ASCP Study Guide 2026

Everything you need to pass the ASCP exam in one place: the exam format, every topic to study, real practice questions with explanations, flashcards, and full-length practice tests. Free, no sign-up needed.

📚 ASCP Topics to Study (35)

✍️ Sample ASCP Questions & Answers

1. Root cause analysis (RCA) in the laboratory is conducted primarily to:
Identify the fundamental system or process failures that allowed an error to occur and prevent recurrence

RCA is a non-punitive, systematic process to identify the root causes (not just proximate causes) of errors. The goal is process improvement and error prevention through system-level changes rather than individual blame.

2. The anion gap (AG) is calculated from serum chemistry as:
Na+ minus (Cl- plus HCO3-)

Anion gap equals Na+ minus (Cl- plus HCO3-). Normal range is 8–12 mEq/L (or 12–16 if K+ is included). AG represents unmeasured anions (albumin, phosphate, sulfate, organic acids) and helps classify metabolic acidosis.

3. On a peripheral blood smear, target cells (codocytes) are most commonly associated with:
Liver disease, thalassemia, hemoglobin C disease, and post-splenectomy

Target cells have excess membrane relative to hemoglobin content, creating a bull's-eye appearance. They are classic for liver disease (altered lipid composition), thalassemia, hemoglobin C or SC disease, and post-splenectomy states.

4. A CSF sample from a patient with suspected cryptococcal meningitis should have which test performed immediately?
India ink preparation and cryptococcal antigen (CrAg) latex agglutination

India ink is a rapid test where the polysaccharide capsule of Cryptococcus neoformans or gattii excludes ink particles, creating a halo around the organism. Cryptococcal antigen (CrAg) latex agglutination is more sensitive (above 90%) and is the preferred rapid test.

5. A synovial fluid WBC of 50,000–200,000/µL with >90% PMNs is most consistent with:
Septic arthritis

Septic arthritis typically shows WBC >50,000/µL with >90% neutrophils; crystals and lower counts are seen in gout and inflammatory arthritis.

6. Microsatellite instability (MSI) testing is most relevant for which condition?
Lynch syndrome (hereditary nonpolyposis colorectal cancer)

Lynch syndrome is caused by germline mutations in mismatch repair (MMR) genes (MLH1, MSH2, MSH6, PMS2). Deficient MMR causes MSI — length changes in repetitive DNA sequences. MSI-H tumors in young patients prompt Lynch syndrome evaluation.

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