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Electrolytes Flashcards

1
Q

Electrolytes for Volume and Osmolality

A

Na
Cl
K

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2
Q

Electrolyte for Myocardial Rhythm and Contractility

A

Na
Ca
Mg

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3
Q

Cofactors

A

Mg
Ca
Zn

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4
Q

Acid Base Balance

A

K
Cl
HCO3

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5
Q

Blood Coagulation

A

Ca

Mg

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6
Q

Neuromuscular excitability

A

K
Ca
Mg

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7
Q

Anions (-) are _________ charge that migrates toward the _________

A

Negatively charge; Anode (+ electrical field)

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8
Q

Cations are __________ charge that migrates toward the __________

A

Positively charge; Cathode (- electrical field)

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9
Q

Based on the concentration of solutes

A

Osmolality

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10
Q

Colligative Properties of Osmolality

A

Boiling Point
Freezing Point
Osmotic Pressure
Vapor Pressure

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11
Q

Increase Osmolality: Increase ___________, _________

A

Increase Boiling point; Increase Osmotic Pressure

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12
Q

Increase Osmolality: Decrease __________, _________

A

Decrease Freezing Point; Decrease Vapor Pressure

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13
Q

A _________ increase in osmolality causes a ___________ increase of ADH

A

A 1-2% increase in osmolality causes a fourfold increase of ADH

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14
Q

A 1-2% decrease in osmolality, ________ the release of ADH

A

A 1-2% decrease in osmolality, inhibits/shuts down the release of ADH

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15
Q

Other name for ADH

A

AVP - Arginine Vasopressin Hormone

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16
Q

AVP increases the reabsorption of ________ that acts on the ___________ of the kidneys

A

AVP increases the reabsorption of water that acts on the collecting duct of the kidneys

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17
Q

Deficit in water will increase _____________

A

plasma osmolality

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18
Q

______is the major defense against Hyperosmolality and Hypernatremia

A

Thirst

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19
Q

Maintains Blood Pressure and Blood Volume

A

Na & H2O

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20
Q

A system that responds to primarily to a decreased blood volume or pressure

A

RAAS - Renin Angiotensin Aldosterone System

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21
Q

Substance - Organ - Conversion/Effect

Renin: _______ = Angiotensinogen - Angiotensin I
_____: Lungs = ________________________
Aldosterone: _______ = Increase ____ reabsorption
____: Posterior Pituitary = Increase water reabsorption in Kidneys + ______ sensation

A

Renin: Kidneys (juxtaglomerular cells) = Angiotensinogen - Angiotensin I
ACE: Lungs = Angiotensin I - Angiotensin II
Aldosterone: Adrenal cortex = Increase K reabsorption
ADH: Posterior Pituitary = Increase water reabsorption in Kidneys + Thirst sensation

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22
Q

Major EXTRAcellular CATion (90%)

