ASCP MLS Breakdown: Entire Exam Content Guidelines

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The ASCP Board of Certification (BOC) determines the huge exam content area for ASCP medical laboratory scientist exam preparation.

The ASCP BOC describes this entire ASCP MLS breakdown in the ASCP MLS content guidelines.

The ASCP MLS breakdown comprise: ASCP MLS reference ranges, topics and key topics of each subject and seven subjects with all their crucial outlines and question percentages.

To pass the MLS (ASCP) exam, you must cover the entire syllabus because the board chooses a different percentage of questions from each subject.

The subjects and their percentages are:

  • Chemistry: 17%-20%
  • Blood Banking: 17%-20%
  • Hematology: 17%-20%
  • Urinalysis and other body fluids: 5%-10%
  • Immunology: 5%-10%
  • Lab Operation: 5%-10%
  • Microbiology: 17%-20%

Whether you are a U.S. candidate or international, the board offers the same MLS ASCP content guidelines for all.

In this article, we will describe the entire ASCP MLS content guideline, with its subjects, outlines, topics, and key topics.

ASCP MLS Breakdown: A-Z Information

Following are all the subjects and their outlines that you have to cover in the ASCP MLS certification exam preparation.

ASCP MLS Breakdown for Blood Banking

This content area covers 17%-22% of exam questions out of 100%.

The following are all its classification:

Blood Product

  • Donor
  • Processing
  • Storage
  • Blood Components
  • Blood Component Quality Control

Blood Group System

  • Genetics
  • Biochemistry/Antigens
  • Blood Group Role in Transfusion

Blood Group Immunology

  • Immune Response
  • Immunoglobulins
  • Antigen-Antibody Interactions
  • Complement

Physiology and Pathophysiology

  • Physiology of Blood
  • Hemostasis & Coagulation
  • Hemolytic Disease of the Newborn & Fetus
  • Anemias
  • Transplantation

Serologic and Molecular Testing

  • Routine Tests
  • Reagents
  • Application of Reagents and Special Tests
  • Leukocyte/Platelet Testing
  • Quality Assurance

Transfusion Practice

ASCP MLS Breakdown for Urinalysis/Other Body Fluids

Out of 100% of questions, it offers 5%-10% questions for the final exam content areas.

The further classification of Urinalysis and body fluids


  • Physical
  • Chemical
  • Microscopic
  • Renal Physiology
  • Disease States

Body Fluids (semen, amniotic, CSF, serous, feces, synovial, etc)

  • Physiology
  • Physical
  • Chemical
  • Disease States
  • Microscopic

ASCP MLS Breakdown for Chemistry

This part presents 17%-22% of the exam questions. It major categories are:

General Chemistry

  • Carbohydrate
  • Lipids
  • Heme Derivatives

Protein and Enzyme

  • Enzyme
  • Proteins and other Nitrogen-Containing Compounds

Acid-Base, Blood Gases, and Electrolytes

  • Electrolytes
  • Acid-Base Determination

Special Chemistry

  • Toxicology
  • Therapeutic Drug Monitoring
  • Vitamins and Nutrition
  • Endocrinology

ASCP MLS Breakdown for Hematology

The ASCP Board of Certification chose 17%-22% of the questions from hematology.

Its major classifications are;

Hematology Physiology

  • Destruction
  • Function
  • Production

Hematology Disease State

  • Erythrocytes
  • Leukocytes
  • Platelets

Hematology Laboratory Testing

  • Cell Counts
  • Differentials & Morphology Evaluation 
  • Hemoglobin
  • Hematocrit
  • Indices
  • Hemolytic Indicators
  • Special Stains
  • Other Studies
  • Flow Cytometry Immunophenotyping

ASCP MLS Breakdown for Immunology

This content area is specific to offer the 5%-10% questions for the ASCP medical lab scientist exam.

