APMLE APMLE Podiatric Surgery and Wound Care 2 — Questions and Answers
Question 1: Which wound healing phase is characterized by fibroblast proliferation and collagen synthesis?
- Proliferative phase (Correct answer)
- Inflammatory phase
- Hemostasis phase
- Remodeling phase
Correct answer: Proliferative phase
The proliferative phase (days 4–21) involves fibroblast migration, collagen synthesis, angiogenesis, and wound contraction.
Question 2: What is the appropriate ankle-brachial index (ABI) threshold below which elective foot surgery should generally be deferred?
- ABI less than 0.5 (Correct answer)
- ABI less than 1.0
- ABI less than 0.8
- ABI greater than 1.3
Correct answer: ABI less than 0.5
An ABI below 0.5 indicates severe peripheral arterial disease and is a relative contraindication to elective foot surgery due to poor healing potential.
Question 3: Which debridement method uses sterile maggots (larvae) to selectively remove necrotic tissue from chronic wounds?
- Biologic (larval) debridement (Correct answer)
- Sharp debridement
- Enzymatic debridement
- Autolytic debridement
Correct answer: Biologic (larval) debridement
Biologic (larval) debridement uses Lucilia sericata maggots that selectively digest necrotic tissue while sparing viable tissue.
Question 4: What type of suture material is preferred for skin closure in podiatric surgery due to its handling characteristics and knot security?
- Nylon (non-absorbable monofilament) (Correct answer)
- Chromic gut (absorbable natural)
- Polyglactin 910 (Vicryl, absorbable braided)
- Silk (non-absorbable braided)
Correct answer: Nylon (non-absorbable monofilament)
Nylon (e.g., Prolene or Ethilon) is commonly used for skin closure in podiatric surgery due to its low reactivity, strength, and easy removal.
Question 5: Which complication of wound healing is characterized by excessive collagen deposition that extends beyond the original wound margins?
- Keloid formation (Correct answer)
- Hypertrophic scar
- Wound dehiscence
- Seroma formation
Correct answer: Keloid formation
Keloids extend beyond the original wound margins due to uncontrolled collagen deposition and are more common in darkly pigmented individuals.
Question 6: What is the gold standard for diagnosing osteomyelitis in the diabetic foot?
- Bone biopsy with culture and histopathology (Correct answer)
- MRI scan
- Plain radiograph
- Bone scan (technetium-99m)
Correct answer: Bone biopsy with culture and histopathology
Bone biopsy with culture and histopathology is the gold standard for diagnosing osteomyelitis, providing definitive microbiological and pathological diagnosis.
APMLE APMLE Podiatric Surgery and Wound Care 2
Which wound healing phase is characterized by fibroblast proliferation and collagen synthesis?