Deck 71: Wound Care

Question 1

A 45-year-old male with remote history of a deep vein thrombosis to the right lower extremity presents with a 3-month history of a shallow, wet ulcer superior to the right medial malleolus. Wound is ruddy red with yellow fibrinous slough. Patient complains of dull aching pain, relieved with elevation. Physical exam is significant for woody leg edema bilaterally, darkened hyperpigmentation and dry scaly skin to the distal lower legs. Distal pulses are 2+ bilaterally. This wound is most likely a description of:

A) Neuropathic ulcer
B) Venous leg ulcer
C) Arterial leg ulcer
D) Traumatic leg ulcer

Answer 1

B

Question 2

When treating most open wounds it is important to choose a dressing that will maintain a moist wound environment.

Answer 2

True

Question 3

You are treating a noninfected chronic ulcer with thick yellow adherent slough covering the wound bed. Which of these actions will best help with wound healing?

A) Leaving the wound open to the air
B) Washing the wound with hydrogen peroxide
C) Painting the wound with povidone-iodine (Betadine)
D) Debride the nonviable tissue

Answer 3

D

Question 4

What test can be done to assess the protective sensation of the foot to determine the risk of foot ulceration?

A) Ankle-Brachial Index (ABI)
B) Simms-Weinstein monofilament
C) MRI
D) Plain film x-ray

Question 5

A 55-year-old female patient with a 20-year history of diabetes noticed new bloody drainage on her sock that started 1 week ago. On exam you note a small, round, moist, pale red, full thickness wound to the plantar surface of the foot under the first metatarsal head. The wound is surrounded by a thick, hard, raised callus. Distal pulses are present. Patient denies pain to the site. This wound is most likely a description of a(n):

A) Neuropathic ulcer
B) Venous ulcer
C) Arterial ulcer
D) Spontaneous rupture of abscess

Question 6

A 45-year-old male presents with a laceration to the left lower leg, which occurred when he fell from his bike a day ago. On physical exam you note a wound whose depth has gone into the subcutaneous tissue. This would be described as a:

A) artial thickness wound
B) Full thickness wound
C) Superficial wound
D) None of the above

Question 7

In aging patients wounds are acquired more easily, wound healing is delayed, and response to infection is decreased. This is due to decreased skin turgor, skin dehydration, and decreased inflammatory response.

Question 8

In treating a venous leg ulcer, the standard of care is:

A) Weekly application of a total noncontact cast
B) Serial sharp debridement
C) Compression therapy with a multilayer compression dressing
D) Negative pressure wound therapy

Question 9

A 72-year-old male presents with a 1-month history of painful wounds to the distal aspect of the right first and second toes. Patient complains of constant, severe, aching pain that is more acute at night and interferes with sleep. Patient has a history of hypertension, coronary artery disease, and a long history of smoking. Physical exam is notable for two round, well-demarcated wounds covered with dry black eschar. Peripheral pulses are faint on the right extremity and 2+ on the left. The right foot is cool with rubor. This wound is most likely a description of a(n):

A) Neuropathic ulcer
B) Venous ulcer
C) Arterial ulcer
D) Spontaneous rupture of abscess

Question 10

The definition of a chronic wound is most appropriately described as a wound that:

A) Has an abrupt onset and heals in a timely manner
B) Is associated with pain
C) Is usually caused by trauma
D) Does not move predictably through the repair process

Question 11

The mainstay of therapy in treatment of diabetic foot ulcer is:

A) Compression therapy
B) Off-loading pressure to the wound
C) Hyperbaric oxygen therapy
D) Split-thickness skin grafting

Question 12

Which of these tests is most appropriate prior to initiation of compression treatment in a patient with a venous leg ulcer?

A) Ankle-Brachial Index (ABI)
B) Simms-Weinstein monofilament
C) MRI
D) Wound culture