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Medical PCM I > Wounds > Flashcards

Wounds Flashcards

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USMLE® Step 1 flashcards
1
Q

Duration of inflammatory phase

A

Injury to day 4 post injury

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2
Q

Cardinal signs of inflammation (english)

A

Redness, swelling, warmth, pain

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3
Q

Cardinal signs of inflammation (Latin)

A

Rubor, Tumor, Calor, Dolore

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4
Q

Endothelial cells produce?

A

Blood vessels

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5
Q

Epithelial cells produce?

A

Skin

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6
Q

Fibroblasts produce?

A

Collagen

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7
Q

Duration of proliferative phase

A

Day 4 to day 21

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8
Q

Theory of hypergranulation tissue

A

Too much oxygen promotes hypergranulation (because synthesis is oxygen dependent). Epithelial cells can’t climb the hump of tissue against gravity and epithelialization is stopped. Skin will start to grow under wound.

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9
Q

Duration of maturation phase

A

Day 21 to 2 years post injury

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10
Q

Characteristics of an immature scar

A

Red, raised, rigid

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11
Q

Characteristics of a mature scar

A

Pale, planar, and pliable

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12
Q

Epibole

A

Hypergranulation causes skin to start to migrate under wound and cause edges of wound to be rounded

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13
Q

When is angiogenesis complete?

A

At the end of the inflammatory stage

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14
Q

Formula for percent chnage

A

(Baseline area - current area)/Baseline area

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15
Q

Crater

A

Tissue defect extending at least to the subcutaneous layer

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16
Q

Dead space

A

Any open area produced as a result of undermining, tunneling, or sinus tracking

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17
Q

Dermis

A

Contains blood vessels, nerve endings, epidermal appendages; composed of collagen and elastin fibers; thickenss depends on site and function

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18
Q

Epidermis

A

Functions for protection, sensation, temperature control;

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19
Q

Fistula

A

Abnormal passage between two organs or between an organ and outside of the body

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20
Q

Sinus Tract

A

A soft cavity or channel without defined edges that involves an area larger than the visible surface of the wound

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21
Q

Subcutaneous tissue

A

Fatty tissue, not well vascularized

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22
Q

Black wound color

A

Presence of necrotic tissue
Usually dry
Least healthy of wound types
Needs debridement/cleaning

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23
Q

Yellow wound color

A

Presence of necrotic tissue, possible infection
Usually heavy exudate
Less healthy than Red wound
Needs debridement/cleaning

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24
Q

Red wound color

A

Clean
Mild to moderate exudate
Granulating
Healing; healthiest of wound types

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25
Q

Stage 1 pressure ulcer

A

Nonblanchable erythema of intact skin that persists for more than thirty minutes after the pressure has been removed
In individuals with darker skin, discoloration, warmth, edema, and induration (hardness)

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26
Q

Stage 2 pressure ulcer

A

Partial thickness skin loss involving epidermis, dermis, or both
Superficial and presents as an abrasion, blister, or shallow crater

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27
Q

Stage 3 pressure ulcer

A

Full thickness skin loss involving damage to or necrosis of subcutaneous tissue that may extend down to, but not through underlying fascia
Presents clinically as a deep crater with or without undermining of adjacent tissue
Typically over a bony prominence

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28
Q

Stage 4 pressure ulcer

A

Full thickness skin loss with extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures
Undermining and sinus tracts

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29
Q

Eschar

A

Thick, leathery skin on top of wound that is dead tissue

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30
Q

What does CEAP stand for?

A

Clinical, etiology, anatomic, pathophysiological

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31
Q

Category I skin tear

A

Tears in which epidermal tissue can be approximated without loss of coverage

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32
Q

Category II skin tear

A

Tears show scant (25%) to moderate (75%) loss of epidermal tissue

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33
Q

Category III skin tear

A

Tears show complete loss of epidermal tissue

34
Q

Contaminated wound

A

Containing non-replicating bacteria, other microorganisms, or foreign material

35
Q

Colonized wound

A

Contain replicating microorgansims adherent to wound, but with no injury to host
Indications of infection (purulent exudate, foul odor, or inflammation) are absent

36
Q

Infection

A

Containing replicating microorganisms within a would with damage to host

37
Q

Equation for infection

A

Dose x virulence / Host resistance

38
Q

Host resistance influenced by

A

Nutritional status
Disease status
Medication use

39
Q

Primary cause of necrotizing facitis and how o treat it

A

Strept A

Treatment: Aggressive surgical debridement and amputation

40
Q

How many colony forming units indicate infection?

A

10^5

41
Q

Symptoms of fungal infections

A 
Pruritis
Inflammation
Swelling
Skin eruptions 
Scaling of skin
42
Q

Who is at increased risk for fungal infections?

