Venous ulcer Flashcards
Stem; A Venous ulcer in forearm, not healed. Biopsy taken.
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Stem; A Venous ulcer in forearm, not healed. Biopsy taken.
Q1. In biopsy report, what are the criteria of malignancy you look for?
Anaplasia Loss of Diff. / loss of polarity/ Increase mitotic figure /Inc. nucleus cytoplasmic ratio/ Hyperchromatism / Invasion of basement memb.
Q2. Six months later, patient developed cervical lymphadenopathy. How does cancer spread to lymph nodes?
Increase in size in local tissue without any limits. Then these tumor cells start to invade nearby tissues. Then tumor cells enter lymphatic and will be embolized to the distant nodes and then grow in the distant sites
Q3: Excision done but not enough, what will you do?
Re-excision with Wide Margin (Frozen section to confirm it)
Q4. What are the advantages of frozen section?
Rapid analysis of tissue introp. Give you confirmation weather you still have a disease of not
Q5. What other alternatives to frozen section?
Moh’s micrographic surgery
Q6. After excision and grafting, graft became infected and sloughed. Swab shows MRSA. What will you do?
Isolate the pt and inform the infection control team
Treat MRSA / In case of Abcess I&D.
OUTpt; Abx oral Vanco then add Refampcin Amox and Tetra Then Linazolid
INpt; IV Vanco/ Tarcopalnin and then same as OUTpt
Q7. Define granulation tissue?
Healing tissue chch by Fibroblast, CT, New Bld Vess and Chronic Inf. Cells
Q8. What is the fate of granulation tissue?
Resorption and laying collagen and forming a scar.
Q. 1ry Vs 2ry Intention in wound healing? Steps of Fibrosis in 2ry int.?
1ry – Edges of the wound are approximated and healing happen without fibroblast invasion.
2ry – Edges are gapped and healing happened by Fibroblast invasion, contraction and scar formation.
**Steps; 1- Fibroblast prolif. 2- Gran. Tissue formation 3- re-epithelization 4- Fibrosis with myofibroblast **
