SB82 Burns - loosely taken from Fiser's ABSITE review
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| Sensory difference between superficial and deep second degree burns | Superficial is painful, deep has decreased sensation
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| Admission criteria for burned patients | 2nd/3rd degree > 10% in ages <10 and > 50; 2nd/3rd degree >20% otherwise; 2nd/3rd degree burns to hands / feet / face / genitalia / perineum / major joints; 3rd degree burns > 5%; electrical; chemical; inhalational injury; suspected child abuse/neglect
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| Most common type of burn ___________ | Scald
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| Use of colloid within the 1st 24 hours after burn can cause complications in this organ system __________ | Pulmonary
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| How quickly after burn should an escharotomy be performed, if indicated? | Within 4-6 hours
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| Child abuse accounts for what percentage of burns in children? ____________ | Fifteen
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| Lung injury from burn is NOT caused by heat but by ________________ | Carbonaceous materials and smoke
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| Risk factors for airway injury with burn include ___________ | Alcohol use, enclosed space, trauma, rapid combustion, extremes of age, delayed extrication
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| Signs / symptoms of possible airway injury | Facial burns, wheezing, carbonaceous sputum
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| The most common infection in burn patients ____________ | Pneumonia
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| Most common cause of death after inhalational injury ______________ | Pneumonia
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| Which produce deeper burns, acid or alkali solutions, and how? | Alkali, through liquefaction necrosis
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| What effect do acid burns produce? ___________ | Coagulation necrosis
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| Treatment for hydrofluoric acid burns ______________ | Topical calcium
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| A patient with an electrical burn has decreased UOP, increased creatinine, and normal CVP. What is the likely cause of his renal failure? _________ | Rhabdomyolysis
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| What is the cause of cardiopulmonary arrest after a lightning strike? | Electrical paralysis of the brainstem
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| Equation for the daily CALORIC need of burn patients | 25 kcal/kg/day + (30 kcal x %burn)
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| Equation for the daily PROTEIN need for burn patients | 1g protein / kg / day + (3g x %burn)
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| What is the best source of non-protein calories in burn patients? __________ | Glucose
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| How quickly should burn wounds be excised? | Within 72 hours
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| What electrolyte abnormality may occur during burn surgery, and what medication used by anesthesia may potentiate it? | Hyperkalemia, potentiated by succinylcholine
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| Skin grafts to a burn wound are contraindicated if a culture swab of the wound is positive for what? | Beta-hemolytic strep or bacteria > 10^5
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| Allografts undergo what process prior to rejection? _________ | Vascularization
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| How long can allografts last? | 2-4 weeks
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| How long can xenografts last? | 2 weeks
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| What are the goals during each burn surgery for blood loss, percentage of skin excised, and number of hours in the OR? | < 1 L blood loss, < 20% skin excised, and < 2 hours in the OR
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| Most common reason for skin graft loss ____________ | Seroma or hematoma
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| Treatment for facial burns | Topical antibiotics for 2 weeks, followed bu full-thickness skin grafts for non-healed areas (unmeshed)
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| Treatment for superficial hand burns | ROM exercises, with splinting in a functional position if there is too much edema
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| Treatment for deep hand burns | Immobilization for 7 days, full-thickness skin grafts, physical therapy
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| Treatment for palmar burns | Splint in extension for 1 week; week 2 place full-thickness non-meshed autograft
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| Treatment for genital burns | Antibiotics for 2 weeks, meshed grafts
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| Most common organism in burn infections __________ | Pseudomonas
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| Burn infections are more common with burn wounds greater than __________ % | Thirty
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| Immune problems found in burn patients | Impaired granulocyte chemotaxis and impaired cell-mediated immunity
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| Side effects of silvadene in burn wounds | Neutropenia and thrombocytopenia
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| Silvadene is contraindicated in patients with G6PD deficiency due to risk of ____________ | Methemoglobinemia
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| Silvadene is effective for treatment of this organism ____________ | Candida
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| Silvadene is INEFFECTIVE for treatment of this organism _____________ | Pseudomonal (and other Gram-negative rods)
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| Side effects of silver nitrate use __________ | Electrolyte imbalances
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| Silver nitrate is INEFFECTIVE against what organisms? ____________ | Pseudomonas (and other Gram-negative rods)
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| Sulfamylon may cause metabolic acidosis through what mechanism? _________ | Inhibition of carbonic anhydrase
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| Which topical burn wound medication has good eschar penetration? _____________ | Sulfamylon
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| Which topical burn wound medication is good for burned areas overlying cartilage? _______________ | Sulfamylon
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| Burn wound sepsis is usually due to this organism _____________ | Pseudomonas
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| Another name for sulfamylon _____________ | Mafenide sodium
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| Most common VIRAL infection in burn wounds ____________ | HSV
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| Gastric ulcer that occurs with burns __________ | Curling’s ulcer
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| Highly-malignant squamous cell carcinoma that arises in chronic, non-healing burn wounds or unstable scars ______________ | Marjolin’s ulcer
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| Hypertrophic scars usually occur in what time frame after a burn? | 3-4 months
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| What is the cause of hypertrophic scars? _____________ | Neovascularity
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| Hypertrophic scars are more likely to occur under what conditions? | Deep thermal injuries that take >3weeks to heal, contraction and epithelial spread or across flexor surfaces
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| How long should you wait before operating on hypertrophic scars? _________ | 1-2 years
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| Treatment for TEN | Prevent wound dessication with topical antimicrobials and xenografts
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| What medication should you avoid in patients with TEN or Stevens-Johnson syndrome? ___________ | Steroids
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