Deck 20: Diseases of the Musculoskeletal System and Connective Tissue

Question 1

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

Answer 1

A

Question 2

What drug could be given to treat rheumatoid arthritis?

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

Answer 2

C

Question 3

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 3

A

Question 4

____ 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 5

____ 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 6

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 7

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 8

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 postoperative 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

Question 9

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

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

Question 10

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 11

____ is when one vertebra slips on another.

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

Question 12

What drug could be given to treat osteoporosis?

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

Question 13

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 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
D)M80.08xA,0QS03ZZ

Question 14

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

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

Question 15

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 16

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 17

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 18

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

Question 19

____ 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 20

____ 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 21

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

Question 22

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

Question 23

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

Question 24

MATCHING
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 25

MATCHING
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 26

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

Question 27

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 28

____________________ 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 29

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

Question 30

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

Question 31

MATCHING
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 32

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

Question 33

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

Question 34

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

Question 35

MATCHING
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 36

MATCHING
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 37

MATCHING
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 38

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 39

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

Question 40

Myelopathy is compression of the ____________________.

Question 41

Right plantar fasciitis (right): __________

Question 42

MATCHING
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 43

Calcification of lumbar disc: __________

Question 44

Degenerative polyarticular arthritis: __________

Question 45

What does the abbreviation AKA stand for?

Question 46

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 47

Tenosynovitis in the right shoulder: __________

Question 48

What does the abbreviation SLE stand for?

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
Family history of other musculoskeletal diseases

Question 50

Staphylococcal pyogenic arthritis of left knee: __________

Question 51

Internal derangement of left knee: __________

Question 52

Tennis elbow (right): __________

Question 53

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 54

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

Question 55

What is the purpose of the musculoskeletal system?

Question 56

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 57

Chondromalacia of the left patella: __________

Question 58

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 59

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 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
Organ or tissue replaced by other means-right hip

Question 61

A patient is admitted for right THR for hip rheumatoid arthritis.The patient has a past medical history of CVA and myelodysplastic syndrome (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.__________

Question 62

Kaschin-Beck disease,right ankle: __________

Question 63

Ankylosis of right shoulder: __________