Dermatology & Burns Flashcards
What are the skin lesions
Macule, patch, papule, plaque
What is a macule
Flat circumscribed area that is a change in colour of the skin: less than 1 cm diameter
What is a patch
A flat, non-palpable irregular shaped macule more than 1 cm diameter
What is a papule
An elevated, firm, circumscribed area less than 1 cm
What is plaque
Elevated, firm, and rough lesion with flat top surface area greater than 1 cm
What kinds of tumours are there
Benign and malignant
What kind of skin tumours are benign
Seborrheic keratosis, actinic kertosis and Nevi
What kind of skin tumours are malignant
Basal cell carcinoma, squamous cell carcinoma, malignant melanoma
What is considered a burn
An alteration in skin integrity resulting in tissue loss or injury caused by thermal, chemical, electrical or radiation
What are the causes of burns
Thermal, chemical, electrical and radioactive
What are the ways to get a thermal burn
Dry heat, moist heat, cold
What are the ways to get a chemical burn
Acidic or alkaline agents
What are the ways to get a Electrical burn
dependant on voltage, duration and current
What are the ways to get a radioactive burn
sunburn, cancer treatment
What are the types of burns
1st degree, 2nd degree (partial thickness) 2nd degree (full thickness) and 3rd degree
Characteristics of a first degree burn
Only involves the epidermis, skin still maintains water vapor and bacterial barrier functions, no treatment, heals in 3-5 days without scarring
Characteristics of 2nd degree superficial burns
Fluid filled blisters appear immediately, nerve endings exposed if blisters break, heal in 3-4 weeks, usually no scar
Characteristics of 2nd degree deep partial-thickness burns
involves entire dermis (hair follicles are preserved), take weeks to heal, lots of scarring, potential for infection
Characteristics of 3rd degree burns
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
How to describe burns
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)
What happens to a person that has severe burns
A lot of inflammation due to release of histamine and prostaglandin
When is burns considered major
When they exceed 20% TBSA
What is burn shock
Both a hypovolemic cardiovascular component and a cellular component
What is fluid resuscitation
Administration of IV (lactated ringers) to restore circulating blood in the time of increased capillary permeability
What happens to the heart when you have burns
Hypotension, massive edema, cardiac contractility decreases, inadequate perfusion
What is the most reliable indicator of success with a patient that has severe burns
Urine output
What is the formula for fluid replacement
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
What happens to cells when there is a severe burn
altered cell membrane permeability, loss of normal electrolyte homeostasis, increased cortisol, excess Na and K
What happens immunologically for people with severe burns
immunosupression with increased susceptibility to potentially fatal systemic burn wound sepsis
What does water loss cause
Ability for the skin to serve as a barrier to evaporative water loss , replacement is mandatory to prevent volume deficit
What are the 3 elements of survival in burns
Meticulous wound management, adequate fluids and nutrition, earlier surgical excision and grafting
Diagnosis and treatment for burns
Rule of 9s, BUN, creatinine clearance, urine output, CBC, electrolytes, Narcotics, remove rings and jewelry ASAP, O2 admin and hydration
