Which of the following is/are true? A. Because of its thickness, the tensile strength of a healing wound on the eyelid is much less than one on the thick skin of the back. B. By 2 days, the experimental burst strength of skin is minimal since collagen has been formed in the wound but has not yet cross-linked. C. Wound strength reaches a plateau by 3 weeks. D. Wounds rarely, if ever, regain the strength of intact tissues.

Which of the following is/are true? A.  Because of its thickness, the tensile strength of a healing wound on the eyelid is much less than one on the thick skin of the back. B.  By 2 days, the experimental burst strength of skin is minimal since collagen has been formed in the wound but has not yet cross-linked. C.  Wound strength reaches a plateau by 3 weeks. D.  Wounds rarely, if ever, regain the strength of intact tissues.
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Answer: BD  DISCUSSION: Tensile strength measures load per cross-section area at rupture, whereas burst strength measures load required to break a wound, regardless of dimension. Therefore, skin wounds have comparable tensile strength, regardless of thickness. Collagen appears in the wound by 3 to 4 days. Minimal wound strength on day 2 is due to fibrin polymerization and adhesion of globular proteins. Wounds rapidly gain strength for about 4 months and then continue to gain strength at a slower rate for more than a year. Wounds do not regain the strength of normal tissue
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Description : In contrast to adult wound healing with scar formation, which of the following are characteristic of scarless fetal skin repair? A. Matrix rich in hyaluronic acid. B. Increased inflammatory response. C. Increased production of TGF-b. D. No collagen deposition. E. Minimal angiogenesis.

Last Answer : Answer: AE DISCUSSION: The ability of a fetus to heal without scar formation depends on its gestational age at the time of injury and the size of the wound defect. In ... repair has possible clinical applications in the modulation of adult fibrotic diseases and abnormal scar-forming conditions

Which of the following statements regarding fibroblasts and their function in wound healing are true? a. IL-1 has both inhibitory and promotional effects on fibroblast growth b. TNFa stimulates fibroblast collagen synthesis c. IL-1 and TNFa have opposite effects on the healing of bone d. In human clinical trials, EGF (epithelial growth factor) has been demonstrated to accelerate epidermal regeneration in cutaneous wounds

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Last Answer : Answer: a, d IL-1 appears to be important in the process of normal wound repair. IL-1 has been shown to stimulate skin fibroblast and keratinocyte growth, as well as ... that recombinant EGF enhances keratinocyte migration. EGF is also a potent chemoattractant for granulation tissue fibroblasts

Which of the following statement(s) is/are true concerning pharmacologic agents used to accelerate wound healing? a. A number of these agents are now currently approved for use in this country b. PDGF (platelet-derived growth factor) promotes fibroblast proliferation, chemotaxis, and collagenase synthesis c. PDGF has been demonstrated in a number of clinical trials to promote healing in chronic wounds d. Growth hormone functions by promoting fibroblast proliferation and collagen synthesis

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Last Answer : Answer: b, c Currently there are no approved clinical agents that accelerate normal healing. Although a number of clinical trials are in progress, no agents are currently ... hormone administration significantly accelerates donor site healing, presumably due to its effects in minimizing catabolism

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Description : Which of the following statement(s) is/are true concerning the remodeling phase of wound healing? a. Total collagen content increases steadily through this phase b. The normal adult ratio ... unwounded skin d. The proteoglycans are responsible for the ground substance of the extracellular matrix

Last Answer : Answer: b, d The transition from the proliferative phase to the remodeling phase of wound healing is defined by reaching collagen equilibrium. Collagen accumulation within the wound becomes maximal by ... in strength for six months or more, eventually reaching 70% of the strength of unwounded skin

Which of the following statement(s) is/are correct concerning the management of an open wound? a. Frequent surgical debridement is usually necessary b. Water irrigation can effectively debride most wounds c. Hydrogen peroxide is particularly useful in the management of open wounds d. A number of the newer dressing products have clearly been shown to promote wound healing compared to simple moist occlusive dressing

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Last Answer : Answer: b Although there are numerous dressing products commercially available at present, no treatment has been demonstrated to improve healing beyond that of standard treatment which adheres to basic ... healing is achieved, there has been no evidence that one product is better than another

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Last Answer : Answer: b, c The proliferative phase of wound healing begins with the formation of a provisional matrix of fibrin and fibronectin as part of the initial clot formation. Initially, the provisional ... The principal collagen type scar is type 1, with lesser amounts of type 3 collagen also present

Which of the following is/are true concerning wound fibroblasts? A. Fibroblasts synthesize and secrete collagen molecules. B. Wound fibroblasts are derived from blood-borne precursor cells. C. Fibroblasts migrate to a wound along fibrin strands, which are used as a scaffold. D. Large amounts of fibrin or blood clot can act as a physical barrier to fibroblast penetration, which delays normal wound healing.

Description : Which of the following is/are true concerning wound fibroblasts? A. Fibroblasts synthesize and secrete collagen molecules. B. Wound fibroblasts are derived from blood-borne precursor cells. C. ... clot can act as a physical barrier to fibroblast penetration, which delays normal wound healing.

