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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. 6% body weight






2. Decreased colloid oncotic pressure -longer duration of action due to longer circulation time






3. Polydispersed complex starch dissolved in 0.9% NaCl -small molecules confer oncotic pressure -large molecule confer duration of action -a synthetic colloid






4. 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






5. A new formulation of hydroxyethyl starch that has decreased coagulopathy effects - safe up to 50 to 100 ml/kg/d






6. The loss of intravascular fluid.






7. A decrease in in capillary oncotic pressure due to protein loss resulting in filtration of fluid into the interstitial fluid.






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






9. 40% body weight






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






11. The difference between unmeasured anions and unmeasured cations.






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






13. 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






14. Osmolality of solution is approximately equal to that of blood - replacing water as well as electrolytes.






15. 5% body weight






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






17. Albumin






18. Pain and irritation -pressure necrosis -infection






19. Expand the intravascular space by 4 to 6 times for a short duration.






20. Resuscitation phase: if the animal is in shock -rehydration phase -maintenance phase






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






22. 30% body weight






23. 80 to 90 ml/kg IV bolus






24. A particle that does not generate osmotic pressure because it is freely permeable across a membrane.






25. 10 to 20 ml/kg IV bolus






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






27. Extracellular water + intracellular water






28. Resuscitation -treating cerebral edema due to head trauma -correction of acute hyponatremia






29. Increased PCV and TP (hemoconcentration) -increased BUN (pre-renal azotemia) -sodium concentration will remain the same with isotonic loss






30. Interstitial fluid + blood






31. Urinary -fecal






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






33. Mucous membrane moistness -skin elasticity -position of the eye in orbit -changes in body weight -volume status (signs of hypovolemia) -thirst mechanism






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






35. 60% body weight






36. Most commonly used to treat coagulopathies.






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






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






39. 4 ml/kg IV bolus






40. Hypovolemic is the most reponsive -distributive shock -obstructive shock - above the obstruction






41. Lateral neck skin






42. Potential for transfusion reactions.






43. Sustained volume expansion of the vascular space






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






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






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






47. 0.45% NaCl -D5W -Norm M






48. 30% body weight






49. Primarily in the vascular space - depending on vascular permeability -increases vascualar volume by 1 to 1.5x volume given






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







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