1
NBCE EXAM PART 3 EXAM QUESTIONS WITH
DETAILED ANSWERS AND ACTUAL IMAGES| 2
DIFFERENT VERSIONS FOR GUARANTEED PASS
What do you put on the case history sheet for the exam? Think about half a sheet
Patient Name
CC
Observe and Ask
LOC (location)
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 affect their ADLs)
Social Hx: sleep, stress, smoke, sexual, sports, diet, drinking, drug use
ROS: heart, lungs, digestion, EENT, reproduction, neuro, skin, abdomen, msk, posture,
weight loss
Was this cc because of trauma?
What tuning fork do you use for hearing?
256 Hz
what tuning fork do you use for vibration?
128 hz
what does Hippironels stand for?
History (ID, CC, Present Illness, Past, family, 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 43 year old male who is an auto
mechanic...
,2
Patient states that the pain started one day ago, the pain is sharp and intense, no
radiation, the severity is moderate unless the patient take a deep breath, the patient
states the paon is constant.
patient has no past medical history red flags or family history red flags.
the patient states that he was unable to go to work today and that he feels weak all
over.
the pain was due to a traumatic event.
what is the ddx for Mr. Murdock:
Rib Subluxation
thoraco-costal strain
thoracic subluxation
what is the management options for Mr. Murdock:
adjust the ribs and thoracics
ergonomic training
spinous percussion and rib compression tests
Case History Example 2: Marie Strumpell is a 41 year old female with a headache.
Patient sppears nervous and emotional. Patient states the location of the headache is
temple area that spreads to the base of the neck. The onset was 2 months ago and
became worse three days ago. Rest, quiet makes it better and noises activities, and
work makes it worse.
The quality of the pain is throbbing (deep)
there is no radiation of pain
severity is 6-7, moderate with the occasional 10.
Patient took aspirin
Dad died when the patient was 4 and mom has a history of headaches.
patient is a day nurse
patient states that she gets dizzy and is clumsy with no trauma related to the
headaches.
what is the likelye diagnosis of Marie S?
tumor
migraine headache
depression
what is the management for Marie S?
refer to an oncologist
refer to a psychiatrist
refer to a neurologist
Case History Example 3: June Hanover is a 25 year old female who is a
housewife.
, 3
patient has joint pain in the wrists and shoulder (patient rubs right wrist and supports it
throughout the interview). the joints hurt from time to time.
The patient states that it started with the baby last year (9 month old)
sleep makes it better and feels achy all over the is radiation into the neck and shoulders
today
severity is 3-10 with achy constantly
gyn and md say its post patrum depression
family history is dad fights depression mom is healthy
social hx is unremarkable
emotional: hurts all over
ROS: kidney infections, skin rashes, joints hurt to flex, hand and feet swollen most of
the time.
Diagnosis of Mrs. Hanover:
Systemic Lupus
Fibromyalgia
Gonococcal arthralgia
what is the management options for Mrs. Hanover?
refer to a rheumatologist
trail of adjustments and co-care
STD Evaluation
Case History Example 4: Frank Flowerfi. the eld is a 58 year old male
Patient is a heavy equipment manager. Patient has bad antalgia where its hard to get
out bed and has to go to the bathroom 2-3 times a night. Patient has had low back pain
on and off for the last 2 years. Patient points to the location of pain near the lumbosacral
region. The patient states that the last 3 days have been worse episode ever. with deep
achy pain that radiates into the left foot with a 8-9 severity level.
has hypertension and takes diuretics regularly.
bladder always feels full and can't void as well as he use to.
What is the ddx for Mr. Flowerfield?
disc involvement
prostate disease
cancer
what are some additional tests to perform on case 4?
radionuclide test
bone panel
cystometric evaluation
Vitals:
NBCE EXAM PART 3 EXAM QUESTIONS WITH
DETAILED ANSWERS AND ACTUAL IMAGES| 2
DIFFERENT VERSIONS FOR GUARANTEED PASS
What do you put on the case history sheet for the exam? Think about half a sheet
Patient Name
CC
Observe and Ask
LOC (location)
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 affect their ADLs)
Social Hx: sleep, stress, smoke, sexual, sports, diet, drinking, drug use
ROS: heart, lungs, digestion, EENT, reproduction, neuro, skin, abdomen, msk, posture,
weight loss
Was this cc because of trauma?
What tuning fork do you use for hearing?
256 Hz
what tuning fork do you use for vibration?
128 hz
what does Hippironels stand for?
History (ID, CC, Present Illness, Past, family, 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 43 year old male who is an auto
mechanic...
,2
Patient states that the pain started one day ago, the pain is sharp and intense, no
radiation, the severity is moderate unless the patient take a deep breath, the patient
states the paon is constant.
patient has no past medical history red flags or family history red flags.
the patient states that he was unable to go to work today and that he feels weak all
over.
the pain was due to a traumatic event.
what is the ddx for Mr. Murdock:
Rib Subluxation
thoraco-costal strain
thoracic subluxation
what is the management options for Mr. Murdock:
adjust the ribs and thoracics
ergonomic training
spinous percussion and rib compression tests
Case History Example 2: Marie Strumpell is a 41 year old female with a headache.
Patient sppears nervous and emotional. Patient states the location of the headache is
temple area that spreads to the base of the neck. The onset was 2 months ago and
became worse three days ago. Rest, quiet makes it better and noises activities, and
work makes it worse.
The quality of the pain is throbbing (deep)
there is no radiation of pain
severity is 6-7, moderate with the occasional 10.
Patient took aspirin
Dad died when the patient was 4 and mom has a history of headaches.
patient is a day nurse
patient states that she gets dizzy and is clumsy with no trauma related to the
headaches.
what is the likelye diagnosis of Marie S?
tumor
migraine headache
depression
what is the management for Marie S?
refer to an oncologist
refer to a psychiatrist
refer to a neurologist
Case History Example 3: June Hanover is a 25 year old female who is a
housewife.
, 3
patient has joint pain in the wrists and shoulder (patient rubs right wrist and supports it
throughout the interview). the joints hurt from time to time.
The patient states that it started with the baby last year (9 month old)
sleep makes it better and feels achy all over the is radiation into the neck and shoulders
today
severity is 3-10 with achy constantly
gyn and md say its post patrum depression
family history is dad fights depression mom is healthy
social hx is unremarkable
emotional: hurts all over
ROS: kidney infections, skin rashes, joints hurt to flex, hand and feet swollen most of
the time.
Diagnosis of Mrs. Hanover:
Systemic Lupus
Fibromyalgia
Gonococcal arthralgia
what is the management options for Mrs. Hanover?
refer to a rheumatologist
trail of adjustments and co-care
STD Evaluation
Case History Example 4: Frank Flowerfi. the eld is a 58 year old male
Patient is a heavy equipment manager. Patient has bad antalgia where its hard to get
out bed and has to go to the bathroom 2-3 times a night. Patient has had low back pain
on and off for the last 2 years. Patient points to the location of pain near the lumbosacral
region. The patient states that the last 3 days have been worse episode ever. with deep
achy pain that radiates into the left foot with a 8-9 severity level.
has hypertension and takes diuretics regularly.
bladder always feels full and can't void as well as he use to.
What is the ddx for Mr. Flowerfield?
disc involvement
prostate disease
cancer
what are some additional tests to perform on case 4?
radionuclide test
bone panel
cystometric evaluation
Vitals:
