AAPC-COC Certified Outpatient Coder - Set 1 - Part 2

Correct Answer: Aneurysm

An aneurysm is a dilation or bulging of a blood vessel caused by weakened vessel walls. Aneurysms are often asymptomatic and detected incidentally during diagnostic tests done for other reasons. Option a is incorrect because it is hardening and narrowing of arteries from plaque buildup in the lining, not a bulging of a weakened vessel wall. Option b is incorrect because it names disease of the heart muscle, which can thicken, enlarge, stiffen, or thin, rather than a blood vessel wall disorder. Option d is incorrect because it involves obstructed vessels in peripheral regions, commonly causing pain during activity and leg or foot ulcers, not a dilated wall.

Correct Answer: Leukemia

Leukemia is cancer of the bone marrow, the body's blood-forming tissues. It involves an abundance of nonfunctional leukocytes, which reduces the ability to fight infection, and it is diagnosed with a bone marrow biopsy. Option a is incorrect because it names a physician who diagnoses and treats blood disorders, a specialist role rather than a disease. Option b is incorrect because it is excessive leukocyte production that raises the infection risk, but it is not itself defined as a cancer of the bone marrow. Option c is incorrect because it describes excessive bleeding that hemostasis cannot control, a medical emergency, and has no connection to white blood cell overproduction.

Correct Answer: Monocytes

Monocytes are one of the five main types of white blood cells. They transform into macrophages in acute infections, where they clear debris and pathogens. Option b is incorrect because their role is defending against parasites and causing allergic reactions through release of histamine and other chemicals. Option c is incorrect because they engulf and destroy bacteria during acute bacterial infections and inflammation, rather than transforming into macrophages. Option d is incorrect because they are tied to adaptive immunity and antibody production, a different function from clearing debris as macrophages.

Correct Answer: Surgical removal of the spleen

The word root splen/o means spleen, and the suffix -ectomy means excision or cut out. Combined, splenectomy is defined as surgical removal of the spleen. Option a is incorrect because suturing is expressed by the suffix -rrhaphy, whereas the suffix in this term, -ectomy, means excision or cut out. Option c is incorrect because that meaning belongs to the suffix -itis; the term here ends in -ectomy, which describes cutting out rather than a condition. Option d is incorrect because enlargement is conveyed by the suffix -megaly, which does not appear in this term built on splen and -ectomy.

Correct Answer: Unpredictable course with greater likelihood of metastasis

Unpredictable behavior and a greater likelihood of metastasis describe non-Hodgkin lymphoma (NHL), which is much less predictable than Hodgkin lymphoma. The other three statements describe Hodgkin lymphoma itself. Option a is incorrect because this is the defining feature of Hodgkin lymphoma, in which lymphocytes grow out of control and produce swollen lymph nodes and growths. Option b is incorrect because these are the findings that result when lymphocytes multiply uncontrollably in Hodgkin lymphoma, so they do describe the disease. Option d is incorrect because early detection and treatment give Hodgkin lymphoma a good chance of cure, so this statement is true of it.

Correct Answer: Paralytic ileus

Paralytic ileus is the condition in which the bowels become temporarily paralyzed, and it appears among the common symptoms of peritonitis, which is inflammation of the peritoneum lining the abdominal cavity. Option a is incorrect because is a general term for liver inflammation from viruses, drugs, alcohol or autoimmune causes, so it concerns the liver rather than bowel paralysis. Option c is incorrect because is the life-threatening infection that can follow when bacteria move from the peritoneum into the bloodstream; it is a complication, not paralyzed bowels. Option d is incorrect because describes stomach acid repeatedly flowing back into the esophagus and irritating its lining, which is a reflux disorder and not a paralysis of the bowels.

Correct Answer: polypectomy

A polypectomy is the procedure that removes colon polyps. Because some polyps may develop into colon cancer over time, removing them greatly reduces the risk for colon cancer. Option a is incorrect because it takes out a section of the small bowel, a surgery listed for Crohn's disease rather than for polyp removal. Option b is incorrect because it creates a stoma by bringing part of the ileum through an opening in the abdomen, and does not remove polyps. Option d is incorrect because it removes the entire colon and rectum in severe inflammatory bowel disease, not just the individual growths on the colon lining.

