Burns(Thermal injury): Degree of burns

Burns(Thermal injury): Degree of burns

Q. 1

During a fire accident a man got blisters on his hand. Which of the following classes of burns does have blister formation?

 A

Superficial first degree burn

 B

Superficial second degree burn

 C

Third degree burn

 D

Deep first degree burn

Q. 1

During a fire accident a man got blisters on his hand. Which of the following classes of burns does have blister formation?

 A

Superficial first degree burn

 B

Superficial second degree burn

 C

Third degree burn

 D

Deep first degree burn

Ans. B

Explanation:

Burns are classified by two different systems: partial thickness or full thickness burns, and first, second, or third degree burns.

First-degree burns show superficial erythema with no blistering.

Second-degree burns may be either superficial or deep.

Superficial second-degree burns show erythema with blister formation, and they may be painful for days.

Deep second-degree burns show more extensive loss of epidermis with blistering, and the skin may be dry, wet, anaesthetic, or painful and it may appear mottled.
Third degree burns show full-thickness destruction of the skin and all its appendages
.
These burns are anaesthetic, leathery, and discolored.
Ref: Color Atlas of Foot & Ankle Dermatology By Gary L. Dockery, Gary L. Dockery Mary Elizabeth Crawford, 1999, Page 280; Schwartz’s Principles of Surgery, 9th edition, Chapter 8. Burns.

 


Q. 2

Blister formation in burn case is in :

 A

Intraepidermal

 B

Subepidermal

 C

Subdermal

 D

Subfascial

Q. 2

Blister formation in burn case is in :

 A

Intraepidermal

 B

Subepidermal

 C

Subdermal

 D

Subfascial

Ans. B

Explanation:

B. i.e. Sub epidermal


Q. 3

True regarding burns:

 A

Only 2nd & 3rd degree is considered in the classification

 B

2nd deg.-epidermis + papillary dermis

 C

Blisters-2nd degree

 D

b and c

Q. 3

True regarding burns:

 A

Only 2nd & 3rd degree is considered in the classification

 B

2nd deg.-epidermis + papillary dermis

 C

Blisters-2nd degree

 D

b and c

Ans. D

Explanation:

Ans is b,c,

The dermis is structurally divided into two areas: a superficial area adjacent to the epidermis, called the papillary region, and a deep thicker area known as the reticular region.

Second-degree burn affects the epidermis and the dermis, is classified as superficial (involving the epidermis and the papillary dermis) or deep (extending into the reticular dermis).

Quiz In Between


Q. 4

Features of Deep Second degree burn are:

 A

Blanching on pressure

 B

Blisters

 C

Hypoesthesia

 D

All

Q. 4

Features of Deep Second degree burn are:

 A

Blanching on pressure

 B

Blisters

 C

Hypoesthesia

 D

All

Ans. C

Explanation:

Ans is C (Hypoesthesia) 

I did not not get any material on option ‘d’. According to a Prof. in Surgery this option is true. Deep Second degree burn involves both epidermis and dermis and thus would thrombose all the vessels in the base.


Q. 5

Pus in burns form in –

 A

2-3 Days

 B

3-5 days

 C

2-3 weeks

 D

4 weeks

Q. 5

Pus in burns form in –

 A

2-3 Days

 B

3-5 days

 C

2-3 weeks

 D

4 weeks

Ans. A

Explanation:

Ans. is `a’ i.e., 2-3 days 

Burn wound will almost inevitably be colonised by micro oraganism within 24-48 hrs.


Q. 6

In 3rd degree burns, all are seen except ‑

 A

Vesicles are absent

 B

Painful

 C

Leathery skin

 D

Reddish due to Hb infiltration

Q. 6

In 3rd degree burns, all are seen except ‑

 A

Vesicles are absent

 B

Painful

 C

Leathery skin

 D

Reddish due to Hb infiltration

Ans. B

Explanation:

Ans. is ‘b’ i.e., Painful 

Quiz In Between


Q. 7

True for superficial burns:

 A

Always require skin grafting

 B

Dry & inelastic

 C

Blister formation

 D

Painless

Q. 7

True for superficial burns:

