CBRN Burn Pathophysiology & Wound Care Management 2 — Questions and Answers
Question 1: Which zone of Jackson's burn model contains irreversibly damaged, necrotic tissue at the burn center?
- Zone of hyperemia
- Zone of stasis
- Zone of coagulation (Correct answer)
- Zone of ischemia
Correct answer: Zone of coagulation
The zone of coagulation is the innermost, most damaged area where protein coagulation causes irreversible cell death.
Question 2: A patient sustains a burn injury. Which mediator is primarily responsible for the early increase in capillary permeability?
- Thromboxane A2
- Histamine (Correct answer)
- Interleukin-6
- Angiotensin II
Correct answer: Histamine
Histamine released from mast cells causes the initial increase in capillary permeability within the first 30 minutes post-burn.
Question 3: During the ebb phase of the burn stress response, which hemodynamic finding is most expected?
- Increased cardiac output
- Decreased vascular resistance
- Decreased cardiac output (Correct answer)
- Elevated core temperature
Correct answer: Decreased cardiac output
The ebb phase (first 48 hours) is characterized by decreased cardiac output, hypoperfusion, and reduced metabolic rate.
Question 4: A full-thickness burn wound appears pale and leathery with no blistering. What best explains the absence of pain in this wound?
- Adequate analgesia administration
- Destruction of nerve endings in the dermis (Correct answer)
- Superficial dermal involvement only
- Vasodilation blocking pain signals
Correct answer: Destruction of nerve endings in the dermis
Full-thickness burns destroy nerve endings, causing insensitivity to pain in the wound itself.
Question 5: Silver sulfadiazine (Silvadene) is contraindicated in which patient population?
- Elderly patients over 65
- Neonates and premature infants (Correct answer)
- Patients with sulfa allergies only
- Immunocompromised adults
Correct answer: Neonates and premature infants
Silver sulfadiazine is contraindicated in neonates and premature infants due to the risk of kernicterus from sulfonamide displacement of bilirubin.
Question 6: Which dressing type is most appropriate for a partial-thickness burn wound that requires moisture retention and autolytic debridement?
- Dry gauze dressing
- Hydrocolloid dressing (Correct answer)
- Dry calcium alginate
- Petroleum gauze without moisture
Correct answer: Hydrocolloid dressing
Hydrocolloid dressings maintain a moist wound environment that promotes autolytic debridement and epithelialization in partial-thickness burns.
Question 7: The Parkland formula for burn resuscitation in the first 24 hours uses which fluid?
- Normal saline (0.9% NaCl)
- Lactated Ringer's solution (Correct answer)
- 5% Dextrose in water
- Albumin 5%
Correct answer: Lactated Ringer's solution
The Parkland formula uses Lactated Ringer's solution at 4 mL/kg/% TBSA over 24 hours.
CBRN Burn Pathophysiology & Wound Care Management 2
Which zone of Jackson's burn model contains irreversibly damaged, necrotic tissue at the burn center?