Practicode IV (301-400) Testbank
Newest 2026-2027. Questions &
Correct Answers. Graded A
CaseID: OPD6931
Primary Diagnosis: M17.11
CPT: 27447-RT – ANS MEDICAL RECORD
SEX: MALE Age: 63DATE OF OPERATION: 1/1/20XXPREOPERATIVE
DIAGNOSIS: PRIMARY DEGENERATIVE JOINT DISEASE-RIGHT
KNEE.PROCEDURES: RIGHT TOTAL KNEE ARTHROPLASTY
(ZIMMER).1. FEMORAL SIZE-SIZE E; RIGHT.2. TIBIAL SIZE 6.3.
ARTICULAR SURFACE-SIZE E-RIGHT; 10-MM HEIGHT.4. TAPER STEM
PLUG AND STEM EXTENSION SCREW.POSTOPERATIVE DIAGNOSIS:
PRIMARY DEGENERATIVE JOINT DISEASE-RIGHT KNEE.SURGEON:
Stephanie Andrews MDANESTHESIA: GENERAL.ANESTHESIOLOGIST:
PROCEDURE: After adequate induction with general anesthesia and the
patient in the supine position, a pneumatic tourniquet was applied to the
high right thigh region and not inflated. The right lower extremity was
scrubbed, prepped with Betadine and draped in the usual manner for knee
surgery. An Esmarch tourniquet was applied to the right lower extremity,
which was elevated for a period of two minutes. The pneumatic tourniquet
was inflated to the appropriate level and the Esmarch removed.A linear
incision was made along the anterior aspect of the right knee from the
distal quadriceps to the tibial tubercle. The incision was brought to the
subcutaneous tissue and undermined medially. A medial parapatellar
1
,incision was made extending from the quadriceps raphe to the medial tibial
tubercle. The patella was mobilized laterally and the infrapatellar fat pad
was excised. The anteromedial and the anterolateral capsule of the
proximal tibia was released. The knee was flexed and the patella
everted.Advanced degenerative changes of the interior of the right knee
was observed, which was most advanced in the patellofemoral and medial
joints with exposure of subchondral bone. The extramedullary alignment
rod was applied to the tibia and fixed with pin. The proximal cut was made
with an oscillating saw, having determined the height by 10-mm of the
lateral tibial plateau. A drill hole
CaseID: OPD6932
Primary Diagnosis: S72.352A
CPT: 27506-LT – ANS MEDICAL RECORD
SEX: MALE Age: 55DATE OF OPERATION: 01/1/20XXPREOPERATIVE
DIAGNOSIS: LEFT FEMUR FRACTURE.PROCEDURES: LEFT FEMUR
INTERMEDULLARY NAILINGPOSTOPERATIVE DIAGNOSIS:
DISPLACED COMMUNITED LEFT FEMORAL SHAFT
FRACTURE.SURGEON:ANESTHESIA: GENERAL VIA ENDOTRACHEAL
TUBE.ESTIMATE BLOOD LOSS: 300 CC.ANTIBIOTICS: 1 GM ANCEF
PREOP AND 1 GM ANCEF POSTOP.COMPLICATIONS:
NONE.INDICATIONS: The patient is a male who was found on train tracks
and on physical examine and x-ray was found to have a displaced
comminuted fracture of the left femur. Options, risks, and benefits were
discussed with the brother, as the patient was unable to give consent. He
agreed with intramedullary nailing. PROCEDURE: The patient was brought
to the operating room and anesthesia was induced via endotracheal tube.
2
,The patient was then positioned on the fracture table and closed reduction
was performed. The left hip and lower extremity were then prepped and
draped in sterile fashion.A longitudinal incision was made superior to the
greater trochanter and taken down through the subcutaneous tissue to the
tip of the trochanter. A guide rod was placed and centered in the AP and
lateral views. This was then over reamed, and a bead guide rod was placed
down the shaft across into the distal fragment. This was then sequentially
reamed up to 10 and then a 10 x 400 Stryker nail was inserted and then the
proximal interlock was done with the guide in the static position. The distal
interlocks were done in a perfect circle technique.Clinically, he had good
rotation compared to the other side and x-ray showed anatomic reduction
and good position of the hardware. The wounds were then irrigated out.
