Burns

Question 1

Severity factors for chemical burns

Answer 1

• ph of the agent
• the concentration of the agent
• the volume
• the duration
• the physical form of the agent

Question 2

Jackson burn model areas ?

Answer 2

• zone of coagulation
• zone of stasis
• zone of hyperemia

Question 3

What’s the difference between “hypertrophic scar” and “keloids” ?

Answer 3

Hypertrophic scar do not extend beyond the boundary of the original wound

Question 4

Mention three complications can happen to burn patients

Answer 4

• compartment syndrome
• infection
• keloid formation

Question 5

What chemical burns with “Acids” produce ?

Answer 5

Coagulative necrosis

Question 6

How to administer the fluid?

Answer 6

Half of the volume during the t 8 hours (from the time of injury

Other half over the next 16 hours

Question 7

How to prevent “post burn contracture”

Answer 7

Skin graft

Question 8

Mention three lines of acute managment of the burn ?

Answer 8

• fluid resuscitation
• pain control
• dressing

Question 9

“Lichtenberg figures” on the skin caused by ?

Answer 9

Electrical injury

Lightening strike

Question 10

How to estimate the “TBSA” ?

Answer 10

Rule of nines

Question 11

What is the management for chemical burns ?

Answer 11

Dilution by water
2-4 hours in alkaline
30 minutes in acids

Question 12

When you’re most likely to develop a keloid scat ?

Answer 12

• black , latino , asian
• younger than 30
• pregnant
• teenager going through puberty
• family history of keloids

Question 13

When “fluorescein eye examination” is mandatory ?

Answer 13

For patient with facial burns

Question 14

What chemical burns with “alkali” produce ?

Answer 14

Liquefactive necrosis

Question 15

What is the most common manifestation of “inhalation injury” ?

Answer 15

Upper airway swelling

Question 16

What’s the areas more likely to get “keloid scar” in the body ?

Answer 16

• chest
• shoulders
• earlobes
• cheeks

Question 17

Whats cause more damage and more penetration in chemical burns ?

Answer 17

Alkaline

Question 18

What’s the post burn contracture

Answer 18

the tightening of the skin after a second or third degree burn

Question 19

What more important in thermal burn

Duration or degree of temperature?

Answer 19

Duration of exposure

Question 20

Indication for extubation after “inhalation injury” ?

Answer 20

• spontaneous breathing for at least 15-30 minutes

- adequate resolution of laryngeal edema

Question 21

What’s the management for “compartment syndrome” ?

Answer 21

Fasciotomy

Question 22

Burn injury severity according to ?

Answer 22

• TBSA
• depth of burn
• patient comorbidities and age
• coexisting traumatic injury

Question 23

What cause more damage in electrical burn, low frequency AC or high frequency AC

Answer 23

Low frequency AC

Question 24

Physical examination characteristics include what ?

Answer 24

• signed nasal hair
• facial burns
• carbonaceous sputum
• hoarseness

Question 25

What the name for the formula we use in burn “fluid resuscitation” ?

Answer 25

The parkland formula | 24 hours requirement = 4 cc x TBSA% x weight in kg

Question 26

What cause the urine color black after electric shock ?

Answer 26

Myoglobin

Question 27

What’s the percentage for getting “keloid scar” in darker skin ?

Answer 27

15-20% more likely

Question 28

What cause pain in electrical burn with high voltage patient ?

Answer 28

Ischemia (compartment syndrome)

Question 29

Criteria for transfer to burn center ? (8 points)

Answer 29

Partial or full thickness burns > 10% TBSA

Question 30

What are the three categories for “inhalation injury” ?

Answer 30

- injury above the glottis (inhalation super heated air) - injury below the glottis (due to smoke particles) - CO poisoning

Question 31

Indications for intubation after “inhalation injury” ?

Answer 31

- swelling - erythema - soot present on examination

Question 32

Classification of thermal burn

Answer 32

- direct flame - scald burn - contact burn - friction burn

Question 33

What’s the mode of inheritance in “Neurofibromatosis” ?

Answer 33

Autosomal dominant

Question 34

What cause more injury in electrical burn ?

Answer 34

AC cause more injury | than AD

Question 35

Definitive diagnosis for “inhalation injury” is made by ?

Answer 35

Direct airway examination using nasopharyngealscope

Question 36

Which fluid we should use with resuscitation?

Answer 36

(LR) Lactate Ringers solution

Question 37

If the patient was with 30% burn only 20% of it was 2nd degree , how to estimate fluid requirements in the first 24 hours?

Answer 37

4 cc x 20% x weight Because there is no fluid loss in the 10% first degree

Question 38

Mention 3 clinical settings cause “compartment syndrome”

Answer 38

- severe burns - arterial injury - trauma

Question 39

Cafe au late spots , associated with which disease ?

Answer 39

Neurofibromatosis

Question 40

How to best judge the adequacy of resuscitation?

Answer 40

Hourly urine output | 0.5 ml/kg/h in adults) (1 ml/kg/h in children