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FHDM Unit 1: Wound Healing > Dr. Atta Nutrition and Wound Healing > Flashcards

Dr. Atta Nutrition and Wound Healing Flashcards

1
Q

How many phases of wound healing are there?

A

3 or 4 phase process depending on if you include hemostasis

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2
Q

What are the 3 phases of wound healing

A

Inflammation –*Hemostatis is included here

Proliferation

Remodeling

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3
Q

What is the goal of hemostasis

A

ensure the formation of the fibrin clot

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4
Q

What are the 2 steps of hemostasis

A
  1. Vascular Constriction
  2. Platelet aggregation
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5
Q

What happens in the inflammation stage

A
  1. neutrophil inflammation
  2. monocyte infiltration and differentiation to macrophage
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6
Q

What are the 4 steps to the proliferation stage

A
  1. re-epithliazation
  2. angiogeneis
  3. collagen synthesis
  4. ECM formation
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7
Q

What happens during the remodeling stage

A
  1. collagen remodeling
  2. Vascular maturation and regression
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8
Q

How does the inflammatory phase begin

A

formation of the fibrin clot

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9
Q

What does hemostasis refer to

A

the cessation of blood flow through a blood vessel or body tissue via a stable fibrin hemostatic plug

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10
Q

What are the important blood clotting factors

A

2,7,9,10

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11
Q

In order for thrombin to be converted to prothrombin what must occur

A

protrombin (factor 2) must bind to calcium

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12
Q

What do factor 2,7,9,10 all have in common

A

they all have glutamic residues in the first 35 residues

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13
Q

gamma glutamyl carboxylase is dependent on what

A

vitamin K dependent

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14
Q

What enzyme is needed to change glutamic acid to gamma glutamyl glutamic acid? What is also needed

A

gamma glutamyl carboxylase. Needs factor K

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15
Q

If a person has a vitamin k deficieny what will happen to blood clotting factors

A

you will have lower than normal levels of blood clotting factors

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16
Q

what kind of drug is known as a vitamin k antagonist

A

warfarin

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17
Q

How does warfarin work?

A

it inhibits the regeneration of vitamin K by inhibiting the reductase

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18
Q

How long does the inflammatory phase last

A

4-6 days

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19
Q

Which phase is this : associated with edema , erythema, heat, pain

A

inflammatory

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20
Q

list 3 cells involved in inflammatory phase

A

platelets, neutrophiles, macrophages

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21
Q

What phase is this:

  1. clot formation
  2. increased vessel permiability
  3. Neutrophil migration in tissue
  4. Macrophages release growth factors
A
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22
Q

What the function of the growth factors that macrophages release in inflammation?

A

They release growth factors that stimulate fibroblast proliferation, and collagen synthesis

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23
Q

What occurs during the first stage of the proliferation stage

A

granulation - connective tissue cells called fibroblasts proliferate under the growth factors that were secreted by macrophages (FGF-2)

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24
Q

What kind of collegen is found in the granulation phase

A

type 3

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25
Q

What does angiogeneiss refer to

A

the sprouting of new blood vessels (stage 2 of phase 2)

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26
Q

What does contraction refer to?

What is the process mediated by?

What stage of wound healing is this?

A

When the wound heals, the edges pull towards each other towards the center. This process is mediated by myofibroblasts.

This happens during the proliferation phase

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27
Q

The process leading to the formation of the fibrin clot is called

A

hemostasis

28
Q

What is an important vitamin needed in the hemostasis stage

A

vitamin k- it activates factors 2,7,9,10

29
Q

Describe the residues look like on factors 2,7.9,10

A

the have glutamate residues that must be gamma carboxylated so they can interact with calcium so that they can interact with phospholipids.

