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Clinical Chemistry > ELECTROLYTES > Flashcards

ELECTROLYTES Flashcards

1
Q

Ions that are capable of carrying an electric charge

A

Electrolytes

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2
Q

Fluid that is one third of the total body water
16 Liters

A

Extracellular fluid

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3
Q

Fluid that is two thirds of the total body water
24 L

A

Intracellular fluid

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4
Q

Major Extracellular Cation, hence the major contributor of Osmolality

A

Sodium

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5
Q

Sodium’s plasma concentration depends greatly on the intake and excretion of __

A

Water

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6
Q

Reference Value of Sodium

A

135 - 145 mmol/L

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7
Q

Promotes absorption of sodium in the distal tubule
Promotes sodium retention and potassium excretion

A

Aldosterone

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8
Q

Blocks aldosterone and renin secretion, and inhibits the action of angiotensin II and vasopressin
Causes Natriuresis

A

Atrial Natriuretic Factor (ANF)

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9
Q
  1. Diabetes insipidus
  2. Renal tubular disorder
  3. Prolonged diarrhea
  4. Profuse sweating
  5. Severe burns
  6. Vomiting
  7. Fever
  8. Hyperventilation
A

Excess Water Loss
Hypernatremia

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10
Q
  1. Hyperaldosteronism (Conn’s disease)
  2. Sodium bicarbonate infusion
  3. Increased oral or IV intake of NaCl
  4. Ingestion of sea water
A

Increased water intake or retention
Hypernatremia

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11
Q
  1. Diuretic use
  2. Saline infusion
A

Increased Sodium loss
Hyponatremia

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12
Q
  1. Renal failure
  2. Nephrotic syndrome
  3. Aldosterone deficiency
  4. Cancer
  5. Syndrome of Inappropriate ADH Secretion
  6. Hepatic cirrhosis
  7. Primary polydipsia
  8. CNS abnormalities
  9. Myxedema
A

Increased water retention
Hyponatremia

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13
Q

Defined as an increased sodium concentration in plasma water,
Sodium levels >145 mmol/L
Caused by loss of water, gain of sodium or both

A

Hypernatremia

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14
Q

Most common electrolyte disorder
Reduced plasma sodium concentration <135mmol/L

A

Hyponatremia

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15
Q

Reduction in serum sodium concentration caused by a systematic error in measurements

A

Pseudohyponatremia

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16
Q

Most common, yet not widely known cause of pseudohyponatremia is ___, a well known cause of pseudohyperkalemia

A

In Vitro Hemolysis

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17
Q
  1. Serum Na - Low
  2. Urine Na - Low
  3. 24-hour Na - Low
  4. Urine Osmolality - Low
  5. Serum K - N/L
A

Overhydration

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18
Q
  1. Serum Na - Low
  2. Urine Na - Low
  3. 24-hour Na - High
  4. Urine Osmolality - Low
  5. Serum K - Low
A

Diuretics

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19
Q
  1. Serum Na - Low
  2. Urine Na - High
  3. 24-hour Na - High
  4. Urine Osmolality - High
  5. Serum K - N/L
A

SIADH

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20
Q
  1. Serum Na - Mildly elevated
  2. Urine Na - Normal
  3. 24-hour Na - N/A
  4. Urine Osmolality - High
  5. Serum K - High
A

Adrenal Failure

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21
Q
  1. Serum Na - Low
  2. Urine Na - Low
  3. 24-hour Na - High
  4. Urine Osmolality - Low
  5. Serum K - Low
A

Bartter’s Syndrome

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22
Q
  1. Serum Na - Low
  2. Urine Na - Normal
  3. 24-hour Na - Normal
  4. Urine Osmolality - Normal
  5. Serum K - High
A

Diabetic Hyperosmolality

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23
Q

Methods used for detection of Sodium levels:

A
  1. Emission Flame Photometry
  2. Ion Selective Electrode (Glass Aluminum silicate)
  3. Atomic Absorption Spectrophotometry
  4. Colorimetry
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24
Q

Major Intracellular Cation
Single most important analyte in terms of abnormality being immediately life threatening

A

Potassium

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25
Q

Potassium has a concentration in the RBCs of ___ which is __x its concentration in plasma

A

105 mmol/L
23x

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26
Q

It is reabsorbed together with Na & Cl by the sodium potassium chloride cotransporter in:

A

Ascending limb of Henle’s Loop

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27
Q

Reference Value of Potassium:

