Multiple Choice Questions (MCQ)

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Category: Critical Care Medicine-Surgery, Trauma, and Transplantation--->Burns
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Question 1# Print Question

An 18-year-old female suffers a 4% superficial partial-thickness burn to her right arm. At an outpatient burn clinic, she is treated with silver sulfadiazine and sent home. She presents to the emergency department 2 days later with increasing tenderness and erythema at the burn site. On examination, the wound appears dark brown and blood is present underneath the eschar. Viable tissue surrounding the eschar is biopsied, revealing >105 viable microorganisms per gram.

What is the most appropriate treatment for this patient?

A. IV antibiotics only
B. IV antibiotics and silver sulfadiazine
C. Surgical excision of infected tissues
D. Application of sodium hypochlorite 0.025%

Question 2# Print Question

A 9-year-old male sustains 45% mixed superficial and deep partialthickness burns after falling into a campfire. During a prolonged ICU stay, he is persistently hyperglycemic, requiring regular insulin administration.

Which of the following correctly identifies two physiologic changes that are associated with the use of insulin within the burn population?

A. Improves muscle protein synthesis and exerts proinflammatory effects
B. Attenuates lean body mass and exerts anti-inflammatory effects
C. Reduced infection rates and exerts proinflammatory effects
D. Increases donor-site healing time and exerts anti-inflammatory effects

Question 3# Print Question

A 53-year-old female presents after being found unconscious in her house during a fire. Upon physical examination, you note that the patient has singed nasal hairs, carbonaceous sputum, and burns to her chin/forehead and is stridorous. You place her on 100% oxygen via a nonrebreather; however, her SpO2 remains in the low 80s, and she is tachypneic to 35. You are concerned for an inhalation injury.

What is the MOST sensitive test for diagnosing an inhalation injury?

A. Physical examination and high clinical suspicion
B. Chest radiograph
C. Ventilation and perfusion scan
D. Bronchoscopy

Question 4# Print Question

An 8-year-old male presented to your burn unit after sustaining 25% TBSA (total body surface area) superficial and deep partial-thickness scald burns to his torso and legs after a pot of boiling water fell onto him. After you complete your primary survey of the patient and adequate fluid resuscitation has begun, you evaluate the wound and note that the genitalia has been spared. You decide on silver nitrate soaks for your dressing as it is painless and readily available at your institution.

What side effect must you be worried about with this dressing? 

A. Methemoglobinemia
B. Hyponatremia
C. Metabolic acidosis
D. Neutropenia

Question 5# Print Question

A 47-year-old, 70 kg male presents as a transfer to the burn unit after sustaining a roughly 10% superficial burn, 30% superficial partialand deep-thickness burn, and a 20% full-thickness burn after being in a warehouse fire. There is no concern for inhalation injury. With the help of EMS and records from the outside hospital, you estimate that the time of injury was at 2 hours prior to arrival at your institution. En route to the outside hospital the patient receives 500 mL of lactated Ringer’s solution. At the outside facility and en route to your burn unit the patient receives an additional 1 L of lactated Ringer’s solution.

What would the additional 24-hour resuscitation requirements entail using the Parkland formula?

A. 688 mL/h for an additional 6 hours, then 263 mL/h for remaining 16 hours
B. 875 mL/h for an additional 8 hours, then 438 mL/h for remaining 16 hours
C. 917 mL/h for an additional 6 hours, then 438 mL/h for remaining 16 hours
D. 583 mL/h for an additional 8 hours, then 583 mL/h for remaining 16 hours

Category: Critical Care Medicine-Surgery, Trauma, and Transplantation--->Burns
Page: 1 of 2