BATES’ GUIDE TO PHYSICAL EXAMINATION
AND HISTORY TAKING 13TH EDITION TEST
BANK BY BICKLEY, SZILAGYI, AND RICHARD M
FULL SOLUTIONS
◉ A 22-year-old advertising copywriter presents for evaluation of
joint pain. The pain is new,
located in the wrists and fingers bilaterally, with some subjective
fever. The patient denies a
rash; she also denies recent travel or camping activities. She has a
family history significant for
rheumatoid arthritis. Based on this information, which of the
following pathologic processes
would be the most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic Answer: B) Inflammatory
,The description is most consistent with an inflammatory process,
although all the other etiologies should be considered. Lyme disease
is an infection which commonly causes
arthritis, hemophilia is a hematologic condition which can cause
bleeding in the joints, and trauma can obviously cause joint pain.
◉ A 47-year-old contractor presents for evaluation of neck pain,
which has been intermittent for several years. He normally takes
over-the-counter medications to ease the pain, but this time they
haven't worked as well and he still has discomfort. He recently
wallpapered the entire second floor in his house, which caused him
great discomfort. The pain resolved with rest. He denies fever, chills,
rash, upper respiratory symptoms, trauma, or injury to the neck.
Based on this description, what is the most likely pathologic
process?
A) Infectious
B) Neoplastic
C) Degenerative
D) Traumatic Answer: C) Degenerative
The description is most consistent with degenerative arthritis in the
neck. The
patient has had intermittent symptoms and the questions asked to
elicit pertinent negative and
,positive findings are negative for infectious, traumatic, or neoplastic
disease.
◉ A 15-year-old high school sophomore comes to the clinic for
evaluation of a 3-week history
of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and
nonproductive cough. Which
is the most likely pathologic process?
A) Infection
B) Inflammation
C) Allergic
D) Vascular Answer: C) Allergic
This description is most consistent with allergic rhinitis.
◉ A 19-year old-college student presents to the emergency room
with fever, headache, and
neck pain/stiffness. She is concerned about the possibility of
meningococcal meningitis.
Several of her dorm mates have been vaccinated, but she hasn't
been. Which of the following
physical examination descriptions is most consistent with
meningitis?
, A) Head is normocephalic and atraumatic, fundi with sharp discs,
neck supple with full range
of motion
B) Head is normocephalic and atraumatic, fundi with sharp discs,
neck with paraspinous
muscle spasm and limited range of motion to the right
C) Head is normocephalic and atraumatic, fundi with blurred disc
margins, neck tender to
palpation, unable to perform range of motion
D) Head is normocephalic and atraumatic, fundi with blurred disc
margins, neck supple with
full range of motion Answer: C) Head is normocephalic and
atraumatic, fundi with blurred disc margins, neck tender to
palpation, unable to perform range of motion
Blurred disc margins are consistent with papilledema, and neck
tenderness and lack of range of motion are consistent with neck
stiffness, which in this scenario is likely to be caused
by meningeal inflammation. Kernig's and Brudzinski's signs are also
helpful in testing for meningeal irritation on exam.
◉ A 37-year-old nurse comes for evaluation of colicky right upper
quadrant abdominal pain. The pain is associated with nausea and
AND HISTORY TAKING 13TH EDITION TEST
BANK BY BICKLEY, SZILAGYI, AND RICHARD M
FULL SOLUTIONS
◉ A 22-year-old advertising copywriter presents for evaluation of
joint pain. The pain is new,
located in the wrists and fingers bilaterally, with some subjective
fever. The patient denies a
rash; she also denies recent travel or camping activities. She has a
family history significant for
rheumatoid arthritis. Based on this information, which of the
following pathologic processes
would be the most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic Answer: B) Inflammatory
,The description is most consistent with an inflammatory process,
although all the other etiologies should be considered. Lyme disease
is an infection which commonly causes
arthritis, hemophilia is a hematologic condition which can cause
bleeding in the joints, and trauma can obviously cause joint pain.
◉ A 47-year-old contractor presents for evaluation of neck pain,
which has been intermittent for several years. He normally takes
over-the-counter medications to ease the pain, but this time they
haven't worked as well and he still has discomfort. He recently
wallpapered the entire second floor in his house, which caused him
great discomfort. The pain resolved with rest. He denies fever, chills,
rash, upper respiratory symptoms, trauma, or injury to the neck.
Based on this description, what is the most likely pathologic
process?
A) Infectious
B) Neoplastic
C) Degenerative
D) Traumatic Answer: C) Degenerative
The description is most consistent with degenerative arthritis in the
neck. The
patient has had intermittent symptoms and the questions asked to
elicit pertinent negative and
,positive findings are negative for infectious, traumatic, or neoplastic
disease.
◉ A 15-year-old high school sophomore comes to the clinic for
evaluation of a 3-week history
of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and
nonproductive cough. Which
is the most likely pathologic process?
A) Infection
B) Inflammation
C) Allergic
D) Vascular Answer: C) Allergic
This description is most consistent with allergic rhinitis.
◉ A 19-year old-college student presents to the emergency room
with fever, headache, and
neck pain/stiffness. She is concerned about the possibility of
meningococcal meningitis.
Several of her dorm mates have been vaccinated, but she hasn't
been. Which of the following
physical examination descriptions is most consistent with
meningitis?
, A) Head is normocephalic and atraumatic, fundi with sharp discs,
neck supple with full range
of motion
B) Head is normocephalic and atraumatic, fundi with sharp discs,
neck with paraspinous
muscle spasm and limited range of motion to the right
C) Head is normocephalic and atraumatic, fundi with blurred disc
margins, neck tender to
palpation, unable to perform range of motion
D) Head is normocephalic and atraumatic, fundi with blurred disc
margins, neck supple with
full range of motion Answer: C) Head is normocephalic and
atraumatic, fundi with blurred disc margins, neck tender to
palpation, unable to perform range of motion
Blurred disc margins are consistent with papilledema, and neck
tenderness and lack of range of motion are consistent with neck
stiffness, which in this scenario is likely to be caused
by meningeal inflammation. Kernig's and Brudzinski's signs are also
helpful in testing for meningeal irritation on exam.
◉ A 37-year-old nurse comes for evaluation of colicky right upper
quadrant abdominal pain. The pain is associated with nausea and
