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

Calciphylaxis is characterized by vascular calcification and occlusion causing painful necrotic skin lesions, most commonly in patients with renal failure.

Question 2

Which laboratory finding is most consistently associated with calciphylaxis?

Accepted Answer

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

Answer

An elevated calcium-phosphate product above 55 mg²/dL² promotes precipitation of calcium salts in vessel walls, a hallmark of calciphylaxis.

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

Pyoderma gangrenosum exhibits pathergy, meaning aggressive debridement worsens the wound; immunosuppression with corticosteroids is the cornerstone of treatment.

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

Livedoid vasculopathy produces small, painful ulcers on the lower legs that heal leaving characteristic ivory-white (atrophie blanche) scars with peripheral hyperpigmentation.

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

Sickle cell ulcers result from microvascular occlusion, hemolysis, and poor oxygen delivery, and characteristically occur over the medial or lateral malleolus.

Wound Care Certification Exam Practice Test

Wound Care Certification Exam Practice Test

Wound Care Certification Exam Wound Care Certification Atypical Wound Etiologies 2