The following are its exam content areas:

Principle of Immunology

  • Immune System Physiology
  • Immunoglobulins
  • Antigen-Antibody Interactions
  • Complement

Disease of the Immune System

  • Autoimmunity
  • Hypersensitivity
  • Immunoproliferative Diseases
  • Immunodeficiency


  • Graft-versus-host Disease
  • HLA Typing
  • Tumor Immunology

Infectious Disease Serology

  • Epidemiology of viral pathogens  and clinical significance
  • Tuberculosis Infection (PPD, interferon-gamma release assay, etc)
  • Stages of Infection of Treponema pallidum & Borrelia burgdorferi

Serologic Procedures

  • Rheumatoid Factor
  • Thyroid Antibodies
  • Cytokine Testing
  • Labeled Immunoassays
  • Nontreponemal Syphilis Testing
  • Immunofluorescence
  • Treponemal Syphilis Testing

Test Result

  • Confirmatory Testing
  • Result Interpretation
  • Disease State Correlation

ASCP MLS Breakdown for Microbiology

It offers 17-22% of questions, and its major topics are:

Preanalytical procedures, analytical procedure of bacteriology, Analytic Procedures for Virology, Mycobacteriology, Mycology, and Parasitology, and postanalytical procedures.

Preanalytical procedures

  • Specimen Collection & Transport
  • Specimen Processing
  • Stain, Principles, Procedures, and Interpretation

Analytic Procedures for Bacteriology

  • Bone Marrow and Blood
  • Cerebrospinal Fluid
  • Body Fluids from Normally Sterile Sites
  • Lower Respiratory
  • Upper Respiratory
  • Skin, Soft Tissue, & Bone Genital Tract
  • Urine
  • Identification Methods
  • Antibiotic Resistance  and Antimicrobial Susceptibility Testing
  • MRSA/MSSA, ESBL/CRE, VRE Screening
  • BSL-3 Pathogens & Select Agents

Analytic Procedures for Mycology, Parasitology, Virology, Mycobacteriology

  • Mycobacteriology & Nocardia spp
  • Virology
  • Parasitology
  • Mycology

Postanalytic Procedures

  • Issuing Corrected Reports
  • Urgent & Critical Value Reporting
  • Autoverification & Result Review
  • Documentation Practices
  • Prevention and Public Health/ Reporting to Infection Control

ASCP MLS Breakdown for Laboratory Operation

Lab operation presents 5%-10% of exam questions for the MLS ASCP exam.

The further classifications of lab operation are

Troubleshooting/ Quality Assessment

  • Compliance
  • Quality Control
  • Postanalytical, Analytical, and Preanalytical
  • Regulation (proficiency testing, accreditation standards, competency assessment, etc)


  • Emergency Procedures (needlesticks, fire, splashes to mucous membranes, etc)
  • Safety Programs & Practices: Safe work practices,  chemicals and reagents safety data sheets,  bloodborne pathogens prevention of infection, PPE (personal protective equipment) usage, transportation of microorganisms and specimens and their packing.

Laboratory Mathematics

  • Standard Curves
  • Normality
  • Dilutions, Volume, and Concentration
  • Molarity
  • Mode, Mean, Confidence Intervals, and Median
  • Predictive Value, Specificity, and Sensitivity

Automated and Manual Methodology & Instrumentation

  • Automated Microbiology Processors
  • Flow Cytometry
  • Fluorometry
  • Chromatography
  • Osmometry
  • Spectrophotometry & Photometry
  • Basic Lab Equipment
  • Hematology Instrumentation
  • Molecular Methods
  • Nephelometry
  • Electrochemistry
  • Electrophoresis
  • Mass Spectrometry

Education Principles

Basic Management Principles

FAQs for ASCP MLS Breakdown

What is the ASCP MLS Breakdown?

The ASCP MLS exam syllabus is also called the ASCP MLS Breakdown. The ASCP BOC recommends seven subjects for the ASCP MLS exam: Chemistry, Microbiology, Immunology, Lab Operation, Hematology, Blood Banking, and Urinalysis/Other Body Fluids.

Are covering the entire ASCP MLS breakdown is important to pass the ASCP MLS exam?

Yes, of course, because the ASCP Board of Certification chooses the different percentage of questions from each content area.

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