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Chapter 149 Wound Healing

Total questions: 13

Worksheet time: 13mins

Name
Class
Date
1.

All of the following are TRUE about the coagulation cascade, EXCEPT FOR:

a)

Platelets are the main cell type involved

b)

Hageman factor XII initiates the intrinsic coagulation cascade

c)

Tissue factor initiates the intrinsic coagulation cascade

d)

Serotonin facilitates cell migration by increased vascular permeability

2.

All the following are TRUE regarding inflammation in wound healing, EXCEPT FOR:

a)

Neutrophil infiltration of the wound site occurs at 24 to 48 hours

b)

Macrophages appear in the wound site at 72 hours

c)

Neutrophils are the main phagocytic cells

d)

Activation of growth factors requires a hypoxic and acidic wound environment

3.

All of the following apply to M1 macrophages, EXCEPT FOR:

a)

Activated by IL-4, IL-13

b)

Releases IL-12

c)

Promotes a proinflammatory Th-1 response

d)

Classically activated macrophages

4.

Delayed healing may result from all of the following, EXCEPT FOR:

a)

Inappropriate levels of inflammation

b)

Presence of biofilms

c)

Moist wound environment during the acute wound phase

d)

C-myc expression on keratinocytes found at wound edges

5.

All of the following are TRUE regarding proliferation, EXCEPT FOR:

a)

PDGF and TGF-B attract fibroblasts to the wound bed and stimulate collagen production

b)

MMP allows re-epithelialization by facilitating detachment of keratinocytes from the wound edge

c)

Connective tissue in the healing wound are formed by collagens I, III, IV, and V

d)

Moist wound environments facilitate the process of epithelialization

6.

All of the following are TRUE regarding the remodeling phase, EXCEPT FOR:

a)

A phenotypic switch occurs and fibroblasts become myofibroblasts

b)

ECM material is altered, where collagen type I becomes collagen type III

c)

Tensile strength increases to a maximum of 80% of non-injured skin

d)

Contraction is responsible for 40% of the decrease in wound size

7.

Repair starts to replace regeneration during what stage of embryogenesis:

a)

First trimester

b)

Second trimester

c)

Third trimester

d)

After childbirth

8.

Which of the following growth factors is FDA approved for wound healing?

a)

PDGF-BB

b)

bFGF

c)

GM-CSF

d)

TGF-B

9.

Identify: Recombinant human PDGF-BB that is the only FDA-approved drug for non-healing neuropathic diabetic foot ulcers.

(a)  

10.

All of the following cytokines/growth factors are correctly paired with their corresponding function, EXCEPT FOR:

a)

PDGF: cytokine with the highest angiogenic activity

b)

TGF-B: over-expression leads to hypertrophic scar and keloid formation

c)

GM-CSF: promotes proliferation of neutrophils

d)

VEGF: parallels hypoxic gradient and stimulates angiogenesis

11.

All the following antiseptics are correctly paired with their main disadvantages, EXCEPT FOR:

a)

Povidone-iodine: toxic to granulation tissue

b)

Chlorhexidine: damages cartilage/ear toxicity

c)

Silver sulfadiazine: promotes fungal growth

d)

Honey alginate: botulism

12.

You're treating a patient with a non-healing ulcer. You noted painful erythema of the wound edges and purulent discharge. You request for cultures, which showed growth of MRSA. Which of the following wound dressings should you avoid?

a)

Hydrogels

b)

Hydrocolloids

c)

Foams

d)

Collagen-based dressings

13.

You are managing a patient with tender, shallow red-based ulcers with no purulent discharge on her bilateral lower legs. She also presented with increased varicosities and long-standing eczematous changes of the surrounding skin. On follow-up, she developed acute, painful, bright red erythema of both legs with no associated systemic symptoms. You took tissue biopsies and cultures and gave an empiric course of oral antibiotics. Tissue biopsy showed nodular angioplasia, sparse infiltrates of lymphocytes in the septa, central lobular ischemic fat necrosis, and lipomembranous changes. Tissue cultures were negative. What therapeutic option can you offer this patient?

a)

Surgical therapy

b)

Graded elastic stockings

c)

Topical antibiotics

d)

Stanozolol