"Walking bleach" is done on ____________
a. the teeth at home by the patient
b. nonvital teeth
c. both a and b
d. neither a nor b
b
RATIONALE: "Walking bleach" is done on nonvital teeth.
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Most, but not all, cancers may produce body masses known as ________
Fill in the blank(s) with correct word
INDICATIONS: 55-year-old male with episodic abdominal pain for almost a year. Recurrence of the pain ultimately led to cholecystectomy in 8–90. Periodically the pain has been severe enough that he goes to the emergency room. I have seen him in the past for left upper quadrant pain, which I felt, was due to irritable bowel syndrome. Four days ago, he had an episode of severe epigastric pain that
seemed to radiate up into his chest and at times his neck. He described the pain as burning. It lasted a few hours and then resolved. Last night the pain recurred and was extremely severe. He was taken to the emergency room where he required parenteral narcotics. PROCEDURE: Following informed consent , he was sedated with Demerol 40 mg and Versed 1 mg IV. Oropharyngeal anesthesia with Cetacaine spray was administered. An Olympus OES type GIF-XQlO endoscope was introduced. The esophagus was unremarkable. The z-line was at 40 cm. from the incisors. There was no endoscopic esophagitis. No hiatal hernia was seen. Retroflex exam of the fundus and cardia was unrevealing. Pylorus , duodenal bulb, and several centimeters of post-bulbar duodenum were also unremarkable. The ampulla of Vater was seen tangentially and normal. He tolerated the procedure well. Two biopsies were taken of the distal esophagus to look for histologic evidence of inflammation. IMPRESSION: Normal esophagogastroduodenoscopy. Wonder if he is having panic attacks. He does describe some symptoms of gastroesophageal reflux disease and irritable bowel syndrome as noted above. PLAN: He will be discharged to home and will remain on Zantac 105 mg po bid. I will notify him with the biopsy reports. He will try Xanax 0.5 mg po at the onset of pain in the future. He is aware that this may cause sedation and that he should be careful around moving vehicles. ICD-9-CM diagnosis code(s): _____________________ __________________________________________________ ICD-10-CM diagnosis code(s): _____________________ __________________________________________________ CPT code(s) with modifier, if applicable: _____________________ What will be an ideal response?