 A

Always require skin grafting

 B

Dry & inelastic

 C

Blister formation

 D

Painless

Ans. C

Explanation:

Ans. C i.e. Blister formation


Q. 8

Which of the following is not seen in 3rd degree burns:  

 A

loss of skin appendages

 B

no vesicles

 C

red colour

 D

Extremely painful

Q. 8

Which of the following is not seen in 3rd degree burns:  

 A

loss of skin appendages

 B

no vesicles

 C

red colour

 D

Extremely painful

Ans. D

Explanation:

Ans. D: Extremely painful

Depth of burn injury (deeper burns are more severe)

  • Superficial burns (first-degree and superficial second-degree burns) First-degree burns
  • Damage above basal layer of epidermis
  • Dry, red, painful (“sunburn”)

Second-degree burns

  • Damage into dermis
  • Skin adnexa (hair follicles, oil glands, etc.) remain
  • Heal by re-epithelialization from skin adnexa
  • The deeper the second-degree burn, the slower the healing (fewer adnexa for re-epithelialization)
  • Moist, red, blanching, blisters, extremely painful
  • Superficial burns heal by re-epithelialization and usually do not scar if healed early.
  • Deep burns (deep second-degree to fourth-degree burns) Deep second-degree burns (deep partial-thickness)
  • Damage to deeper dermis
  • Less moist, less blanching, less pain
  • Heal by scar deposition, contraction and limited re-epithelialization

Third-degree burns (full-thickness)

  • Entire thickness of skin destroyed (into fat)
  • Any color (white, black, red, brown), dry, less painful (dermal plexus of nerves destroyed)
  • Heal by contraction and scar deposition (no epithelium left in middle of wound)

Fourth-degree burns

  • Burn into muscle, tendon, bone
  • Need specialized care (grafts will not work)
  • Deep burns usually need skin grafts to optimize results and lead to hypertrophic (raised) scars if not grafted

Q. 9

In second degree burns, re-epithelialisation occurs around:       

 A

1 week

 B

2 weeks

 C

3 weeks

 D

4 weeks

Q. 9

In second degree burns, re-epithelialisation occurs around:       

 A

1 week

 B

2 weeks

 C

3 weeks

 D

4 weeks

Ans. C

Explanation:

Ans. C: 3 weeks

Deep dermal burns take 3 weeks or more to heal without surgery and usually lead to hypertrophic scarring.

If the wound shows no signs of re-epithelialisation in this time, the wound requires debridement and grafting.

Quiz In Between


Q. 10

Blister formation in burn is classified as:

DNB 09; Bihar 11

 A

First degree

 B

Second degree superficial

 C

Second degree deep

 D

Third degree

Q. 10

Blister formation in burn is classified as:

DNB 09; Bihar 11

 A

First degree

 B

Second degree superficial

 C

Second degree deep

 D

Third degree

Ans. B

Explanation:

Ans. Second degree superficial


Q. 11

A lady with burns, skin appears waxy and dry with little pain, the degree of burn is:

CMC (Ludhiana) 11

 A

First degree

 B

Second degree superficial

 C

Second degree deep

 D

Third degree

Q. 11

A lady with burns, skin appears waxy and dry with little pain, the degree of burn is:

CMC (Ludhiana) 11

 A

First degree

 B

Second degree superficial

 C

Second degree deep

 D

Third degree

Ans. D

Explanation:

Ans. Third degree


Q. 12

Muscles are observed in a burns deceased. This indicates that the person is exposed to intense heat above what temperature

 A

30°C

 B

40°C

 C

50°C

 D

60°C

Q. 12

Muscles are observed in a burns deceased. This indicates that the person is exposed to intense heat above what temperature

 A

30°C

 B

40°C

 C

50°C

 D

60°C

Ans. D

Explanation:

Ans. d. 60°C

  • When temperature of flame is 65″C or above, body is rigid with limbs flexed known as pugilistic or fencing posture due to coagulation of albumin constituents of muscles (Boxer’s posture in defense). It is seen in death due to burning, high voltage electrocution, or falling into hot liquid.”

Quiz In Between



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