Which statement is true regarding healing of burns?

A. Diabetes is incorrect because diabetes mellitus is a chronic metabolic disorder caused by insufficient insulin production or insulin resistance. It is unrelated to the acute fluid shifts or volume depletion seen in burn injuries, so it is not a complication of burns.

B. Hypovolemic shock is correct because severe burns damage the skin, which acts as a protective barrier, allowing significant fluid, plasma, and protein loss through the injured tissue. This results in a decrease in circulating blood volume, leading to reduced tissue perfusion, hypotension, tachycardia, and potential organ dysfunction. Hypovolemic shock is a life-threatening complication in the acute phase of burn injury. Early recognition and prompt fluid resuscitation using formulas like the Parkland formula are critical to restore intravascular volume, maintain organ perfusion, and prevent multi-organ failure.

C. Pneumonia is incorrect because pneumonia is primarily a respiratory complication, often arising from inhalation injury, aspiration, or prolonged immobility, rather than from fluid loss. While burn patients are at increased risk for infections due to compromised skin integrity and immune suppression, pneumonia is not the direct result of hypovolemia.

D. Heart failure is incorrect because heart failure occurs when the heart is unable to pump blood effectively due to structural or functional problems. Although severe burns can stress the cardiovascular system, the immediate threat from fluid loss is hypovolemic shock, not intrinsic heart failure.

A. A mole that is smaller than 6 mm is incorrect because while size can be a factor in melanoma, smaller moles are generally less concerning. Melanomas are often larger than 6 mm, but early lesions can be smaller, so size alone is not the most alarming sign.

B. A mole that resembles all other moles on the body is incorrect because this represents the “E” or “evolution” principle in dermatology, meaning moles that are similar to surrounding moles are less likely to be malignant. Melanoma often stands out as different from other moles (the “ugly duckling” sign).

C. A mole with multiple colors is correct because the “C” in the ABCD mnemonic stands for Color. A mole with multiple shades of brown, black, tan, red, white, or blue is concerning for melanoma. Variation in color reflects abnormal melanocyte activity and irregular pigment deposition, which is a hallmark of malignant change.

D. A mole with symmetrical borders is incorrect because symmetrical moles are generally less concerning. The “B” in ABCD stands for Border, and irregular, scalloped, or poorly defined borders are a warning sign of melanoma. Symmetry is more characteristic of benign nevi.