ELECTROLYTES Flashcards
(113 cards)
1
Q
Ions that are capable of carrying an electric charge
A
Electrolytes
2
Q
Fluid that is one third of the total body water
16 Liters
A
Extracellular fluid
3
Q
Fluid that is two thirds of the total body water
24 L
A
Intracellular fluid
4
Q
Major Extracellular Cation, hence the major contributor of Osmolality
A
Sodium
5
Q
Sodium’s plasma concentration depends greatly on the intake and excretion of __
A
Water
6
Q
Reference Value of Sodium
A
135 - 145 mmol/L
7
Q
Promotes absorption of sodium in the distal tubule
Promotes sodium retention and potassium excretion
A
Aldosterone
8
Q
Blocks aldosterone and renin secretion, and inhibits the action of angiotensin II and vasopressin
Causes Natriuresis
A
Atrial Natriuretic Factor (ANF)
9
Q
- Diabetes insipidus
- Renal tubular disorder
- Prolonged diarrhea
- Profuse sweating
- Severe burns
- Vomiting
- Fever
- Hyperventilation
A
Excess Water Loss
Hypernatremia
10
Q
- Hyperaldosteronism (Conn’s disease)
- Sodium bicarbonate infusion
- Increased oral or IV intake of NaCl
- Ingestion of sea water
A
Increased water intake or retention
Hypernatremia
11
Q
- Diuretic use
- Saline infusion
A
Increased Sodium loss
Hyponatremia
12
Q
- Renal failure
- Nephrotic syndrome
- Aldosterone deficiency
- Cancer
- Syndrome of Inappropriate ADH Secretion
- Hepatic cirrhosis
- Primary polydipsia
- CNS abnormalities
- Myxedema
A
Increased water retention
Hyponatremia
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
14
Q
Most common electrolyte disorder
Reduced plasma sodium concentration <135mmol/L
A
Hyponatremia
15
Q
Reduction in serum sodium concentration caused by a systematic error in measurements
A
Pseudohyponatremia
16
Q
Most common, yet not widely known cause of pseudohyponatremia is ___, a well known cause of pseudohyperkalemia
A
In Vitro Hemolysis
17
Q
- Serum Na - Low
- Urine Na - Low
- 24-hour Na - Low
- Urine Osmolality - Low
- Serum K - N/L
A
Overhydration
18
Q
- Serum Na - Low
- Urine Na - Low
- 24-hour Na - High
- Urine Osmolality - Low
- Serum K - Low
A
Diuretics
19
Q
- Serum Na - Low
- Urine Na - High
- 24-hour Na - High
- Urine Osmolality - High
- Serum K - N/L
A
SIADH
20
Q
- Serum Na - Mildly elevated
- Urine Na - Normal
- 24-hour Na - N/A
- Urine Osmolality - High
- Serum K - High
A
Adrenal Failure
21
Q
- Serum Na - Low
- Urine Na - Low
- 24-hour Na - High
- Urine Osmolality - Low
- Serum K - Low
A
Bartter’s Syndrome
22
Q
- Serum Na - Low
- Urine Na - Normal
- 24-hour Na - Normal
- Urine Osmolality - Normal
- Serum K - High
A
Diabetic Hyperosmolality
23
Q
Methods used for detection of Sodium levels:
A
- Emission Flame Photometry
- Ion Selective Electrode (Glass Aluminum silicate)
- Atomic Absorption Spectrophotometry
- Colorimetry
24
Q
Major Intracellular Cation
Single most important analyte in terms of abnormality being immediately life threatening
A
Potassium
25
Potassium has a concentration in the RBCs of ___ which is __x its concentration in plasma
105 mmol/L
23x
26
It is reabsorbed together with Na & Cl by the sodium potassium chloride cotransporter in:
Ascending limb of Henle's Loop
27
Reference Value of Potassium:
3.5 - 5.2 mmol/L
28
Reference Value of Potassium:
3.5 - 5.2 mmol/L
29
Plasma levels are ___ compared to serum levels because of the release of platelets into serum on clot formation
LOWER
30
1. Acute or Chronic Renal Failure
2. Severe Dehydration
3. Addison's Disease
Hyperkalemia due to
Decreased renal excretion
31
1. Acidosis
2. Muscle/Cellular injury
3. Chemotherapy
4. Vigorous exercise
5. Digitalis intoxication
Hyperkalemia due to
Extracellular shift
32
Other causes of Hyperkalemia:
Increased intake
Use of immunosuppressive drugs
33
1. Gastric suction & Laxative abuse
2. Intestinal tumor and malabsorption
3. Cancer and Radio therapy
4. Vomiting and Diarrhea
Hypokalemia due to
Gastrointestinal loss
34
