Keloid vs Normal Scars: Fibrosis and Healing
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Questions and Answers

How does a keloid scar differ from a normal linear scar in terms of growth pattern?

  • Linear scars exhibit significant growth and thickening over time, while keloid scars remain relatively stable.
  • Both keloid and linear scars demonstrate similar growth patterns, with neither extending beyond the original wound.
  • Keloid scars remain confined to the original wound area, while linear scars spread beyond it.
  • Keloid scars grow beyond the boundaries of the original wound, while linear scars stay within it. (correct)

Which characteristic is most indicative of a hypertrophic scar (keloid) compared to a normal healing scar?

  • A significant elevation above the surrounding skin and irregular shape. (correct)
  • A lighter pigmentation compared to surrounding skin.
  • A flat, smooth surface that blends with the skin.
  • A shrinking size over time.

What visual cue primarily distinguishes a keloid from a typical scar?

  • A keloid appears as a sunken area, while a typical scar is raised.
  • A keloid has a pale, almost translucent appearance, unlike a typical scar.
  • A keloid extends beyond the initial wound site, unlike a typical scar. (correct)
  • A keloid is characterized by a perfectly smooth and even surface, unlike a typical scar.

What does the term 'overgrown scar' specifically refer to in the context of scar formation?

<p>A scar that becomes excessively large and raised due to overproduction of collagen. (A)</p> Signup and view all the answers

Considering the visual characteristics of keloid scars, which description most accurately represents their typical appearance in the early stages of formation?

<p>A significantly raised, reddish-purple lesion with an irregular shape. (A)</p> Signup and view all the answers

Which of the following complications of fibrosis would most directly lead to difficulty in swallowing?

<p>Esophageal scarring and obstruction (A)</p> Signup and view all the answers

A patient with advanced liver cirrhosis develops intestinal obstruction. Which complication of fibrosis is MOST likely the cause?

<p>Adhesions and twisting of the intestines (C)</p> Signup and view all the answers

A 25-year-old patient presents with a surgical wound. Which factor would MOST effectively promote optimal healing?

<p>Ensuring adequate intake of protein and vitamins A and C. (D)</p> Signup and view all the answers

An elderly patient with a history of diabetes and peripheral vascular disease has a leg ulcer. Which of these factors would MOST significantly delay the healing process?

<p>Presence of diabetes and circulatory problems. (C)</p> Signup and view all the answers

A patient develops limited range of motion in their elbow following a burn injury. Which of the listed complications of fibrosis is MOST likely responsible for this?

<p>Contractures (A)</p> Signup and view all the answers

A patient undergoing chemotherapy for cancer treatment develops a skin wound. How does chemotherapy MOST likely affect the healing process?

<p>By suppressing the immune system and impairing cell proliferation. (B)</p> Signup and view all the answers

How do collagen fibers contribute to the development of contractures in fibrotic tissue?

<p>By shortening and hardening over time, restricting tissue movement. (C)</p> Signup and view all the answers

Which of the following is the BEST description of stenosis as a complication of fibrosis?

<p>Permanent narrowing of a tube or opening in the body. (C)</p> Signup and view all the answers

Which of the following conditions would have the MOST POSITIVE impact on wound healing?

<p>Effective circulation (A)</p> Signup and view all the answers

A patient taking glucocorticoids for a chronic inflammatory condition sustains a minor injury. How do glucocorticoids affect wound healing?

<p>They reduce inflammation but impair fibroblast function and collagen deposition. (A)</p> Signup and view all the answers

Following an injury, which process results in the complete restoration of both structure and function in the affected tissue?

<p>Resolution (A)</p> Signup and view all the answers

Under what circumstances does fibrosis typically occur during the healing process?

<p>When the damage is extensive and cells are incapable of mitosis. (B)</p> Signup and view all the answers

Which of the following processes involves the replacement of dead cells with new cells of the same type?

