Wound Healing and Tissue repair MCQs: Bailey and Love Surgery (Chapter 3)

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Wound Healing and Tissue repair

Bailey and Love Surgery Chapter 3 Based MCQs

1. Which of the following is false regarding the Inflammatory phase of wound healing?

A. Starts immediately after injury
B. Starts 1 hour after injury
C. Starts 4 hours after injury
D. Starts 24 hours after injury
Answer: A  

– The inflammatory phase begins immediately after wounding and lasts 2–3 days.   
2. Which of the following is false statement wrt Proliferative phase of wound healing?

A. Fibroblasts require vitamin C to produce collagen
B. Proliferative phase begins from third day
C. Main cell involved is fibroblast
D. Production of collagen and ground substance takes place
E. Glycosaminoglycans and proteoglycans are produced    
Answer: C  

– Proliferative phase lasts from the third day to the third week
– Consisting mainly of fibroblast activity with the production of collagen and ground substance
– Glycosaminoglycans and proteoglycans are produced
– Fibroblasts require vitamin C to produce collagen
3. Which of the following statement is false wrt Remodelling phase of wound healing?

A. Remodelling phase is characterised by the maturation of collagen
B. Type III replacing type I until a ratio of 4:1 is achieved 
C. Collagen fibres align along the lines of tension 
D. Wound vascularity is decreased 
E. Wound contraction due to fibroblast and myofibroblast activity 
Answer: B  

– Remodelling phase is characterised by maturation of collagen
– Type I replaces type III until a ratio of 4:1 is achieved 
– Collagen fibres align along the lines of tension
– Wound vascularity is decreased 
– Wound contraction is due to fibroblast and myofibroblast activity
4. Which of the following statement is false regarding healing process of nerves?  

A. Wallerian degeneration occurs distal to site of injury
B. Wallerian degeneration occurs proximal to the site of injury
C. Proximally the degeneration occurs up to the node of Ranvier
D. Regenerating nerve fibres are attracted to their receptors by neurotropism  
Answer: B  

– Distal to the wound, Wallerian degeneration occurs.
– Proximally, the nerve suffers traumatic degeneration as far as the last node of Ranvier.
– The regenerating nerve fibres are attracted to their receptors by neurotropism, which is mediated by growth factors
5. After tendon repair, it regains its tensile strength after ___weeks:

A. 1-2 weeks
B. 2-3 weeks
C. 1-3 weeks
D. 3-6 weeks
Answer: D  

– The random nature of the initial collagen produced means that the tendon lacks tensile strength for the first 3–6 weeks.
– Active mobilisation prevents adhesions limiting range of motion, but the tendon must be protected by splintage in order to avoid rupture of the repair. 
6. Wound which is left open and heals by granulation, contraction and epithelialisation, is termed as:

A. Healing by Primary Intention
B. Healing by Secondary Intention
C. Healing by Tertiary Intention
D. Healing by Quaternary Intention      
Answer: B  

Classification of wound closure and healing

– Primary intention: Wound edges opposed, Normal healing, Minimal scar

– Secondary intention: Wound left open, Heals by granulation, contraction and epithelialisation, Increased inflammation and proliferation, Poor scar

– Tertiary intention (also called delayed primary intention): Wound initially left open, Edges later opposed when healing conditions favourable
7. Repair of nerves is done using which of the following suture materials:

A. 4/0 or 6/0 vicryl
B. 8/0 or 10/0 monofilament nylon
C. 8/0 or 10/0 vicryl
D. 4/0 or 6/0 monofilament nylon
Answer: B  

– Repair of nerves under magnification (loupes or microscope) using 8/0 or 10/0 monofilament nylon is usual.  
8. Which of the following statements regarding compartment syndrome is false:

A. Absence of distal pulses mainly drives the decision for fasciotomy in management of compartment syndrome
B. Fasciotomy is indicated when pressures are constantly greater than 30 mmHg
C. For crush injuries presenting several days later, immediate fasciotomy is advised
D. Compartment syndrome is not possible in open injuries
Answer: B  

– The compartment syndrome is characterised by severe pain, pain on passive movement of the affected compartment muscles, distal sensory disturbance and, finally, by the absence of pulses distally (a late sign).
– If pressures are constantly greater than 30 mmHg or if the above clinical signs are present, then fasciotomy should be performed 
– Crush injuries that present several days after the event, a late fasciotomy can be dangerous as dead muscle produces myoglobin which, if suddenly released into the bloodstream, causes myoglobinuria with glomerular blockage and renal failure.
– In the late treatment of lower limb injuries, therefore, it may be safer to amputate the limb once viable and non-viable tissues have demarcated.   
9. The most common site for pressure sore is:

A. Sacrum
B. Greater Trochanter
C. Ischium
D. Heel
Answer: C  

Pressure sore frequency in descending order :

-Ischium
-Greater trochanter
-Sacrum
-Heel
-Malleolus (lateral then medial)
-Occiput
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Surgery PreTest Self-Assessment and Review, 13th ed

SURGERY COMPLETE – 2019

Surgery For PGMEE 13th Edition – 2019 by Amit Ashish

BEST TEXTBOOKS FOR GENERAL SURGERY

Bailey & Love’s Short Practice of Surgery, 27th Edition

Sabiston’s Textbook of Surgery

Schwartz’s Principles Of Surgery

SRB’S Manual Of Surgery

BEST BOOKS FOR OPERATIVE SURGERY

Operative Techniques in Surgery by Michael W. Mulholland et al

Chassin’s Operative Strategy in General Surgery

Farquharson’s Textbook of Operative General Surgery, 10th Edition

 

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