Bates’ Guide to Physical Examination and History Taking, 11th Edition
Chapter 7: The Head and Neck
Multiple Choice
1. A 38-year-old accountant comes
... [Show More] to your clinic for evaluation of a headache. The throbbing
sensation is located in the right temporal region and is an 8 on a scale of 1 to 10. It started a few
hours ago, and she has noted nausea with sensitivity to light; she has had headaches like this in
the past, usually less than one per week, but not as severe. She does not know of any inciting
factors. There has been no change in the frequency of her headaches. She usually takes an overthe-counter analgesic and this results in resolution of the headache. Based on this description,
what is the most likely diagnosis of the type of headache?
A) Tension
B) Migraine
C) Cluster
D) Analgesic rebound
Ans: B
Chapter: 07
Page and Header: 196, The Health History
Feedback: This is a description of a common migraine (no aura). Distinctive features of a
migraine include phonophobia and photophobia, nausea, resolution with sleep, and unilateral
distribution. Only some of these features may be present.
2. A 29-year-old computer programmer comes to your office for evaluation of a headache. The
tightening sensation is located all over the head and is of moderate intensity. It used to last
minutes, but this time it has lasted for 5 days. He denies photophobia and nausea. He spends
several hours each day at a computer monitor/keyboard. He has tried over-the-counter
medication; it has dulled the pain but not taken it away. Based on this description, what is your
most likely diagnosis?
A) Tension
B) Migraine
C) Cluster
D) Analgesic rebound
Ans: A
Chapter: 07
Page and Header: 196, The Health History
Feedback: This is a description of a typical tension headache.
3. Which of the following is a symptom involving the eye?
A) Scotomas
B) Tinnitus
C) Dysphagia
D) Rhinorrhea
Ans: A
Chapter: 07
Page and Header: 196, The Health History
Feedback: Scotomas are specks in the vision or areas where the patient cannot see; therefore,
this is a common/concerning symptom of the eye.
4. A 49-year-old administrative assistant comes to your office for evaluation of dizziness. You
elicit the information that the dizziness is a spinning sensation of sudden onset, worse with head
position changes. The episodes last a few seconds and then go away, and they are accompanied
by intense nausea. She has vomited one time. She denies tinnitus. You perform a physical
examination of the head and neck and note that the patient's hearing is intact to Weber and Rinne
and that there is nystagmus. Her gait is normal. Based on this description, what is the most likely
diagnosis?
A) Benign positional [Show Less]