NCCAOM BIOMEDICINE
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A 55-year-old patient presents with sudden onset of severe epigastric pain radiating to the
back, along with nausea and vomiting. Lab results reveal significantly elevated serum lipase.
What is the most likely diagnosis?
A. Acute Cholecystitis
B. Acute Pancreatitis
C. Perforated Peptic Ulcer
D. Myocardial Infarction
Answer: B
Conceptual Explanation: The clinical triad of epigastric pain radiating to the back,
vomiting, and elevated serum lipase is highly specific for acute pancreatitis.
2. Which of the following physical examination findings is most indicative of a positive
Murphy sign?
A. Pain in the RLQ during palpation of the LLQ
,B. Pain at the mid-point between the umbilicus and the ASIS
C. Inspiration arrest during deep palpation of the right subcostal area
D. Pain in the RUQ when the patient coughs
Answer: C
Conceptual Explanation: Murphy sign is positive when a patient stops breathing in
(inspiratory arrest) because the gallbladder is inflamed and hits the examiner’s hand
during deep palpation of the RUQ.
3. A patient with chronic Vitamin B12 deficiency is at risk for developing which of the
following conditions?
A. Microcytic hypochromic anemia
B. Pernicious anemia and neurological degeneration
C. Increased risk of bone fractures
D. Night blindness
Answer: B
Conceptual Explanation: B12 deficiency causes macrocytic (megaloblastic) anemia and
can lead to subacute combined degeneration of the spinal cord.
4. Which hormone is primarily responsible for the ‘Moon Face’ and ‘Buffalo Hump’ observed
in Cushing’s Syndrome?
A. Cortisol
, B. Thyroxine
C. Aldosterone
D. Growth Hormone
Answer: A
Conceptual Explanation: Cushing’s syndrome results from hypercortisolism, which leads
to fat redistribution to the face and upper back.
5. A positive Babinski sign in an adult (upward movement of the great toe) is indicative of
damage to which system?
A. Lower Motor Neuron (LMN)
B. Basal Ganglia
C. Cerebellum
D. Upper Motor Neuron (UMN)
Answer: D
Conceptual Explanation: The Babinski sign is a classic indicator of corticospinal tract
damage, which is an Upper Motor Neuron lesion.
6. What is the diagnostic threshold for HbA1c to confirm a diagnosis of Diabetes Mellitus?
A. 5.7% or higher
B. 6.5% or higher
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A 55-year-old patient presents with sudden onset of severe epigastric pain radiating to the
back, along with nausea and vomiting. Lab results reveal significantly elevated serum lipase.
What is the most likely diagnosis?
A. Acute Cholecystitis
B. Acute Pancreatitis
C. Perforated Peptic Ulcer
D. Myocardial Infarction
Answer: B
Conceptual Explanation: The clinical triad of epigastric pain radiating to the back,
vomiting, and elevated serum lipase is highly specific for acute pancreatitis.
2. Which of the following physical examination findings is most indicative of a positive
Murphy sign?
A. Pain in the RLQ during palpation of the LLQ
,B. Pain at the mid-point between the umbilicus and the ASIS
C. Inspiration arrest during deep palpation of the right subcostal area
D. Pain in the RUQ when the patient coughs
Answer: C
Conceptual Explanation: Murphy sign is positive when a patient stops breathing in
(inspiratory arrest) because the gallbladder is inflamed and hits the examiner’s hand
during deep palpation of the RUQ.
3. A patient with chronic Vitamin B12 deficiency is at risk for developing which of the
following conditions?
A. Microcytic hypochromic anemia
B. Pernicious anemia and neurological degeneration
C. Increased risk of bone fractures
D. Night blindness
Answer: B
Conceptual Explanation: B12 deficiency causes macrocytic (megaloblastic) anemia and
can lead to subacute combined degeneration of the spinal cord.
4. Which hormone is primarily responsible for the ‘Moon Face’ and ‘Buffalo Hump’ observed
in Cushing’s Syndrome?
A. Cortisol
, B. Thyroxine
C. Aldosterone
D. Growth Hormone
Answer: A
Conceptual Explanation: Cushing’s syndrome results from hypercortisolism, which leads
to fat redistribution to the face and upper back.
5. A positive Babinski sign in an adult (upward movement of the great toe) is indicative of
damage to which system?
A. Lower Motor Neuron (LMN)
B. Basal Ganglia
C. Cerebellum
D. Upper Motor Neuron (UMN)
Answer: D
Conceptual Explanation: The Babinski sign is a classic indicator of corticospinal tract
damage, which is an Upper Motor Neuron lesion.
6. What is the diagnostic threshold for HbA1c to confirm a diagnosis of Diabetes Mellitus?
A. 5.7% or higher
B. 6.5% or higher
