Question 1

Which of the following is the most common diagnostic test for epilepsy?

Accepted Answer

EEG (electroencephalogram) is the most common diagnostic test for epilepsy as it measures the electrical activity in the brain and can detect abnormal brain waves that are typical in epilepsy. MRI (magnetic resonance imaging) may also be used to rule out other possible causes of seizures, but it is not the primary diagnostic test for epilepsy. Ultrasound (sonography) and EMG (electromyography) are not typically used in the diagnosis of epilepsy.

Question 2

A patient with known metastatic cancer to the ribs is admitted for pain control.The patient has a history of lung cancer,which was surgically excised.The patient is administered fentanyl.

Accepted Answer

C79.51 - Secondary malignant neoplasm of bone
G89.3 - Neoplasm related pain (secondary to metastatic cancer)
Z85.118 - Personal history of malignant neoplasm of lung

All three codes are necessary to accurately describe the patient's condition and history. Choice B is the only option that includes all three codes.

Question 3

What drug could be given to treat Alzheimer's?

Accepted Answer

Aricept (donepezil) is a medication commonly used to treat Alzheimer's disease. It works by increasing the levels of a neurotransmitter called acetylcholine in the brain, which can improve cognitive function and help with memory, thinking, and behavior. Sinemet (carbidopa/levodopa) is a medication used to treat Parkinson's disease, while Depakote (valproic acid) and Dilantin (phenytoin) are anti-seizure medications and are not commonly used to treat Alzheimer's.

Question 4

Patient came to the ER after falling off her horse at the county fair rodeo.X-rays reveal two fractured ribs on the left.Patient is admitted for acute pain control.

Accepted Answer

- S22.42xA: Fracture of one rib, initial encounter for closed fracture, left side
- G89.11: Acute pain due to trauma
- V80.010A: Animal-rider injured in collision with other animal, initial encounter (fall from horse)
- Y92.39: Other sports and athletic area as the place of occurrence of the external cause
- Y93.52: Activity, horseback riding and rodeo

Choice A is incorrect because R52 is not necessary as G89.11 already captures acute pain due to trauma.

Choice B is incorrect because G89.18 specifically refers to other acute pain, but we know the pain is related to the fractured ribs.

Choice D is incorrect because R52 is not necessary as G89.11 already captures acute pain due to trauma.

Question 5

Bacterial meningitis is ____.

Accepted Answer

Bacterial meningitis is treated with antibiotics. Without proper and timely treatment, it can lead to severe brain damage, coma or death. High doses of vitamins or chlorhexidine are not effective treatments for bacterial meningitis.

Question 6

What drug could be given to treat epilepsy?

Accepted Answer

Dilantin is an anticonvulsant medication that is commonly used to treat epilepsy. It works by stabilizing the electrical activity in the brain, which can help prevent seizures. Cognex and Aricept are medications used to treat Alzheimer's disease, and Sinemet is used to treat Parkinson's disease, none of which are suitable for treating epilepsy.

Question 7

A patient is admitted with an acute change in mental status.Patient has a history of CHF,DM type 2,and prostate cancer.Patient had a prostatectomy 2 years PTA.Upon completion of the lab work,the physician documents metabolic encephalopathy due to urinary tract infection.Patient was treated with IV antibiotics.

Accepted Answer

The correct codes are N39.0 for the urinary tract infection (UTI) which caused the metabolic encephalopathy, G93.41 for the metabolic encephalopathy itself, I50.9 for congestive heart failure (CHF), E11.9 for diabetes mellitus type 2 (DM type 2), and Z85.46 for the personal history of prostate cancer.

Question 8

Which of the following is/are sent from the somatic nervous system to the central nervous system?

Accepted Answer

The somatic nervous system is responsible for carrying sensory information from the sensory organs to the central nervous system, which includes taste, hearing, and smell among other senses.

Question 9

A disorder of the brain that causes a progressive decline in mental and physical function is called ____.

Accepted Answer

Alzheimer's disease is characterized by the accumulation of abnormal protein deposits in the brain that cause the death of brain cells, leading to cognitive and behavioral changes. It is a progressive disorder that worsens over time and currently has no cure. Schizophrenia is a mental disorder that affects how a person thinks, feels, and behaves, but it does not necessarily involve a decline in function. Hydrocephalus is a condition where excess cerebrospinal fluid accumulates in the brain, which can cause pressure and damage to brain tissue, but it can often be treated with surgery. Hutchinson's disease is not a recognized medical condition.