<p>Regeneration (D)</p> Signup and view all the answers

In a scenario where a minor skin abrasion heals completely without any scarring, which healing process is most likely responsible?

<p>Resolution through damaged cell recovery (A)</p> Signup and view all the answers

Why is the formation of a blood clot essential at the beginning of the healing process?

<p>To seal off the injured area and prevent further complications. (A)</p> Signup and view all the answers

Which of the following best describes the role of macrophages during the second stage of wound healing by both first and second intention?

<p>Removing dead tissue and debris from the wound area. (B)</p> Signup and view all the answers

In wound healing by first intention, what is the primary mechanism that leads to the closure of the wound?

<p>Epithelial regeneration and contraction of fibrous tissue. (D)</p> Signup and view all the answers

How does the role of new capillaries forming relate to wound healing?

<p>They deliver essential nutrients to the healing tissue. (B)</p> Signup and view all the answers

Which of the following is a key difference between healing by first intention and healing by second intention?

<p>The extent of scar tissue formation, with more scar tissue in second intention. (D)</p> Signup and view all the answers

What is the primary purpose of scab formation in both first and second intention wound healing?

<p>To protect the wound from external factors and infection. (D)</p> Signup and view all the answers

Which process is most directly associated with the action of fibroblasts during the granulation tissue stage?

<p>Collagen fiber deposition. (C)</p> Signup and view all the answers

What role do neutrophils play in the initial stage of both first and second intention wound healing?

<p>Fighting infection and initiating the healing process. (D)</p> Signup and view all the answers

How does contraction of fibrous tissue aid in the healing process?

<p>By physically pulling the wound edges closer together. (D)</p> Signup and view all the answers

A patient with a history of gastritis requires an analgesic. Which of the following medications would be LEAST suitable, considering their potential to exacerbate the patient's condition?

<p>Salicylic acid (C)</p> Signup and view all the answers

A patient experiencing both inflammation and pain needs a medication that addresses both symptoms but also minimizes the risk of delayed blood clotting. Which medication should be avoided?

<p>Aspirin (A)</p> Signup and view all the answers

Which medication used to treat inflammation is LEAST likely to provide pain relief?

<p>Prednisone (A)</p> Signup and view all the answers

A patient with a known hypersensitivity to aspirin needs an antipyretic medication. Which of the following would be the MOST appropriate and safe choice?

<p>Acetaminophen (B)</p> Signup and view all the answers

A patient presents symptoms of inflammation, pain, and fever, but has a high risk of cardiovascular events. Considering the adverse effect profiles, which of the following medications should be administered with the MOST caution?

<p>Ibuprofen (C)</p> Signup and view all the answers

Following a minor cut, a patient experiences redness and warmth around the wound. Which of the following mechanisms BEST explains these early signs of acute inflammation?

<p>Release of histamine, causing vasodilation and increased blood flow. (B)</p> Signup and view all the answers

How does the cellular composition of chronic inflammation differ from that of acute inflammation?

<p>Chronic inflammation is characterized by infiltration of lymphocytes, macrophages, and fibroblasts, while acute inflammation is dominated by neutrophils. (B)</p> Signup and view all the answers

A patient presents with persistent joint pain and swelling lasting several months. Which of the following processes is MOST likely contributing to the patient's chronic inflammation?

<p>Ongoing release of inflammatory mediators due to persistent cause. (D)</p> Signup and view all the answers

What is the primary reason for increased fibrosis (scarring) in chronic inflammation compared to acute inflammation?

<p>Greater proliferation of fibroblasts and subsequent collagen production. (C)</p> Signup and view all the answers

A patient who has undergone surgery is experiencing significant pain around the incision site. How does the inflammatory process contribute MOST directly to this sensation of pain?

<p>Release of kinins irritates nerve endings. (C)</p> Signup and view all the answers

After suffering a superficial skin abrasion, the damaged tissue is fully restored with the same cell type. Which healing process is MOST accurately described in this scenario?

