Question 1

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

Accepted Answer

M84.552A is the correct code for a pathologic fracture of the left femur due to a neoplasm, and C40.22 is not a valid code for osteosarcoma of the femur; the correct code for osteosarcoma of the femur would be in the C40.2x range, but the specific code for osteosarcoma of the femur was not provided among the options. The choice was selected based on the correct coding for the pathologic fracture, despite the inaccuracy in the neoplasm code provided.

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).

Accepted Answer

D

Question 3

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

Accepted Answer

The musculoskeletal system is made up of bones, ligaments, tendons, and cartilage. Therefore, all of the choices listed make up the musculoskeletal system.

Question 4

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

Accepted Answer

The answer of Patient with a family history of rheumatoid...

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.

Accepted Answer

The correct ICD-10 code for Paget's disease of the left femur is M88.852.

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.

Accepted Answer

The correct ICD-10-CM code for a pathological fracture due to osteoporosis is M80.08xA. The procedure codes for vertebroplasty and fracture reduction are 0QU03JZ and 0QS03ZZ, respectively.

Question 7

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

Accepted Answer

Anterior and ventral both refer to the front of the body or an organ. Anterior is commonly used in human anatomy, while ventral is used across various species, especially in describing the position of body parts in animals.

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.

Accepted Answer

The answer of A patient is admitted to rule out...

Question 9

____ is when one vertebra slips on another.

Accepted Answer

Spondylolisthesis is the condition where one vertebra slips on another, typically in the lumbar region of the spine. Facet joint, spondylosis, and spinal stenosis are all different conditions that can occur in the spine but do not involve one vertebra slipping on another.

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.

Accepted Answer

Lordosis is an exaggerated inward curvature of the spine which may occur due to various reasons like obesity, pregnancy or abdominal tumors. Kyphosis, on the other hand, is an exaggerated outward curvature of the spine, and scoliosis is a sideways curvature of the spine. Myosis is the constriction of the pupil.

Question 11

What drug could be given to treat rheumatoid arthritis?

Accepted Answer

Celebrex is a nonsteroidal anti-inflammatory drug (NSAID) that can reduce inflammation and relieve pain associated with rheumatoid arthritis. Boniva and Fosamax are used for treating osteoporosis, not rheumatoid arthritis, while calcium can help with bone health but is not used to treat the symptoms of rheumatoid arthritis.

Question 12

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

Accepted Answer

Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. Bursitis is an inflammation of small, fluid-filled sacs surrounding the joints, postlaminectomy syndrome is pain that persists after spine surgery, and rhabdomyolysis is a rare but serious condition in which muscle tissue breaks down and releases harmful substances into the bloodstream.

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.

Accepted Answer

- M94.0: Costochondritis
- I10: Hypertension
- F17.210: Nicotine dependence, cigarettes, uncomplicated
- E66.3: Overweight
- Z82.49: Family history of ischemic heart disease and other diseases of the circulatory system. 
These codes best represent the patient's final diagnoses as costochondritis was the most likely cause of chest pain and the patient has hypertension, current nicotine dependence, is overweight, and has a family history of ischemic heart disease.

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.

Accepted Answer

The answer of A patient is admitted for a total...

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.

Accepted Answer

Systemic lupus erythematosus (SLE) fits the description provided as a chronic, inflammatory, autoimmune disease that can affect various organs and tissues in the body, including the skin, joints, kidneys, and lungs. Scleroderma is also a chronic autoimmune disease that can damage connective tissue, but it primarily affects the skin and blood vessels, and not as many organs as SLE. Osteoarthritis is a degenerative joint disease, while spondylosis refers to spinal degeneration.

Question 16

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

Accepted Answer

The correct codes are M46.28 for subacute osteomyelitis of the sacrum, L89.153 for a stage 3 decubitus sacral ulcer, and B95.61 for infection due to Staphylococcus aureus as the causative organism. The order of the codes is based on the guidelines for coding and reporting, prioritizing the condition that is being primarily treated or investigated.

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.

Accepted Answer

The correct codes are M84.621A for the pathologic fracture of the proximal right humerus and M85.421 for the unicameral bone cyst in the right humerus. M84.621A specifically indicates a pathologic fracture, not elsewhere classified, of the right humerus, initial encounter for fracture, which is appropriate given the patient's first-time presentation for this issue. M85.421 is used for the bone cyst in the right humerus, which is the underlying cause of the fracture.

Question 18

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

Accepted Answer

Dorsopathies are conditions or diseases that affect the back and spine, not the front or rib cage.

Question 19

____ are the connective tissues that attach muscle to bones.

Accepted Answer

Joints are the points where two or more bones meet, ligaments are the connective tissues that attach bone to bone providing stability, and tendons are the connective tissues that attach muscle to bone enabling movement. Therefore, the correct answer is C - tendons.

Question 20

What drug could be given to treat osteoporosis?

Accepted Answer

Fosamax is a medication commonly used to treat osteoporosis. It works by increasing bone density and decreasing the risk of fractures. Celebrex and NSAIDs are not typically used to treat osteoporosis, and muscle relaxants do not have any effect on bone density.

Quiz 19: Diseases of the Musculoskeletal System and Connective Tissue