Question 1

____ 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 condition that causes widespread pain and tenderness to the touch, along with fatigue and other symptoms. It affects an estimated 10 million people in the United States and is more common in women than in men. It is a chronic condition with no cure, but treatments can help manage symptoms.

Question 2

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 code is M32.14, 0TB13ZX. This code represents lupus nephritis with membranous glomerulonephritis, which is the most common type of lupus nephritis. The code 0TB13ZX indicates that the biopsy was performed on the left kidney.

Question 3

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 4

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 5

____ 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) is a chronic, inflammatory, autoimmune disease that can affect multiple organs and tissues, including the skin, joints, nervous system, kidneys, lungs, and heart. SLE is caused by abnormalities in the immune system that lead to inflammation and damage to various connective tissues in the body.

Question 6

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

Accepted Answer

Z13.828 is used for screening for musculoskeletal disorders, and Z82.61 is used for a family history of arthritis.

Question 7

____ are the connective tissues that attach muscle to bones.

Accepted Answer

Tendons are the connective tissues that attach muscle to bones. Joints are the point where two bones meet and allow for movement, while ligaments are the connective tissues that attach bone to bone and provide stability to joints.

Question 8

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 or spine, not the front or rib cage.

Question 9

What drug could be given to treat osteoporosis?

Accepted Answer

Fosamax is a medication used to treat and prevent osteoporosis by inhibiting bone breakdown and promoting bone formation. Celebrex and NSAIDs are anti-inflammatory drugs used to treat pain and inflammation but do not address the underlying issue of bone loss in osteoporosis. Muscle relaxants are not typically used to treat osteoporosis.

Question 10

The patient was admitted with disc herniation at L4 to 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 lb 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 11

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 12

____ 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 characterized by an exaggerated inward curvature of the spine, often associated with increased abdominal girth due to obesity, pregnancy, or abdominal tumors. Kyphosis refers to an exaggerated outward curvature of the spine, typically seen in elderly individuals, while scoliosis is a lateral (sideways) curvature of the spine. Myosis refers to constriction of the pupil, which is not related to spinal curvature.

Question 13

____ is when one vertebra slips on another.

Accepted Answer

Spondylolisthesis is a condition where one vertebra slips on another, typically in the lower back. This can cause spinal instability and may require surgery to correct. Facet joint and spinal stenosis are different conditions that do not involve vertebral slippage. Spondylosis is a general term for degenerative changes in the spine, which may or may not involve vertebral slippage.

Question 14

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 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 disease

Accepted Answer

Paget disease of bone is coded as M88.8-, with the fifth character indicating the site. Since the disease affects the left femur, the correct code is M88.852, which specifies Paget's disease of the left femur. The code for severe hip pain (M25.552) is not necessary as the final diagnosis directly attributes the pain to Paget disease.

Question 15

____ 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 16

What drug could be given to treat rheumatoid arthritis?

Accepted Answer

Celebrex is a nonsteroidal anti-inflammatory drug (NSAID) that can help reduce inflammation and relieve pain associated with rheumatoid arthritis.

Question 17

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 18

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

Accepted Answer

The musculoskeletal system is composed of bones, ligaments, tendons, and cartilage, among other structures. Therefore, all of the choices listed (bones, ligaments, tendons, and cartilage) make up the musculoskeletal system.

Question 19

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

The diagnosis of osteoporosis is coded as M80.08xA, and the procedure performed (percutaneous vertebroplasty) is coded as 0QU03JZ. The additional code for the pathologic fracture due to senile osteoporosis is not necessary as it is already indicated in the diagnosis code for osteoporosis. Therefore, choice C is the best option.

Question 20

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...

Quiz 20: Diseases of the Musculoskeletal System and Connective Tissue