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1. 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
2. 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
3. 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?
4. foot arched: An 85-year-old retired housewife comes with her daughter to estab-
lish 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
5. 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?
6. mechanical low back pain: A 33-year-old construction worker comes for evalu-
ation 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
, BATES TEST BANK
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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?
7. 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?
8. 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?
9. 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?
10. 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
11. 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?
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12. 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?
13. 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
14. 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
15. Cauda equina: Marion presents to your office with back pain associated with
constipation and urinary retention. Which of the following is most likely?
16. pain: Louise, a 60-year-old, complains of left knee pain associated with tender-
ness 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
17. 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
18. 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?
19. 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?
, BATES TEST BANK
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A) Obesity
B) Late menopause
C) Having an aunt with osteoporosis
D) Delayed menarche
20. 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
21. 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?
22. 2-3 weeks: A man's wife is upset because when she hugs him with her hands on
his left shoulder blade, "it feels creepy." This came on gradually after a recent severe
left-sided rotator cuff tear. How long does it usually take to develop muscular atrophy
with increased prominence of the scapular spine following a rotator cuff tear?
23. Acromioclavicular joint involvement: Phil comes to your office with left "shoul-
der pain." You find that the pain is markedly worse when his left arm is drawn across
his chest (adduction). What would you suspect?
24. Lateral epicondylitis (tennis elbow): Two weeks ago, Mary started a job which
requires carrying 40-pound buckets. She presents with elbow pain worse on the
right. On examination, it hurts her elbows to dorsiflex her hands against resistance
when her palms face the floor. What condition does she have?
25. scaphoid fx: A high school football player injured his wrist in a game. He is
tender between the two tendons at the base of the thumb. Which of the following
should be considered?
26. median nerve: Mrs. Fletcher complains of numbness of her right hand. On
examination, sensation of the volar aspect of the web of the thumb and index finger
and the pulp of the middle finger are normal. The pulp of the index finger has
decreased sensation. Which of the following is affected?
27. Trochanteric bursitis: A 50-year-old woman presents with "left hip pain" of
several weeks duration. There is marked tenderness when you press over her
proximal lateral thigh. What do you think she has?
28. Torn medial meniscus: Sarah presents with left lateral knee pain and has some
locking in full extension. There is tenderness over the medial joint line. When the
knee is extended with the foot externally rotated and some valgus stress is applied,
a click is noted. What is the most likely diagnosis?
Study online at https://quizlet.com/_9xkzvn
1. 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
2. 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
3. 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?
4. foot arched: An 85-year-old retired housewife comes with her daughter to estab-
lish 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
5. 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?
6. mechanical low back pain: A 33-year-old construction worker comes for evalu-
ation 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
, BATES TEST BANK
Study online at https://quizlet.com/_9xkzvn
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?
7. 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?
8. 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?
9. 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?
10. 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
11. 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?
, BATES TEST BANK
Study online at https://quizlet.com/_9xkzvn
12. 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?
13. 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
14. 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
15. Cauda equina: Marion presents to your office with back pain associated with
constipation and urinary retention. Which of the following is most likely?
16. pain: Louise, a 60-year-old, complains of left knee pain associated with tender-
ness 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
17. 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
18. 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?
19. 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?
, BATES TEST BANK
Study online at https://quizlet.com/_9xkzvn
A) Obesity
B) Late menopause
C) Having an aunt with osteoporosis
D) Delayed menarche
20. 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
21. 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?
22. 2-3 weeks: A man's wife is upset because when she hugs him with her hands on
his left shoulder blade, "it feels creepy." This came on gradually after a recent severe
left-sided rotator cuff tear. How long does it usually take to develop muscular atrophy
with increased prominence of the scapular spine following a rotator cuff tear?
23. Acromioclavicular joint involvement: Phil comes to your office with left "shoul-
der pain." You find that the pain is markedly worse when his left arm is drawn across
his chest (adduction). What would you suspect?
24. Lateral epicondylitis (tennis elbow): Two weeks ago, Mary started a job which
requires carrying 40-pound buckets. She presents with elbow pain worse on the
right. On examination, it hurts her elbows to dorsiflex her hands against resistance
when her palms face the floor. What condition does she have?
25. scaphoid fx: A high school football player injured his wrist in a game. He is
tender between the two tendons at the base of the thumb. Which of the following
should be considered?
26. median nerve: Mrs. Fletcher complains of numbness of her right hand. On
examination, sensation of the volar aspect of the web of the thumb and index finger
and the pulp of the middle finger are normal. The pulp of the index finger has
decreased sensation. Which of the following is affected?
27. Trochanteric bursitis: A 50-year-old woman presents with "left hip pain" of
several weeks duration. There is marked tenderness when you press over her
proximal lateral thigh. What do you think she has?
28. Torn medial meniscus: Sarah presents with left lateral knee pain and has some
locking in full extension. There is tenderness over the medial joint line. When the
knee is extended with the foot externally rotated and some valgus stress is applied,
a click is noted. What is the most likely diagnosis?
