Previous Exam Questions Flashcards
Where do blisters occur?
Between epidermis and dermis
Where does a callus form?
Epidermis
Which type of cells secrete histamine in response to inflammation?
Mast cells
What are the functions of the dermis? (5)
- Support and nourish epidermis
- House epidermal appendages
- Assist with infection control
- Assist with thermoregulation
- Provide sensation
What part of the body does not have hair follicles?
Lips, palms of hands, and soles of feet
What are the functions of the epidermis? (7)
- Barrier
- Regulate fluid
- Light touch sensation
- Thermoregulation
- Excretion assist
- Endogenous Vit D production
- Cosmesis/appearance
What are the two most common skin problems in nursing homes?
Xerosis and pruritus (dry and itchy)
What cells help with fibroblast migration across the matrix?
Integrins
Which of the following is not a primary lesion?
a. Vesicle
b. Nodule
c. Scales
d. Wheals
C. Scales
- they are secondary, below the plane of the skin
Dressing was on for 12 days and you notice that there is a distinct odor, what is the best course of action?
a. Culture the wound immediately
b. Odor is normal at this point, proceed as normal
c. There is clearly an infection, call the doctor immediately
b. Odor is normal at this point
- can’t culture IMMEDIATELY because you didn’t clean the wound first
- not enough info to tell if it is infected
Which populations are NOT at risk for MRSA? a. Prisons b. Contact sports teams c. Military D. People with AIDS E. People from third world countries
E. People from third world countries
Baby picture with purple/reddish pigmentation on half of his face
PORT-WINE STAIN
You are performing an ice massage and notice “hives” on the patient’s skin, this is an indicator of?
Urticaria
Which of the following would you be concerned about if your patient was very religious? (specifically animals)
a. Allograft
b. Autograft
c. Xenograft
C. Xenograft
- they use pigs
What is the most common type of skin cancer?
Basal cell carcinoma
Know the picture of squamous cell and basal cell carcinoma
SEE PICTURE
Which of the following represents skin pigmentation disorders?
a. Nevi, vitilligo, lipoma
b. Melasma, ephilides, lentigines
c. Melasma, cherry angioma, nevi
b. Melasma, ephilides, lentigines
How does smoking affect arterial insufficiency?
smoking increases clot formation and blood viscosity
What is considered an abnormal drop in ABI with a repeated test?
> 0.15
The following characteristics describe what condition?
-Skin is hard, smooth, and stiff. Slow progressive, inflammatory disorder that requires ROM interventions
Scleroderma
Which of the following are fungal infections?
a. varicella-zoster, tinea pedis
b. cellulitis, candidiasis
c. . tinea pedis, cellulitis
d. tinea pedis, candidiasis
d. tinea pedis, candidiasis
Rate from slowest to fastest healing wounds.
Square, circular, linear
Circular, square, linear
Rate from fastest to slowest types of wound closure.
a. Primary, delay, secondary
b. Primary, secondary, delay
c. Secondary, delay, primary
d. Secondary, primary, delay
b. Primary, secondary, delay
Chronic wounds typically have which of the following:
a. Equal amounts of MMPs and TIMPs
b. High TIMPs and low MMPs
c. High MMPs and low TIMPs
c. High MMPs and low TIMPs
Normal skin microflora is what?
10^3 per g/tissue
What microbe number would be considered an infection?
10^5
Diabetes is a disorder of what?
Carbs, protein, fat metabolism
Type II diabetes is less common. T or F
False. Type II makes up 90% of diabetes
What enzyme is typically used for enzymatic? The only one FDA approved
Collagenase (Santyl)
Charcot or rocker bottom foot deformation is commonly found in what condition?
Diabetes
What percentage of ulcers are venous?
