Multiple Choice Questions (MCQ)

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Category: Surgery--->Burns
Page: 3

Question 11# Print Question

Which of the following is true regarding nutritional needs ofburn patients? 

A. The hypermetabolic response to burn wounds typically raises the basic metabolic rate by 120%
B. Oxandrolone, an anabolic steroid, can improve lean body mass but can be associated with hyperglycemia and clinically significant rise in hepatic transaminitis
C. Early enteral feeding is safe when burns are less than 20% TBSA, otherwise enteral feeding should await return of bowel function to avoid feeding a patient with gastric ileus
D. For patients with greater than 40% TBSA, caloric needs are estimated to be 25 kcal/kg/day plus 40 kcal/% TBSA/ day

Question 12# Print Question

A 14-year-old girl sustains a steam burn measuring 6 by 7 inches over the ulnar aspect of her right forearm. Blisters develop over the entire area of the burn wound, and by the time the patient is seen 6 hours after the injury, some of the blisters have ruptured spontaneously. All of the following therapeutic regimens might be considered appropriate for this patient EXCEPT:

A. Application of silver sulfadiazine cream (Silvadene) and daily washes, but no dressing
B. Application of mafenide acetate cream (Sulfamylon), but no daily washes or dressing
C. Homograft application without sutures to secure it in place, but no daily washes or dressing
D. Heterograft (pigskin) application with sutures to secure it in place and daily washes, but no dressing

Question 13# Print Question

Which is FALSE concerning surgical treatment of burn wounds?

A. Tangential excision consists of tangential slices of burn tissue until bleeding tissue is encountered. Thus, excision can be associated with potentially significant blood loss
B. Human cadaveric allograft is a permanent alternative to split-thickness skin grafts when there are insufficient donor sites
C. Bleeding from tangential excision can be helped with injection of epinephrine tumescence solution, pneumatic tourniquets, epinephrine soaked compresses, and fibrinogen and thrombin spray sealant
D. Meshed split thickness skin grafts allow serosanguinous drainage to prevent graft loss and provide a greater area of wound coverage

Question 14# Print Question

 A 45-year-old woman is admitted to a hospital because of a third-degree burn injury to 40% of her TBSA, and her wounds are treated with topical silver sulfadiazine cream (Silvadene). Three days after admission, a burn wound biopsy semiquantitative culture shows 104 Pseudomonas organisms per gram of tissue. The patient's condition is stable at this time.

The most appropriate management for this patient would be to: 

A. Repeat the biopsy and culture in 24 hours
B. Start subeschar clysis with antibiotics
C. Administer systemic antibiotics
D. Surgically excise the burn wounds

Question 15# Print Question

Fourteen days after admission to the hospital for a 30% partial thickness burn and hemodynamic instability requiring central venous access, a patient develops a spiking temperature curve. On physical examination, the central venous catheter insertion site was red, tender, and warm.

The best treatment for this complication is to:

A. Exchange of central venous catheter over guidewire, culture tip of previous catheter
B. Treat patient with IV antibiotics until blood cultures drawn from catheter are negative
C. Removal of central venous catheter, culture tip, and placement of new catheter on contralateral site
D. Removal of catheter and treat patient with oral antibiotics and pain medication as needed

Category: Surgery--->Burns
Page: 3 of 3