Deck 19: Diseases of the Musculoskeletal System and Connective Tissue

Question 1

Pathologic fracture of distal left femur due to osteosarcoma of femur.

A)M84.552A,C40.22
B)M84.551A,C40.22
C)M84.352A,C40.21
D)M84.552G,C40.10

Answer 1

A

Question 2

The patient was admitted with disc herniation at L4-L5.The patient has failed conservative treatments such as physical therapy.NSAIDs and even steroid injections did not provide much relief.The patient was taken to surgery,and an open discectomy was performed.The patient recovered uneventfully and was discharged.Instructions were given to avoid lifting anything heavier than 10 pounds until after the post-operative clinic visit.Final Diagnosis: Herniated disc.Procedure: Discectomy (partial).

A)M51.27,0ST40ZZ
B)M51.06,0ST20ZZ
C)M51.25,0SB40ZZ
D)M51.26,0SB20ZZ

Answer 2

D

Question 3

Which of the following make(s) up the musculoskeletal system?

A)Bones
B)Ligaments
C)Tendons
D)Cartilage
E)All of the above

Answer 3

E

Question 4

Patient with a family history of rheumatoid arthritis is being screened for rheumatoid arthritis.

A)Z13.820,Z82.69
B)Z13.89,Z82.62
C)Z13.828,Z82.61
D)Z13.828

Question 5

The patient was admitted to the hospital because of severe left hip pain that is often worse during the night.X-rays of the hip were taken in the ER.A preliminary report showed that the patient possibly had Paget's disease of the left femur,which was responsible for the patient's pain.Alkaline phosphatase was elevated,and a bone scan was done to determine the extent of the disease.Final Diagnoses: Severe hip pain due to Paget's disease.

A)M25.552,M88.852
B)M88.852
C)M88.851
D)M88.89

Question 6

An 83-year-old woman with severe back pain is admitted.CT shows osteoporosis and possible compression fracture of the lumbar spine.The patient is seen by interventional radiology,and a percutaneous vertebroplasty and reduction of fracture is performed.Discharge Diagnosis: Pathologic fracture of lumbar vertebra due to senile osteoporosis.

A)M81.0,M80.08xA,0QU03JZ
B)M80.08xG,0QS03ZZ
C)M80.08xA,0QU03JZ,0QS03ZZ
D)M80.08xA,0QS03ZZ

Question 7

____ is/are the front of the body or organ.

A)Anterior
B)Dorsal
C)Proximal
D)Ventral
E)Anterior and ventral

Question 8

A patient is admitted to rule out lupus nephritis.The patient was diagnosed with systemic lupus erythematosus 5 years ago.A percutaneous left kidney biopsy is performed,and lupus nephritis is confirmed.

A)M32.14,0TB13ZX
B)M32.15,0T910ZX
C)M32.14,0TB13ZZ
D)M32.14,0TB13ZX

Question 9

____ is when one vertebra slips on another.

A)Facet joint
B)Spondylosis
C)Spinal stenosis
D)Spondylolisthesis

Question 10

____ is an exaggerated inward curvature of the spine that may be caused by increased abdominal girth due to obesity,pregnancy,or abdominal tumors.

A)Lordosis
B)Kyphosis
C)Scoliosis
D)Myosis

Question 11

What drug could be given to treat rheumatoid arthritis?

A)Boniva
B)Fosamax
C)Celebrex
D)Calcium

Question 12

____ is one of the most common diseases affecting the muscles;it is characterized by widespread muscle pain associated with chronic fatigue.

A)Postlaminectomy syndrome
B)Bursitis
C)Fibromyalgia
D)Rhabdomyolysis

Question 13

The patient was admitted from the ER for chest pain to rule out MI.The patient also had some difficulty breathing and pain when taking a deep breath.The patient does have a family history of ischemic heart disease and is positive for the following cardiac risk factors: male,older than age 65,hypertension,smoker,and overweight.After evaluation and monitoring,an MI was ruled out.Cardiology thought the most likely cause for his chest pain was costochondritis.Final Diagnoses: Chest pain due to costochondritis.Hypertension.Smoker,current nicotine dependence (cigarettes).Overweight.Family history of ischemic heart disease.