70-90%
When can you use a total contact cast?
a. All neuropathic ulcers
b. Wagner grade 3 and 4
c. Wagner grade 1 and 2
d. Never with neuropathic ulcers
Wagner 1 and 2 ONLY
Your patient has a bounding pulse, how do you document it?
a. 1+
b. 3+
c. 2+
d. 0
b. 3+
You notice your patient has 2-4mm of indentation that rebounds in <10 seconds, how do you classify this pitting edema?
a. 1+
b. 2+
c. 3+
d. 4+
b. 2+
Your patient is able to sense the 4.17 monofilament, however is not able to sense the 10g pressure produced. What is this an indicator of?
a. Loss of protective sensation
b. This is normal, you shouldn’t be able to sense 10g
c. The patient is lying, 4.17 and 10g are the same thing
d. They have decreased sensation
a. Loss of protective sensation
What is considered to be a positive indicator for wound healing?
20-40% decrease in wound surface area withing 2-4 weeks
List in order of least to worst.
-critical colonization, infection, colonization, contamination
Contamination
Colonization
Critical Colonization
Infection
T or F. Biofilms may INCREASE bacterial virulence and resistance
TRUE
Anaerobes CANNOT survive in what type of environment?
Oxygenated
What increases the risk of fungal infections? (4)
- Taking antibiotics
- Immunocompromised
- Diabetes
- Moist, occluded areas on skin
What temperature should thermal insulation of a wound dressing be?
37 degree Celsius
What is the purpose of secondary dressings?
Protection
Cushioning
Absorption
Occulsion
List from MOST to LEAST absorptive Hydrocolloid Semipermeable film Alginates Semipermeable foam Hydrogels
Alginates Semipermeable foam Hydrocolloids Hydrogels Semepermeable film
List the dressings from LEAST to MOST occlusive
Loose gauze Fine gauze Calcium Alginates Impregnated gauze Semipermeable film Semipermeable foam Hydrogel Hydrocolloids
Semipermeable films are:
a. impermeable to water but not bacteria
b. Impermeable to bacteria but not water
c. Impermeable to both bacteria and water
d. Impermeable to neither bacteria nor water
c. impermeable to both bacteria and water
T or F. Sheet hydrogels are impermeable to gas and water
FALSE. Sheet hydrogels are permeable to both gas and water
What are the characteristics of hydrocolloid dressing? They are impermeable to what?
Impermeable to water, O2 and bacteria
What should you never use with silver dressings?
Saline solution - sodium chloride will deactivate it
T or F. Silver can be slow acting and have effects for up to 7 days
TRUE
What is not an example of a growth factor?
a. Allodermazyme
b. Becaplermin
c. Porcine submucosa
a. Allodermazyme
- Becaplermin is used on diabetic foot ulcers
- Porcine submucosa is used on partial thickness chronic ulcers
When would you use a growth factor?
Chronic wound that is not responding to other interventions
Which of the following is correct?
a. Ulcer–> ischemic rest pain –> intermittent claudication –>arterial insufficiency
b. ischemic rest pain –> arterial insufficiency –> intermittent claudication –> Ulcer
c. arterial insufficiency–> intermittent claudication–> ischemic rest pain–>Ulcer–>
c. arterial insufficiency–> intermittent claudication–> ischemic rest pain–>Ulcer–>
What is normal ABI?
0.9-1.1
At what ABI would you consider revasularization?
0.5-0.7
Compression is contraindicated if ABI is lower than?
<0.7
What are NOT predictive of VI ulcer healing? (4)
- Gender
- Race
- Skin Condition
- Presence of infection
What are the parameters for compression at the ankle?
30-40mmHg
All of the following are contraindications for compression EXCEPT?
a. Acute infection
b. Pulmonary edema
c. Uncontrolled/ severe CHF
d. History of DVT
d. History of DVT
- ACTIVE DVT is contraindicated
What are the pressure ulcer risk assessments?
Braden
Norton
Gosnell
What are the assessments of a pressure ulcer wound?
Sessing
PUSH
BWATT
What is is maximum tissue strength after wound closure?
80%
What are the main locations of pressure ulcers?
Sacrum Greater trochanter Ischial tuberosity Posterior calcaneus Lateral malleolus
A decrease in weight will have what effects on a diabetic?
good for everything - lipids, HTN, cholesterol
Diabetic footwear would include what?
1/2 inch longer than longest toe
Extra depth toe box
Heel height <1 in