Last Answer : Answer: ACD DISCUSSION: Fibroblasts appear in the wound on about the third day of healing and begin to synthesize and secrete collagen molecules. Wound fibroblasts arrive from cells surrounding ... enzymes, and large amounts of fibrin and blood clot prevent fibroblasts from entering the wound

A patient with gross fecal contamination and peritonitis from a ruptured sigmoid diverticulum has his midline wound left open to heal by secondary intention. Which of the following statement(s) describes this healing process? a. Wounds healing in this fashion have an altered sequence of healing compared to a primarily closed wound b. A bed of granulation tissue forms over exposed subcutaneous tissue c. Epithelialization is enhanced in the face of bacterial colonization d. The ability of a wound to form granulation tissue is dependent on the blood supply of the tissue

Description : A patient with gross fecal contamination and peritonitis from a ruptured sigmoid diverticulum has his midline wound left open to heal by secondary intention. Which of the following statement(s) describes this ... of a wound to form granulation tissue is dependent on the blood supply of the tissue

Last Answer : Answer: b, d Open wounds, whether they be ulcers or open surgical incisions closing by secondary intention, heal with the same sequence of inflammation, matrix deposition, epithelialization ... via bacterial and phagocytic cell products such as proteases, collagenases, elastases, and other enzymes

The hormonal alterations that follow operation and injury favor accelerated gluconeogenesis. This new glucose is consumed by which of the following tissues? A. Central nervous system. B. Skeletal muscle. C. Bone. D. Kidney. E. Tissue in the healing wound.

Description : The hormonal alterations that follow operation and injury favor accelerated gluconeogenesis. This new glucose is consumed by which of the following tissues? A. Central nervous system. B. Skeletal muscle. C. Bone. D. Kidney. E. Tissue in the healing wound.

Last Answer : Answer: ADE DISCUSSION: Glucose is produced in increased amounts to satisfy the fuel requirements of the healing wound. In addition, nerve tissue and the renal medulla also utilize this substrate. Skeletal muscle primarily utilizes fatty acids, and bone utilizes mineral substrate

Which of the following statement(s) is/are true concerning the role of antibiotics in wound care? a. Systemic antibiotics are indicated for all open wounds b. Bacterial resistance can occur with systemic but not topical antibiotics c. An indication for systemic antibiotic administration is a granulation tissue bacterial count in excess of greater than 105 organisms/gram of tissue on quantitative analysis d. Silver sulfadiazine is useful only for the management of burns

Description : Which of the following statement(s) is/are true concerning the role of antibiotics in wound care? a. Systemic antibiotics are indicated for all open wounds b. Bacterial resistance can occur with ... of tissue on quantitative analysis d. Silver sulfadiazine is useful only for the management of burns

Last Answer : Answer: c The role of antibiotics in wound care is controversial. All open wounds are colonized with bacteria. Only when surrounding tissue is invaded (cellulitis) are systemic antibiotics clearly ... of relevant drug-resistant plasmids in bacteria, and its low cost make it a good choice

Which of the following statement(s) describe the effects of aging on wound healing? a. A finer, more cosmetic scar might be expected b. In vitro studies demonstrate decreased proliferative potential of fibroblasts and epithelial cells c. Skin sutures should be left in for a longer period of time d. Wound infection occurs more frequently in elderly patients due to diminished ability to fight infection

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Last Answer : Answer: a, b, c There are important age-dependent aspects of wound healing. The elderly heal more slowly and with less scarring. There is a gradual attenuation of the inflammatory ... the sutures. There is no evidence to suggest that wound infections occur more commonly in elderly patients

Wounds are classified according to the likelihood of bacterial contamination. Which of the following statement(s) is/are true concerning wound classifications? a. A clean-contaminated wound would be that associated with an elective colon resection with adequate mechanical and antibiotic bowel preparation b. A contaminated wound would include a resection of obstructed bowel with gross spillage of intestinal contents c. In a clean wound, no viscus is entered d. Antibiotic prophylaxis should be administered for all clean-contaminated and contaminated wounds and selectively in patients involving a clean wound

Description : Wounds are classified according to the likelihood of bacterial contamination. Which of the following statement(s) is/are true concerning wound classifications? a. A clean-contaminated wound would ... all clean-contaminated and contaminated wounds and selectively in patients involving a clean wound

Last Answer : Answer: a, b, c, d Wounds are classified under three classes according to the likelihood of bacterial contamination: 1) clean (no viscus is entered; e.g., herniorrhaphy); 2) clean- ... tenet involves cases in which a prosthetic material may be used (artificial joint, heart valve, tissue patch)

There are a multitude of various dressings available. Which of the following statement(s) is/are true concerning options for surgical dressings? a. Hydrocolloids, such as karaya compounds, offer the primary advantage of increased absorptive ability b. Films, such as Op-site, provide a water impermeable environment to achieve a dry wound c. Impregnates are fine gauze impregnated with a variety of substances such as antibiotics or moisturizing agents that adhere tightly to the wound and do not require a secondary dressing d. Absorptive powders and paste are highly useful in debriding necrotic and fibrous material from wounds and absorbing wound serum

Description : There are a multitude of various dressings available. Which of the following statement(s) is/are true concerning options for surgical dressings? a. Hydrocolloids, such as karaya compounds, offer ... are highly useful in debriding necrotic and fibrous material from wounds and absorbing wound serum

