Using the image provided, calculate the total body surface area (TBSA) involved if an individual sustains burns to the body as follows:

Entire front of torso

Entire right arm

Front of right leg

Face and front of neck

BODY SURFACE AREA (BSA)

A. Macule is incorrect because a macule is a flat, non-palpable lesion that represents a change in skin color. Examples include freckles or flat rashes. Macules do not contain fluid or pus, nor are they raised.

B. Pustule is correct because a pustule is a small, elevated, erythematous lesion that contains purulent material (pus). Pustules are commonly seen in infections such as acne, impetigo, or folliculitis. The presence of pus indicates an inflammatory response to infection, trauma, or obstruction of a gland.

C. Papule is incorrect because a papule is a solid, raised lesion without fluid. Papules can be caused by a variety of dermatologic conditions such as warts or early stages of acne, but they do not contain pus.

D. Nodule is incorrect because a nodule is a larger, solid, firm lesion that extends deeper into the dermis or subcutaneous tissue. Nodules can result from cysts, tumors, or chronic inflammatory processes, but they are not typically associated with purulent exudate.

A. High-grade daytime fever is incorrect because TB typically presents with a low-grade fever that is more pronounced in the late afternoon or evening. Night sweats are a classic symptom of TB and reflect the body’s immune response to the persistent infection, rather than a high fever during the day. High daytime fevers are more characteristic of acute bacterial infections, not the chronic course seen in TB.

B. Weight gain is incorrect because individuals with active TB often experience weight loss. Chronic infection increases metabolic demands, and the infection itself can suppress appetite, leading to progressive wasting and muscle loss. Weight gain would be unusual in the context of active TB.

C. Blood-tinged sputum is correct because active pulmonary TB can cause cavitation of lung tissue, where necrotic lesions erode into pulmonary blood vessels. This results in hemoptysis, which may range from small streaks of blood in sputum to more significant bleeding. Hemoptysis is a hallmark of active TB and often signals advanced disease or tissue destruction. Other accompanying respiratory symptoms include persistent cough, chest pain, and shortness of breath, reflecting inflammation and airway involvement.

D. Increased appetite is incorrect because TB typically causes anorexia, a loss of appetite, as part of the systemic effects of chronic infection. Reduced food intake, combined with increased metabolic demands and catabolism due to the infection, contributes to weight loss and fatigue.