100+ Free SM Practice Questions
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An antibiogram (cumulative susceptibility report) should be updated at least:
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Key Facts: SM Exam
100
Total Items
ASCP BOC
2h 30m
Exam Time
ASCP
CLSI M100
Annual Breakpoints
Most-tested standard
BSL-2/3
Biosafety Level
Routine vs TB/select agents
The ASCP SM (Specialist in Microbiology) is a Specialist-level BOC credential. 100 MCQ items, 2h 30m, ~$270 fee. Eligibility: doctorate + 2 yrs OR master's + 3 yrs micro experience. Master CLSI breakpoints (M100), Gram stain interpretation, organism ID by biochemicals + MALDI-TOF, antimicrobial resistance mechanisms, and CDC sentinel laboratory rule-outs (Brucella, Bacillus anthracis, Yersinia pestis).
Sample SM Practice Questions
Try these sample questions to test your SM exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A blood culture from a patient with endocarditis grows Gram-positive cocci in clusters, catalase positive, coagulase positive, and resistant to cefoxitin on disk diffusion. Which gene is most likely responsible for the resistance phenotype?
2A urine culture from a sexually active 19-year-old woman grows >100,000 CFU/mL of a Gram-positive coccus that is catalase negative, coagulase negative, and resistant to novobiocin. The most likely organism is:
3A throat swab from a child with pharyngitis grows beta-hemolytic, catalase-negative, Gram-positive cocci that are bacitracin susceptible and PYR positive. The organism is:
4Identification of Streptococcus pneumoniae from sputum is best supported by which combination of test results?
5A blood culture isolate of Enterococcus faecium is reported as vancomycin MIC >32 µg/mL and teicoplanin MIC >32 µg/mL. The most likely resistance gene is:
6Listeria monocytogenes is best distinguished from group B Streptococcus by which feature?
7A wound culture from a sheep farmer grows large, Gram-positive rods that produce a 'medusa-head' colony, are non-motile, and produce a capsule. The most likely organism is:
8A CSF Gram stain from an unvaccinated infant shows Gram-negative diplococci. Growth occurs on chocolate agar but not on Thayer-Martin selective medium because the organism is inhibited by vancomycin. The most likely identification is:
9A urine isolate of E. coli has MIC values: ceftriaxone 16 µg/mL, ceftazidime 8 µg/mL, and cefotaxime + clavulanate shows >=3 doubling-dilution decrease versus cefotaxime alone. This phenotype indicates:
10Which test is the CLSI-recommended phenotypic confirmation for carbapenemase production in Enterobacterales?
About the SM Exam
ASCP BOC Specialist-level credential for senior clinical microbiology technologists. Validates expertise across bacteriology (Gram positive/negative/anaerobic/mycobacteria), mycology, parasitology, virology, antimicrobial susceptibility (CLSI breakpoints, ESBL/CRE detection, MRSA, VRE), molecular methods (MALDI-TOF, NAAT panels), and laboratory management.
Questions
100 scored questions
Time Limit
2 hours 30 minutes
Passing Score
Scaled
Exam Fee
~$270 (effective Jan 2026) (ASCP BOC)
SM Exam Content Outline
Bacteriology (Gram+/Gram-/Anaerobic/Mycobacteria)
Staph, Strep, Enterococcus, Enterobacterales, Pseudomonas, anaerobes, M. tuberculosis
Mycology
Yeasts (Candida, Cryptococcus), dimorphic fungi, dermatophytes, Aspergillus, Mucorales
Parasitology
Protozoa (Plasmodium, Giardia, Cryptosporidium), helminths (Ascaris, Taenia, Schistosoma)
Virology
HIV, HCV, HBV, HSV/VZV/CMV/EBV, influenza, RSV, COVID-19
Antimicrobial Susceptibility & Stewardship
CLSI breakpoints, ESBL/CRE/KPC, MRSA, VRE, D-test
Methods, MALDI-TOF, Molecular
Blood culture, MALDI-TOF, NAAT, 16S rRNA, WGS
Lab Management, QC, Safety, Outbreak
BSL-2/3, CAP/CLIA, sentinel labs, antibiogram
How to Pass the SM Exam
What You Need to Know
- Passing score: Scaled
- Exam length: 100 questions
- Time limit: 2 hours 30 minutes
- Exam fee: ~$270 (effective Jan 2026)
Keys to Passing
- Complete 500+ practice questions
- Score 80%+ consistently before scheduling
- Focus on highest-weighted sections
- Use our AI tutor for tough concepts
SM Study Tips from Top Performers
Frequently Asked Questions
What is the difference between SM and the base M credential?
SM (Specialist in Microbiology) is the senior, supervisory credential requiring doctorate + 2 yrs or master's + 3 yrs experience. M(ASCP) is the entry-level Microbiology Technologist credential. SM tests advanced topics including antimicrobial stewardship, lab management, and complex case workups.
What CLSI document is most important?
CLSI M100 (Performance Standards for Antimicrobial Susceptibility Testing) is updated annually with current breakpoints. Other key documents: M07 (broth dilution methods), M02 (disk diffusion), M27 (yeast antifungal), M61 (mold antifungal), M39 (antibiogram). Know the difference between FDA-approved breakpoints (older) vs CLSI breakpoints (current).
How is MRSA detected?
MRSA (methicillin-resistant Staphylococcus aureus) is detected via cefoxitin disk diffusion (≥22 mm = susceptible; ≤21 mm = resistant) — cefoxitin better induces mecA expression than oxacillin. Confirmatory: PCR for mecA/mecC; PBP2a latex agglutination. MRSA screening commonly nasal swab NAAT.
How should I study for ASCP SM?
Plan 60-100 hours over 8-12 weeks. Focus heaviest on Bacteriology (30%) — master Gram stain interpretation, biochemical identification, MALDI-TOF. Cover Antimicrobial Susceptibility (15%) with CLSI M100 breakpoints, resistance mechanisms (ESBL, AmpC, carbapenemases KPC/NDM/OXA-48), and ASTs.