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.

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 2

What drug could be given to treat rheumatoid arthritis?

Accepted Answer

Celebrex is a nonsteroidal anti-inflammatory drug (NSAID) that can relieve pain and inflammation associated with rheumatoid arthritis. Boniva and Fosamax are drugs used to treat osteoporosis, and calcium is a dietary supplement that is important for bone health but does not treat rheumatoid arthritis.

Question 3

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 4

____ 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 common disease affecting the muscles which is characterized by widespread muscle pain associated with chronic fatigue. Postlaminectomy syndrome refers to persistent pain or the recurrence of pain after spinal surgery, bursitis is the inflammation of the bursae (small sacs filled with synovial fluid) between bones and tendons, while rhabdomyolysis is a serious condition caused by the breakdown of muscle tissue leading to the release of muscle fiber contents, including myoglobin, into the bloodstream.

Question 5

____ are the connective tissues that attach muscle to bones.

Accepted Answer

Joints are the points where bones come together and allow movement, ligaments are the connective tissues that attach bones to bones, and tendons are the connective tissues that attach muscle to bones. Therefore, the correct answer is tendons only (choice C).

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.

Accepted Answer

- M94.0: Costochondritis
- I10: Hypertension
- F17.210: Nicotine dependence, cigarettes, uncomplicated
- E66.3: Overweight
- Z82.49: Family history of ischemic heart disease

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.

Accepted Answer

The correct diagnosis code for lupus nephritis is M32.14. The procedure code for a percutaneous kidney biopsy without imaging is 0TB13ZX. Therefore, the correct choice is D, which includes both the correct diagnosis and procedure codes.

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).

Accepted Answer

The answer of The patient was admitted with disc herniation...

Question 9

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 above (options A, B, C, D) make up the musculoskeletal system.

Question 10

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 11

____ is when one vertebra slips on another.

Accepted Answer

Spondylolisthesis is a condition where one vertebra slips forward or backward on the vertebra below it. It can be caused by a defect or fracture in the vertebra or by degeneration of the spinal discs.

Question 12

What drug could be given to treat osteoporosis?

Accepted Answer

Fosamax is a bisphosphonate drug that works by increasing bone density and reducing bone loss. It is commonly prescribed to treat osteoporosis. Celebrex and NSAIDs are nonsteroidal anti-inflammatory drugs that can help alleviate pain and inflammation associated with osteoporosis, but do not treat the underlying condition. Muscle relaxants are not typically used to treat osteoporosis.

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.

Accepted Answer

- M80.08xA: Senile osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture
- 0QU03JZ: Percutaneous skeletal procedure with diagnostic imaging guidance, lumbar vertebral body, unilateral, includes imaging guidance; this code represents the percutaneous vertebroplasty intervention performed
Therefore, option C is the best choice as it accurately reflects the patient's condition, the causative factor, and the procedure performed.

Question 14

____ 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 15

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

Accepted Answer

The patient is being screened for rheumatoid arthritis, so the appropriate screening code is Z13.828. Additionally, the patient has a family history of rheumatoid arthritis, so the appropriate family history code is Z82.61. Therefore, the best choice is Z13.828, Z82.61 (option C).

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.

Accepted Answer

The answer of The patient was admitted to the hospital...

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.

Accepted Answer

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

Question 18

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

Accepted Answer

Dorsopathies actually refer to conditions or diseases that affect the back, such as spinal deformities or degenerative disc disease.

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.

Accepted Answer

Systemic lupus erythematosus is a chronic autoimmune disease that can cause inflammation and damage to various organs and tissues in the body, including the skin, joints, kidneys, lungs, and nervous system. Scleroderma is another autoimmune disease that can damage connective tissue, but it primarily affects the skin and blood vessels. Osteoarthritis and spondylosis are degenerative joint diseases that are not autoimmune in nature.

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.

Accepted Answer

Lordosis is an exaggerated inward curvature of the spine that may be caused by increased abdominal girth due to obesity, pregnancy, or abdominal tumors. Kyphosis is an exaggerated outward curvature of the upper spine, and scoliosis is a sideways curvature of the spine. Myosis refers to constriction of the pupil of the eye.

Quiz 20: Diseases of the Musculoskeletal System and Connective Tissue