EXAM QUESTIONS On Wound Healing and Surgical Site Infections

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EXAM QUESTIONS on Wound Healing and Surgical Site Infections Peak of collagen synthesis 7 days Maximum burst: 6 months

Women came in a few months after operation with a subcutaneous nodule containing giant cells. What is it? Granuloma Patient operated on for rupture appendicitis. Which is the best way to close wound? Leave open with daily wound care Effect of Aspirin: Decreased collagen synthesis Which of the ff downregulates angiogenesis: Vin Hippel Lindau Protein Maximum collagen synthesis: 42 days Regarding the rate of wound healing all are true except: Effects are reversible one year after last tx Regarding MMP, which is correct: Disruption of basal membrane is a critical determinant for collagenase activity Keloids and hypertrophic include all except: Predominant collagen is Type 1 Which statement about hypertrophic scars is incorrect: Scar parallel to the underlying muscle can prevent dehiscence Regarding the inflammatory phase of wound healing correct: The first cells to arrive are neutrophils Most abundant collagen in human body: Collagen Type II (?) The ff statements re regeneration are true except: Accuracy preferred over speed Characteristic of clean wound except: Examples are breast surgery, thyroidectomy and hemorrhoidectomy Contaminated except: Obvious purulent material Mortality rates of acute appendicitis: Had gone down to about 10% Which statement re SSI true:

Antibiotics have had less impact on surgical compared to medical All have anaerobic coverage except: Cefalexin Classification of wounds is: Theoretical number of bacterial contaminant in wound The most common source of bacteria that cause post surgical infection: Patients endogenous bacteria All of the ff are accepted principle for use of prophylactic antibiotics except: Given IV at the time the incision is made All are indications for use of prophylactic antibiotics except: Operations where there is obvious evidence of infection at the outset All the ff are known to increase risk of infection except: Failing to continue prophylactic for 24H Antibiotic therapy alone with drainage is not enough to tx abcesses because of the ff except: The bacteria within the abscess are actively dividing True of cellulitis except: Break in skin All are true regarding intrabdominal infections except: Antibiotics must be continued for 2 weeks All of the ff will benefit from pre op prophylactic tx except: Thyroidectomy All are SSI or are clues to SSI except: Cellulitis The most common nosocomial infection in surgical Pxs is: SSI (?) The wound infection rate in clean wounds: 2% The only cephalosporin with significant antibiotic activity: Cefoxitin (Tx dose: 1 g Prophylactic dose: 2 g) Appendicitis with perforation at the tip all are true except: Wound in dirty Ruptured appendicitis was operated on and developed fever on 4 th day. Most likely cause of fever at this time: SSI (4 5 days) Most appropriate thing to do in previous question: Inspect the wound

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