The patient is a 65-year-old male who was brought to the eme…

The patient is a 65-year-old male who was brought to the emergency department by his wife after he complained of acute worsening of his chronic lower back pain and a sudden ­difficulty in urinating. The patient is also experiencing numbness and weakness in his legs. The patient states that he has been diagnosed with lumbar spinal stenosis with neurogenic claudication in the past. Imaging studies are performed and severe spinal stenosis at the level of L5 is confirmed. The patient is diagnosed with cauda equina syndrome and is taken to the operating room for an emergent decompression of the spinal cord. An L5 laminectomy is performed to relieve the pressure on the spinal cord. The patient is kept in the hospital for further monitoring of his neurological condition after the surgery. The patient’s final diagnoses are cauda equina syndrome and lumbar spinal stenosis with neurogenic claudication. Principal Diagnosis: Secondary Diagnosis: Principal Procedure:

The patient is a 40-year-old female with Down syndrome who w…

The patient is a 40-year-old female with Down syndrome who was admitted to the hospital for a repeat penetrating keratoplasty (corneal transplant). The patient lives 120 miles away from the hospital with elderly parents and, because of the distance to be traveled, was being admitted instead of having an outpatient procedure. The patient had a penetrating keratoplasty on the left eye in the past. She developed a corneal ulcer and perforation, requiring a repeat penetrating keratoplasty via percutaneous approach in the left eye. The patient did understand the procedure and agreed to it, but the consent form was signed by her father. At the time of the corneal transplant, it was noted again that her eye was soft and appeared to be perforated, with a flat anterior chamber. The donor cornea was prepared. The previous donor cornea was removed from the patient’s eye. Four interrupted 10-0 nylon cardinal sutures were placed to secure the new donor tissue to the host, and a symmetrical rhomboid crease on the donor was noted. A total of 12 more interrupted 10-0 nylon sutures were placed equally distant from each other to secure the donor to the host, and the chamber was intermittently formed. The wound was checked for leaks, and none were seen. Subtenon injections of 80 mg Depo-Medrol and 40 mg gentamicin were administered as part of the procedure. Vigamox eye drops were placed in the eye. A bandage contact lens was placed in the eye with a shield on top. The patient was awakened and transferred to the recovery room. She stayed in the hospital overnight for pain control and management. She was examined the next morning by the ophthalmic surgeon and discharged to the care of her adult brother and parents to be driven home. Principal Diagnosis: Secondary Diagnosis: Hint:  This is a Z code to show the patient’s corneal transplant status. Add’l Diagnosis: Principal Procedure: Secondary Procedure: HINT: There are no extra blanks.