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Interim Mls Content Guideline 7-21
Interim Mls Content Guideline 7-21
EXAMINATION MODEL
The MLS(ASCP) and MLS(ASCPi) certification examination is composed of 100 questions given in a 2 hour 30 minute time
frame. All exam questions are multiple-choice with one best answer. The certification exam is administered using the
format of computer adaptive testing (CAT).
With CAT, when a person answers a question correctly, the next test question has a slightly higher level of difficulty. The
difficulty level of the questions presented to the examinee continues to increase until a question is answered incorrectly.
Then a slightly easier question is presented. In this way, the test is tailored to the individual’s ability level.
Each question in the test bank is calibrated for level of difficulty and is classified by content area. The content area aligns
with the examination specific content outline. The examinee must answer enough questions correctly to achieve a
measure above the pass point in order to successfully pass the certification examination. There is no set number of
questions one must answer to pass, nor is there a set percentage one must achieve to pass. If at the end of the exam the
examinee’s score is above the pass point, then he or she passes the exam.
EXAM
CONTENT AREA DESCRIPTION
PERCENTAGE
Blood products, blood group systems, blood group immunology, physiology
BLOOD BANKING 17 – 22%
and pathophysiology, serologic and molecular testing, transfusion practice
URINALYSIS AND Physical and chemical testing, microscopic analysis, physiology, disease
5 – 10%
OTHER BODY FLUIDS states
Carbohydrates, lipids, heme derivatives, enzymes, proteins and other
nitrogen-containing compounds, acid-base determinations (including blood
CHEMISTRY 17 – 22%
gases), electrolytes, endocrinology, vitamins and nutrition, therapeutic
drug monitoring, toxicology
Physiology, disease states, laboratory testing, hemostasis (including
HEMATOLOGY 17 – 22%
physiology, disease states, and laboratory determinations)
Principles of immunology, diseases of the immune system, transplantation,
IMMUNOLOGY 5 – 10%
infectious disease serology, serologic procedures, test results
Preanalytic procedures; analytic procedures for bacteriology; analytic
MICROBIOLOGY procedures for mycobacteriology, virology, parasitology, and mycology; 17 – 22%
postanalytic procedures
Quality assessment/troubleshooting, safety, laboratory mathematics,
LABORATORY
manual/automated methodology and instrumentation, basic management 5 – 10%
OPERATIONS
principles, education principles
For a more specific overview of the MLS exam, please refer to the CONTENT OUTLINE starting on page 2.
ASCP BOC 33 West Monroe Street, Suite 1600, Chicago, IL 60603 | www.ascp.org/boc | Revised: July 2021 | Page 1 of 15
VALID ONLY FOR MLS(ASCP) AND MLS(ASCPi) TESTING
DATES BEGINNING JANUARY 1, 2022
Examination questions, which are related to the subtest areas outlined below, may be both theoretical and/or procedural.
Theoretical questions measure skills necessary to apply knowledge, calculate results, and correlate patient results to
disease states. Procedural questions measure skills necessary to perform laboratory techniques and follow quality
assurance protocols. Additionally, regulatory questions are based on U.S. sources (e.g., AABB, FDA, CLIA).
IMPORTANT NOTE ABOUT COVID-19: FDA guidance for changes in donor eligibility during the COVID-19 pandemic are to
ensure an adequate blood supply and only apply for the duration of the pandemic. Donor eligibility questions are based
on pre-pandemic requirements and will not reflect temporary changes.
