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Emergency Medicine: Fluid Therapy
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Subjects
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health-sciences
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emergency-medicine
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. Primarily in the vascular space - depending on vascular permeability -increases vascualar volume by 1 to 1.5x volume given
bloodwork changes and dehydration
hydroxyethyl starch volume of distribution
osmolality
blood volume in adults
2. 40 ml/kg/day
isotonic crystalloids volume of distribution
maintenance for a normal adult horse
potassium
bloodwork changes and dehydration
3. Resuscitation -anesthetic patients -to treat significant dehydration and ongoing losses -critiacally ill patients
osmolality
the effects of the loss of hypotonic fluid (water deprivation)
typical uses for IV route of administration
hypovolemia
4. Proportional to the number of non-dissociable (active) ions in solution -not a function of the weight of an ion
properties of colloids with large macromolecules
properties of isotonic crystalloids
osmolality
typical uses for IV route of administration
5. Most commonly used to treat coagulopathies.
plasma volume in cats
adverse effects of canine plasma
indications for canine plasma
hypertonic crystalloids
6. Interstitial fluid + blood
ICF in large animals
goals of fluid resuscitation
hydration parameters for physical examone
extracellular fluid (ECF)
7. Changes in body weight over time.
law of electroneutrality
most sensitive test for estimating fluid loss
complications of catheterization
hydration parameters for physical examone
8. 10 to 20 ml/kg IV bolus
types of shock that are reponsive to fluid therapy
maintenance for a normal adult dog
shock does for hetastarch
adverse affects of hydroxyethyl starch
9. The concentration of effective osmoles + the concentration of ineffective osmoles.
isotonic crystalloids volume of distribution
anion gap
normal vascular oncotic pressure
total osmolality
10. Osteomyelitis -often only short-lived access
properties of isotonic crystalloids
sodium
indications for canine plasma
disadvantages of the IO route of administration
11. 70% body weight
TBW in large animals less that 30 days of age
traditional shock dose
influence in body condition on the skin elasticity test
properties of colloids with large macromolecules
12. Osmolality of ECF does not change - initiating no fluid shift - between the ECF and ICF -ECF decreases - TBW decreases - and ICF is static
osmotic determinants of volume: ICF
ECF in large animal adults
the effects of isotonic fluid loss
law of electroneutrality
13. Obese animals have increased elasticity -very thin animals have decreased elasticity
clinical indications for hydroxyethyl starch
hypotonic crystalloids
insensible losses
influence in body condition on the skin elasticity test
14. Lateral neck skin
influence in body condition on the skin elasticity test
insensible losses
hydroxyethyl starch volume of distribution
location of the skin elasticity test in horses
15. Resuscitation -treating cerebral edema due to head trauma -correction of acute hyponatremia
clinical indication for hypertonic crystalloids
hypertonic crystalloids
clinical indications for hydroxyethyl starch
adverse affects of hydroxyethyl starch
16. 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)
goals of fluid resuscitation
blood volume in adults
clinical indications for hypotonic crystalloids
TBW in adults
17. Normalization of vital signs -MAP above 65 -urine output about 0.5 ml/kg/hr
maintenance for a normal adult cow
goals of fluid resuscitation
effective osmoles
clinical indication for hypertonic crystalloids
18. Access to a vascular space when IV is not possible -rapid placement
TBW is obese large animals and extremely large horses
Vetstarch
advantages of the IO route of administration
advantages of the SC route of administration
19. Urinary -fecal
interstitial fluid
types of shock that are reponsive to fluid therapy
sensible fluid losses
influence in body condition on the skin elasticity test
20. 5% body weight
hydroxyethyl starch volume of distribution
plasma volume in adults
hydroxyethyl starch
most important colloid in the blood
21. 50 m;/kg/day
ICF in large animals
hypertonic crystalloids
maintenance for a normal adult cow
blood volume in cats
22. 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
isotonic crystalloids volume of distribution
acidifying crystalloids
hypotonic crystalloids volume of distribution
contraindications for hypotonic crystalloids
23. TBW - ECF -contains transcellular fluids such as peritonial fluid - CSF - pleural fluid - and synovial fluid.
interstitial fluid
hypotonic crystalloids volume of distribution
blood volume in adults
primary effect of colloids
24. A sunken eyes is associated with reduced volume in the ] - retrobulbar fat -qualitative
assessment in the position of the eye in orbit
canine plasma
complications of catheterization
skin elasticity test
25. Short duration of volume expansion -transient hypernatremia -reflex bradycardia
primary effect of colloids
dehydration
adverse effects of hypertonic crystalloids
interstitial fluid
26. 1/4 from the intravascular space -3/4 from the interstitium
breakdown of the loss from the ECF compartment
influence of age on the skin elasticity test
extracellular fluid (ECF)