<p>Regeneration of the original tissue. (B)</p> Signup and view all the answers

Why does chronic inflammation typically result in greater tissue destruction compared to acute inflammation?

<p>The prolonged presence of inflammatory cells and mediators. (A)</p> Signup and view all the answers

How does the presence of granulomas contribute to the characteristics of chronic inflammation?

<p>Granulomas represent an attempt to wall off and contain persistent, non-digestible substances or pathogens. (C)</p> Signup and view all the answers

A patient sustains a deep wound to their arm. If the healing process results in the formation of scar tissue, which component of the inflammatory response was MOST likely insufficient to restore the original tissue structure and function?

<p>Regeneration of the original tissue. (A)</p> Signup and view all the answers

A biopsy of a tissue sample reveals a significant presence of lymphocytes, macrophages, and fibroblasts. Which type of inflammatory response is MOST likely occurring in this tissue?

<p>Chronic inflammation, potentially leading to fibrosis. (B)</p> Signup and view all the answers

During an inflammatory response, how does the alteration in plasma protein levels, specifically increased fibrinogen, contribute to the elevated ESR (erythrocyte sedimentation rate)?

<p>Increased fibrinogen neutralizes the negative charge on red blood cells, reducing their repulsion and increasing aggregation. (D)</p> Signup and view all the answers

Following a myocardial infarction (heart attack), which blood test result would be MOST indicative of cardiac tissue damage, based on the changes observed in blood during inflammation?

<p>Elevated cardiac enzymes. (D)</p> Signup and view all the answers

A patient presents with symptoms of systemic inflammation. While awaiting specific diagnostic results, which initial blood test would provide the MOST general indication of an inflammatory process?

<p>C-reactive protein (CRP) level. (B)</p> Signup and view all the answers

How does leukocytosis, characterized by an increase in white blood cells, primarily aid in the body's response to inflammation?

<p>By facilitating the migration of immune cells to the site of inflammation to combat pathogens or remove debris. (B)</p> Signup and view all the answers

In a patient experiencing chronic inflammation, why might monitoring C-reactive protein (CRP) levels be more useful than monitoring cell enzyme levels for assessing disease activity?

<p>CRP levels provide a more general and consistent measure of overall inflammation, whereas cell enzyme elevation is specific to tissue damage. (A)</p> Signup and view all the answers

During the process of wound healing, granulation tissue serves to directly replace which of the following?

<p>The initial blood clot (B)</p> Signup and view all the answers

The high vascularity of granulation tissue, resulting from angiogenesis, is most directly important for which aspect of wound healing?

<p>Delivering nutrients and oxygen to the healing site (C)</p> Signup and view all the answers

Fibroblasts play a critical role in scar formation by performing which of the following actions?

<p>Producing collagen to create a structural framework (C)</p> Signup and view all the answers

Compared to normal tissue, scar tissue is characterized by which of the following properties?

<p>Reduced functional capabilities and altered structure (A)</p> Signup and view all the answers

Which of the following best describes the inherent fragility of granulation tissue in the context of wound healing?

<p>Its newly formed blood vessels and immature matrix make it susceptible to damage (A)</p> Signup and view all the answers

Flashcards

Hypertrophic Scar

A raised scar that remains within the original wound boundaries.

Keloid

A type of scar that is raised and extends beyond the original wound area.

Linear Scar

A thin, raised scar that follows a straight line pattern.

Scar Characteristics

Hypertrophic scars are raised, reddish-purple, and irregularly shaped.

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Overgrown Scars

An informal term referring to both hypertrophic scars and keloids.

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Esophageal Scarring

Scar tissue formation in the esophagus causing obstruction.

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Adhesions

Band-like scar tissue that binds loops of intestines together.

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Contractures

Permanent shortening of muscles or skin due to scarring.