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
Hypokalemia due to
Renal Loss
35
1. Alkalosis
2. Insulin Overdose
Hypokalemia due to
Intracellular Shift
36
Almost always due to impaired Renal Excretion
Hyperkalemia
37
Elevations in serum K can directly stimulate the adrenal cortex to release:
Aldosterone
38
Three major mechanisms of diminieshed renal potassium:
1. Reduced aldosterone
2. Renal Failure
3. Reduced distal dedlivery of sodium
39
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
Hyporeninemic Hypoaldosteronism
40
Reduced GFR and decreased tubular secretion causes accumulation of potassium (Mg, PO4) in plasma
Renal Failure
41
Plasma K levels of ___ is fatal and can cause cardiac arrest
10 mmol/L
42
Hyperkalemic drugs:
1. Captopril
2. Spironolactone
3. Digoxin
4. Cyclosporine
5. Heparin
43
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
Causes of Pseudohyperkalemia
44
Hpomagnesemia leads to ___ by promoting urinary loss of potassium
Hypokalemia
45
Most common cause of hypokalemia
Can be attributed to increased activity of aldosterone or other mineralocorticoid
Impaired Renal function or Renal Loss
46
___ is the most common cause of extra renal loss of potassium
Diarrhea
47
___ can cause falsely decrease potassium levels because K is taken up by WBC
Leukocytosis
48
Methods to measure Potassium levels
1. Emission Flame Photometry
2. Ion Selective Electrode (Valinomycin gel)
3. AAS
4. Colorimetry (Lockhead & Purcell)
49
Major Extracellular Anion
Chief counter ion of sodium in ECF
Promotes maintenance of water balance & osmotic pressure
Chloride
50
Only anion to serve as an enzyme activator
Chlorine
51
Reference Value of Chlorine
98 - 107 mmol/L
52
Indicator: Diphenylcarbazone
End: HgCl2 (Blue-Violet)
Mercurimetric Titration
**Schales & Schales**
53
Mercuric Thiocyanate (Reddish)
Ferric Perchlorate
Spectrophotometric Method
54
Cotlove Chloridometer
Coulometric Amperometric Titration
55
Most commonly used method for detecting Chloride levels:
Ion Selective Electrode
56
1. Renal Tubular Acidosis
2. Diabetes insipidus
3. Salicylate intoxication
4. Primary hyperparathyroidism
5. Metabolic acidosis
6. Prolonged diarrhea
Hyperchloremia
(>107 mmol/L)
57
1. Prolonged vomiting
2. Aldosterone deficiency
3. Metabolic Alkalosis
4. Salt-losing nephritis
Hypochloremia
(<98 mmol/L)
58
Present almost exclusively in the plasma
Involved in blood coagulation, enzyme activity, excitability of skeletal and cardiac muscle, and maintenance of blood pressure
Calcium
59
Calcium is maximally absorbed in the ___, the absorption is favored at an acidic pH
Duodenum
60
Reference Value of Total Calcium
1. Adult: 8.6-10 mg/dL
2. Child: 8.8-10.8 mg/dL
61
Reference Value for Ionized Calcium
1. Adult: 4.6-5.3 mg/dL
2. Child: 4.8-5.5 mg/dL
62
Hypocalcemia can be a consequence of reduced plasma ___
Albumin
63
Increases intestinal absorption of Calcium
Increases reabsorption in the kidneys
Increases mobilization of calcium from bones
1,25-Dihydroxycholecalciferol (1,25-(OH)2D3)
Activated Vit D3
64
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
Parathyroid Hormone
65
Secreted by the parafollicular C cells of the thyroid gland
Inhibits PTH & Vitamin D3
Inhibits bone resorption
Promotes urinary excretion of Calcium
Calcitonin
66
End Product: Oxalic Acid
Purple
| Calcium Methods
Clark Collip Precipitation
67
End: Chloranilic Acid
Purple
| Calcium Methods
Ferro Ham Chloranilic Acid Precipitation
68
Dye: Arzeno III
Mg inhibitor: 8-hydroxyquinoline (chelator)
| Calcium Methods
Ortho-Cresolphthalein Complexone Dyes
69
Reference Method for detection of Calcium levels:
Atomic Absorption Spectrophotometry
70
Other Methods for detecting Chloride levels:
EDTA Titration Method
Ion Selective Electrode (Liquid membrane)
Emission Flame Photometry
71
1. Primary Hyperparathyroidism
2. Cancer
3. Acidosis
4. Increased Vit D
