Module 1 - Wound care & Healing

Wound Care & Healing



Question 1 - Which of the following statements is FALSE

A contusion is a bruise without a break in the skin
An abrasion is a superficial removal of skin
An avulsion refers to tissues torn off partially or fully
A laceration refers to intact skin over a crush injury

Question 2 - Which collagen type is most abundant in the Proliferative stage of wound healing?

Type I
Type II
Type III
Type IV

Question 3 - Which of the following is NOT a component of an ideal ulcer dressing?

Protection
Immobilization
Compression
Absorption
Improved esthetics

Question 4 - Which of the following is FALSE regarding amputation?

Reattachment should be attempted if within 6 hrs of injury
Keep the amputated part moist by soaking in normal saline with ice
Keep the amputated part moist by wrapping it in gauze soaked with normal saline
Keep the amputated part in a clean bag and place the bag in ice

Question 5 - All of the following factors impair wound healing EXCEPT:

Immunosuppression
Smoking
Hypertension
Vitamin A
Hematoma

Question 6 - A patient has a chronic ulcer located on the lower left leg, over the medial malleolus. It is moderately painful with some relief when elevated. This ulcer is most likely of which type?

Pressure ulcer
Arterial ulcer
Diabetic ulcer
Venous ulcer

Question 7 - When does a wound have maximum tensile strength?

0-10 days
10-20 days
20-30 days
30-40 days
40-50 days

Question 8 - The following are features of the inflammatory phase of wound healing EXCEPT:

This phase lasts a finite length of time of approximately 4 days in primary intention healing.
The inflammation is mediated by a number of factors that cause dilation of capillaries at the wound site and lymphatic blockade, as well as migration of leukocytes through vessel wall into the wound.
This phase is marked by loss of function of the wounded area, as well as pain, redness, heat and swelling
This phase is marked by an increased rate of collagen synthesis from fibroblasts.
In this phase, neutrophil phagocytosis aids in the removal of clot, bacteria and other debris from the wound

Question 9 - Which of the following is NOT indicated for the management of chronically contaminated wounds?

Systemic antibiotics
Debribement
Frequent dressing changes
Final closure with a delayed flap, skin graft or flap
Application of silver sulfadiazine and/or mafenide acetate

Question 10 - The following are all true regarding cellulitis EXCEPT:

Most common organisms are Staphylococcus aureus and beta-hemolytic Streptococcus
Erythema with sharply demarcated borders is present
Often occurs secondary to trauma
Can lead to ascending lymphangitis (red streaks in skin proximal to area of infection)

Question 11 - Select the best combination of answers: Human bite injuries in the hand are treated with irrigation, exploration and debribement, +/- culture as well as broad spectrum antibiotic coverage. In addition, the following treatments are required: i. Tetanus, if no immunization in the last 10 yrs ii. Clavulinic acid iii. Primary closure iv. Secondary closure

i, iii
ii, iii
ii, iv
i, ii, iii
i, ii, iv

Question 12 - What are the 3 stages of wound healing, in order?

Proliferative phase, substrate phase, remodeling phase
Fibrin phase, remodeling phase, inflammatory phase
Substrate phase, Proliferative phase, remodeling phase
Inflammatory phase, dynamic stage, neutrophil phase

Question 13 - Which of the following is TRUE regarding leg ulcers?

The majority are arterial in nature.
Diabetic foot ulcers are deep ulcers
Distal pulses are decreased with venous ulcers
Venous ulcers are common over the medial malleolus
Arterial ulcers are painless

Question 14 - The following are contradictions to primary wound closure EXCEPT:

Animal/human bites
Infection
<6 hrs post injury
Too much tension on the wound

Question 15 - An ICU patient presented with an infection which lead to gangrene of the subcutaneous tissue and subsequent necrosis of more superficial layers. He was diagnosed with necrotizing fasciitis. What is the infectious cause of Type I necrotizing fasciitis?

Polymicrobial
Beta-hemolytic Streptococcus
Staphylococcal aureus
Viral

Question 16 - A human bite will grow what type of bacteria most commonly?

Eikenella corrodens
Pastenella multocida
Streptococcus viridans
Staphylococcus aureus

Question 17 - Which of the following is INCORRECT regarding stages of wound healing?

The first phase is inflammatory, or reactive, phase
The most important cell in the proliferative phase is the neutrophil
The remodeling phase can take from 6 wks to 1 year
Connective tissue regeneration involves contraction

Question 18 - Which is INCORRECT in the treatment of human bites?

Debribe wound, cleanse thoroughly
Culture the wound
Rule out penetration of joint space if applicable
Broad spectrum antibiotics
Suturing the wound

Question 19 - 19-year-old man presents to ED early Sunday morning and laceration over his knuckles. Most appropriate treatment is:

Clean, suture, tetanus booster
Clean, suture, give tetanus immunoglobin
Clean, suture, give antibiotics and tetanus immunoglobulin
Clean do not suture, give antibiotics and tetanus booster

Question 20 - Which bacterial species is unique to the oropharyngeal microflora?

Pasturella multocida
Eikenella corrodens
Streptococcus viridans
Staphylococcus epidermidis