10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
The CP exam has 330 questions and runs 6 hours 36 minutes.
These 10 free CP questions are organized by exam domain, so you can see how each part of the Certification in Clinical Pathology (CP) blueprint is tested. Reveal the answer and explanation under each question.
Domain 1: Blood Banking/Transfusion Medicine 23% of exam
Question 1
A patient receiving daratumumab needs red-cell transfusion. ABO/RhD typing is unequivocal, but the antibody screen is panreactive. The pretreatment screen was negative, and there is no history of clinically significant alloantibodies. Testing with reagent cells treated with conventional 0.2 mol/L dithiothreitol (DTT) is now negative. The patient's K antigen status is unknown. In addition to ABO/RhD compatibility, what red-cell selection is required because of this testing method?
Show answer & explanation
Correct answer: B - K-negative units selected from the available inventory
Question 2
A 78-year-old patient with chronic kidney disease receives two red-cell units over three hours. Near the end of the second unit, oxygen saturation falls to 84%, blood pressure rises from 132/74 to 190/102 mmHg, and jugular venous distention and bilateral crackles appear. Chest radiography shows pulmonary edema. The patient is 2.8 L fluid positive, and echocardiography supports elevated left-sided filling pressure. The transfusion is stopped and respiratory support is begun. The reaction is best classified as:
Show answer & explanation
Correct answer: D - Transfusion-associated circulatory overload
Question 3
A patient receiving chemotherapy has a body surface area of 1.8 m². An ABO-identical platelet transfusion yesterday produced a 30-minute corrected count increment (CCI) of 2,200. Today, a component containing 3.0 × 10^11 platelets raises the count from 8,000/µL to 12,000/µL at 30 minutes. The patient is afebrile, without bleeding, DIC, or splenomegaly; HLA class I antibodies have been demonstrated. CCI equals the count increment per µL multiplied by body surface area, divided by the platelet dose in units of 10^11. Using a repeated early CCI below 5,000 to define refractoriness, which assessment and support strategy fits?
Show answer & explanation
Correct answer: B - CCI 2,400; trial crossmatch-compatible platelet support
Domain 2: Chemical Pathology 20% of exam
Question 4
An alert outpatient has a sodium result of 121 mmol/L on a chemistry analyzer that uses an indirect ion-selective electrode. The specimen is markedly lipemic; triglycerides are 4,800 mg/dL. Measured serum osmolality is 289 mOsm/kg, glucose is 96 mg/dL, and sodium measured promptly by a direct ion-selective electrode is 138 mmol/L. The clinician asks whether the low chemistry-analyzer result requires sodium correction. What advice is justified by these findings?
Show answer & explanation
Correct answer: A - Do not correct sodium; this is pseudohyponatremia
Question 5
MRI obtained for progressive visual-field loss and hypogonadism shows a 4.6-cm sellar mass. Serum prolactin is 42 ng/mL (laboratory reference interval, 4-20) on a two-site immunometric assay. Renal function and thyroid testing are normal, and the patient takes no dopamine-antagonist medication. Before the prolactin result is used to characterize the mass as nonfunctioning, the most informative next laboratory step is:
Show answer & explanation
Correct answer: B - Repeat prolactin after validated serial dilution of the specimen
Domain 3: Hematopathology 25% of exam
Question 6
Six weeks after an uncomplicated delivery, a woman with no previous bleeding history develops extensive ecchymoses and a large thigh hematoma. Her platelet count and PT are normal. A properly collected peripheral specimen has an aPTT of 86 seconds (reference interval, 25-35). A 1:1 mix with normal plasma measures 33 seconds immediately and 71 seconds after two hours at 37°C. She has received no anticoagulants, and her thrombin time is normal. Which paired studies should be prioritized to establish the cause of bleeding?
Show answer & explanation
Correct answer: D - Factor VIII activity and a Nijmegen-Bethesda inhibitor assay
Question 7
During review of a new leukemia specimen, the pathologist finds abnormal heavily granulated promyelocytes, including cells with bundles of Auer rods. The platelet count is 18 × 10^9/L, fibrinogen is 72 mg/dL, and PT is prolonged. Urgent clinical notification has been made. To establish the suspected genetic subtype without waiting for the complete sequencing panel, which target should be prioritized for rapid FISH or RT-PCR?
Show answer & explanation
Correct answer: C - PML::RARA
Domain 4: Management and Informatics 9% of exam
Question 8
Before releasing a chemistry run, a technologist notes control results of +2.4 SD and −0.5 SD relative to their established means. For each control level, the preceding five results were within ±1 SD and alternated above and below the mean. Instrument and calibration checks are satisfactory. Under the laboratory's original Westgard multirule procedure, how should this run be handled?
Show answer & explanation
Correct answer: A - Accept the run after documenting review of the isolated 1_2s warning
Domain 5: Medical Microbiology 23% of exam
Question 9
A Staphylococcus aureus isolate from a drained abscess is erythromycin resistant and initially clindamycin susceptible by routine testing. In a correctly performed disk-approximation test, the clindamycin inhibition zone is flattened on the side facing the erythromycin disk. Quality-control results are acceptable. How should the laboratory finalize the clindamycin result?
Show answer & explanation
Correct answer: C - Report resistant because the D-zone demonstrates inducible clindamycin resistance
Question 10
A lung biopsy from a patient with prolonged neutropenia shows angioinvasive, broad, ribbon-like hyphae with sparse septation and irregular branching. Serum Aspergillus galactomannan and beta-D-glucan are negative. What should be favored in the preliminary interpretation while culture and molecular identification are pending?
Show answer & explanation
Correct answer: D - An invasive Mucorales infection
That's 10 of 1,030
The full bank has 1,020 more CP questions with explanations.