Medical Sciences Questions and Answers April 13, 2020

What stains are used for.

differences between prokaryotes and eukaryotes

Difference between respiration and fermentation

What a mutation is and that it can be harmful, beneficial, or neutral.

Explain false negative COVID tests and what the significance

How can nurses prevent burn out at work?

In the Martin van Heel paper on phase contrast microscopy, he talks about the phase problem. What is the phase problem in crystallography which makes it difficult to derive the crystal structure of the material under study using diffraction intensities T

As teachers, we encounter many sensitive issues with our students over the years. We may be the first to notice that a student needs help with health and safety issues (e.g., homelessness, drug addiction, domestic violence). Although we are not trained school counselors, or school nurses, we have to have a plan in place to guide students to the

My daughter has had a bad fever, and now she is having trouble breathing, and albuterol doesnt help. HPI Terri Collins is an 8-year-old African-American girl who presents to the ED with a 2-day history of fevers, malaise, and nonproductive cough. The mother gave acetaminophen and ibuprofen to help control the fever. Mother stated that a lot of

Meds Albuterol 2.5 mg nebulized Q 46 H PRN wheezing Fluticasone propionate 44 mcg MDI two puffs BID Acetaminophen 160 mg5 mL10 mL Q 4 H PRN fever Ibuprofen 100 mg5 mL10 mL Q 6 H PRN fever All NKA ROS () Fever, cough, increased work of breathing Physical Examination Gen Alert and oriented but in mild distress with difficulty breathing vs BP 12569,

What is the goal of personalized medicines?

What is the of following is not a characteristic of Staphylococcus aureus? a) Nutrient agar - golden yellow pigmented colonies. b) it is Catalase positive. c)it produces wide zone of alpha hemolysis.(on Blood Agar) d) slide caogulase is due to clumping factor.

1. Describe the incidents that require immediate notification concerning radiation exposure. ovel

An infant born at 33 weeks underwent five photocoagulation treatments to both eyes due to retinopathy of prematurity at six months of age. The physician used an operating microscope during these procedures. These treatments occurred once per day for a defined treatment period of five days. How would you report all of these services? a. 67229 -50

Todd had a tumor removed from his left temporal bone. How would you report this service? a. 61563 b. 61500 c. 69979, 69990-51 d. 69970

Jennifer was admitted to the hospital for an aspiration of two thyroid cysts. Her physician completed this procedure with CT guidance of the needle including interpretation and report. How would you report the professional services? a. 60300-26, 76942-26 b. 60300 x 2, 77012-26 c. 10021, 60300-51, 77012-26 d. 60300

Baby Smith was diagnosed with meningitis. His physician placed a needle through the fontanel at the suture line to obtain a spinal fluid sample on Monday. The needle was withdrawn and the area bandaged. The baby required another subdural tap bilaterally on Wednesday. How would you report Wednesdays service? a. 61001 b. 61000, 61001 c. 61070 d.

Max had a bilateral revision fenestration operation. How would you report this procedure? a. 69840 b. 69840-50 c. 69820 d. Both a and c

Dr. Martin performed an excision at the middle cranial fossa for a vascular lesion. This procedure was completed in an intradural fashion with dural repair and graft. His partner, Dr. Sutter, performed an infratemporal approach with decompression of the auditory canal. How should Dr. Martin report her services? a. 61590, 61606-51 b. 61606-62 c.

After a snow skiing accident, Barry had a cervical laminoplasty to four vertebral segments. How should you report this procedure? a. 63050 x 4 b. 22600, 63051-51 c. 22842, 63045, 63050 d. 63050

How is a neuroplasty procedure described in the CPT Professional Edition? a. The decompression or freeing of intact nerve from scar tissue, including external neurolysis and/or transposition b. The surgical repair of nerves using only microscopic techniques c. The position of nerves tested one or more anatomic digits d. The decompression or

Phyllis fell down on the ice and fractured her leg. The fall also caused severe injury to the muscles and tore several nerves. Her physician completed suturing of two major peripheral nerves in her leg without transposition and shortened the bone. After the surgery she was seen by a physical therapist for ongoing treatment and gait training. How

John was hospitalized for a repair of a laceration to his left conjunctiva by mobilization and rearrangement. How should you report this procedure? a. 65273-LT b. 67930 c. 65272 d. 67930-LT

The patient is a 64-year-old female who is undergoing a removal of a previously implanted Medtronic pain pump and catheter due to a possible infection. The back was incised; dissection was carried down to the previously placed catheter. There was evidence of infection with some fat necrosis in which cultures were taken. The intrathecal portion of

