NPTE Clinical Files

By Dr. Kyle Rice

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Description

NPTE Clinical Files is a podcast from the creator of Dominating the NPTE, hosted by Kyle Rice. NPTE Clinical Files explains a true clinical scenario in the form of a mock NPTE-based question. Each question is followed by a set of answer choices, where Dr. Kyle Rice explains the right answer with a detailed rationale. Each season covers all of the major systems and topics found in physical therapy and likely to be found on an NPTE. NPTE Clinical Files gives the Physical Therapist a weekly opportunity to solve clinical puzzles while learning the latest research related to the topic.

Episode Date
S01 Episode 27 - Standard Wheelchair Measurements
10:24

Sonia presents to physical therapy post-MVA a T10 spinal cord injury. She has been using a wheelchair for her primary mode of transportation and now has bilateral hip pain. The physical therapist is challenged with prescribing the correct wheelchair changes in order to reduce hip pain. 

Do you know standard wheelchair measurements?

We will uncover all of it in this excellent episode about standard wheelchair measurements.

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Jun 15, 2018
S01 Episode 26 - Knee Biomechanics
10:06

Keven presents to physical therapy with an MCL sprain that he suffered during a basketball game. The physical therapist is challenged with understanding joint biomechanics during a full squat.  

Can you recall and apply knee biomechanics to a clinical case?

We will uncover how in this excellent episode about assessing joint biomechanics. 

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Jun 13, 2018
S01 Episode 25 - TMJ Dysfunction
09:30

Jessie presents to physical therapy with right-sided jaw pain and a long history of clicking during mouth opening. The physical therapist is challenged with correlating subjective information with a physical assessment to determine the patient's diagnosis. 

Do you know the difference between disc displacement and capsular fibrosis?

We will uncover all of it in this excellent episode about diagnosing TMJ dysfunction.

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Jun 08, 2018
S01 Episode 24 - Assessing Lab Values
12:55

James is being seen in the acute care setting for community-acquired pneumonia. The patient has several lab values that the therapist must assess to determine appropriateness for PT services.

Do you know normal lab values, critical levels, and when it is appropriate to treat your patient? 

We will uncover all of it in this excellent episode about assessing lab values.

Click to listen now:

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Jun 06, 2018
S01 Episode 23 - Lumbar Herniated Disc
09:53

Xavier presents with excruciating lower back pain secondary to a lifting accident at work. The patient's MRI confirms a lumbar HNP at L4-L5. 

The physical therapist is challenged with determining what findings are consistent with the patient's diagnosis. 

Do you know the most common examination findings of a patient with an L4-L5 HNP? We will uncover all of it in this excellent episode about Lumbar Herniated Discs. 

Click to listen now:

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Jun 01, 2018
S01 Episode 22 - Middle Cerebral Artery Stroke
13:03

Pam has a history of a middle cerebral artery stroke and is currently having difficulty combing her hair. Despite multiple teaching strategies, the patient she continues to show no improvement. 

The physical therapist is challenged with uncovering the specific phenomenon that is present. 

Do you know the differences between signs of aphasia and apraxia? We will uncover all of it in this excellent episode about middle cerebral artery strokes.

Click to listen now:
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May 30, 2018
S01 Episode 21 - Traumatic Brain Injury
11:27

Trevor is a 19 year old male who suffered a TBI after a tragic diving incident at the pool. The therapist has categorized the patient as having a level IV on the RLA scale.  

The physical therapist is challenged with understanding factors that can increase the patient's level of confusion. 

We will learn how to treat a level IV TBI without increasing their level of confusion in this excellent episode about traumatic brain injuries. 

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May 23, 2018
S01 Episode 20 - Claudication
10:53

Eddie is a 71-year-old male who presents with significant leg pain after ambulating greater than 5 minutes. The patient reports that the symptoms are getting progressively worse over time. 

The physical therapist is challenged with correlating the findings of an ABI test and the subjective assessment. 

Do you know your ABI scale? We will uncover all of it in this excellent episode about claudication. 

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May 18, 2018
S01 Episode 19 - Electromyography
10:43

Daniel is a 17 year old male who fell off a ladder fracturing his proximal tibia. The patient has severed his common peroneal nerve and is undergo EMG.

The physical therapist is challenged with anticipating what readings will show up on the patient's EMG report. 

We will uncover the answer in this excellent episode about Electromyography. 

