Fluid Management (Kane) Final Exam COPY Flashcards
What percentage of total body water (TBW) is found in the average adult?
A. 50%
B. 55%
C. 60%
D. 70%
C. 60%
Slide 2
Which of the following are true about water distribution in the body?
A. 60% of TBW in the average pediatric patient
B. High percentage of water in adipose tissue
C. Low percentage of water in adipose tissue
D. Found equally in all types of tissues
C. Low percentage of water in adipose tissue
Slide 2
Which fluid compartment includes plasma volume?
A. Intracellular
B. Interstitial
C. Intravascular
D. Transcellular
C. Intravascular
Slide 2
Which of the following is NOT included in the transcellular fluid compartment?
A. GI tract fluid
B. Urine
C. Plasma volume
D. CSF
C. Plasma volume
GI tract, urine, csf, joint fluid, aqueous humor, Pericardial fluid
Slide2
Which of the following are components of the extracellular fluid compartment? Select 3
A. Intracellular fluid
B. Interstitial fluid
C. Intravascular fluid
D. Transcellular fluid
E. Cytoplasm
B. Interstitial fluid
C. Intravascular fluid
D. Transcellular fluid
Slide 2
The intersitial compartment includes _______ and ______________ fluid around cells.
A. lymphatics; protein-poor
B. intracellular; plasma;
C. lymphatics and ; plasma
D. intracellular; protein-poor
A. protein-poor; lymphatics
Slide 2
What is the direction of solute movement in diffusion?
A. Low to high concentration
B. High to low concentration
C. Random movement
D. No movement
B. High to low concentration
Solute particles fill solvent
Slide 3
Which ion is the primary extracellular cation?
A. Potassium (K)
B. Calcium (Ca)
C. Sodium (Na)
D. Magnesium (Mg)
C. Sodium (Na)
slide 3
Which ion is the primary intracellular cation?
A. Sodium (Na)
B. Potassium (K)
C. Calcium (Ca)
D. Magnesium (Mg)
B. Potassium (K)
Slide 3
The speed of diffusion is proportional to _______ .
A. distance
B. distance squared
C. time squared
D. volume
B. distance squared
Slide 3
Which of the following are types of solutes involved in diffusion? Select 3
A. Glucose
B. Proteins
C. Electrolytes
D. Water
E. Lipids
A. Glucose
B. Proteins
C. Electrolytes
Slide 3
Which of the following are true about diffusion? Select 2
A. Can relate to electrical gradients
B. Moves from low to high concentration
C. Can occur across permeable membranes
D. Does not relate to electrical gradients
E. Speed is proportional to distance cubed
A. Can relate to electrical gradients
C. Can occur across permeable membranes
As well as:
* Solute particles fill solvent
* High to low concentration
* Speed is proportional to distance squared*
Slide 3
What type of membrane is involved in osmosis?
A. Impermeable
B. Semipermeable
C. Permeable
D. Nonpermeable
B. Semipermeable
A semipermeable membrane separates pure water from water with dissolved solute
Osmosis Jones… 2001 throwback..
Slide 4
In osmosis, water diffuses from _______ concentration to _______ concentration.
A. low; high
B. high; low
C. equal; unequal
D. random; specific
A. low; high
Slide 4
What factor directly affects osmotic pressure?
A. Pressure
B. Volume
C. Temperature
D. Gravity
C. Temperature
Slide 4
Which factors affect osmotic pressure? Select 3
A. Temperature
B. Number of molecules
C. Volume
D. Speed
A. Temperature
B. Number of molecules
C. Volume (inversely affects pressure)
*P = nRT/V
*
Slide 4
True or False
Osmotic pressure is the pressure that resists the movement of water through osmosis
True
Slide 4
What does osmolarity measure?
A. The number of osmotically active particles per liter of solutes
B. The number of osmotically active particles per liter of solvent
C. The number of osmotically active particles per gram of solvent
D. The number of osmotically inactive particles per liter of solvent
B. The number of osmotically active particles per liter of solvent
Kane - know the difference unless you are eating McDonalds
Slide 5
Which statements are true about osmolarity and its effects?
A. Higher osmolarity has higher pulling power
B. Lower osmolarity has higher pulling power
C. Osmolality is measured in particles per liter of solvent
D. Patient with higher serum glucose has lower osmolarity
A. Higher osmolarity has higher pulling power
Slide 5
Patient A has a serum glucose of 600 mg/dL, and Patient B has a serum glucose of 250 mg/dL. _______ has higher osmolarity because of the higher number of _______.
