1
AMT MLS Exam NEWEST 2025/2026 Actual
Exam – Complete Real Exam Questions | 100%
Verified | Graded A+ Detailed Rationales – Pass
Guaranteed – A+ Graded
[SECTION 1: Hematology & Coagulation — Questions 1-60]
Q1: A patient's CBC results show the following: Hgb 10.0 g/dL, Hct 30%, MCV 72 fL, MCHC
33 g/dL, and RDW 18%. Which of the following is the most likely diagnosis?
A. Iron deficiency anemia
B. Vitamin B12 deficiency
C. Anemia of chronic disease
D. Acute blood loss
Correct Answer: A
Rationale: The MCV of 72 fL indicates microcytic anemia. The combination of microcytosis
(low MCV), normal MCHC, and elevated RDW (anisocytosis) is characteristic of iron deficiency
anemia (IDA). Vitamin B12 deficiency presents with macrocytosis (high MCV). Anemia of
chronic disease is typically normocytic, and acute blood loss is initially normocytic.
Q2: Which RBC inclusion body is composed of nuclear remnants that appear as a dense
basophilic granule and are commonly seen in splenectomy patients or megaloblastic anemias?
A. Howell-Jolly bodies
B. Heinz bodies
C. Pappenheimer bodies
D. Cabot rings
Correct Answer: A
Rationale: Howell-Jolly bodies are small, round, nuclear remnants (DNA) that are usually
removed by the spleen. Their presence in peripheral blood suggests functional asplenia or
,2
splenectomy. Heinz bodies are denatured hemoglobin seen in G6PD deficiency. Pappenheimer
bodies are iron granules seen in sideroblastic anemia. Cabot rings are mitochondrial remnants
seen in severe anemia.
Q3: A manual differential reveals a white blood cell count of 30.0 x 10^9/L with 60% segmented
neutrophils, 20% bands, 15% lymphocytes, and 5% monocytes. Which term best describes this
finding?
A. Leukopenia
B. Leukocytosis with a left shift
C. Leukocytosis with a right shift
D. Lymphocytosis
Correct Answer: B
Rationale: The WBC count is elevated (leukocytosis) at 30.0 x 10^9/L. A "left shift" refers to an
increase in immature granulocyte forms (bands, metamyelocytes) relative to mature neutrophils,
indicating an active inflammatory response or infection. A right shift implies hypersegmentation
(e.g., >5 lobes), seen in megaloblastic anemia.
Q4: Which coagulation factor is NOT part of the intrinsic pathway but is essential for the
extrinsic pathway?
A. Factor VIII
B. Factor IX
C. Factor VII
D. Factor XII
Correct Answer: C
Rationale: Factor VII is the initiating factor of the extrinsic pathway, activated by tissue factor
(thromboplastin). Factors VIII, IX, and XII are components of the intrinsic pathway (contact
activation pathway). Deficiency in Factor VII prolongs the PT (Prothrombin Time), not the PTT.
,3
Q5: A peripheral blood smear shows numerous schistocytes (helmet cells), thrombocytopenia,
and a prolonged PT and PTT. What is the most likely diagnosis?
A. Idiopathic thrombocytopenic purpura (ITP)
B. Disseminated Intravascular Coagulation (DIC)
C. Hemophilia A
D. von Willebrand disease
Correct Answer: B
Rationale: The presence of schistocytes indicates microangiopathic hemolytic anemia
(fragmentation of RBCs). Combined with thrombocytopenia and prolonged coagulation times
(PT/PTT), Disseminated Intravascular Coagulation (DIC) is the primary diagnosis. ITP typically
presents with isolated thrombocytopenia without coagulopathy or schistocytes. Hemophilia
affects only PTT.
Q6: In the automated reticulocyte count, what is the principle behind the staining method?
A. Supravital staining with new methylene blue or thiazole orange
B. Wright-Giemsa staining
C. Peroxidase staining
D. Sudan black B staining
Correct Answer: A
Rationale: Reticulocytes are immature RBCs containing residual RNA. They require supravital
staining (while the cell is still living) with dyes like new methylene blue or thiazole orange to
precipitate the RNA, making it visible for counting. Wright-Giemsa is for standard morphology.
Peroxidase is for leukocyte differentiation.
Q7: A patient has a mean corpuscular volume (MCV) of 110 fL. Which of the following
laboratory findings is most consistent with this macrocytic anemia?
A. Low serum iron, high TIBC
B. Low vitamin B12, low intrinsic factor antibodies
, 4
C. Normal ferritin, low hemoglobin
D. Positive direct Coombs test
Correct Answer: B
Rationale: Macrocytic anemia (MCV > 100 fL) is most commonly caused by vitamin B12 or
folate deficiency. Low serum B12 combined with the presence of intrinsic factor antibodies is
diagnostic for pernicious anemia. Low iron/TIBC suggests iron deficiency (microcytic). Positive
Coombs test suggests autoimmune hemolytic anemia.
Q8: Which of the following is a characteristic finding in the bone marrow of a patient with
Aplastic Anemia?
A. Hypercellularity with megakaryocytic hyperplasia
B. Hypocellularity with fatty replacement
C. Granulocytic hyperplasia
D. Increased lymphocytic aggregates
Correct Answer: B
Rationale: Aplastic anemia is characterized by pancytopenia and a hypocellular bone marrow
with fatty replacement due to stem cell failure. Hypercellularity is seen in leukemias or
hemolytic anemias. Granulocytic hyperplasia suggests bacterial infection.