A

3.5 - 5.2 mmol/L

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28
Q

Reference Value of Potassium:

A

3.5 - 5.2 mmol/L

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29
Q

Plasma levels are ___ compared to serum levels because of the release of platelets into serum on clot formation

A

LOWER

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30
Q
  1. Acute or Chronic Renal Failure
  2. Severe Dehydration
  3. Addison’s Disease
A

Hyperkalemia due to
Decreased renal excretion

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31
Q
  1. Acidosis
  2. Muscle/Cellular injury
  3. Chemotherapy
  4. Vigorous exercise
  5. Digitalis intoxication
A

Hyperkalemia due to
Extracellular shift

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32
Q

Other causes of Hyperkalemia:

A

Increased intake
Use of immunosuppressive drugs

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33
Q
  1. Gastric suction & Laxative abuse
  2. Intestinal tumor and malabsorption
  3. Cancer and Radio therapy
  4. Vomiting and Diarrhea
A

Hypokalemia due to
Gastrointestinal loss

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34
Q
  1. Diuretics use
  2. Hyperaldosteronism
  3. Cushing’s Syndrome
  4. Leukemia
  5. Bartter’s Syndrome
  6. Gitelman’s Syndrome
  7. Liddle’s Syndrome
  8. Malignant Hypertension
A

Hypokalemia due to
Renal Loss

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35
Q
  1. Alkalosis
  2. Insulin Overdose
A

Hypokalemia due to
Intracellular Shift

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36
Q

Almost always due to impaired Renal Excretion

A

Hyperkalemia

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37
Q

Elevations in serum K can directly stimulate the adrenal cortex to release:

A

Aldosterone

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38
Q

Three major mechanisms of diminieshed renal potassium:

A
  1. Reduced aldosterone
  2. Renal Failure
  3. Reduced distal dedlivery of sodium
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39
Q

Most common cause of chronic hyperkalemia due to impaired renal excretion of plasma is ____, which is caused by chronic renal insufficiency of primarily tubulointerstitial disease

A

Hyporeninemic Hypoaldosteronism

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40
Q

Reduced GFR and decreased tubular secretion causes accumulation of potassium (Mg, PO4) in plasma

A

Renal Failure

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41
Q

Plasma K levels of ___ is fatal and can cause cardiac arrest

A

10 mmol/L

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42
Q

Hyperkalemic drugs:

A
  1. Captopril
  2. Spironolactone
  3. Digoxin
  4. Cyclosporine
  5. Heparin
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43
Q
  1. Sample Hemolysis
  2. Thrombocytosis
  3. Prolonged Tourniquet Application
  4. Fist Clenching
  5. Blood stored in ice
  6. IV fluid
  7. High blast counts in acure or accelerated phase leukemias
A

Causes of Pseudohyperkalemia

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44
Q

Hpomagnesemia leads to ___ by promoting urinary loss of potassium

A

Hypokalemia

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45
Q

Most common cause of hypokalemia
Can be attributed to increased activity of aldosterone or other mineralocorticoid

A

Impaired Renal function or Renal Loss

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46
Q

___ is the most common cause of extra renal loss of potassium

A

Diarrhea

47
Q

___ can cause falsely decrease potassium levels because K is taken up by WBC

A

Leukocytosis

48
Q

Methods to measure Potassium levels

A
  1. Emission Flame Photometry
  2. Ion Selective Electrode (Valinomycin gel)
  3. AAS
  4. Colorimetry (Lockhead & Purcell)
49
Q

Major Extracellular Anion
Chief counter ion of sodium in ECF
Promotes maintenance of water balance & osmotic pressure

A

Chloride

50
Q

Only anion to serve as an enzyme activator

A

Chlorine

51
Q

Reference Value of Chlorine

A

98 - 107 mmol/L

52
Q

Indicator: Diphenylcarbazone
End: HgCl2 (Blue-Violet)

A

Mercurimetric Titration
Schales & Schales

53
Q

Mercuric Thiocyanate (Reddish)
Ferric Perchlorate

A

Spectrophotometric Method

54
Q

Cotlove Chloridometer

A

Coulometric Amperometric Titration

55
Q

Most commonly used method for detecting Chloride levels:

A

Ion Selective Electrode

56
Q
  1. Renal Tubular Acidosis
  2. Diabetes insipidus
  3. Salicylate intoxication
  4. Primary hyperparathyroidism
  5. Metabolic acidosis
  6. Prolonged diarrhea
A

