FRCS Principles of Surgery & Wound Healing

Question 1

A patient is in Class III haemorrhagic shock. What is the estimated blood loss and the expected physiological response?

Accepted Answer

1500–2000 mL; marked tachycardia, decreased BP, decreased urine output

Answer

750–1500 mL; mild tachycardia, normal BP

Answer

2000–2500 mL; tachycardia, normal BP, anxiety

Answer

<750 mL; minimal tachycardia, normal BP

Question 2

Which growth factor is the primary driver of the proliferative phase of wound healing?

Accepted Answer

Platelet-derived growth factor (PDGF)

Answer

TNF-alpha

Answer

Transforming growth factor-beta (TGF-β)

Answer

Vascular endothelial growth factor (VEGF) for fibroplasia

Question 3

What type of collagen is predominantly synthesised during the proliferative phase of wound healing and replaced in the remodelling phase?

Accepted Answer

Type III collagen

Answer

Type I collagen

Answer

Type II collagen

Answer

Type IV collagen

Question 4

What is primary intention wound healing?

Accepted Answer

Healing by direct apposition of wound edges with sutures, clips, or glue

Answer

Healing that occurs without any surgical intervention

Answer

Healing where the wound is left open to heal from the base

Answer

Healing assisted by a vacuum-assisted closure device

Question 5

Which sign indicates early systemic inflammatory response syndrome (SIRS) in a surgical patient?

Accepted Answer

Temperature 38.6°C, heart rate 102 bpm, RR 22 breaths/min, WBC 13.5 × 10⁹/L

Answer

Temperature 38.2°C, heart rate 95 bpm, RR 19 breaths/min, WBC 9.5 × 10⁹/L

Answer

Temperature 37.8°C, heart rate 88 bpm, RR 16 breaths/min, WBC 8 × 10⁹/L

Answer

Temperature 36.8°C, heart rate 75 bpm, RR 14 breaths/min, WBC 10 × 10⁹/L

Question 6

Keloid scarring differs from hypertrophic scarring in which key way?

Accepted Answer

Hypertrophic scars remain within wound margins; keloid scars extend beyond the original wound boundary

Answer

Keloid scars remain within the original wound boundary; hypertrophic scars extend beyond it

Answer

Keloid scars regress spontaneously; hypertrophic scars do not

Answer

Hypertrophic scars occur only in dark skin; keloid scars occur in any skin type