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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. 40% body weight






2. 70% body weight






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






4. 8% body weight






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






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






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






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






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






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






11. Sodium and associated anions






12. Osmolality of the solution is less that blood - causing a net increase in free water.






13. 20 to 25 mmHG






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






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






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






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






18. Plasma proteins -sodium and associated anions






19. Lower eyelid






20. Potassium - magnesium - and associated anions.






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






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






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






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






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






26. 0.45% NaCl -D5W -Norm M






27. 30% body weight






28. 300 mosm/L






29. Changes in body weight over time.






30. Saliva -evaporation at skin -evaporation at the respiratory tract






31. 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






32. 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






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






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






35. Potential for transfusion reactions.






36. Obese animals have increased elasticity -very thin animals have decreased elasticity






37. 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






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






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






40. Interstitial fluid + blood






41. 0.9% NaCl -Plasmalyte -LRS






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






43. Urinary -fecal






44. Most commonly used to treat coagulopathies.






45. Total body water






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






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






48. Pain and irritation -pressure necrosis -infection






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






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







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