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Stenosis

Narrowing of a tube or opening in the body due to scar formation.

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Granulation Tissue

Newly formed tissue during healing, replacing the clot.

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Vascular Nature of Granulation Tissue

Granulation tissue is highly vascular due to angiogenesis.

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Fibroblasts

Cells that produce collagen to create scar tissue.

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Collagen

Protein that provides strength to scar tissue.

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Scar Tissue Function

Scar tissue provides strength but does not restore normal function.

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Factors promoting healing

Age, nutrition, hemoglobin levels, circulation, clean wounds, and absence of infection aid healing.

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Youth

Younger individuals typically heal faster due to vigorous cellular activity.

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Nutrition's Role

Good nutrition with adequate protein, vitamins A and C is crucial for healing.

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Factors delaying healing

Advanced age, poor nutrition, anemia, circulatory issues, infections, and trauma hinder healing.

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Infection's Impact

Infection and foreign materials in a wound significantly delay the healing process.

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Healing Process

Tissue repair begins after a blood clot seals the injury.

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Resolution

Restoration of structure and function after damaged cells recover.

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Regeneration

Replacement of damaged cells through mitosis of adjacent cells.

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Fibrosis

Formation of scar tissue when damage is extensive and cells can't divide.

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Scar Formation

Replacement of tissue with connective tissue following severe injury.

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Injury and Inflammation

Initial phase after a wound occurs, including scab and clot formation and inflammation.

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Epithelial Regeneration

Process where epithelial cells grow over the wound to close it.

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First Intention Healing

Wound healing by primary closure, resulting in small scars.

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Second Intention Healing

Wound healing by secondary intention, often leading to larger scars.

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Scar Contraction

Process where scar tissue shrinks, often more pronounced in first intention healing.

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Acute Inflammation

The initial response to tissue injury characterized by redness, heat, swelling, and pain.

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Chemical Mediators

Substances like histamine, kinins, and prostaglandins released during inflammation.

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Phagocytosis

The process where white blood cells engulf and destroy debris and pathogens.

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Chronic Inflammation

A prolonged inflammatory response due to persistent injury or irritants.

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Collagen Production

Increase in collagen fiber creation during chronic inflammation leading to fibrosis.

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Granulomas

Small masses formed by a collection of macrophages in chronic inflammation.

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White Blood Cell Types

Lymphocytes and macrophages are prevalent in chronic inflammation.

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Tissue Destruction

Greater damage occurs to tissue due to chronic inflammation compared to acute.

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Anti-inflammatory drugs

Medications that reduce inflammation in the body.

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Analgesic drugs

Medications that relieve pain without causing loss of consciousness.

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Antipyretic drugs

Medications that reduce fever.

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NSAIDs

Nonsteroidal anti-inflammatory drugs that relieve pain and inflammation.

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Glucocorticoids

A class of drugs that reduce inflammation and suppress the immune system.

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Leukocytosis

Increased numbers of white blood cells, especially neutrophils, during inflammation.

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C-reactive protein (CRP)

A protein that appears in the blood during acute inflammation and necrosis within 24-48 hours.

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Differential count

Proportion of each type of white blood cell changes based on the cause of inflammation.

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Increased ESR

Elevated sedimentation rate of red blood cells due to increased plasma proteins.

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Cell enzymes

Enzymes released from necrotic cells; can indicate the site of inflammation.

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Study Notes

Hypertrophic Scar (Keloid)

  • Image A shows a linear scar, Image B shows a raised, hypertrophic scar.
  • Hypertrophic scars are raised but do not extend past the original wound boundaries.
  • Keloids are raised scars that extend beyond the original wound boundaries.

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Description

Explore the characteristics of keloid and hypertrophic scars, differentiating them from normal scars based on growth patterns and visual cues. Also covered are complications of fibrosis like intestinal obstruction and factors promoting surgical wound healing in patients with conditions like diabetes or liver cirrhosis.

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