ASCP BOC 33 West Monroe Street, Suite 1600, Chicago, IL 60603 | www.ascp.org/boc | Revised: July 2021 | Page 2 of 15
VALID ONLY FOR MLS(ASCP) AND MLS(ASCPi) TESTING
DATES BEGINNING JANUARY 1, 2022
ASCP BOC 33 West Monroe Street, Suite 1600, Chicago, IL 60603 | www.ascp.org/boc | Revised: July 2021 | Page 3 of 15
VALID ONLY FOR MLS(ASCP) AND MLS(ASCPi) TESTING
DATES BEGINNING JANUARY 1, 2022
ASCP BOC 33 West Monroe Street, Suite 1600, Chicago, IL 60603 | www.ascp.org/boc | Revised: July 2021 | Page 4 of 15
VALID ONLY FOR MLS(ASCP) AND MLS(ASCPi) TESTING
DATES BEGINNING JANUARY 1, 2022
ASCP BOC 33 West Monroe Street, Suite 1600, Chicago, IL 60603 | www.ascp.org/boc | Revised: July 2021 | Page 5 of 15
VALID ONLY FOR MLS(ASCP) AND MLS(ASCPi) TESTING
DATES BEGINNING JANUARY 1, 2022
ASCP BOC 33 West Monroe Street, Suite 1600, Chicago, IL 60603 | www.ascp.org/boc | Revised: July 2021 | Page 6 of 15
VALID ONLY FOR MLS(ASCP) AND MLS(ASCPi) TESTING
DATES BEGINNING JANUARY 1, 2022
ASCP BOC 33 West Monroe Street, Suite 1600, Chicago, IL 60603 | www.ascp.org/boc | Revised: July 2021 | Page 7 of 15
VALID ONLY FOR MLS(ASCP) AND MLS(ASCPi) TESTING
DATES BEGINNING JANUARY 1, 2022
IMMUNOLOGY
(5 – 10% of total exam) V. SEROLOGIC PROCEDURES
I. PRINCIPLES OF IMMUNOLOGY A. ANA
A. Immune System Physiology B. Thyroid Antibodies
1. Primary and secondary response C. Rheumatoid Factor
2. B and T cells, macrophages D. Labeled Immunoassays (e.g., ELISA)
3. Genetics E. Nontreponemal Syphilis Testing (e.g., RPR)
B. Immunoglobulins F. Treponemal Syphilis Testing (e.g., MHATP)
1. Classes and subclasses G. Cytokine Testing
2. Structure H. Immunofluorescence
3. Biologic and physical properties
C. Antigen-Antibody Interactions VI. TEST RESULTS
1. Principles A. Interpretation
2. Testing B. Confirmatory Testing
a. Principles C. Disease State Correlation
b. Methods
D. Complement
1. Classical and alternative pathway MICROBIOLOGY
mechanisms (17 – 22% of total exam)
2. Biologic properties I. PREANALYTIC PROCEDURES
A. Specimen Collection and Transport
II. DISEASES OF THE IMMUNE SYSTEM 1. Patient identification and specimen labeling
A. Autoimmunity 2. Specimen collection
1. Systemic (e.g., SLE) 3. Specimen transport systems and conditions
2. Organ-specific (e.g., Graves disease) for all organisms
B. Hypersensitivity B. Specimen Processing
1. I, II, III, IV 1. Specimen prioritization and rejection
C. Immunoproliferative Diseases criteria
1. Monoclonal gammopathies (e.g., plasma 2. Biosafety cabinet and personal protective
cell myeloma, Waldenström equipment
macroglobulinemia) 3. Specimen preparation methods and
D. Immunodeficiency applications
1. Hereditary (e.g., SCID) 4. Media
2. Acquired (e.g., HIV) 5. Inoculation of media
6. Incubation conditions (e.g., temperature,
III. TRANSPLANTATION atmosphere, duration)
A. Graft-versus-host Disease 7. Preparation methods for slides used for
B. HLA Typing stains
C. Tumor Immunology C. Stains: Procedure, Principle, and Interpretation
1. Gram
IV. INFECTIOUS DISEASE SEROLOGY 2. Acid-fast
A. Clinical Significance and Epidemiology of Viral 3. Modified acid-fast
Pathogens (e.g., hepatitis [A, B, C], EBV, HIV, 4. KOH and calcofluor-white
CMV, rubella, measles) 5. Trichrome
B. Stages of Infection of Treponema pallidum and 6. Giemsa
Borrelia burgdorferi 7. Acridine orange
C. Tuberculosis Infection (e.g., interferon-gamma
release assay, PPD)
ASCP BOC 33 West Monroe Street, Suite 1600, Chicago, IL 60603 | www.ascp.org/boc | Revised: July 2021 | Page 8 of 15
VALID ONLY FOR MLS(ASCP) AND MLS(ASCPi) TESTING
DATES BEGINNING JANUARY 1, 2022
ASCP BOC 33 West Monroe Street, Suite 1600, Chicago, IL 60603 | www.ascp.org/boc | Revised: July 2021 | Page 9 of 15
VALID ONLY FOR MLS(ASCP) AND MLS(ASCPi) TESTING
DATES BEGINNING JANUARY 1, 2022
F. Gastrointestinal
1. Colony morphology and identification of 3. Correlation of colony counts with clinical
major pathogens (e.g., Salmonella spp., significance
Shigella spp., toxigenic Escherichia coli, 4. Correlation of culture with urinalysis results
Campylobacter spp., Vibrio spp., Yersinia J. Identification Methods (Theory, Interpretation,
enterocolitica, Aeromonas spp., and Application)
Plesiomonas shigelloides) 1. Colony morphology
2. Direct detection and molecular methods 2. Rapid tests used for presumptive
