Wound Care Certification Exam Wound Care Certification Atypical Wound Etiologies 4

Question 1

A traveler returning from South America presents with a painless, crusted, nodular ulcer on the forearm that has not healed for 3 months.
Tissue culture and smear reveal intracellular organisms.
The most likely diagnosis is:

Accepted Answer

Leishmaniasis

Answer

Sporotrichosis

Answer

Buruli ulcer

Answer

Mycobacterium marinum infection

Question 2

Buruli ulcer caused by Mycobacterium ulcerans is best characterized by which clinical feature?

Accepted Answer

Painless, undermined necrotic ulcer with extensive subcutaneous tissue destruction

Answer

Painful, rapidly spreading cellulitis

Answer

Multiple satellite pustules around a central nodule

Answer

Superficial erosion limited to the epidermis

Question 3

When evaluating a suspected atypical wound, which diagnostic test provides the highest-yield information about the wound etiology?

Accepted Answer

Punch biopsy from the wound edge for histopathology and culture

Answer

Surface wound swab culture

Answer

Doppler ultrasound of leg veins only

Answer

Wound pH measurement

Question 4

A patient with rheumatoid arthritis develops multiple, small, punched-out leg ulcers with no signs of venous or arterial disease. The clinician considers rheumatoid vasculitis. Which lab finding would best support this diagnosis?

Accepted Answer

Elevated rheumatoid factor and ANCA positivity

Answer

Low serum ferritin

Answer

Thrombocytopenia and elevated D-dimer

Answer

Elevated serum calcium

Question 5

A fungating malignant wound is best described as:

Accepted Answer

A wound arising from tumor infiltration through the skin causing ulceration, exudate, and malodor

Answer

A wound infected with fungal organisms

Answer

A deep tissue pressure injury with fungal superinfection

Answer

A wound in a patient who uses antifungal medications

Question 6

Which of the following is the MOST important goal when managing a fungating malignant wound?

Accepted Answer

Symptom management including odor, exudate, and pain control

Answer

Achieving complete wound closure

Answer

Aggressive debridement to reduce tumor burden

Answer

Promoting granulation tissue formation

Question 7

Pyoderma gangrenosum is most commonly associated with which underlying systemic condition?

Accepted Answer

Inflammatory bowel disease (Crohn's disease or ulcerative colitis)

Answer

Chronic kidney disease

Answer

Systemic lupus erythematosus

Answer

Type 1 diabetes mellitus