Last Answer : Answer: a, d Although the simplest dressing of gauze and tape combined with the use of antibacterial ointment can achieve moist wound healing in most patients. A multitude of other ... agents have high absorbency for tissue wound fluid and debride necrotic and fibrous material from the wound

Scar formation is part of the normal healing process following injury. Which of the following tissues has the ability to heal without scar formation? a. Liver b. Skin c. Bone d. Muscle

Description : Scar formation is part of the normal healing process following injury. Which of the following tissues has the ability to heal without scar formation? a. Liver b. Skin c. Bone d. Muscle

Last Answer : Answer: c Every tissue in the body undergoes reparative processes after injury. Bone has the unique ability to heal without scar and liver has the potential to regenerate parenchyma, the only organ ... scar (cirrhosis) as well. With these exceptions, all other mature human tissues heal with scar

Which of the following statement(s) is/are true about the role of macrophages in the wound healing process? a. Macrophages are the dominant cell type during the inflammatory phase of wound healing b. Macrophages are not essential for wound healing c. The macrophage role in wound healing is limited to phagocytosis d. Macrophages are a source of a number of humoral factors essential for wound healing

Description : Which of the following statement(s) is/are true about the role of macrophages in the wound healing process? a. Macrophages are the dominant cell type during the inflammatory phase of wound ... phagocytosis d. Macrophages are a source of a number of humoral factors essential for wound healing

Last Answer : Answer: a, d Within three or four days after injury, macrophages become the dominant cell type in the inflammatory phase of wound healing. The role of macrophages is not limited only ... . These studies confirm the dominant role of the macrophage and the inflammatory phase of wound healing

Which of the following statement(s) is/are true concerning the clinical management of an open wound? a. A wet-to-dry dressing is the most optimal form of wound management b. A moist occlusive dressing promotes epithelialization and reduces pain c. The protein rich plasma exudate covering the open wound facilitates healing d. Irrigation of the wound disrupts epithelialization therefore inhibiting the healing process

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Last Answer : Answer: b Epithelialization is more rapid under moist conditions than dry conditions. Without dressings, a superficial wound, or one with minimal devitalized tissue forms a scab or ... dysfunction, increases the distance for diffusion from oxygen and nutrient sources to their metabolic targets

Which of the following factors have been demonstrated to promote wound healing in normal individuals? a. Vitamin A supplementation b. Vitamin C supplementation c. Vitamin E application to the wound d. Zinc supplementation e. None of the above

Description : Which of the following factors have been demonstrated to promote wound healing in normal individuals? a. Vitamin A supplementation b. Vitamin C supplementation c. Vitamin E application to the wound d. Zinc supplementation e. None of the above

Last Answer : Answer: e Several important systemic factors or conditions influence wound healing. Interestingly, there are no known systemic conditions that lead to enhanced or more rapid wound healing. ... support the concept that supranormal provision of these factors enhance wound healing in normal patients

Which of the following is/are acceptable reasons for the transfusion of red blood cells based on currently available data? A. Rapid, acute blood loss with unstable vital signs but no available hematocrit or hemoglobin determination. B. Symptomatic anemia: orthostatic hypotension, severe tachycardia (greater than 120 beats per minute), evidence of myocardial ischemia, including angina. C. To increase wound healing. D. A hematocrit of 26% in an otherwise stable, asymptomatic patient.

Description : Which of the following is/are acceptable reasons for the transfusion of red blood cells based on currently available data? A. Rapid, acute blood loss with unstable vital signs but no available ... increase wound healing. D. A hematocrit of 26% in an otherwise stable, asymptomatic patient.

Last Answer : Answer: AB DISCUSSION: Currently accepted guidelines for the transfusion of packed red blood cells include acute ongoing blood loss, as might occur in an injured patient, and the development of ... not be given based solely or predominantly on a numerical value such as a hematocrit of 28%

Hepatic abnormalities have been noted in adults since the beginning of hyperalimentation. Which of the following statements are true? A. Hepatic steatosis appears to be associated with an overload of glucose. B. Hepatic steatosis is usually associated with abnormalities in hepatic enzymes. C. Hyperbilirubinemia is inevitably associated with hepatic steatosis. D. Abnormalities in the portal insulin-glucagon ratio are thought to be causative of hepatic steatosis in experimental animals.

Description : Hepatic abnormalities have been noted in adults since the beginning of hyperalimentation. Which of the following statements are true? A. Hepatic steatosis appears to be associated with an overload ... insulin-glucagon ratio are thought to be causative of hepatic steatosis in experimental animals.

