NBCE Part II flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Sensitivity formula

Sensitivity equals true positives divided by true positives plus false negatives; it is the proportion of people with disease who correctly test positive.

Positive likelihood ratio

LR-positive equals sensitivity divided by one minus specificity. Values above 10 substantially raise post-test probability; values between 2 and 5 raise it modestly.

Post-test odds calculation

Multiply pre-test odds by the likelihood ratio to obtain post-test odds, then convert odds to probability using probability equals odds divided by one plus odds.

HbA1c diagnostic threshold

An HbA1c of 6.5 percent or greater, fasting plasma glucose of 126 mg/dL or greater, or two-hour OGTT of 200 mg/dL or greater diagnoses diabetes.

Glasgow Coma Scale

Scores eye, verbal, and motor responses for a total of 3 to 15; a score of 8 or less indicates severe impairment and typically prompts airway protection.

McBurney point tenderness

Point one-third the distance from the anterior superior iliac spine to the umbilicus; tenderness there suggests acute appendicitis and warrants urgent surgical evaluation.

C7 reflex and myotome

The C7 nerve root supplies the triceps brachii for elbow extension and the triceps reflex; the middle finger is its characteristic dermatomal sensory area.

L5 motor and sensory

L5 innervates the extensor hallucis longus and ankle dorsiflexors and supplies sensation to the dorsum of the foot and great toe.

Upper motor neuron signs

Hyperreflexia, spasticity, Babinski sign, and clonus indicate upper motor neuron lesions; lower motor neuron lesions instead cause atrophy, fasciculations, and hyporeflexia.

Straight leg raise test

Passive hip flexion with the knee extended reproduces radicular leg pain between 30 and 70 degrees, suggesting lower lumbar disc herniation or nerve root irritation.

Spurling test

Cervical extension, ipsilateral rotation, and axial compression reproduce radicular arm pain, indicating cervical foraminal narrowing or nerve root compression.

Hoffman sign significance

Forceful snapping of the middle fingernail causing reflexive thumb and index finger flexion suggests cervical myelopathy and warrants further neurologic workup.

MRI absolute contraindications

Ferromagnetic intracranial aneurysm clips, most cardiac pacemakers, cochlear implants, and metallic intraocular foreign bodies are absolute contraindications because the magnetic field can dislodge or heat them.

Meyerding spondylolisthesis grading

Grades I through V describe 0-25, 26-50, 51-75, 76-100, and greater than 100 percent anterior translation of one vertebra over the one below.

T1 versus T2 MRI

On T1-weighted images fat is bright and fluid is dark; on T2-weighted images fluid becomes bright, making edema and cerebrospinal fluid conspicuous.

Five radiographic densities

From most radiolucent to most radiopaque: air, fat, water or soft tissue, bone, and metal. Recognizing these densities guides interpretation of any plain film.

Scotty dog sign

On oblique lumbar radiographs the pars interarticularis forms the dog's neck; a break there indicates spondylolysis and appears as a collared Scotty dog.

Diversified technique characteristics

Uses high-velocity low-amplitude thrusts delivered with a specific pisiform contact and short lever, often with the patient side-posture for lumbar segments.

Vertebrobasilar insufficiency screening

Ask about the five Ds (dizziness, diplopia, dysarthria, dysphagia, drop attacks) and three Ns (nausea, numbness, nystagmus) before cervical manipulation.

Flexion-distraction indication

Cox technique uses slow, repeated flexion-distraction of the spine; it is commonly selected for disc herniation, radiculopathy, and spinal stenosis.

Absolute manipulation contraindications

Acute fracture, dislocation, malignancy involving bone, spinal infection, upper cervical instability, and cauda equina syndrome are absolute contraindications to high-velocity thrust manipulation.

Activator instrument adjusting

A spring-loaded or electromechanical instrument delivers a low-force, high-speed impulse; it is often chosen for patients who cannot tolerate manual thrusts.

Vertebral subluxation complex components

The five components are kinesiopathology, neuropathophysiology, myopathology, histopathology, and biochemical abnormalities; together they describe the chiropractic model of spinal dysfunction.

Number of vertebrae by region

The adult spine has 7 cervical, 12 thoracic, 5 lumbar, 5 fused sacral, and 4 coccygeal vertebrae, totaling 33 segments before sacral and coccygeal fusion.

First chiropractic adjustment

D. D. Palmer performed the first adjustment in 1895 on Harvey Lillard, a janitor with hearing loss, reportedly restoring his hearing.

Wilk versus AMA ruling

The 1987 federal appellate decision held that the American Medical Association's boycott of chiropractors violated antitrust law, supporting chiropractic's professional standing.

Informed consent elements

Practitioners must disclose diagnosis, nature and risks of proposed care, alternatives, and consequences of refusal, then document the patient's voluntary agreement.

Anion gap formula

Anion gap equals sodium minus the sum of chloride and bicarbonate; the normal range is roughly 8 to 12 mEq/L, with elevation suggesting metabolic acidosis.

Friedewald LDL calculation

LDL cholesterol approximates total cholesterol minus HDL cholesterol minus triglycerides divided by five, valid when triglycerides are below 400 mg/dL.

Phases of tissue healing

Hemostasis occurs within hours, inflammation peaks over the first four days, proliferation lasts roughly four to twenty-one days, and remodeling may continue for a year.

Erythrocyte sedimentation rate

ESR is a nonspecific marker of inflammation; a common upper reference is age divided by two in men and age plus ten divided by two in women.

Normal serum potassium range

Serum potassium normally ranges from about 3.5 to 5.0 mEq/L; values outside this range risk cardiac arrhythmia and require prompt evaluation.