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53 Cards in this Set

  • Front
  • Back
What is a second degree burn?
both epidermis and superficial dermis are affected
Appearance/characteristics of full thickness burn?
white or charred
anaesthetic (nerve destruction)
Appearance/characteristics of partial thickness burn?
pink or mottled with blisters; painful
type of necrosis in a burn tissue sample?
coagulative, w/inflammatory cells in adjacent tissue
burns of at least 20% of the body cause what?
shift of bodily fluids to interstitial compartment causing hypovolemic shock
Why does fluid want to go to the interstial compartment when you have over 20% of your body burned? (2)
increase in interstitial osmotic pressure (because of fragmented dead cells)
increases in vascular permeability
What effect do water soluble gases (ammonia, chlorine, sulfur oxides) inhaled in a fire have on the airway
lead to inflammation of the upper airway, causing obstruction
What effect do lipid soluble gases (nitrous oxide, burning plastics) inhaled in a fire have on the airway
reach the deeper airways, causing pneumonitis
Leading cause of death in burn patients?
organ system failure due to sepsis
most common bug that infects burn patients? Other two to worry about too?
most common: psuedomonas aeruginosa

others: staph, candida
Why is a burn site ideal for infection? (3)
serum and cellular debris provide nutrients
no inflammatory response because burn compromised blood flow
cellular and humoral defenses against infection are compromised
two purposes of aggressive, early debridement of burn wounds?
provide a clean, vascularized surface for wound repair
allow phagocytes ready access to invading/opportunistic bugs
why do burn patients starve to death?
burns over 40% of the body cause hypermetabolism (double normal). Tissues end up being broken down for protein to use.
treatment for hypermetabolic state of burn patients?
elevate room temp to avoid body heat loss
nutritional supplementation
Three kinds of hyperthermia?
heat cramps
heat exhaustion
heat stroke
what are heat cramps?
loss of electrolytes through sweating, happens in voluntary muscles during exercise
What is heat exhaustion?
the CV system fails to compensate for hypovolemia due to water loss from sweat. You collapse and then spontaneously recover
what is heat stroke
thermoregulatory mechanisms fail and core body temp rises
mechanism of heat stroke
marked peripheral vasodilation, so the blood pools up there and doesn't circulate effectively
what can hasten the lowering of body temperature in hypothermia?
cold, wet clothing
superficial vasodilation from alcohol
what is trench foot?
slowly developing change that happens w/hypothermia: vasoconstriction and increased vasopermeability lead to edema, followed by atrophy and fibrosis
So trench foot is a slow drop in temp, what happens with a fast drop in temp?
sudden vasoconstriction and increased blood viscosity cause ischemic injury and damage to peripheral nerves.
Fast drop in temps produce ischemia in tissues, what does this do?
hypoxic changes and infarction of the affected tissues (gangrenous toes for example).
why is wet skin more vulnerable to electrocution than dry skin
lower resistance, means less of the energy is dissipated right away and it can travel through you
flashover - def?
when lightning hits someone and is conducted around them, blasting off the clothing but causing little damage
Mech of high altitude illness?
low oxygen causes confusion, and increased capillary permeability leading to pulmonary and generalized edema
air blast injury - what happens?
violent increase in pressure (blast wave) collapses the thorax or abdomen, can rupture internal organs
difference between air blast and immersion blast injury?
immersion happens in water and the force comes from all sides, not just one
mech of decompression (Caisson) disease?
deep sea divers have lots of atmospheric pressure, causing lots of oxygen and nitrogen to dissolve in the blood. When they come up and the pressure is released, the gas makes bubbles that come together and form an embolus in the vessel
What is caisson disease of the bones?
foci of aseptic necrosis in the bones, due to embolic occlusion of blood supply
what does food preserved by smoking have in it?
N-nitrosamines, a carcinogen
Three components of an adequate diet?
energy (carbs, fats, protein)
amino/fatty acids (used for making proteins and lipids)
vitamins and minerals
what is primary malnutrition?
one of the three essential components of the diet is missing
what is secondary/conditional malnutrition?
supply of nutrients is ok, but something is wrong in the body, and they aren't able to work right (malabsorption, impaired use/storage, etc.)
what happens to infants fed only milk?
iron deficiency
what is PEM?
protein-energy malnutrition - range of clinical syndromes caused by inadequate dietary intake of protein and calories
important nutritional deficiency in alcoholics?
thiamine deficiency
What are the somatic and visceral protein compartments?
somatic - skeletal muscle

visceral - in organs, mainly the liver
marasmus - def?
calorie deficiency
Kwashiorkor - def?
protein deficiency
how can you tell if the visceral protein compartment has enough protein?
serum protein levels
clinical definition of malnourishment?
body weight falls to less than 80% of normal
why does a child w/Marasmus lose muscle?
the somatic protein department is being catabolized to make up for the deficiency in calories
expected serum albumin levels in a marasmus patient? why?
normal, because the serum protein reflects the visceral protein compartment status, and that is barely affected in marasmus (visceral protein is more precious to life than somatic)
immune effects of marasmus?
T cell deficiency
why do you get generalized (aka dependent) edema w/Kwashiorkor?
because protein is lost from the visceral compartment causing hypoalbuminuria, makes fluid leave the vasculature and cause edema
how does kwashiorkor affect muscle mass and fat stores?
doesn't really
skin lesions characteristic of Kwashiorkor?
alternating hyper/hypopigmentation ("flaky paint")
difference in liver condition of Kwashiorkor vs marasmus?
in kwashiorkor you see enlarged, fatty liver due to reduced synth of carrier proteins
name for malnutrition seen in pts w/secondary PEM. what are the symptoms?

depletion of sub q fat
muscle wasting
sacral or ankle edema
difference in signs of cachexia and anorexia nervosa?
cachexia you lose both fat and muscle
effect of marasmus on the small intestine?
mucosal atrophy and loss of villi and microvilli - this means they can't just be put on a normal diet right away (won't work)
effect of marasmus/kwashiorkor on bone marrow? type of anemia seen?
hypoplastic, because of fewer red cell precursors.

hypochromic microcytic anemia