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.
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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
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
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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
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.
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