Chapter 7 PA Exam With Correct Actual Questions And Correctly Well Defined.

CASE 1 PREOPERATIVE DIAGNOSIS : Basal cell carcinoma (postoperative and preoperative diagnosis) POSTOPERATIVE DIAGNOSIS : Same OPERATION : Mohs micrographic surgery (Mohs surgery is performed) Indications: The patient has a biopsy-proven basal cell carcinoma on the nasal tip (Location) measuring 8 x 7 mm. (Size) Due to its location, Mohs surgery is indicated. The Mohs surgical procedure was explained including other therapeutic options, and the inherent risks of bleeding, scar formation, reaction to local anaesthesia, cosmetic deformity, recurrence, infection, and nerve damage. Informed consent was obtained and the patient underwent fresh tissue Mohs surgery as follows. STAGE I : (Mohs surgery is performed in stages, this report indicates only one stage) The site of the skin cancer was identified concurrently by both the patient and doctor and marked with a surgical pen; the margins of the excision were delineate - correct answer 17311, C44.311 CASE 2 CHIEF COMPLAINT : The patient is a 42-year-old female with infected right axillary hidradenitis. (The diagnosis to report, and location of the hidradenitis.) PROCEDURE NOTE : With the patient in the supine position and under general anaesthesia, the right axilla was prepped and draped in the usual sterile fashion. A skin incision was made in the axilla to excise most of the hidradenitis tracts. The incision was carried down through the subcutaneous tissue. The underlying subcutaneous tissue was excised. (The excision went to the subcutaneous tissue.) Bleeding points were controlled by means of electrocautery. The subcutaneous tissues were closed in intermediate layers (The repair was intermediate.) with a suture of 2-0 Vicryl. The skin edges were stapled together and a dry sterile dressing was applied. The patient tolerated the procedure well. What are the CPT® and ICD-10-CM codes reported? - correct answer 11450-RT, L73.2 CASE 3 PREOPERATIVE DIAGNOSIS : Right breast mass, lower outer quadrant. POSTOPERATIVE DIAGNOSIS : Right breast mass, lower outer quadrant. (Postoperative diagnosis is used for coding.) PROCEDURE: Right breast lumpectomy.(Procedure to be performed.) ANESTHESIA : A 1% lidocaine with epinephrine mixed 1:1 with 0.5% Marcaine along with IV sedation. INDICATIONS : The patient is a 23-year-old female who recently noted a right breast mass (lower outer quadrant). This has grown somewhat in size and we decided it should be excised. FINDINGS AT THE TIME OF OPERATION: This appeared to be a fibroadenoma. ("Appeared to be" would not be considered a definitive diagnosis.) OPERATIVE PROCEDURE : The patient was first identified in the holding area and the surgical site was reconfirmed and marked. Informed consent was obtained. She was then brought back to the operating room where she was placed on the operating room table in - correct answer 19301-RT, N63.13 PREOPERATIVE DIAGNOSIS : Segmental obesity of posterior thighs. POSTOPERATIVE DIAGNOSIS : Segmental obesity of posterior thighs. (Postoperative diagnosis to be used for coding) OPERATIVE PROCEDURE : Posterior thigh suction-assisted lipectomy of the posterior medial thigh, bilateral. (procedure performed) CLINICAL NOTE : This obese patient presents for the above procedure. She understood the potential risks and complications including the risk of anaesthesia, bleeding, infection, wound healing problems, unfavourable scarring, and the potential need for secondary surgery. She understood and desired to proceed. PROCEDURE : The patient was placed on the operating table in the supine position. General anaesthesia was induced. (General anaesthesia.) Once she was asleep, she was turned and positioned prone. The buttocks and thigh regions were prepped and draped in the usual sterile fashion. She had been marked in the aw - correct answer 15879-50, E66.8 PREOPERATIVE DIAGNOSIS : Hypoplasia of the breast. POSTOPERATIVE DIAGNOSIS : Hypoplasia of the breast. (Postoperative diagnosis is used for coding.) OPERATIVE PROCEDURE : Bilateral augmentation mammoplasty. (Breast augmentation performed bilaterally.) ANESTHESIA : General. (General anaesthesia.) OPERATIVE SUMMARY : The patient was brought to the operating room awake and placed in a supine position, where general anaesthesia was induced without any complications. The patient's chest was prepped and draped in the usual sterile fashion. The patient had previous inframammary crease incisions on both the left and right sides. The extent of the dissection would be to the sternal border within two fingerbreadths of the clavicle and slightly beyond the anterior axillary line. The left breast(Left breast.) was operated upon first. An incision was made in the inframammary crease going through skin, subcutaneous tissue, dow - correct answer 19325-50, N64.82 PREOPERATIVE DIAGNOSIS: Rapidly enlarging suspicious lesion on patient's right side of forehead. POSTOPERATIVE DIAGNOSIS: Rapidly enlarging suspicious lesion on patient's right side of forehead. OPERATION PERFORMED : Wide local excision with intermediate closure of the right side of the forehead. INDICATIONS : The patient is a 78-year-old white male who noticed within the last month or so, a rapidly enlarging suspicious lesion on the right side of his forehead. DESCRIPTION OF PROCEDURE : The patient was placed in the supine position on the table, and was given no sedation. The area of his right forehead was draped and prepped with Betadine paint in a normal sterile fashion. The area to be excised was on the right side of the patient's mid-forehead. This lesion had a maximum diameter of 1.1 cm with a 0.3 cm margin designed for total resection of 1.7 cm. The area for excision was infiltrated with 1% lidocaine with - correct answer 12052, 11442-51, L85.8