NCCAOM BOARDS: BIOMEDICINE FINAL EXAM 2026 RECENT UPDATE [MOST
EXAMINED QUESTIONS] COMPREHENSIVE QUESTIONS AND CORRECT ANSWERS
GRADED A+ PASSED GET IT RIGHT
Question 1
A patient presents with fatigue, loss of appetite, and symptoms of "wet" beriberi (edema and
heart failure). Which vitamin deficiency is most likely responsible?
A) Vitamin B2 (Riboflavin)
B) Vitamin B3 (Niacin)
C) Vitamin B1 (Thiamin)
D) Vitamin B6 (Pyridoxine)
E) Vitamin B12 (Cobalamin)
Correct Answer: C) Vitamin B1 (Thiamin)
Rationale: Vitamin B1 (thiamin) deficiency causes beriberi. "Dry" beriberi affects the
nervous system (wasting and partial paralysis), while "wet" beriberi affects the
cardiovascular system, leading to edema and heart failure.
Question 2
A patient complains of persistent mouth sores and angular cheilitis (cracks at the corners of the
mouth). Upon examination, the tongue appears magenta. Which deficiency should be suspected?
A) Vitamin B1 (Thiamin)
B) Vitamin B2 (Riboflavin)
C) Vitamin B5 (Pantothenic Acid)
D) Vitamin B9 (Folic Acid)
E) Vitamin B12 (Cobalamin)
Correct Answer: B) Vitamin B2 (Riboflavin)
Rationale: Clinical signs of Vitamin B2 (riboflavin) deficiency include angular cheilitis,
glossitis (magenta tongue), mouth sores, and dry skin.
Question 3
Which vitamin deficiency is specifically associated with adrenal insufficiency and peripheral
nerve damage?
A) Vitamin B1
B) Vitamin B2
C) Vitamin B5 (Pantothenic Acid)
D) Vitamin B6
E) Vitamin B12
Correct Answer: C) Vitamin B5 (Pantothenic Acid)
Rationale: Vitamin B5 is essential for the synthesis of coenzyme A and is involved in adrenal
hormone production. Deficiency can lead to adrenal problems and "burning foot
syndrome" or nerve damage.
Question 4
A patient taking Isoniazid (INH) for tuberculosis is at high risk for developing seizures and
, 2
anemia due to a deficiency in which vitamin?
A) Vitamin B1
B) Vitamin B2
C) Vitamin B3
D) Vitamin B6 (Pyridoxine)
E) Vitamin B12
Correct Answer: D) Vitamin B6 (Pyridoxine)
Rationale: Vitamin B6 deficiency can cause sideroblastic anemia, skin problems, and
neurological issues like seizures. Certain medications, like INH, interfere with B6
metabolism, requiring supplementation.
Question 5
Severe chronic alcoholics are most frequently deficient in which two B-complex vitamins?
A) B1 and B2
B) B3 and B5
C) B6 and B12
D) B9 (Folic Acid) and B12 (Cobalamin)
E) B1 and B6
Correct Answer: D) B9 (Folic Acid) and B12 (Cobalamin)
Rationale: Alcohol interferes with the absorption and storage of many nutrients, but folic
acid and B12 are the most critically depleted, often leading to macrocytic anemia and
neurological decline.
Question 6
A strict vegan patient who does not consume animal products or fortified cereals is most likely to
develop a deficiency in:
A) Vitamin B1
B) Vitamin B2
C) Vitamin B6
D) Vitamin B9
E) Vitamin B12 (Cobalamin)
Correct Answer: E) Vitamin B12 (Cobalamin)
Rationale: Vitamin B12 is found naturally only in animal products (meat, dairy, eggs).
Vegetarians and especially vegans must supplement to avoid pernicious anemia and
irreversible nerve damage.
Question 7
A child presents with hemolytic anemia. Which antioxidant vitamin deficiency is the most likely
cause in the pediatric population?
A) Vitamin A
B) Vitamin C
, 3
C) Vitamin D
D) Vitamin E (Tocopherols)
E) Vitamin K
Correct Answer: D) Vitamin E (Tocopherols)
Rationale: Vitamin E protects red blood cell membranes from oxidative stress. Deficiency in
children or premature infants can lead to the premature destruction of RBCs, known as
hemolytic anemia.
Question 8
A patient presents with thinning hair (alopecia) and scaly skin rashes. They mention they have
been consuming large amounts of raw egg whites. Which vitamin is likely being depleted?
A) Vitamin B1
B) Vitamin B6
C) Vitamin H (Biotin)
D) Vitamin B9
E) Vitamin B12
Correct Answer: C) Vitamin H (Biotin)
Rationale: Biotin (Vitamin H or B7) deficiency causes hair loss and skin problems. Raw egg
whites contain avidin, a protein that binds biotin and prevents its absorption.
