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






2. Osteomyelitis -often only short-lived access






3. 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)






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






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






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






7. Total body water






8. 4% body weight






9. 70% body weight






10. The difference between unmeasured anions and unmeasured cations.






11. 6% body weight






12. 20% body weight






13. 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






14. 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






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






16. 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.






17. 40 ml/kg/day






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






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






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






21. The loss of intravascular fluid.






22. 5% body weight






23. 0.9% NaCl -Plasmalyte -LRS






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






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






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






27. 20 to 25 mmHG






28. Potential for transfusion reactions.






29. 8% body weight






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






31. Most commonly used to treat coagulopathies.






32. Interstitial fluid + blood






33. Lower eyelid






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






35. 60% body weight






36. 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






37. 0.45% NaCl -D5W -Norm M






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






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






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






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






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






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






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






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






46. 40% body weight






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






48. 10 to 20 ml/kg IV bolus






49. 40% body weight






50. 1/4 from the intravascular space -3/4 from the interstitium






Can you answer 50 questions in 15 minutes?



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