Q9: The presence of Auer rods in a peripheral blood smear is pathognomonic for:
A. Pernicious anemia
B. Acute myeloid leukemia (AML)
C. Chronic lymphocytic leukemia (CLL)
D. Infectious mononucleosis
Correct Answer: B
AMT MLS Exam NEWEST 2025/2026 Actual
Exam – Complete Real Exam Questions | 100%
Verified | Graded A+ Detailed Rationales – Pass
Guaranteed – A+ Graded
[SECTION 1: Hematology & Coagulation — Questions 1-60]
Q1: A patient's CBC results show the following: Hgb 10.0 g/dL, Hct 30%, MCV 72 fL, MCHC
33 g/dL, and RDW 18%. Which of the following is the most likely diagnosis?
A. Iron deficiency anemia
B. Vitamin B12 deficiency
C. Anemia of chronic disease
D. Acute blood loss
Correct Answer: A
Rationale: The MCV of 72 fL indicates microcytic anemia. The combination of microcytosis
(low MCV), normal MCHC, and elevated RDW (anisocytosis) is characteristic of iron deficiency
anemia (IDA). Vitamin B12 deficiency presents with macrocytosis (high MCV). Anemia of
chronic disease is typically normocytic, and acute blood loss is initially normocytic.
Q2: Which RBC inclusion body is composed of nuclear remnants that appear as a dense
basophilic granule and are commonly seen in splenectomy patients or megaloblastic anemias?
A. Howell-Jolly bodies
B. Heinz bodies
C. Pappenheimer bodies
D. Cabot rings
Correct Answer: A
Rationale: Howell-Jolly bodies are small, round, nuclear remnants (DNA) that are usually
removed by the spleen. Their presence in peripheral blood suggests functional asplenia or
,2
splenectomy. Heinz bodies are denatured hemoglobin seen in G6PD deficiency. Pappenheimer
bodies are iron granules seen in sideroblastic anemia. Cabot rings are mitochondrial remnants
seen in severe anemia.
Q3: A manual differential reveals a white blood cell count of 30.0 x 10^9/L with 60% segmented
neutrophils, 20% bands, 15% lymphocytes, and 5% monocytes. Which term best describes this
finding?
A. Leukopenia
B. Leukocytosis with a left shift
C. Leukocytosis with a right shift
D. Lymphocytosis
Correct Answer: B
Rationale: The WBC count is elevated (leukocytosis) at 30.0 x 10^9/L. A "left shift" refers to an
increase in immature granulocyte forms (bands, metamyelocytes) relative to mature neutrophils,
indicating an active inflammatory response or infection. A right shift implies hypersegmentation
(e.g., >5 lobes), seen in megaloblastic anemia.
Q4: Which coagulation factor is NOT part of the intrinsic pathway but is essential for the
extrinsic pathway?
A. Factor VIII
B. Factor IX
C. Factor VII
D. Factor XII
Correct Answer: C
Rationale: Factor VII is the initiating factor of the extrinsic pathway, activated by tissue factor
(thromboplastin). Factors VIII, IX, and XII are components of the intrinsic pathway (contact
activation pathway). Deficiency in Factor VII prolongs the PT (Prothrombin Time), not the PTT.
,3
Q5: A peripheral blood smear shows numerous schistocytes (helmet cells), thrombocytopenia,
and a prolonged PT and PTT. What is the most likely diagnosis?
A. Idiopathic thrombocytopenic purpura (ITP)
B. Disseminated Intravascular Coagulation (DIC)
C. Hemophilia A
D. von Willebrand disease
Correct Answer: B
Rationale: The presence of schistocytes indicates microangiopathic hemolytic anemia
(fragmentation of RBCs). Combined with thrombocytopenia and prolonged coagulation times
(PT/PTT), Disseminated Intravascular Coagulation (DIC) is the primary diagnosis. ITP typically
presents with isolated thrombocytopenia without coagulopathy or schistocytes. Hemophilia
affects only PTT.
Q6: In the automated reticulocyte count, what is the principle behind the staining method?
A. Supravital staining with new methylene blue or thiazole orange
B. Wright-Giemsa staining
C. Peroxidase staining
D. Sudan black B staining
Correct Answer: A
Rationale: Reticulocytes are immature RBCs containing residual RNA. They require supravital
staining (while the cell is still living) with dyes like new methylene blue or thiazole orange to
precipitate the RNA, making it visible for counting. Wright-Giemsa is for standard morphology.
Peroxidase is for leukocyte differentiation.
Q7: A patient has a mean corpuscular volume (MCV) of 110 fL. Which of the following
laboratory findings is most consistent with this macrocytic anemia?
A. Low serum iron, high TIBC
B. Low vitamin B12, low intrinsic factor antibodies
, 4
C. Normal ferritin, low hemoglobin
D. Positive direct Coombs test
Correct Answer: B
Rationale: Macrocytic anemia (MCV > 100 fL) is most commonly caused by vitamin B12 or
folate deficiency. Low serum B12 combined with the presence of intrinsic factor antibodies is
diagnostic for pernicious anemia. Low iron/TIBC suggests iron deficiency (microcytic). Positive
Coombs test suggests autoimmune hemolytic anemia.
Q8: Which of the following is a characteristic finding in the bone marrow of a patient with
Aplastic Anemia?
A. Hypercellularity with megakaryocytic hyperplasia
B. Hypocellularity with fatty replacement
C. Granulocytic hyperplasia
D. Increased lymphocytic aggregates
Correct Answer: B
Rationale: Aplastic anemia is characterized by pancytopenia and a hypocellular bone marrow
with fatty replacement due to stem cell failure. Hypercellularity is seen in leukemias or
hemolytic anemias. Granulocytic hyperplasia suggests bacterial infection.
Q9: The presence of Auer rods in a peripheral blood smear is pathognomonic for:
A. Pernicious anemia
B. Acute myeloid leukemia (AML)
C. Chronic lymphocytic leukemia (CLL)
D. Infectious mononucleosis
Correct Answer: B
