CBM Nutritional Support for Burns 2 — Questions and Answers
Question 1: Which vitamin is critically depleted in burn patients due to its role in collagen synthesis and antioxidant defense?
- Vitamin D
- Vitamin C (Correct answer)
- Vitamin K
- Vitamin B12
Correct answer: Vitamin C
Vitamin C is rapidly consumed in burn patients because it is essential for collagen synthesis and acts as a key antioxidant during the hypermetabolic stress response.
Question 2: In a 70 kg patient with a 40% TBSA burn, approximately how many grams of protein per day are recommended using standard burn nutrition guidelines?
- 70 g/day
- 105 g/day
- 175 g/day (Correct answer)
- 280 g/day
Correct answer: 175 g/day
Standard burn guidelines recommend approximately 1.5–2.5 g/kg/day of protein; for a 70 kg patient with major burns, ~2.5 g/kg yields approximately 175 g/day.
Question 3: What is the primary rationale for using indirect calorimetry in burn patients rather than predictive equations?
- It is less expensive to perform
- Predictive equations consistently underestimate needs
- It directly measures actual resting energy expenditure (Correct answer)
- It avoids the need for laboratory values
Correct answer: It directly measures actual resting energy expenditure
Indirect calorimetry directly measures oxygen consumption and carbon dioxide production, giving an accurate real-time measurement of resting energy expenditure in the highly variable burn hypermetabolic state.
Question 4: Which trace element supplementation is most strongly supported in burn care to promote wound healing and immune function?
- Iron
- Manganese
- Zinc (Correct answer)
- Copper
Correct answer: Zinc
Zinc is the most extensively studied trace element in burn nutrition, supporting immune function, protein synthesis, and wound healing, and is frequently supplemented due to significant urinary losses.
Question 5: Early enteral nutrition in burn patients (within 6 hours of injury) primarily helps to prevent which complication?
- Hyperglycemia
- Gut mucosal atrophy and bacterial translocation (Correct answer)
- Fluid overload
- Hypophosphatemia
Correct answer: Gut mucosal atrophy and bacterial translocation
Early enteral feeding maintains gut mucosal integrity, preventing villous atrophy and the translocation of intestinal bacteria that can lead to sepsis in burn patients.
Question 6: Which carbohydrate administration rate should NOT be exceeded in burn patients to avoid lipogenesis and CO2 overproduction?
- 3 mg/kg/min
- 5 mg/kg/min (Correct answer)
- 7 mg/kg/min
- 10 mg/kg/min
Correct answer: 5 mg/kg/min
Glucose infusion rates above 5 mg/kg/min promote lipogenesis and excessive CO2 production, which can worsen respiratory status in burn patients.
Question 7: A burn patient's prealbumin level is 8 mg/dL. What does this most accurately reflect in the acute burn setting?
- Adequate protein stores
- Severe malnutrition requiring immediate parenteral nutrition
- An acute-phase response rather than true nutritional deficit alone (Correct answer)
- Renal failure causing protein loss
Correct answer: An acute-phase response rather than true nutritional deficit alone
Prealbumin is a negative acute-phase reactant; in the acute burn setting low levels primarily reflect the inflammatory response rather than isolated nutritional insufficiency.
CBM Nutritional Support for Burns 2
Which vitamin is critically depleted in burn patients due to its role in collagen synthesis and antioxidant defense?