NCCAOM-BIOMEDICINE STUDY GUIDE
EXAM 2026 QUESTIONS AND ANSWERS
1. A 65-year-old patient presents with a sudden onset of ‘the worst headache of my life.’
Physical examination reveals neck stiffness and photophobia. Which of the following is the
most likely diagnosis?
A. Migraine headache
B. Cluster headache
C. Subarachnoid hemorrhage
D. Tension headache
Answer: C
Conceptual Explanation: A sudden ‘thunderclap’ headache described as the worst
headache of one’s life, accompanied by meningeal signs like neck stiffness, is a classic
presentation of subarachnoid hemorrhage, often due to a ruptured aneurysm.
2. Which of the following cranial nerves is responsible for the motor innervation of the
muscles of mastication?
A. CN VII (Facial)
,B. CN IX (Glossopharyngeal)
C. CN V (Trigeminal)
D. CN XII (Hypoglossal)
Answer: C
Conceptual Explanation: The mandibular branch (V3) of the Trigeminal nerve (CN V)
provides motor innervation to the muscles of mastication, including the temporalis and
masseter.
3. A patient with a history of long-term NSAID use presents with epigastric pain that is
relieved by food. Which pathology is most likely?
A. Gastric ulcer
B. Acute pancreatitis
C. Duodenal ulcer
D. Cholecystitis
Answer: C
Conceptual Explanation: Duodenal ulcers often present with pain that is relieved by
eating, whereas gastric ulcer pain is typically exacerbated by food. NSAIDs are a major risk
factor for both.
4. In the cardiac cycle, the S2 heart sound (the ‘dub’) is produced by which event?
A. Closure of the aortic and pulmonary valves
, B. Opening of the aortic and pulmonary valves
C. Closure of the mitral and tricuspid valves
D. Rapid ventricular filling
Answer: A
Conceptual Explanation: The S2 heart sound marks the end of systole and is caused by
the closure of the semilunar valves (aortic and pulmonary).
5. A positive Murphy’s sign during physical examination is strongly suggestive of which
condition?
A. Acute appendicitis
B. Nephrolithiasis
C. Splenic rupture
D. Acute cholecystitis
Answer: D
Conceptual Explanation: Murphy’s sign involves cessation of inspiration upon deep
palpation of the right upper quadrant and is highly indicative of acute cholecystitis.
6. Which laboratory value is the most specific indicator of acute myocardial infarction within
the first 6 hours of chest pain onset?
A. Creatine Kinase (CK-MB)
B. Cardiac Troponin I or T
EXAM 2026 QUESTIONS AND ANSWERS
1. A 65-year-old patient presents with a sudden onset of ‘the worst headache of my life.’
Physical examination reveals neck stiffness and photophobia. Which of the following is the
most likely diagnosis?
A. Migraine headache
B. Cluster headache
C. Subarachnoid hemorrhage
D. Tension headache
Answer: C
Conceptual Explanation: A sudden ‘thunderclap’ headache described as the worst
headache of one’s life, accompanied by meningeal signs like neck stiffness, is a classic
presentation of subarachnoid hemorrhage, often due to a ruptured aneurysm.
2. Which of the following cranial nerves is responsible for the motor innervation of the
muscles of mastication?
A. CN VII (Facial)
,B. CN IX (Glossopharyngeal)
C. CN V (Trigeminal)
D. CN XII (Hypoglossal)
Answer: C
Conceptual Explanation: The mandibular branch (V3) of the Trigeminal nerve (CN V)
provides motor innervation to the muscles of mastication, including the temporalis and
masseter.
3. A patient with a history of long-term NSAID use presents with epigastric pain that is
relieved by food. Which pathology is most likely?
A. Gastric ulcer
B. Acute pancreatitis
C. Duodenal ulcer
D. Cholecystitis
Answer: C
Conceptual Explanation: Duodenal ulcers often present with pain that is relieved by
eating, whereas gastric ulcer pain is typically exacerbated by food. NSAIDs are a major risk
factor for both.
4. In the cardiac cycle, the S2 heart sound (the ‘dub’) is produced by which event?
A. Closure of the aortic and pulmonary valves
, B. Opening of the aortic and pulmonary valves
C. Closure of the mitral and tricuspid valves
D. Rapid ventricular filling
Answer: A
Conceptual Explanation: The S2 heart sound marks the end of systole and is caused by
the closure of the semilunar valves (aortic and pulmonary).
5. A positive Murphy’s sign during physical examination is strongly suggestive of which
condition?
A. Acute appendicitis
B. Nephrolithiasis
C. Splenic rupture
D. Acute cholecystitis
Answer: D
Conceptual Explanation: Murphy’s sign involves cessation of inspiration upon deep
palpation of the right upper quadrant and is highly indicative of acute cholecystitis.
6. Which laboratory value is the most specific indicator of acute myocardial infarction within
the first 6 hours of chest pain onset?
A. Creatine Kinase (CK-MB)
B. Cardiac Troponin I or T
