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Emergency Medicine: Fluid Therapy

Instructions:
  • Answer 50 questions in 15 minutes.
  • If you are not ready to take this test, you can study here.
  • Match each statement with the correct term.
  • Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

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. 0.45% NaCl -D5W -Norm M






2. Replacing a free water deficit (hypernatremia) -during heart or renal disease when the patient has an impaired ability to handle sodium -maintenance fluid therapy (lower Na - high K)






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






4. Proportional to the number of non-dissociable (active) ions in solution -not a function of the weight of an ion






5. 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






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






7. Albumin






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






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






10. 5% body weight






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






12. 40% body weight






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






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






15. Osteomyelitis -often only short-lived access






16. 1/4 from the intravascular space -3/4 from the interstitium






17. Most commonly used to treat coagulopathies.






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






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






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






21. Lateral neck skin






22. 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






23. 40 ml/kg/day






24. The concentration of effective osmoles.






25. Categorized based on tonicity compared to normal plasma -categorized based on electrolyte composition -categorized based on acid-base effects






26. All body fluids are iso-osmolar is relation to other body flids despite a different ionic composition.






27. TBW - ECF -contains transcellular fluids such as peritonial fluid - CSF - pleural fluid - and synovial fluid.






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






29. Lower eyelid






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






31. Access to a vascular space when IV is not possible -rapid placement






32. Direct vascular access and expansion -rapid administration possible -multiple type of fluids can be used






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






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






35. 0.9% NaCl -Plasmalyte -LRS






36. 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






37. 70% body weight






38. Total body water






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






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






41. 300 mosm/L






42. 70 x BW (kg)^0.75






43. LRS (lactate) -Plasmalyte (acetate) -Norm R (gluconate) -each provides a bicarbonate precursor






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






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






46. Sustained volume expansion of the vascular space






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






48. Used in neonates and avian species with limited vascular access.






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






50. Urinary -fecal