Deck 21: Diseases of the Genitourinary System

Question 1

A patient is admitted to the hospital for further evaluation of stage 4 kidney disease. The patient is known to have been born with only one kidney, and on routine checkup, it was found that the patient's kidney function was markedly abnormal. One year ago, the patient's lab test results were relatively normal. The patient's blood pressure was monitored, and it was decided that medications would be necessary to treat the patient's hypertension. The patient was advised about fluid intake and restriction and dietary considerations regarding protein and potassium. Referral was made to a nephrologist because the CKD appears to be progressing rapidly, and arrangements may be necessary for dialysis.Final Diagnoses: Chronic progressive renal failure, stage 4
Hypertension

A)I12.9, N18.4, Q60.1
B)I12.0, N18.3, Q60.0
C)N18.5, I12.9, Q60.1
D)I12.9, N18.4, Q60.0

Answer 1

D

Question 2

Patient was admitted to the hospital with acute renal failure due to dehydration. Patient will have to be rehydrated slowly due to CHF.

A)E86.0, N18.9, I50.9
B)N17.9, E86.1
C)N17.9, E86.0, I50.9
D)E86.0, N17.9, I50.9

Answer 2

C

Question 3

A patient is admitted to the hospital for fluid overload due to noncompliance with attending renal dialysis sessions. Patient has stage 5 CKD. Multiple sessions of hemodialysis are performed.

A)E87.70, N18.6, Z91.15, 5A1D60Z
B)E87.70, N18.6, Z91.15, 5A1D00Z
C)N18.6, E87.79, Z99.2, 5A1D00Z
D)E87.79, N18.5, Z99.2, 5A1D60Z

Answer 3

A

Question 4

The patient was admitted for treatment of BPH with urinary retention and a history of frequent urinary tract infections. The patient's PSA was normal. A TURP was performed. The patient recovered uneventfully with only minimal hematuria, which had resolved by the time of discharge.Final Diagnosis: Benign prostatic hypertrophy Procedure: Transurethral resection of prostate

A)N41.0, R33.0, Z87.441, 0VB07ZZ
B)N41.1, R33.9, Z87.442, 0VB08ZZ
C)N40.0, R33.8, Z87.442, 0VB08ZZ
D)N40.1, R33.8, Z87.440, 0VB08ZZ

Question 5

A patient is admitted to the hospital with acute renal failure due to dehydration. The patient is treated with IV fluids.

A)E86.0, N18.6
B)E87.1, N17.9
C)N17.9, E86.0
D)N17.9, E87.1

Question 6

Medication(s) that may be used to treat urinary symptoms such as incontinence is/are ____.

A)Detrol
B)Flomax
C)corticosteroids
D)antibiotics

Question 7

A patient is admitted with acute pyelonephritis. Blood cultures are negative, but urine cultures are positive for Escherichia coli. The patient is treated with IV fluids and antibiotics.Discharge Diagnosis: Acute pyelonephritis due to E. coli

A)N11.1, B96.89
B)N11.9, B96.29
C)N10, B96.89
D)N10, B96.20

Question 8

Which of the following is/are Z code(s) that may be used with diseases of the genitourinary system?

A)Z16.21 Resistance to vancomycin
B)Z87.448 Personal history of other diseases of urinary system
C)Z93.59 Artificial opening status, other cystostomy
D)All of the above

Question 9

____ is inflammation of the fallopian tubes, which are the most common site of pelvic inflammation.

A)Endometritis
B)Oophoritis
C)Peritonitis
D)Salpingitis

Question 10

A patient has stage 3 chronic kidney disease and benign hypertension.