A

Compromised immune system
Antibiotic therapy
Diabetes

43
Q

Examples of fungal infections

A

Candida (thrush and intertriago)
Ringworm
Athletes foot; jock itch
Aspergilli (mold)

44
Q

Bacteriostatic

A

A substance that prevents or arrests the growth of microorganisms by preventing multiplication

45
Q

Bactericidal

A

An agent that prevents or arrests the action of microorganisms either by inhibiting their activity or by destroying or killing them

46
Q

Antiseptic

A

An agent used on living skin, either bactericidal or bacteriostatic

47
Q

Risk Assessment Tools

A

Braden scale
Norton scale (specificity of 0.75)
Risk Assessment Pressure Sore (RAPS)

48
Q

Categories of Norton Pressure Sore Risk

A 
Physical condition 
Mental condition 
Activity 
Mobility 
Incontinence
49
Q

Guidelines for Bed Pressure - High Risk

A

Dynamic flotation mattress
Low air loss bed system
Air-fluidized bed

50
Q

Guidelines for Bed Pressure - Medium Risk

A

Static air-filled mattress overlay
Gel mattress overlay
T-foam mattress overlay

51
Q

Guidelines for Bed Pressure - Low Risk

A

Mattress overlay 3”-4” foam
Gel mattress overlay
Water-filled mattress overlay

52
Q

Guidelines for Bed Pressure - No Immediate Risk

A

Sheepskin pads - questionable effect
Heel protectors
Convoluted foam mattress tops

53
Q

Autolysis

A

Disintegration of liquefaction of tissue or of cells by the body’s own mechanisms, such as leukocytes and enzymes

54
Q

Crusted

A

Covered over with dried secretions

55
Q

Denude

A

Removal of epidermis

56
Q

Stripping

A

Denuding by mechanical means

57
Q

Eschar

A

Dry, black or brown leathery materials; result of destruction of cells/blood vessels and desiccation of devitalized tissue

58
Q

Ischemia

A

Deficiency of blood supply to a tissue, often leading to tissue necrosis

59
Q

Macerate

A

To soften by wetting or soaking; refers to degenerative changes and disintegration of skin when it has been kept too moist

60
Q

Necrosis

A

Death of tissue

61
Q

Pus

A

Thick fluid indicative of infection containing leukocytes, bacteria and cellular debris

62
Q

Scab

A

Dried exudate covering superficial wounds, usually containing hemolytic components

63
Q

Slough

A

Moist yellowing or gray substance composed of a mixture of fibrin tissue debris and pus that contains bacteria and leukocytes

64
Q

Autolytic

A

Use of synthetic dressing to cover a wound and allow eschar to self-digest by the action of enzymes present in wound fluids

65
Q

Enzymatic

A

Topical application of proteolytic substances (enzymes) to breakdown devitalized tissue

66
Q

Mechanical

A

Removal of foreign material and devitalized or contaminated tissue from a wound by physical forces rather than by chemical or natural forces

67
Q

Non-selective debridement

A

Removes both healthy and non-healthy tissue

68
Q

Selective debridement

A

Removes only necrotic tissue

69
Q

Examples of non-selective debridement

A 
Wet to dry 
Vigorous whirlpool jet agitation 
Wound irrigation 
Dakin's 
Hydrogen peroxide
70
Q

Examples of selective debridement

A

Sharp/surgical
Enzymatic
Autolytic

71
Q

Collagenase (chemical agent) most effective on what kind of tissue

A

Yellow-green fibrotic tissue and eschars

72
Q

Indications for hydrotherapy

A

Need for hydration and increased circulation
Removal of cellular debris, foreign contaminants, and loosely attached necrotic tissue
Softening of thick, hard necrotic eschar
Ischemic wounds that have decreased pain when dependent

73
Q

Use of calcium alginates

A

Moderately to highly exudative full thickness wounds and as fillers for moderately to highly exudative full thickness wound cavities

74
Q

Use of cadexomer iodine

A

Chronic venous ulcers

75
Q

Use of foam dressings

A

Full thickness wounds with moderate to heavy exudate

76
Q

Use of hydrocolloid

A

Wounds with light to moderate exudate

77
Q

Use of hydrogel

A

To fill a deep, dry wound

78
Q

Use of transparent film

A

Open partial thickness wounds with minimal exudate or on closed wounds

79
Q

Use of biosynethic dressings

A

Temporary or extended coverage of skin loss wounds like burns, donor sites, or skin tears

80
Q

Indications for packing

A

Dead space impairs wound healing and predisposes abcess formation and infection

81
Q

Contraindications for packing

A

Patient at increased risk for bleeding
Damage to tissue
Infection

Medical PCM I (4 decks)

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