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Stage 1 pressure ulcer: This stage presents as non-blanchable erythema (redness) of intact skin, usually over a bony prominence. The skin is still intact, and there is no open wound. While the area may be painful, firm, soft, warmer, or cooler than surrounding tissue, the epidermis is not broken. This is why option A is incorrect for a stage 2 ulcer.

Stage 4 pressure ulcer: At this stage, full-thickness skin loss occurs, extending into muscle, bone, or supporting structures. This severe damage often exposes tendons or bone and carries a high risk of infection. Option B is incorrect because stage 2 ulcers do not involve muscle or bone.

Stage 3 pressure ulcer: This stage involves full-thickness skin loss extending into the subcutaneous tissue, possibly down to the underlying fascia. The adipose layer may be visible, but muscle, tendon, and bone are not exposed. Stage 3 is deeper than stage 2, making option C incorrect.

A fissure is a narrow, linear crack in the skin, usually occurring in areas where the skin is dry, tight, or under mechanical stress. Examples include cracks at the corners of the mouth (angular cheilitis) or on the soles of the feet or heels. Unlike an ulcer, a fissure does not create a broad cavity and generally does not involve extensive tissue loss.

A pustule is a small, raised lesion filled with pus, often less than 1 cm in diameter. Pustules are commonly seen in acne, folliculitis, or bacterial infections. Pustules are superficial; the skin remains mostly intact, unlike an ulcer where tissue is destroyed.

A macule is a flat, circumscribed area of discoloration, less than 1 cm in diameter. Examples include freckles, flat moles, or some rashes. A macule does not involve any loss of skin tissue, bleeding, or exudate, so it is distinctly different from an ulcer.

This situation is associated with a type I hypersensitivity reaction (immediate, IgE-mediated), which can cause anaphylaxis in susceptible individuals. It is not cytotoxic because it involves allergic reaction mechanisms rather than direct destruction of cells.

Systemic lupus erythematosus (SLE) is primarily associated with type III hypersensitivity reactions, where immune complexes deposit in tissues, causing inflammation and tissue damage. It is not primarily cytotoxic (type II).

A tuberculin skin test elicits a type IV hypersensitivity reaction (delayed-type, cell-mediated). This reaction involves T lymphocytes responding to antigens, causing localized skin induration, rather than antibody-mediated cytotoxicity.

The convalescence stage is the recovery phase of infection. During this stage, the host’s immune system has controlled the pathogen, symptoms decline, and the body begins to repair damaged tissues. Pathogen multiplication has largely ceased, making this stage incorrect.

The prodromal stage is when early, nonspecific symptoms begin to appear, such as malaise, fatigue, or mild fever. The pathogen continues to multiply, but the focus of this stage is the emergence of initial symptoms, not the start of replication.

The acute stage is characterized by full-blown, specific symptoms of the infection. Pathogen levels are typically at their peak, and the immune response is fully activated. This stage follows the incubation and prodromal periods.

This statement is incorrect. While surgical manipulation of tumors must be done carefully, metastasis is not caused simply by handling in surgery. Tumor cells can naturally spread through the body via established pathways, independent of surgical procedures.

This describes seeding, a type of local spread where malignant cells migrate across serous membranes such as the peritoneum or pleura. This is not metastasis, which specifically refers to distant spread.

This describes local invasion, the process by which a tumor grows into neighboring tissues. While it contributes to cancer progression, it is not considered metastasis, which involves distant dissemination.

Quarternary intention is not a recognized classification in wound healing. This option is incorrect.

Tertiary intention, also called delayed primary closure, occurs when a wound is initially left open to allow for drainage or infection control and is later closed surgically. This method is used for contaminated or infected wounds, not clean wounds that can be approximated immediately.

Secondary intention occurs when wounds cannot be approximated, often due to significant tissue loss, infection, or pressure ulcers. Healing occurs from the base upward, filling in with granulation tissue over time. This process is slower, results in larger scars, and carries a higher risk of infection compared to primary intention.

Individuals with Down syndrome typically have short, broad hands rather than large or narrow ones. A distinctive feature is the single transverse palmar crease (Simian crease), which is present in many but not all cases. Fingers are often short and stubby, and the fifth finger may show clinodactyly (curvature). Thus, large narrow hands are not characteristic of Down syndrome.

Yellowed sclera indicates jaundice, which is caused by elevated bilirubin levels due to liver dysfunction or hemolysis. This is not a feature of Down syndrome and is unrelated to the genetic condition.

Down syndrome is generally associated with delayed sexual development and puberty, particularly in females. Fertility can be reduced, especially in males, although some may be capable of reproduction. Early sexual maturation is not characteristic of this condition.

While some immunodeficiency disorders may indirectly affect blood cells, anemia is not the primary or most common complication. Anemia is usually related to nutritional deficiencies, chronic disease, or bone marrow disorders rather than immunodeficiency itself.

Hypersensitivity reactions (types I–IV) occur due to overactive immune responses, not immunodeficiency. While some immune disorders may involve both deficiency and dysregulation, hypersensitivity is not the primary risk for classic immunodeficiency.

Autoantibody production occurs in autoimmune disorders, where the immune system attacks self-antigens. Immunodeficiency is characterized by underactive or defective immunity, so autoantibody production is not the main complication.

Hormones generally regulate growth, metabolism, and cellular function, but they do not directly trigger apoptosis under normal physiological conditions. Some hormonal changes can indirectly influence apoptosis, but they are not a primary trigger.

Progression through the cell cycle is part of normal cell division. While errors in the cell cycle can lead to apoptosis, progression itself is not a trigger; rather, checkpoints detect abnormalities and may initiate apoptosis if needed.

Differentiation is the process by which cells specialize to perform specific functions. While differentiation may lead to eventual cell turnover, the act of differentiation itself does not trigger apoptosis. Apoptosis occurs later if the differentiated cell becomes damaged or reaches the end of its lifespan.