NCCAOM-BIOMEDICINE 2026
ADVANCED COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. A 55-year-old male presents with sudden onset of severe pain in the first
metatarsophalangeal joint. Laboratory results show elevated serum uric acid levels. Which of
the following medications is most appropriate for acute management of this condition?
A. Allopurinol
B. Probenecid
C. Colchicine
D. Warfarin
Answer: C
Conceptual Explanation: Colchicine or NSAIDs are used for acute gout attacks. Allopurinol
and Probenecid are used for chronic management and may worsen an acute attack if
started during the flare.
,2. Which of the following physical examination findings is most characteristic of a patient
with Parkinson’s disease?
A. Cogwheel rigidity
B. Intention tremor
C. Hyperreflexia
D. Muscle fasciculations
Answer: A
Conceptual Explanation: Parkinson’s disease is characterized by a resting tremor,
bradykinesia, and cogwheel rigidity. Intention tremor is typical of cerebellar dysfunction.
3. A patient taking Lisinopril for hypertension develops a persistent, dry cough. This side
effect is primarily attributed to the accumulation of which substance?
A. Bradykinin
B. Renin
C. Angiotensin II
D. Aldosterone
Answer: A
Conceptual Explanation: ACE inhibitors like Lisinopril block the breakdown of
bradykinin, leading to its accumulation in the lungs, which causes a dry cough in some
patients.
, 4. Which cranial nerve is responsible for the efferent limb of the corneal reflex?
A. Facial nerve (CN VII)
B. Oculomotor nerve (CN III)
C. Trigeminal nerve (CN V)
D. Abducens nerve (CN VI)
Answer: A
Conceptual Explanation: The Trigeminal nerve (CN V) is the afferent limb (sensory),
while the Facial nerve (CN VII) is the efferent limb (motor, causing the eye to blink).
5. A positive McMurray test indicates potential injury to which of the following structures?
A. Meniscus
B. Medial collateral ligament
C. Anterior cruciate ligament
D. Patellar tendon
Answer: A
Conceptual Explanation: The McMurray test is a physical exam maneuver used to identify
a tear in the meniscus of the knee.
6. In a patient with suspected iron deficiency anemia, which of the following lab findings
would be most expected?
A. High MCV, high ferritin
ADVANCED COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. A 55-year-old male presents with sudden onset of severe pain in the first
metatarsophalangeal joint. Laboratory results show elevated serum uric acid levels. Which of
the following medications is most appropriate for acute management of this condition?
A. Allopurinol
B. Probenecid
C. Colchicine
D. Warfarin
Answer: C
Conceptual Explanation: Colchicine or NSAIDs are used for acute gout attacks. Allopurinol
and Probenecid are used for chronic management and may worsen an acute attack if
started during the flare.
,2. Which of the following physical examination findings is most characteristic of a patient
with Parkinson’s disease?
A. Cogwheel rigidity
B. Intention tremor
C. Hyperreflexia
D. Muscle fasciculations
Answer: A
Conceptual Explanation: Parkinson’s disease is characterized by a resting tremor,
bradykinesia, and cogwheel rigidity. Intention tremor is typical of cerebellar dysfunction.
3. A patient taking Lisinopril for hypertension develops a persistent, dry cough. This side
effect is primarily attributed to the accumulation of which substance?
A. Bradykinin
B. Renin
C. Angiotensin II
D. Aldosterone
Answer: A
Conceptual Explanation: ACE inhibitors like Lisinopril block the breakdown of
bradykinin, leading to its accumulation in the lungs, which causes a dry cough in some
patients.
, 4. Which cranial nerve is responsible for the efferent limb of the corneal reflex?
A. Facial nerve (CN VII)
B. Oculomotor nerve (CN III)
C. Trigeminal nerve (CN V)
D. Abducens nerve (CN VI)
Answer: A
Conceptual Explanation: The Trigeminal nerve (CN V) is the afferent limb (sensory),
while the Facial nerve (CN VII) is the efferent limb (motor, causing the eye to blink).
5. A positive McMurray test indicates potential injury to which of the following structures?
A. Meniscus
B. Medial collateral ligament
C. Anterior cruciate ligament
D. Patellar tendon
Answer: A
Conceptual Explanation: The McMurray test is a physical exam maneuver used to identify
a tear in the meniscus of the knee.
6. In a patient with suspected iron deficiency anemia, which of the following lab findings
would be most expected?
A. High MCV, high ferritin
