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100+ Free CT(IAC) Exam Practice Questions

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IAC International Board of Cytopathology

Practice Questions
2026 Statistics

Key Facts: CT(IAC) Exam Exam

Fully digital

CT(IAC) is delivered digitally and is entirely multiple choice since 2024

IAC - CT(IAC) examination format

3 sections

Digital slides, projected visual images and written multiple-choice questions

IAC - CT(IAC) examination format

80 questions

The written section contains 80 multiple-choice questions

IAC - CT(IAC) examination format

30 slides

The digital-slide section uses 30 whole-slide images over 90 minutes

IAC - CT(IAC) examination format

3 years

Three years of full-time gynecological and non-gynecological experience is required

IAC - Application for the CT(IAC) examination

90 Euro

The CT(IAC) examination fee is 90 Euro at the time of writing

IAC - CT(IAC) examination format

Level A and B

The slide section is scored on a two-level system: categorization then specific diagnosis

IAC - CT(IAC) examination format

100

Free original practice questions in this bank

OpenExamPrep

The CT(IAC) examination from the International Academy of Cytology certifies experienced cytotechnologists and, since 2024, is delivered fully digitally as an all-multiple-choice test. It has three sections: 30 digital whole-slide images in 90 minutes, a projected visual-image section of about 35 minutes, and 80 written multiple-choice questions. Candidates bring their own laptop and need three years of full-time gynecological and non-gynecological cytotechnology experience before sitting; the fee is 90 Euro. The slide section is scored on a two-level system (Level A categorization, Level B specific diagnosis) rather than a single published pass percentage. This 100-question bank covers gynecologic and non-gynecologic cytology, the Bethesda system, FNA, microbiology, cytopreparation and quality control.

