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Emergency Medicine: Fluid Therapy

Instructions:
  • Answer 50 questions in 15 minutes.
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  • Match each statement with the correct term.
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This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. Resuscitation -treating cerebral edema due to head trauma -correction of acute hyponatremia






2. No restricted by the endothelium -equilibrate rapidly between the interstitial and vascular spaces -cell membranes restrict movement from interstitial space - into cells bases on osmolality






3. The concentration of effective osmoles + the concentration of ineffective osmoles.






4. Extracellular space - with rapid redistribution into the interstitium -only 20 to 30% of the fluids administered remain in the intravascular space after 20 to 30 minutes






5. Osmolality of solution is greater than that of blood - causing a shift from fluid from the intersitium into the vascular space and rapid vascular volume expansion.






6. Potential for transfusion reactions.






7. 6% body weight






8. 132 x BW (kg)^0.75






9. Osmolality of the solution is less that blood - causing a net increase in free water.






10. Creation of acid-base disorders -tissue edema -pro-inflammatory effects






11. 40% body weight






12. The elasticity of skin depends on hydration status -pull up the skin over the thorax and watch the speed at which - it returns to normal position -also able to assess overhydration






13. The loss of isotonic fluids from the ECF - primarily from the interstitium






14. Normalization of vital signs -MAP above 65 -urine output about 0.5 ml/kg/hr






15. A function of daily obligatory solute excretion -based on body surface area rather than body weight






16. Generates osmotic pressure by causing a shift of water across a boundary that is not permeable to the osmotically active particle.






17. 10 to 20 ml/kg IV bolus






18. Unreliable rate of absorption -cannot be used for resuscitation or replacement of fluids in critically ill patients -hypo- or hypertonic solutions cannot be used due to tissue damage and injury






19. Osteomyelitis -often only short-lived access






20. 4 ml/kg IV bolus






21. Omolality of ECF increases - causing fluid to shift from the ICF to the ECF -ECF volume is partially maintained -ICF decreases - TBW decreases






22. Changes in body weight over time.






23. 4% body weight






24. Dextrose allows for an initial match in blood osmolality - but does not act as an effective osmol - as it is rapidly metabolized.






25. Osmolality of ECF does not change - initiating no fluid shift - between the ECF and ICF -ECF decreases - TBW decreases - and ICF is static






26. 30% body weight






27. Saliva -evaporation at skin -evaporation at the respiratory tract






28. A natural colloid that is not very efficient at raising albumin or COP.






29. Increased colloid oncotic pressure -shorter duration of effect due to rapid excretion






30. Sustained volume expansion of the vascular space






31. 8% body weight






32. Extracellular water + intracellular water






33. Never use for resuscitation -never bolus; cannot administer rapidly






34. Maintain the animal in zero fluid balance - with input equaling output.






35. 300 mosm/L






36. 50 m;/kg/day






37. 60% body weight






38. Urinary -fecal






39. 80 to 90 ml/kg IV bolus






40. Practical - with limited equipment required -can be administered on an outpatient basis






41. 5% body weight






42. 70 x BW (kg)^0.75






43. Dose dependent coagulopathy due to dilution of clotting factors and impaired platelet aggregation - especially with hetastarch.






44. The amount of saliva and tear film varies inversely with - hydration status -this is a qualitative test






45. Along with magnesium - constitutes the majority of positively charged ions in the ICF.






46. A sunken eyes is associated with reduced volume in the ] - retrobulbar fat -qualitative






47. Obese animals have increased elasticity -very thin animals have decreased elasticity






48. The concentration of effective osmoles.






49. Lateral neck skin






50. Correction of acid-base disorders -rehydration -replacement of ongoing losses -resuscitation







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