A

Na - Sodium

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23
Q

Major Function of Na

A

Osmolality

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24
Q

Osmolality Formula

A

2 (Sodium (mmol/L) + Glucose mg/dL/18 + BUN/2.8

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25
This diuretic promote or induces sodium and potassium loss without interfering ADH
Thiazide
26
Countercurrent ion of K
Na - sodium
27
Counterion of Cl
Na - Sodium
28
Major hormone that regulate sodium retention and potassium excretion
Aldosterone
29
Promote Natriuresis
ANP - Atrial Natriuretic Peptide
30
Function of ANP
Inhibit RAAS Promote Natriuresis Anti Hypertensive agent
31
Critical values Hypernatremia: __________ Hyponatremia: __________
Hypernatremia: >160 mmol/L Hyponatremia: <120 mmol/L
32
Counterion of Na: _____ Countercurrent ion of Na: ____ Counterbalance of Na: ____
Counterion of Na: Cl Countercurrent ion of Na: K Counterbalance of Na: Cl
33
Most Routine Method of Electrolyte Measurement
Ion Selective Electrode
34
Membrane Electrode of Na
Glass Aluminum Silicate
35
FEP: Flame Color - Na+
Yellow
36
Colorimetric Method - Sodium
Albenese Lein
37
Cause of Hypernatremia
``` Diabetes Insipidus Diarrhea Severe Burns Excess water loss Decrease water intake ```
38
Cause of Hyponatremia
``` Diabetes Mellitus SIADH K deificiency Addisons disease Increased water intake Vomiting Diarrhea ```
39
Potassium is also know as __________
"Kalium"
40
Major INTRAcellular CATION
Potassium
41
Reabsorption of all K
PCT
42
Principal determinant of Potassium urinary excretion
Distal Convoluted Tubule
43
Part of the Nephron which secretion of K occurs regulated by aldosterone
DCT and CD
44
Hormone responsible for K excretion
Aldosterone
45
Causes of Hypokalemia
``` GI Loss - Vomiting, Diarrhea, Malabsorption Renal Tubular Acidosis Alkalosis Insulin Overdose Hyperaldestronism Hypomagnesemia Intestinal tumor Diuretics ```
46
Causes of Hyperkalemia
``` Type I DM Hypoaldosteronism - Addison's disease Acidosis Renal Insufficiency Leukemia - Chemotherapy Diuretics Oral - IV Replacement Hemolysis Thrombosis Prolonged Tourniquet application - Fist Clenching ```
47
FEP - Flame Color of Na
Violet
48
ISE Membrane of Sodium
Valinomycin Gel
49
Colorimetric Method of K
Lockhead and Purcell
50
Threshold Value - Critical Hyperkalemia: _________ Hypokalemia: _________
Hyperkalemia: 6.5 mml/L Hypokalemia: 2.5 mmol/L
51
Couterion of K: Counter current ion of K: Counter Balance of K:
Couterion of K: Phosphate Counter current ion of K: Na Counter Balance of K: Magnesium
52
K Value: Less muscle Excitability
8.0 mmol/L
53
K Value: Cardiac Arrest
10.0 mmol/L
54
K Value: Arrythmias and Paralysis
3.0 - 3.4 mmol/L
55
Major EXTRAcellular ANION
Chloride
56
_____ is the only ANION to serve as Enzyme Activator
Chloride
57
Chloride Shift
Exchange between Cl and HCO3- across the membrane of RBCs
58
Counterion of Cl: Countercurrent ion of Cl: Counter pH balance of Chloride:
Counterion of Cl: Na Countercurrent ion of Cl: Phosphate Counter pH balance of Chloride: HCO3-
59
Excessive sweating stimulates _____________ secretion to conserve Na and Cl in the sweat glands
Aldosterone
60
Two ways how CL maintain Electroneutrality 1. ____________ 2. ___________
1. Reabsorption in PCT acting as a Rate liming factor of Na | 2. Chloride Shift
61
Causes of Hyperchloremia
Diabetes Insipidus Metabolic Acidosis RTA Increase HCO3- loss
62
Causes of Hypochloremia
``` High Serum HCO3 Addison's disease Prolonged Vomiting Salt losing (Pyelonephritis) Alkalosis ```
63
Mercuric Titration is also known as ___________
Schales and Schales Method
64
Indicator used in Schales and Schales Method
Diphenylcarbozene
65
Schales and Schales Method End Color
Blue Violet
66
Mercuric Titration - Schales & Schales Method Indicator: ______________ End Color: _____________ End Product: ___________
Indicator: Diphenylcarbazone End Color: Blue Violet End Product: Mercuric Chloride
67
Reagent used in Spectrophotometric Analysis of Chloride
Mercuric thiocyanate & Ferric Ion
68
End Color - Spectrophotometric Analysis of Chloride
Red Color Complex
69
Principle in Coulometric Amperometric Titration
Catlove Chloridometer
70
ISE membrane of Chloride
Tri-n-acetylpropyl ammonium chloride decanol
71
Essential in Myocardial Contraction
Ca
72
Most predominant Ca Form
Ionized (active) Calcium
73
Functions of Ca
Blood Coagulation Cofactor Myocardial Contraction
74
