EBM Flashcards
How many burns are treated in the US each year?
450,000 burns treated each year
Who is at higher risk for burns?
low income families
rural parts of the country
children & elderly
What is the appearance of burns?
1st degree: red w/o blistering, dry, painful (sunburn)
2nd degree: red w/ blisters, moist, painful, yellow or white
3rd degree: stiff & white/brown/black, charred, eschar, leathery, painless
What is eschar?
dead tissue cast off after the burn
What are the most dangerous things in burns?
shock
sepsis
respiratory insufficiency
What happens to the cardiovascular system w/ burns?
capillary permeability increases, loss of proteins, fluids
systemic hypotension
end organ hypo perfusion
**crush them with fluids
How do you diagnosis an infection secondary to a burn?
fever symptoms pain, swelling, change in appearance of burn wounds Look @ extent of burn: rule of nines Severity: depends on % of total body surface area is burned High risk: >20% burned high WBC count High fasting blood glucose Pathogens in blood urine culture
What are symptoms of patients w/ sepsis or infection following a burn?
high temp
etc
etc look up
How do you treat burn patients?
ABCs
Fluid resuscitation: use Parkland formula
Feeding tube (high carb)
Skin Grafting (get rid of burns unlikely to heal)
Get them to a burn unit
Treat psychosocial issues
What is the role of inflammation in thermal injuries?
systemic capillary permeability
protein leakage into interstitial space
edema
hypovolemic shock
damaged tissue–>inflammation (helps heal, but can hurt)
SIRS can result if inflammation lasts too long–>sepsis. Bad.
T/F May times prostate cancer is clinically inconsequential.
True. Although sometimes it can spread.
When are most cases of prostate cancer diagnosed?
after the age of 65
How does inflammation relate to prostate cancer?
occurs in every step of prostatic malignancy
mutated cell avoids apoptotic signals & keeps dividing & releasing inflammatory mediators.
oncogenic cells escape & can cause more inflammation @ other sites.
How do you diagnose prostate cancer?
nocturia dysuria hematuria increased urinary frequency bone pain high PSA rectal exam family hx ethnicity Best thing: prostate needle biopsy
How is prostate cancer treated?
surgery radiotherapy ???? Alternative: external beam radiotherapy endocrine therapy (try to suppress testosterone, remove testicles)
What do inflammatory responses lead to?
removal of damaged tissue
tumorneogenesis
mutation of DNA thru ROS
???
What is influenza?
viral respiratory infection caused by a number of H & N antigen variants
How many people die from influenza & flu & pneumonia?
50K per year
Who is at high risk for flu-related complications?
over age 50
pregnant
chronic medical condition
less than 6 months old
Why are we susceptible to new flu strains?
antigenic drift
**influenza frequently mutates & surface proteins change & this makes it difficult for our immune system to adapt
What are the severe symptoms associated w/ influenza?
tachycardia myalgias high fever exacerbation of underlying medical conditions: COPD, asthma, Diabetes nausea vomiting diarrhea
How do you diagnose influenza?
**can’t be diagnosed by symptoms alone. Could be common cold.
Rapid Diagnostic Tests: around 20 minute test
Longer tests: viral culture, PCR, immunofluorescent & serologic tests
Chest X ray in elderly
What is the pathogenesis of influenza?
Innate response: activated alveolar macrophages: TNF alpha & NO
Adaptive Immune Response: dendritic cells activate cytotoxic T cells & T helper cells
inflammatory cytokines are released
What is the treatment for influenza?
vaccine to prevent
fluids & rest
antiviral medications: neuraminidase inhibitor (tamiflu), M2 protein inhibitors
T/F Influenza is a viral respiratory infection that can lead to pneumonia.
TRUE
