ASCP SH study plan

Map the hematopoietic hierarchy from hematopoietic stem cell through each committed progenitor, listing the cytokine or growth factor that drives each transition

Trace normal erythrocyte maturation and identify the morphologic checkpoint (nucleus loss, hemoglobin accumulation) at which each stage becomes identifiable on a Wright-stained smear

Explain hemoglobin structure, oxygen dissociation, and the roles of 2,3-DPG, pH, and temperature in shifting the curve

Calculate and interpret RBC indices (MCV, MCH, MCHC, RDW) from a given CBC and classify the result as normocytic, microcytic, or macrocytic

Differentiate microcytic hypochromic anemias by interpreting iron studies (serum iron, TIBC, ferritin, transferrin saturation) and distinguishing iron deficiency from anemia of chronic disease and thalassemia trait

Compare megaloblastic versus non-megaloblastic macrocytic anemia using B12/folate values, methylmalonic acid, reticulocyte count, and peripheral smear findings

Classify hemolytic anemias by intravascular versus extravascular mechanism and by intrinsic versus extrinsic defect, and predict the expected labs for each

Interpret a reticulocyte count with correction for anemia and use it to separate hypoproliferative from hyperproliferative processes

Work through hemoglobinopathies (sickle cell, Hb C, Hb E) and predict solubility, electrophoresis, and peripheral smear findings for each

Identify the morphologic hallmarks of RBC membrane defects (spherocytes, elliptocytes) and enzyme deficiencies (bite cells, Heinz bodies) and the confirmatory tests for each

Distinguish inherited versus acquired leukocyte quantitative disorders, including neutrophilia, neutropenia, and lymphocytosis, with a differential cause list for each

Describe normal leukocyte maturation sequences in granulopoiesis and lymphopoiesis to establish the baseline for later dysplasia recognition

Apply the WHO classification framework to separate myeloid from lymphoid neoplasms and to place myelodysplastic, myeloproliferative, and mixed categories correctly

Interpret flow cytometry panels by matching surface markers (CD13, CD33, CD34, CD19, CD20, CD3, CD5, CD10) to lineage and maturation stage

Correlate cytogenetic and molecular findings (t(9;22), t(15;17), t(8;21), JAK2 V617F, CALR) with specific diagnoses and prognostic groups

Evaluate acute leukemia cases using blast percentage, Auer rods, cytochemistry, and immunophenotype to assign myeloid versus lymphoid lineage

Sequence the coagulation cascade by pathway, naming each factor, its common synonym, and the laboratory test that assesses it

Interpret PT, aPTT, thrombin time, and mixing studies to localize a defect to factor deficiency, inhibitor, or lupus anticoagulant

Explain platelet adhesion, activation, and aggregation, and differentiate inherited (von Willebrand disease, Glanzmann, Bernard-Soulier) from acquired platelet disorders

Recognize the laboratory profile of disseminated intravascular coagulation and distinguish it from primary fibrinolysis and liver disease

Evaluate hypercoagulable states by listing inherited and acquired thrombophilias with the appropriate screening and confirmatory assay for each

Interpret heparin and warfarin monitoring tests, including anti-Xa, and identify interferences such as HIT and direct oral anticoagulant effects

Describe preanalytical variables that invalidate coagulation testing (tube ratio, fill volume, hemolysis, clot) and state the corrective action for each

Apply quality control rules to Levey-Jennings charts and differentiate random from systematic error using shift, trend, and 1-3s/2-2s/R-4s criteria

Compare impedance, optical, and flow-cytometric analyzer principles and explain which cell property each method measures

Troubleshoot spurious CBC results such as platelet clumping, cold agglutinins, lipemia, and nucleated RBC interference, stating the corrective step for each

Apply Westgard multi-rules and method validation concepts (linearity, precision, accuracy, reference intervals) to a laboratory scenario

Outline quality assurance requirements for proficiency testing, competency assessment, and specimen rejection criteria

Synthesize all five domains by working timed mixed-topic question sets and reviewing every missed item to its underlying principle

Re-derive the highest-yield morphologic and laboratory decision rules from memory without notes

Identify the two personal weakest subtopics from practice performance and remediate each with targeted review

Rehearse a test-day time-allocation strategy on a full-length simulated exam