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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. Extracellular water + intracellular water






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






3. 4 ml/kg IV bolus






4. 5% body weight






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






6. 300 mosm/L






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






8. The loss of intravascular fluid.






9. Pain and irritation -pressure necrosis -infection






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






11. Osmolality of ECF decreases - causing fluid to shift from the ECF to the ICF -ICF volume increases -ECF volume decreases - TBW decreases






12. Lateral neck skin






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






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






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






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






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






18. 70% body weight






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






20. 30% body weight






21. Most commonly used to treat coagulopathies.






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






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






24. 132 x BW (kg)^0.75






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






26. Potential for transfusion reactions.






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






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






29. Total body water






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






31. 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






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






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






34. Short duration of volume expansion -transient hypernatremia -reflex bradycardia






35. Changes in body weight over time.






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






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






38. 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.






39. 40% body weight






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






41. 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






42. 30% body weight






43. 0.9% NaCl -reduction of SID due to an increase in Cl in relation to Na






44. 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)






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






46. Plasma proteins -sodium and associated anions






47. 40 ml/kg/day






48. Albumin






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






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







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