Regulates Ca Levels
Vit. D3 - 1, 25 - dihydroxycholecalciferol Parathyroid hormone Calcitonin
75
Vitamin D3 increases __________ & ________ reabsorption of Calcium
Intestinal & Renal
76
Calcium Metabolism and Activation Skin: 7 dehydrocholeserol -------- _________ ------- Vit. D (cholecalciferol) ____: Vit. D ------------ _____________ Kidney: 25, hydroxycholecalciferol -------- __________ --------- 1, 25 - hydroxycholecalciferol
Calcium Metabolism and Activation Skin: 7 dehydrocholeserol -------- UV Light ------- Vit. D (cholecalciferol) Liver: Vit. D ------------ 25, hydroxycholecalciferol Kidney: 25, hydroxycholecalciferol -------- 1a - hydroxylase --------- 1, 25 - hydroxycholecalciferol
77
____ stimulates the release of 1a - hydroxylase to activate Vit. D3
PTH
78
Target Organs of PTH
Bone - Inc. Bone resorption Kidneys - Inc. Ca reabsorption and HPO4 excretion Small Intestines - activation of 1a hydroxylase
79
Hypercalcemic Agents
PTH | Vit. D3
80
Hypocalcemic Agemt
Calcitonin
81
Secreted by parafollicular cells of the thyroid gland to lower calcium level
Calcitonin
82
Function of Cacitonin
Inhibit: PTH Vit. D3 Bone resorption
83
Causes of Hypercalcemia
``` Primary Hyperparathyroidism Hyperthyroidism Increase Vitamin D Multiple Myeloma Malignancy - Cancer Sarcoidism ```
84
Causes of Hypocalcemia
``` Primary Hypoparathyroidism Severe Hypomagnesemia Vit. D Deficiency Renal Disease Alkalosis ```
85
Reference Method: Ca Analysis
AAS - Atomic Absorption Spectrophotometry
86
ISE Membrane - Calcium
Organic Liquid Membrane
87
Precipitation & Redox Reaction Method - End Product - End Color Clark Colip: ____________ - ___________ Ferro Ham: ____________ - ___________
Clark Colip: Oxalic Acid - VIOLET | Ferro Ham: Chloranilic Acid - VIOLET
88
Colorimetric Method of Calcium Analysis
Ortho-cresolphthalein Complexone
89
Dye used in Ortho-cresolphthalein
Arsenzo III
90
End color: Ortho-cresolphthalein (Colorimetry)
Red Complex
91
FEP - Calcium
Orange
92
Electrolyte that is is inversely related to Calcium
Phosphorus
93
Only phosphorus that is MEASURED in the laboratory
Inorganic Phosphorus
94
ONLY ELECTROLYTE THAT REQUIRE FASTING
Phosphorus
95
Most common Method - Phosphorus
Fiske and Subbarow Method
96
Most Common reducing agent
PICTOL
97
End Product - Fiske Subbarow Method
Ammonium molybdate BLUE complex
98
Fiske & Subbarow Method Rgt: _______________ Reducing agent: ______________ End product: ______________
Fiske & Subbarow Method Rgt: Ammonium Molybdate Reducing agent: PICTOL End product: Ammonium molybdate blue complex
99
Causes of Hyperphosphatemia
Hypoparathyroidism Increased Vit. D Renal Failure Lymphoblastic Leukemia
100
Causes of Hypokalemia
``` Hyperparathyroidism Low Vit. D Ketoacidosis Alcohol abuse Infusion of dextrose solution Use of Antacids ```
101
Effect of PTH to PO4-
Increase renal excretion of PO4
102
Major regulating factor of PO4-
PTH
103
4th most abundant cation; 2nd most abundant intracellular cation
Mg2+
104
Major reabsorption site of Mg in kidneys
Ascending loop of Henle
105
__________ increases the intestinal and renal reabsorption of Mg2+
PTH
106
Increases Renal Excretion of Mg
Aldosterone and Thyroxine
107
Colorimetric Method: Mg2+ Calmagite: ____________ Formazen dye: ___________ Methylthymol blue: ________
Colorimetric Method: Mg2+ Calmagite: Reddish-violet Formazen dye: Dark Blue Methylthymol blue: Blue
108
Reference Method - Mg2+
AAS
109
Cause of Hypermagnesemia
Hypoaldosteronism Hypothyroidism Hypopituitarism Diabetes MellitusAcute/Chronic Renal Failure
110
Cause of Hypomagnesemia
``` Hyperthyroidism Hyperaldosteronism Hyperparathyroidism Malnutrition Pancreatitis Tetany ```
111
Mg2+ value which life threatening values occur: ______ mmol/L
5 mmol/L
112
The difference of unmeasured cation and unmeasured anion
Anion gap
113
Anion gap is also a form of ____________ to the analyzer used to measure its analytes
Quality control
114
Anion Gap Total unmeasured Cations: _________________ Total unmeasured Anions: _________________
Anion Gap Total unmeasured Cations: Na, K Total unmeasured Anions: Cl, HCO3-
115
Increased Anion Gap | Mnemonics: MUDPILES
``` Methanol Uremia Diabetic Ketoacidosis Paracetamol Isothiazine Lactic Acid Ethanol/Ethylene glycol Salicylate/Sialic acid ```
116
Anion Gap Formula
``` AG = Na - (Cl + HCO3-) AG = (Na + K) - (Cl = HCO3-) ```

Clinical Chemistry (20 decks)

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