A)M94.20,I10,E66.2,F17.211,Z82.49
B)M94.0,I11.9,F17.229,E66.3,Z82.41
C)M94.0,I10,F17.210,E66.3,Z82.49
D)M94.1,I10,Z72.0,E66.8,Z82.49

Question 14

A patient is admitted for a total hip replacement with a metal-on-polyethylene prosthesis because of primary osteoarthritis of the right hip.Patient has had a previous left hip replacement.

A)M16.11,Z96.642,0SRB0J9
B)M16.51,Z96.642,0SRB04Z
C)M16.9,Z96.649,0SR90JZ
D)M16.11,Z96.642,0SR902Z

Question 15

____ is a chronic,inflammatory,autoimmune disease that can damage connective tissue anywhere in the body.It causes inflammation of the skin,joints,nervous system,kidneys,lungs,and other organs.

A)Systemic lupus erythematosus
B)Scleroderma
C)Osteoarthritis
D)Spondylosis

Question 16

Subacute osteomyelitis of sacrum with decubitus sacral ulcer,stage 3.Staphylococcus aureus is the causative organism.

A)M46.28,L89.153,B95.61
B)M46.28,L89.153,B95.62
C)B95.61,M46.28,L89.153
D)M46.27,L89.152,B95.62

Question 17

A pediatric patient was admitted with a pathologic fracture of the proximal right humerus.Radiographic evidence suggests that the fracture was caused by a unicameral bone cyst (solitary).An orthopedic consult was obtained to see whether this should be treated surgically.It was decided to treat conservatively and monitor healing with serial X-rays.Final Diagnosis: Unicameral bone cyst proximal right humerus with pathologic fracture.

A)M84.621A,M85.421
B)M84.622A
C)M85.422,M84.621A
D)M84.621D,M85.421

Question 18

Dorsopathies are conditions or diseases that affect the front or rib cage.

Question 19

____ are the connective tissues that attach muscle to bones.

A)Joints
B)Ligaments
C)Tendons
D)All of the above
E)None of the above

Question 20

What drug could be given to treat osteoporosis?

A)Celebrex
B)Fosamax
C)NSAIDs
D)Muscle relaxant

Question 21

____________________ affects children usually between the ages of 2 and 5 years;it may affect only a few joints or many joints in the body.

Question 22

Match each item to one of the following definitions.
a.Medial
b.Cranial
c.Ventral
d.Superior
e.Caudal
f.Dorsal
g.Lateral
The back of the body or organ

Question 23

ICD-10-CM has different codes to identify laterality for many musculoskeletal conditions.

Question 24

Match each item to one of the following definitions.
a.Medial
b.Cranial
c.Ventral
d.Superior
e.Caudal
f.Dorsal
g.Lateral
Closer to the median plane than another structure in the body

Question 25

Spinal decompression is a surgical procedure that frees the ____________________ in the spinal canal.

Question 26

Match each item to one of the following definitions.
a.Medial
b.Cranial
c.Ventral
d.Superior
e.Caudal
f.Dorsal
g.Lateral
The front of the body or organ

Question 27

ICD-10-CM uses the sixth character extension when coding pathologic fractures.

Question 28

Match each item to one of the following definitions.
a.Medial
b.Cranial
c.Ventral
d.Superior
e.Caudal
f.Dorsal
g.Lateral
Toward the head

Question 29

Match each item to one of the following definitions.
a.Medial
b.Cranial
c.Ventral
d.Superior
e.Caudal
f.Dorsal
g.Lateral
The position of the body or an organ relative to the vertical axis of the body

Question 30

Spinal fusion is the creation of a solid bone bridge between two or more adjacent vertebrae to create stability between levels of the spine.