Last Answer : Answer: AD DISCUSSION: The most common metabolic complication of TPN in adults is hepatic steatosis. Unlike the hepatic abnormalities in children, which may progress to cholestasis, liver damage, ... glucagon, which is elicited by certain amino acids, results in the mobilization of hepatic lipid

Which of the following surgical techniques lead to improved wound healing? a. Atraumatic handling of tissue b. Approximation of underlying fatty tissue to obliterate dead space c. Protecting the wound from water for at least one week d. Meticulous hemostasis

Description : Which of the following surgical techniques lead to improved wound healing? a. Atraumatic handling of tissue b. Approximation of underlying fatty tissue to obliterate dead space c. Protecting the wound from water for at least one week d. Meticulous hemostasis

Last Answer : Answer: a, d There are numerous practical implications for the care of wounds and surgical incisions. Meticulous hemostasis reduces the inflammation of phagocytosis necessary to clear the wound of ... or shower one or two days after surgery actually serves useful purpose in debriding the wound

Which of the following cells or blood elements play a role in the initial phases of wound healing? a. Polymorphonuclear leukocytes (PMNs) b. Platelets c. Monocytes d. Lymphocytes

Description : Which of the following cells or blood elements play a role in the initial phases of wound healing? a. Polymorphonuclear leukocytes (PMNs) b. Platelets c. Monocytes d. Lymphocytes

Last Answer : Answer: a, b, c, d Shortly after the initial injury, the wound is full of debris which is cleared over the next several days by recruited and activated phagocytic cells. ... in the initial hemostatic process as well as releasing chemotactic factors and factors leading to fibroblast proliferation

Which of the following factors can be associated with impaired wound healing? a. Chemotherapy b. Chronic steroid use c. Peripheral vascular disease d. Radiation therapy e. Diabetes mellitus

Description : Which of the following factors can be associated with impaired wound healing? a. Chemotherapy b. Chronic steroid use c. Peripheral vascular disease d. Radiation therapy e. Diabetes mellitus

Last Answer : Answer: a, b, c, d, e Bone marrow suppression, a common consequence of chemotherapy, is detrimental to wound healing. Quantitative and qualitative lymphocyte and monocyte deficiency impairs cellular ... be a primary cause of impaired healing, and may be also a cofactor with other conditions

Which of the following cell types are not crucial for healing a clean, incisional wound? A. Macrophage. B. Platelet. C. Fibroblast. D. Polymorphonuclear leukocyte. E. Myofibroblast.

Description : Which of the following cell types are not crucial for healing a clean, incisional wound? A. Macrophage. B. Platelet. C. Fibroblast. D. Polymorphonuclear leukocyte. E. Myofibroblast.

Last Answer : Answer: DE DISCUSSION: Experimental studies have shown that healing may progress normally in the absence of polymorphonuclear leukocytes in an uninfected wound. In contrast, depletion of monocytes and ... wound contraction in open defects but have little if any role in clean, incisional wounds

Which of the following tissues contain significant collagen useful for placing sutures to allow the prolonged tension necessary to maintain tissue approximation? a. Dermis b. Intestinal submucosa c. Muscular fascia d. Blood vessel wall

Description : Which of the following tissues contain significant collagen useful for placing sutures to allow the prolonged tension necessary to maintain tissue approximation? a. Dermis b. Intestinal submucosa c. Muscular fascia d. Blood vessel wall

Last Answer : Answer: a, b, c, d It takes at least three weeks for collagen to undergo sufficient remodeling and cross linking to attain moderate strength. Since most skin sutures are removed at one to ... , Scarpa's fascia, and blood vessel wall represent a partial list of tissues with high collagen content

Which of the following interfere with normal collagen formation or cross-linking? A. Beta-aminopropionitrile. B. Iron chelators. C. Vitamin C depletion. D. Proline analogs (e.g., cis-hydroxyproline). E. D-Penicillamine.

Description : Which of the following interfere with normal collagen formation or cross-linking? A. Beta-aminopropionitrile. B. Iron chelators. C. Vitamin C depletion. D. Proline analogs (e.g., cis-hydroxyproline). E. D-Penicillamine.

Last Answer : Answer: ABCDE DISCUSSION: Intramolecular and intermolecular cross-links are crucial for collagen structural stability. Formation of cross-links can be inhibited by two ... concentration, proline analogs prevent collagen formation with minimal effects on noncollagenase protein synthesis

Hemostasis and the cessation of bleeding require which of the following processes? A. Adherence of platelets to exposed subendothelial glycoproteins and collagen with subsequent aggregation of platelets and formation of a hemostatic plug. B. Interaction of tissue factor with factor VII circulating in the plasma. C. The production of thrombin via the coagulation cascade with conversion of fibrinogen to fibrin. D. Cross-linking of fibrin by factor XIII.

Description : Hemostasis and the cessation of bleeding require which of the following processes? A. Adherence of platelets to exposed subendothelial glycoproteins and collagen with subsequent aggregation of platelets and ... conversion of fibrinogen to fibrin. D. Cross-linking of fibrin by factor XIII.

