8. Wounds

In a simple wound, the skin, mucosa, subcutis, superficial fascia and some muscle may be damaged.

T

Bases in high concentrations cause coagulation necrosis.

F

Wound flap with distal orientation may result in wound necrosis.

T

The passive immunization form of tetanus vaccine contains inactivated toxin from Clostridium tetani.

F

Verorab protects against tetanus infection.

F

Bone marrow is one of the most sensitive tissues to irradiation.

T

Special wounds are caused by animals that release toxins, poisons into the wound.

T

Combustion causes metabolic changes.

T

Chronic wound healing means that normal wound healing does not occur in two weeks.

F

Myofibroblasts are responsible for reducing wound size.

T

Hypoxia induces angiogenesis during wound healing.

T

Macrophages are the first immune cells to appear in the wound following injury.

F

During the remodelling phase of wound healing, collagen degeneration and synthesis occurs.

T

Mixed wound infections involve both superficial and deeper tissue layers.

T

Retention sutures are recommended after keloid removal.

F

What is the Latin equivalent of a torn wound?

a) vulnus punctum

b) vulnus morsum

c) vulnus lacerum

d) vulnus contusum

c

What is the Latin equivalent of an abraded wound?

a) vulnus punctum

b) vulnus morsum

c) vulnus abrasum

d) vulnus contusum

c

What is the Latin equivalent of a punctured wound?

a) vulnus punctum

b) vulnus morsum

c) vulnus abrasum

d) vulnus contusum

a

What is the Latin equivalent of an incised wound?

a) vulnus punctum

b) vulnus scissum

c) vulnus abrasum

d) vulnus contusum

b

What is the Latin equivalent of a cut wound?

a) vulnus punctum

b) vulnus scissum

c) vulnus caesum

d) vulnus contusum

c

What is the Latin equivalent of a crushed wound?

a) vulnus punctum

b) vulnus scissum

c) vulnus caesum

d) vulnus contusum

d

What is the Latin equivalent of a lacerated wound?

a) vulnus punctum

b) vulnus scissum

c) vulnus lacerum

d) vulnus contusum

c

What is the Latin equivalent of a shot wound?

a) vulnus punctum

b) vulnus scissum

c) vulnus caesum

d) vulnus sclopetarium

d

What is the Latin equivalent of a bite wound?

a) vulnus punctum

b) vulnus scissum

c) vulnus morsum

d) vulnus sclopetarium

c

What is the Latin equivalent of a freezing wound?

a) disruption

b) combustion

c) dehiscentia

d) congelatio

d

What is the Latin equivalent of burn injury?

a) disruption

b) combustion

c) dehiscentia

d) congelatio

b

What is the Latin equivalent of partial wound separation?

a) disruptio

b) combustion

c) dehiscentia

d) congelatio

c

What is the Latin equivalent of complete wound separation?

a) disruptio

b) combustion

c) dehiscentia

d) congelatio

a

Characteristic of an acute wound:

a) active angiogenesis

b) few fibroblasts

c) infection

d) more matrix metalloproteinases

a

Characteristic of sanatio per primam intetionem:

a) infection may cause

b) major tissue defect

c) linear wound healing

d) scar tissue

c

Characteristic of sanatio per secundam intetionem:

a) without complications

b) linear wound healing

c) can be caused by infection

d) no or minimal tissue loss

c

Characteristic of keloid:

a) Predilection sites are shoulder, sternal area, ears.

b) Spontaneous regression.

c) No difference in frequency of occurrence in each population.

d) Type III collagen fibers are located parallel to the surface

a

Characteristic of hypertrophic scar:

a) Overgrows the wound edges.

b) Predilection sites are shoulder, sternal area, ears.

c) Spontaneous regression.

d) Mostly affects African and Asian populations

c

What is this definition?