The patient is a 73-year-old gentleman who was noted to have progressive gait instability over the past several months. Magnetic resonance imaging demonstrated a ventriculomegaly. It was recommended that the patient proceed forward with right frontal ventriculoperitoneal shunt placement with Codman programmable valve. What is the correct code for

What is the CPT code for the decompression of the median nerve found in the space in the wrist on the palmar side? A. 64704 B. 64713 C. 64721 D. 64719

2-year-old Hispanic male has a chalazion on both upper and lower lid of the right eye. He was placed under general anesthesia. With an #11 blade the chalazion was incised and a small curette was then used to retrieve any granulomatous material on both lids. What code should be used for this procedure? A. 67801 B. 67805 C. 67800 D. 67808

MRI reveals patient has cervical stenosis. It was determined he should undergo bilateral cervical laminectomy at C3 through C6 and fusion. The edges of the laminectomy were then cleaned up with a Kerrison and foraminotomies were done at C4, C5, and,,C6. The stenosis is central: a facetectomy is performed by using a burr. Nerve root canals were

An extracapsular cataract removal is performed on the right eye by manually using an iris expansion device to expand the pupil. A phacomulsicfication unit was used to remove the nucleus and irrigation and aspiration was used to remove the residual cortex allowing the insertion of the intraocular lens. What code should be used for this procedure?

An infant who has chronic otitis media was placed under general anesthesia and a radial incision was made in the posterior quadrant of the left tympanic membrane. A large amount of mucoid effusion was suctioned and then a ventilating tube was placed in both ears. What CPT and ICD-9-CM codes should be reported: A. 69436-50, 381.20 B. 69436-50,

A craniectomy is being performed on a patient who has Chiari malformation. Once the posterior inferior scalp was removed a C-1 and a partial C-2 laminectomy was then performed. The right cerebellar tonsil was dissected free of the dorsal medulla and a gush of cerebrospinal fluid gave good decompression of the posterior fossa content. Which CPT

Under fluoroscopic guidance an injection of a combination of steroid and analgesic agent is performed on T2-T3, T4-T5, T6-T7 and T8-T9 on the left side into the paravertebral facet joints. The procedure was performed for pain due to thoracic root lesions. What are the procedure codes? A. 64479, 64480x3, 77003 B. 64490, 64491, 64492x2, 77003 C.

An entropian repair is performed on the left lower eyelid in which undermining was performed with scissors of the inferior lid and inferior temporal region. Deep sutures were used to separate the eyelid margin outwardly along with stripping the lateral tarsus to provide firm approximation of the lower lid to the globe. The correct CPT code is: A.

The patient was taken to the procedure room and placed prone and the L4L5 interspace was identified using fluoroscopy to determine the injection site. The patient was prepped in routine sterile fashion with Betadine and covered in sterile drape. 1% lidocaine was used to anesthetize the skin, subcutaneous tissue, and muscle. Once the proper

A 65-year-old patient presented with ectropion of the right lower eyelid. Repair with tarsal wedge excision is performed for correction. Attention was then directed to the left eye. The patient also had an ectropion of the left lower lid which was repaired by suture repair. Code this procedure. A. 67916-50 B. 67916-E4, 67914-E2 C. 67914-50 D.

A 42-year-old patient returns to the hospital neurology clinic for follow-up. He was checked three days prior to this visit where a lumbar puncture was done to find the etology of the patients headaches. The headaches have increased in intensity over the past three days. The neurologist examines the patient and finds a CSF leak from the lumbar

A 63-year-old woman presented to the eye clinic as a new patient with symptoms of flashing lights and floaters in the right eye for two days duration. The ophthalmologist does a general evaluation of the complete visual system, including dilating her eyes and checking her with the indirect ophthalmoscope, revealing peripheral retinal tear. The

What is the full CPT code description for 61535 A. Craniotomy with elevation of bone flap for subdural implantation of an electrode array, for longterm seizure monitoring for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure) B. Craniotomy with elevation of bone flap for removal of epidural or

Postoperative Diagnosis: Carpal tunnel syndrome right wrist The patient was brought to the operating room and sedated by anesthesia. After sterile prepping and draping of the right hand, wrist and arm the patients area of incision was infiltrated with Xylocaine/Marcaine infiltration. After satisfactory anesthesia an Esmarch bandage was used to

A 35-year-old man presents to the urgent care center with severe neck pain. The physician examines the patient and makes the diagnosis of cervical nerve impingement and injects an anesthetic agent into the cervical plexus using three injections. Select the procedure and diagnosis codes. A. 64400 x 3 B. 64405 C. 64413 D. 64413 x 3

A four-year-old with chronic otitis media and fluid buildup in both ears was admitted by her otolaryngologist for a bilateral tympanostomy. The procedure was performed with placement of ventilating tubes. The procedure required general anesthetic due to the patients age. Select the procedure code for this procedure. A. 69420-50 B. 69421-50 C.