30
Q

what is needed to activate factors 2,7, 9 ,10

A

vitamin K

31
Q

A personal has an abnormal prothrombin time what does that indicate

A

it indicates vitamin k deficient . Basically this means that the prothrombin time will be elevated and they will have prolonged bleeding

32
Q

a condition that makes someone at high risk for vitamin k deficiney is ,…

A

cystic fibrosis

33
Q

What part of a person having cystic fibrosis makes them at higher risk for increased prothrombin time

A

they have an increased prothrombin time because they have clogged ducts which makes it more difficult for fat-soluble vitamins to be released

34
Q

How does warfarin work

A

it is an inhibitior of one of the enzyme that is required to regenerate vitamin K

35
Q

What specific enzyme does warfarin inhibit

A

vitamin K epoxide reductase

36
Q

an example of a vitamin k antagonist is

A

warfarin

37
Q

warfarin inhibits formation of __________ in factors 2,7,9,10 because they are vitamin ___ dependent

A

gama carboxy glutamate

k

38
Q

Angiogenesis is initiated by

A

fibroblasts

39
Q

A chronic wound is usually arrested in what stage

A

inflammatory stage

40
Q

infected wounds heal by what intention

A

tertiary

41
Q

describe what wound healing by secondary intention means

A

heal by granulation - burns pressure ulcers, wounds with large peices of missing skin - RISK OF INFECTION

42
Q

what does an infected wound look like

A

reddish coloration angry looking,

43
Q

symptoms of vitamin c deficiency

A

ecchymoses (discoloration of skin), skin hemmorhages, loose teeth, scurvy , poor wound healing

44
Q

How is vitamin c related to poor wound healing

A

vitamin c plays a role because it plays a critical role in the hydoxylation of proline and glycine.

45
Q

List 4 important minerals that are needed for wound healing

A

Fe, Cu, Zn, Se

46
Q

a person has an inability to taste and smell, what deficifny do they likely have

A

zinc deficiency

47
Q

In which phase of wound healing does zinc play a role

A

in the inflammatory phase- if there is a deficiency it leads to impaired phagocytosis in macrophages and neutrophils.

48
Q

What is the function of collagenase and what vitamin is required

A

collagenase destroys collagen type 3 . In remodeling type 3 is replaced by type 1

49
Q

what produces fibroblast growth factors

A

macrophages

50
Q

What kind of collegen is seen in the granulation phase

A

type 3

51
Q

contraction is mediated by

A

myofibroblasts

52
Q

What are the 4 phases of the proliferative phase

A
  1. Granulation
  2. Angiogenesis
  3. Contraction
  4. Epithelization
53
Q

In the absense of _________a wound can not be considered healed

A

re-epithelization

54
Q

In the remodeling phase collogen is remodeled from type ___ to type ___

A

type 3 to type 1

55
Q

Type 1 collegen is layed down during which stage of wound healing?

A
56
Q

What does a chronic wound mean

A

it has arrested in one of the wound healing stages

57
Q

What is the function of fibroblast growth factors

A

fibroblast growth factors enhance proliferation and recruitment of macrohphages and fibroblasts

58
Q

What is the role of vitamin c in wound healing and what phase is it important in

A

it is a cofactor for prolyl and lysly hydroxylases for proline during the proliferative phase

59
Q

vitamin c is also known as

A

ascorbic acid

60
Q

what kind of collegen is found in granulation tissue

A

collagen type 3

61
Q

the more organized type 1 collegen is found in what phase

A

remodeling phase

62
Q

every 3rd residue is a —- in collegen

A

glycine

63
Q

someone has decreased tensile strength in collegen, what vitamin deficieny do they have

A

Cu

64
Q

Zn is used during which phase of wound healing? What is its function

A

during the inflammatory phase - it forms superoxide dismutase to kill bacteria

65
Q

A person has loose teeth and ecchymosis what vitamin are they deficient in

A

vitamin c deficiency

66
Q

deficiency of a vitamin that acts as a coenzyme for gamma glutamate carboxylase would most likely present as which of the following

A

hyperprothmbic anemia

FHDM Unit 1: Wound Healing (4 decks)

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