Wound Care Certification Exam Wound Care Certification Atypical Wound Etiologies 3

Question 1

A patient with systemic lupus erythematosus (SLE) develops painful digital ulcers and skin necrosis. Antiphospholipid antibodies are detected. Which mechanism best explains this wound presentation?

Accepted Answer

Hypercoagulability causing thrombotic occlusion of microvasculature

Answer

Autoimmune neutrophil infiltration of dermis

Answer

Complement-mediated direct tissue destruction

Answer

Immune complex deposition causing vasodilation

Question 2

Epidermolysis bullosa (EB) wounds are best managed with which primary dressing consideration?

Accepted Answer

Non-adherent, silicone-based dressings to minimize trauma at removal

Answer

Adhesive hydrocolloid dressings to maintain occlusion

Answer

Wet-to-dry gauze for mechanical debridement

Answer

Zinc oxide paste bandages

Question 3

A patient with chronic hepatitis C presents with palpable purpura, arthralgias, and lower extremity ulcers. Serum immunofixation shows a type II cryoglobulin. The underlying wound etiology is:

Accepted Answer

Cryoglobulinemic vasculitis

Answer

Venous insufficiency

Answer

Pyoderma gangrenosum

Answer

Diabetic microangiopathy

Question 4

Necrobiosis lipoidica diabeticorum (NLD) most commonly presents in which anatomical location?

Accepted Answer

Pretibial area of the lower leg

Answer

Dorsum of the hand

Answer

Medial ankle

Answer

Plantar foot

Question 5

A clinician suspects a factitious wound (dermatitis artefacta) in a patient with a geometric wound pattern that does not fit any known vascular distribution. The most important next step in management is:

Accepted Answer

Psychiatric evaluation and a non-confrontational therapeutic approach

Answer

Aggressive debridement

Answer

Immediate skin grafting

Answer

High-dose systemic corticosteroids

Question 6

Which of the following best distinguishes vasculitic ulcers from venous leg ulcers on clinical examination?

Accepted Answer

Vasculitic ulcers are typically multiple, punched-out, and extremely painful

Answer

Vasculitic ulcers are painless and located on the gaiter area

Answer

Vasculitic ulcers have irregular sloping edges and surrounding hemosiderin staining

Answer

Vasculitic ulcers respond promptly to compression therapy

Question 7

A patient develops a painful, non-healing ulcer on the lower leg following initiation of hydroxyurea therapy for polycythemia vera. The most likely diagnosis is:

Accepted Answer

Hydroxyurea-induced leg ulcer

Answer

Arterial ulcer from drug-induced vasospasm

Answer

Venous ulcer exacerbated by polycythemia

Answer

Pressure injury from bedrest