Isotonic fluid

Q) Isotonic fluid  solution is
A. Half normal saline
B. 1/5
th normal saline
C. Ringer lactate
D. Dextrose in Normal saline

Answer is free

Ringer lactate and Normal saline are isotonic fluid. they are useful in replacing GI losses. Ringer lactate has a bit of potassium as well.

Body actually requires bicarbonate and not lactate. Lactate is the more stable form in IV solutions and is used, it is converted by liver into bicarbonates.

Half NS is used in replacing losses when sodium concentration is high in the body, mainly as maintenance fluid

1/5th NS is hardly used clinically

Dextrose in Saline or DNS is used for maintenance and is not isotonic

Natural Killer cells

Q) What are natural killer cells?

a) Multinuclear monocytes

b) Special macrophages

c) Antibody presenting cells

d) Large granular lymphocytes?

Answer is free

d

Large granular lymphocytes

Natural killer cells are a part of lymphocytes called "null cells"  These are large granular lymphocytes and the 1st line of defence against viruses and bacteria

They belong to null cells as they do not rely on specific match or memory.

They control both tumor and microbial spread in the body. 

Unlike T cells ( which mature in thymus), natural killer cells develop in bone marrow. They identify the viruses and other harmful cells by lack of major histocompatibility complexes (MHC)

Antigen presenting cells are B cells

T cells are direct cyto toxic cells

 

Ref: https://study.com/academy/lesson/natural-killer-cells-definition-functions-quiz.html

        Sabiston 20th page 601

Burns management

Q) A 45 year old male sustains 30% burns on both legs and anterior abdominal wall.  There was  mild inhalation  injury associated with it. He initially responded well to treatment with IV fluids, Inj Tramadol and enteral feeding.

Three days after the treatment he is having slight tachypnea (30/min) pulse 110/min and BP 98/60. His temp is 97degree F and some areas of partial thickness have converted into full thickness. He is currently on Inj Magnamycin. His platelets are 70ooo, TLC is 17000 and sugar is 200 mg%. What is the next step in management?

a) Continue same management

b) Upgrade the antibiotic and send a fresh culture from skin

c) Treat it as carbon monoxide poisoning

d) Manage in lines of Acute Tubular Necrosis

Answer for premium members

Burns management involves critical care, intensive phase and rehabilitation. Loss of skin and eschar formation predispose individuals to gram positive, gram negative and fungal infections.