A)N18.3, I12.9
B)I12.9, N18.3
C)I12.9, N18.4
D)I13.10, N18.3

Question 11

A patient is admitted to the hospital with fever and chills, flank pain, and burning on urination with increased frequency. CT scan shows stranding around the right kidney consistent with pyelonephritis. Urine culture is positive for Proteus mirabilis. The patient has a long history of obstructive uropathy due to BPH.Final Diagnosis: Fever due to acute pyelonephritis due to P. mirabilis Obstructive uropathy due to benign prostatic hypertrophy

A)N11.0, B96.4, N40.1, N13.8
B)N10, B96.5, N40.0, N13.9
C)N10, B96.4, N40.1, N13.8
D)N11.9, B96.89, N40.0, N13.1

Question 12

A patient was admitted for investigation of asymptomatic microscopic hematuria. The patient plans to donate a kidney to a family member, and any renal disease must be ruled out. The patient had a percutaneous needle biopsy of the left kidney. The patient has a past medical history of GERD, which is treated with Nexium, and had a pneumothorax caused by a motor vehicle accident several years ago.Final Diagnosis: Potential kidney donor with microscopic hematuria Procedure: Diagnostic kidney biopsy

A)R31.21, K21.9, 0TB13ZX
B)R31.21, K21.9, 0T913ZX
C)R31.9, K21.0, 0TB03ZX
D)R31.1, K21.0, 0T903ZX

Question 13

What type of dialysis uses the peritoneal membrane to filter out wastes and excess fluid?

A)HD
B)CAPD
C)CCPD
D)COPD

Question 14

A 28-year-old woman came to the ER with nausea and vomiting, fever, lower abdominal pain, and vaginal discharge with foul odor. The patient was started on IV antibiotics and was transferred to the medical unit. Per social history, the patient has engaged in some high-risk heterosexual sexual practices and was advised regarding safer sex practices. She was discharged with a prescription of oral antibiotics and will follow up with her regular gynecology practitioner.Final Diagnosis: Lower abdominal pain due to pelvic inflammatory disease

A)N73.1, Z72.52
B)N73.9, Z72.51
C)N73.1, Z72.51
D)N73.3, Z72.53

Question 15

Which of the following is NOT a common genitourinary condition?

A)Glomerulonephritis
B)Diabetes
C)Urinary tract infection
D)Chronic renal failure

Question 16

Overflow incontinence is the constant dribbling of urine. Treatments for overflow incontinence include all of the following EXCEPT ____.

A)Kegel exercises
B)diet
C)immediate surgery
D)bladder training

Question 17

____ is a lower urinary tract infection that affects the bladder.

A)Urethritis
B)Pyelonephritis
C)Cystitis
D)None of the above

Question 18

A patient is admitted to the hospital for a percutaneous left kidney biopsy, which confirms Berger disease.Discharge Diagnosis: Berger disease with glomerular lesion

A)N02.8, 0TB13ZX
B)N02.9, 0TB13ZZ
C)N02.8, 0TB13ZZ
D)N02.9, 0TB13ZX

Question 19

____ is abnormal dilation of the renal pelvis caused by pressure from urine that cannot flow past an obstruction in the urinary tract.

A)Genital prolapse
B)Hydronephrosis
C)Oophoritis
D)Pyelonephritis

Question 20

Which of the following can be detected by a urinalysis test?

A)Kidney stones
B)Diabetes
C)Cystitis
D)All of the above

Question 21

The kidneys and ureters are the upper urinary tract, and the bladder and urethra are the lower urinary tract.

Question 22

The main parts of the male genital or reproductive tract include the testes, epididymis, vas deferens, seminal vesicles, prostate, and penis.

Question 23

Cancer of the prostate with radical prostatectomy (including bilateral seminal vesicles) with bilateral regional pelvic lymphadenectomy (diagnostic sampling).

A)D29.1, 0VT00ZZ, 0VT30ZZ, 07BC0ZZ
B)D29.8, 0VT04ZZ, 0VTC4ZZ, 07BC4ZZ
C)C63.7, 0VT04ZZ, 0VTC4ZZ, 07BC4ZX
D)C61, 0VT00ZZ, 0VT30ZZ, 07BC0ZX

Question 24

If causative bacteria are documented by the physician, this code should NEVER be coded in addition to the urinary tract infection.

Question 25

____________________ is a chronic condition in which endometrial material, the tissue that lines the inside of the uterus, grows outside the uterus and attaches to other organs in the pelvic cavity.

