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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. For every positively charged ion in body fluids - there is a balancing negatively charged ion.






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






3. Occur at the loss of 30% of blood volume -occur when dehydration reached 10% of body weight






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






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






6. 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






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






8. 0.9% NaCl -reduction of SID due to an increase in Cl in relation to Na






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






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






11. 8% body weight






12. Interstitial fluid + blood






13. Potential for transfusion reactions.






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






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






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






17. The loss of intravascular fluid.






18. 4% body weight






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






20. The concentration of effective osmoles.






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






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






23. 80 to 90 ml/kg IV bolus






24. 70 x BW (kg)^0.75






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






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






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






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






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






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






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






32. 30% body weight






33. 40% body weight






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






35. The difference between unmeasured anions and unmeasured cations.






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






37. 20 to 25 mmHG






38. 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






39. 5% body weight






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






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






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






43. 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)






44. Osteomyelitis -often only short-lived access






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






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






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






48. 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






49. 1/4 from the intravascular space -3/4 from the interstitium






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







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