Practicode I - V Exam Questions and
Correct Answers
Question 1
CaseID: OPD7030
Primary Diagnosis: I51.7, J18.1
CPT: 71046-26
Correct Answer
MEDICAL RECORD
RADIOLOGY REPORT
Location: Mountain HospitalSex: FemaleAGE: 64DATE OF EXAM:
1/01/20XXPHYSICIAN(S):PROCEDURE: X-RAY CHEST TWO VIEWS, PA AND
LATERALCOMPARISON: None.INDICATIONS: Fever, cough, and
weakness.TECHNIQUE: PA and lateral radiographs of the chest were
performed.FINDINGS:CARDIAC: Cardiomegaly. Pulmonary vascularity is within
normal limits.LUNGS: Patchy air space disease in the right lower lobe
pneumonia.MEDIASTINUM: Normal.PLEURA: No effusion or pneumothorax.BONES:
Normal for age.CONCLUSION:1. CARDIOMEGALY.2. PATCHY AIR SPACE
CONSOLIDATION IN THE RIGHT LOWER LOBE - LOBAR PNEUMONIA.Electronically
signed by 1/1/20XX
Page 1 of 498
,Question 2
CaseID: OPD7451
Primary Diagnosis: I34.0, I65.23, I45.89
Secondary Diagnosis: Z86.73, Z98.890
CPT: 93350, 93325
E/M Level: 99214-25
Correct Answer
MEDICAL RECORD
OFFICE - ESTABLISHEDCARDIOLOGYSEX: FEMALEAGE: 65Date: 01/01/20XXPROBLEM
LIST:1. Female patient with paroxysmal atrial fibrillation, six months S/P atrial
fibrillation ablation.2. Hypertension.3. She is seven years S/P gastric bypass
surgery.4. Hepatitis C.5. Questionable TIA (01/20XX) manifest as a syncopal spell. No
localizing neurologic symptoms.ALLERGIES: No known drug
allergies.MEDICATIONS:Albuterol inhaler q.d.Omeprazole 20 mg t.i.d.KCl 10 mEq
b.i.d. Gabapentin 800 mg t.i.d.Tramadol 50 mg t.i.d.Sotalol 160 mg b.i.d.Diovan
HCTZ 320/12.5 mg 1/2 tab q.h.s. Trazodone 100 mg q.d. q.h.s. Multivitamins
q.d.Calcium with vitamin D q.d.Fiber q.d.Valerian root q.d.Lasix 20 mg q.d.KCl 10
mEq q.d.INTERVAL HISTORY:Carotid Doppler (01/01/20XX) shows:1. 80-99% right
ICA stenosis.2. 60-79% left ICA stenosis.Labs (01/01/20XX) show:1. Fasting lipids:
Total cholesterol 115, triglycerides 54, HDL 65, LDL 44.2. TSH 1.6.Chemistry panel
(01/01/20XX) shows:1. BUN 14, creatinine 0.56.2. GFR of 100.Labs (01/01/20XX)
show:1. CBC: Hemoglobin 11.6 grams percent, platelet count 257, white cell count
6.3.PHYSICAL EXAMINATION:VITAL SIGNS: BP 128/62, pulse 54 and regular, oxygen
saturation 91% on room air.CONSTITUTIONAL: She appears somewhat pale, in no
acute distress.HEENT: Thyroidectomy scar is well-healed, otherwise negative. Eyes:
Fundi unremarkable. No A-V nicking. No hemorrhages. No xanthelasma or
exophthalmos. No arcus senilis. Tongue midline. Mucous membranes moist, with no
cyanosis. No cervical lymphadenopathy. Thyroid unremarkable.RESPIRATORY:
Respirations even and unlabored. Slightly reduced air entrybilaterally with bilateral
expiratory rhonchi. Chest has normal contour.CARDIOVASCULAR: PMI
unremarkable. Neck veins borderline elevated with a positive Kussmaul sign. No
carotid bruits. S1 is normal. S2 is single and not acc
Page 2 of 498
,Question 3
CaseID: OPD7253
Primary Diagnosis: R68.12
E/M Level: 99282
Correct Answer
MEDICAL RECORD
EMERGENCY DEPARTMENT
SEX: Female AGE: 1
DOS: 1/1/20XX
Time Seen: 9:27 bed 25.