Question 26

Patient with ESRD and hypertension is admitted for creation of an arteriovenous graft (left brachial artery to axillary vein using a synthetic graft). Patient has been on dialysis with a M, W, and F schedule for the past 3 months.

A)N18.6, I12.0, 03170JD
B)I12.0, N18.6, Z99.2, 03180JD
C)I10, N18.6, Z99.2, 03150ZD
D)N18.6, Z99.2, 03180K1

Question 27

When the site is known, urinary tract infections are assigned codes based on the site of the infection.

Question 28

____________________ is an inflammation of the glomeruli of the kidneys. It can be a temporary, reversible, or chronic progressive condition, resulting in chronic renal failure and end-stage renal disease.

Question 29

Patient has ESRD on dialysis with a M,W,F schedule but has been noncompliant with hemodialysis sessions. Patient admitted for fluid overload, which was treated with multiple sessions of dialysis. Patient takes medication for hyperparathyroidism of renal origin.

A)E87.70, N18.6, N25.81, Z91.15, 5A1D60Z
B)N18.6, E87.70, Z99.2, N25.81, 5A1D60Z
C)N18.6, Z91.15, E21.1, 5A1D00Z
D)Z99.2, N18.6, N21.1, 5A1D00Z

Question 30

UTI stands for ____________________.

Question 31

Patient was seen in the ER with left flank pain. Discharge diagnosis is stone, left kidney.

A)N20.0, N23
B)N20.0
C)R10.9
D)N23

Question 32

Use of code category N18.- with Z94.0 ALWAYS indicates transplant rejection or failure.

Question 33

Patient is seen for CKD stage 4. The patient's kidney transplant has failed, and he may have to receive dialysis in the near future.

A)T86.12, N18.4, Y83.0
B)N18.4, T86.12, Y83.0
C)N18.4, Z94.0
D)N18.6, T86.12

Question 34

GN stands for ____________________.

Question 35

A kidney transplant is the least common transplant procedure performed and is hardly ever performed when a transplant is needed.

Question 36

Patient was admitted for TURP (partial prostatectomy via endoscope) for BPH with urinary obstruction.

A)N13.8, N40.0, 0VT07ZZ
B)N40.1, N13.8, 0VB08ZZ
C)N40.0, 0VB08ZZ
D)N40.3, N13.8, 0VB07ZZ

Question 37

In ICD-10-CM, there is a code to identify postprocedural renal failure.

Question 38

Patient was seen in the clinic with hematuria. A diagnosis of acute cystitis was made.

A)N30.00
B)N30.01
C)N30.90
D)N30.91

Question 39

____________________ is the presence of blood in the urine.

Question 40

ICD-10-CM classifies chronic kidney disease based on severity.

Question 41

Vesicoureteral reflux with nephropathy of the right kidney: __________

Question 42

Match each definition to one of the following items.
a.Urolithiasis
b.Nephrotic syndrome
c.Fistula
d.Prostatitis
e.Urinary tract infections (UTIs)
f.Hemodialysis
g.Endometritis
h.Renal colic
i.Mastitis
j.Acute renal failure
Term that describes a stone or calculus in the urinary system

Question 43

Male patient with intrinsic sphincter deficiency with urinary stress incontinence with insertion of artificial bladder neck sphincter via open approach: __________

Question 44

Small kidneys, bilaterally: __________

Question 45

Chronic interstitial cystitis: __________

Question 46

Match each definition to one of the following items.
a.Urolithiasis
b.Nephrotic syndrome
c.Fistula
d.Prostatitis
e.Urinary tract infections (UTIs)
f.Hemodialysis
g.Endometritis
h.Renal colic
i.Mastitis
j.Acute renal failure
Uses a machine called a hemodialyzer to remove waste from the blood

Question 47

Hydronephrosis is the abnormal ____________________ of the renal pelvis caused by pressure from urine that cannot flow past an obstruction in the urinary tract.