A patient presents to the emergency department with complaint of painful eye. The patient states that her right eye is constantly tearing and is sensitive to light. The physician performs an exam and identifies a corneal foreign body in the right eye. Utilizing a slit lamp, the foreign body is removed. Code the encounter. A. 65205-RT B. 65220-RT

The physician performs a right thyroid lobectomy. The patient was prepped and draped. After adequate general anesthesia, the neck was incised on the right side and sharp dissection was then used to cut down onto the strap muscles and sternodcleidomastoid muscles. The strap muscles were separated and transected on the right side. A small thyroid

PROCEDURE: Bilateral lumbar medial branch block under fluoroscopy for the L3, L4, L5 medial branches for the L4-L5, L5-S/1 facets for diagnostic and therapeutic purposes. PROCEDURE: The patient was placed in the prone position on the fluoroscopy table and automated blood pressure cuff and pulse oximeter applied. The skin entry points for

A 43-year-old patient who suffers from severe intermittent vertigo has been definitively diagnosed with Menieres disease. After a year of various treatments, medications, tests, and behavior/lifestyle changes that have failed to lessen the symptoms, she now presents for a transcanal chemical labyrinthotomy to the right ear. Dr. Miller visualizes

What code(s) would be reported for the following case? Preoperative diagnosis: Bilateral impacted ventilating tube Postoperative diagnosis: Same Anesthesia: General Procedure performed: Removal and replacement of new tubes, bilaterally via tympanostomy Procedure: Sammie, a 16-year-old patient, was admitted and taken to the operative suite and

James returned two weeks after surgery, as planned, for a change in his drug delivery system. Today Dr. Harvey opened the previous incision site. The previously placed reservoir was removed and a new programmable subcutaneous pump was connected to the catheter and secured with sutures, tested, and programmed. The subcutaneous incision was closed

Dr. Adams completed an anterior discectomy with decompression including osteophytectomy to levels C3C5.During the same session, he stabilized C3C5 with anterior cervical interbody fusion. For proper visualization, Dr. Adams used an operating microscope during all phases of the procedure.How should Dr. Adams report this procedure? a. 63075,

With which code set or individual codes can add-on code 61781 be correctly reported? a. 6172061791 b. 62201 or 77432 c. 7737177373 d. None of the above

Carl, a 28-year-old patient, has a history of epilepsy with recurrent seizures. His seizures are intolerable even with medication management. He does not experience non-epileptic seizures, which was confirmed by EEG recordings. Today he underwent an open procedure for implantation of cranial nerve neurostimulator electrode array, which was coiled

A 6-month-old patient required a bilateral subdural tap through a suture. How would this initial procedure be reported? a. 61000 b. 61001-63 c. 61000-50 d. 61020-63, 61000-50

A patient with Bells palsy is unable to squint, blink, or close her left eyelid. To protect the eye, Dr. Risser completes a temporary tarsorrhaphy with a Frost suture technique. How would you report this procedure? a. 67875-LT b. 67710-LT c. 67840-LT d. 67950-LT

What code(s) should be reported with the following case? Preoperative diagnosis: Total retinal detachment, right eye Postoperative diagnosis: Same Procedure performed: Complex repair of retinal detachment with photocoagulation, scleral buckle, sclerotomy/vitrectomy Anesthesia: Local Procedure: The patient was placed, prepped, and draped in the

A patient had a bilateral strabismus surgery involving the medial and lateral rectus muscles. The surgeon explored and repaired a detached extraocular muscle in the right eye and placed bilateral posterior fixation sutures with muscle recession. How should you report this procedure? a. 67316-50, 67332-RT, 67334-50 b. 67316-50, 67332-RT, 67335-50

Explain the Parental concern associated with adolescents

All of the following physiological changes are seen in pregnancy except a) Increased stroke volume b) Increased cardiac output c) Increased intravascular volume d) Increased peripheral resistance

Primary Amenorrhea with absent uterus, normal breasts and scanty pubic hair is seen in a) Mayer Rokitanski Kuster Hauser syndrome b) Turners syndrome c) Androgen Insensitivity Syndrome d) Noonan syndrome

