A 45-year-old male patient presents with sudden onset of severe low back pain that began while lifting a heavy box at work yesterday. Which element of the history is MOST important to document first?
Nbce Part3 Case History
Question · Easy
What six elements does the OPQRST framework prompt a clinician to capture during a pain history?
Case History
Flashcard
A 32-year-old female patient reports headaches that occur 2-3 times per week, described as throbbing pain on the right side of her head, accompanied by nausea and sensitivity to light. Each episode lasts 4-6 hours. Which classification of headache is MOST consistent with this presentation?
Question · Medium
Organ-by-organ checklist built from questions about symptoms the patient has now or has had before.
Patient interview
Guess the Term
Introduction & Exam Overview
1.1 Current Exam Facts
Study guide
Cheat sheet
During the review of systems for a 58-year-old male patient with chronic neck pain, he mentions experiencing dizziness when turning his head to look over his shoulder while driving. Which associated symptom would be MOST concerning for vertebrobasilar insufficiency?
Question · Hard
Read the clue and guess the term in 6 tries.
Game
A patient with new low back pain also reports losing 15 pounds without trying over the past two months. What does this combination of history findings require?
A patient presents with low back pain and states, "I had the same thing about 5 years ago, and it lasted for months." Which aspect of the past medical history is the patient describing?
Chronological account of a complaint from its first sign or symptom, or from the previous visit, to now.
A 28-year-old patient reports consuming 6-8 alcoholic beverages daily and smoking one pack of cigarettes per day. In which section of the case history should this information be recorded?
During history taking, a patient volunteers new saddle numbness and difficulty urinating along with severe low back pain. What must the clinician rule out immediately?
A 52-year-old patient with diabetes and hypertension presents with new-onset foot pain. Which finding in the family history would be MOST relevant to document?
Blood-flow turbulence that is longer than a heart sound and may be systolic, diastolic, or continuous.
Physical Examination
1.2 TMCQ, EMCQ, and DXI Formats
During the cardiovascular examination of a 67-year-old patient, you auscultate a regular rhythm with a rate of 72 beats per minute. You note an extra heart sound immediately preceding S1 that is low-pitched and heard best at the apex. This finding is MOST consistent with:
Nbce Part3 Physical Examination
Swap tiles to line up three of the same term.
Term Match
In an acute trauma case, which history detail should be documented first, ahead of past medical or social history?
A patient presents with acute low back pain. Before performing orthopedic testing, which vital sign measurement would be MOST important to assess?
Swelling of soft tissues caused by increased interstitial fluid; it may be generalized or local.
During a general survey of a 55-year-old patient, you observe pallor of the conjunctivae and nail beds, along with tachycardia at rest. These findings are MOST suggestive of:
A young adult reports morning low back stiffness lasting over an hour that improves with activity, plus a family history of psoriasis. What does this history pattern suggest?
During the respiratory examination of a patient with thoracic spine pain, which finding would be MOST concerning for a cardiopulmonary condition requiring immediate referral?
Supine nerve-root tension test in which pain between 30° and 70° of hip flexion is positive.
Neuromusculoskeletal Examination
1.3 Study Plan and Timed Pacing
During abdominal examination of a patient with low back pain, you palpate a pulsatile mass in the midline superior to the umbilicus. What is the MOST appropriate next action?
Flip two cards at a time to find matching terms.
Term Pairs
What are 'constitutional symptoms' in a case history, and why do they change the clinical picture?
A patient with suspected cervical radiculopathy is asked to extend the neck and rotate toward the symptomatic side. This test is called the:
Nbce Part3 Neuromusculoskeletal Exam
Walking pattern whose normal performance requires integrity of the motor, vestibular, cerebellar, and proprioceptive pathways.
During gait analysis, you observe that a patient's foot makes initial contact with the floor using the lateral border of the foot rather than the heel. This gait pattern is called:
Which four vital signs form the baseline of every physical examination?
The deep tendon reflex test for the C6 nerve root involves tapping which tendon?
Test that is highly sensitive for early bone and joint changes and can detect osteonecrosis before x-rays do.
Radiology
Case History: Complaint and Background
2.1 Chief Complaint
A patient with low back pain is asked to lie supine and raise the straight leg to 30 degrees, which reproduces radiating pain down the posterior thigh to the knee. Which structure is MOST likely being tensioned to produce this symptom?
Find five hidden terms in a grid of letters.
Term Search
A patient has right upper quadrant pain that sharply worsens, stopping their inhalation, when the examiner palpates under the right costal margin. What sign is this and what does it suggest?
During postural examination, you observe that a patient's head is positioned anteriorly relative to the plumb line, with increased cervical lordosis and rounded shoulders. This postural pattern is called:
Central bone-density test, commonly of the hip and spine, reported as a T-score in postmenopausal women and men 50 or older.
A patient reports pain in the buttock and posterior thigh that worsens with sitting. On examination, you note weakness of hip extension and difficulty standing on the affected leg. Which peripheral nerve is MOST likely involved?
Percussion tenderness over the costovertebral angle points to irritation of which organ system?
On a lateral cervical spine radiograph, which finding is MOST consistent with a Jefferson fracture?
Nbce Part3 Diagnostic Imaging
Laboratory panel that measures hemoglobin, red cell indices, white cells, and platelets.
Clinical Laboratory
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