Question 48

Match each definition to one of the following items.
a.Urolithiasis
b.Nephrotic syndrome
c.Fistula
d.Prostatitis
e.Urinary tract infections (UTIs)
f.Hemodialysis
g.Endometritis
h.Renal colic
i.Mastitis
j.Acute renal failure
Sudden and severe impairment of renal function characterized by oliguria, increased serum urea, and acidosis

Question 49

Vesicoperineal fistula: __________

Question 50

Match each definition to one of the following items.
a.Urolithiasis
b.Nephrotic syndrome
c.Fistula
d.Prostatitis
e.Urinary tract infections (UTIs)
f.Hemodialysis
g.Endometritis
h.Renal colic
i.Mastitis
j.Acute renal failure
Term that describes the intense pain that is associated with the body's efforts to try to force a urinary stone through the ureters

Question 51

Match each definition to one of the following items.
a.Urolithiasis
b.Nephrotic syndrome
c.Fistula
d.Prostatitis
e.Urinary tract infections (UTIs)
f.Hemodialysis
g.Endometritis
h.Renal colic
i.Mastitis
j.Acute renal failure
Inflammation or infection of the breast

Question 52

Match each definition to one of the following items.
a.Urolithiasis
b.Nephrotic syndrome
c.Fistula
d.Prostatitis
e.Urinary tract infections (UTIs)
f.Hemodialysis
g.Endometritis
h.Renal colic
i.Mastitis
j.Acute renal failure
A general term used to describe infections of any area in the urinary tract

Question 53

List one reason a breast biopsy would be performed.

Question 54

Match each definition to one of the following items.
a.Urolithiasis
b.Nephrotic syndrome
c.Fistula
d.Prostatitis
e.Urinary tract infections (UTIs)
f.Hemodialysis
g.Endometritis
h.Renal colic
i.Mastitis
j.Acute renal failure
Inflammation of the prostate that can be either acute or chronic in nature resulting from bacteria or inflammation not caused by bacteria

Question 55

Match each definition to one of the following items.
a.Urolithiasis
b.Nephrotic syndrome
c.Fistula
d.Prostatitis
e.Urinary tract infections (UTIs)
f.Hemodialysis
g.Endometritis
h.Renal colic
i.Mastitis
j.Acute renal failure
A condition marked by proteinuria (protein in the urine); low levels of protein in the blood; swelling of the eyes, feet, and hands; and hypercholesterolemia

Question 56

Stress incontinence is the involuntary loss of small amounts of ____________________ due to increased pressure from coughing, sneezing, or laughing.

Question 57

Match each definition to one of the following items.
a.Urolithiasis
b.Nephrotic syndrome
c.Fistula
d.Prostatitis
e.Urinary tract infections (UTIs)
f.Hemodialysis
g.Endometritis
h.Renal colic
i.Mastitis
j.Acute renal failure
Inflammation of the uterus

Question 58

Rectocele is the descent of the ____________________, pressing against the vaginal wall.

Question 59

Match each definition to one of the following items.
a.Urolithiasis
b.Nephrotic syndrome
c.Fistula
d.Prostatitis
e.Urinary tract infections (UTIs)
f.Hemodialysis
g.Endometritis
h.Renal colic
i.Mastitis
j.Acute renal failure
An abnormal passage between two internal organs or leading from an organ to the surface of the body

Question 60

Hypotonic bladder: __________

Question 61

Ulceration of the vulva: __________

Question 62

Acute and chronic pyelonephritis due to Pseudomonas: __________

Question 63

Priapism: __________

Question 64

CKD stage 2 in patient who has a kidney transplant: __________

Question 65

Carbuncle of the scrotum: __________

Question 66

A patient is admitted with hematuria and renal colic. Renal ultrasound shows a UPJ stone with left hydronephrosis. ESWL on the left ureter was performed. Patient has a history of UTIs and Parkinson disease. __________

Question 67

Mittelschmerz: __________

Question 68

Leukoplakia of vulva: __________

Question 69

Postmenopausal atrophic vaginitis: __________

Question 70

Acute kidney injury (nontraumatic): __________

Question 71

Benign hyperplasia of the prostate with nocturia times three: __________

Question 72

Tight hymenal ring: __________