MLS ASCP EXAM QUESTIONS AND
ANSWERS WITH SOLUTIONS 2024
c antigen is most common in blacks and whites; anti-c would be most common reactive - ANSWER Rh
antibodies show enhanced reactivity with enzyme pretreated cells. The M and Fya antigens are cleaved
from enzyme pretreated cells and therefore there would be no reaction between enzyme pretreated
cells and serum containing anti-M or anti-Fya. The incidence of the c antigen is 80% in whites and 96% in
blacks. The incidence of the E antigen is 29% in whites and 22% in blacks. Increased reactivity with
enzyme pretreated cells and incompatible results with 8 of 10 donor units is most likely due to anti-c.
Procainamide - ANSWER NAPA
loose clusters of small spherical microconidia, positive urease - ANSWER Trichophyton mentagrophytes
BHCG tumor marker - ANSWER chorocarcinoma
5HIAA - ANSWER carcinoid tumors
Proteus vulgaris vs P. mirabilis indole test - ANSWER P. vulgaris is indole pos. P. mirabilis is indole neg
Hydatid cyst fluid - ANSWER used to neutralize Anti-P1 antibody
Antacid overdose - ANSWER Check pH
Prolonged PT, PTT, and thrombin after collecting from catheter - ANSWER heparin contamination
mixing study that was performed with a prolonged PTT that couldn't be corrected - ANSWER DRVVT
(Dilute Russell Viper Venom Test)
two pt's ran in duplicate (PT and PTT). The PTT seemed to always be prolonged but PT looked ok -
ANSWER check the CaCl/phospholipid reagent delivery
,Patient is on coumadin therapy, what will be affected - ANSWER Decreased protein C
Lot's of stomatocytes - ANSWER Liver disease
Burr cells - ANSWER Uremia
Picture of target cells with hemoglobin C crystals. The white count was high on instrument 1, so a second
instrument was used with a stronger lysing agent, and the white count was corrected - ANSWER anti-
lysing target cells are what increased the white count? Erythrocytes containing hemoglobin C do not lyse
normally (sickle cell diseases)
A sodium citrate tube was drawn for a HCT on a pt but the hematocrit was abnormal - ANSWER recollect
with decreased anticoagulant. high hct (>55%) causes low plasma so you need less anticoagulant
Question that gives a red blood cells count, HGB, and HCT. I did the rule of 3 and found that the HGB
didn't meet the rule of 3 because it was too high - ANSWER check for lipemia (elevates HGB)
PBS with an elevated reticulocyte count and howell jolly bodies in the RBC's - ANSWER Prussian blue for
howell jolly bodies made of iron. Prussian blue stain, which is not taken up by reticulocytes, is helpful in
differentiating the two.
what is composed of DNA? - ANSWER howell jolly bodies
what falsely increases ESR - ANSWER vibration, tilting of tube, higher temps, >1 hr test time, improper
mixing of blood, improper dilution
factors decreasing ESR - ANSWER Polycythemia, Microcytosis (Hb C), Sickle cells, spherocytes, Anti-
inflammatory medications, Hypogammaglobulinemia, Hypofibrinogenemia (DIC), High WBC count,
Hyperviscosity
Factors increasing ESR - ANSWER Anemia, Macrocytosis, Female gender, Age >50 years, Obesity,
Pregnancy, Hypercholesterolemia, cancer, multiple myeloma, rouleaux, infections, inflammation
, what falsely decreases ESR - ANSWER low blood/ room temps, air bubbles, tests <1 hr, improper mixing
of blood, improper dilution
lactic acid collection - ANSWER separate from serum and put on ice
coefficient of variation - ANSWER (standard deviation/ mean) X 100
Carbon dioxide electrode measures what - ANSWER Used to measure free carbon dioxide ions by
detecting pH. The change in pH is measured by an internal pH sensor, which is proportional to the
carbon dioxide level.
patient that had a random glucose >200 and an FPG >126. What do you do next? - ANSWER diagnosis
with diabetes mellitus.
(need secondary confirmation from 4 criteria. FRG >126, Random glucose >200, ogtt >200, or Hb A1c
>6.5)
Man tested positive for syphilis 2 years ago but may have again, how would you test him? - ANSWER RPR
Person tested positive for HIV-1 and HIV-2 but western blot was indeterminate. What do you do? -
ANSWER repeat western blot in a month.
There was a positive DAT on cord blood; mother is Rh pos, baby is Rh neg. What is most likely coating the
baby's red cells? - ANSWER K (kell)
Picture of what looks like cold agglutinins - ANSWER Paroxysmal cold hemoglobinuria? (Aggregation of
the RBCs can occur, but this is considered mild compared with cold hemagglutinin disease. )
Mycoplasma infections more likely?
