Electrolytes Flashcards
(86 cards)
1
Q
Thyroid gland begins to produce at what week of gestation
A
11 weeks
2
Q
butterfly shaped gland
A
thyroid gland
3
Q
thyroid lobes are connected by a narrow band called
A
isthmus
4
Q
fundamental structural unit of thyroid gland
A
follicleis
5
Q
follicular cells produces
A
T3 and T4
6
Q
parafollicular cells produces
A
calcitonin
7
Q
glycoprotein stored at follicular colloid of the thyroid gland
A
thyroglobulin
8
Q
most important element of thyroid hormones
A
iodine
9
Q
Major extracellular cation
A
sodium
10
Q
reference value of Na
A
135-145 mmol/L
11
Q
Thresehold crit value of Na
A
160 mmol/L - hypernatremia
120 mmol/L - hyponatremia
12
Q
CSF sodium value:
A
136-150 mmol/L
13
Q
Hormones affecting Sodium levels:
A
Aldosterone
Atrial Natriuretic Factor (ANF)
14
Q
Promotes absorption of calcul in distal tubule; excretion of potassium
A
Aldosterone
15
Q
Endogenous antihypertensive agent excreted from the cardiac atria
Blocks aldosterone and renin secretion, and inhibits the action of angiotensin II and vasopressin
Natriuresis
A
Atrial Natriuretic Factor (ANF)
16
Q
- Excess water loss
a. Diabetes insipidus
b. Renal tubular disorder
c. Prolonged diarrhea
d. Profuse sweating
e. Severe burns
f. Vomiting
g. Fever
h. Hyperventilation - Decreased water intake
- Increased water intake or retention
a. Hyperaldosteronism (Conn’s disease)
b. Sodium bicarbonate infusion
c. Increased oral or IV intake of NaCl
d. Ingestion of sea water
A
Hypernatremia
17
Q
- Increased sodium loss
a. Diuretic use
b. Saline infusion - Increased water retention
a. Renal failure
b. Nephrotic syndrome
c. Aldosterone deficiency
d. Cancer
e. Syndrome of Inappropriate ADH Secretion (SIADH)
f. Hepatic cirrhosis
g. Primary polydipsia
h. CNS abnormalities - meningitis, encephalitis, multiple sclerosis
A
Hyponatremia
18
Q
pseudohyperkalemia
reduction in serium sodium concentration caused by systematic error in measurement
A
Pseudohyponatremia
19
Q
also associated with hyperlipidemia or hyperproteinemia — decrease
sodium is due to excess retention of water in the collecting ducts.
A
Artifactual hyponatremia
20
Q
Serum Na Low
Urine Na Low
24-hour UNa Low
Urine osmolality Low
Serum K Normal or low
A
Overhydration
21
Q
Serum Na Low
Urine Na Low
24-hour UNa High
Urine osmolality Low
Serum K low
A
Diuretics
22
Q
Serum Na Low
Urine Na high
24-hour UNa high
Urine osmolality high
Serum K Normal or low
A
SIADH
23
Q
Serum Na Low
Urine Na low
24-hour UNa high
Urine osmolality normal
Serum K high
A
Bartter’s syndrome
24
Q
Serum Na Low
Urine Na Normal
24-hour UNa Normal
Urine osmolality Normal
Serum K High
A
Diabetic hyperosmolarity
25
Quantity of a substance excreted in the urine expressed as a
fraction of the filtered load of the same substance.