Question 10

Patient is admitted for a senile cataract in the right eye to be removed by phacoemulsification with IOL replacement via percutaneous approach.

Accepted Answer

The correct diagnosis code for senile cataract in the right eye is H25.9. The correct procedure code for phacoemulsification with IOL replacement is 08RJ3JZ (percutaneous approach). The correct codes are therefore H25.9, 08RJ3JZ. Option A is incorrect because 08RK3JZ is for removal of a non-autologous tissue substitute from the right eye, not IOL insertion. Option B is incorrect because H25.89 is for other cataract types, not senile cataract specifically. Option D is incorrect because 08DJ3ZZ is for a different approach to cataract surgery (endoscopic) and not indicated in the scenario.

Question 11

It is acceptable to code pain as a principal diagnosis when ____.

Accepted Answer

The answer of It is acceptable to code pain as...

Question 12

All of the following are symptoms of meningitis EXCEPT ____.

Accepted Answer

Sensitivity to darkness is not a typical symptom of meningitis. The other symptoms listed are common in meningitis.

Question 13

A patient with intractable epilepsy presents for open implantation of a single-array neurostimulator pulse generator with leads.The generator was placed in the chest via open approach,and the leads were placed in the neck and attached to the vagus nerve via percutaneous approach.

Accepted Answer

The answer of A patient with intractable epilepsy presents for...

Question 14

Which of the following is not a layer of the meninges that covers the brain?

Accepted Answer

The endocardium is not a layer of the meninges that covers the brain. It is a layer of tissue that lines the interior of the heart. The dura, arachnoid, and pia are all layers of the meninges that cover the brain.

Question 15

An infant is admitted for placement of a ventriculoperitoneal shunt (open approach)for hydrocephalus.The patient has lumbar spina bifida.

Accepted Answer

The correct ICD-10-CM code for lumbar spina bifida is Q05.2, and the procedure code for placement of a ventriculoperitoneal shunt (open approach) is 00160J6. Therefore, the correct choice is B. Choice A is incorrect because it does not include the spina bifida diagnosis. Choice C is incorrect because it includes a different form of spina bifida (occulta) than what is stated in the question stem. Choice D is incorrect because it uses the wrong procedure code (0W110JG is for a ventricular shunt revision, not initial placement).

Question 16

A patient is admitted for pain control.The patient has metastatic prostate cancer to the vertebrae and liver.The patient is started on a PCA pump,and pain is more manageable.

Accepted Answer

The patient has metastatic prostate cancer to the vertebrae and liver, which are coded as C61 (malignant neoplasm of prostate) and C78.7 (secondary malignant neoplasm of liver and intrahepatic bile duct), respectively. The pain control is the reason for admission, which is coded as G89.3 (neoplasm-related pain). The PCA pump is used for pain management, which is not coded separately as it is included in the G89.3 code. Therefore, the correct codes are G89.3, C61, C78.7, and C79.51 (secondary malignant neoplasm of bone). Option D includes all the correct codes.

Question 17

A college student is admitted with fever,headache,and a stiff neck.Lumbar puncture is performed in the ER,and lab results reveal pneumococcal meningitis.The patient is given IV fluids for volume depletion and IV antibiotics to treat meningitis.

Accepted Answer

The answer of A college student is admitted with fever,headache,and...

Question 18

Patient comes to the ER with high fever and headache.Meningitis is suspected.A lumbar puncture is performed and reveals bacterial meningitis.

Accepted Answer

The diagnosis for this patient is bacterial meningitis (G00.9) based on the results of the lumbar puncture. The additional codes R51 (headache), R50.9 (fever), and 009U3ZX (diagnostic lumbar puncture) are all appropriate for this case. Codes A and B are incorrect because they do not include all of the necessary codes for this case.

Question 19

A patient with trigeminal neuralgia and a history of migraine headaches is admitted for an open rhizotomy.A day after the procedure,the patient develops a severe headache diagnosed as a migraine.

Accepted Answer

The answer of A patient with trigeminal neuralgia and a...

Question 20

A patient is admitted following a seizure.Laboratory work reveals that the patient is dehydrated and hyponatremic.The final diagnosis lists seizure due to severe hyponatremia.

Accepted Answer

(CC 1Q 2014 p7)

Quiz 15: Diseases of the Nervous System, diseases of the Eye and Adnexa, and Diseases of the Ear and Mastoid Process