Wound Care Certification Exam Wound Care Certification Atypical Wound Etiologies 2

Question 1

A patient with end-stage renal disease on dialysis develops extremely painful, stellate-shaped necrotic lesions on the thighs and abdomen.
Skin biopsy reveals calcium deposits in small vessel walls.
Which condition is most likely?

Accepted Answer

Calciphylaxis

Answer

Pyoderma gangrenosum

Answer

Livedoid vasculopathy

Answer

Martorell ulcer

Question 2

Which laboratory finding is most consistently associated with calciphylaxis?

Accepted Answer

Elevated calcium-phosphate product (>55 mg²/dL²)

Answer

Elevated ESR

Answer

Low serum albumin

Answer

Elevated D-dimer

Question 3

A wound clinician notes a wound with a violaceous, undermined border that rapidly expands despite standard wound care. The patient has a history of inflammatory bowel disease. The most appropriate next step is to:

Accepted Answer

Start immunosuppressive therapy and minimize debridement

Answer

Debride aggressively to remove necrotic tissue

Answer

Apply compression bandaging

Answer

Order venous duplex ultrasound

Question 4

Livedoid vasculopathy (atrophie blanche) is best characterized by which of the following wound presentations?

Accepted Answer

Ivory-white stellate scars surrounded by hyperpigmentation on the lower leg

Answer

Large necrotic plaques on the abdomen

Answer

Punched-out ulcers on the heel

Answer

Nodular lesions along lymphatic channels

Question 5

A patient presents with a non-healing leg ulcer, sickle cell disease, and no signs of venous or arterial insufficiency. The ulcer is located on the medial malleolus. The primary etiology of this wound is most likely:

Accepted Answer

Microvascular occlusion from sickled red blood cells

Answer

Venous hypertension

Answer

Peripheral arterial disease

Answer

Trauma

Question 6

Which of the following is the most appropriate initial treatment for a hypertensive ischemic ulcer (Martorell ulcer)?

Accepted Answer

Strict blood pressure control combined with wound care

Answer

Compression therapy

Answer

Aggressive surgical debridement only

Answer

Antibiotic therapy alone

Question 7

A patient undergoing radiation therapy for pelvic cancer develops a non-healing wound in the irradiated field with pale, fibrotic tissue and poor granulation. This wound is best categorized as:

Accepted Answer

Radiation-induced wound

Answer

Arterial ulcer

Answer

Pressure injury stage 4

Answer

Fungating malignant wound