Page 1 of 1
What is the primary physiologic role of albumin in the circulation?
Increasing red blood cell production
Maintaining plasma oncotic pressure and circulating blood volume
Stimulating platelet aggregation
Producing clotting factors
Why does albumin remain primarily within the intravascular space?
Its molecular size prevents it from readily crossing the vascular endothelium.
It is continuously synthesized within blood vessels.
It is actively transported by endothelial cells.
It binds to erythrocytes.
A patient is profoundly dehydrated after several days of severe vomiting. Which albumin formulation would most appropriately restore intravascular volume?
25% albumin
20% albumin
5% albumin
Either concentration is equally effective.
A patient with decompensated heart failure has significant peripheral edema but low effective circulating volume. Which albumin concentration is most appropriate?
5% albumin
25% albumin
Either concentration produces identical physiologic effects
Albumin is contraindicated.
Administration of 100 mL of 25% albumin produces approximately how much plasma volume expansion under ideal conditions?
100 ml
250 ml
500 ml
1000 ml
The effectiveness of 25% albumin depends primarily on which physiologic factor?
Adequate hepatic albumin synthesis
Availability of interstitial fluid to shift intravascularly
Normal renal function
High serum sodium concentration
Which clinical scenario best represents relative hypovolemia rather than net hypovolemia?
Acute blood loss following trauma
Severe diarrhea
Extensive cellulitis with third-spacing of fluid
Excessive diuretic use
A patient undergoes major surgery with significant hemorrhage. Which albumin concentration would best address the underlying physiology?
25% albumin
5% albumin
Both concentrations are equally appropriate.
Neither concentration expands plasma volume.
Which question should clinicians ask themselves first when selecting an albumin concentration?
What is the patient's serum albumin level?
Is the patient experiencing net or relative hypovolemia?
Does the patient have liver disease?
What infusion pump is available?
A patient with septic shock develops profound capillary leak and third spacing. Which albumin concentration is generally more appropriate according to the physiologic principles described?
5% albumin
25% albumin
Either concentration regardless of fluid status
Albumin should never be used in septic shock
When administering albumin to a hemodynamically unstable patient with hypovolemia, which infusion strategy is most appropriate?
Infuse over four hours regardless of clinical status.
Delay administration until serum albumin results return.
Administer relatively rapidly while monitoring the patient's response.
Never repeat a dose.
Which adverse event most directly indicates cardiovascular overload during albumin infusion?
Bradycardia
Muscle cramping
Hyperglycemia
Pulmonary edema with worsening dyspnea
A patient receiving albumin develops rigors and shortness of breath during the infusion. What is the most appropriate immediate action?
Increase the infusion rate.
Continue the infusion unchanged.
Slow or stop the infusion and reassess the patient.
Flush the IV with sterile water.
Besides maintaining oncotic pressure, albumin also plays an important physiologic role by:
Producing antibodies.
Transporting drugs, hormones, and enzymes.
Activating clotting factors.
Stimulating erythropoiesis.
Which statement best summarizes the practical difference between 5% and 25% albumin?
25% albumin primarily expands plasma volume by recruiting interstitial fluid, whereas 5% mainly replaces intravascular volume directly.
5% albumin draws fluid from tissues, whereas 25% simply replaces intravascular volume.
Both concentrations produce identical plasma expansion.
Albumin concentration should be selected solely based on serum albumin level.
Page 1 of 1