A. Patient A; particles
B. Patient B; particles
C. Patient A; cells
D. Patient B; cells
A. Patient A; particles
Slide 5
True or False
Osmolality refers to the number of osmotically active particles per liter of solvent.
False (The correct measurement is per kilogram of solvent)
Slide 6
The normal range of osmolality in the human body is _______ to _______ mOsm.
A. 260; 270
B. 270; 280
C. 280; 290
D. 290; 300
C. 280- 290
Slide 6
What is oncotic pressure?
A. The total pressure exerted by water in the body
B. The total osmotic pressure due to colloids
C. The total pressure exerted by electrolytes in the body
D. The total osmotic pressure exerted by glucose in the bloodstream
B. The component of total osmotic pressure due to colloids
Slide 7
What percentage of oncotic pressure is contributed by albumin?
A. 50-60%
B. 60-70%
C. 65-75%
D. 70-80%
C. 65-75%
Slide 7
Which of the following proteins contribute to oncotic pressure?
A. Albumin
B. Globulins
C. Fibrin
D. Fibrinogen
E. Hemoglobin
F. Hematocrit
A. Albumin
B. Globulins
D. Fibrinogen
Slide 7
MATCHING
Match the Average Intake to our Average Output
Kane - in general what we intake is relatively equal to our output
Slide 8
What percentage of daily water loss is due to urinary secretion?
A. 30%
B. 40%
C. 50%
D. 60%
D. 60%
slide 9
What activates Atrial Natriuretic Peptide (ANP)?
A. Decreased fluid volume
B. Increased fluid volume
C. Increased potassium levels
D. Decreased sodium levels
B. Increased fluid volume
*↑ atrial stretch = ↑ renal excretion.
*
slide 9
Which hormone regulates renal H₂O excretion in response to plasma tonicity?
A. Aldosterone
B. Antidiuretic Hormone (ADH)
C. Atrial Natriuretic Peptide (ANP)
D. Renin
B. Antidiuretic Hormone (ADH)
slide 9
If sodium and fluid volume decrease, _______ is released, causing sodium and water conservation.
A. Atrial Natriuretic Peptide (ANP)
B. Antidiuretic Hormone (ADH)
C. Aldosterone
D. Renin
C. Aldosterone
slide 9
Which sensors are involved in the regulation of overall fluid balance? Select 3
A. Osmoreceptors in the kidney
B. Low pressure baroreceptors
C. High pressure baroreceptors
D. Hypothalamic chemoreceptors
E. Hypothalamic osmoreceptors
B. Low pressure baroreceptors in large veins and right atrium
C. High pressure baroreceptors in the carotid sinus and aortic arch
E. Hypothalamic osmoreceptors
Slide 10
Where are high pressure baroreceptors located?
A. Large veins and right atrium
B. Hypothalamus
C. Carotid sinus and aortic arch
D. Lungs
C. Carotid sinus and aortic arch
Slide 10
Where are low pressure baroreceptors located?
A. Carotid sinus
B. Aortic arch
C. Large veins and right atrium
D. Hypothalamus
C. Large veins and right atrium
Slide 10
Triggers for maintaining fluid balance include increased _______ or _______ release.
A. thirst; aldosterone
B. hunger; ADH
C. thirst; ADH
D. hunger; aldosterone
C. thirst; ADH
Slide 10
Which of the following are compensatory mechanisms activated in response to acute disturbances in circulating volume? Select 3
A. Venoconstriction
B. Mobilization of venous reservoir
C. Increased urine production
D. Autotransfusion from ISF to plasma
E. Decreased heart rate
A. Venoconstriction -Platelet aggregation
B. Mobilization of venous reservoir -Blood is shunted to primary organs
D. Autotransfusion from ISF to plasma -We don’t need it extracellularly, we need circulating volume
Kane - compensation may happen in minutes to hours. At that hour mark that it takes to completely compensate, it only works if you are NOT losing any more volume.
If we continue to lose volume, that compensation with partly or totally delayed
Slide 11
What happens to cardiac output (CO) during acute disturbances in circulating volume?
A. It remains the same
B. It increases significantly
C. It decreases
D. It stabilizes
C. It decreases, leading to tachycardia and increased inotropy
Slide 11
True or False
During acute disturbances in circulating volume, reduced urine production is a compensatory mechanism to maintain circulating volume.
True
Slide 11
Which sensors are involved in the response to acute disturbances in circulating volume? Select 3
A. Low pressure baroreceptors
B. High pressure baroreceptors
C. Osmoreceptors
D. Chemoreceptors
E. Thermoreceptors
F. Mechanoreceptors
G. RAA axis
A. Low pressure baroreceptors
B. High pressure baroreceptors
D. RAA axis
Slide 11
Renin is released from _______ cells in the kidney and cleaves angiotensinogen to make _______ .
