Burns
Hypovolaemia: haemorrhage, dehydration (vomiting, diarrhoea), burns, and diuretic overuse.
What our notes say
- Hypovolaemia: haemorrhage, dehydration (vomiting, diarrhoea), burns, and diuretic overuse. (Junior Clerkship in Internal Medicine (MBIM4100) main exam, Paper One: 31 Januar)
- Dehydration from diarrhoea and vomiting, burns and haemorrhage. (Paediatrics end of fourth year main exam: 1 July 2019, Paper One, 99 of 100 MCQs)
- Cell breakdown (rhabdomyolysis, haemolysis, tumour lysis, burns) releases intracellular potassium, and potassium-rich feeds, blood transfusion and drugs (ACE inhibitors, spironolactone) add to it. (Paediatrics end of fourth year main exam: 1 July 2019, Paper One, 99 of 100 MCQs)
- Topics: acute abdomen, trauma (ATLS principles), hernias, burns, thyroid, breast lumps, bowel obstruction, perioperative care and surgical infection. (Surgery Question Bank: 12 Clinical MCQs)
- A man has burns covering the whole of his anterior trunk and one entire arm (adult). (Surgery Question Bank: 12 Clinical MCQs)
- • An injury, infection, burns or a severe allergic reaction (anaphylaxis) that causes the throat to become swollen and narrowed (Examination of Respiratory system — Past Paper Questions & Answers)
Study material on Burns
- Surgery Question Bank: 12 Clinical MCQs
- Obesity Types, Causes and Treatments
- General pathology — Past Paper Questions & Answers
Practice questions on Burns
A patient with severe burns shows elevated serum levels of cardiac troponin despite no chest pain. This finding indicates:
- Subclinical myocardial infarction
- Loss of plasma membrane integrity in cardiac myocytes
- Increased synthesis of troponin due to stress
- False positive due to hemolysis
Answer: B. Troponins are intracellular proteins released into circulation when plasma membrane integrity is lost during necrosis. Their detection indicates membrane damage and cell death, not increased synthesis. While burns can cause cardiac stress, elevated troponin specifically reflects membrane rupture and protein leakage—a hallmark of necrosis. ---
A 39-year-old man incurs a burn injury to his hands and arms while working on a propane furnace. Over the next 3 weeks, the burned skin heals without the need for skin grafting. Which of the following is the most critical factor in determining whether the skin in the region of the burn will regenerate?
- Good cardiac output with tissue perfusion
- Persistence of skin appendages
- Maintenance of underlying connective tissue
- Diminished edema and erythema
- Granulation tissue formation
Answer: B. The skin appendages have epithelium from which the surface epidermis can regenerate. A partial thickness burn retains epithelial elements in the skin. This is why a full thickness burn is much worse and requires grafting. ---
A burn patient develops edema at the injury site. Examination of the fluid shows high protein content and cellular debris. What term best describes this fluid?
- Transudate
- Exudate
- Effusion
- Pus
- Serous fluid
Answer: B. An exudate is extravascular fluid with HIGH protein content and cellular debris, indicating increased vascular permeability from inflammation. Transudates have LOW protein (mostly albumin), little/no cells, and result from osmotic or hydrostatic imbalance WITHOUT increased permeability (seen in heart failure, liver disease). Effusions are fluid accumulations in body cavities and can be either exudates or transudates.
A burn patient develops green-blue pus with a fruity odor. The organism is
- Klebsiella pneumoniae
- Staphylococcus aureus
- Pseudomonas
- Escherichia coli
- Occurs only after chronic exposure
Answer: C. Pseudomonas produces pyocyanin (blue-green pigment) and pyoverdine giving green-blue pus with a characteristic grape-like or fruity odor. This organism is a common opportunistic pathogen in burn wounds. ---
A burn patient develops green-blue pus with a fruity odor. The organism is
- Klebsiella pneumoniae
- Staphylococcus aureus
- Pseudomonas
- Escherichia coli
- Occurs only after chronic exposure
Answer: C. Pseudomonas produces pyocyanin (blue-green pigment) and has a characteristic grape-like or fruity odor. ---
A burn patient develops green-blue pus with a fruity odor. The organism is
- Pseudomonas aeruginosa
- Staphylococcus aureus
- Streptococcus pyogenes
- Klebsiella pneumoniae
Answer: A. Pseudomonas aeruginosa is an opportunistic pathogen that commonly infects burns and wounds. It is known for producing characteristic pigments (pyocyanin, giving a blue-green color) and a distinctive fruity odor (grape-like) in infected tissues and pus.