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May 16, 2018
S01 Episode 18 - Diabetes Mellitus Type 2
12:06

Janice presents to physical therapy with a past medical history consistent with diabetes mellitus type 2. The patient also has a resting blood glucose level of 275 mg/dl prior to today's treatment. 

The physical therapist is challenged with understanding the correct exercise protocol and glucose monitoring procedures with a patient who presents with hyperglycemia. 

We will uncover the answer in this excellent episode about treating a patient diabetes mellitus type 2.

 

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May 11, 2018
S01 Episode 17 - Adolescent Lower Extremity Pain
10:57

Angela presents to physical therapy with a 5-year history of intermittent flare-ups of her hip and knee joints bilaterally. Angela has a history of joint stiffness and unexplained weight loss. 

The physical therapist is challenged with diagnosing the correct condition utilizing a subjective assessment.  

We will uncover the answer in this excellent episode about adolescent lower extremity pain. 

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May 09, 2018
S01 Episode 16 - Plantar Foot Pain
11:36

Drew presents to physical therapy with complaints of plantar surface foot pain. The patient states the symptoms are progressive and have a burning and tingling type sensation.

The physical therapist is challenged with identifying the correct condition based on the subjective assessment and confirming the condition with the correct examination tools. 

We will uncover the answer in this excellent episode about diagnosing plantar foot pain. 

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May 04, 2018
S01 Episode 15 - Cystic Fibrosis
13:58

Shelley presents to physical therapy with complaints of deconditioning and shortness of breath. She has a history consistent with CF and the therapist would like to select the most appropriate interventions to treat her impairments. 

The physical therapist is challenged with selecting the correct interventions to mobilize the patient's secretions. 

We will uncover the answer in this excellent episode about Cystic Fibrosis

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May 02, 2018
S01 Episode 14 - Cerebral Palsy
10:40

Isabelle presents to physical therapy with a history of cerebral palsy and a developmental age of 8 months. 

The physical therapist is challenged with determining which activity the child will not be able to perform given her developmental age. 

Do you know your developmental milestone? When should a child be able to sit independently and rotate their trunk? We will uncover the answer in this excellent episode about cerebral palsy and developmental milestones.   

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Apr 27, 2018
S01 Episode 13 - Right Bicipital Tendinitis
14:33

Michael presents to physical therapy with complaints of severe right shoulder pain. The treating therapist has diagnosed him with bicipital tendinitis.

The physical therapist is challenged with utilizing the correct medication and setup for iontophoresis. 

Do you know the correct setup for iontophoresis? We will uncover the answer in this excellent episode about iontophoresis. 

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Apr 25, 2018
S01 Episode 12 - Infection Control Guidelines
11:08

Cindy is seen in the acute care setting for bacterial meningitis. The treating therapist is concerned about the transmission of her illness to other patients. 

The physical therapist is challenged with selecting and adhering to the correct infection control guidelines. 

Do you know the difference between airborne, droplet, contact and standard infection control precautions? Which one would you use for bacterial meningitis? We will uncover the answer in this excellent episode about selecting appropriate infection control guidelines.  

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Apr 20, 2018
S01 Episode 11 - Acute Myocardial Infarction
12:17

Robert is 6 days status post-acute myocardial infarction and is currently being seen in cardiac rehabilitation phase 1. 

The physical therapist is challenged with prescribing the correct exercise intensity to ensure safety during this phase of rehabilitation. 

Do you know the exercise intensity recommendations for a patient post-acute myocardial infarction? We will uncover the answer in this excellent episode about exercise prescription for a patient status post acute MI. 

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Apr 18, 2018
S01 Episode 10 - Lateral Ankle Sprain
12:55

Jason has a recent onset of a lateral ankle sprain. He is being treated in the outpatient physical therapy clinic with therapeutic ultrasound.

The physical therapist is challenged with determining the cause of the patient's pain underneath the sound head. 

Do you know what ultrasound parameters can lead to pain underneath the ultrasound head? We will uncover the answer in this excellent episode about treating an acute lateral ankle sprain. 

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Apr 13, 2018
S01 Episode 9- Secondary Lymphedema
16:50

Annie has a history of a right radical mastectomy with axillary node dissection. She presents today with secondary lymphedema with a negative stemmer's sign, but her lymphedema no longer improves with elevation.

The physical therapist is challenged with determining the current stage of the lymphedema and selecting the best combination of interventions to reduce Annie's edema. 

Do you know what research states about the best interventions to treat lymphedema? We will uncover the answer in this excellent episode about treating lymphedema. 