Last Answer : Answer: ABCD DISCUSSION: Hemostasis requires the interaction of platelets with the exposed subendothelial structures at the site of injury followed by aggregation of more platelets in that area. ... form a stable clot that incorporates the platelet plug and fibrin thrombus into a stable clot

Wound healing by secondary intention takes place: C A. when the wound does not break apart B. when the wound edges are brought together C. much more slowly than healing by first intention D. in surgically incised wounds

Description : Wound healing by secondary intention takes place: C A. when the wound does not break apart B. when the wound edges are brought together C. much more slowly than healing by first intention D. in surgically incised wounds

Last Answer : much more slowly than healing by first intention

Which of the following statements concerning perioperative nutrition is true concerning the above-described patient? a. Since the patient’s weight had been stable with no preoperative nutritional deficit, 5% dextrose intravenous solutions are adequate for the initial postoperative source of nutrition b. Preoperative immunologic status should be determined including total peripheral lymphocyte count and delayed hypersensitivity reaction to determine skin-test response to common antigens c. Routine postoperative fluid administration with intravenous 5% glucose solutions can provide the calories to meet basal energy requirements d. A jejunal feeding catheter should be placed at the time of surgery for postoperative enteral feeding

Description : Which of the following statements concerning perioperative nutrition is true concerning the above-described patient? a. Since the patient's weight had been stable with no preoperative nutritional deficit ... feeding catheter should be placed at the time of surgery for postoperative enteral feeding

Last Answer : Answer: a Most patients undergoing elective operations are adequately nourished. Unless the patient has suffered significant preoperative malnutrition, characterized by weight loss greater than ... gastrointestinal surgery, this technique would not appear indicated in the patient described above

When the method of wound healing is one in which wound edges are not surgically approximated and integumentary continuity is restored by granulations, the wound healing is termed a) second intention healing. When wounds dehisce, they will be allowed to heal by secondary intention. b) primary intention healing. Primary or first intention healing is the method of healing in which wound edges are surgically approximated and integumentary continuity is restored without granulating.

Description : When the method of wound healing is one in which wound edges are not surgically approximated and integumentary continuity is restored by granulations, the wound healing is termed a) ... of wound edges is delayed and integumentary continuity is restored by bringing apposing granulations together.

Last Answer : a) second intention healing. When wounds dehisce, they will be allowed to heal by secondary intention.

Which of the following statements are true of elevated–anion gap metabolic acidosis? A. Hypoperfusion from the shock state rarely produces an elevated anion gap. B. Retention of sulfuric and phosphoric acids may lead to this form of acidosis. C. Copious diarrhea does not produce this condition. D. Rapid volume expansion may produce this form of acidosis. E. Use of lactated Ringer's solution is inappropriate in the treatment of lactic acidosis.

Description : Which of the following statements are true of elevated-anion gap metabolic acidosis? A. Hypoperfusion from the shock state rarely produces an elevated anion gap. B. Retention of sulfuric and phosphoric ... E. Use of lactated Ringer's solution is inappropriate in the treatment of lactic acidosis.

Last Answer : Answer: BC DISCUSSION: An elevated anion gap may be produced by lactic acidosis from shock or by retention of inorganic acids from uremia. Lactated Ringer's solution rapidly corrects the ... . Bicarbonate loss from diarrhea and dilutional acidosis are non-anion gap types of metabolic acidosis

The following statement(s) is/are true concerning initial microbiologic diagnostic techniques. a. Appropriate expeditious transport of specimens to the microbiology laboratory is essential for obtaining accurate clinical information b. The use of potassium hydroxide in preparing a specimen slide for light microscopy will be useful in identification of anaerobic bacteria c. Antibiotic sensitivity is determined by exposing the specific microorganism to varying amounts of antibiotic with the concentration of the antibiotic inhibiting growth referred to as the MIC (minimal inhibitory concentration) d. Serum levels of antimicrobial agents should achieve in excess of a 4-to 8-fold increase over the MIC to be considered clinically efficacious.

Description : The following statement(s) is/are true concerning initial microbiologic diagnostic techniques. a. Appropriate expeditious transport of specimens to the microbiology laboratory is essential for obtaining accurate ... a 4-to 8-fold increase over the MIC to be considered clinically efficacious.

Last Answer : Answer: a, c, d Because most surgical infections are polymicrobial, specimens should be cultured for aerobic and anaerobic bacteria, as well as fungi. Although aerobic and aerotolerant ... fold increase over MIC during the peak serum level have been demonstrated to be clinically efficacious

In the nutritional support of patients with cancer, which of the following statements is/are true? A. Nutritional support benefits the patient's lean body mass but does not enable the tumor to grow. B. In experimental animals, the growth of implanted tumors is directly proportional to the amount of calories and protein supplied. C. Prospective randomized trials of nutritional support utilizing chemotherapy and radiation therapy have revealed benefits to patients receiving total parenteral nutrition. D. Studies of nutritional support for patients with cancer about to undergo surgery revealed decreased morbidity and mortality, especially morbidity from sepsis.

Description : In the nutritional support of patients with cancer, which of the following statements is/are true? A. Nutritional support benefits the patient's lean body mass but does not enable ... with cancer about to undergo surgery revealed decreased morbidity and mortality, especially morbidity from sepsis.