Sample CT(IAC) Exam Practice Questions

Try these sample questions to test your CT(IAC) Exam exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1In the Bethesda System for reporting cervical cytology, koilocytes are the hallmark cytologic feature of which finding?
A.High-grade squamous intraepithelial lesion (HSIL)
B.Low-grade squamous intraepithelial lesion (LSIL)
C.Atypical glandular cells (AGC)
D.Reactive cellular change
Explanation: Koilocytes - squamous cells with a sharply demarcated perinuclear clear halo and an enlarged, hyperchromatic, raisinoid nucleus - are the classic cytopathic effect of HPV and define LSIL in the Bethesda System. LSIL also includes changes traditionally called mild dysplasia/CIN 1.
2Which interpretation should a cytotechnologist assign when squamous cells show nuclear changes that are more pronounced than reactive change but fall short of a definitive low-grade lesion?
A.NILM
B.ASC-US
C.HSIL
D.Squamous cell carcinoma
Explanation: ASC-US (atypical squamous cells of undetermined significance) is used when changes are qualitatively or quantitatively short of a definitive intraepithelial lesion but exceed those expected for a reactive process. It is the most common abnormal Bethesda squamous category.
3A liquid-based Pap shows clusters of squamous cells with high nuclear-to-cytoplasmic ratios, coarse chromatin, and immature cytoplasm. ASC-H is reported because the changes are suspicious for but not diagnostic of which lesion?
A.LSIL
B.HSIL
C.Atrophy
D.Endometrial cells
Explanation: ASC-H (atypical squamous cells, cannot exclude HSIL) is reported when cells raise concern for a high-grade lesion but are too few or not sufficiently abnormal for a definitive HSIL interpretation. It carries a higher risk of underlying CIN 2/3 than ASC-US.
4Which organism is identified on a Pap test by pear-shaped or rounded blue-gray trophozoites, often with eccentric pale nuclei and cytoplasmic eosinophilic granules?
A.Candida albicans
B.Trichomonas vaginalis
C.Actinomyces species
D.Herpes simplex virus
Explanation: Trichomonas vaginalis appears as a pear-shaped or rounded cyanophilic organism roughly 15-30 micrometers, with a small eccentric nucleus and eosinophilic cytoplasmic granules. Leptothrix bacteria and inflammatory squamous change often accompany it.
5The classic 'shish kebab' or skewered appearance of squamous cells pierced by fungal pseudohyphae on a Pap test indicates infection with:
A.Trichomonas vaginalis
B.Candida species
C.Gardnerella vaginalis
D.Chlamydia trachomatis
Explanation: Candida produces budding yeast and pseudohyphae that align squamous cells along their length, creating the characteristic skewered 'shish kebab' pattern. The pseudohyphae are eosinophilic to cyanophilic and show pinched constrictions.
6'Clue cells' on a Pap test, defined as squamous cells whose borders are obscured by a coating of coccobacilli, are associated with which condition?
A.Candidiasis
B.Bacterial vaginosis
C.Atrophic vaginitis
D.Follicular cervicitis
Explanation: Clue cells are squamous cells covered by a film of small coccobacilli (notably Gardnerella vaginalis) that blur the cell borders, against a 'dirty' background lacking lactobacilli. They are the cytologic correlate of bacterial vaginosis.
7Under the Bethesda System, what is the minimum squamous cellularity criterion for a satisfactory liquid-based (e.g., ThinPrep) gynecologic specimen?
A.Approximately 5,000 well-visualized squamous cells
B.Approximately 8,000 to 12,000 squamous cells
C.Approximately 25,000 squamous cells
D.An endocervical component is the only requirement
Explanation: Bethesda requires an estimated minimum of about 5,000 well-visualized/preserved squamous cells for a liquid-based preparation to be satisfactory (8,000-12,000 is the conventional smear minimum). Cellularity is estimated using reference images, not counted.
8A Pap test from a 55-year-old shows multinucleated squamous cells with nuclear molding, peripheral chromatin margination and a ground-glass appearance. Which infection is most likely?
A.Human papillomavirus
B.Herpes simplex virus
C.Cytomegalovirus
D.Trichomonas vaginalis
Explanation: Herpes simplex virus produces the '3 Ms': multinucleation, molding of nuclei against one another, and margination of chromatin to the periphery giving a ground-glass center. Cowdry type A intranuclear inclusions may also be seen.
9Which Bethesda category is used for glandular cells that show atypia exceeding reactive change but lacking unequivocal features of adenocarcinoma?
A.ASC-US
B.AGC (atypical glandular cells)
C.LSIL
D.NILM
Explanation: AGC (atypical glandular cells) covers endocervical, endometrial or otherwise unspecified glandular cells that are atypical beyond a reactive process but not diagnostic of adenocarcinoma in situ or invasive adenocarcinoma. It warrants careful clinical follow-up because of associated risk.
10Endocervical adenocarcinoma in situ (AIS) on cytology classically shows which architectural feature?
A.Single dispersed cells with abundant cytoplasm
B.Crowded strips and rosettes with nuclear feathering at the periphery
C.Flat honeycomb sheets with even spacing
D.Multinucleated giant cells
Explanation: AIS shows hyperchromatic crowded groups arranged as strips, rosettes and pseudostratified columnar clusters, with nuclei protruding at the group edge ('feathering'). Mitoses and apoptotic bodies are common, and a clean background helps distinguish AIS from invasive adenocarcinoma.

About the CT(IAC) Exam Exam

The IAC Cytotechnologist Examination, leading to the CT(IAC) credential from the International Academy of Cytology, is a voluntary international examination that measures the proficiency of experienced cytotechnologists. Since 2024 it is delivered fully digitally and is entirely multiple choice: candidates use their own laptop to view whole-slide images that can be panned, enlarged and zoomed instead of using a microscope. The examination has three sections - digital slides, projected visual images, and 80 written multiple-choice questions - and requires three years of full-time gynecological and non-gynecological cytotechnology experience immediately before the exam. Content spans gynecologic cytology and the Bethesda system, non-gynecologic cytology including respiratory, urinary and body-fluid specimens, fine-needle aspiration of the thyroid, breast, lymph node and salivary gland, microbiology and infections seen in cytology, cytopreparation, quality control, and normal cytology and histology. This bank provides original practice across these areas to help candidates rehearse screening morphology and reporting systems.

Assessment

Three all-multiple-choice sections: digital slides (30 whole-slide images), projected visual images, and 80 written multiple-choice questions. The glass/digital-slide section is scored on a two-level system (Level A categorization, Level B specific diagnosis).

Time Limit

One sitting: 90 minutes for digital slides, about 35 minutes for projected visual images, and roughly 80-90 minutes for the written multiple-choice questions.

Passing Score

The IAC examination committee sets the required standard across all sections; a single fixed percentage pass mark is not published, and the slide section is graded with Level A and Level B scoring.