(e.g., Clostridioides difficile, Shiga toxin) identification (e.g., coagulase, catalase,
3. Serotyping of Escherichia coli, Salmonella oxidase, indole, PYR)
spp., and Shigella spp. 3. Conventional biochemical identification
4. Organism pathogenicity (e.g., etiology, (e.g., X and V factors, Neisseria
transmission, virulence mechanisms) carbohydrate utilization)
5. Detection methods for Helicobacter pylori 4. Commercial kits
G. Skin, Soft Tissue, and Bone 5. Automated methods
1. Specimen sources (e.g., wound, abscess, 6. MALDI-TOF MS
biopsy) 7. Multiplex molecular methods
2. Indigenous flora colony and Gram stain 8. Sequencing (e.g., 16S)
morphology K. Antimicrobial Susceptibility Testing and
3. Colony morphology and identification of Antibiotic Resistance
major pathogens 1. Method, theory, interpretation, and
4. Organism pathogenicity (e.g., etiology, application
transmission, virulence mechanisms) 2. Phenotypic detection of resistance (e.g.,
H. Genital Tract beta-lactamase, ESBL, inducible clindamycin
1. Specimen sources (e.g., vaginal, cervical, resistance, carbapenamases)
urethral, endocervical) 3. Mechanisms of action of major antibiotic
2. Indigenous organisms colony and Gram classes
stain morphology 4. Detection of genetic determinants of
3. Methods for detection of pathogens resistance (e.g., mecA, vanA, blaKPC)
associated with vaginitis (e.g., Trichomonas 5. Intrinsic resistance patterns for common
vaginalis, Candida spp., bacterial vaginosis) species
4. Culture and/or molecular detection (e.g., L. MRSA/MSSA, VRE, ESBL/CRE Screening
Neisseria gonorrhoeae, Chlamydia 1. Specimen sources
trachomatis, Streptococcus agalactiae, and 2. Culture methods
Mycoplasma spp.) 3. Molecular methods
5. Organism pathogenicity (e.g., etiology, M. BSL-3 Pathogens and Select Agents
transmission, virulence mechanisms) (Bioterrorism)
I. Urine 1. Specimen sources (e.g., blood, sputum,
1. Specimen sources (e.g., mid-stream clean- tissue, lymph node)
catch, catheterized, suprapubic, 2. Colony morphology and rapid tests used for
nephrostomy) presumptive identification (e.g., Bacillus
2. Colony morphology and identification of anthracis, Yersinia pestis, Brucella spp.,
major urinary pathogens (e.g., Francisella tularensis)
Enterobacteriaceae, Enterococcus spp., 3. Role of regional laboratory and Laboratory
Streptococcus agalactiae, Candida spp., Response Network
Staphylococcus saprophyticus) 4. Organism pathogenicity (e.g., etiology,
transmission, virulence mechanisms)
ASCP BOC 33 West Monroe Street, Suite 1600, Chicago, IL 60603 | www.ascp.org/boc | Revised: July 2021 | Page 10 of 15
VALID ONLY FOR MLS(ASCP) AND MLS(ASCPi) TESTING
DATES BEGINNING JANUARY 1, 2022
ASCP BOC 33 West Monroe Street, Suite 1600, Chicago, IL 60603 | www.ascp.org/boc | Revised: July 2021 | Page 11 of 15
VALID ONLY FOR MLS(ASCP) AND MLS(ASCPi) TESTING
DATES BEGINNING JANUARY 1, 2022
ASCP BOC 33 West Monroe Street, Suite 1600, Chicago, IL 60603 | www.ascp.org/boc | Revised: July 2021 | Page 12 of 15
VALID ONLY FOR MLS(ASCP) AND MLS(ASCPi) TESTING
DATES BEGINNING JANUARY 1, 2022
THE EXAMINEE IS EXPECTED TO KNOW THESE ADDITIONAL CALCULATIONS AND REFERENCE RANGES:
CALCULATIONS
- % Transferrin saturation/UIBC/TIBC
- Unconjugated/indirect bilirubin
- LDL/Friedewald equation/non-HDL
- A/G ratio
- Timed urine calculations
- Creatinine clearance calculations
- Beer’s law
- Corrected WBC counts when > 10 nRBCs present
- Manual hemocytometer counts
- Red blood cell indices (e.g., MCV, MCH, MCHC)
- Absolute cell counts given the relative values (e.g., WBCs, reticulocytes)
ASCP BOC 33 West Monroe Street, Suite 1600, Chicago, IL 60603 | www.ascp.org/boc | Revised: July 2021 | Page 13 of 15
VALID ONLY FOR MLS(ASCP) AND MLS(ASCPi) TESTING
DATES BEGINNING JANUARY 1, 2022
ASCP BOC 33 West Monroe Street, Suite 1600, Chicago, IL 60603 | www.ascp.org/boc | Revised: July 2021 | Page 14 of 15
VALID ONLY FOR MLS(ASCP) AND MLS(ASCPi) TESTING
DATES BEGINNING JANUARY 1, 2022
All values on the MLS exam can be interpreted using the reference ranges above. These reference ranges will not be given
on the exam. Other reference ranges will be provided as needed on the exam.
ASCP BOC 33 West Monroe Street, Suite 1600, Chicago, IL 60603 | www.ascp.org/boc | Revised: July 2021 | Page 15 of 15