Last Answer : Answer: B DISCUSSION: The problem with the patient with cancer is a very vexing one. Clearly, one of the metabolic effects of cancer, cachexia, affects patients in the last quartile ... undoubtedly reveal that there are certain nutrients that tumors require, which probably should be best avoided

Which of the following statements regarding transforming growth factor b (TGF-b) are true? a. TGF-b expression is autoregulated b. TGF-b enhances collagen synthesis c. TGF-b inhibits extracellular matrix production d. TGF-b may inhibit or promote cellular proliferation

Description : Which of the following statements regarding transforming growth factor b (TGF-b) are true? a. TGF-b expression is autoregulated b. TGF-b enhances collagen synthesis c. TGF-b inhibits extracellular matrix production d. TGF-b may inhibit or promote cellular proliferation

Last Answer : Answer: a, b, d TGF-b appears to be one of the key cytokines in control of tissue repair. TGF-b is strongly chemotactic for neutrophils, T cells, monocytes, and fibroblasts. ... TGF-b stimulates the proliferation of densely plated human marrow fibroblasts, but is inhibitory at high concentrations

Which of the following statement(s) is/are true concerning the management of a patient with hemophilia A undergoing an elective surgical operation? a. Concentrates of factor VIII should be given several days prior to elective surgery b. The half-life of factor VIII concentrates is less than 24 hours c. A dose of 40–50 IU/kg of factor VIII concentrate should be given prior to the planned surgical procedure d. Factor VIII concentration administration should be given for the first 24 hours after surgery but may then be stopped if no abnormal bleeding has been observed e. A new recombinant preparation of factor VIII offers the advantage of being virus-free

Description : Which of the following statement(s) is/are true concerning the management of a patient with hemophilia A undergoing an elective surgical operation? a. Concentrates of factor VIII should be given ... observed e. A new recombinant preparation of factor VIII offers the advantage of being virus-free

Last Answer : Answer: b, c, e Although the half-life of factor VIII is 2.9 days in normal individuals, the half-life of factor VIII concentrates is 9 to l8 hours. Levels of 80% to ... infection in the hemophilia population. A new recombinant preparation of factor VIII offers the advantage of being virus-free

Which of the statements listed below about bleeding disorders is/are correct? A. Acquired bleeding disorders are more common than congenital defects. B. Deficiencies of vitamin K decrease production of factors II, VII, IX, and X, protein C, and protein S. C. Hypothermia below 32؛C rarely causes a bleeding disorder. D. Von Willebrand's disease is a very uncommon congenital bleeding disorder.

Description : Which of the statements listed below about bleeding disorders is/are correct? A. Acquired bleeding disorders are more common than congenital defects. B. Deficiencies of vitamin K decrease production ... disorder. D. Von Willebrand's disease is a very uncommon congenital bleeding disorder.

Last Answer : Answer: AB DISCUSSION: Acquired bleeding disorders are significantly more common than congenital bleeding defects. Vitamin K deficiency may be related to malnutrition or competitive inhibition ... a relatively common disorder of bleeding and is generally undetectable by routine screening methods

I have a sore throat , should I use nebanal powder ? My penis was sore ,,,, then I started using nebanal powder there ,,, !! Cos used to come out from the first wound, then it stopped because of giving powder ,,,, but now it shows that pus has accumulated ,,, !!! I have been using this for about 3 days ,,, !! Should I continue with this powder now ? Is it possible for me to get better ? Or should I change ? And what are the symptoms of wound healing ?

Description : I have a sore throat , should I use nebanal powder ? My penis was sore ,,,, then I started using nebanal powder there ,,, !! Cos used to come out from the first wound, then it stopped because of ... it possible for me to get better ? Or should I change ? And what are the symptoms of wound healing ?

Last Answer : Yes, you can apply this powder on a regular basis. I hope you will find a solution. And do not water or soak the wound. Keep the wound dry and clean. If necessary, clean it with lukewarm ... day and give this nebanal powder. And take antibiotics as soon as possible with the advice of a doctor.

Although TPN has major beneficial effects to the patient and specific organ systems, TPN has a downside which is related to intestinal disuse. Which of the following statement(s) is/are true concerning the effects of TPN on the GI tract? a. Patients receiving TPN have an accentuated systemic response to endotoxin challenge compared to enterally fed volunteers b. TPN can result in disruption of intestinal microflora c. In experimental models, bacterial translocation from the gut is increased d. Effects of TPN on the gut may lead to multiple organ failure

Description : Although TPN has major beneficial effects to the patient and specific organ systems, TPN has a downside which is related to intestinal disuse. Which of the following statement(s) is/are true concerning the ... from the gut is increased d. Effects of TPN on the gut may lead to multiple organ failure

Last Answer : Answer: a, b, c, d A number of studies have examined the effects of TPN on intestinal function and immunity. Although most of these studies have been done in animal models, ... the release of bacteria and/or cytokines leading to pronounced systemic responses and possibly multiple organ failure

Reconstitution of the epithelial barrier (epithelialization) begins within hours of the initial injury. Which of the following statement(s) is/are true concerning the process of epithelialization? a. Bacteria, protein exudate, and necrotic tissue all will compromise this process b. Epithelial cells exhibit contact proliferation c. Epithelialization occurs only from the margins of the wound d. Visible scarring can occur only when the injury extends deeper than the superficial dermis

Description : Reconstitution of the epithelial barrier (epithelialization) begins within hours of the initial injury. Which of the following statement(s) is/are true concerning the process of epithelialization? a. ... d. Visible scarring can occur only when the injury extends deeper than the superficial dermis

Last Answer : Answer: a, d The initial step of epithelialization involves epithelial cells from the basal layer of the wound edge flattening and migrating across the wound, completing wound coverage within 24- ... abrasions and burns may scar significantly. Whenever the dermis is incised, a scar will form

Which of the following connective tissue disorders is characterized by insoluble collagen being formed and accumulating excessively in the tissues? a) Scleroderma Scleroderma occurs initially in the skin but also occurs in blood vessels, major organs, and body systems, potentially resulting in death.

