CPCA Reading Comprehension 5

Question 1

A pathology report reads: 'Sections show moderately differentiated adenocarcinoma with lymphovascular invasion. Surgical margins are negative. 3 of 12 regional lymph nodes are positive for metastatic disease.' What does 'negative surgical margins' mean?

Accepted Answer

No cancer cells were found at the cut edges of the removed tissue

Answer

Negative surgical margins mean the outer edges of the removed specimen are free of cancer cells, suggesting complete resection.

Question 2

A physician writes in a SOAP note: 'S: Patient reports sharp, 8/10 chest pain worsened by inspiration. O: Pleural friction rub auscultated at left lower base. A: Pleuritis. P: NSAIDs initiated.' What does the 'A' in a SOAP note represent?

Accepted Answer

Assessment — the physician's clinical diagnosis or impression

Answer

In a SOAP note, 'A' stands for Assessment, which is the clinician's diagnosis or clinical impression based on the subjective and objective findings.

Question 3

An admission note documents: 'Neurological exam: Patient is alert and oriented x3. Cranial nerves II-XII grossly intact. Strength 5/5 in all extremities. DTRs 2+ bilaterally.' What does 'oriented x3' mean?

Accepted Answer

The patient is aware of person, place, and time

Answer

Oriented x3 means the patient correctly identifies themselves (person), their location (place), and the current date/time (time).

Question 4

A procedure note reads: 'Under fluoroscopic guidance, a 22-gauge spinal needle was advanced into the L4-L5 interspace. CSF was clear and colorless. Opening pressure was 18 cmH2O. Three tubes of CSF were collected and sent for analysis.' What procedure was performed?

Accepted Answer

Lumbar puncture (spinal tap)

Answer

A lumbar puncture (spinal tap) involves inserting a needle into the lumbar subarachnoid space to collect cerebrospinal fluid (CSF) for analysis.

Question 5

A clinical note reads: 'Review of systems is positive for fatigue, pallor, and exertional dyspnea. CBC shows Hgb 7.2 g/dL, MCV 72 fL, MCHC 28%. Peripheral smear demonstrates microcytic, hypochromic red cells.' What type of anemia does this presentation suggest?

Accepted Answer

Iron deficiency anemia (microcytic, hypochromic)

Answer

Microcytic (low MCV) and hypochromic (low MCHC) red cells are classic findings in iron deficiency anemia, the most common type globally.

CPCA Exam Practice Test

CPCA Exam Practice Test

CPCA Reading Comprehension 5