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Emergency Medicine: Fluid Therapy

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  • 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. Plasma proteins -sodium and associated anions






2. 80 to 90 ml/kg IV bolus






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






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






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






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






7. 70% body weight






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






9. Omolality of ECF increases - causing fluid to shift from the ICF to the ECF -ECF volume is partially maintained -ICF decreases - TBW decreases






10. 40 ml/kg/day






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






12. 5% body weight






13. 0.45% NaCl -D5W -Norm M






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






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






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






17. 0.9% NaCl -reduction of SID due to an increase in Cl in relation to Na






18. 40% body weight






19. 10 to 20 ml/kg IV bolus






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






21. 20 to 25 mmHG






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






23. Extracellular water + intracellular water






24. 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)






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






26. 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






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






28. 30% body weight






29. Interstitial fluid + blood






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






31. Lower eyelid






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






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






34. 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






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






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






37. Potential for transfusion reactions.






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






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






40. 70% body weight






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






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






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






45. The concentration of effective osmoles.






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






47. 1/4 from the intravascular space -3/4 from the interstitium






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






49. 300 mosm/L






50. Most commonly used to treat coagulopathies.







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