Hyperchloremia
(>107 mmol/L)

57
Q
  1. Prolonged vomiting
  2. Aldosterone deficiency
  3. Metabolic Alkalosis
  4. Salt-losing nephritis
A

Hypochloremia
(<98 mmol/L)

58
Q

Present almost exclusively in the plasma
Involved in blood coagulation, enzyme activity, excitability of skeletal and cardiac muscle, and maintenance of blood pressure

A

Calcium

59
Q

Calcium is maximally absorbed in the ___, the absorption is favored at an acidic pH

A

Duodenum

60
Q

Reference Value of Total Calcium

A
  1. Adult: 8.6-10 mg/dL
  2. Child: 8.8-10.8 mg/dL
61
Q

Reference Value for Ionized Calcium

A
  1. Adult: 4.6-5.3 mg/dL
  2. Child: 4.8-5.5 mg/dL
62
Q

Hypocalcemia can be a consequence of reduced plasma ___

A

Albumin

63
Q

Increases intestinal absorption of Calcium
Increases reabsorption in the kidneys
Increases mobilization of calcium from bones

A

1,25-Dihydroxycholecalciferol (1,25-(OH)2D3)
Activated Vit D3

64
Q

Conserves Calcium by increasing reabsorption in the kidneys
Increases the levels by mobilizing bone calcium
Activates process of bone resorption
Suppresses urinary loss of calcium
Stimulates conversion of inactive Vit D to active Vit D3 in kidneys

A

Parathyroid Hormone

65
Q

Secreted by the parafollicular C cells of the thyroid gland
Inhibits PTH & Vitamin D3
Inhibits bone resorption
Promotes urinary excretion of Calcium

A

Calcitonin

66
Q

End Product: Oxalic Acid
Purple

Calcium Methods

A

Clark Collip Precipitation

67
Q

End: Chloranilic Acid
Purple

Calcium Methods

A

Ferro Ham Chloranilic Acid Precipitation

68
Q

Dye: Arzeno III
Mg inhibitor: 8-hydroxyquinoline (chelator)

Calcium Methods

A

Ortho-Cresolphthalein Complexone Dyes

69
Q

Reference Method for detection of Calcium levels:

A

Atomic Absorption Spectrophotometry

70
Q

Other Methods for detecting Chloride levels:

A

EDTA Titration Method
Ion Selective Electrode (Liquid membrane)
Emission Flame Photometry

71
Q
  1. Primary Hyperparathyroidism
  2. Cancer
  3. Acidosis
  4. Increased Vit D
  5. Multiple Myeloma
  6. Sarcoidosis
  7. Hyperthyroidism
  8. Milk-Alkali Syndrome
A

Hypercalcemia
CHIMPS

72
Q
  1. Alkalosis
  2. Vitamin D deficiency
  3. Primary Hypoparathyroidism
  4. Acute Pancreatitis
  5. Hypomagnesemia
  6. Malabsorption Syndrome
  7. Renal Tubular Failure
A

Hypocalcemia
CHARD

73
Q

Inversely related to Calcium
Maximally absorbed in the jejunum
Essential for the insulin-mediated entry of glucose into cells by a process involving phosphorylation of the glucose and co-entry of K+

A

Inorganic Phosphorus

74
Q

Reference Value of Phosphorous

A

Adult: 2.7 - 4.5 mg/dL
Child: 4.5 - 5.5 mg/dL

75
Q

Principal anion within cells

A

Organic Phosphate

76
Q

Part of the blood buffer

A

Inorganic Phosphate

77
Q

Decreases phosphate by renal excretion

A

Parathyroid Hormone

78
Q

Inhibits bone resorption

A

Calcitonin

79
Q

Increases phosphate renal absorption

A

Growth Hormone

80
Q

Most commonly used method to measure serum inorganic phosphate
End: ammonium-molybdate complex (unstable)

A

Fiske Subbarow Method
Ammonium Molybdate Method

81
Q

Most common reducing agent for Fiske Subbarow Method:

A

Pictol
Amino Naphthol Sulfonic Acid

82
Q
  1. Hypoparathyroidism
  2. Renal Failure
  3. Lymphoblastic leukemia
  4. Hypervitaminosis D
A

Hyperphosphatemia

83
Q
  1. Alcohol Abuse (MCC)
  2. Primary Hyperparathyroidism
  3. Avitaminosis D (No Vit D)
  4. Myxedema
A

Hypophosphatemia

84
Q

Major cause of hypophosphatemia
Increase shift of phosphate into cells can deplete phosphate in the blood

