Wound Care Certification Exam Wound Care Certification Atypical Wound Etiologies 5

Question 1

A patient with a known hypercoagulable state (Factor V Leiden mutation) presents with a painful lower leg ulcer.
Biopsy shows fibrin thrombi in dermal vessels with minimal inflammation.
This pattern is most consistent with:

Accepted Answer

Livedoid vasculopathy

Answer

Pyoderma gangrenosum

Answer

Calciphylaxis

Answer

Leukocytoclastic vasculitis

Question 2

When treating calciphylaxis, sodium thiosulfate is used because it:

Accepted Answer

Chelates calcium and has antioxidant properties, dissolving calcium deposits

Answer

Inhibits parathyroid hormone secretion

Answer

Promotes phosphate excretion through the kidneys

Answer

Directly vasodilates calcified arterioles

Question 3

A wound clinician encounters a patient with sickle cell leg ulcers. Which treatment approach is CONTRAINDICATED due to risk of worsening ischemia?

Accepted Answer

High-pressure compression bandaging

Answer

Hydroxyurea therapy

Answer

Zinc supplementation

Answer

Gentle moist wound healing dressings

Question 4

A patient with a history of ANCA-associated vasculitis presents with a new lower extremity ulcer. Which biopsy finding would confirm vasculitis as the etiology?

Accepted Answer

Fibrinoid necrosis of vessel walls with neutrophilic infiltration

Answer

Fibrin thrombi with minimal inflammation

Answer

Calcium deposits in the media of arterioles

Answer

Dermal edema with hemosiderin deposits

Question 5

Which of the following atypical wound etiologies is most strongly associated with a history of bone marrow or organ transplantation?

Accepted Answer

Pyoderma gangrenosum due to graft-vs-host disease

Answer

Calciphylaxis due to post-transplant mineral dysregulation

Answer

Leishmania reactivation due to immunosuppression

Answer

Sickle cell ulcer due to hemolysis

Question 6

A patient presents with a painless ulcer on the perimalleolar area with a 'wet wood' odor and extensive undermining. They recently returned from West Africa. The most appropriate initial diagnostic step is:

Accepted Answer

PCR testing of wound tissue for Mycobacterium ulcerans

Answer

Venous duplex scan

Answer

ANCA panel and ANA titer

Answer

Wound surface swab for MRSA

Question 7

Which statement best describes the principle of pathergy in the context of atypical wounds?

Accepted Answer

Minor skin trauma triggers disproportionately large wound formation in susceptible patients

Answer

Wounds heal faster after minor trauma due to growth factor release

Answer

Wound infection spreads to adjacent skin following debridement

Answer

Repeated trauma leads to protective callus formation