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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. 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)






2. 30% body weight






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






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






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






6. 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






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






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






9. 0.45% NaCl -D5W -Norm M






10. The most abundant positively charged ion in the ECF.






11. Most commonly used to treat coagulopathies.






12. 40% body weight






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






14. Extracellular water + intracellular water






15. Osteomyelitis -often only short-lived access






16. 132 x BW (kg)^0.75






17. Extravasation of the catheter into the SC -thrombosis and thromboembolism -thrombophlebitis -infection of the catheter site and into the blood -can fragment and become a foreign body






18. Urinary -fecal






19. 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.






20. Pain and irritation -pressure necrosis -infection






21. 30% body weight






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






23. 1/4 from the intravascular space -3/4 from the interstitium






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






25. Resuscitation -anesthetic patients -to treat significant dehydration and ongoing losses -critiacally ill patients






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






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






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






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






30. Young animals have increased elasticity -old animals have decreased elasticity






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






32. 0.9% NaCl -reduction of SID due to an increase in Cl in relation to Na






33. Sodium and associated anions






34. The difference between unmeasured anions and unmeasured cations.






35. Potassium - magnesium - and associated anions.






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






37. Plasma proteins -sodium and associated anions






38. 80 to 90 ml/kg IV bolus






39. Typically an isotonic crystalloid with potassium added - -hypotonic crystalloids for animals with compromised renal - function of in heart failure -






40. 20% body weight






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






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






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






44. Sustained volume expansion of the vascular space






45. Resuscitation - to attain sustained vascular expansion - oncotic support during hypoproteinemia






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






47. 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






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






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






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







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