Description : Which of the following connective tissue disorders is characterized by insoluble collagen being formed and accumulating excessively in the tissues? a) Scleroderma Scleroderma occurs initially in the ... In polymyalgia rheumatic, immunoglobulin is deposited in the walls of inflamed temporal arteries.

Last Answer : a) Scleroderma Scleroderma occurs initially in the skin but also occurs in blood vessels, major organs, and body systems, potentially resulting in death.

A 22-year-old man sustains a single stab wound to the left chest and presents to the emergency room with hypotension. Which of the following statement(s) is/are true concerning his diagnosis and management? a. The patient likely is suffering from hypovolemic shock and should respond quickly to fluid resuscitation b. Beck’s triad will likely be an obvious indication of compressive cardiogenic shock due to pericardial tamponade c. Echocardiography is the most sensitive noninvasive approach for diagnosis of pericardial tamponade d. The placement of bilateral chest tubes will likely resolve the problem

Description : A 22-year-old man sustains a single stab wound to the left chest and presents to the emergency room with hypotension. Which of the following statement(s) is/are true concerning his ... diagnosis of pericardial tamponade d. The placement of bilateral chest tubes will likely resolve the problem

Last Answer : Answer: c Shock from cardiac compression occurs when external pressure on the heart impairs ventricular filling. Because ventricular filling is a function of venous return and myocardial compliance, ... sternotomy. Chest tube placement would not be appropriate as the sole treatment in this patient

Which of the following statement(s) is/are true concerning excessive scarring processes? a. Keloids occur randomly regardless of gender or race b. Hypertrophic scars and keloid are histologically different c. Keloids tend to develop early and hypertrophic scars late after the surgical injury d. Simple reexcision and closure of a hypertrophic scar can be useful in certain situations such as a wound closed by secondary intention

Description : Which of the following statement(s) is/are true concerning excessive scarring processes? a. Keloids occur randomly regardless of gender or race b. Hypertrophic scars and keloid are histologically different ... scar can be useful in certain situations such as a wound closed by secondary intention

Last Answer : Answer: d True keloids are uncommon and occur predominantly in dark skinned people with a genetic predisposition for keloid formation. In most cases, the gene appears to be ... subside. Hypertrophic scars usually develop within the first month after wounding and often subside gradually

Which of the following statement(s) is/are true concerning wound contraction? a. Wound contraction accounts for similar rates of reduction of wound size regardless of their location b. The fibroblast, at the cellular level, is the primary force driving wound contraction c. Excessive wound contraction, when occurring over a joint, may lead to disability d. Actin microfillaments are found in fibroblasts and may play a role in wound contracture

Description : Which of the following statement(s) is/are true concerning wound contraction? a. Wound contraction accounts for similar rates of reduction of wound size regardless of their location b. The fibroblast ... d. Actin microfillaments are found in fibroblasts and may play a role in wound contracture

Last Answer : Answer: b, c, d Wound contraction is an important event which contrasts healing open wounds and closed incisions. When open wounds contract, the surrounding skin is pulled over the open wound ... number in contracting wounds and are felt to play an active role in the process of wound contraction

A 59-year-old trauma patient has suffered multiple septic complications including severe pneumonia, intraabdominal abscess, and major wound infection. He has now developed signs of multisystem organ failure. Which of the following statement(s) is/are true concerning necessary changes to be made in his nutritional management? a. Carbohydrate load should be reduced in the face of respiratory failure b. In patients with renal failure, protein intake should be diminished c. During hemodialysis protein intake should be limited to the same extent d. In patients with hepatic failure, carbohydrate load should be increased

Description : A 59-year-old trauma patient has suffered multiple septic complications including severe pneumonia, intraabdominal abscess, and major wound infection. He has now developed signs of multisystem organ ... the same extent d. In patients with hepatic failure, carbohydrate load should be increased

Last Answer : Answer: a, b The most severe complication of sepsis is multiple system organ dysfunction syndrome, which may result in death. The development of organ failure requires changes in the ... should be provided as fat emulsion. If encephalopathy develops, protein load should also be reduced0

Which of the following is/are true of the actions of transforming growth factor beta (TGF-b) during wound repair? A. Increased matrix and proteoglycan synthesis. B. Inhibition of proteases. C. Stimulation of plasminogen inhibitor. D. Chemotaxis for fibroblasts and macrophages. E. Autoinduction of TGF-b.

Description : Which of the following is/are true of the actions of transforming growth factor beta (TGF-b) during wound repair? A. Increased matrix and proteoglycan synthesis. B. Inhibition of proteases. ... of plasminogen inhibitor. D. Chemotaxis for fibroblasts and macrophages. E. Autoinduction of TGF-b.

