100+ Free ABPath Clinical Pathology Practice Questions

The ABPath Clinical Pathology (CP) exam is a primary certification examination offered by the American Board of Pathology for pathologists completing CP-only or combined AP/CP residency training. It is a one-day computer-based exam delivered at Pearson VUE testing centers, with 330 one-best-answer multiple-choice questions in a combined Written/Practical format covering hematopathology, transfusion medicine, medical microbiology, clinical chemistry, and laboratory management/informatics.

The CP exam contains 330 multiple-choice one-best-answer questions delivered in a combined Written/Practical format over approximately 6 hours 36 minutes. Practical questions include graphs, charts, formulas, diagrams, red cell antibody panels, electropherograms, and calculations. Both written conceptual and practical problem-solving questions are integrated across all content areas.

The 2026 CP blueprint (effective January 2026) allocates weights: Hematopathology 25%, Blood Banking/Transfusion Medicine 23%, Medical Microbiology 23%, Chemical Pathology 20%, and Management and Informatics 9%. Molecular pathology questions are integrated across all five domains, accounting for 10-15% of the exam overall. Medical microscopy questions may appear in both chemistry and hematopathology subsections.

ABPath uses criterion-referenced scoring with a scaled passing standard set by content experts through a modified Angoff process. Candidates are measured against a fixed content standard, not curved against peers. The pass/fail determination is made in a single administration. Score reports include diagnostic performance by content domain for candidates who need to refocus study before retaking.

Candidates must hold an MD or DO degree, have completed ACGME-accredited pathology training (CP-only = 3 years; combined AP/CP = 4 years), and maintain an active unrestricted medical or osteopathic license. Applications are submitted via the PATHway portal during the February 16–May 15 window for Fall primary exams (or September–December window for Spring exams).

The ABPath primary certification exam fee in 2026 is $2,100 for CP-only or $2,600 for combined AP/CP taken in the same window. The fee includes a $200 non-refundable administrative fee. Candidates taking AP and CP in separate windows pay $2,100 each ($4,200 total). There is no late application fee — applications must be submitted by the May 15 deadline.

Hematopathology (25%) — master iron studies, PT/aPTT/mixing study interpretation, TTP/ADAMTS13 <10%, HIT 4Ts + PF4 ELISA → SRA, myeloma IMWG, and acute leukemias (APL t(15;17), CML BCR-ABL). Blood Banking (23%) — ABO genetics, DAT/antibody ID, PROPPR 1:1:1 MTP, TRALI vs TACO, DHTR with Kidd antibodies, irradiation indications, RhIG, apheresis ASFA categories. Microbiology (23%) — MRSA mecA, VRE vanA, CRE by carbapenemase type, hepatitis serology, CLSI breakpoints. Chemistry (20%) — acid-base/osmolar gap (methanol, salicylate, EG), Friedewald, hs-troponin, HbA1c, acetaminophen Rumack-Matthew, TDM (vanc AUC, digoxin 0.5-0.9, lithium 0.6-1.2). Management (9%) — CLIA complexity, PT rules, HIPAA, Westgard, LOINC/CPT, FDA 2024 LDT rule.

Use the official ABPath 2026 CP Blueprint as a roadmap. Build a 12-18 month longitudinal plan through CP/AP-CP residency: rotate through each of the five domains (heme, BB/TM, micro, chem, management) with problem-based learning. Integrate current guidelines: AABB Technical Manual/Standards (21st ed), IDSA infection treatment, CLSI M100 breakpoints (annual updates), ADA/AHA-ACC biomarker recommendations, CAP/AMP NGS validation, and the 2024 FDA LDT rule. Practice interpreting antibody panels, Levey-Jennings charts, and calculations (Friedewald, Rumack-Matthew, AUC/MIC).