A

Transcellular Shift

85
Q

Intracellular cation second in abundance to potassium
4th most abundant cation in the body; enzyme activator
A Vasodilator and cause decrease uterine hyperactivity

A

Magnesium

86
Q

Reference Value of Magnesium

A

1.2 - 2.1 mEq/L

87
Q

Increases renal reabsorption of Magnesium
Increases intestinal absorption of Magnesium

A

Parathyroid Hormone

88
Q

Increases renal excretion of Magnesium

A

Aldosterone & Thyroxine

89
Q
  1. Diabetic coma
  2. Addison’s disease
  3. Chronic renal failure
  4. Increased intake of antacids, enemas & cathartics
A

Hypermagnesemia

90
Q
  1. Acute renal failure
  2. Malnutrition
  3. Malabsorption Syndrome (Sprue)
  4. Chronic Alcoholism
  5. Severe diarrhea
A

Hypomagnesemia

91
Q

End: Reddish-Violet complex

Magnesium Methods

A

Calmagite Method

92
Q

End: Colored complex

A

Formazen Dye Method

Magnesium Method

93
Q

End: Colored Complex

A

Magnesium Thymol Blue Method

Magnesium Method

94
Q

Second most abundant anion in the ECF
Accounts for 90% of the total CO2 at physiologic pH
Buffers excess hydrogen ion by combining with acid

A

Bicarbonate

95
Q

Specimen for Bicarbonate:

A

Blood anaerobically collected

96
Q

Reference Value for Bicarbonate:

A

21-28 mEq/L

97
Q

Difference between the unmeasured cations (Sodium & Potassium) and unmeasured anions (Chloride & Bicarbonate)

A

Anion Gap

98
Q

Used to monitor recovery from diabetic ketoacidosis

A

Anion Gap (AG)

99
Q

Anion Gap formula:

A

AG = Na - (Cl + HCO3)
AG = (Na + K) - (Cl + HCO3)

100
Q
  1. Uremia/ Renal Failure
  2. Ketoacidosis
  3. Poisoning by Methanol, Ethanol, Ethylene glycol, or Salicylate
  4. Lactic Acidosis
  5. Hypernatremia
  6. Instrument Error
A

Increased Anion Gap

101
Q
  1. Hypoalbuminemia
  2. Hypercalcemia
  3. Hyperlipidemia
  4. Elevated Myeloma proteins
A

Decreased Anion gap

102
Q

Usually recognized in infancy or early childhood
Produce abnormally thick secretions of mucus, elevation of sweat electrolytes, increased organic and enzymatic constituents of saliva and overactivity of the ANS

A

Cystic Fibrosis
Mucoviscidosis

103
Q

Diagnostic Test for Cystic Fibrosis

A

Sweat Test - Coulometry

Increased Na & Cl

104
Q

Positive result for Cystic Fibrosis for Pilocarpine Iontophoresis

A

(> 65 mmol/L) of sweat electrolytes

105
Q

Common metallic element important for the synthesis of hemoglobin
Prooxidant, contributing to lipid peroxidartion, atherosclerosis, DNA damage and carcinogenesis
Stored as Ferritin and Hemosiderin primarily in spleen, bone marrow and liver

A

Iron

106
Q

Reference Value of Iron:

A

Male: 50-160 ug/dL
Female: 45-150 ug/dL

107
Q

Refers to the amount of iron that could be bound by saturating transferrin and other minor-iron binding proteins present in the serum & plasma sample

A

Total Iron Binding Capacity (TIBC)

108
Q

TIBC is a direct measure of the total number of functional ferrous ion-binding sites in ____

A

Transferrin

109
Q

Reference Value of TIBC

A

Adult: 245-425 ug/dL
(>40 yrs old: 10-250 ug/dL)
Newborn & Child: 100-200 ug/dL

110
Q

also known as: Transferrin saturation
Ratio of serum iron to TIBC

A

Percent Saturation

111
Q

Normal Ratio of Percent Saturation

A

1:3

112
Q

Lowest levels of Percent Saturation is seen in:

A

Iron Deficiency Anemia

113
Q

Reference Value of % Saturation

A

20-50%

Clinical Chemistry (16 decks)

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