A 23-year-old man comes to the emergency department with an open wound on his right hand. He states that he got into a bar fight about an hour ago. He appears heavily intoxicated and does not remember the whole situation, but he does recall lying on the ground in front of the bar after the fight. He does not recall any history of injuries but does remember a tetanus shot he received 6 years ago. His temperature is 37°C (98.6°F), pulse is 77/min, and blood pressure is 132/78 mm Hg. Examination shows a soft, nontender abdomen. His joints have no bony deformities and display full range of motion. There is a 4-cm (1.6-in) lesion on his hand with the skin attached only on the ulnar side. The wound, which appears to be partly covered with soil and dirt, is irrigated and debrided by the hospital staff. Minimal erythema and no purulence is observed in the area surrounding the wound. What is the most appropriate next step in management?
AApposition of wound edges under tension + rifampin
BSurgical treatment with skin flap + ciprofloxacin
CSurgical treatment with skin graft + tetanus vaccine
DTension-free apposition of wound edges + sterile dressing
EApplication of moist sterile dressing + tetanus vaccine
A 23-year-old woman is brought to the emergency department 30 minutes after stepping on a piece of broken glass. Physical examination shows a 3-cm, ragged laceration on the plantar aspect of the left foot. The physician uses hydrogen peroxide to clean the wound. Which of the following is the most likely mechanism of action of this disinfectant?
AFormation of free radicals
BIntercalation of DNA
CCrosslinking of proteins
DHalogenation of nucleic acids
ECongealing of cytoplasm
During examination of a stab wound, a forensic pathologist notes that one end is sharp and pointed while the other is square or blunt. The wound track shows a consistent width. Which of the following weapon characteristics is most likely?
AIce pick
BDouble-edged knife
CScissors
DSingle-edged knife
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