Correct Answer: Osteonecrosis

Osteonecrosis combines oste/o (bone) with necrosis and refers to bone death due to lack of adequate blood supply. The other terms describe softening, a malignant tumor, or reduced bone mass. Option a is incorrect because it refers to the softening of bone, not to death of bone tissue from inadequate blood supply. Option b is incorrect because it names a malignant tumor of bone, which is a cancer rather than a loss of blood supply. Option c is incorrect because it describes an abnormal reduction of bone mass, a decrease in density that does not mean the bone has died.

Correct Answer: Spiral

A spiral fracture is the type in which the bone has twisted apart. Fractures are classified by complexity, location and other features, and spiral is the term tied to the twisting mechanism. Option b is incorrect because this term applies when a bone is crushed into pieces, a matter of fragmentation rather than twisting. Option c is incorrect because describes a bone broken at an angle, which is a different pattern from a break caused by the bone twisting apart. Option d is incorrect because a transverse fracture runs straight across the bone, so the break line has no twisting component.

Correct Answer: Sprain

A sprain is an injury to a joint in which a ligament is stretched or torn. It differs from a strain, which involves a muscle or tendon being overstretched or torn. Option a is incorrect because it is defined as pain in muscle fibers with widespread pain, sleep problems and fatigue, so it is not a ligament injury. Option c is incorrect because it refers to inflammation of a tendon that causes pain around a joint, usually after repeated injury, rather than a stretched or torn ligament. Option d is incorrect because a strain is an injury to a muscle or tendon from being overstretched or torn, not an injury involving a joint ligament.

Correct Answer: Ataxia

Ataxia is the movement disorder of cerebral palsy marked by poor balance and coordination. Cerebral palsy is classified by the main type of movement disorder involved: spasticity, dyskinesia or ataxia. Option b is incorrect because it refers to uncontrollable movements, so it is a separate type of movement disorder in cerebral palsy rather than a balance problem. Option c is incorrect because it is the word part meaning weakness or problems with using the muscles, not a named movement disorder type used to classify cerebral palsy. Option d is incorrect because it describes stiff muscles, a different cerebral palsy movement disorder, and does not describe the loss of balance and coordination.

Correct Answer: Conductive hearing loss

Conductive hearing loss occurs when something in the external or middle ear obstructs sound transmission. Cerumen impaction, which is earwax blocking the ear canal, is a named example of this type. Option a is incorrect because it is a form of sensorineural hearing loss tied to aging through gradual nerve degeneration, and nothing in the documentation describes aging or nerve changes. Option b is incorrect because it results from pathology of the inner ear, nerve damage, or damage to auditory areas of the brain, none of which is documented here. Option c is incorrect because it involves abnormal bone formation in the middle ear, whereas this documentation describes a blocked ear canal with the middle ear not mentioned as affected.

Correct Answer: Nyctalopia

Nyctalopia, or night blindness, means poor vision at night or in dim light, including difficulty adapting from bright to dim settings. It is a symptom of an underlying eye problem, usually retinal, not a disease itself. Option b is incorrect because a viral or bacterial infection producing swelling and redness in the conjunctiva and sclera, with itching and crusty drainage, is what this term describes. Option c is incorrect because blurry vision from irregular curvature of the cornea or lens defines it, and glasses or contact lenses treat it. Option d is incorrect because it is a disorder causing involuntary, rhythmic eye movements that keep the eyes from fixing on an object, not a problem with dim-light vision.

Correct Answer: Broca's area

Broca's area lies in the frontal lobe of the dominant hemisphere and is responsible for the production of language and controlling movements responsible for speech. Intact comprehension with impaired word production points to this area. Option a is incorrect because processes general sensations such as touch, pressure, pain, itch, and vibration, so it does not govern speech production. Option b is incorrect because sits in the temporal lobe and handles comprehension of written and spoken language, which this patient still has intact. Option c is incorrect because is the anterior portion of the frontal lobe and supplies planning, problem-solving, and short-term memory rather than the motor control of speech.

