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ACVP Phase II Clinical Pathology Examination — Information & Free Practice

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ACVP Phase II Clinical Pathology Examination

Provider
American College of Veterinary Pathologists (ACVP); delivered with Meazure Learning
Format
Multiple-choice examination at a Meazure Learning Testing Center or by Live Remote Proctoring
Exam questions
300 multiple-choice questions in 3 sections of 100 questions
Time limit
7.5 hours plus two breaks totaling 45 minutes
Passing score
A score equal to or greater than the established passing point (cut score)
Examination outline
  • Task 1: Identify and interpret microscopic features of blood, bone marrow, fluids (including urine), and tissues (i.e. cytology and histology) from domestic and non-domestic animals. (published approximate allocation: ~33%) (33%)
    • Knowledge: Normal tissue or fluid components, including species variations (e.g. leukocyte proportions, bone marrow lineages, elements in body cavity fluids and tissue aspirates, histopathology architecture for commonly aspirated tissue such as liver and lymph nodes)
    • Knowledge: Normal cell morphology, including species and stain variations (e.g. rapid stain versus Wright-Giemsa, canine versus feline RBCs, heterophils versus eosinophils in avian and reptilian blood smears)
    • Knowledge: Artifactual and non-pathologic findings (e.g. stain precipitate, formalin artifact, urinalysis contaminants, cell changes in aged blood samples)
    • Knowledge: Infectious organism morphology, and those most likely to occur in a particular cell or tissue (e.g. rickettsial morulae in neutrophils, Pythium spp. in gastrointestinal aspirate, blastomycosis in cutaneous biopsy)
    • Knowledge: Most likely causes of inflammatory patterns in particular tissues (e.g. eosinophilic pleocytosis in CSF, pyogranulomatous dermatitis, neutrophilic arthritis, lymphocytosis on blood smears)
    • Knowledge: Neoplastic cell and tissue morphology (e.g. features of malignancy, architecture patterns)
    • Knowledge: Most likely diagnosis(es) associated with specific morphologic abnormalities (e.g. Melamed-Wolinska bodies and urothelial carcinoma, calcareous corpuscles and trematode infections)
    • Knowledge: Most likely diagnosis(es) associated with cytochemical, histochemical, and immunostain results (e.g. Mycobacterium and acid fast, osteosarcoma and ALP staining, CD3 and CD79a and lymphoma, reticulin and trichrome in bone marrow)
    • Skill: Identifying abnormal microscopic features in images (e.g. etiologic agents, cellular inclusions, blood cell morphology, criteria of malignancy)
    • Skill: Identifying multiple disease processes and the likely primary versus secondary process (e.g. fluid with lymphoma and secondary septic inflammation from gastrointestinal rupture)
    • Skill: Differentiating artifactual changes from non-pathologic and pathologic abnormalities (e.g. Pelger-Huet abnormality (needs to be anomaly, not abnormality) versus true inflammatory leukogram, lysosomal storage disease inclusions versus Doehle bodies, stain precipitate versus hemoparasite)
    • Skill: Differentiating inflammatory from hyperplastic/reactive from neoplastic conditions (e.g. myeloid hyperplasia with left shift in bone marrow versus acute leukemia, reactive mesothelial cells from carcinoma in peritoneal fluid)
    • Skill: Formulating a diagnosis using image findings and clinical information
  • Task 2: Interpret static visual test results of healthy and diseased domestic and non-domestic animals. (published approximate allocation: ~15%) (15%)
    • Knowledge: Routine and advanced hematology instrumentation methodology (e.g. Advia, Sysmex, TEG, point-of-care devices)
    • Knowledge: Routine and advanced hematology data
    • Knowledge: Macroscopic hematology test methodology (e.g. cross match, blood typing)
    • Knowledge: Microscopic hematology test methodology (e.g. cross-match, Coomb’s test, saline dispersion)
    • Knowledge: Marker selection for liquid and solid tissue sample immunophenotyping (e.g. CD3 for T cell, cytokeratin for epithelial)
    • Knowledge: Cytochemical and histochemical stains (e.g. Congo red for amyloid, alcian blue for mucin, GMS)
    • Knowledge: How sample attributes (i.e. gross appearance) impact test results
    • Knowledge: Standard QA/QC data acquisition, presentation, validation, and relevance (e.g. Levy-Jennings, Bland-Altman plots)
    • Knowledge: Clonality test plots (e.g. electrophoresis, PCR)
    • Knowledge: Relevant visual tests included within the recent veterinary literature
    • Skill: Interpreting routine hematology cytograms
