Wound Care Certification Atypical Wound Etiologies Flashcards
7 cards from real Wound Care Certification Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
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A patient with systemic lupus erythematosus (SLE) develops painful digital ulcers and skin necrosis. Antiphospholipid antibodies are detected. Which mechanism best explains this wound presentation?
Answer: Hypercoagulability causing thrombotic occlusion of microvasculature
Antiphospholipid syndrome promotes a hypercoagulable state leading to thrombosis of small and medium vessels, resulting in ischemic ulcers and digital necrosis.
Epidermolysis bullosa (EB) wounds are best managed with which primary dressing consideration?
Answer: Non-adherent, silicone-based dressings to minimize trauma at removal
EB skin is extremely fragile; non-adherent silicone dressings prevent the trauma of dressing removal, which can shear new epithelium and create additional wounds.
A patient with chronic hepatitis C presents with palpable purpura, arthralgias, and lower extremity ulcers. Serum immunofixation shows a type II cryoglobulin. The underlying wound etiology is:
Answer: Cryoglobulinemic vasculitis
Hepatitis C-associated cryoglobulinemia causes immune complex deposition in vessel walls, triggering small vessel vasculitis that produces purpura and ulceration.
Necrobiosis lipoidica diabeticorum (NLD) most commonly presents in which anatomical location?
Answer: Pretibial area of the lower leg
NLD classically appears on the pretibial surface as waxy, yellow-brown plaques with a violaceous border that may ulcerate in the center.
A clinician suspects a factitious wound (dermatitis artefacta) in a patient with a geometric wound pattern that does not fit any known vascular distribution. The most important next step in management is:
Answer: Psychiatric evaluation and a non-confrontational therapeutic approach
Factitious wounds are self-inflicted; addressing the underlying psychiatric condition and building patient trust is essential before any wound intervention.
Which of the following best distinguishes vasculitic ulcers from venous leg ulcers on clinical examination?
Answer: Vasculitic ulcers are typically multiple, punched-out, and extremely painful
Vasculitic ulcers are typically multiple, have punched-out edges, and are severely painful, reflecting ischemia from inflamed and occluded small vessels.
A patient develops a painful, non-healing ulcer on the lower leg following initiation of hydroxyurea therapy for polycythemia vera. The most likely diagnosis is:
Answer: Hydroxyurea-induced leg ulcer
Hydroxyurea can cause a specific form of drug-induced leg ulcer through mechanisms including impaired wound healing, endothelial dysfunction, and altered blood rheology.