BATES TEST BANK
tenderness
You are assessing a patient with joint pain and are trying to decide whether it is inflammatory
or noninflammatory in nature. Which one of the following symptoms is consistent with an
inflammatory process?
A) Tenderness
B) Cool temperature
C) Ecchymosis
D) Nodules
lupus
You are assessing a patient with diffuse joint pains and want to make sure that only the joints
are the problem, and that the pain is not related to other diseases. Which of the following is a
systemic cause of joint pain?
A) Gout
B) Osteoarthritis
C) Lupus
D) Spondylosis
lyme disease
A 19-year-old college sophomore comes to the clinic for evaluation of joint pains. The
student has been back from spring break for 2 weeks; during her holiday, she went camping.
She notes that she had a red spot, shaped like a target, but then it started spreading, and
then the joint pains started. She used insect repellant but was in an area known to have
ticks. She has never been sick and takes no medications routinely; she has never been
sexually active. What is the most likely cause of her joint pain?
foot arched
An 85-year-old retired housewife comes with her daughter to establish care. Her daughter is
concerned because her mother has started to fall more. As part of her physical examination,
you ask her to walk across the examination room. Which of the following is not part of the
stance phase of gait?
A) Foot arched
B) Heel strike
C) Mid-stance
D) Push-off
straight leg-raise
A 32-year-old warehouse worker presents for evaluation of low back pain. He notes a
sudden onset of pain after lifting a set of boxes that were heavier than usual. He also states
,that he has numbness and tingling in the left leg. He wants to know if he needs to be off of
work. What test should you perform to assess for a herniated disc?
mechanical low back pain
A 33-year-old construction worker comes for evaluation and treatment of acute onset of low
back pain. He notes that the pain is an aching located in the lumbosacral area. It has been
present intermittently for several years; there is no known trauma or injury. He points to the
left lower back. The pain does not radiate and there is no numbness or tingling in the legs or
incontinence. He was moving furniture for a friend over the weekend. On physical
examination, you note muscle spasm, with normal deep tendon reflexes and muscle
strength. What is the most likely cause of this patient's low back pain?
Cervical sprain
A 50-year-old realtor comes to your office for evaluation of neck pain. She was in a motor
vehicle collision 2 days ago and was assessed by the emergency medical technicians on
site, but she didn't think that she needed to go to the emergency room at that time. Now, she
has severe pain and stiffness in her neck. On physical examination, you note pain and
spasm over the paraspinous muscles on the left side of the neck, and pain when you make
the patient do active range of motion of the cervical spine. What is the most likely cause of
this neck pain?
Fibromyalgia
A 28-year-old graduate student comes to your clinic for evaluation of pain "all over." With
further questioning, she is able to relate that the pain is worse in the neck, shoulders, hands,
low back, and knees. She denies swelling in her joints; she states that the pain is worse in
the morning; there is no limitation in her range of motion. On physical examination, she has
several points on the muscles of the neck, shoulders, and back that are tender to palpation;
muscle strength and range of motion are normal. Which of the following is likely the cause of
her pain?
Rotator cuff tendinitis
A 68-year-old retired banker comes to your clinic for evaluation of left shoulder pain. He
swims for 30 minutes daily, early in the morning. He notes a sharp, catching pain and a
sensation of something grating when he tries overhead movements of his arm. On physical
examination, you note tenderness just below the tip of the acromion in the area of the tendon
insertions. The drop arm test is negative, and there is no limitation with shoulder shrug. The
patient is not holding his arm close to his side, and there is no tenderness to palpation in the
bicipital groove when the arm is at the patient's side, flexed to 90 degrees, and then
supinated against resistance. Based on this description, what is the most likely cause of his
shoulder pain?
tendons
,A high school soccer player "blew out his knee" when the opposing goalie's head and
shoulder struck his flexed knee while the goalie was diving for the ball. All of the following
structures were involved in some way in his injury, but which of the following is actually an
extra-articular structure?
A) Synovium
B) Joint capsule
C) Juxta-articular bone
D) Tendons
Extra-articular
Ray works a physical job and notes pain when he attempts to lift his arm over his head.
When you move the shoulder passively, he has full range of motion without pain and there is
no gross swelling or tenderness. What type of joint disease does this most likely represent?
Cartilaginous
Mark is a contractor who recently injured his back. He was told he had a "bulging disc" to
account for the burning pain down his right leg and slight foot drop. The vertebral bodies of
the spine involve which type of joint?