The gluteus fascia was closed with interrupted 0-Vicryl. The subcutaneous
tissue was closed with interrupted 2-0 Vicryl. Skin was closed with skin
clips as were the interloc
CaseID: OPD6947
Primary Diagnosis: M16.11
Secondary Diagnosis: M85.451, Q27.30
CPT: 27130-RT – ANS MEDICAL RECORD
Age 68Sex: MALEDate of Service: 1/1/20XXService Department:
Orthopedic Group GeneralPREOPERATIVE DIAGNOSIS: Arteriovenous
malformation with severe primary osteoarthritis of the right
hip.POSTOPERATIVE DIAGNOSIS: Same.NAME OF PROCEDURE:
Right total hip arthroplasty.SURGEON:ANESTHESIA:
GeneralDESCRIPTION OF PROCEDURE: The patient was taken to the
operating room and after satisfactory general anesthesia the patient had an
3
, intrathecal block performed for postoperative pain control he was placed in
the lateral decubitus position with his right hip uppermost. The right hip was
then thoroughly scrubbed, prepped and draped in the usual sterile manner.
The hip was incised longitudinally down to the fascia lata which was also
split. This was retracted and the hip identified. The anterior half of the
abductors were incised at the insertion of the greater trochanter. The leg
was externally rotated. The capsule was then identified and a t-shaped
incision was made in the capsule. The hip was dislocated anterolaterally.
The femoral neck was the transected at the appropriate location to hold the
medial neck prosthesis. The acetabulum was curetted. The labrum was
removed and the acetabulum was then prepared with the combination
reamers to hold a size 60 Press-Fit bone ingrowth prosthesis. The dome of
the acetabulum had a large bone cyst. This was curetted. Kessel's node
harvested from the patient's femoral head. The Press-Fit 60 mm prosthesis
was then impacted in position. The Polyethylene liner was then inserted
with the 10 degree buildup at the 10 o'clock position. The femur was then
prepared with the Stryker instrument to hold a size 10 Press-Fit bone
ingrowth prosthesis. This was impacted down the femoral canal. Trial
reduction was performed with the -5 to -2.5 and 0 head and neck length.
The -2.5 was selected. This
CaseID: OPD6949
Primary Diagnosis: M19.011
Secondary Diagnosis: M75.41
CPT: 29824-RT, 29826-RT – ANS MEDICAL RECORD
Age: 46 Sex: FEMALEDate of Service: 1/1/20XXService Department:
Orthopedic Group GeneralPREOPERATIVE DIAGNOSIS: Right shoulder
4
Newest 2026-2027. Questions &
Correct Answers. Graded A
CaseID: OPD6931
Primary Diagnosis: M17.11
CPT: 27447-RT – ANS MEDICAL RECORD
SEX: MALE Age: 63DATE OF OPERATION: 1/1/20XXPREOPERATIVE
DIAGNOSIS: PRIMARY DEGENERATIVE JOINT DISEASE-RIGHT
KNEE.PROCEDURES: RIGHT TOTAL KNEE ARTHROPLASTY
(ZIMMER).1. FEMORAL SIZE-SIZE E; RIGHT.2. TIBIAL SIZE 6.3.
ARTICULAR SURFACE-SIZE E-RIGHT; 10-MM HEIGHT.4. TAPER STEM
PLUG AND STEM EXTENSION SCREW.POSTOPERATIVE DIAGNOSIS:
PRIMARY DEGENERATIVE JOINT DISEASE-RIGHT KNEE.SURGEON:
Stephanie Andrews MDANESTHESIA: GENERAL.ANESTHESIOLOGIST:
PROCEDURE: After adequate induction with general anesthesia and the
patient in the supine position, a pneumatic tourniquet was applied to the
high right thigh region and not inflated. The right lower extremity was
scrubbed, prepped with Betadine and draped in the usual manner for knee
surgery. An Esmarch tourniquet was applied to the right lower extremity,
which was elevated for a period of two minutes. The pneumatic tourniquet
was inflated to the appropriate level and the Esmarch removed.A linear
incision was made along the anterior aspect of the right knee from the
distal quadriceps to the tibial tubercle. The incision was brought to the
subcutaneous tissue and undermined medially. A medial parapatellar
1
,incision was made extending from the quadriceps raphe to the medial tibial
tubercle. The patella was mobilized laterally and the infrapatellar fat pad
was excised. The anteromedial and the anterolateral capsule of the
proximal tibia was released. The knee was flexed and the patella
everted.Advanced degenerative changes of the interior of the right knee
was observed, which was most advanced in the patellofemoral and medial
joints with exposure of subchondral bone. The extramedullary alignment
rod was applied to the tibia and fixed with pin. The proximal cut was made
with an oscillating saw, having determined the height by 10-mm of the
lateral tibial plateau. A drill hole
CaseID: OPD6932
Primary Diagnosis: S72.352A
CPT: 27506-LT – ANS MEDICAL RECORD
SEX: MALE Age: 55DATE OF OPERATION: 01/1/20XXPREOPERATIVE
DIAGNOSIS: LEFT FEMUR FRACTURE.PROCEDURES: LEFT FEMUR
INTERMEDULLARY NAILINGPOSTOPERATIVE DIAGNOSIS:
DISPLACED COMMUNITED LEFT FEMORAL SHAFT
FRACTURE.SURGEON:ANESTHESIA: GENERAL VIA ENDOTRACHEAL
TUBE.ESTIMATE BLOOD LOSS: 300 CC.ANTIBIOTICS: 1 GM ANCEF
PREOP AND 1 GM ANCEF POSTOP.COMPLICATIONS:
NONE.INDICATIONS: The patient is a male who was found on train tracks
and on physical examine and x-ray was found to have a displaced
comminuted fracture of the left femur. Options, risks, and benefits were
discussed with the brother, as the patient was unable to give consent. He
agreed with intramedullary nailing. PROCEDURE: The patient was brought
to the operating room and anesthesia was induced via endotracheal tube.
