Manjolins Ulcer quiz

Question 1

What is a Maryolin’s Ulcer?

Answer 1

Marjolin’s ulcers are the malignant transformation of chronic wounds

Question 2

90% of Marjolin's Ulcers develop from:
A) Diabetes Mellitus
B) Scars from burns
C) Wound lacerations
D) lnfections

Answer 2

B) Scars from burns

Question 3

Marjolin's Ulcers occur most often on:
A) Trunk
B) Extremities
C) Wounds present for 30 years or more
D) Both b and c

Answer 3

D) Both b and c

Question 4

Histological examination of a Marjolin's Ulcer will show in around 95% of cases
to be related to:
A) BCC
B)  SCC
C) Osteomyelitis
D) Melanoma

Answer 4

B) SCC

Question 5

Marjolin's Ulcers generally have the following characteristics:
A) Well defined margins
B) Lots of granulation tissue
C) Poorly defined margins
D) both a and b

Answer 5

D) both a and b

Question 6

How is a diagnosis of Marjolin's Ulcer reached?
A) Wide excision of ulcer
B) Multiple core biopsies
C) Wound swabs
D) Wound scrapings

Answer 6

B) Multiple core biopsies

Question 7

First Line Treatment (depending on size and location of Ulcer) would generally be:

a) Wide excision of lesion
b) Split Skin Graft (SSG)
c) Chemotherapy
d) Both a and b

Answer 7

d) Both a and b

Question 8

When Osteomyelitis is present or a Marjolin’s Ulcer reoccurs, what might be the recommended treatment?

a) Vacuum Dressings
b) Amputation of extremity
c) Silver nitrate dressings
d) Hydrocolloid dressings
e) Identify characteristic as either Squamous Cell Carcinoma (SCC)or Basal Cell Carcinoma (BCC)

Answer 8

b) Amputation of extremity

Question 9

Identify characteristic as either Squamous Cell Carcinoma (SCC)or Basal Cell Carcinoma (BCC)

Waxy nodule with rolled translucent pearly borders

Answer 9

BCC

Question 10

Identify characteristic as either Squamous Cell Carcinoma (SCC)or Basal Cell Carcinoma (BCC)

Nodular, pigmented, superficial lesion

Answer 10

BCC

Question 11

Identify characteristic as either Squamous Cell Carcinoma (SCC)or Basal Cell Carcinoma (BCC)

Rough, thickened scaly lesion

Answer 11

SCC

Question 12

Identify characteristic as either Squamous Cell Carcinoma (SCC)or Basal Cell Carcinoma (BCC)

Higher incidence of metastasis and is invasive

Answer 12

SCC

Question 13

Identify characteristic as either Squamous Cell Carcinoma (SCC)or Basal Cell Carcinoma (BCC)

Rarely metastasises

Answer 13

BCC

Question 14

Identify characteristic as either Squamous Cell Carcinoma (SCC)or Basal Cell Carcinoma (BCC)

Is a tumour on the keratinising cells of the epidermis

Answer 14

SCC

Question 15

Identify characteristic as either Squamous Cell Carcinoma (SCC)or Basal Cell Carcinoma (BCC)

Occurs from single layer of basal cells between the dermis and epidermis

Answer 15

BCC

Question 16

10. What other considerations are there when caring for a patient with a Marjolin’s Ulcer or any other form of Chronic Ulcer?

Answer 16

Undertake an assessment for management of – Odour, Pain Relief, Product selection, diet, lifestyle or behaviour issues, psychological state and risk, comorbidities, environmental factors, palliative care issues
Consider consultation with Wound Care CNS, dietician, podiatrist etc, Wounds West information, or other resources needed for patients

Question 17

11. What it important to observe and document when you are doing a wound dressing?

Answer 17

Exudate, odour, wound edges, surrounding skin, colour, temperature, wound measurements (depth, width, length, and shape),
Other factors to document - Wound swab results, Level of pain experienced, Effectiveness of pain relief (if given) or need for pain relief

Question 18

What would you do if you were a Community Nurse and the patients wound was not improving? What might you suspect?

Answer 18

Patient assessment may indicate infection (increased temperature, increased HR, Respirations) or may indicate high colonization of the wound. Inform the patients Dr. Contact the CNS Wound Manager, review products applied (in consultation with Dr and CNS), document. Check the patients’ medications, infection is present are they taking the right Antibiotics.

Question 19

What specific Discharge Advice could you provide to your patient following a wide excision and SSG?

Answer 19

Education about care and S & S of infection or changing conditions, maintain a healthy well balanced diet and protein intake for tissue repair, use of pain medication. Lifestyle education is needed about avoiding sun exposure and use of protective sunscreen.
Appropriate management of leg is managed by elevating foot as much as possible if it is venous ulcer, compression if it is arterial. Use of Tubigrip as directed to increase venous return.
Any signs of infection are reported promptly and to maintain post -operative wound dressings to graft and donor site as ordered by the surgeon. Follow up appointments as directed.

Question 20

14. True or False?

Marjolin’s ulcers are a common cutaneous malignancy?

Answer 20

False

Question 21

14. True or False?

Marjolin’s Ulcers are more common in Developing Countries?

Answer 21

True