NCCAOM-BIOMEDICINE FINAL EXAM
2026 QUESTIONS AND ANSWERS
1. A patient presents with sharp pain on the radial side of the wrist that worsens when
gripping. A positive Finkelstein test is noted. What is the most likely diagnosis?
A. Carpal Tunnel Syndrome
B. Scaphoid Fracture
C. De Quervain’s Tenosynovitis
D. Intersection Syndrome
Answer: C
Conceptual Explanation: Finkelstein’s test is specifically used to diagnose De Quervain’s
tenosynovitis, which involves the abductor pollicis longus and extensor pollicis brevis
tendons.
2. Which of the following physical exam findings is most suggestive of acute cholecystitis?
A. McBurney’s Point tenderness
B. Murphy’s Sign
C. Rovsing’s Sign
,D. Grey Turner’s Sign
Answer: B
Conceptual Explanation: Murphy’s sign is performed by palpating the right upper
quadrant while the patient inhales; a sharp halt in inspiration due to pain suggests
gallbladder inflammation.
3. A patient taking Lisinopril for hypertension develops a persistent, dry non-productive
cough. This is most likely caused by an increase in which substance?
A. Angiotensin II
B. Aldosterone
C. Renin
D. Bradykinin
Answer: D
Conceptual Explanation: ACE inhibitors like Lisinopril prevent the breakdown of
bradykinin, which can accumulate in the lungs and cause a dry cough.
4. A 65-year-old male presents with sudden onset of ‘the worst headache of his life.’ What is
the most appropriate next step?
A. Refer immediately to the emergency department for a suspected subarachnoid
hemorrhage
B. Advise the patient to take NSAIDs and rest
, C. Perform a complete neurological exam and treat for migraine
D. Schedule an outpatient MRI for the following week
Answer: A
Conceptual Explanation: A ‘thunderclap’ headache or the ‘worst headache of one’s life’ is
a red flag for subarachnoid hemorrhage and requires emergency evaluation.
5. Which cranial nerve is responsible for the motor innervation of the muscles of facial
expression?
A. CN V (Trigeminal)
B. CN VII (Facial)
C. CN IX (Glossopharyngeal)
D. CN XII (Hypoglossal)
Answer: B
Conceptual Explanation: The Facial Nerve (CN VII) provides motor innervation to the
muscles of facial expression, while the Trigeminal Nerve (CN V) provides sensory to the
face and motor to muscles of mastication.
6. An HbA1c level of 8.5% in a patient indicates which of the following?
A. Normal blood glucose control
B. Prediabetes
C. Acute hypoglycemia
2026 QUESTIONS AND ANSWERS
1. A patient presents with sharp pain on the radial side of the wrist that worsens when
gripping. A positive Finkelstein test is noted. What is the most likely diagnosis?
A. Carpal Tunnel Syndrome
B. Scaphoid Fracture
C. De Quervain’s Tenosynovitis
D. Intersection Syndrome
Answer: C
Conceptual Explanation: Finkelstein’s test is specifically used to diagnose De Quervain’s
tenosynovitis, which involves the abductor pollicis longus and extensor pollicis brevis
tendons.
2. Which of the following physical exam findings is most suggestive of acute cholecystitis?
A. McBurney’s Point tenderness
B. Murphy’s Sign
C. Rovsing’s Sign
,D. Grey Turner’s Sign
Answer: B
Conceptual Explanation: Murphy’s sign is performed by palpating the right upper
quadrant while the patient inhales; a sharp halt in inspiration due to pain suggests
gallbladder inflammation.
3. A patient taking Lisinopril for hypertension develops a persistent, dry non-productive
cough. This is most likely caused by an increase in which substance?
A. Angiotensin II
B. Aldosterone
C. Renin
D. Bradykinin
Answer: D
Conceptual Explanation: ACE inhibitors like Lisinopril prevent the breakdown of
bradykinin, which can accumulate in the lungs and cause a dry cough.
4. A 65-year-old male presents with sudden onset of ‘the worst headache of his life.’ What is
the most appropriate next step?
A. Refer immediately to the emergency department for a suspected subarachnoid
hemorrhage
B. Advise the patient to take NSAIDs and rest
, C. Perform a complete neurological exam and treat for migraine
D. Schedule an outpatient MRI for the following week
Answer: A
Conceptual Explanation: A ‘thunderclap’ headache or the ‘worst headache of one’s life’ is
a red flag for subarachnoid hemorrhage and requires emergency evaluation.
5. Which cranial nerve is responsible for the motor innervation of the muscles of facial
expression?
A. CN V (Trigeminal)
B. CN VII (Facial)
C. CN IX (Glossopharyngeal)
D. CN XII (Hypoglossal)
Answer: B
Conceptual Explanation: The Facial Nerve (CN VII) provides motor innervation to the
muscles of facial expression, while the Trigeminal Nerve (CN V) provides sensory to the
face and motor to muscles of mastication.
6. An HbA1c level of 8.5% in a patient indicates which of the following?
A. Normal blood glucose control
B. Prediabetes
C. Acute hypoglycemia
