NPTE cheat sheet

Orthostatic hypotension criterion: a drop of at least 20 mm Hg systolic or 10 mm Hg diastolic within 3 minutes of standing.

Valsalva maneuver raises intrathoracic pressure, reduces venous return, and can cause transient hypotension, dizziness, or syncope.

Exercise increases sympathetic outflow and circulating catecholamines while parasympathetic withdrawal raises heart rate.

Chronic hypoxemia from lung disease causes pulmonary vasoconstriction, increased right ventricular workload, and cor pulmonale.

Diabetic autonomic neuropathy blunts heart rate responses and predisposes to postural hypotension and exercise intolerance.

Anemia lowers oxygen-carrying capacity; compensatory tachycardia and dyspnea occur during exertion.

Renal failure causes fluid retention and hypertension, increasing cardiac workload and exercise risk.

Immobility reduces venous return, bone mineral density, and glucose tolerance through multiple systems.

Thoracic or abdominal surgery can reduce vital capacity, cough effectiveness, and secretion clearance.

Fall risk factors include age over 65, prior falls, polypharmacy, orthostatic hypotension, cognitive impairment, and gait or balance deficits.

Weight-bearing status: NWB means no weight; TTWB means toe touch; PWB means partial; WBAT means as tolerated; FWB means full.

A gait belt is secured around the waist over clothing and used to guide or stabilize the trunk during transfers and gait.

Universal precautions require gloves for blood or body fluids and hand hygiene before and after patient contact.

Electrical stimulation contraindications include pacemaker over the chest, carotid sinus placement, and pregnancy over the abdomen.

Burn care: avoid ice, assess airway, and cover the wound with a sterile dry dressing.

Seizure precautions: protect the head, remove dangerous objects, do not restrain, and position on the side after the seizure.

Sharps safety: do not recap needles; place used needles directly into a puncture-resistant sharps container.

Orthostatic vital signs are measured supine, seated, and standing; hold ambulation if the patient becomes symptomatic.

Informed consent elements: diagnosis, proposed intervention, risks, benefits, alternatives, and the right to refuse.

HIPAA permits disclosure of the minimum necessary protected health information for treatment, payment, or operations.

State practice acts define PT scope of practice and the tasks that may be delegated to PT aides.

Mandatory reporting includes suspected child abuse, elder abuse, neglect, and certain communicable diseases per state law.

Documentation must be timely, accurate, objective, and dated; late entries are labeled as late.

Negligence elements: duty, breach of duty, causation, and damages.

Conflict of interest: disclose gifts or relationships that could influence clinical decisions.

APTA Code of Ethics emphasizes patient autonomy, informed consent, and nondiscrimination.

Supervision levels include immediate, direct, and indirect; the required level depends on state law and payer rules.

Sensitivity = true positives / (true positives + false negatives); high sensitivity helps rule out disease.

Specificity = true negatives / (true negatives + false positives); high specificity helps rule in disease.

Positive predictive value = true positives / (true positives + false positives) and depends on prevalence.

Negative predictive value = true negatives / (true negatives + false negatives) and depends on prevalence.

Relative risk = incidence in exposed / incidence in unexposed.

Odds ratio for a 2x2 table = (a x d) / (b x c).

Number needed to treat = 1 / absolute risk reduction.

A p value is the probability of obtaining results at least as extreme as observed if the null hypothesis is true.

A confidence interval excluding the null value (1 for ratios, 0 for differences) indicates statistical significance.

Ottawa ankle rules: X-ray if malleolar pain plus bony tenderness at the posterior malleoli or inability to bear weight for 4 steps.

Ottawa knee rules: X-ray if age 55 or older, isolated patellar tenderness, fibular head tenderness, inability to flex 90 degrees, or inability to bear weight.

Hip capsular pattern: internal rotation most limited, then flexion, abduction, and extension.

Shoulder capsular pattern: external rotation most limited, then abduction, then internal rotation.

Radiculopathy shows dermatomal pain or numbness, myotomal weakness, diminished reflex, and a positive straight leg raise.

A strain injures muscle or tendon; a sprain injures a ligament.

ACL resists anterior tibial translation; PCL resists posterior tibial translation.

Trendelenburg sign indicates weakness of the stance-side hip abductors, especially gluteus medius.

Muscle strain grades: I mild, II moderate partial tear, III complete tear.

Upper motor neuron signs include hyperreflexia, spasticity, Babinski sign, and clonus.

Lower motor neuron signs include fasciculations, atrophy, hypotonia, and areflexia.

Key dermatomes: C6 thumb, C7 middle finger, C8 little finger, L4 medial leg, L5 dorsum of foot, S1 lateral foot.

Key myotomes: C5 shoulder abduction, C6 elbow flexion, C7 elbow extension, L3 knee extension, L4 ankle dorsiflexion, S1 plantarflexion.

Glasgow Coma Scale: eye 1-4, verbal 1-5, motor 1-6; total score 3-15.

Cranial nerve VII controls facial movement; cranial nerves IX and X control gag and swallow.

Spinal shock after SCI causes flaccid paralysis, absent reflexes, and sensory loss below the lesion.

Autonomic dysreflexia: hypertension, bradycardia, headache, and sweating; sit upright and remove the noxious stimulus.

Deep tendon reflexes: biceps C5-6, brachioradialis C5-6, triceps C7, patellar L2-4, Achilles S1-2.

Normal resting heart rate is 60-100 bpm; normal blood pressure is below 120/80 mm Hg; normal respiratory rate is 12-20 breaths/min.

Cardiac output = heart rate x stroke volume; normal resting cardiac output is 4-8 L/min.

1 MET = 3.5 mL O2/kg/min; 2-3 METs is light activity and 4-6 METs is moderate activity.

Borg RPE scale ranges 6-20; RPE 12-14 corresponds to moderate intensity.

COPD: pursed-lip breathing and diaphragmatic breathing reduce dyspnea and dynamic hyperinflation.

FEV1/FVC below 0.70 indicates an obstructive pattern; restrictive pattern shows reduced FVC with normal or high ratio.

Peripheral arterial disease: intermittent claudication, diminished pulses, dependent rubor, and pallor on elevation.

DVT: unilateral calf pain or swelling; avoid massage; duplex ultrasound is used for confirmation.

Heart failure: exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and edema; weight gain of 2 kg or more in 3 days suggests fluid retention.