Wound Healing MCQ — NEET PG Practice Question | NEETPGAI
Wound Healing
medium
microscope Pathology
A 28-year-old woman undergoes surgical excision of a benign skin lesion on her back. During the follow-up visits, she develops a hypertrophic scar. Which is the most common cause of hypertrophic scar formation in this patient?
A. Premature termination of the inflammatory phase
B. Excessive Type I collagen deposition with organized fiber arrangement
C. Inadequate angiogenesis in the wound bed
D. Excessive Type III collagen deposition with disorganized fiber arrangement
Explanation
Hypertrophic Scar Formation
Pathophysiology of Hypertrophic Scars
Key Point
Hypertrophic scars result from excessive deposition of Type I collagen with a relatively organized (parallel to skin surface) fiber arrangement. This is distinct from keloids, which also have excessive Type I collagen but in a markedly disorganized, nodular pattern.
Comparison: Normal Scar vs. Hypertrophic Scar vs. Keloid
Excessive fibroblast proliferation and collagen synthesis → predominantly Type I collagen
3.
Impaired collagen remodeling → net accumulation of collagen
4.
Fibers arranged parallel to the skin surface → raised but organized scar
5.
Scar remains within original wound boundaries — key distinguishing feature from keloid
Why the Other Options Are Wrong
Option B (Type III collagen, disorganized): Type III collagen is the early provisional collagen in granulation tissue; it is normally replaced by Type I during remodeling. Hypertrophic scars are characterized by excess Type I, not Type III. Disorganized arrangement is more characteristic of keloids.
Option C (Inadequate angiogenesis): Poor angiogenesis leads to impaired healing and chronic wounds, not hypertrophic scars.
Option D (Premature termination of inflammatory phase): Premature termination of inflammation would impair healing; hypertrophic scars are associated with prolonged, not premature, inflammation.
Clinical Pearl
High-Yield (Robbins & Cotran Pathologic Basis of Disease): Hypertrophic scars are characterized by excessive Type I collagen deposition with fibers arranged parallel to the skin surface, remaining within the original wound boundaries. Keloids, by contrast, show thick, disorganized collagen bundles extending beyond the wound margins and are more common in darkly pigmented individuals with a genetic predisposition.
Mnemonic
"Hypertrophic = Type I, organized, within borders" — Hypertrophic scars have excess Type I collagen in an organized pattern and do NOT extend beyond the wound. Keloids = excess Type I, disorganized, extends beyond wound.
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