NPLEX I case studies
NPLEX I · Put your knowledge to work in context.
The NPLEX (Naturopathic Physicians Licensing Examinations) are administered by NABNE, the North American Board of Naturopathic Examiners - an independent, nonprofit organization formed as a service to the naturopathic profession and the agencies that license or register naturopathic physicians. Regulatory authorities in the US and Canada (with some exceptions) use NPLEX results as part of the licensure or registration process, so the exams are intended for graduates of approved naturopathic medical programs who are pursuing that credential. The NPLEX I case studies are 5 cases and about 3,114 words.
1Fatigue, cold intolerance, and a low TSH in early pregnancy
A 29-year-old woman at 9 weeks gestation presents with 6 weeks of fatigue, constipation, and cold intolerance. She has no prior thyroid history and takes only a prenatal vitamin.
542 words, about 3 min2Chest pain with a normal ECG in a 58-year-old diabetic
A 58-year-old man with type 2 diabetes and hypertension presents at 07:00 with 45 minutes of substernal pressure radiating to the left jaw, associated with nausea and diaphoresis, that began while shoveling snow. He took two sublingual nitroglycerin tablets without relief.
597 words, about 3 min3New focal deficit 3 days after a fall on warfarin
A 74-year-old woman on warfarin for atrial fibrillation (last INR 2.6, checked 5 days ago) is brought in after a mechanical fall at home 3 days ago; she struck the back of her head but did not seek care. This morning her daughter found her confused with right-arm weakness and slurred speech that has fluctuated over 2 hours.
632 words, about 3 min4Refractory hypertension in a patient with resistant disease
A 61-year-old man with obesity (BMI 34), type 2 diabetes, and stage 3a CKD has office BP 158/96 despite lisinopril 40 mg, amlodipine 10 mg, and chlorthalidone 25 mg daily. Home readings average 150/94.
632 words, about 3 min5A rural clinic decides how to screen for colorectal cancer
You are the sole clinician at a rural clinic with 1,200 adult patients, no on-site endoscopy, and a 3-week wait for the nearest colonoscopy center 90 minutes away. Budget allows either (a) mailed FIT kits with navigation, or (b) an annual colonoscopy referral drive.
711 words, about 4 min