Burns and its management

MCQS in Burns and its management


 

Q1. Which of the following is not an indication for admission in a case of burns

a) Full thickness burns more than 5% of total body surface area (TBSA)
b) Partial thickness burns more than 10% in adults
c) Partial thickness burns more than 10% in children

d) Inhalationsl burns

 1.b

Indications of admission for a burn patient are generally
- Partial thickness burn more than 10% in age less than 10 and more than 50 years
- Partial thickness burn more than 20% in adults
- Partial thickness burn of face, hand, feet, perineum
- Full thickness burn more than 5% TBSA
- Chemical burns, Inhalational burns, Electric burns
- Burns with other medical illness
- Burns with other trauma, like bony fractures

Note- scalds are the most common burns in civilian practise


Q2. Which is the site for escharotomies in extremities for deep burns?
a) Anterior aspect
b) Posterior Aspect of the limb
c) Medial or lateral aspect of limb

d) It can be anywhere

 2 c

The escharotomy should be away from the main arterial and venous blood supply. Mid medial or mid lateral aspect of extremity is chosen for escharotomy.
the incision is taken  deep to the eschar through to the dermis  into the subcutaneous fat.
Notes
1st degree burns-- Involve the epidermis, Do not blister, erythematous
2nd degree superficial partial thickness involves upper dermis. It is very sensitive and forms blister
2nd degree deep partial thickness burn involves Reticular dermis
3rd degree burn all layers of dermis with contractures

4th degree burn involves the subcutaneous tissue as well.


Q3. Which of the following is not true about carbon monoxide poisoning?
a)  It shift the oxygen hemoglobin dissociation curve to left
b) Kills cytochrome
c) It increases displacemnet of oxygen from hemoglobin

d) Direct action occurs on central nervous system

 3. c

Poisoning with carbon monoxide poisoning leads to formation of carboxyhemoglobin which has 200 times more affinity for hemoglobin.

Carboxyhemoglobin prevents reversible displacement of oxygen. It shifts the oxygen hemoglobin dissociation curve to the left , kills the cytochrome, direct action on CNS and direct toxicity to cardiac and skeletal muscles.


Q4. Which is not  true regarding infectious complications in a burn patient?
a) The incidence of serious infections increase in proportion to the total body surface area (BSA)
b) Flame, Chemical, Inhalational burn injury and full thickness burns are more prone for infection
c) Catheter related sepsis is more common than local wound sepsis
d) Burn wound septicemia has 80% mortality in children


Q5 . Most common cause of fire in operation theatre
a) Electro Surgical units
b) LASER
c) Anesthesia Chemicals

d) Fiber optic  instruments


Q6)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


Q7) The most efficacious anticatabolic treatment option in burns is
1. GH
2. IGF 1
3. Oxandrolone
4.Propranolol


Q) 8. Which of the following acid burns cause cardiac arrythmias
1. Formic acid
2. Hydrofluoric acid
3. Acetic acid
4. Sulphuric acid


Q9)  In high-voltage electrical burns to an extremity which is true

a. More chances of large skin burns 

b.IV fluid calculations same as thermal burns ie Parklands and Brookes

c. Antibiotic prophylaxis is not required

d. Evaluation for fracture of the other extremities and visceral injury is indicated