Question 9
A patient reports an intense craving for non-food items like ice or dirt (pica), along with fatigue
and brittle nails. Which mineral deficiency is indicated?
A) Zinc
B) Iodine
C) Iron
D) Magnesium
E) Calcium
Correct Answer: C) Iron
Rationale: Iron deficiency is the most common cause of anemia worldwide. Symptoms
include fatigue, poor concentration, itching, and pica (the craving for non-nutritive
substances).
Question 10
A community in a remote mountainous region shows a high prevalence of simple goiter and
cretinism in children. Which mineral is lacking in their diet?
A) Iron
B) Fluoride
C) Zinc
D) Iodine
E) Copper
, 4
Correct Answer: D) Iodine
Rationale: Iodine is essential for thyroid hormone synthesis. Deficiency leads to goiter
(enlarged thyroid) in adults and cretinism (severe developmental delay) in children.
Question 11
Which mineral is essential for immune function, wound healing, and reducing the duration of the
common cold?
A) Iron
B) Iodine
C) Fluoride
D) Zinc
E) Selenium
Correct Answer: D) Zinc
Rationale: Zinc is a critical cofactor for many enzymes involved in cell growth and immune
response. It is used clinically to promote wound healing and manage diarrhea.
Question 12
Which group of nutrients serve as essential coenzymes that facilitate the biochemical reactions in
the Krebs cycle?
A) Fat-soluble vitamins
B) Vitamin C and Vitamin E
C) B vitamins and Biotin (Vitamin H)
D) Iron and Calcium
E) Zinc and Iodine
Correct Answer: C) B vitamins and Biotin (Vitamin H)
Rationale: The Krebs (Citric Acid) cycle requires B vitamins (Thiamin, Riboflavin, Niacin,
Pantothenic acid) and Biotin to function as cofactors for energy production.
Question 13
Which class of drugs is most likely to deplete the entire B-complex group due to interference
with absorption or metabolism?
A) Anticoagulants
B) Oral contraceptives and Hormone Replacement Therapy (HRT)
C) Antihypertensives
D) Antipsychotics
E) Beta-blockers
Correct Answer: B) Oral contraceptives and Hormone Replacement Therapy (HRT)
Rationale: Estrogens found in oral contraceptives and HRT can significantly lower levels of
several B vitamins, including B2, B6, B9, and B12.
EXAMINED QUESTIONS] COMPREHENSIVE QUESTIONS AND CORRECT ANSWERS
GRADED A+ PASSED GET IT RIGHT
Question 1
A patient presents with fatigue, loss of appetite, and symptoms of "wet" beriberi (edema and
heart failure). Which vitamin deficiency is most likely responsible?
A) Vitamin B2 (Riboflavin)
B) Vitamin B3 (Niacin)
C) Vitamin B1 (Thiamin)
D) Vitamin B6 (Pyridoxine)
E) Vitamin B12 (Cobalamin)
Correct Answer: C) Vitamin B1 (Thiamin)
Rationale: Vitamin B1 (thiamin) deficiency causes beriberi. "Dry" beriberi affects the
nervous system (wasting and partial paralysis), while "wet" beriberi affects the
cardiovascular system, leading to edema and heart failure.
Question 2
A patient complains of persistent mouth sores and angular cheilitis (cracks at the corners of the
mouth). Upon examination, the tongue appears magenta. Which deficiency should be suspected?
A) Vitamin B1 (Thiamin)
B) Vitamin B2 (Riboflavin)
C) Vitamin B5 (Pantothenic Acid)
D) Vitamin B9 (Folic Acid)
E) Vitamin B12 (Cobalamin)
Correct Answer: B) Vitamin B2 (Riboflavin)
Rationale: Clinical signs of Vitamin B2 (riboflavin) deficiency include angular cheilitis,
glossitis (magenta tongue), mouth sores, and dry skin.
Question 3
Which vitamin deficiency is specifically associated with adrenal insufficiency and peripheral
nerve damage?
A) Vitamin B1
B) Vitamin B2
C) Vitamin B5 (Pantothenic Acid)
D) Vitamin B6
E) Vitamin B12
Correct Answer: C) Vitamin B5 (Pantothenic Acid)
Rationale: Vitamin B5 is essential for the synthesis of coenzyme A and is involved in adrenal
hormone production. Deficiency can lead to adrenal problems and "burning foot
syndrome" or nerve damage.
Question 4
A patient taking Isoniazid (INH) for tuberculosis is at high risk for developing seizures and
, 2
anemia due to a deficiency in which vitamin?
