NCCAOM BIOMEDICINE
COMPREHENSIVE FINAL EXAM
QUESTIONS AND ANSWERS
1. A 55-year-old male presents with sudden onset of severe chest pain that radiates to the
left jaw and arm. An EKG shows ST-segment elevation in leads V1-V4. Which of the following
is the most likely diagnosis?
A. Unstable Angina
B. Pericarditis
C. Anterior Wall Myocardial Infarction
D. Aortic Dissection
Answer: C
Conceptual Explanation: ST-segment elevation in leads V1-V4 specifically indicates an
acute myocardial infarction involving the anterior wall of the heart, usually involving the
left anterior descending artery.
2. Which physical examination maneuver is most specific for diagnosing acute cholecystitis?
A. McBurney’s Sign
,B. Rovsing’s Sign
C. Psoas Sign
D. Murphy’s Sign
Answer: D
Conceptual Explanation: Murphy’s sign involves palpating the right upper quadrant while
the patient inhales; a sharp halt in inspiration due to pain is highly indicative of
cholecystitis.
3. A patient presents with bilateral ‘slapped cheek’ rash and lacy reticular rash on the trunk.
Which virus is the most likely cause?
A. Human Herpesvirus 6
B. Varicella-Zoster Virus
C. Coxsackievirus A16
D. Parvovirus B19
Answer: D
Conceptual Explanation: Parvovirus B19 causes Erythema Infectiosum (Fifth Disease),
characterized by the ‘slapped cheek’ appearance and a reticular rash.
4. Which of the following laboratory findings is most characteristic of Hashimoto’s
Thyroiditis?
A. Low TSH, High Free T4
, B. High TSH, High Free T4
C. High TSH, Low Free T4, Positive TPO antibodies
D. Low TSH, Low Free T4
Answer: C
Conceptual Explanation: Hashimoto’s is primary hypothyroidism; the pituitary
compensates by increasing TSH, while the failing thyroid produces low T4. TPO antibodies
are markers of the autoimmune process.
5. A patient taking Warfarin (Coumadin) should be advised to maintain a consistent intake of
which vitamin to avoid fluctuations in INR?
A. Vitamin C
B. Vitamin D
C. Vitamin B12
D. Vitamin K
Answer: D
Conceptual Explanation: Vitamin K is the antagonist to Warfarin. Sudden increases in
Vitamin K (found in leafy greens) can decrease the drug’s effectiveness and lower the INR.
6. Which cranial nerve is assessed by checking the gag reflex and the symmetry of the soft
palate elevation?
A. CN VII (Facial)
COMPREHENSIVE FINAL EXAM
QUESTIONS AND ANSWERS
1. A 55-year-old male presents with sudden onset of severe chest pain that radiates to the
left jaw and arm. An EKG shows ST-segment elevation in leads V1-V4. Which of the following
is the most likely diagnosis?
A. Unstable Angina
B. Pericarditis
C. Anterior Wall Myocardial Infarction
D. Aortic Dissection
Answer: C
Conceptual Explanation: ST-segment elevation in leads V1-V4 specifically indicates an
acute myocardial infarction involving the anterior wall of the heart, usually involving the
left anterior descending artery.
2. Which physical examination maneuver is most specific for diagnosing acute cholecystitis?
A. McBurney’s Sign
,B. Rovsing’s Sign
C. Psoas Sign
D. Murphy’s Sign
Answer: D
Conceptual Explanation: Murphy’s sign involves palpating the right upper quadrant while
the patient inhales; a sharp halt in inspiration due to pain is highly indicative of
cholecystitis.
3. A patient presents with bilateral ‘slapped cheek’ rash and lacy reticular rash on the trunk.
Which virus is the most likely cause?
A. Human Herpesvirus 6
B. Varicella-Zoster Virus
C. Coxsackievirus A16
D. Parvovirus B19
Answer: D
Conceptual Explanation: Parvovirus B19 causes Erythema Infectiosum (Fifth Disease),
characterized by the ‘slapped cheek’ appearance and a reticular rash.
4. Which of the following laboratory findings is most characteristic of Hashimoto’s
Thyroiditis?
A. Low TSH, High Free T4
, B. High TSH, High Free T4
C. High TSH, Low Free T4, Positive TPO antibodies
D. Low TSH, Low Free T4
Answer: C
Conceptual Explanation: Hashimoto’s is primary hypothyroidism; the pituitary
compensates by increasing TSH, while the failing thyroid produces low T4. TPO antibodies
are markers of the autoimmune process.
5. A patient taking Warfarin (Coumadin) should be advised to maintain a consistent intake of
which vitamin to avoid fluctuations in INR?
A. Vitamin C
B. Vitamin D
C. Vitamin B12
D. Vitamin K
Answer: D
Conceptual Explanation: Vitamin K is the antagonist to Warfarin. Sudden increases in
Vitamin K (found in leafy greens) can decrease the drug’s effectiveness and lower the INR.
6. Which cranial nerve is assessed by checking the gag reflex and the symmetry of the soft
palate elevation?
A. CN VII (Facial)
