Chapter 5, Emergency Wound Management Video Solutions, Emergency Medicine Examination & Board Review

Problem 1

Which of the following statements is TRUE with regard to the management of mammalian bites?
(A) Puncture wounds, wounds >24 hours old, and most wounds on the hand and foot should be left open.
(B) Cephalexin, dicloxacillin, erythromycin, or clindamycin are all adequate prophylactic single-agent coverage choices for cat bites.
(C) Although a minority of dog bites become infected, those occurring in postsplenectomy or other immunocompromised patients should have prophylactic antimicrobial coverage initiated.
(D) Cat-scratch disease typically develops 1 to 2 days following a cat bite or scratch.

Joanna Quigley

Numerade Educator

01:07

Problem 2

Which statement is MOST correct in regard to wound preparation for primary closure?
(A) Local anesthesia should be performed following irrigation to avoid introduction of bacteria deeper into the wound.
(B) Irrigation with normal saline at 5-8 psi is the most effective means of decreasing wound bacterial counts.
(C) Hair that interferes with wound closure should be removed by shaving to prevent entrapment within the wound.
(D) Wounds should be lightly scrubbed to remove particulate matter, followed by irrigation with a povidone-iodine solution.

Hunza Gilgit

Numerade Educator

Problem 3

What are some benefits of cyanoacrylate tissue adhesives compared to standard suture material for wound closure?
(A) Rapid and painless application.
(B) Decreased rate of wound dehiscence.
(C) Increased wound tensile strength.
(D) Improved cosmetic outcome.

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Problem 4

Which of the following eyelid wounds is not a clear indication for ophthalmologic referral for further management?
(A) Laceration of the inner surface of the lid.
(B) Lid margin lacerations.
(C) Medial lacerations involving the lacrimal system.
(D) Lateral wounds running parallel to the lid margin.

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Problem 5

A 21-year-old male presents with a lower extremity laceration that occurred after falling out of his canoe in a nearby river approximately 4 hours prior to arrival. What statement is most correct regarding this patient's injury?
(A) Irrigation of the wound is not required as the wound was immediately cleansed while submerged in the water.
(B) Infectious complications in this type of wound usually occur in a delayed fashion at 7-10 days postinjury.
(C) Antimicrobial prophylaxis is not indicated.
(D) Aeromonas hydrophila exposure should be considered.

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Problem 6

A 22-year-old night club bouncer presents with a dorsal hand laceration following an altercation the night prior to arrival. The wound is approximately 0.5 cm in length, overlying the third metacarpophalangeal joint. What statement is correct in considering this patient's management?
(A) Radiography is rarely indicated unless bone or joint tenderness is present.
(B) Evidence of infection necessitates immediate hand surgeon consultation.
(C) Meticulous wound inspection through range of motion is required.
(D) Eikenella corrodens is the most common bacterial species implicated in human bite infections.

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Problem 7

A 40-year-old carpenter presents with a digital fingertip amputation. There is a soft tissue defect (approximately 1 cm × 1 cm) of the volar pad without bony exposure. Which of the following statements best describes the optimal management of this injury?
(A) Primary closure is indicated, via undermining of the wound edges, even if significant wound tension exists.
(B) Immediate hand specialist consultation is required.
(C) Use of the amputated portion for full thickness grafting clearly results in the best functional and cosmetic outcome.
(D) Conservative management with serial dressing changes is indicated.

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