B
Rationale: Aldolase is expressed in high concentrations in
skeletal muscle tissue, and serum elevations directly reflect
skeletal muscle inflammatory or degenerative pathology
In parasitology, which morphologic feature uniquely identifies a
pathogenic Entamoeba histolytica trophozoite compared to non-
pathogenic amoebae?
A) Ingested red blood cells and a small, central karyosome
B) Coarse, uneven peripheral chromatin and large glycogen
vacuoles
C) Multiple nuclei with large, blot-like karyosomes
D) Ingested bacteria and prominent chromatin bars with rounded
ends
Correct Answer: A
Rationale: True Entamoeba histolytica trophozoites exhibit
erythrophagocytosis (ingested RBCs) along with a
characteristically small, centrally located karyosome
An individual inherits the genotype (Le) (sese) Which Lewis
antigen phenotype will be expressed on their red blood cells?
A) Le(a- b-)
B) Le(a+ b-)
C) Le(a- b+)
D) Le(a+ b+)
Correct Answer: B
,Rationale: Because the non-secretor allele (sese) is present,
the 𝑳𝒆𝒂 antigen cannot be converted to 𝑳𝒆𝒃 via secretor
transferase; thus, only 𝑳𝒆𝒂 is adsorbed onto the erythrocyte
surface, yielding Le(a+ b-)
An immunoassay with high specificity but low sensitivity will
demonstrate which of the following performance characteristics?
A) High rate of false-positive results and few false-negative
results
B) Accurate identification of disease presence but frequent false
positives
C) Accurate identification of disease absence and very few false-
positive results
D) High overall detection rate of affected individuals with minimal
false negatives
Correct Answer: C
Rationale: High specificity ensures that healthy individuals
without the disease test negative (yielding minimal false
positives), whereas low sensitivity increases the potential for
false negatives
Which fungal pathogen accounts for approximately 20% of all
urinary yeast isolates in hospital clinical settings?
A) Candida albicans
B) Candida glabrata
C) Cryptococcus neoformans
D) Trichosporon asahii
, Correct Answer: B
Rationale: Candida glabrata is the second most common
cause of candidiasis and accounts for roughly 20% of urinary
yeast isolates, often displaying reduced susceptibility to
azole antifungals
A patient present with joint stiffness and Raynaud's phenomenon
Antinuclear antibody (ANA) testing yields a high titer (1:1280) with
a distinct centromere pattern What is the most likely diagnosis?
A) Systemic Lupus Erythematosus (SLE)
B) CREST syndrome (limited cutaneous systemic sclerosis)
C) Sjögren's syndrome
D) Mixed Connective Tissue Disease (MCTD)
Correct Answer: B
Rationale: The anticentromere ANA pattern is highly specific
for CREST syndrome (Calcinosis, Raynaud's, Esophageal
dysmotility, Sclerodactyly, Telangiectasia)
Which blood collection procedure uses leukapheresis to harvest a
patient's buffy coat for photoactivation and reinfusion?
A) Plasmapheresis
B) Photopheresis
C) Plateletpheresis
D) Erythrocytapheresis
Correct Answer: B
COMPUTER ADAPTIVE TESTING EXAM REVIEW
WITH QUESTIONS AND CORRECT ANSWERS
GRADED A+
A peripheral blood smear demonstrates an abundance of
teardrop-shaped red blood cells (dacryocytes) Which clinical
condition is most strongly associated with this finding?
A) Megaloblastic anemia
B) Primary myelofibrosis
C) Hereditary spherocytosis
D) Glucose-6-phosphate dehydrogenase deficiency
Correct Answer: B
Rationale: Teardrop cells (dacryocytes) typically form when
erythrocytes are squeezed through fibrotic bone marrow or
an enlarged spleen, making primary myelofibrosis the classic
associated condition
Which enzyme assay is specifically utilized to evaluate and
monitor clinical conditions involving skeletal muscle damage or
disease?
A) Lipase
B) Aldolase
C) Gamma-glutamyl transferase (GGT)
D) Amylase
,Correct Answer: B
Rationale: Aldolase is expressed in high concentrations in
skeletal muscle tissue, and serum elevations directly reflect
skeletal muscle inflammatory or degenerative pathology
In parasitology, which morphologic feature uniquely identifies a
pathogenic Entamoeba histolytica trophozoite compared to non-
pathogenic amoebae?
A) Ingested red blood cells and a small, central karyosome
B) Coarse, uneven peripheral chromatin and large glycogen
vacuoles
C) Multiple nuclei with large, blot-like karyosomes
D) Ingested bacteria and prominent chromatin bars with rounded
ends
Correct Answer: A
Rationale: True Entamoeba histolytica trophozoites exhibit
erythrophagocytosis (ingested RBCs) along with a
characteristically small, centrally located karyosome
An individual inherits the genotype (Le) (sese) Which Lewis
antigen phenotype will be expressed on their red blood cells?
A) Le(a- b-)
B) Le(a+ b-)
C) Le(a- b+)
D) Le(a+ b+)
Correct Answer: B
,Rationale: Because the non-secretor allele (sese) is present,
the 𝑳𝒆𝒂 antigen cannot be converted to 𝑳𝒆𝒃 via secretor
transferase; thus, only 𝑳𝒆𝒂 is adsorbed onto the erythrocyte
surface, yielding Le(a+ b-)
An immunoassay with high specificity but low sensitivity will
demonstrate which of the following performance characteristics?
A) High rate of false-positive results and few false-negative
results
B) Accurate identification of disease presence but frequent false
positives
C) Accurate identification of disease absence and very few false-
positive results
D) High overall detection rate of affected individuals with minimal
false negatives
Correct Answer: C
Rationale: High specificity ensures that healthy individuals
without the disease test negative (yielding minimal false
positives), whereas low sensitivity increases the potential for
false negatives
Which fungal pathogen accounts for approximately 20% of all
urinary yeast isolates in hospital clinical settings?
A) Candida albicans
B) Candida glabrata
C) Cryptococcus neoformans
D) Trichosporon asahii
, Correct Answer: B
Rationale: Candida glabrata is the second most common
cause of candidiasis and accounts for roughly 20% of urinary
yeast isolates, often displaying reduced susceptibility to
azole antifungals
A patient present with joint stiffness and Raynaud's phenomenon
Antinuclear antibody (ANA) testing yields a high titer (1:1280) with
a distinct centromere pattern What is the most likely diagnosis?
A) Systemic Lupus Erythematosus (SLE)
B) CREST syndrome (limited cutaneous systemic sclerosis)
C) Sjögren's syndrome
D) Mixed Connective Tissue Disease (MCTD)
Correct Answer: B
Rationale: The anticentromere ANA pattern is highly specific
for CREST syndrome (Calcinosis, Raynaud's, Esophageal
dysmotility, Sclerodactyly, Telangiectasia)
Which blood collection procedure uses leukapheresis to harvest a
patient's buffy coat for photoactivation and reinfusion?
A) Plasmapheresis
B) Photopheresis
C) Plateletpheresis
D) Erythrocytapheresis
Correct Answer: B