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Apr 10, 2018
S01 Episode 8 - Arterial Blood Gases
12:29

Michael is treated in the acute care setting for confusion, restlessness, and blurred vision. The patient presents with impaired arterial blood gases. 

The physical therapist is challenged with recognizing signs and symptoms related to arterial blood gas dysfunction and determining the specific type of condition present. 

Do you know your arterial blood gas values? What is normal and what isn't? The answer is what we will uncover in this excellent episode based on examining arterial blood gases. 

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Apr 06, 2018
S01 Episode 7 - Low Back Pain
15:40

Amiee is a 35-year-old female who developed low back pain after 

The physical therapist is challenged with recognizing signs an symptoms related to a specific low back condition and determining the approach steps to treating the condition.

Do you know the most effective interventions to resolve lower back pain? This is what we will uncover in this excellent episode based on treating a patient with low back pain.

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Apr 04, 2018
S01 Episode 6 - Anterior Cerebral Artery Stroke
14:46

John is a 56-year-old male who had an anterior cerebral artery stroke.

The physical therapist is challenged with determining the specific Brunnstrom stage and the appropriate intervention to treat a patient in this stage. 

This is what we will uncover in this excellent episode based on treating a patient with an Anterior Cerebral Artery Stroke.

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Mar 28, 2018
S01 Episode 5 - Diastasis Recti
11:33

Mary is a 32-year-old female who is 2 weeks postpartum and presents with a 2.25cm diastasis recti. 

The physical therapist is challenged with recalling the proper treatment strategy for a patient with DR and avoiding exercises that can increase the severity of the separation.

Which intervention is the best to treat a 2.25cm diastasis recti? 

This is what we will uncover in this excellent episode based on treating a patient with Diastasis Recti.

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Mar 21, 2018
S01 Episode 4 - Hypothyroidism
12:12

Shirley is a 48-year-old female who has a past medical history of hypothyroidism. She has non-pitting edema, dry skin, and poor peripheral circulation.  

The physical therapist is challenged with recalling the signs and symptoms consistent with hypothyroidism while using critical thinking to eliminate attractive answer choices. 

Which examination finding should we expect to find with our patient?

This is what we will uncover in this excellent episode based on evaluating a patient with hypothyroidism.

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Mar 14, 2018
S01 Episode 3 - Congestive Heart Failure
16:33

Darryl is a 59-year-old male who presents the physical therapy with Class III Congestive Heart Failure. He has arrived from the inpatient unit after a severe exacerbation of his CHF but he is cleared by his M.D. for exercise.

The physical therapist is challenged with understanding the pathophysiology related to congestive heart failure as well as the New York Heart Association stages.

This knowledge is required in order to make sound and safe judgments regarding exercise prescription.

Should we send this patient back to the physician for medical clearance or treat him?

This is what we will uncover in this excellent episode based on treating Class III congestive heart failure.

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[ Listen Here ] 

 

Mar 07, 2018
S01 Episode 2 - Duchene's Muscular Dystrophy
14:09

David is an 11-year old male with a history of Duchene's Muscular Dystrophy (DMD). He is coming to physical therapy with complaints of difficulty with ADLs.

The physical therapist is challenged with understanding the progression of this condition as well as the primary impairments in each stage. 

The physical therapist in this clinical scenario is creating a sound POC and will need to know what to focus on to provide the most significant impact on the patient's condition. Is David's primary impairment weakness or limitations in soft tissue mobility? 

This is what we will uncover in this excellent episode based on treating DMD. 

[Listen Here] 

Feb 27, 2018
S01 Episode 1- The Proximal Humeral Fracture
14:58

This first episode of The NPTE Clinical Files focuses on a patient named, Betty, who fell from her bed three weeks ago. 

Unfortunately, she sustained a closed proximal humeral fracture and is now presenting to physical therapy for rehabilitation. 

The physical therapist is challenged with determining the primary impairments in this stage of healing along with selecting a safe intervention to address this impairment.

Several factors should be considered when treating a fracture...

Are you familiar with the indications, precautions, and contraindications related to the treatment of a proximal humeral fracture? 

Listen to this podcast as Dr. Rice explains Betty's story and how physical therapy should be handled at three weeks out. 

Are you looking for an active NPTE prep group with committed members who are dedicated to passing the NPTE? Finally, there is an active and free NPTE Prep Facebook group to help you get some structure and direction. Get in our group! http://bit.ly/SNPGroup 

 

 

Feb 16, 2018