LE4 Surgery >:( Flashcards
Among the different zones of cutaneous burn wounds which can be reversed by prompt and adequate treatment? *
A. Hyperemic zone
B. Stasis zone
C. Coagulation zone
D. A and B
E. All of the above
D. A and B
The stasis zone (zone of stasis) is the area surrounding the most severely burned skin (zone of coagulation) and can potentially be salvaged with prompt and adequate treatment.
Which among the following statement/s is/are true? *
A. Clothing does not retain the heat on the skin for a longer period in scald burn
B. thick soups and sauces causes deep burns because it remain in contact longer with the skin
C. exposed areas tend to be burned less deeply than areas covered with thin clothing
D. A and B
E. C and B
B. thick soups and sauces causes deep burns because it remain in contact longer with the skin
Most common cause of cutaneous burns: *
A. Scald burns
B. Flame burns
C. Flash burns
D. Contact burn
A. Scald burns
Scald burns from hot liquids are the most common cause of burn injuries, especially in children.
Which of the following can create the deepest form of scald burn *
A. Boiling water
B. Brewed coffee
C. Hot oil
D. Asphalt
E. None of the above
C. Hot oil
Hot oil can cause deeper burns than boiling water or brewed coffee due to its higher temperature and the ability to retain heat longer.
Which cause of cutaneous burn is clothing usually considered as protective? *
A. Scald burns
B. Flame burns
C. Flash burns
D. Contact burn
E. All of the above
E. All of the above
Clothing can provide a protective barrier to some extent against scald burns, flame burns, flash burns, and contact burns, though its effectiveness varies with the type of exposure and material of the clothing.
25 y/o male accidentally spilled a water with a temperature of 100 degrees centigrade. What is the most probable depth of burn? *
A. Superficial Dermal Burns
B. Deep Dermal Burns
C. Full thickness Burns
D. First degree burns
E. Fourth degree burns
C. Full thickness Burns
Asphalt injury can cause what type of burns? *
A. Scald burns
B. Flame burns
C. Flash burns
D. Contact burns
A. Scald burns
Severity of injury caused by burns is proportionate to the size of the following except: *
A. Total burn
B. Depth of the burn
C. Age of the patient
D. Etiology of the burn
E. None of the above
D. Etiology of the burn
The severity of a burn injury is generally determined by the total burn surface area, depth of the burn, and the patient’s age, not directly by the etiology of the burn.
Moderate burns are defined as the following
EXCEPT: *
A. Burns with associated medical diseases
B. Superficial burns 15 to 25% TBSA in adults
C. Full thickness burns of <10% TBSA in adults
D. Burns not involving the eyes, ears, face, hands, feet or perineum
A. Burns with associated medical diseases
Which of the following should be the preferred mode of transportation if the distance is 150 km to the nearest hospital with burn unit? *
A. ground ambulance
B. helicopter transport
C. aircraft
D. none of the above
B. helicopter transport
Helicopter transport is usually faster and more suitable for critically injured patients over such distances.
Small burns may be treated initially with? *
A. cool water
B. ice water
C. mentholated creams
D. toothpaste
E. tomatoes
A. cool water
Immediate cooling with cool water can help reduce the severity of the burn and alleviate pain.
Which of the following are signs of inhalational
injury? *
A. Coughing
B. Expiratory wheezes
C. Sneezing
D. Hoarseness
B. Expiratory wheezes
OR
AOTA
Coughing, expiratory wheezes, and hoarseness are signs of inhalational injury. (Note: “Sneezing” is not typically a primary sign of inhalational injury, but it was not listed as an option to choose from in the provided answers.)
A 40 y/o female was brought to the emergency room after sustaining a 40% TBSA deep dermal burn from a scald burn. What should be the first priority at the ER? *
A. Secure airway
B. Breathing
C. Circulation
D. Burn wound management
E. Referral to a burn unit
A. Secure airway
Airway management is the top priority in the initial treatment of severe burns to ensure the patient can breathe.
Which of the following are sure signs of inhalation injury? *
A. Expiratory wheezing
B. Carbonaceous sputum
C. Acrid smell of smoke on a victim’s throat
D. Burn in an enclosed area
E. All of the above
E. All of the above
Expiratory wheezing, carbonaceous sputum, and burns in an enclosed area are indicators of potential inhalation injury.
What is the minimum percent burn needed to cause local inflammatory cytokine activation in the circulation causing a systemic inflammatory response? *
A. 15%
B. 50%
C. 20%
D. 40%
E. none of the above
C. 20%
Burns affecting more than 20% TBSA can lead to a systemic inflammatory response, characterized by the release of cytokines and other mediators into the circulation. This threshold is recognized in the context of adult burn injuries, where burns exceeding 20% TBSA are associated with increased risk of systemic complications, including SIRS, sepsis, and multi-organ dysfunction syndrome (MODS).
Which of the following should be done to a 4 year old patient with complete immunization suffering from a 30% TBSA superficial burn? *
A. Admission to a burn unit
B. Cutdown of lower extremity for IV line
C. Tetanus prophylaxis
D. A & C
E. B &
D. A & C
Admission to a burn unit for specialized care and tetanus prophylaxis, even with complete immunization, are appropriate steps.
In a 35 year old male with a 25% TBSA deep dermal burn, fluid resuscitation would be monitored by: *
A. Urine output
B. Central venous pressure
C. Swan Ganz catherter monitoring
D. All of the above
D. All of the above
Fiberoptic bronchoscopy is needed to diagnose
smoke inhalation injury. *
A. True
B. False
A. True
Explanation: Fiberoptic bronchoscopy can be a crucial diagnostic tool for assessing airway injuries, identifying soot, and evaluating the extent of damage in smoke inhalation injuries.
Pain medications should be given orally in burn
patients. *
A. True
B. False
B. False
Explanation: In severe burn patients, especially in the acute phase, pain management often requires routes other than oral due to issues with absorption, the severity of pain, and the potential for gastrointestinal dysfunction. IV administration is commonly preferred for immediate and effective pain control.
Deep dermal burns does not cause wound scarring.
*
A. True
B. False
B. False
Explanation: Deep dermal burns often result in significant scarring. They can lead to hypertrophic scars and require interventions like skin grafting or reconstructive surgery.
Severity of injury caused by burns is proportionate to
the size of age of the patient. *
A. True
B. False
B. False
Explanation: The severity of burn injuries is influenced by the age of the patient (with very young and older patients generally being more vulnerable to severe outcomes), but the phrasing “size of age” seems incorrect. Age and the total body surface area (TBSA) burned are important factors in determining the severity of burn injuries.
Severity of injury caused by burns is proportionate to
associated medical problems or injuries. *
A. True
B. False
A. True
Explanation: The overall severity of burn injuries and the prognosis can be significantly affected by associated medical problems or injuries, which can complicate treatment and recovery.
The primary rule for the emergency physician is to ignore the burn. As with any form of trauma, the airway, breathing, and circulation protocol must be
strictly followed. *
A. True
B. False
A. True
Explanation: The statement is somewhat misleadingly phrased but essentially true. The initial approach in treating a burn patient, like any trauma patient, is to prioritize the ABCs (Airway, Breathing, Circulation) before addressing burn-specific treatments. “Ignore the burn” means to not let the presence of burns distract from these life-saving steps.
Because of the high incidence of septic thrombophlebitisin burn patients, lower extremities may be used as portals for peripheral intravenous lines *
A. True
B. False
B. False
Explanation: The statement is misleading. While septic thrombophlebitis is a concern, the choice of IV line placement is based on the accessibility and condition of veins rather than a specific avoidance of the lower extremities due to septic thrombophlebitis.