ACE ASCP EXAM QUESTIONS AND
ANSWERS (VERIFIED AND UPDATED)
Which of the following condition is the most common cause of increase anion gap?
A.Metabolic alkalosis
B. Metabolic acidosis
Respiratory acidosis
Respiratory alkalosis - ANS B. Metabolic acidosis
High anion gap metabolic acidosis is caused generally by the body producing too much acid or
not producing enough bicarbonate. This is often due to an increase in lactic acid or ketoacids, or
it may be a sign of kidney failure. More rarely, high anion gap metabolic acidosis may be caused
by ingesting methanol or overdosing on aspirin.
Which of the following enzymes has the longest elevation after Myocardial Infarction (MI)?
CK-MB
Myoglobin
Troponin
AOTA - ANS C. Troponin
@2026/2027 ALLRIGHTS RESERVED.
,Troponin is elevated up to 10-14 days after Myocardial Infarction.
Lactic acid specimen:
Chilled and separated from cells
Heated
Room temperature
Request EDTA sample only - ANS A. Chilled and separated from cells
Feedback Special Handling: No tourniquet. Place on ice immediately and deliver to lab or
aliquot within 15 minutes. DO NOT FREEZE WHOLE BLOOD SPECIMEN.
Specific gravity measured by refractometer: 1.035. Protein and glucose both trace in reagent
strip:
Presence X-ray medium
Albuminuria
Glucosuria
Normal - ANS A. Presence X-Ray medium
Feedback Xray medium/Radiographic dye can cause erroneous results in urine specific gravity
measurement.
@2026/2027 ALLRIGHTS RESERVED.
,A patient with walking pneumonia is being treated with penicillin. State one possible condition
why the patient is not recovering:
The organism produces beta lactamase
The organism has no cell wall
The organism has capsule
The organism produces an enzyme that neutralizes the antibiotic - ANS B. The organism has
no cell wall.
Feedback Pneumonia caused by Mycoplasma pneumoniae is routinely treated with antibiotics,
although the disease is usually self-limiting. The disease is treated with macrolide, tetracycline,
or fluoroquinolone classes of antibiotics. All mycoplasmas lack a cell wall and, therefore, all are
inherently resistant to beta-lactam antibiotics (e.g., penicillin).
What is the coefficient of variation if the mean is 90 and the standard deviation is 5.48?
2.75
6.09
5.68
30 - ANS B. 6.09
Feedback:
CV= SD/meanX100,
(5.48/90)X100= 6.09.
@2026/2027 ALLRIGHTS RESERVED.
, Blood smear below denotes Hairy Cell Leukemia (HCL), which of the following test is used to
identify this type of leukemia?
Image. 1
Myeloperoxidase
Tartrate-resistant acid phosphatase
Tartrate-resistant alkaline phosphatase
Sudan Black - ANS B. Tartrate-resistant acid phosphatase
Feedback:
Hairy cells demonstrate strong positivity for tartrate-resistant acid phosphatase (TRAP) staining.
The hairy cells are larger than normal and positive for CD19, CD20, CD22, CD11c, CD25, CD103,
and FMC7.
Use to differentiate Salmonella from Citrobacter:
Lysine decarboxylase
ONPG
Indole
Vogues Proskauerterm-9 - ANS A. Lysine decarboxylase
Feedback:
Salmonella (+); Citrobacter (-)
@2026/2027 ALLRIGHTS RESERVED.
ANSWERS (VERIFIED AND UPDATED)
Which of the following condition is the most common cause of increase anion gap?
A.Metabolic alkalosis
B. Metabolic acidosis
Respiratory acidosis
Respiratory alkalosis - ANS B. Metabolic acidosis
High anion gap metabolic acidosis is caused generally by the body producing too much acid or
not producing enough bicarbonate. This is often due to an increase in lactic acid or ketoacids, or
it may be a sign of kidney failure. More rarely, high anion gap metabolic acidosis may be caused
by ingesting methanol or overdosing on aspirin.
Which of the following enzymes has the longest elevation after Myocardial Infarction (MI)?
CK-MB
Myoglobin
Troponin
AOTA - ANS C. Troponin
@2026/2027 ALLRIGHTS RESERVED.
,Troponin is elevated up to 10-14 days after Myocardial Infarction.
Lactic acid specimen:
Chilled and separated from cells
Heated
Room temperature
Request EDTA sample only - ANS A. Chilled and separated from cells
Feedback Special Handling: No tourniquet. Place on ice immediately and deliver to lab or
aliquot within 15 minutes. DO NOT FREEZE WHOLE BLOOD SPECIMEN.
Specific gravity measured by refractometer: 1.035. Protein and glucose both trace in reagent
strip:
Presence X-ray medium
Albuminuria
Glucosuria
Normal - ANS A. Presence X-Ray medium
Feedback Xray medium/Radiographic dye can cause erroneous results in urine specific gravity
measurement.
@2026/2027 ALLRIGHTS RESERVED.
,A patient with walking pneumonia is being treated with penicillin. State one possible condition
why the patient is not recovering:
The organism produces beta lactamase
The organism has no cell wall
The organism has capsule
The organism produces an enzyme that neutralizes the antibiotic - ANS B. The organism has
no cell wall.
Feedback Pneumonia caused by Mycoplasma pneumoniae is routinely treated with antibiotics,
although the disease is usually self-limiting. The disease is treated with macrolide, tetracycline,
or fluoroquinolone classes of antibiotics. All mycoplasmas lack a cell wall and, therefore, all are
inherently resistant to beta-lactam antibiotics (e.g., penicillin).
What is the coefficient of variation if the mean is 90 and the standard deviation is 5.48?
2.75
6.09
5.68
30 - ANS B. 6.09
Feedback:
CV= SD/meanX100,
(5.48/90)X100= 6.09.
@2026/2027 ALLRIGHTS RESERVED.
, Blood smear below denotes Hairy Cell Leukemia (HCL), which of the following test is used to
identify this type of leukemia?
Image. 1
Myeloperoxidase
Tartrate-resistant acid phosphatase
Tartrate-resistant alkaline phosphatase
Sudan Black - ANS B. Tartrate-resistant acid phosphatase
Feedback:
Hairy cells demonstrate strong positivity for tartrate-resistant acid phosphatase (TRAP) staining.
The hairy cells are larger than normal and positive for CD19, CD20, CD22, CD11c, CD25, CD103,
and FMC7.
Use to differentiate Salmonella from Citrobacter:
Lysine decarboxylase
ONPG
Indole
Vogues Proskauerterm-9 - ANS A. Lysine decarboxylase
Feedback:
Salmonella (+); Citrobacter (-)
@2026/2027 ALLRIGHTS RESERVED.
