Operative Report PREOPERATIVE DIAGNOSIS: Perimenopausal bleeding; possible endometrial hypoplasia POSTOPERATIVE DIAGNOSIS: Perimenopausal bleeding PROCEDURES: Hysteroscopy; D&C SPECIMEN TO LAB: Endometrial curetting ESTIMATED BLOOD LOSS: Less than 5 mL DESCRIPTION OF PROCEDURE: The patient was taken to the OR and, under satisfactory general anesthesia, was examined and noted to have a normal-size uterus. No adnexal masses were noted. She was prepped and draped in the routine fashion, the speculum was placed in the vagina, and the anterior lip of the cervix was grasped with a single-tooth tenaculum. The uterus sounded to 8 cm and easily admitted a #21 K-Pratt, so no further dilation was necessary. A 12-degree hysteroscope was placed, using lactated Ringer’s as the distending medium, and the cervical canal was normal. The cavity revealed just fronds of tissue. There was tissue sticking out that did not have a particularly polypoid appearance. No other lesions could be appreciated that were polypoid. Curettage with a Milan curette, a serrated curette, and then polyp forceps revealed minimal tissue, and one piece of tissue of 5 mm was revealed that might be consistent with what was seen on the previous sonogram. The hysteroscope was then replaced. No other lesions could be appreciated, and the walls appeared smooth. At this time, the hysteroscope and tenaculum were removed. The tenaculum site was touched with silver nitrate. The bleeding was minimal at the end of the procedure. She was taken to the recovery room in satisfactory condition. Procedure code:

The OB/GYN physician delivers a baby via cesarean section. The physician has provided allobstetrical care prior to delivery and will continue to follow the patient for her postpartum care. Procedure code:

Operative Report POSTOPERATIVE DIAGNOSIS: Bladder neck contracture PROCEDURE: Vaporization of bladder neck contracture DESCRIPTION OF PROCEDURE: The patient was prepped and draped in the usual sterile manner. Anesthesia was administered, and the patient was placed in the lithotomy position. A cystoscope was introduced into the bladder and forced through the bladder neck contracture. A KTP laser was passed through the working channel of the cystoscope to vaporize the fibrous bladder neck contracture. The patient was sent to recovery in stable condition. Procedure Code:  

Operative Report PREOPERATIVE DIAGNOSIS: History of low-grade transitional cell carcinoma POSTOPERATIVE DIAGNOSIS: Same PROCEDURE: Flexible cystoscopy INDICATIONS: The patient was a 49-year-old male diagnosed with low-grade transitional cell carcinoma of the bladder. He was here today for his regular bladder tumor follow-up. DETAILS: The patient’s genitalia were prepped and draped in the typical fashion. 20 cc of 2 percent lidocaine jelly was instilled into the urethra. The anesthesia was given five minutes to set in. The 19-French flexible cystoscope was passed through the urethra into the bladder. Once inside the bladder, the entire bladder mucosa was evaluated. No lesions were identified. Both ureteral orifices were seen and found to be normal. At this point, the scope was removed. The patient will be called in three months for his next follow-up. Procedure code:

The patient is a 50 YO female.  Operative Note: The surgeon performed a cystoscopy with resection of a 4.0-cm bladder tumor. The procedure concluded with a steroid injection into the urethral stricture. First-Listed Diagnosis: Add’l Diagnosis: First-Listed Procedure: Add’l Procedure:

List the 4 purposes of internal controls.

A researcher maps a specific gene responsible for fur density to a precise, permanent physical position on chromosome 4 in mice. This physical geographic coordinates of a gene on a chromosome is referred to as its:

Lead disrupts glutamate reuptake at the blood-brain barrier, contributing to excitotoxic neuronal injury in lead encephalopathy. Dysfunction of which glial cell type, which normally maintains the BBB and clears synaptic glutamate, best explains this mechanism?

In vitro kinetic studies show lead inhibits ALA dehydratase with a Ki of 0.1 µM, but inhibits ferrochelatase with a Ki of 10 µM. Based on these binding affinities, which enzymatic reaction would be expected to show reduced activity at the lowest (earliest, most sensitive) blood lead levels?

Indicate the specific type of synovial joint moving plus the movement described for each listed action: TYPE OF SYNOVIAL JOINT MOVEMENT (write one only) Bending the elbow Turning the head from center to the side Lowering your arm from a T down to your side (in the coronal plane) Rolling your ankle/ turning the sole of the foot medially