NBCE Part 4 Exam
What do you placed on the case records sheet for the exam? Think approximately half a
sheet
Patient Name
CC
Observe and Ask
LOC (area)
Onset
Palliative and Provoking
Quality
Radiation
Severity
Temporal Patterns (start getting better/worse) (timing)
PMHx: Surgeries, Hospitalizations, Injuries, Trauma, Meds
Gender
Family Hx: DM, Heart, Cancer
Occupation (does the cc have an effect on their ADLs)
Social Hx: sleep, strain, smoke, sexual, sports, diet, consuming, drug use
ROS: coronary heart, lungs, digestion, EENT, duplicate, neuro, skin, stomach, msk, posture,
weight reduction
Was this cc due to trauma?
What tuning fork do you operate for listening to?
256 Hz
what tuning fork do you operate for vibration?
128 hz
what does Hippironels stand for?
History (ID, CC, Present Illness, Past, circle of relatives, occupation, social, and ROS)
Inspection
Palpation
Instrumentation
Range of Motion
Orthopedics
, Neurological
X-rays (E)
Labs
Special Testing ( NCV, EMG, ECHO, EKG)
Case History Example 1: Fred Murdock is a forty three 12 months old male who's an
automobile mechanic...
Patient states that the ache started out one day ago, the pain is sharp and severe, no
radiation, the severity is moderate except the patient take a deep breath, the patient states
the paon is steady.
Patient has no past scientific history crimson flags or own family records red flags.
The patient states that he become not able to go to work these days and that he feels
vulnerable all over.
The pain became due to a traumatic event.
What is the ddx for Mr. Murdock:
Rib Subluxation
thoraco-costal strain
thoracic subluxation
what is the management alternatives for Mr. Murdock:
regulate the ribs and thoracics
ergonomic schooling
spinous percussion and rib compression checks
Case History Example 2: Marie Strumpell is a forty one yr old woman with a headache.
Patient sppears fearful and emotional. Patient states the vicinity of the headache is temple
region that spreads to the bottom of the neck. The onset changed into 2 months in the past
and became worse three days ago. Rest, quiet makes it better and noises sports, and work
makes it worse.
The exceptional of the ache is throbbing (deep)
there's no radiation of ache
severity is 6-7, slight with the occasional 10.
Patient took aspirin
Dad died when the patient was 4 and mother has a records of complications.
Patient is an afternoon nurse
What do you placed on the case records sheet for the exam? Think approximately half a
sheet
Patient Name
CC
Observe and Ask
LOC (area)
Onset
Palliative and Provoking
Quality
Radiation
Severity
Temporal Patterns (start getting better/worse) (timing)
PMHx: Surgeries, Hospitalizations, Injuries, Trauma, Meds
Gender
Family Hx: DM, Heart, Cancer
Occupation (does the cc have an effect on their ADLs)
Social Hx: sleep, strain, smoke, sexual, sports, diet, consuming, drug use
ROS: coronary heart, lungs, digestion, EENT, duplicate, neuro, skin, stomach, msk, posture,
weight reduction
Was this cc due to trauma?
What tuning fork do you operate for listening to?
256 Hz
what tuning fork do you operate for vibration?
128 hz
what does Hippironels stand for?
History (ID, CC, Present Illness, Past, circle of relatives, occupation, social, and ROS)
Inspection
Palpation
Instrumentation
Range of Motion
Orthopedics
, Neurological
X-rays (E)
Labs
Special Testing ( NCV, EMG, ECHO, EKG)
Case History Example 1: Fred Murdock is a forty three 12 months old male who's an
automobile mechanic...
Patient states that the ache started out one day ago, the pain is sharp and severe, no
radiation, the severity is moderate except the patient take a deep breath, the patient states
the paon is steady.
Patient has no past scientific history crimson flags or own family records red flags.
The patient states that he become not able to go to work these days and that he feels
vulnerable all over.
The pain became due to a traumatic event.
What is the ddx for Mr. Murdock:
Rib Subluxation
thoraco-costal strain
thoracic subluxation
what is the management alternatives for Mr. Murdock:
regulate the ribs and thoracics
ergonomic schooling
spinous percussion and rib compression checks
Case History Example 2: Marie Strumpell is a forty one yr old woman with a headache.
Patient sppears fearful and emotional. Patient states the vicinity of the headache is temple
region that spreads to the bottom of the neck. The onset changed into 2 months in the past
and became worse three days ago. Rest, quiet makes it better and noises sports, and work
makes it worse.
The exceptional of the ache is throbbing (deep)
there's no radiation of ache
severity is 6-7, slight with the occasional 10.
Patient took aspirin
Dad died when the patient was 4 and mother has a records of complications.
Patient is an afternoon nurse
