Chloride and Bicarbonate (RVSP) Flashcards Preview

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Flashcards in Chloride and Bicarbonate (RVSP) Deck (58):
0

Major extracellular anion

Chloride (Cl-)

1

3 functions of chloride

- maintains osmolality
- maintains blood volume
- maintains electric neutrality

2

Cl- shifts secondarily to a movement of ___ and ___

Na+
HCO3-

3

Organ that absorbs Cl-

Small intestine

4

Passively reabsorbs Cl-

Proximal tubules

5

Excess Cl- is excreted in the _____ and ______

Urine
Sweat

6

Stimulates aldosterone secretion; Cl-

Excessive sweating

7

Effect of aldosterone on serum Cl- levels

Increased Cl- levels

8

Effect of aldosterone on sweat Cl- levels

Decreased Cl- levels

9

Electrolyte that is the partner of Na+

Cl-

10

2 ways in which Cl- maintains electric neutrality

- Cl- acts as a rate-limiting component in Na+ reabsorption
- Chloride shift

11

Buffers H+ inside the red cell

Deoxyhemoglobin

12

Process of maintaining electric neutrality where Cl- diffuses into the red cell as HCO3- didfuses out into the plasma

Chloride shift

13

True/False. Cl- passively follows Na+

True

14

Excessive loss of HCO3-; increased serum Cl-

Hyperchloremia

15

Excessive loss of Cl-

Hypochloremia

16

Causes of hyperchloremia

- GI losses
- RTA
- metabolic acidosis

17

Causes of hypochloremia

- prolnged vomiting
- diabetic ketoacidosis
- aldosterone deficiency
- salt-losing renal diseases (ex: pyelonephritis)
- metabolic alkalosis
- compensatory respiratory acidosis

18

Specimens for Cl-

- serum
- plasma (lithium heparin)
- whole blood
- urine (24 hr)
- sweat

19

Effect of hemolysis on Cl- levels

Decreased (because of dilutional effect)

20

Most commonly used method for Cl-

ISE

21

Mts for Cl-; uses silver wire coated with AgCl as electrode

ISE

22

Reaction for Colorimetric determination of Cl-

Cl- + Hg(SCN)2 ---> HgCl2 + SCN-
SCN- + Fe3+ ---> Fe(SCN)3

23

Cl- mtd; Ag+ combines with Cl-; excess/free Ag+ indicates endpoint

Cotlove Chloridometer/Whitehorn/Sendroy Stiff/Amperometric-Coulometric

24

Cl- mtd; excess amount of Hg measured by titrating diphenylcarbazone

Schales and Schales / Mercurimetric titration

25

Endpoint of Schales and Schales mtd for Cl-

Blue violet color

26

Reaction for Schales and Schales / Mercurimetric titration for Cl-

Cl- + Hg(NO3)2 ---> HgCl2 + NO3-

27

Titrated in the mercurimetric titration/Schales and Schales method for Cl-

Diphenylcarbazone

28

RR for Cl- (Serum/plasma and urine)

Serum/plasma: 98-107 mmol/L
Urine: 110-250 mmol/day, varies with diet

29

Indicator if Cl- movement

Na+

30

Second most abundant anion in the ECF

Bicarbonate (HCO3-)

31

Composition of Total CO2

- Bicarbonate ion (HCO3-): 90%
- carbonic acid (H2CO3)
- dissolved CO2

32

Indicative of Total CO2 measurement

HCO3- measurement

33

Major component of the buffering system of blood

HCO3-

34

Reaction in the production of HCO3-

CO2 + H2O H2CO3 H+ + HCO3-

35

Is CO2 acidic or basic?

Acidic

36

Reabsorbs 85% of HCO3-

Proximal tubules

37

Reabsorbs 15% of HCO3-

Distal tubules

38

HCO3- is reabsorbed in the tubules as _______

CO2

39

Problem in alkalosis

Too much HCO3-

40

Remedy for alkalosis

Excrete HCO3-

41

Problem in Acidosis

Too much H+

42

Remedy for Acidosis

- excrete H+
- reabsorb HCO3-

43

HCO3- level in metabolic acidosis

Decreased

44

Response for metabolic acidosis

Hyperventilation

45

Total CO2 level in metabolic alkalosis

Increased

46

Response for metabolic alkalosis

Hypoventilation

47

3 causes of metabolic alkalosis

- severe vomiting
- hypokalemia
- excessive alkali intake

48

Specimens for HCO3- determnation

Serum
Plasma (lithium heparin)

ANAEROBIC (specimens should be capped)

49

Rate of decrease in CO2 if specimen is left uncapped

6 mmol/L/hr

50

HCO3- mtd; uses an acid reagent to convert all forms of CO2 to CO2 gas; uses pCO2 electrode

ISE

51

In the ISE mtd for HCO3-, all forms of CO2 is converted to _______

CO2 gas

52

Electrode used in ISE for HCO3-

pCO2 electrode

53

Reagent used in ISE for HCO3-

Acid reagent

54

HCO3- mtd; Sx is alkalinized to convert all forms of CO2 to HCO3-

Enzymatic mtd

55

In enzymatic mtd for HCO3-, all forms of CO2 is converted to ______

HCO3-

56

Reaction for Enzymatic mtd for HCO3-

1. Phosphoenolpyruvate (PEP) + HCO3- --PEP Carboxylase--> Oxaloacetate + H2PO4-

2. Oxaloacetate + NADH + H+ --MDH--> malate + NAD+

MDH: malate dehydrogenase

57

RR for HCO3- (plasma, serum)

CO2, venous 23-29 mmol/L