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Forget Nots > Burn/Wound/PRS > Flashcards

Burn/Wound/PRS Flashcards

1
Q

Most commonly used burn drug?

A

Silver sulfadiazine

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2
Q

Which burn drug causes transient leukopenia?

A

Silver sulfadiazine

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3
Q

Burn drug that’s an anhydrase inhibitor. Side effect?

A

Mafenide acetate

Side effect metabolic acidosis

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4
Q

Which burn drug cause hyponatremia?

A

Silver nitrate

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5
Q

Which burn drug causes methemoglobinemia?

A

Silver nitrate

treatment for methhemoglobinemia: methylene blue

treatment for cyanide toxicity: sodium nitrite, sodium thiosulfate

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6
Q

Which stage of frostbite has numbness and edema?

A

Superficial stage. Stage I

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7
Q

Which stage of frostbite has milky white blisters?

Hemorrhagic blisters?

What do you do about these blisters?

A

Stage 2. Partial thickness. Drain the milky white blusters

Hemorrhagic blisters: stage 3. You leave these alone

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8
Q

Car mechanic found down under a car, no evidence of trauma. Treatment?

A

Hyperbaric oxygen chamber. Carbon monoxide poisoning.

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9
Q

Hypothermia is body temp under what?

How is hypothermia classified?

A

35C, 95F

Mild hypo: 90-94F (32-34) - shiver, mental status, tachy
Moderate hypo: 84-89F (29-32) - agitated, combative, slowed respirations
Severe: 70-84 (<29) - prolonged qt, Osborn waves

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10
Q

CPR and active rewarming in hypothermic asystole pt should be continued until what?

A

Until T is 90F and K > 12 mmol/L

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11
Q

Meshed split thickness vs. full thickness skin graft

Which one has better cosmetic results?

What does meshing do?

Which one gets worse pigmentation?

Which one has higher rate of engraftment?

A

Full thickness has better cosmetic results

Meshing reduceds seroma/hematoma formation. doesn’t improve imbibition

Split thickness gets worse pigmentation

Split thickness higher rate of engraftment because they have less dermis and require lower metabolism

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12
Q

Which burn drug can cause methemoglobinemia?

A

Silver nitrate

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13
Q

What’s primary contraction vs. secondary contraction?

Split thickness graft has more or less primary/secondary contraction?

A

Primary contraction: how much it contracts after harvesting and before grafting
Secondary contraction: how much it contracts after grafting

Split thickness - less primary contraction, more secondary contraction

Full thickness - more primary contraction, less secondary contraction

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14
Q

Predominant cells in 24-48hr after surgery

A

Neutrophils

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15
Q

What timeframe do macrophages show up in the wound after surgery?

A

48-96hr after surgery

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16
Q

When do lymphocytes show up to wound after surgery?

A

3 day Mark

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17
Q

When do fibroblasts show up at the wound after surgery?

A

Within 24hrs then predominate @ ~10 days

18
Q

Wound healing. When is there maximum amount of collagen accumulation?

On what day do the fibroblasts dominate?

A

21 days

Fibroblasts dominate at 10 days. Collagen is maxed at 21 days

19
Q

Mafenide acetate is used for what degree burns? Why?

A

Full thickness

Excellent eschar penetration

20
Q

Which topical hurts when you apply?

A

Mafenide acetate

AKA

Sulfamylon

21
Q

What is the other name for silver sulfadiazine?

what is its side effect?

A

Silvadene

leukopenia

22
Q

Most commonly used burn drug for partial thickness burn?

A

Silver sulfadiazine/silvadene

23
Q

Singed hair has high or low sensitivity to predict inhalation injury?

Airway damage from inhalation damage is primarily from the heat?

A

Singed hair is not that sensitive

No the heat of inhalation injury mostly dissipates in the upper airway. Damage is mostly from INHALED TOXINS

24
Q

For burn pts, urinary output of how much is appropriate for adults and children?

A

Adults: 0.5 - 1 cc/kg
Children: 1 - 1.5 cc/kg

25
Q

What is primary and secondary contraction and which one is more pertinent to split thickness vs full thickness skin grafts?

A

Primary contraction: how much the graft contracts after harvesting

Secondary contraction: how much the graft contracts after grafting over time

Split thickness: less primary contraction, more secondary contraction

Full thickness: more primary contraction, less secondary contraction

26
Q

Which type of skin graft is better for flexor surface of the elbow?

A

Full thickness

27
Q

Burn drug that causes hyponatremia?

A

Silver nitrate

28
Q

Which burn drug causes transient neutropenia?

A

Silvadene. Or silver sulfadiazine

29
Q

Cell type in a healing wound:

  • first to show up
  • predominant type in the first 24-48hrs
  • predominant type in the first 48-96 hrs
  • predominate around 10d mark
  • when do fibroblasts and lymphocytes show up?
A
  • first to show up: platelet
  • predominant type in the first 24-48hrs: neutrophils
  • predominant type in the first 48-96 hrs: macrophages
  • predominate around 10d mark: fibroblasts
  • when do fibroblasts first show up? Within the first 24 hrs
  • arrive around 3 day mark: lymphocytes
30
Q

Which interleukin is secreted by macrophages?

A

IL-1

31
Q

Interleukin 2 is secreted by what cells?

A

T Lymphocytes

32
Q

Treatment for hydrofluoric acid burn includes copious washing and what?

A

Calcium gluconate cream. If systemic toxicity: IV calcium gluconate

Hydrofluoric acid binds calcium

33
Q

Collagen synthesis in wound begins in what day?

Collagen accumulates to the max on what day of wound healing?

when to fibroblasts come? when are the predominant?

When does type III collagen start converting to type I?

A

Begins within 10 hrs of injury

Accumulates to the max at 21 days

fibroblasts show up at 24 hrs. predominate at 10 days

Day 7

34
Q

What cell type secretes tumor necrosis factor?

A

Macrophages

35
Q

Interferons are released by what cells?

What do they do?

A

By lymphocytes.

They promote production of new cellular RNA and proteins. To activate immune reponse

36
Q

Burn drug for MRSA infection

A

Mupirocin

37
Q

Most common electrolyte abnormality in burn patients

A

Hyperkalemia because of tissue necrosis and loss of intracellular potassium

38
Q

Which burn drug is associated with methemoglobinemia?

A

Silver nitrate

39
Q

What stimulates the fibroblasts in a healing wound?

A

Macrophages

40
Q

What is the greatest risk factor to developing keloids or hypertrophic scars?

extends beyond scar boundary

does not extend beyond boundary

A

Genetics

extends beyond scar boundary: keloid

does not extend beyond boundary: hypertrophic scar (triamcinolone injection)

41
Q

What is marjolin’s ulcer?

Treatment?

More aggressive or less aggressive compared to UV skin cancers?

Radiation?

A

Cancer that develops from chronic non healing wound

Treatment: WLE with 5-20mm margin

More aggressive than basal or sq

Chemo/radiation usually not effective. Only radiation if pt refuses other treatment

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