Arrived- By private vehicle. Historian- mother and father. Note: Patient has a primary
care physician on staff; PCP has been notified.
HISTORY OF PRESENT ILLNESS
Chief Complaint- FUSSY and WON'T STOP CRYING. This started about 3 days ago
and is still present. It has been intermittent. Symptoms are described as severe. No
fever, ear pain or eye irritation or eye discharge. No nasal discharge or congestion,
sore throat, cough or difficulty breathing. No vomiting, diarrhea, bloody stools,
abdominal pain or ear-pulling. No headache, seizure, difficulty with urination, skin
rash or diaper rash. Has not had decreased oral intake or been acting differently. No
decreased urine output. No history of substance ingestion. (This delightful 2 month
old got her shots 2 days ago. That night, and the 2 intervening, she began crying
about 8, and wouldn't stop for about 2 hours. No other c/os, and acts totally normal
the rest of the time. Bottle fed on Similac sensitive stomach.).
The patient is bottle fed. No known contact with a sick individual.
Similar symptoms previously: None.
Recent medical care: The patient was seen recently at this facility in the office. (she
got her shots 3 days ago).
REVIEW OF SYSTEMS: Described in HPI. All systems otherwise negative, except as
recorded above.
PAST HISTORY: Negative. See nurses notes.
Delivered by C-section. Premature birth (37 weeks gestation).Additional Surgeries:
no known surgeries.Medications: None.Allergies: No Known Drug Allergy.
SOCIAL HISTORY: Not exposed to second-hand smoke at home. Caregiver- mother
and father.
ADDITIONAL NOTES:
The nursing notes have been reviewed with agreement regarding the chief
complaint, HPI, ROS, PMH and patient medications and allergies.
Weight: 6.8 kg measured. Hei
Page 3 of 498
, Question 4
CaseID: OPD7197
Primary Diagnosis: H50.331, H50.332, H51.12
CPT: 67311-50, 67320
Correct Answer
MEDICAL RECORD
OPERATIVE REPORTSEX: FemaleAGE: 39DATE OF PROCEDURE: 1/1/20XXSURGEON:
Levi Andrews, M.D.ANESTHESIOLOGIST: Joe D. Jones, M.D.PREOPERATIVE
DIAGNOSES: Intermittent monocular exotropia, convergence
excess.POSTOPERATIVE DIAGNOSES: Intermittent monocular exotropia,
convergence excess.PROCEDURE: Bilateral lateral rectus recession with transposition
of superior.ANESTHESIA: GeneralINDICATIONS FOR EYE SURGERY: Eye muscle
imbalance.FINDINGS OF THE EYE SURGERY: Normal eye muscle.PROCEDURE IN
DETAIL: The patient was brought to the operating room, placed under general
anesthesia, and prepped and draped in standard fashion for eye surgery. A lid
speculum was placed in the right eye. An inferotemporal conjunctival incision was
made 10 mm from the limbus. The quadrant was spread with scissors. The lateral
rectus muscle was hooked and cleaned with blunt dissection. 6-0 Vicryl double-arm
was placed through the muscle in von Pirquet fashion. The muscle was excised at its
insertion. Bleeding was stopped with cautery. Locking forceps were placed on the
insertion stump. The sclera was marked 5.5 mm posterior to the original insertion
and 5 mm posterior placed. Sutures were brought through the sclera and at that
point tied and cut. Conjunctiva was closed with three interrupted 6-0 plain sutures.
