Pharmacology

Question 1

Fluids are prescribed for what three roles?

Answer 1

Fluid resuscitation.
Fluid maintenance.
Fluid replacement.

Question 2

What are the two main fluid compartments of the body?

Answer 2

Intracellular fluid.

Extracellular fluid.

Question 3

Extracellular fluid compartment is split into which two compartments?

Answer 3

Intravascular fluid.

Interstitial fluid.

Question 4

How are the ion characteristics between the intracellular fluid and extracellular fluid different?

Answer 4

Intracellular fluid - high potassium, low sodium.

Extracellular fluid - low potassium, high sodium.

Question 5

What are the water requirements of the average person?

Answer 5

25-30ml/kg/day.

Question 6

What are the sodium, chloride and potassium requirements of the average person?

Answer 6

1mmol/kg/day of each.

Question 7

What are the glucose requirements of the average person?

Answer 7

50-100g/day.

Question 8

What forms is fluid lost from the body?

Answer 8

Urine. 
Gastrointestinal (faeces). 
Insensible. 
Miscellaneous. 
Others.

Question 9

What is the minimum acceptable urine output for an average person?

Answer 9

0.5ml/kg/hour.

Question 10

What are insensible fluid losses?

Answer 10

Fluid losses that cannot be measured (sweating, breathing).

Question 11

How much insensible fluid is lost daily for the average person?

Answer 11

800ml.

Question 12

What is the composition of sodium chloride 0.9% (and compare these concentrations to normal plasma)?

Answer 12

Na 154mmol/l (more than plasma).

Cl 154mmol/l (more than plasma).

Question 13

What is the composition of glucose 5%?

Answer 13

Glucose 50g/l.

Question 14

What is the composition of Hartmann’s solution (and compare these concentrations to normal plasma)?

Answer 14

Na 131mmol/l (less than plasma).
Cl 111mmol/l (same/slightly more than plasma).
K 5mmol/l (same/slightly more than plasma).
Lactate 29mmol/l.
Ca 2mmol/l (slightly less).

Question 15

List the clinical signs of hypovolaemia.

Answer 15

Absent/low JVP. 
Decreased skin turgor. 
Dry mucous membranes. 
Low BP. 
Oliguria/anuria. 
Orthostatic hypotension. 
Prolonged cap refill. 
Tachycardia.

Question 16

List the clinical signs of hypervolaemia.

Answer 16

Cough. 
Hypertension. 
Pulmonary oedema (crackles). 
Peripheral oedema. 
Dyspnoea. 
Raised JVP. 
S3/4 heart sounds. 
Tachycardia.

Question 17

What fluid, how much of it and over what period of time is appropriate for fluid resuscitation?

Answer 17

500ml sodium chloride 0.9% over less than 15 minutes.