A) Vitamin B1
B) Vitamin B2
C) Vitamin B3
D) Vitamin B6 (Pyridoxine)
E) Vitamin B12
Correct Answer: D) Vitamin B6 (Pyridoxine)
Rationale: Vitamin B6 deficiency can cause sideroblastic anemia, skin problems, and
neurological issues like seizures. Certain medications, like INH, interfere with B6
metabolism, requiring supplementation.
Question 5
Severe chronic alcoholics are most frequently deficient in which two B-complex vitamins?
A) B1 and B2
B) B3 and B5
C) B6 and B12
D) B9 (Folic Acid) and B12 (Cobalamin)
E) B1 and B6
Correct Answer: D) B9 (Folic Acid) and B12 (Cobalamin)
Rationale: Alcohol interferes with the absorption and storage of many nutrients, but folic
acid and B12 are the most critically depleted, often leading to macrocytic anemia and
neurological decline.
Question 6
A strict vegan patient who does not consume animal products or fortified cereals is most likely to
develop a deficiency in:
A) Vitamin B1
B) Vitamin B2
C) Vitamin B6
D) Vitamin B9
E) Vitamin B12 (Cobalamin)
Correct Answer: E) Vitamin B12 (Cobalamin)
Rationale: Vitamin B12 is found naturally only in animal products (meat, dairy, eggs).
Vegetarians and especially vegans must supplement to avoid pernicious anemia and
irreversible nerve damage.
Question 7
A child presents with hemolytic anemia. Which antioxidant vitamin deficiency is the most likely
cause in the pediatric population?
A) Vitamin A
B) Vitamin C
, 3
C) Vitamin D
D) Vitamin E (Tocopherols)
E) Vitamin K
Correct Answer: D) Vitamin E (Tocopherols)
Rationale: Vitamin E protects red blood cell membranes from oxidative stress. Deficiency in
children or premature infants can lead to the premature destruction of RBCs, known as
hemolytic anemia.
Question 8
A patient presents with thinning hair (alopecia) and scaly skin rashes. They mention they have
been consuming large amounts of raw egg whites. Which vitamin is likely being depleted?
A) Vitamin B1
B) Vitamin B6
C) Vitamin H (Biotin)
D) Vitamin B9
E) Vitamin B12
Correct Answer: C) Vitamin H (Biotin)
Rationale: Biotin (Vitamin H or B7) deficiency causes hair loss and skin problems. Raw egg
whites contain avidin, a protein that binds biotin and prevents its absorption.
Question 9
A patient reports an intense craving for non-food items like ice or dirt (pica), along with fatigue
and brittle nails. Which mineral deficiency is indicated?
A) Zinc
B) Iodine
C) Iron
D) Magnesium
E) Calcium
Correct Answer: C) Iron
Rationale: Iron deficiency is the most common cause of anemia worldwide. Symptoms
include fatigue, poor concentration, itching, and pica (the craving for non-nutritive
substances).
Question 10
A community in a remote mountainous region shows a high prevalence of simple goiter and
cretinism in children. Which mineral is lacking in their diet?
A) Iron
B) Fluoride
C) Zinc
D) Iodine
E) Copper
, 4
Correct Answer: D) Iodine
Rationale: Iodine is essential for thyroid hormone synthesis. Deficiency leads to goiter
(enlarged thyroid) in adults and cretinism (severe developmental delay) in children.
Question 11
Which mineral is essential for immune function, wound healing, and reducing the duration of the
common cold?
A) Iron
B) Iodine
C) Fluoride
D) Zinc
E) Selenium
Correct Answer: D) Zinc
Rationale: Zinc is a critical cofactor for many enzymes involved in cell growth and immune
response. It is used clinically to promote wound healing and manage diarrhea.
Question 12
Which group of nutrients serve as essential coenzymes that facilitate the biochemical reactions in
the Krebs cycle?
A) Fat-soluble vitamins
B) Vitamin C and Vitamin E
C) B vitamins and Biotin (Vitamin H)
D) Iron and Calcium
E) Zinc and Iodine
Correct Answer: C) B vitamins and Biotin (Vitamin H)
Rationale: The Krebs (Citric Acid) cycle requires B vitamins (Thiamin, Riboflavin, Niacin,
Pantothenic acid) and Biotin to function as cofactors for energy production.
Question 13
Which class of drugs is most likely to deplete the entire B-complex group due to interference
with absorption or metabolism?
A) Anticoagulants
B) Oral contraceptives and Hormone Replacement Therapy (HRT)
C) Antihypertensives
D) Antipsychotics
E) Beta-blockers
Correct Answer: B) Oral contraceptives and Hormone Replacement Therapy (HRT)
Rationale: Estrogens found in oral contraceptives and HRT can significantly lower levels of
several B vitamins, including B2, B6, B9, and B12.