After wound cleansing, hemostasis and wound closure, the wound is treated openly for 3-8 days. If there is no evidence of inflammation or foreign body, the wound is closed after excision of the wound edge.

a) Primary wound closure

b) Primary delayed wound closure

c) Secondary early wound closure

d) Acute wound care

b

It is a circumscribed injury caused by external force. May involve any organ or tissue.

a) Surgery

b) Surgical hemostasis

c) Wound

d) Tetanus vaccination

c

This wound type develops in 8 weeks without treatment or in 4 weeks with treatment.

a) Chronic wound

b) Radiation-induced wound

c) Special wound

d) Crushed wound

a

This wound is red without sign of inflammation. Dressings should be changed every 2-3 days. Hydrocolloid and hydrogel treatment will help the wound healing.

a) Chronic wound in the necrotic phase

b) Chronic wound in the exudation phase

c) Chronic wound in the granulation phase

d) Chronic wound in the epithelialization phase

c

This wound heals without complications, resulting in linear wound healing.

a) Sanatio per secundam intentionem

b) Sanatio per compensationem

c) Sanatio per primam intentionem

d) Sanatio per terciam intentionem

c

Insufficient collagen production results in this wound healing disorder.

a) Atrophic scar

b) Hypertrophic scar

c) Keloid

d) Infection

a

What IS TRUE about a cut wound?

a) It occurs under sterile conditions.

b) Sharp and blunt force result it.

c) Wound stupor.

d) Torn wound edges.

b

WHAT'S TRUE about the punctured wound?

a) Negligibly small.

b) In all cases it is a simple wound type.

c) Anaerobic bacteria can cause serious infection.

d) Verorab injection is necessary.

c

What IS TRUE for congelatio?

a) Rewarming of the whole body is required.

b) Verorab vaccination required.

c) Severe bleeding.

d) Gastric perforation may occur.

a

What is NOT TRUE for a gunshot wound?

a) Always has an entry and exit wound.

b) It contains foreign bodies.

c) There is a necrotic zone.

d) No wound care is required.

a

What is NOT TRUE for a bite wound?

a) Causes amputation.

b) Can be associated with a lacerated wound type.

c) Tetanus prophylaxis required.

d) Wound stupor.

d

Phases of chronic wound healing:

a) Hemostasis, granulation, remodelling

b) Hemostasis-inflammation, granulation, remodelling

c) Necrosis, exudation, granulation, epithelialization

d) Necrosis, granulation, remodelling

c

Phases of acute wound healing:

a) Hemostasis, granulation, remodelling

b) Hemostasis-inflammation, granulation-proliferation, remodelling

c) Necrosis, exudation, granulation, epithelialization

d) Hemostasis, inflammation, necrosis, granulation

b

Which statement is FALSE?

a) Fibroblasts are activated during the granulation-proliferation phase.

b) Fibroblasts may be activated by platelets.

c) Myofibroblast is the result of phenotype alteration of fibroblasts.

d) Fibroblasts are most active during the remodelling phase

d

Which statement is TRUE?

a) The keloid remains within the wound boundary.

b) The predilection sites are the limbs.

c) The keloid is a scar tissue that is constantly growing.

d) The keloid develops mainly in Europeans.

c

Which statement is FALSE?

a) Hematoma is an early wound healing disorder.

b) A hematoma is serosus fluid accumulation.

c) Sterile puncture can be used to remove the hematoma.

d) The use of anticoagulants increases the chance of developing hematoma.

b

Open wound management required:

a) For a gunshot wound.

b) For an incised wound.

c) For a shallow puncture wound.

d) For a cut wound.

a

Tetanus infection can be expected if

a) The time between injury and care is more than 6 hours.

b) The depth of the wound is less than 1 cm.

c) The wound is incised.

d) If there is an abraded wound.

a

Treatment of combustion

a) Warming.

b) Cooling.

c) Close the wound with stitches.

d) Covering the bullae

b

What is true of clean-contaminated wounds?

a) Perionitis

b) Surgical intervention in the GI system

c) Acute inflammation

d) Develops before surgical intervention

b

Major events in the granulation-proliferation phase of acute wound healing:

a) Collagen re-synthesis

b) Angiogenesis

c) Macrophage activation

d) Platelet activation

b

Local factors that inhibit wound healing:

a) Oedema

b) Age

c) Diabetes mellitus

d) Smoking

a

Always apply delayed wound closure for the following injuries:

a) Dura mater

b) Thoracic cavity

c) Abdominal cavity

d) Infected wound to extremity

d

Complications of late wound healing may be:

a) Seroma

b) Inflammation

c) Wound disruption

d) Hematoma

b

Wound Infection:

a) Only develops in the early stages of wound healing.

b) Mostly affects the skin.

c) Always contains necrotic tissue.

d) Can be diffuse or localized.

d