Temporomandibular joint
Which of the following synovial joints would be an example of a condylar joint?
A) Hip
B) Interphalangeal joints of the hand
C) Temporomandibular joint
D) Intervertebral joint
Pain that is bilateral
A 58-year-old man comes to your office complaining of bilateral back pain that now awakens
him at night. This has been steadily increasing for the past 2 months. Which one of the
following is the most reassuring in this patient with back pain?
A) Age over 50
B) Pain at night
C) Pain lasting more than 1 month or not responding to therapy
D) Pain that is bilateral
Cauda equina
Marion presents to your office with back pain associated with constipation and urinary
retention. Which of the following is most likely?
pain
, Louise, a 60-year-old, complains of left knee pain associated with tenderness throughout,
redness, and warmth over the joint. Which of the following is least helpful in determining if a
joint problem is inflammatory?
A) Tenderness
B) Pain
C) Warmth
D) Redness
Articular joint pain
Pain, swelling, loss of both active and passive motion, locking, and deformity would be
consistent with which of the following?
A) Articular joint pain
B) Bursitis
C) Muscular injury
D) Nerve damage
Gonococcal arthritis
You are working in a college health clinic and seeing a young woman with a red, painful,
swollen DIP joint on the left index finger. There are also a few papules, pustules, and
vesicles on reddened bases, located on the distal extremities. This would be consistent with
with what?
Delayed menarche
An obese 55-year-old woman went through menarche at age 16 and menopause 2 years
ago. She is concerned because an aunt had severe osteoporosis. Which of the following is a
risk factor for osteoporosis?
A) Obesity
B) Late menopause
C) Having an aunt with osteoporosis
D) Delayed menarche
Rheumatoid arthritis
A 38-year-old woman comes to you and has multiple small joints involved with pain,
swelling, and stiffness. Which of the following is the most likely explanation?
A) Rheumatoid arthritis
B) Septic arthritis
C) Gout
D) Trauma
Temporomandibular joint syndrome
Mrs. Fletcher comes to your office with unilateral pain during chewing, which is chronic. She
does not have facial tenderness or tenderness of the scalp. What is the most likely cause of
her pain?
tenderness
You are assessing a patient with joint pain and are trying to decide whether it is inflammatory
or noninflammatory in nature. Which one of the following symptoms is consistent with an
inflammatory process?
A) Tenderness
B) Cool temperature
C) Ecchymosis
D) Nodules
lupus
You are assessing a patient with diffuse joint pains and want to make sure that only the joints
are the problem, and that the pain is not related to other diseases. Which of the following is a
systemic cause of joint pain?
A) Gout
B) Osteoarthritis
C) Lupus
D) Spondylosis
lyme disease
A 19-year-old college sophomore comes to the clinic for evaluation of joint pains. The
student has been back from spring break for 2 weeks; during her holiday, she went camping.
She notes that she had a red spot, shaped like a target, but then it started spreading, and
then the joint pains started. She used insect repellant but was in an area known to have
ticks. She has never been sick and takes no medications routinely; she has never been
sexually active. What is the most likely cause of her joint pain?
foot arched
An 85-year-old retired housewife comes with her daughter to establish care. Her daughter is
concerned because her mother has started to fall more. As part of her physical examination,
you ask her to walk across the examination room. Which of the following is not part of the
stance phase of gait?
A) Foot arched
B) Heel strike
C) Mid-stance
D) Push-off
straight leg-raise
A 32-year-old warehouse worker presents for evaluation of low back pain. He notes a
sudden onset of pain after lifting a set of boxes that were heavier than usual. He also states
,that he has numbness and tingling in the left leg. He wants to know if he needs to be off of
work. What test should you perform to assess for a herniated disc?
mechanical low back pain
A 33-year-old construction worker comes for evaluation and treatment of acute onset of low
back pain. He notes that the pain is an aching located in the lumbosacral area. It has been
present intermittently for several years; there is no known trauma or injury. He points to the
left lower back. The pain does not radiate and there is no numbness or tingling in the legs or
incontinence. He was moving furniture for a friend over the weekend. On physical
examination, you note muscle spasm, with normal deep tendon reflexes and muscle
strength. What is the most likely cause of this patient's low back pain?