    • Skill: Interpreting advanced microscopic and macroscopic hematology test results
    • Skill: Interpreting platelet and hemostasis testing results
    • Skill: Interpreting flow cytometry plots
    • Skill: Interpreting cytochemical, histochemical, and immunochemical stains
    • Skill: Interpreting quality assurance and quality control graphical data
    • Skill: Interpreting protein electrophoretograms and immunofixation reactions
    • Skill: Interpreting PCR clonality traces
  • Task 3: Evaluate and interpret clinicopathologic data of healthy and diseased domestic and non-domestic animals. (published approximate allocation: ~25%) (25%)
    • Knowledge: Expected physiology for species, breed, age, and sex and reproductive differences
    • Knowledge: Pathophysiology in organ systems (e.g. kidney, liver) and associated biomarkers (e.g. urea nitrogen, creatinine, bilirubin)
    • Knowledge: Pathophysiology in systemic processes (e.g. acid-base, lipid metabolism, proteins) and associated biomarkers (e.g. pH, HCO3, triglycerides, CRP, SAA)
    • Knowledge: Enzymology (e.g. isoenzymes, half-lives, tissue specificity, species differences)
    • Knowledge: Ancillary (e.g. disease specific or advanced) tests to confirm diagnosis (e.g. endocrine disease)
    • Knowledge: Biologic variability in standard laboratory animals including use of control and pretreatment data
    • Knowledge: Current language pertaining to clinicopathologic data and diagnoses (e.g. normal versus healthy, range versus interval, specific current clinicopathologic terms)
    • Skill: Interpretation of individual and population-based laboratory data
    • Skill: Integrating laboratory abnormalities into a diagnosis or a refined list of differentials
    • Skill: Selection and interpretation of appropriate ancillary tests
  • Task 4: Understand the principles of commonly used laboratory instrumentation and methods. (published approximate allocation: ~10%) (10%)
    • Knowledge: Analyzer and test procedure methodologies (e.g. flow versus impedance, direct versus indirect measurements)
    • Knowledge: Sample types and collection methods, errors and interferences on test results (e.g. pre-analytical, analytical, post-analytical)
    • Knowledge: Procedures for reference interval determination and validation (e.g. index of individuality, sample size)
    • Knowledge: The principles of microscopy (e.g. parts of microscope, fundamentals of digital scanning)
    • Knowledge: Quality control and quality assurance including relevant statistics (e.g. six sigma, total allowable error)
    • Knowledge: Test properties and selection (e.g. sensitivity, specificity, predictive values, ROC)
    • Knowledge: Procedures for method validation (e.g. imprecision, species specificity, bias determination)
    • Knowledge: Procedures for and uses of routine, cytochemical, histochemical, and immunochemical stains (e.g. New methylene blue, ALP, Wright- Giemsa)
    • Skill: Identifying erroneous test results and the associated cause
  • Task 5: Apply the pathophysiology of disease in domestic and non-domestic animals to manifestations in clinicopathologic test results. (published approximate allocation: ~17%) (17%)
    • Knowledge: Normal physiologic mechanisms (e.g. renal handling of water, electrolytes, and waste products; hepatic uptake, conjugation, and excretion of metabolites; thyroid and adrenal hormone production)
    • Knowledge: Neoplastic disease pathogenesis (e.g. paraneoplastic hypercalcemia, acute tumor lysis syndrome)
    • Knowledge: Metabolic disease pathogenesis (e.g. corticosteroid leukograms and hyperglycemia, diabetic ketoacidosis, negative energy balance and hepatic lipidosis)
    • Knowledge: Infectious disease pathogenesis (e.g. babesiosis and anemia, fungal infections and hypercalcemia)
    • Knowledge: Inflammatory disease pathogenesis (e.g. immune mediated polyarthritis, pancreatitis)
    • Knowledge: Pathogenesis of toxicity (e.g. Heinz bodies/eccentrocytes and oxidative injury)
    • Knowledge: Hemodynamic disease pathogenesis (e.g. effusion formation, congenital and acquired hemostatic deficiencies, disseminated intravascular coagulation)
    • Knowledge: Degenerative disease pathogenesis (e.g. hepatic insufficiency and biochemical changes, renal disease and biomarkers)
    • Knowledge: Genetic disease pathogenesis (e.g. RBC enzymopathies, leukocyte adhesion deficiency)
    • Knowledge: Species variations in physiology and pathogenesis (e.g. hepatocellular and cholestatic liver enzymes, major acute phase proteins, likely causes of oxidative injury)
    • Skill: Integrating mechanisms of disease with clinicopathologic test results
Examination sources