The paired-term biochemistry exam comprises five pairs of "unrelated" biochemical terms, where the collection of pairs, overall, is unique for each student. The student selects four of the pairs and answers three short essay questions about each, with a focus on how structure leads to function at the molecular level. Both "structure" and "function" can be interpreted broadly by the student, depending on their understanding of the terms, and their creativity. To do well on the exam, the student needs to have a good understanding of biochemistry. The exam is easy to prepare; holds back cheating even when taken remotely; can be open-book (as practiced here); and received a favorable student response in both an undergraduate and graduate course.