Question 31

Arthroscopic surgery is a highly invasive surgery that involves the use of instruments to perform surgery through very large incisions.

Question 32

Myelopathy is compression of the ____________________.

Question 33

Alendronate,calcitonin,and calcium with vitamin D are common medications used to treat osteoporosis.

Question 34

Osteomyelitis is an infection of the bone that often starts in another part of the body and is spread by the blood.

Question 35

Match each item to one of the following definitions.
a.Medial
b.Cranial
c.Ventral
d.Superior
e.Caudal
f.Dorsal
g.Lateral
To the side of the body

Question 36

ICD-10-CM has a combination code for osteoporosis with pathologic fracture.

Question 37

Ball joints are small stabilizing joints located between and behind adjacent vertebrae.

Question 38

Spinal stenosis is the widening or rupture of the spinal canal.

Question 39

____________________ is a metabolic bone disorder that results in decreased bone mass and density.

Question 40

Necrotizing fasciitis,also called ____________________,is a rare but serious condition in which an infection occurs in the tissues below the skin.It usually is caused by group A Streptococcus.

Question 41

Match the following Z codes.
a.Z87.39
b.Z82.61
c.Z82.69
d.Z96.641
e.Z89.512
f.Z13.828
g.Z13.820
Special screening-rheumatoid arthritis

Question 42

Internal derangement of left knee: __________

Question 43

Match each item to one of the following definitions.
a.Medial
b.Cranial
c.Ventral
d.Superior
e.Caudal
f.Dorsal
g.Lateral
Toward the tail

Question 44

Match the following Z codes.
a.Z87.39
b.Z82.61
c.Z82.69
d.Z96.641
e.Z89.512
f.Z13.828
g.Z13.820
Family history of arthritis

Question 45

Tennis elbow (right): __________

Question 46

Tenosynovitis in the right shoulder: __________

Question 47

Match the following Z codes.
a.Z87.39
b.Z82.61
c.Z82.69
d.Z96.641
e.Z89.512
f.Z13.828
g.Z13.820
Personal history of arthritis

Question 48

What is the correct abbreviation for dual-energy X-ray absorptiometry?

Question 49

Match the following Z codes.
a.Z87.39
b.Z82.61
c.Z82.69
d.Z96.641
e.Z89.512
f.Z13.828
g.Z13.820
Organ or tissue replaced by other means-right hip

Question 50

Calcification of lumbar disc: __________

Question 51

What does the abbreviation SLE stand for?

Question 52

Match the following Z codes.
a.Z87.39
b.Z82.61
c.Z82.69
d.Z96.641
e.Z89.512
f.Z13.828
g.Z13.820
Lower limb amputation status-below left knee

Question 53

Chondromalacia of the left patella: __________

Question 54

Staphylococcal pyogenic arthritis of left knee: __________

Question 55

Degenerative polyarticular arthritis: __________

Question 56

Right plantar fasciitis (right): __________

Question 57

Match the following Z codes.
a.Z87.39
b.Z82.61
c.Z82.69
d.Z96.641
e.Z89.512
f.Z13.828
g.Z13.820
Special screening-osteoporosis

Question 58

What is the purpose of the musculoskeletal system?

Question 59

What does the abbreviation AKA stand for?

Question 60

Match the following Z codes.
a.Z87.39
b.Z82.61
c.Z82.69
d.Z96.641
e.Z89.512
f.Z13.828
g.Z13.820
Family history of other musculoskeletal diseases

Question 61

Ankylosis of right shoulder: __________

Question 62

Kaschin-Beck disease,right ankle: __________

Question 63

A patient is admitted for right THR for hip rheumatoid arthritis.The patient has a past medical history of CVA and MDS.The patient has an open total hip replacement (ceramic on ceramic prosthesis) and on day 1 is transfused with two autologous units of red blood cells via peripheral vein.Coder queries physician regarding the reason for the blood transfusion,and the physician documents acute blood loss anemia.__________