Burn Pathophysiology & the Systemic Response

Chapter 23 of Volume 3, Skin, Burns & Surgical Principles. Revision notes and examiner-style viva questions with model answers for the FRCS (Plast).

22 viva questions in this chapter

1. What actually happens to skin when you burn it?
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2. Why does the same exposure produce different depths at different sites?
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3. What does the mechanism of injury tell you?
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4. Why is a hot oil scald worse than a hot water scald?
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5. Describe the local response to a burn.
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6. What converts the zone of stasis?
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7. How does the oedema evolve over time?
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8. What is burn shock?
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9. Tell me about myocardial depression after a burn. Is there really a myocardial depressant factor?
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10. Explain the ebb and flow phases.
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11. At what burn size does the response become systemic?
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12. Take me through the systemic effects of a major burn.
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13. Tell me about Curling’s ulcer. Do you still see it?
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14. Describe the immune response to a burn.
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15. Which mediators drive the burn response?
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16. What do you mean by the hypermetabolic response?
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17. How does a burn wound heal?
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18. Why do deep dermal burns heal so badly?
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19. Where does the 21-day rule come from?
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20. A patient with a 55 percent burn cannot straighten his elbow at three months. What is going on?
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21. Has anything changed in your understanding of burn pathophysiology in the last few years?
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22. His wife says: “The wounds are healed. Why is he still so weak? Why isn’t he coming home?”
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