NAGELHOUT 21, 22, 38 EXAM
QUESTIONS AND ANSWERS 100%
VERIFIED
Total body water represents that percentage of lean body mass? - ANSWER-60%
What is the primary cation and anion of the ECV? - ANSWER-Na+Cl-
What is the primary cation and anion of the ICV? - ANSWER-K+PO4-
What is the daily fluid volume required to maintain TBW homeostasis? - ANSWER-25-
35mL/k per day (2-3 L)
Which of the four transcapillary pressures are is slightly negative? - ANSWER-Pif -
interstitial fluid pressure. Due to lymphatic vessels.
What is the primary determinant of both capillary and interstitial oncotic pressure? -
ANSWER-albumin
What transcapillary pressures favor filtration of fluid into the interstitial space? -
ANSWER-capillary hydrostatic and interstitial oncotic.
What transcapillary pressure favor absorption of fluid into the intravascular space? -
ANSWER-interstitial hydrostatic and capillary oncotic
What results from positive net filtration when discussing transcapillary pressures? -
ANSWER-edema
What results from negative net filtration when discussing transcapillary pressures? -
ANSWER-fluid absorption into the vasculature
The regulation of the ECV is largely dependent on which ion? - ANSWER-sodium
What are negative effects of hyperchloremia from large volumes of NS? - ANSWER-
Decreased GFR, increased salt and water retention
Which patient population is NS most appropriate for? - ANSWER-Neurosurgical
patients. (In small amounts, d/t slight hyperosmolarity reducing risk of cerebral edema)
Which patient populations is LR contraindicated in? - ANSWER-Diabetics, TBI,
neurovascular insults
, Which 3 fluids are considered the most isotonic of the balanced salt solutions? -
ANSWER-Plasmalyte, normasol, isolyte
What are the buffers used in plasmalyte, normasol, and isolyte? - ANSWER-Sodium
gluconate and sodium acetate
What starling force do colloids directly affect? - ANSWER-Increase Plasma oncotic
How does dextran affect coagulation? (3) - ANSWER-Impairs vWF, activates
plasminogen, interferes with platelet aggregation
Hydroxylethyl starches are contraindicated in which patient population? - ANSWER-
Allergies to starchy plants; potatoes, maize, sorghum
What did thr CREST study determine about hydroxylethyl starches? - ANSWER-
Increase the risk of renal injury. (Black box warning)
What is the Donnan effect? - ANSWER-Becuase of albumins negative charge, it binds
ions which increases plasma osmolarity and intravascular volume
What did the SAFE trial determine? - ANSWER-No difference in outcomes with albumin
and NS. Except neurotrauma; albumin increased mortality.
What are the guidelines for fluid replacement for Superficial Trauma:Minimal Trauma
(herniorrhaphy): Moderate Trauma (major nonabd or laparoscopic abd. surgery):
Severe Trauma (major open abd. surgery): - ANSWER-Superficial Trauma (orofacial):
1-2 mL/kg per hrMinimal Trauma (herniorrhaphy): 2-4 mL/kg per hrModerate Trauma
(major nonabdor laparoscopic abd surgery): 4-6 mL/kg per hr Severe Trauma (major
open abd surgery): 6-8 mL/kg per hr
What are unreliable methods of determining fluid responsiveness and volume status? -
ANSWER-CVP, urine output,
What are the x and y axis on a Frank-Starling curve? - ANSWER-x: LVEDV, y: pressure
(SV)
What are the segments of the Frank-Starling curve? - ANSWER-Ascending: preload
dependence. Plateau: preload independence
The patient is considered fluid responsive if their pulse pressure variation is greater than
what values? - ANSWER-13-15%
What are the 3 main goals of ERAS protocols? - ANSWER-decrease postop
complications, accelerate recovery , and promote early mobilization and discharge
QUESTIONS AND ANSWERS 100%
VERIFIED
Total body water represents that percentage of lean body mass? - ANSWER-60%
What is the primary cation and anion of the ECV? - ANSWER-Na+Cl-
What is the primary cation and anion of the ICV? - ANSWER-K+PO4-
What is the daily fluid volume required to maintain TBW homeostasis? - ANSWER-25-
35mL/k per day (2-3 L)
Which of the four transcapillary pressures are is slightly negative? - ANSWER-Pif -
interstitial fluid pressure. Due to lymphatic vessels.
What is the primary determinant of both capillary and interstitial oncotic pressure? -
ANSWER-albumin
What transcapillary pressures favor filtration of fluid into the interstitial space? -
ANSWER-capillary hydrostatic and interstitial oncotic.
What transcapillary pressure favor absorption of fluid into the intravascular space? -
ANSWER-interstitial hydrostatic and capillary oncotic
What results from positive net filtration when discussing transcapillary pressures? -
ANSWER-edema
What results from negative net filtration when discussing transcapillary pressures? -
ANSWER-fluid absorption into the vasculature
The regulation of the ECV is largely dependent on which ion? - ANSWER-sodium
What are negative effects of hyperchloremia from large volumes of NS? - ANSWER-
Decreased GFR, increased salt and water retention
Which patient population is NS most appropriate for? - ANSWER-Neurosurgical
patients. (In small amounts, d/t slight hyperosmolarity reducing risk of cerebral edema)
Which patient populations is LR contraindicated in? - ANSWER-Diabetics, TBI,
neurovascular insults
, Which 3 fluids are considered the most isotonic of the balanced salt solutions? -
ANSWER-Plasmalyte, normasol, isolyte
What are the buffers used in plasmalyte, normasol, and isolyte? - ANSWER-Sodium
gluconate and sodium acetate
What starling force do colloids directly affect? - ANSWER-Increase Plasma oncotic
How does dextran affect coagulation? (3) - ANSWER-Impairs vWF, activates
plasminogen, interferes with platelet aggregation
Hydroxylethyl starches are contraindicated in which patient population? - ANSWER-
Allergies to starchy plants; potatoes, maize, sorghum
What did thr CREST study determine about hydroxylethyl starches? - ANSWER-
Increase the risk of renal injury. (Black box warning)
What is the Donnan effect? - ANSWER-Becuase of albumins negative charge, it binds
ions which increases plasma osmolarity and intravascular volume
What did the SAFE trial determine? - ANSWER-No difference in outcomes with albumin
and NS. Except neurotrauma; albumin increased mortality.
What are the guidelines for fluid replacement for Superficial Trauma:Minimal Trauma
(herniorrhaphy): Moderate Trauma (major nonabd or laparoscopic abd. surgery):
Severe Trauma (major open abd. surgery): - ANSWER-Superficial Trauma (orofacial):
1-2 mL/kg per hrMinimal Trauma (herniorrhaphy): 2-4 mL/kg per hrModerate Trauma
(major nonabdor laparoscopic abd surgery): 4-6 mL/kg per hr Severe Trauma (major
open abd surgery): 6-8 mL/kg per hr
What are unreliable methods of determining fluid responsiveness and volume status? -
ANSWER-CVP, urine output,
What are the x and y axis on a Frank-Starling curve? - ANSWER-x: LVEDV, y: pressure
(SV)
What are the segments of the Frank-Starling curve? - ANSWER-Ascending: preload
dependence. Plateau: preload independence
The patient is considered fluid responsive if their pulse pressure variation is greater than
what values? - ANSWER-13-15%
What are the 3 main goals of ERAS protocols? - ANSWER-decrease postop
complications, accelerate recovery , and promote early mobilization and discharge
