Vesiculobullous disorders: fluid management in toxic epidermal necrolysis: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Dermatology · Vesiculobullous disorders: fluid management in toxic epidermal necrolysis

Sample item

A 40-year-old with toxic epidermal necrolysis involving 60 percent of the body surface is transferred to a burn unit. Compared with a patient with a thermal burn of similar size, what is true of her fluid needs?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. They are lower than in an equivalent thermal burn

Fluid loss in toxic epidermal necrolysis is less than in an equivalent burn, as the dermis is spared and there is no major capillary leak. Over-resuscitation risks pulmonary and tissue oedema.

Option by option

  • A. They are not needed because the skin is intact

    Fluid is needed because large areas of epidermis are lost, even though some skin is intact.

  • B. They are identical

    They are not identical, since a burn destroys the dermis and causes more leak.

  • C. They are much higher than in a thermal burn

    Needs are not higher because the dermis stays intact.

  • D. They are lower than in an equivalent thermal burn (correct)

    Correct. Fluid requirements are less than in a thermal burn of the same area.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Dermatology questions

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is D, They are lower than in an equivalent thermal burn. Fluid loss in toxic epidermal necrolysis is less than in an equivalent burn, as the dermis is spared and there is no major capillary leak.

Why is "They are not needed because the skin is intact" not the answer?

Fluid is needed because large areas of epidermis are lost, even though some skin is intact.

Why is "They are identical" not the answer?

They are not identical, since a burn destroys the dermis and causes more leak.

Why is "They are much higher than in a thermal burn" not the answer?

Needs are not higher because the dermis stays intact.

What concept does this question test?

It tests Vesiculobullous disorders: fluid management in toxic epidermal necrolysis in Dermatology. Over-resuscitation risks pulmonary and tissue oedema.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Vesiculobullous disorders: fluid management in toxic epidermal necrolysis?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.