canine plasma
27. Lower eyelid
hydroxyethyl starch
location of the skin elasticity test in cattle
shock dose for hypertonic saline
alkalinizing crystalloids
28. Potassium - magnesium - and associated anions.
mucous membrane moistness
hypovolemia
osmotic determinants of volume: ICF
osmotic determinants of volume: BV
29. Along with magnesium - constitutes the majority of positively charged ions in the ICF.
maintenance water requirement
potassium
osmotic determinants of volume: ICF
adverse effects of canine plasma
30. 40% body weight
clinical indications for hydroxyethyl starch
ECF in large animals less than 30 days of age
total body water (TBW)
disadvantages of the SC route of administration
31. Osmolality of ECF decreases - causing fluid to shift from the ECF to the ICF -ICF volume increases -ECF volume decreases - TBW decreases
shock dose for hypertonic saline
phases of a fluid therapy plan
clinical indication for hypertonic crystalloids
the effects of electrolyte loss without water loss (dialysis)
32. Increased PCV and TP (hemoconcentration) -increased BUN (pre-renal azotemia) -sodium concentration will remain the same with isotonic loss
law of electroneutrality
advantages of the IO route of administration
hypovolemia
bloodwork changes and dehydration
33. Increased colloid oncotic pressure -shorter duration of effect due to rapid excretion
properties of colloids with small macromolecules
dextrose 5% in water (D5W)
complications of the SC route of administration
disadvantages of the IO route of administration
34. LRS (lactate) -Plasmalyte (acetate) -Norm R (gluconate) -each provides a bicarbonate precursor
skin elasticity test
alkalinizing crystalloids
disadvantages of the IO route of administration
disadvantages of the SC route of administration
35. Categorized based on tonicity compared to normal plasma -categorized based on electrolyte composition -categorized based on acid-base effects
categorizations of crystalloids
plasma volume in adults
adverse affects of hydroxyethyl starch
isotonic crystalloids volume of distribution
36. 300 mosm/L
hypertonic crystalloids
normal osmolality of body fluid
location of the skin elasticity test in horses
hydroxyethyl starch volume of distribution
37. Resuscitation - to attain sustained vascular expansion - oncotic support during hypoproteinemia
adverse effects of hypertonic crystalloids
properties of colloids with large macromolecules
maintenance for a normal adult horse
clinical indications for hydroxyethyl starch
38. Resuscitation phase: if the animal is in shock -rehydration phase -maintenance phase
bloodwork changes and dehydration
normal vascular oncotic pressure
alkalinizing crystalloids
phases of a fluid therapy plan
39. 80 to 90 ml/kg IV bolus
skin elasticity test
primary effect of colloids
traditional shock dose
contraindications for hypotonic crystalloids
40. Sustained volume expansion of the vascular space
most sensitive test for estimating fluid loss
hydroxyethyl starch volume of distribution
disadvantages of the IO route of administration
primary effect of colloids
41. 4% body weight
typical uses for IV route of administration
plasma volume in cats
TBW in large animals less that 30 days of age
the effects of the loss of hypotonic fluid (water deprivation)
42. Decreased colloid oncotic pressure -longer duration of action due to longer circulation time
tonicity
properties of colloids with large macromolecules
disadvantages of the IO route of administration
normal osmolality of body fluid
43. 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
canine plasma
blood volume in cats
complications of catheterization
properties of colloids with small macromolecules
44. Omolality of ECF increases - causing fluid to shift from the ICF to the ECF -ECF volume is partially maintained -ICF decreases - TBW decreases
osmotic determinants of volume: BV
the effects of the loss of hypotonic fluid (water deprivation)
TBW in large animals less that 30 days of age
primary effect of colloids
45. Correction of acid-base disorders -rehydration -replacement of ongoing losses -resuscitation
influence in body condition on the skin elasticity test
clinical indications for isotonic crystalloids
typical uses for IO route of administration
adverse affects of hydroxyethyl starch
46. The loss of isotonic fluids from the ECF - primarily from the interstitium
dehydration
general properties of crystalloids
edema
effective osmoles
47. 20% body weight
properties of colloids with small macromolecules
ECF in small animal adults
hypertonic crystalloids
dehydration
48. Generates osmotic pressure by causing a shift of water across a boundary that is not permeable to the osmotically active particle.
clinical indications for hypotonic crystalloids
effective osmoles
typical uses for IO route of administration
interstitial fluid
49. A particle that does not generate osmotic pressure because it is freely permeable across a membrane.
hypotonic crystalloids
effective osmoles
ineffective osmole
clinical indications for hydroxyethyl starch
50. 0.45% NaCl -D5W -Norm M
hydration parameters for physical examone
osmolality
hypotonic crystalloids
total body water (TBW)
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