Correct Answer: Lymph

Lymph is the clear-to-white fluid formed when interstitial fluid enters the lymphatic capillaries. The lymphatic system transports it to the bloodstream and it carries immune system cells and dietary lipids. Option b is incorrect because interstitial fluid is the fluid found between cells in tissues; it becomes lymph only after it enters the lymphatic capillaries. Option c is incorrect because histamine is a chemical released during the immune response and is a primary cause of allergy symptoms, not a fluid carried by lymph vessels. Option d is incorrect because an antigen is a specific substance that triggers an exaggerated immune response in hypersensitivity, rather than a fluid moved to the bloodstream.

Correct Answer: Radioactive iodine uptake test

A radioactive iodine uptake test evaluates how well the thyroid is functioning by administering radioactive iodine and measuring how much the thyroid takes up. It is often performed together with a thyroid scan. Option a is incorrect because it determines hormone levels in the blood when an endocrine disorder is suspected and does not involve administering radioactive material to the thyroid. Option b is incorrect because it uses a radioactive iodine tracer to show the structure and function of the gland through computer images, rather than measuring the amount taken up. Option c is incorrect because it checks blood levels of sodium, potassium, and calcium, which is separate from evaluating how well the thyroid takes up iodine.

Correct Answer: Hirsutism

Hirsutism refers to overgrowth of hair in women, such as on the chin and face, due to excessive production of androgens. Endocrine disorders such as polycystic ovary syndrome and Cushing's syndrome can cause it. Option a is incorrect because it refers to high levels of glucose in the blood, which is the result of diabetes mellitus rather than hair overgrowth. Option c is incorrect because it is linked with diabetes insipidus and diabetes mellitus as a urinary finding that accompanies thirst, not a condition of hair growth. Option d is incorrect because it names the study of the endocrine system, a field of medicine, so it cannot label a patient's clinical finding.

Correct Answer: Pressure

Life depends on certain physical factors from the environment: water, oxygen, nutrients, heat, and pressure. Pressure is the one missing from the student's list, so it completes the set. Option b is incorrect because responsiveness, or irritability, is the life process of detecting changes in internal or external environments, so it is a body activity rather than an outside factor. Option c is incorrect because metabolism covers all the chemical reactions in the body and is one of the basic life processes, not an environmental factor. Option d is incorrect because homeostasis is the state of relative constancy of the internal environment that the body maintains; it is not a physical factor drawn from the environment.

Correct Answer: Protection

The protection function lets the skin shield the body from wind, water, and ultraviolet light, act as a barrier against dehydration, and serve as the first line of defense against abrasive activity such as grit. Option a is incorrect because vitamin D synthesis supports calcium and phosphorous absorption for bone health, which has no link to the barrier effects described here. Option b is incorrect because sensory function involves specialized sensory nerve structures in the epidermis, dermis, and hypodermis, and the excerpt describes resistance to environmental harm rather than detecting stimuli. Option c is incorrect because this function concerns temperature and electrolyte balance, while the excerpt centers on intact skin resisting wind, sun, dehydration, and abrasive grit.

Correct Answer: Diarthrosis

A diarthrosis is a freely movable joint whose bone ends have articular cartilage, are separated by a joint cavity, and are enclosed in a capsule with a synovial membrane. Such joints are also called synovial joints. Option a is incorrect because it describes a slightly movable joint joined by hyaline cartilage or fibrocartilage, such as the symphysis pubis, rather than one with a cavity and synovial membrane. Option b is incorrect because it is a structural category, not a functional one by amount of movement, and it does not describe a joint cavity lined by synovial membrane. Option d is incorrect because it names an immovable joint, where bones are separated only by a thin layer of fibrous connective tissue, like skull sutures, with no joint cavity.