A. juxtaglomerular; angiotensin I
B. adrenal; angiotensin II
C. juxtaglomerular; angiotensin II
D. adrenal; vasopressin
A. juxtaglomerular; angiotensin I
Slide 12
Angiotensin I becomes Angiotensin II and causes _______ and _______ release.
A. vasoconstriction; aldosterone
B. vasodilation; renin
C. Vasoconstriction; renin
D. water excretion; aldosterone
A. vasoconstriction; aldosterone
Slide 12
Aldosterone is released from the adrenal cortex and stimulates:
Select 2
A. Salt and water retention
B. Regulates potassium levels
C. Regulates
D. Salt and water excretion
A. Salt and water retention
B. Regulates potassium levels
Where sodium goes, water follows
Slide 12
In the absence of ongoing loss, how long does it take to restore volume through the RAA axis?
A. 1-2 hours
B. 12-72 hours
C. 4-8 weeks
D. 1-2 days
B. 12-72 hours
Slide 12
In the absence of ongoing loss, how long does it take for the RAA axis to restore RBC numbers through erythropoiesis?
A. 12-72 hours
B. 1-2 weeks
C. 4-8 weeks
D. 2-4 days
C. 4-8 weeks
Slide 12
Which intravenous fluid has an osmolality closest to normal plasma osmolality (280-290 mOsm)?
A. Normal Saline (NS)
B. Lactated Ringers (LR)
C. Plasmalyte A
D. D5
C. Plasmalyte A
*Plasmalyte is the closest to normal osmolality (280-290)
Sodium and potassium is normal
Chloride is normal
*
Slide 14
Why is D5 considered a bad idea for fluid therapy?
A. It has high sodium content
B. It turns into free water
C. It has low potassium content
D. It causes vasoconstriction
B. It turns into free water
Slide 14
Which fluid is recommended for diabetic patients?
A. Lactated Ringers (LR)
B. D5
C. Normal Saline (NS)
D. Albumin 5%
C. Normal Saline (NS)
Slide 14
Which fluid is not recommended for patients with liver injury/failure?
A. Normal Saline (NS)
B. Lactated Ringers (LR)
C. Plasmalyte A
D. Hetastarch
B. Lactated Ringers (LR)
*Kane - NS, Plasmalyte is ok.
Lactated ringers is not good because of the high levels of Lactate in it
*
Slide 14
If Plasmalyte is not available what is the next fluid that is closest to normal osmolarity?
A. Normal Saline (NS)
B. Lactated Ringers (LR)
C. Albumbin
D. Hetastarch
B. Lactated Ringers (LR)
LR is close to osmolality
Electrolyte composition is close
Slide 14
Which of the following are examples of crystalloids? Select 4
A. Blood products
B. Normal Saline (0.9%)
C. Hypertonic Saline (3%)
D. Lactated Ringers
E. Dextrose Solutions
F. Albumin
B. Normal Saline (0.9%)
C. Hypertonic Saline (3%)
D. Lactated Ringers
E. Dextrose Solutions
Slide 15
What is the primary use of crystalloids in medical treatment?
A. Replacement of free water and vitamins
B. Replacement of free water and electrolytes
C. Replacement of free water and glucose
D. Replacement of free water and colloids
B. Replacement of free water and electrolytes
Slide 15
Which of the following statements about crystalloids are true?
Select 3
A. They are solutions of electrolytes in water
B. They are used for volume expansion
C. They are primarily used to provide essential vitamins
D. They are known for increasing blood pressure
E. They are often referred to as balanced solutions
A. They are solutions of electrolytes in water
B. They are used for volume expansion
F. They are often referred to as balanced solutions -*aka Isotonic…but not exactly, but they are close *
Slide 15
What percentage of crystalloids is distributed into the intravascular space 20 minutes after administration?
A. 30%
B. 50%
C. 70%
D. 90%
C. 70% is in the intravascular space (ECF)
slide 16
What happens to crystalloids 30 minutes after administration?
A. 30% remains intravascular
B. 50% remains intravascular
C. 50% is gone
D. 70% is gone
C. 50% is left in the intravascular space
Slide 16
Crystalloids can leak into interstitial components such as _______ , _______ , and _______ , leading to tissue edema.
A. blood vessels; soft tissues; gut
B. lung; gut; soft tissues
C. heart; liver; kidneys
D. muscles; lungs; soft tissues
B. lung; gut; soft tissues
Slide 16