NCCAOM Biomedicine and Diagnosis 3 — Questions and Answers
Question 1: A patient has a blood pressure of 180/110 mmHg, papilledema, and confusion. This presentation is best classified as:
- Hypertensive urgency
- Hypertensive emergency (Correct answer)
- Stage 1 hypertension
- White coat hypertension
Correct answer: Hypertensive emergency
Hypertensive emergency is defined by severely elevated BP with acute target organ damage such as papilledema and altered mental status requiring immediate intervention.
Question 2: The Romberg test primarily evaluates the integrity of which sensory system?
- Vestibular system
- Cerebellar coordination
- Proprioception and dorsal column function (Correct answer)
- Visual acuity
Correct answer: Proprioception and dorsal column function
The Romberg test assesses proprioception; a positive result (increased sway with eyes closed) indicates loss of dorsal column sensory input rather than cerebellar dysfunction.
Question 3: Which dermatome corresponds to the umbilicus?
- T6
- T8
- T10 (Correct answer)
- T12
Correct answer: T10
The T10 dermatome innervates the skin at the level of the umbilicus, a landmark used in neurological and spinal cord injury assessment.
Question 4: A patient's CBC shows microcytic, hypochromic anemia with low serum ferritin. The most likely diagnosis is:
- Vitamin B12 deficiency anemia
- Anemia of chronic disease
- Iron-deficiency anemia (Correct answer)
- Thalassemia trait
Correct answer: Iron-deficiency anemia
Low serum ferritin is the most specific finding for iron-deficiency anemia, which produces small, pale red blood cells (microcytic, hypochromic).
Question 5: Crepitus detected over a joint on passive range-of-motion testing most commonly suggests:
- Acute synovitis
- Osteoarthritis (Correct answer)
- Rheumatoid arthritis
- Ligamentous instability
Correct answer: Osteoarthritis
Crepitus (grinding or crackling sensation) during joint movement is a hallmark of osteoarthritis, reflecting irregular cartilage surfaces rubbing together.
Question 6: Which of the following is the most reliable clinical indicator of dehydration in an adult patient?
- Dry mucous membranes
- Skin tenting
- Orthostatic hypotension (Correct answer)
- Decreased urine output
Correct answer: Orthostatic hypotension
Orthostatic hypotension (a drop of ≥20 mmHg systolic upon standing) is one of the most reliable signs of significant volume depletion in adults.
Question 7: The QRS complex on an ECG represents which cardiac electrical event?
- Atrial depolarization
- Ventricular repolarization
- Ventricular depolarization (Correct answer)
- AV node conduction
Correct answer: Ventricular depolarization
The QRS complex reflects simultaneous ventricular depolarization, the electrical activation that triggers ventricular contraction.
NCCAOM Biomedicine and Diagnosis 3
A patient has a blood pressure of 180/110 mmHg, papilledema, and confusion.
This presentation is best classified as: