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 ...
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
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