The lid speculum was removed and placed in the left eye. The same procedure was
done to the left eye, recessing it 5.5 mm and supraplacing it 5
mm.COMPLICATIONS: NoneBLOOD LOSS: NoneRonnie Kramer, MDElectronically
signed by RONNIE KRAMER, MD 1/1/20XX
Page 4 of 498
Correct Answers
Question 1
CaseID: OPD7030
Primary Diagnosis: I51.7, J18.1
CPT: 71046-26
Correct Answer
MEDICAL RECORD
RADIOLOGY REPORT
Location: Mountain HospitalSex: FemaleAGE: 64DATE OF EXAM:
1/01/20XXPHYSICIAN(S):PROCEDURE: X-RAY CHEST TWO VIEWS, PA AND
LATERALCOMPARISON: None.INDICATIONS: Fever, cough, and
weakness.TECHNIQUE: PA and lateral radiographs of the chest were
performed.FINDINGS:CARDIAC: Cardiomegaly. Pulmonary vascularity is within
normal limits.LUNGS: Patchy air space disease in the right lower lobe
pneumonia.MEDIASTINUM: Normal.PLEURA: No effusion or pneumothorax.BONES:
Normal for age.CONCLUSION:1. CARDIOMEGALY.2. PATCHY AIR SPACE
CONSOLIDATION IN THE RIGHT LOWER LOBE - LOBAR PNEUMONIA.Electronically
signed by 1/1/20XX
Page 1 of 498
,Question 2
CaseID: OPD7451
Primary Diagnosis: I34.0, I65.23, I45.89
Secondary Diagnosis: Z86.73, Z98.890
CPT: 93350, 93325
E/M Level: 99214-25
Correct Answer
MEDICAL RECORD
OFFICE - ESTABLISHEDCARDIOLOGYSEX: FEMALEAGE: 65Date: 01/01/20XXPROBLEM
LIST:1. Female patient with paroxysmal atrial fibrillation, six months S/P atrial
fibrillation ablation.2. Hypertension.3. She is seven years S/P gastric bypass
surgery.4. Hepatitis C.5. Questionable TIA (01/20XX) manifest as a syncopal spell. No
localizing neurologic symptoms.ALLERGIES: No known drug
allergies.MEDICATIONS:Albuterol inhaler q.d.Omeprazole 20 mg t.i.d.KCl 10 mEq
b.i.d. Gabapentin 800 mg t.i.d.Tramadol 50 mg t.i.d.Sotalol 160 mg b.i.d.Diovan
HCTZ 320/12.5 mg 1/2 tab q.h.s. Trazodone 100 mg q.d. q.h.s. Multivitamins
q.d.Calcium with vitamin D q.d.Fiber q.d.Valerian root q.d.Lasix 20 mg q.d.KCl 10
mEq q.d.INTERVAL HISTORY:Carotid Doppler (01/01/20XX) shows:1. 80-99% right
ICA stenosis.2. 60-79% left ICA stenosis.Labs (01/01/20XX) show:1. Fasting lipids:
Total cholesterol 115, triglycerides 54, HDL 65, LDL 44.2. TSH 1.6.Chemistry panel
(01/01/20XX) shows:1. BUN 14, creatinine 0.56.2. GFR of 100.Labs (01/01/20XX)
show:1. CBC: Hemoglobin 11.6 grams percent, platelet count 257, white cell count
6.3.PHYSICAL EXAMINATION:VITAL SIGNS: BP 128/62, pulse 54 and regular, oxygen
saturation 91% on room air.CONSTITUTIONAL: She appears somewhat pale, in no
acute distress.HEENT: Thyroidectomy scar is well-healed, otherwise negative. Eyes:
Fundi unremarkable. No A-V nicking. No hemorrhages. No xanthelasma or
exophthalmos. No arcus senilis. Tongue midline. Mucous membranes moist, with no
cyanosis. No cervical lymphadenopathy. Thyroid unremarkable.RESPIRATORY:
Respirations even and unlabored. Slightly reduced air entrybilaterally with bilateral
expiratory rhonchi. Chest has normal contour.CARDIOVASCULAR: PMI
unremarkable. Neck veins borderline elevated with a positive Kussmaul sign. No
carotid bruits. S1 is normal. S2 is single and not acc
Page 2 of 498
,Question 3
CaseID: OPD7253
Primary Diagnosis: R68.12
E/M Level: 99282
Correct Answer
MEDICAL RECORD
EMERGENCY DEPARTMENT
SEX: Female AGE: 1
DOS: 1/1/20XX
Time Seen: 9:27 bed 25.