Normal functioning ovaries are seen in which of the following condition a) RokitanskyKusterHauser syndrome b) Turner syndrome c) Sawyer syndrome d) Adnrogen insensitivity syndrome

After coming head of breech will have difficulty in delivery in all of the following conditions except a) Hydrocephalus b) Placenta previa c) Incomplete dilation of cervix d) Extension of head

Which of the following is the least likely complication of pregnancyinduced hypertension a) Renal failure b) Preeclampsia c) HELLP syndrome d) Fetal macrosomia

Maternal to child transmission of HIV is prevented by a) Nevirapine b) Lamivudine c) Didanosine d) Abacavir

What would be the ideal management of a woman with infertilty who is detected to have bilateral cornual block on hysterosalpingography a) Tuboplasty b) Invitro fertilization c) Hydrotubation d) Hysteroscopy and laparoscopy

A 20 year old female is diagnosed with granulosa cell tumor of the ovary. Which of the following biomarkers would be most useful for followup of patient a) CA 199 b) CA 50 c) Inhibin d) Neuronspecific enolase

HRT is helpful in all of the following except a) Vaginal atrophy b) Flushing c) Osteoporosis d) Coronary heart disease

Placental alkaline phosphatase is marker of a) Theca cell tumor b) Teratoma c) Choriocarcinoma d) Dysgerminoma

For an elect, forceps deliver) tth a cephalic presentation of the fetus, which of the following is correct a) Fetal head should be at station 0 b) Forceps can be used for 15 degree head rotation from AP diameter c) Can be used in vertex, mentoanterior and face presentation d) Should not be used with caput succedaeneum

Karyotyping of the fetus can be done through all of the following invasive methods except a) Chorionic villus sampling b) Cordocentesis c) Amniocentesis d) Fetal skin biopsy

Which of the following histories is not an indication to perform oral glucose tolerance test to diagnose gestational diabetes mellitus a) Past history of eclampsia b) Past history of congenital anomalies in the fetus c) Past history of unexplained fetal loss d) Past history of polyhydramnios

Painful vaginal ulcer with inguinal lymphadenopathy and school of fish appearance of microorganism or microscopy are characteristic of a) Syphilis b) LGV c) Granuloma inguinale d) Chancroid

Treatment of carcinoma Cervix stage IIIB include a) Wertheims hysterectomy b) Schuatas hysterectomy c) Chemotherapy d) Concurrent chemoradiation

A female presents with 8 weeks amenorrhea with pain left lower abdomen. On USG, there was thick endometrium with mass in lateral adnexa. Most probable diagnosis a) Ectopic pregnancy b) Torsion of dermoid cyst c) Tuboovarian mass d) Hydrosalpinx

In a study it is observed that the right ovary ovulates more than the left, all are possible explanation for the cause except a) Anatomical difference between right and left side b) Difference in blood supply to both sides c) Right handedness is more common in population d) Some embryological basis

Which of the following is least seen in uterine fibroid a) Hyaline degeneration b) Sarcomatous change c) Red degeneration d) Fatty degeneration

Test not useful in case of tubal pregnancy a) Pelvic examination b) USG c) HCG levels d) Hysterosalpingography

A 19 year old patient came to the out patient department with complaints of primary amenorrhea. She had well developed breast and pubic hair. However there was absence of vagina and uterus. Likely diagnosis is a) XYY b) Mullerian agenesis c) Gonadal dysgenesis d) Klinefelters syndrome

lady with previous cesarean section presents in labour. Trial of normal vaginal delivery is contraindicated in a) Breech presentation b) Fact of knowing that previous cesarean section was due to CPD c) Previous classical cesarean section d) No previous vaginal delivery

A young female presents with cyclical pain, dysmenorrheal and complain of infertility. Which of the following would be investigation of choice in her a) TVS b) Diagnostic laparoscopy c) Aspirate from pouch of Douglas d) Hormonal assessment

Shock index (HRSBP) can be used to know the severity of the bleeding in cases of hemorrhage. Which of the following is most indicative for significant PPH a) 0.30.5 b) 0.50.7 c) 0.70.9 d) 0.91.1

Forceps are preferred over vacuum for the delivery because of the following reasons except a) Vacuum requires more clinical skills than forceps b) Vacuum is preferred more than forceps in HIV patient c) Forceps are more commonly associated with fetal facial injury d) Vacuum has more chance of formation of cephalhe matoma

Which of the following findings can be seen during clinical examination of a pregnant female with heart disease compared with normal pregnancy a) Pedal edema b) Engorged neck veins c) Dyspnea d) Exercise intolerance

