ASCP BOARD OF CERTIFICATION MLS EXAM
2025/2026 WITH 100% CORRECT ANSWERS
1. A critically ill 86-year-old female was admitted to the intensive care unit
(ICU) after arriving at the emergency department with symptoms that
included shortness of breath and fever. Her temperature was 39°C (102°F)
and pulse rate 110/minute. A white blood count (WBC) was ordered and was
elevated at 15.0 x 109/L. The differential showed an increase in segmented
and immature neutrophils. Another testing was ordered after admission to
ICU, including a procalcitonin (PCT). The result was 2.15 ng/mL (The
reference value for normal at the 95th percentile is <0.05 ng/mL).
No risk of severe sepsis/septic shock
High risk of severe sepsis/septic shock
Systemic inflammation, not related to infection
Low risk of severe sepsis/septic shock
2. A patient presents with dark urine and joint pain. After testing, homogentisic
acid is found in their urine. What condition might this indicate, and what
further steps should be taken?
This suggests a urinary tract infection; antibiotics should be
prescribed immediately.
This may indicate alkaptonuria; further evaluation of the patient's
metabolic pathways and management of joint symptoms should
be considered.
This indicates liver dysfunction; a liver biopsy should be performed.
This suggests dehydration; the patient should be advised to increase
fluid intake.
,3. What characteristic of small dense LDL molecules contributes to their
atherogenicity?
Higher cholesterol content
Larger particle size
Increased antioxidant properties
Greater mobility in the endothelium and arterial wall
4. Lactobacillus are an example of a/an:
Obligate anaerobe
Microaerophilic
Facultative anaerobe
Obligate aerobe
Aerotolerant anaerobe
5. In a clinical scenario where a patient presents with joint pain and swelling,
which laboratory test would be most relevant to identify an infection
caused by Phialophora spp.?
Joint fluid analysis for fungal culture
Liver function test
Complete blood count
Blood glucose level test
6. Describe the significance of separating serum proteins into fractions using
cellulose acetate electrophoresis.
It identifies the presence of pathogens in the serum.
, Separating serum proteins into fractions helps in diagnosing
various medical conditions by analyzing protein levels and types.
It is a method for determining blood cell counts.
It is primarily used to measure glucose levels in the blood.
7. What disease is primarily associated with Phialophora verrucosa?
Chromoblastomycosis
Histoplasmosis
Aspergillosis
Candidiasis
8. What is the role of leucovorin in methotrexate containing regimens for ALL
and lymphoma?
Enhance toxicity of methotrexate
Prevent methotrexate induced mucositis
Prevent folic acid deficiency
Prevent methotrexate toxicity in normal cells
9. Which of the following antibodies would usually have the mildest effects on
the newborn if it was the cause of HDFN?
Anti-Fyb
Anti-D
Anti-K
Anti-A,B
Anti-Jka
, 10. Which ABO types of fresh frozen plasma are compatible for transfusion to
an AB negative patient?
O negative and O positive
A positive and B negative
A negative and B positive
AB negative and AB positive
11. Using serum electrophoresis, protein can be separated into how many
fractions?
Six
Five
Four
Three
12. Describe the significance of a positive ketone test in the context of
diabetes mellitus.
A positive ketone test shows that the body is producing excess
insulin.
A positive ketone test suggests normal glucose metabolism.
A positive ketone test indicates that the body is using fat for
energy instead of glucose, which can occur in uncontrolled
diabetes.
A positive ketone test indicates a deficiency in red blood cells.
2025/2026 WITH 100% CORRECT ANSWERS
1. A critically ill 86-year-old female was admitted to the intensive care unit
(ICU) after arriving at the emergency department with symptoms that
included shortness of breath and fever. Her temperature was 39°C (102°F)
and pulse rate 110/minute. A white blood count (WBC) was ordered and was
elevated at 15.0 x 109/L. The differential showed an increase in segmented
and immature neutrophils. Another testing was ordered after admission to
ICU, including a procalcitonin (PCT). The result was 2.15 ng/mL (The
reference value for normal at the 95th percentile is <0.05 ng/mL).
No risk of severe sepsis/septic shock
High risk of severe sepsis/septic shock
Systemic inflammation, not related to infection
Low risk of severe sepsis/septic shock
2. A patient presents with dark urine and joint pain. After testing, homogentisic
acid is found in their urine. What condition might this indicate, and what
further steps should be taken?
This suggests a urinary tract infection; antibiotics should be
prescribed immediately.
This may indicate alkaptonuria; further evaluation of the patient's
metabolic pathways and management of joint symptoms should
be considered.
This indicates liver dysfunction; a liver biopsy should be performed.
This suggests dehydration; the patient should be advised to increase
fluid intake.
,3. What characteristic of small dense LDL molecules contributes to their
atherogenicity?
Higher cholesterol content
Larger particle size
Increased antioxidant properties
Greater mobility in the endothelium and arterial wall
4. Lactobacillus are an example of a/an:
Obligate anaerobe
Microaerophilic
Facultative anaerobe
Obligate aerobe
Aerotolerant anaerobe
5. In a clinical scenario where a patient presents with joint pain and swelling,
which laboratory test would be most relevant to identify an infection
caused by Phialophora spp.?
Joint fluid analysis for fungal culture
Liver function test
Complete blood count
Blood glucose level test
6. Describe the significance of separating serum proteins into fractions using
cellulose acetate electrophoresis.
It identifies the presence of pathogens in the serum.
, Separating serum proteins into fractions helps in diagnosing
various medical conditions by analyzing protein levels and types.
It is a method for determining blood cell counts.
It is primarily used to measure glucose levels in the blood.
7. What disease is primarily associated with Phialophora verrucosa?
Chromoblastomycosis
Histoplasmosis
Aspergillosis
Candidiasis
8. What is the role of leucovorin in methotrexate containing regimens for ALL
and lymphoma?
Enhance toxicity of methotrexate
Prevent methotrexate induced mucositis
Prevent folic acid deficiency
Prevent methotrexate toxicity in normal cells
9. Which of the following antibodies would usually have the mildest effects on
the newborn if it was the cause of HDFN?
Anti-Fyb
Anti-D
Anti-K
Anti-A,B
Anti-Jka
, 10. Which ABO types of fresh frozen plasma are compatible for transfusion to
an AB negative patient?
O negative and O positive
A positive and B negative
A negative and B positive
AB negative and AB positive
11. Using serum electrophoresis, protein can be separated into how many
fractions?
Six
Five
Four
Three
12. Describe the significance of a positive ketone test in the context of
diabetes mellitus.
A positive ketone test shows that the body is producing excess
insulin.
A positive ketone test suggests normal glucose metabolism.
A positive ketone test indicates that the body is using fat for
energy instead of glucose, which can occur in uncontrolled
diabetes.
A positive ketone test indicates a deficiency in red blood cells.