Arrived- By private vehicle. Historian- mother and father. Note: Patient has a primary
care physician on staff; PCP has been notified.
HISTORY OF PRESENT ILLNESS
Chief Complaint- FUSSY and WON'T STOP CRYING. This started about 3 days ago
and is still present. It has been intermittent. Symptoms are described as severe. No
fever, ear pain or eye irritation or eye discharge. No nasal discharge or congestion,
sore throat, cough or difficulty breathing. No vomiting, diarrhea, bloody stools,
abdominal pain or ear-pulling. No headache, seizure, difficulty with urination, skin
rash or diaper rash. Has not had decreased oral intake or been acting differently. No
decreased urine output. No history of substance ingestion. (This delightful 2 month
old got her shots 2 days ago. That night, and the 2 intervening, she began crying
about 8, and wouldn't stop for about 2 hours. No other c/os, and acts totally normal
the rest of the time. Bottle fed on Similac sensitive stomach.).
The patient is bottle fed. No known contact with a sick individual.
Similar symptoms previously: None.
Recent medical care: The patient was seen recently at this facility in the office. (she
got her shots 3 days ago).
REVIEW OF SYSTEMS: Described in HPI. All systems otherwise negative, except as
recorded above.
PAST HISTORY: Negative. See nurses notes.
Delivered by C-section. Premature birth (37 weeks gestation).Additional Surgeries:
no known surgeries.Medications: None.Allergies: No Known Drug Allergy.
SOCIAL HISTORY: Not exposed to second-hand smoke at home. Caregiver- mother
and father.
ADDITIONAL NOTES:
The nursing notes have been reviewed with agreement regarding the chief
complaint, HPI, ROS, PMH and patient medications and allergies.
Weight: 6.8 kg measured. Hei
Page 3 of 498
, Question 4
CaseID: OPD7197
Primary Diagnosis: H50.331, H50.332, H51.12
CPT: 67311-50, 67320
Correct Answer
MEDICAL RECORD
OPERATIVE REPORTSEX: FemaleAGE: 39DATE OF PROCEDURE: 1/1/20XXSURGEON:
Levi Andrews, M.D.ANESTHESIOLOGIST: Joe D. Jones, M.D.PREOPERATIVE
DIAGNOSES: Intermittent monocular exotropia, convergence
excess.POSTOPERATIVE DIAGNOSES: Intermittent monocular exotropia,
convergence excess.PROCEDURE: Bilateral lateral rectus recession with transposition
of superior.ANESTHESIA: GeneralINDICATIONS FOR EYE SURGERY: Eye muscle
imbalance.FINDINGS OF THE EYE SURGERY: Normal eye muscle.PROCEDURE IN
DETAIL: The patient was brought to the operating room, placed under general
anesthesia, and prepped and draped in standard fashion for eye surgery. A lid
speculum was placed in the right eye. An inferotemporal conjunctival incision was
made 10 mm from the limbus. The quadrant was spread with scissors. The lateral
rectus muscle was hooked and cleaned with blunt dissection. 6-0 Vicryl double-arm
was placed through the muscle in von Pirquet fashion. The muscle was excised at its
insertion. Bleeding was stopped with cautery. Locking forceps were placed on the
insertion stump. The sclera was marked 5.5 mm posterior to the original insertion
and 5 mm posterior placed. Sutures were brought through the sclera and at that
point tied and cut. Conjunctiva was closed with three interrupted 6-0 plain sutures.
The lid speculum was removed and placed in the left eye. The same procedure was
done to the left eye, recessing it 5.5 mm and supraplacing it 5
mm.COMPLICATIONS: NoneBLOOD LOSS: NoneRonnie Kramer, MDElectronically
signed by RONNIE KRAMER, MD 1/1/20XX
Page 4 of 498
