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
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