Cervical sprain
A 50-year-old realtor comes to your office for evaluation of neck pain. She was in a motor
vehicle collision 2 days ago and was assessed by the emergency medical technicians on
site, but she didn't think that she needed to go to the emergency room at that time. Now, she
has severe pain and stiffness in her neck. On physical examination, you note pain and
spasm over the paraspinous muscles on the left side of the neck, and pain when you make
the patient do active range of motion of the cervical spine. What is the most likely cause of
this neck pain?
Fibromyalgia
A 28-year-old graduate student comes to your clinic for evaluation of pain "all over." With
further questioning, she is able to relate that the pain is worse in the neck, shoulders, hands,
low back, and knees. She denies swelling in her joints; she states that the pain is worse in
the morning; there is no limitation in her range of motion. On physical examination, she has
several points on the muscles of the neck, shoulders, and back that are tender to palpation;
muscle strength and range of motion are normal. Which of the following is likely the cause of
her pain?
Rotator cuff tendinitis
A 68-year-old retired banker comes to your clinic for evaluation of left shoulder pain. He
swims for 30 minutes daily, early in the morning. He notes a sharp, catching pain and a
sensation of something grating when he tries overhead movements of his arm. On physical
examination, you note tenderness just below the tip of the acromion in the area of the tendon
insertions. The drop arm test is negative, and there is no limitation with shoulder shrug. The
patient is not holding his arm close to his side, and there is no tenderness to palpation in the
bicipital groove when the arm is at the patient's side, flexed to 90 degrees, and then
supinated against resistance. Based on this description, what is the most likely cause of his
shoulder pain?
tendons
,A high school soccer player "blew out his knee" when the opposing goalie's head and
shoulder struck his flexed knee while the goalie was diving for the ball. All of the following
structures were involved in some way in his injury, but which of the following is actually an
extra-articular structure?
A) Synovium
B) Joint capsule
C) Juxta-articular bone
D) Tendons
Extra-articular
Ray works a physical job and notes pain when he attempts to lift his arm over his head.
When you move the shoulder passively, he has full range of motion without pain and there is
no gross swelling or tenderness. What type of joint disease does this most likely represent?
Cartilaginous
Mark is a contractor who recently injured his back. He was told he had a "bulging disc" to
account for the burning pain down his right leg and slight foot drop. The vertebral bodies of
the spine involve which type of joint?
Temporomandibular joint
Which of the following synovial joints would be an example of a condylar joint?
A) Hip
B) Interphalangeal joints of the hand
C) Temporomandibular joint
D) Intervertebral joint
Pain that is bilateral
A 58-year-old man comes to your office complaining of bilateral back pain that now awakens
him at night. This has been steadily increasing for the past 2 months. Which one of the
following is the most reassuring in this patient with back pain?
A) Age over 50
B) Pain at night
C) Pain lasting more than 1 month or not responding to therapy
D) Pain that is bilateral
Cauda equina
Marion presents to your office with back pain associated with constipation and urinary
retention. Which of the following is most likely?
pain
, Louise, a 60-year-old, complains of left knee pain associated with tenderness throughout,
redness, and warmth over the joint. Which of the following is least helpful in determining if a
joint problem is inflammatory?
A) Tenderness
B) Pain
C) Warmth
D) Redness
Articular joint pain
Pain, swelling, loss of both active and passive motion, locking, and deformity would be
consistent with which of the following?
A) Articular joint pain
B) Bursitis
C) Muscular injury
D) Nerve damage
Gonococcal arthritis
You are working in a college health clinic and seeing a young woman with a red, painful,
swollen DIP joint on the left index finger. There are also a few papules, pustules, and
vesicles on reddened bases, located on the distal extremities. This would be consistent with
with what?
Delayed menarche
An obese 55-year-old woman went through menarche at age 16 and menopause 2 years
ago. She is concerned because an aunt had severe osteoporosis. Which of the following is a
risk factor for osteoporosis?
A) Obesity
B) Late menopause
C) Having an aunt with osteoporosis
D) Delayed menarche
Rheumatoid arthritis
A 38-year-old woman comes to you and has multiple small joints involved with pain,
swelling, and stiffness. Which of the following is the most likely explanation?
A) Rheumatoid arthritis
B) Septic arthritis
C) Gout
D) Trauma
Temporomandibular joint syndrome
Mrs. Fletcher comes to your office with unilateral pain during chewing, which is chronic. She
does not have facial tenderness or tenderness of the scalp. What is the most likely cause of
her pain?
