lOMoAR cPSD| 47061011
Bates’ Guide to Physical Examination and History
Taking, 12th Edition
Chapter 16: The Musculoskeletal System
Multiple Choice
1. 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
Ans: A
Chapter: 16
Page and Header: 575, The Health History
Feedback: Tenderness implies an inflammatory process along with increased temperature and
tenderness.
2. 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
Ans: C
Chapter: 16
, lOMoAR cPSD| 47061011
Page and Header: 578, Joint Pain and Systemic Disorders
Feedback: Lupus is a systemic disease, one symptom of which may be joint pain. It is important
to consider the presence of a systemic illness when a patient presents with arthritis.
3. 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? A) Trauma
B) Gonococcal arthritis
C) Psoriatic arthritis
D) Lyme disease
Ans: D
Chapter: 16
Page and Header: 578, Joint Pain and Systemic Disorders
Feedback: Lyme disease is characterized by a target-shaped red spot at the site of the bite, which
disappears, then reappears and starts spreading (erythema migrans). Lyme disease can also result
in joint pain as well as cardiac and neurologic manifestations.
4. 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
, lOMoAR cPSD| 47061011
D) Push-off
Ans: A
Chapter: 16
Page and Header: 587, Techniques of Examination
Feedback: The foot when it is flat is part of the stance phase of gait, not the foot when it is
arched.
5. 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?
A) Leg-length test
B) Straight-leg raise
C) Tinel's test
D) Phalen's test
Ans: B
Chapter: 16
Page and Header: 642, Table 16-1
Feedback: The straight-leg raise involves having the patient lie supine with the examiner raising
the leg. If the patient experiences a sharp pain radiating from the back down the leg in an L5 or S1
distribution, that suggests the presence of a herniated disc.
6. 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
Bates’ Guide to Physical Examination and History
Taking, 12th Edition
Chapter 16: The Musculoskeletal System
Multiple Choice
1. 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
Ans: A
Chapter: 16
Page and Header: 575, The Health History
Feedback: Tenderness implies an inflammatory process along with increased temperature and
tenderness.
2. 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
Ans: C
Chapter: 16
, lOMoAR cPSD| 47061011
Page and Header: 578, Joint Pain and Systemic Disorders
Feedback: Lupus is a systemic disease, one symptom of which may be joint pain. It is important
to consider the presence of a systemic illness when a patient presents with arthritis.
3. 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? A) Trauma
B) Gonococcal arthritis
C) Psoriatic arthritis
D) Lyme disease
Ans: D
Chapter: 16
Page and Header: 578, Joint Pain and Systemic Disorders
Feedback: Lyme disease is characterized by a target-shaped red spot at the site of the bite, which
disappears, then reappears and starts spreading (erythema migrans). Lyme disease can also result
in joint pain as well as cardiac and neurologic manifestations.
4. 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
, lOMoAR cPSD| 47061011
D) Push-off
Ans: A
Chapter: 16
Page and Header: 587, Techniques of Examination
Feedback: The foot when it is flat is part of the stance phase of gait, not the foot when it is
arched.
5. 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?
A) Leg-length test
B) Straight-leg raise
C) Tinel's test
D) Phalen's test
Ans: B
Chapter: 16
Page and Header: 642, Table 16-1
Feedback: The straight-leg raise involves having the patient lie supine with the examiner raising
the leg. If the patient experiences a sharp pain radiating from the back down the leg in an L5 or S1
distribution, that suggests the presence of a herniated disc.
6. 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