5. Multiple Myeloma
6. Sarcoidosis
7. Hyperthyroidism
8. Milk-Alkali Syndrome
Hypercalcemia
**CHIMPS**
72
1. Alkalosis
2. Vitamin D deficiency
3. Primary Hypoparathyroidism
4. Acute Pancreatitis
5. Hypomagnesemia
6. Malabsorption Syndrome
7. Renal Tubular Failure
Hypocalcemia
**CHARD**
73
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+
Inorganic Phosphorus
74
Reference Value of Phosphorous
Adult: 2.7 - 4.5 mg/dL
Child: 4.5 - 5.5 mg/dL
75
Principal anion within cells
Organic Phosphate
76
Part of the blood buffer
Inorganic Phosphate
77
Decreases phosphate by renal excretion
Parathyroid Hormone
78
Inhibits bone resorption
Calcitonin
79
Increases phosphate renal absorption
Growth Hormone
80
Most commonly used method to measure serum inorganic phosphate
End: ammonium-molybdate complex (unstable)
Fiske Subbarow Method
Ammonium Molybdate Method
81
Most common reducing agent for Fiske Subbarow Method:
Pictol
Amino Naphthol Sulfonic Acid
82
1. Hypoparathyroidism
2. Renal Failure
3. Lymphoblastic leukemia
4. Hypervitaminosis D
Hyperphosphatemia
83
1. Alcohol Abuse (MCC)
2. Primary Hyperparathyroidism
3. Avitaminosis D (No Vit D)
4. Myxedema
Hypophosphatemia
84
Major cause of hypophosphatemia
Increase shift of phosphate into cells can deplete phosphate in the blood
Transcellular Shift
85
Intracellular cation second in abundance to potassium
4th most abundant cation in the body; enzyme activator
A Vasodilator and cause decrease uterine hyperactivity
Magnesium
86
Reference Value of Magnesium
1.2 - 2.1 mEq/L
87
Increases renal reabsorption of Magnesium
Increases intestinal absorption of Magnesium
Parathyroid Hormone
88
Increases renal excretion of Magnesium
Aldosterone & Thyroxine
89
1. Diabetic coma
2. Addison's disease
3. Chronic renal failure
4. Increased intake of antacids, enemas & cathartics
Hypermagnesemia
90
1. Acute renal failure
2. Malnutrition
3. Malabsorption Syndrome (Sprue)
4. Chronic Alcoholism
5. Severe diarrhea
Hypomagnesemia
91
End: Reddish-Violet complex
| Magnesium Methods
Calmagite Method
92
End: Colored complex
Formazen Dye Method
| Magnesium Method
93
End: Colored Complex
Magnesium Thymol Blue Method
| Magnesium Method
94
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
Bicarbonate
95
Specimen for Bicarbonate:
Blood anaerobically collected
96
Reference Value for Bicarbonate:
21-28 mEq/L
97
Difference between the unmeasured cations (Sodium & Potassium) and unmeasured anions (Chloride & Bicarbonate)
Anion Gap
98
Used to monitor recovery from diabetic ketoacidosis
Anion Gap (AG)
99
Anion Gap formula:
AG = Na - (Cl + HCO3)
AG = (Na + K) - (Cl + HCO3)
100
1. Uremia/ Renal Failure
2. Ketoacidosis
3. Poisoning by Methanol, Ethanol, Ethylene glycol, or Salicylate
4. Lactic Acidosis
5. Hypernatremia
6. Instrument Error
Increased Anion Gap
101
1. Hypoalbuminemia
2. Hypercalcemia
3. Hyperlipidemia
4. Elevated Myeloma proteins
Decreased Anion gap
102
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
Cystic Fibrosis
Mucoviscidosis
103
Diagnostic Test for Cystic Fibrosis
Sweat Test - Coulometry
| Increased Na & Cl
104
Positive result for Cystic Fibrosis for Pilocarpine Iontophoresis
(> 65 mmol/L) of sweat electrolytes
105
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
Iron
106
Reference Value of Iron:
Male: 50-160 ug/dL
Female: 45-150 ug/dL
107
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
Total Iron Binding Capacity (TIBC)
108
TIBC is a direct measure of the total number of functional ferrous ion-binding sites in ____
Transferrin
109
Reference Value of TIBC
Adult: 245-425 ug/dL
(>40 yrs old: 10-250 ug/dL)
Newborn & Child: 100-200 ug/dL
110
also known as: Transferrin saturation
Ratio of serum iron to TIBC
Percent Saturation
111
Normal Ratio of Percent Saturation
1:3
112
Lowest levels of Percent Saturation is seen in:
Iron Deficiency Anemia
113
Reference Value of % Saturation
20-50%