Last Answer : Answer: ABDE DISCUSSION: Through autocrine and paracrine mechanisms TGF-b stimulates the deposition of collagen and other matrix components by fibroblasts, inhibits proteases, blocks plasminogen inhibitor, ... effects. The sustained production of TGF-b at the wound site leads to tissue fibrosis

Which of the following statement(s) is/are true concerning hemophilia A? a. Hemophilia A is inherited as a sex-linked recessive deficiency of factor VIII b. A positive family history for bleeding disorders present in all patients c. Laboratory tests reveal a prolongation of aPTT, prothrombin time (PT), thrombin clotting time and platelet aggregation d. Spontaneous bleeding is unusual with factor VIII levels greater than 10% of normal

Description : Which of the following statement(s) is/are true concerning hemophilia A? a. Hemophilia A is inherited as a sex-linked recessive deficiency of factor VIII b. A positive family history for ... platelet aggregation d. Spontaneous bleeding is unusual with factor VIII levels greater than 10% of normal

Last Answer : Answer: a, d Hemophilia A is inherited as a sex-linked recessive deficiency of factor VIII although 0% of cases are secondary to spontaneous mutation. The incidence of this abnormality is ... factor levels as low as 1% have been noted and patients are at risk for spontaneous bleeding

Answer: b, c The body contains fuel reserves which it can mobilize and utilize during times of starvation or stress. By far the greatest energy component is fat, which is calorically dense since it provides about 9 calories/gram. Body protein comprises the next largest mass of utilizable energy, but amino acids yield only about 4 kcal/gram. Unlike fat reserves, body protein is not a storage form of energy but rather serves as a structural functional component of the body; loss of body protein, if severe, is associated with functional consequences. Glycogen stored in muscle and liver and free glucose have a trivial caloric value of less than 1000 kcal for a 70 kg male

Description : Answer: b, c The body contains fuel reserves which it can mobilize and utilize during times of starvation or stress. By far the greatest energy component is fat, which is calorically dense since it ... liver and free glucose have a trivial caloric value of less than 1000 kcal for a 70 kg male

Last Answer : Which of the following statement(s) is/are true concerning the indications and administration of nutritional support to cancer patients? a. Preoperative nutritional support should be provided to all ... total parenteral nutrition solutions maintain integrity of the small bowel e. None of the above

The following statement(s) is/are true concerning newer detection methods of systemic infection. a. Enzyme-linked immunosorbent assay (ELISA) is a rapid immunologic assay used for both antigen and antibody detection b. Southern, northern, and western immunoblot techniques are used to detect DNA, RNA, or proteins, respectively c. Polymerase chain reaction (PCR) is a sensitive assay used to detect small amounts of microbial DNA, thus detecting infection at its early stages d. Infectious agents currently detected using advanced molecular techniques include cytomegalovirus (CMV) and human immunodeficiency virus (HIV)

Description : The following statement(s) is/are true concerning newer detection methods of systemic infection. a. Enzyme-linked immunosorbent assay (ELISA) is a rapid immunologic assay used for ... detected using advanced molecular techniques include cytomegalovirus (CMV) and human immunodeficiency virus (HIV)

Last Answer : Answer: a, b, c, d Although the classic detection of infection based on clinical signs of infection and bacterial culture remain the most common clinical tools, increasing ... including CMV and HIV. Furthermore, preliminary investigations into possible detection of fungal pathogens are underway

The following statement(s) is/are true concerning cellular defense mechanisms. a. Macrophages function solely as antigen processing cells in the initial reaction to exposure to an antigen b. Macrophages may become activated and secrete cytokines c. Macrophages serve as phagocytic cells in the tissues but not within the bloodstream d. Polymorphonucleocytes (PMNS) are normally present in only small numbers within the tissue and enter an area of infection through diapedesis

Description : The following statement(s) is/are true concerning cellular defense mechanisms. a. Macrophages function solely as antigen processing cells in the initial reaction to exposure to an antigen b. Macrophages ... in only small numbers within the tissue and enter an area of infection through diapedesis

Last Answer : Answer: b, d A wide variety of cell types serve to provide host defense at several levels. Macrophages act as the initial antigen processing cell that serves to ... through diapedesis after chemotactic stimuli are excluded by macrophages, bacterial breakdown products, and complement activation

Essential fatty acid deficiency may complicate total parenteral nutrition (TPN). Which of the following statements are true? A. Essential fatty acid deficiency may be prevented by the administration of 1% to 2% of total calories as fat emulsion. B. Fat-free parenteral nutrition results in the appearance of plasma abnormalities, indicating essential fatty acid deficiency, within 7 to 10 days of initiation. C. An abnormal plasma eicosatrienoic-arachidonic acid ratio is always associated with essential fatty acid deficiency. D. Following initiation of fat-free parenteral nutrition, dry, scaly skin associated with a maculopapular rash indicates essential fatty acid deficiency.

Description : Essential fatty acid deficiency may complicate total parenteral nutrition (TPN). Which of the following statements are true? A. Essential fatty acid deficiency may be prevented by the ... , dry, scaly skin associated with a maculopapular rash indicates essential fatty acid deficiency.

Last Answer : Answer: BD DISCUSSION: Biochemical evidence of essential fatty acid deficiency may occur as early as 7 to 10 days following initiation of fat-free parenteral nutrition. The decrease in ... essential to the diagnosis of essential fatty acid deficiency, but this plasma abnormality is often present