Exam Fee

90 Euro at the time of writing; confirm the current fee on the official IAC website when you apply. (International Academy of Cytology (IAC))

CT(IAC) Exam Exam Content Outline

40%

Gynecologic Cytology

Pap test screening and reporting with the Bethesda system: specimen adequacy, NILM, ASC-US and ASC-H, LSIL, HSIL, AGC and carcinoma, glandular lesions, HPV cytopathic effect and co-testing, reactive and reparative changes, atrophy, organisms (Trichomonas, Candida, Actinomyces, herpes, bacterial vaginosis) and hormonal patterns.

35%

Non-Gynecologic Cytology and FNA

Respiratory, urinary and serous body-fluid cytology, cerebrospinal fluid, and fine-needle aspiration of thyroid (Bethesda system), breast, lymph node, salivary gland (Milan system) and other sites; urinary cytology and the Paris system; benign, reactive, neoplastic and malignant patterns.

25%

Microbiology, Cytopreparation, Quality and Normal Cytology

Infectious organisms and viral cytopathic effects, Papanicolaou and May-Grunwald-Giemsa staining, fixation, conventional smears versus liquid-based preparation, immunocytochemistry and ancillary molecular testing, quality control and proficiency, laboratory safety, and normal cell and tissue morphology.

How to Pass the CT(IAC) Exam Exam

What You Need to Know

  • Passing score: The IAC examination committee sets the required standard across all sections; a single fixed percentage pass mark is not published, and the slide section is graded with Level A and Level B scoring.
  • Assessment: Three all-multiple-choice sections: digital slides (30 whole-slide images), projected visual images, and 80 written multiple-choice questions. The glass/digital-slide section is scored on a two-level system (Level A categorization, Level B specific diagnosis).
  • Time limit: One sitting: 90 minutes for digital slides, about 35 minutes for projected visual images, and roughly 80-90 minutes for the written multiple-choice questions.
  • Exam fee: 90 Euro at the time of writing; confirm the current fee on the official IAC website when you apply.

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

CT(IAC) Exam Study Tips from Top Performers

1Drill the Bethesda system categories until you can match each cytologic pattern (ASC-US, ASC-H, LSIL, HSIL, AGC) to its criteria and recommended follow-up without hesitation.
2For the digital-slide section, practise systematic whole-slide screening with on-screen zoom and panning so you can categorize at Level A before committing to a Level B specific diagnosis.
3Build a mental atlas of organisms and viral cytopathic effects (Trichomonas, Candida, Actinomyces, HSV, HPV koilocytes) because these recur across gynecologic image questions.
4Learn the non-gynecologic reporting systems side by side: Bethesda for thyroid, Milan for salivary gland and Paris for urinary cytology, including their category numbers and risk of malignancy.
5Review staining and preparation theory - Papanicolaou versus May-Grunwald-Giemsa, fixation, and liquid-based versus conventional smears - because cytopreparation and quality-control questions reward exact knowledge.
6Keep screening real cases during your study period; daily microscopy or digital review keeps pattern recognition sharp for the timed image and slide sections.

Frequently Asked Questions

Is the CT(IAC) examination multiple choice?

Yes. Since 2024 the CT(IAC) examination is delivered fully digitally and every section is multiple choice. Candidates view whole-slide images on their own laptop, which they can pan, enlarge and zoom instead of using a microscope.

How is the CT(IAC) examination structured?

It has three sections: a digital-slide section with 30 whole-slide images (90 minutes), a projected visual-image section (about 35 minutes), and a written section of 80 multiple-choice questions. The slide section uses Level A and Level B scoring.

What experience do I need to sit the CT(IAC) examination?

You need three years of full-time experience in gynecological and non-gynecological cytotechnology immediately before the examination, along with cytotechnology qualifications recognized for practice in your country.

How much does the CT(IAC) examination cost?

The examination fee is 90 Euro at the time of writing. Confirm the current fee and any local administration costs on the official International Academy of Cytology website when you apply.

What reporting systems does the exam cover?

Gynecologic cytology uses the Bethesda system for the Pap test. Non-gynecologic cytology covers the Bethesda system for thyroid FNA, the Milan system for salivary gland and the Paris system for urinary cytology, among other patterns.

How is CT(IAC) different from the IAC International Board of Cytopathology exam?

CT(IAC) certifies cytotechnologists who screen and report cytology specimens. The IAC International Board of Cytopathology exam is a separate diplomate examination for pathologists practicing diagnostic cytopathology.