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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. 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)






2. 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






3. Potential for transfusion reactions.






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






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






6. 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






7. 20 to 25 mmHG






8. Changes in body weight over time.






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






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






11. Lateral neck skin






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






13. The concentration of effective osmoles.






14. Albumin






15. 0.9% NaCl -reduction of SID due to an increase in Cl in relation to Na






16. Plasma proteins -sodium and associated anions






17. 4 ml/kg IV bolus






18. Resuscitation -anesthetic patients -to treat significant dehydration and ongoing losses -critiacally ill patients






19. Interstitial fluid + blood






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






21. 70 x BW (kg)^0.75






22. Sustained volume expansion of the vascular space






23. 0.9% NaCl -Plasmalyte -LRS






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






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






26. Pain and irritation -pressure necrosis -infection






27. 50 m;/kg/day






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






29. 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






30. 300 mosm/L






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






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






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






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






35. 0.45% NaCl -D5W -Norm M






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






37. 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






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






39. Urinary -fecal






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






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






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






43. 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.






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






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






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






47. 30% body weight






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






49. Lower eyelid






50. 40% body weight







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