2
,The patient was then positioned on the fracture table and closed reduction
was performed. The left hip and lower extremity were then prepped and
draped in sterile fashion.A longitudinal incision was made superior to the
greater trochanter and taken down through the subcutaneous tissue to the
tip of the trochanter. A guide rod was placed and centered in the AP and
lateral views. This was then over reamed, and a bead guide rod was placed
down the shaft across into the distal fragment. This was then sequentially
reamed up to 10 and then a 10 x 400 Stryker nail was inserted and then the
proximal interlock was done with the guide in the static position. The distal
interlocks were done in a perfect circle technique.Clinically, he had good
rotation compared to the other side and x-ray showed anatomic reduction
and good position of the hardware. The wounds were then irrigated out.
The gluteus fascia was closed with interrupted 0-Vicryl. The subcutaneous
tissue was closed with interrupted 2-0 Vicryl. Skin was closed with skin
clips as were the interloc
CaseID: OPD6947
Primary Diagnosis: M16.11
Secondary Diagnosis: M85.451, Q27.30
CPT: 27130-RT – ANS MEDICAL RECORD
Age 68Sex: MALEDate of Service: 1/1/20XXService Department:
Orthopedic Group GeneralPREOPERATIVE DIAGNOSIS: Arteriovenous
malformation with severe primary osteoarthritis of the right
hip.POSTOPERATIVE DIAGNOSIS: Same.NAME OF PROCEDURE:
Right total hip arthroplasty.SURGEON:ANESTHESIA:
GeneralDESCRIPTION OF PROCEDURE: The patient was taken to the
operating room and after satisfactory general anesthesia the patient had an
3
, intrathecal block performed for postoperative pain control he was placed in
the lateral decubitus position with his right hip uppermost. The right hip was
then thoroughly scrubbed, prepped and draped in the usual sterile manner.
The hip was incised longitudinally down to the fascia lata which was also
split. This was retracted and the hip identified. The anterior half of the
abductors were incised at the insertion of the greater trochanter. The leg
was externally rotated. The capsule was then identified and a t-shaped
incision was made in the capsule. The hip was dislocated anterolaterally.
The femoral neck was the transected at the appropriate location to hold the
medial neck prosthesis. The acetabulum was curetted. The labrum was
removed and the acetabulum was then prepared with the combination
reamers to hold a size 60 Press-Fit bone ingrowth prosthesis. The dome of
the acetabulum had a large bone cyst. This was curetted. Kessel's node
harvested from the patient's femoral head. The Press-Fit 60 mm prosthesis
was then impacted in position. The Polyethylene liner was then inserted
with the 10 degree buildup at the 10 o'clock position. The femur was then
prepared with the Stryker instrument to hold a size 10 Press-Fit bone
ingrowth prosthesis. This was impacted down the femoral canal. Trial
reduction was performed with the -5 to -2.5 and 0 head and neck length.
The -2.5 was selected. This
CaseID: OPD6949
Primary Diagnosis: M19.011
Secondary Diagnosis: M75.41
CPT: 29824-RT, 29826-RT – ANS MEDICAL RECORD
Age: 46 Sex: FEMALEDate of Service: 1/1/20XXService Department:
Orthopedic Group GeneralPREOPERATIVE DIAGNOSIS: Right shoulder
4