What phase can rouleux not be detected in? - ANSWER AHG
Picture of ABO type with mixed field reaction in the forward type - ANSWER patient was transfused with
O blood
ANSWERS WITH SOLUTIONS 2024
c antigen is most common in blacks and whites; anti-c would be most common reactive - ANSWER Rh
antibodies show enhanced reactivity with enzyme pretreated cells. The M and Fya antigens are cleaved
from enzyme pretreated cells and therefore there would be no reaction between enzyme pretreated
cells and serum containing anti-M or anti-Fya. The incidence of the c antigen is 80% in whites and 96% in
blacks. The incidence of the E antigen is 29% in whites and 22% in blacks. Increased reactivity with
enzyme pretreated cells and incompatible results with 8 of 10 donor units is most likely due to anti-c.
Procainamide - ANSWER NAPA
loose clusters of small spherical microconidia, positive urease - ANSWER Trichophyton mentagrophytes
BHCG tumor marker - ANSWER chorocarcinoma
5HIAA - ANSWER carcinoid tumors
Proteus vulgaris vs P. mirabilis indole test - ANSWER P. vulgaris is indole pos. P. mirabilis is indole neg
Hydatid cyst fluid - ANSWER used to neutralize Anti-P1 antibody
Antacid overdose - ANSWER Check pH
Prolonged PT, PTT, and thrombin after collecting from catheter - ANSWER heparin contamination
mixing study that was performed with a prolonged PTT that couldn't be corrected - ANSWER DRVVT
(Dilute Russell Viper Venom Test)
two pt's ran in duplicate (PT and PTT). The PTT seemed to always be prolonged but PT looked ok -
ANSWER check the CaCl/phospholipid reagent delivery
,Patient is on coumadin therapy, what will be affected - ANSWER Decreased protein C
Lot's of stomatocytes - ANSWER Liver disease
Burr cells - ANSWER Uremia
Picture of target cells with hemoglobin C crystals. The white count was high on instrument 1, so a second
instrument was used with a stronger lysing agent, and the white count was corrected - ANSWER anti-
lysing target cells are what increased the white count? Erythrocytes containing hemoglobin C do not lyse
normally (sickle cell diseases)
A sodium citrate tube was drawn for a HCT on a pt but the hematocrit was abnormal - ANSWER recollect
with decreased anticoagulant. high hct (>55%) causes low plasma so you need less anticoagulant
Question that gives a red blood cells count, HGB, and HCT. I did the rule of 3 and found that the HGB
didn't meet the rule of 3 because it was too high - ANSWER check for lipemia (elevates HGB)
PBS with an elevated reticulocyte count and howell jolly bodies in the RBC's - ANSWER Prussian blue for
howell jolly bodies made of iron. Prussian blue stain, which is not taken up by reticulocytes, is helpful in
differentiating the two.
what is composed of DNA? - ANSWER howell jolly bodies
what falsely increases ESR - ANSWER vibration, tilting of tube, higher temps, >1 hr test time, improper
mixing of blood, improper dilution
factors decreasing ESR - ANSWER Polycythemia, Microcytosis (Hb C), Sickle cells, spherocytes, Anti-
inflammatory medications, Hypogammaglobulinemia, Hypofibrinogenemia (DIC), High WBC count,
Hyperviscosity
Factors increasing ESR - ANSWER Anemia, Macrocytosis, Female gender, Age >50 years, Obesity,
Pregnancy, Hypercholesterolemia, cancer, multiple myeloma, rouleaux, infections, inflammation
, what falsely decreases ESR - ANSWER low blood/ room temps, air bubbles, tests <1 hr, improper mixing
of blood, improper dilution
lactic acid collection - ANSWER separate from serum and put on ice
coefficient of variation - ANSWER (standard deviation/ mean) X 100
Carbon dioxide electrode measures what - ANSWER Used to measure free carbon dioxide ions by
detecting pH. The change in pH is measured by an internal pH sensor, which is proportional to the
carbon dioxide level.
patient that had a random glucose >200 and an FPG >126. What do you do next? - ANSWER diagnosis
with diabetes mellitus.
(need secondary confirmation from 4 criteria. FRG >126, Random glucose >200, ogtt >200, or Hb A1c
>6.5)
Man tested positive for syphilis 2 years ago but may have again, how would you test him? - ANSWER RPR
Person tested positive for HIV-1 and HIV-2 but western blot was indeterminate. What do you do? -
ANSWER repeat western blot in a month.
There was a positive DAT on cord blood; mother is Rh pos, baby is Rh neg. What is most likely coating the
baby's red cells? - ANSWER K (kell)
Picture of what looks like cold agglutinins - ANSWER Paroxysmal cold hemoglobinuria? (Aggregation of
the RBCs can occur, but this is considered mild compared with cold hemagglutinin disease. )
Mycoplasma infections more likely?
What phase can rouleux not be detected in? - ANSWER AHG
Picture of ABO type with mixed field reaction in the forward type - ANSWER patient was transfused with
O blood
