Burns

Question 1

Which of the following is not a type of burn? 
•	Thermal 
•	Toxin 
•	Electrical 
•	Radiation

Answer 1

B (chemical)

Question 2

Describe the rule of 9

Answer 2

• divides the body into regions that are multiples of 9% of total body surface area - head and neck (9), each forelimb itself (9), each hind limb (18), dorsal and ventral trunk halves each (18)

Question 3

Name the layers of a burn from deepest to most superficial
Zone…
hint: CaSH

Answer 3

• Zone of coagulation/necrosis/destruction - no viable tissue remains
• Zone of stasis - decreased perfusion = VULNERABLE
• Zone of hyperemia - inflammation - viable unless further damage done

Question 4

Edema after burns peaks at which time after the injury?
•	3h
•	6h
•	12h
•	18h

Answer 4

C 12

Question 5

Which is FALSE concerning burns?
• direct fluid losses from a full-thickness burn wound are 3 to 20 times greater than intact skin,
• partial-thickness burn can increase evaporation by 66% compared with intact skin.
• The combination of extravasation and evaporation creates profound hypovolemia within hours after a serious burn
• erythrocyte deformability is decreased

Answer 5

B (33%) evaporative increase

Question 6

what are 3 ways to transfer heat in a thermal burn?

Answer 6

conduction
convection
radiation

Question 7

True/false: Second degree burns extend through the dermis to the underlying SQ and are painful.

Answer 7

False
1st= partial (pain)
2nd = full epidermal
3rd = to underlying SQ

Question 8

3 mechanisms of carbon monoxide to exert toxic effects

Answer 8

1. preferentially bind Hg
2. COHb shift dissociation curve left reducing O2 delivery
3. CO + myoglobin reduces O2 availability

Question 9

What percent of plasma volume can be lost in 6 hrs after a 20% total body surface area burn?

Answer 9

28%

Question 10

T/F: a Hypermetabolic state or flow phase is seconadry, and loss of body mass comes from increased adipose metabolism for basal energy

Answer 10

False: Lean body mass loss from increased PROTEIN catabolism up to 30% energy needs

Question 11

What is burn diabetes?

Answer 11

upregulation of hepatic gluconeogenesis and relative insulin resistance; burn wound has increased rate of glucose uptake from anaerobic glycolysis. Exists in acute and chronic stages

Question 12

What post burn zone has edema?

Answer 12

zone of stasis

Question 13

What are causes of edema in a burn wound?

Answer 13

NO and substance P = vasodilatory

endotoxin, PGE2, histamine, activated complement –> increased capillary permeability

Question 14

Why do burn wound take longer to heal?
A. lower [cytokines]
B. <5% normal levels FGF-2
C. none of capillary endothelial chemotactic and proliferative activity seen in normal surgical wounds
D. All of the above

Answer 14

D