560I FUNCTIONAL MEDICINE COMP ACTUAL
PAPER 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◉ Finding elevated urinary alpha-ketoisocaproate and alpha-
ketoisovalerate is an indication of what essential nutrient
deficiency?
A.) Coenzyme Q10
B.) Vitamin B1
C.) Vitamin B6
D.) Vitamin D. Answer: B.) Vitamin B1
◉ When serum lipid peroxides are elevated even though all serum
antioxidant vitamins are in their upper normal ranges, what other
abnormality is likely to be present?
A.) High vitamin D
B.) High polyunsaturated fatty acids in plasma
C.) Low polyunsaturated fatty acids in plasma
D.) Low biotin. Answer: B.) High polyunsaturated fatty acids in
plasma
◉ Which compound is measured as a laboratory test for vitamin K
deficiency?
,A.) Sepiapterin
B.) Undercarboxylated osteocalcin
C.) 7-Dehydrocholesterol
D.) Dehydroascorbic acid. Answer: B.) Undercarboxylated
osteocalcin
◉ Assessment of vitamin D deficiency is done by measuring serum
levels of what compound?
A.) 1,25-Dihydroxyvitamin D
B.) Calcitriol
C.) 25-Hydroxyvitamin D
D.) Previtamin D3. Answer: C.) 25-Hydroxyvitamin D
◉ A patient can have normal serum vitamin B12, but still show
elevated urinary methylmalonate because
A. Methylmalonate causes anemia from folic acid deficiency.
B.) The folate trap prevents proper methylation.
C.) Methylmalonate metabolism requires intra-cellular activity of
vitamin B12.
D.) Vitamin B12 promotes the formation of methylmalonate..
Answer: C.) Methylmalonate metabolism requires intra-cellular
activity of vitamin B12.
,◉ Which of the following is NOT a folate deficiency sign?
A.) Plasma homocysteine elevation
B.) Neutrophyl hypersegmentation
C.) Urinary xanthurenic acid elevation
D.) Urinary formiminoglutamate elevation. Answer: C.) Urinary
xanthurenic acid elevation
◉ Which vitamin insufficiencies are indicated by elevated branched
chain keto acids in urine?
A.) Antioxidants
B.) Ascorbates
C.) B-complex
D.) Cholecalciferols. Answer: C.) B-Complex
◉ Why is it incorrect to speak of a "folic acid" deficiency?
A.) Folic acid is not related to tetrahydrofolate
B.) Folic acid is not an essential nutrient
C.) Human tissues can synthesize folic acid
D.) Folic acid is highly toxic. Answer: B.) Folic acid is not an essential
nutrient
◉ Vitamin B6 deficiency causes elevated homocysteine by what
mechanism?
, A.) Accelerating the conversion of methionine to homocysteine
B.) Blocking the transfer of methyl groups to THF
C.) Impairing the conversion of homocysteine to cysteine
D.) Reducing the active form of vitamin B12. Answer: C.) Impairing
the conversion of homocysteine to cysteine
◉ What does the abbreviation BH4 represent?
A.) A part of vitamin B12 structure
B.) A catabolic product of vitamin B6
C.) Tetrahydrobiopterin
D.) A test for B-complex vitamin deficiency. Answer: C.)
Tetrahydrobiopterin
◉ Which of the following is NOT useful for assessing iron status?
A.) Transferrin saturation
B.) Hair iron concentration
C.) Serum ferritin
D.) Total iron binding capacity. Answer: Hair iron concentration
◉ A patient with chronic negative calcium balance is expected to
have elevated calcium in which specimen type?
A.) Erythrocytes
PAPER 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◉ Finding elevated urinary alpha-ketoisocaproate and alpha-
ketoisovalerate is an indication of what essential nutrient
deficiency?
A.) Coenzyme Q10
B.) Vitamin B1
C.) Vitamin B6
D.) Vitamin D. Answer: B.) Vitamin B1
◉ When serum lipid peroxides are elevated even though all serum
antioxidant vitamins are in their upper normal ranges, what other
abnormality is likely to be present?
A.) High vitamin D
B.) High polyunsaturated fatty acids in plasma
C.) Low polyunsaturated fatty acids in plasma
D.) Low biotin. Answer: B.) High polyunsaturated fatty acids in
plasma
◉ Which compound is measured as a laboratory test for vitamin K
deficiency?
,A.) Sepiapterin
B.) Undercarboxylated osteocalcin
C.) 7-Dehydrocholesterol
D.) Dehydroascorbic acid. Answer: B.) Undercarboxylated
osteocalcin
◉ Assessment of vitamin D deficiency is done by measuring serum
levels of what compound?
A.) 1,25-Dihydroxyvitamin D
B.) Calcitriol
C.) 25-Hydroxyvitamin D
D.) Previtamin D3. Answer: C.) 25-Hydroxyvitamin D
◉ A patient can have normal serum vitamin B12, but still show
elevated urinary methylmalonate because
A. Methylmalonate causes anemia from folic acid deficiency.
B.) The folate trap prevents proper methylation.
C.) Methylmalonate metabolism requires intra-cellular activity of
vitamin B12.
D.) Vitamin B12 promotes the formation of methylmalonate..
Answer: C.) Methylmalonate metabolism requires intra-cellular
activity of vitamin B12.
,◉ Which of the following is NOT a folate deficiency sign?
A.) Plasma homocysteine elevation
B.) Neutrophyl hypersegmentation
C.) Urinary xanthurenic acid elevation
D.) Urinary formiminoglutamate elevation. Answer: C.) Urinary
xanthurenic acid elevation
◉ Which vitamin insufficiencies are indicated by elevated branched
chain keto acids in urine?
A.) Antioxidants
B.) Ascorbates
C.) B-complex
D.) Cholecalciferols. Answer: C.) B-Complex
◉ Why is it incorrect to speak of a "folic acid" deficiency?
A.) Folic acid is not related to tetrahydrofolate
B.) Folic acid is not an essential nutrient
C.) Human tissues can synthesize folic acid
D.) Folic acid is highly toxic. Answer: B.) Folic acid is not an essential
nutrient
◉ Vitamin B6 deficiency causes elevated homocysteine by what
mechanism?
, A.) Accelerating the conversion of methionine to homocysteine
B.) Blocking the transfer of methyl groups to THF
C.) Impairing the conversion of homocysteine to cysteine
D.) Reducing the active form of vitamin B12. Answer: C.) Impairing
the conversion of homocysteine to cysteine
◉ What does the abbreviation BH4 represent?
A.) A part of vitamin B12 structure
B.) A catabolic product of vitamin B6
C.) Tetrahydrobiopterin
D.) A test for B-complex vitamin deficiency. Answer: C.)
Tetrahydrobiopterin
◉ Which of the following is NOT useful for assessing iron status?
A.) Transferrin saturation
B.) Hair iron concentration
C.) Serum ferritin
D.) Total iron binding capacity. Answer: Hair iron concentration
◉ A patient with chronic negative calcium balance is expected to
have elevated calcium in which specimen type?
A.) Erythrocytes
