Test two (wound and infection)

1. Predisposing factors for the development of keloid scars include:
a. patients of Afro-Carribean origin with dark complexion

b. wound infection

c. steroid therapy

d. secondary wound closure 

e. use of local bupivacaine

2. The following statements are true of wound infections:

a. Staphylococcus aureus is the most common organism to infect the surgical wound

b. MRSA wound infection is usually the result of wound contamination by hospital staff

c. anaerobic organisms exert their lethal effects by producing endo- and exotoxins

d. with opportunistic organisms, they are the result of a patient's reduced immune defence

e. necrotizing fasciitis is commoner in carrier of MRSA


3. Wound healing by secondary intention takes place:

a. when the wound does not break apart

b. when the wound edges are brought together

c. when there is irreparable skin loss

d. much more slowly than healing by first intention

e. when the wound becomes infected

4. Options for sterilization include:

a. ethylene oxide

b. gamma irradiation

c. 160 C dry heat for 30 minutes

d. low temperature steam of 730 C for 20 minutes

e. high temperature steam of 1340  C for 3 minutes

5. Clostridium tetani:
a. causes gas gangrene

b. produces an exotoxin

c. has a terminal spore

d. is an obligatory anaerobe

e. is non-motile

6. True statements concerning necrotizing fasciitis are correct:

a. antibiotic therapy and hyperbaric oxygen do not limit the spread

b. there is a severe infective process, but the skin initially appears normal

c. conservative excision of the necrotic fascia and skin and muscle should be carried out 
    within 24 hours

d. it is not common after minor trauma

e. high doses benzylpenicillin (4 mega units) given intravenously are indicated

7.Keloid scars:

a. are distinguished from hypertrophic scars by their extent.

b. extends beyond the original incisional scar

c. are caused by the excess deposition of fibrin in the wound

d. are common on the deltoid region

e. may be prevented by pressure dressing

8. Staphylococcus aureus is sensitive to:

a. vancomycin

b. cefuroxime

c. flucloxacillin

d. clindamycin

e. methicillin

9. Lignocaine:
a. inhibits the uptake of sodium into nerve cell membranes

b. has a local vasodilatory effect

c. toxicity should be suspected if the patient develops slurred speech

d. is an alkaline solution

e. 1% solution contains 1 g of lignocaine in 100 ml fluid

10. Local anaesthetic injections are less painful if:

a. the anaesthetic is cooled.

b. they are combined with adrenaline

c. they are given rapidly

d. the pH is neutralized prior to administration

e. a thinner needle is used.

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