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CWS : Etiologic Considerations – Questions & Answers
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CWS : Etiologic Considerations – Questions & Answers
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CWS : Etiologic Considerations – Questions & AnswersPrimary lymphedema is caused by Right Ans - congenital disorder of
lymphatic vessels
During what time frame would a normally healing post-surgical wound reach
its maximum strength Right Ans - 3-6 months
A patient presents with a 5x 2x 0.4 cm wound on the left lower extremity. The
lower limb is edematous and the skin in the malleolar area has a reddish-
brown discoloration. The foot is warm to the touch with palpable pulses. Hair
is present on legs and toes. The patient rates his pain as 6/10 when standing
or sitting. the wound drains to the point the inside of the patient's shoe gets
wet. An ankle brachial index of 0.8 is noted. What is the most likely wound
etiology? Right Ans - Venous insufficiency
Which of the following conditions places the patient at greater risk for
developing an infection? Right Ans - Deep 2nd degree burn >20% of the
body
Which of the following statements is descriptive of biofilms? Right Ans -
Biofilms consist of bacteria embedded in a barrier of sugars and proteins
A 59-year-old male presents to the clinic with complaints of swelling to
bilateral lower legs. he states this has been present for years. swelling is so
bad and heavy it makes him feel tired. he keeps the legs elevated when sitting,
but this has minimal effect on swelling. on review of history, it is noted that
the patient has had multiple surgeries and frequent cellulitis of his legs. on
examination, non-pitting edema, pronounced fibrosis and some areas of
hyperkeratosis are noted. the patient also has positive stemmers sign.
according to this history and assessment what stage of lymphedema is patient
manifesting? Right Ans - Stage II
Rationale :
Stage 0: Patient begins to feel heaviness in limb and fluid accumulation can
occur before visible swelling or pitting
Stage I: elevation reduces swelling and tissue pits on pressure. the stemmers
sign can be positive, or negative and no palpable fibrosis is noted.
, Stage II: edema is present, but limb elevation alone does not reduce edema,
proteins stimulate fibroblast formation and connective and scar tissue
proliferates a positive stemmer's sign is present.
Stage III: massive enlargement of limb, progressive fibrosis, papillomatosis
and ulceration
Which of the following anatomical sites is of greatest risk for development of
deep tissue injury due to its relatively thin soft tissue and cover small radius
of curvature Right Ans - Heel
The Primary means by which edema interferes with wound healing is by
Right Ans - Interfering with oxygen diffusion
Venous hypertension leads to poor oxygenation delivery due to Right Ans -
Capillary damage
A patient presents to the wound center with painful, indurated lesions on the
lower legs. The lesions have ragged edges and red-blush discoloration as
noted in the photograph. these lesions are characteristic of which of the
following disorders? Right Ans - Pyoderma Gangrenosum
A patient presents to the clinic for treatment of a wound on the mid-thigh
secondary to trauma. The patient is currently taking steroids for management
of another condition. What should the wound specialist be most concerned
about in this case? Right Ans - Delayed Collagen synthesis
A patient presents with the ulcer as noted in the picture. He complains of
significant pain at rest and the 4th digit has become gangrenous over the past
several weeks. The patients ankle brachial index is 0.55 and his gemoglobin
a1c is 5.9%. There is also negative Stemmer's sign. which of the following is
the most likely cause of the ulceration Right Ans - Ischemia
Stage I lymphedema of the limb is distinguished from other forms in that
Right Ans - swelling may go away without treatment
Which of the following findings would be indicative of autonomic dysfunction
in a person with diabetes Right Ans - Skin dryness and cracking
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