All of the following complications are more common in ventouse assisted delivery than forceps except a) Subgaleal hemorrhage b) Cephalhematoma c) Intracranial hemorrhage d) Transient lateral rectus palsy

All of the following are risk factors of cervical cancer except a) Low parity b) Multiple partners c) Early sexual intercourse d) Smoking

.A 16 years old girl came for evaluation of primary amenorrhea. She was having hirsutism, irregular bleeding and infertility, diagnosed as PCOS. Which of the following drugs should not be given a) Spironolactone b) Tamoxifen c) OCPS d) Clomiphene citrate

Maximal level of cardiac output is seen at September 2009 a) 2226 weeks of pregnancy b) 2630 weeks of pregnancy c) 3034 weeks of pregnancy d) 3438 weeks of pregnancy

A woman with 20 weeks pregnancy presents with bleeding per vaginum. On speculum examination, the os is open but no products have comes t. The most likely diagnosis is a) Incomplete abortion b) Complete abortion c) Inevitable abortion d) Missed abortion

A 26 years old healthy female got pregnant for 1st time and LSCS was done for fetal distress. Mild hypertension was present during pregnancy. Two days after delivery she had headache and seizures but proteinuria was not seen. CT scan shows 2 x 3 cm parasagittal hematoma. Diagnosis is a) Eclampsia b) Hypertensive intracranial hemorrhage c) Sagittal

If untreated, percentage of mother to child transmission of HIV during delivery without intervention in a nonbreast fed child is a) 4050 b) 1015 c) 1530 d) 5

Dose of radiation for early and locally advanced cancer cervix at point A during brachytherapy a) 7075 Gray and 75 80 Gray b) 7580 Gray and 8085 Gray c) 8085 Gray and 8590 Gray d) 8590 Gray and 9095 Gray

Which of the following is not true about latent phase of labour a) According to ACOG it starts after 34 cm cervical dilatation but they are planning to increase it to 5 cm b) Begins at the end of active phase and is a part of 1st stage of labour c) Patient may present with false labour due to mild cramps d) Starts with contractions of the uterus

A 16year old female presents with primary amenorrhea and raised FSH level. On examination, her height was 58 inches. What would be the histopathological finding in the ovary a) Absence of oocytes in the ovaries (streak ovaries) b) Mucinous cystadenoma c) Psamomma bodies d) Hemorrhagic corpus leuteum

Most accurate and safe method to diagnose viable pregnancy at 6weeks a) Doppler assessment of fetal cardiac activity b) USG for fetal cardiac activity c) Urinary BetahCG determination d) Per vaginal examination of uterine size corresponding to 6 weeks gestation

Most common site of primary for intraocular metastasis is from a) Breast b) Ovary c) Cervix d) Endometrium

All of the following are used for screening cancers in females except a) CA125 Ovarian cancer b) Office endometrial aspirate Endometrial carcinoma c) Pap smear Cervical cancer d) Mammography Breast cancer

Which type of abnormality in sexual development has best prognosis a) Congenital adrenal hyperplasia b) Mixed gonadal dysgenesis c) Androgen insensitivity syndrome d) True hermaphroditism

Which of the following drug is not the first line treatment for anovulatory abnormal uterine bleeding in a 13year old girl a) Tranexemic acid b) Mefenamic acid c) Progesterone d) Estrogen progesterone

Studies have shown that complications of prematurity, IUGR are not affected by the time of cesarean section. What is the recommended timing of cesarean section a) 37 weeks b) 38 weeks c) 39 weeks d) 40 weeks

Which of the following is not an abdominal laparoscopic technique for tubal ligation a) Pomeroy b) Parkland Essure d) Irving

A girl with normal stature and minimal or absent pubertal development is seen in a) Kallman syndrome b) Turner syndrome c) Testicular feminization syndrome d) Pure gonadal dysgenesis

If the life style factor that is causing infertility in a young male is identified. Which of the following life style modification will have no effect a) Weight gain b) Less exercise c) Vegetarian diet d) Weight loss

Which of the following drug is Category B (adequate studies in pregnant woman have failed to demonstrate a fetal risk) a) Brimonidine b) Pilocarpine c) Latanoprost d) Dorzolamide

All of the following are true about augmentation of labor except a) Twin pregnancy precludes the use of oxytocin b) Amniotomy decreases the need for oxytocin use c) Methods of augmentation does not increase the risk of operational management d) Associated with a risk of uterine hyper stimulation