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3rd Year Medical Specialties > Intravenous Fluids > Flashcards

Intravenous Fluids Flashcards

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USMLE® Step 1 flashcards
1
Q

How is total body water divided?

A

(60% total mass)
40% Intracellular
20% Extracellular (ISF + Plasma)

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2
Q

Where is extracellular fluid located/

A

Interstitial fluid
Intravascular fluid
Water in connective tissue
Transcellular fluid

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3
Q

What is osmolality?

A

Number Osmoles of solute/Kg

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4
Q

How are body fluids measured?

A

Millimolar concentrations

mosm/kg

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5
Q

What is Osmolarity?

A

Number Osmoles of solute/L

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6
Q

What is normal plasma osmolarity?

A

298 (300) mosm/L

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7
Q

What is Tonicity?

A

Effective Osmolality

Only particles RESTRICTED to one comparment will determine water distribution

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8
Q

Hypotonicity leads to what?

A

Cellular swelling
Raised ICP
Compromised CBF, herniation

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9
Q

Hypertonicity leads to what?

A

Cellular dehydration

Venous Sinus thrombosis

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10
Q

How are IV fluid types divided?

A

Crystalloids

Colloids

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11
Q

What are the colloids?

A

Gelatins
Starches
Dextrans
Albumin and Blood

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12
Q

Why are crystalloids used?

A

Cheap

ECF expansion

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13
Q

Why are colloids used?

A

Anaphylaxis
Coagulopathy
Renal failure

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14
Q

What are the negative effects of 0.9% saline?

A

Hypercholaemic acidosis
Decreased renal blood flow .’. GFR
Exacerbates sodium retention

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15
Q

What are the ‘balanced’ fluids?

A

Ringer’s Lactate

Hartmann’s Solution

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16
Q

What are the insensible losses of fluids?

A 
Urine
Sweat
Skin
Lungs
Faeces
17
Q

How are body fluid levels measured?

A

Oesophageal doppler
Pulmonary artery catheter
IVC collapsibility

18
Q

What are the signs a patient may need fluid resuscitation?

A 
ABCDE 
Systolic BP: <100mmHg
HR: >90bpm
Slow capillary refill/cold peripheries 
RR >20
NEWS >5
Postural hypertensions
Thirst, abnormal losses
FBC, U+Es
19
Q

What are the key points on a fluid prescription chart?

A

24hrs
Patient weight
4 questions
Consultant

20
Q

What are the fluid prescription chart 4 questions?

A

Assess patient
Why give fluids?
How much fluid?
Which fluid?

21
Q

Outline the prescription of maintenance fluids?

A 
NEVER over 100ml/hr - hyponatraemia
30ml/kg/24hrs (20-25ml in frail)
Subtract other fluids
.18% NaCl/4% Gluc/.3% KCl
Correct rate
22
Q

Outline the prescription of replacement fluids?

A

Add up losses in last 24hrs - give same volume back
NEVER speed up maintenance fluids
Plasmalyte 148

23
Q

Outline the prescription of resuscitation fluids?

A

Plasmalyte 148/Colloid/Blood

250-500mls over 5-15mins then reassess

24
Q

How does sepsis lead to oedema?

A

Sepsis attacks endothelial wall increasing its permeability leading to oedema

3rd Year Medical Specialties (18 decks)

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