Dermatology & Burns

Question 1

What are the skin lesions

Answer 1

Macule, patch, papule, plaque

Question 2

What is a macule

Answer 2

Flat circumscribed area that is a change in colour of the skin: less than 1 cm diameter

Question 3

What is a patch

Answer 3

A flat, non-palpable irregular shaped macule more than 1 cm diameter

Question 4

What is a papule

Answer 4

An elevated, firm, circumscribed area less than 1 cm

Question 5

What is plaque

Answer 5

Elevated, firm, and rough lesion with flat top surface area greater than 1 cm

Question 6

What kinds of tumours are there

Answer 6

Benign and malignant

Question 7

What kind of skin tumours are benign

Answer 7

Seborrheic keratosis, actinic kertosis and Nevi

Question 8

What kind of skin tumours are malignant

Answer 8

Basal cell carcinoma, squamous cell carcinoma, malignant melanoma

Question 9

What is considered a burn

Answer 9

An alteration in skin integrity resulting in tissue loss or injury caused by thermal, chemical, electrical or radiation

Question 10

What are the causes of burns

Answer 10

Thermal, chemical, electrical and radioactive

Question 11

What are the ways to get a thermal burn

Answer 11

Dry heat, moist heat, cold

Question 12

What are the ways to get a chemical burn

Answer 12

Acidic or alkaline agents

Question 13

What are the ways to get a Electrical burn

Answer 13

dependant on voltage, duration and current

Question 14

What are the ways to get a radioactive burn

Answer 14

sunburn, cancer treatment

Question 15

What are the types of burns

Answer 15

1st degree, 2nd degree (partial thickness) 2nd degree (full thickness) and 3rd degree

Question 16

Characteristics of a first degree burn

Answer 16

Only involves the epidermis, skin still maintains water vapor and bacterial barrier functions, no treatment, heals in 3-5 days without scarring

Question 17

Characteristics of 2nd degree superficial burns

Answer 17

Fluid filled blisters appear immediately, nerve endings exposed if blisters break, heal in 3-4 weeks, usually no scar

Question 18

Characteristics of 2nd degree deep partial-thickness burns

Answer 18

involves entire dermis (hair follicles are preserved), take weeks to heal, lots of scarring, potential for infection

Question 19

Characteristics of 3rd degree burns

Answer 19

Destruction of entire epidermis, dermis and underlying tissues, elasticity of dermis is destroyed, edema present, escharotomies to relieve pressure (painless due to destroyed nerve endings

Question 20

How to describe burns

Answer 20

The rule of 9s
*do not include first degree burns (9 for entire head, each leg, chest, abdomen, 4.5 for each arm, 1 for privates)

Question 21

What happens to a person that has severe burns

Answer 21

A lot of inflammation due to release of histamine and prostaglandin

Question 22

When is burns considered major

Answer 22

When they exceed 20% TBSA

Question 23

What is burn shock

Answer 23

Both a hypovolemic cardiovascular component and a cellular component

Question 24

What is fluid resuscitation

Answer 24

Administration of IV (lactated ringers) to restore circulating blood in the time of increased capillary permeability

Question 25

What happens to the heart when you have burns

Answer 25

Hypotension, massive edema, cardiac contractility decreases, inadequate perfusion

Question 26

What is the most reliable indicator of success with a patient that has severe burns

Answer 26

Urine output

Question 27

What is the formula for fluid replacement

Answer 27

Basal fluid replacement: 1500ml/day/m2 body surface area = 24 hour requirement Evaporated water loss: (25 + % of total body surface area burn) x (2 m2 body surface area) = ml/hr Basal fluid requirements per day/ 24 hours + evaporated water loss = ml/hr

Question 28

What happens to cells when there is a severe burn

Answer 28

altered cell membrane permeability, loss of normal electrolyte homeostasis, increased cortisol, excess Na and K

Question 29

What happens immunologically for people with severe burns

Answer 29

immunosupression with increased susceptibility to potentially fatal systemic burn wound sepsis

Question 30

What does water loss cause

Answer 30

Ability for the skin to serve as a barrier to evaporative water loss , replacement is mandatory to prevent volume deficit

Question 31

What are the 3 elements of survival in burns

Answer 31

Meticulous wound management, adequate fluids and nutrition, earlier surgical excision and grafting

Question 32

Diagnosis and treatment for burns

Answer 32

Rule of 9s, BUN, creatinine clearance, urine output, CBC, electrolytes, Narcotics, remove rings and jewelry ASAP, O2 admin and hydration