Distinguish between acute tubular and prerenal azotemia
Fractional excretion (FE)
26
Methods for Sodium detection (ICE A)
Ion Selective Electrode- Glass aluminum silicate - most common
Colorimetry - albanese lein
Emission of flame photometry
AAS
27
Methods for Sodium detection (ICE A)
Ion Selective Electrode- Glass aluminum silicate - most common
Colorimetry - albanese lein
Emission Flame Photometry
28
Major intracellular cation
Potassium
29
Threshold critical value of potassium:
6.5 mmol/L (hyperkalemia)
2.5 mmol/L (hypokalemia)
30
1. Decreased renal excretion
a. Acute or chronic renal failure
b. Severe dehydration
c. Addison's disease
Hyperkalemia
31
2. Extracullur shift
a. Acidosis
b. Muscle/cellular injury
c. Chemotherapy
d. Vigorous exercise
e. Digitalis intoxication
Hyperkalemia
32
3. Increased intake — oral or IV infusion
4. Use of immunosuppressive drugs
- tacrolimus and cyclosporine
Hyperkalemia
33
1. Gastrointestina loss
a. Gastric suction and laxative abuse
b. Intestinal tumor and malabsorption
c. Cancer and radio therapy
d. Vomitting and diarrhea
Hypokalemia
34
2. Renal loss
a. Diuretics use (thiazides)
b. Hyperaldosteronism
c. Cushing syndrome
d. Leukemia
e. Bartter's syndrome
f. Gitelman's syndrome
g. Liddle's syndrome
h.Malignant hypertension
Hypokalemia
35
3. Intracelluiar shift — alkalosis and insulin overdose
Hypokalemia
36
Three major mechanism of diminished renal potassium excretion
Reduced aldosterone
Renal Faiure
37
Three major mechanism of diminished renal potassium excretion
Reduced aldosterone
Renal Failure
Reduced distal delivery of sodium
38
Most common cause of chronic hyperkalemia due to impaired renal excretion of potassium
hyporeninemic hypoaldosteronism
39
Reduced GFR and decreased tubular secretion uses accumulation of
potassium
40
Causes: sample hemolysis, thrombocytosis,
prolonged tourniquet
application, fist clenching,
blood stored in ice,
IV fluid and high blast counts in acute or accelerated phase leukemias (blast
may lyse during standard phlebotomy releasing K+)
Pseudohyperkalemia
41
Thrombocytosis and severe leukocytosis cause ______ release from the platelets
potassium
42
Hypomagnesemia also leads to
hypokalemia
43
Hypomagnesemia also leads to
hypokalemia
44
Methods for Potassium measurement:
Emission flame photometry
Ion selective Electrode (Valinomycin gel)
Atomic absorption spectrophotometry
45
Methods for Potassium measurement:
Emission flame photometry
Ion selective Electrode (Valinomycin gel)
Atomic absorption spectrophotometry
Colorimetry (Lockhead and purcell)
46
________- is preferred over serum due to potassium released during blood clotting
Heparinized plasma
47
Major extracellular cation; counter ion of sodium
chloride
48
Marked hemolysis in chloride shows:
decreased levels
49
High HCO3 levles shows:______ chloride
low serum values
50
Method for detecting chloride
Mercurimetric titration (Schales and Schales)
Spectrophotometric
Colorimetric Amperometric Titration
51
end point color of schales and schales
HgCl2: BLUE VIOLET
52
Dipheny;carazone is in schales and schales
indicator
53
Indicator for schales and schales
Diphenylacarbazone
54
Spectrophotometric method for chloride
Mercurin thiocyanite (whitehorn titration method)
Ferric perchlorate
55
Whitehorn titration method = chloride forms
reddish complexion
56
Ferric perchlorate produces
colored complex
57
Colorimetric amperometric titration in chloride
Cotlove chloridometer
58
Ion selective electrode uses
tri-n-octylpropylammononium chloride
59
Most commonly used for detecting chloride
Ion Selective Electrode
60
Hypochloremia
1. Prolonged vomitting
2. Aldosterone deficiency
3. Metabolic alkalosis
4. Salt-!osing nephritis
Hypochloremia
61
1. Renal tubular acidosis
2. Diabetes insipidus
3. Salicylate intoxication
4. Primary hyperparathyroidism
5. Metabolic acidosis
6. Prolonged diarrhea
Hyperchloremia
62
Present almost exclusively in plasma
Calcium
63
involved in blood coagulation, enzyme activity, excitability of skeletal and cardiac muscle, and
maintenance of blood pressure.
maximally absorbed in the duodenum - the absorption is favored at an acidic PH
Calcium
64
Forms of Calcium:
1. Ionized(active) Calcium = 50 %
2. Protein-bound Calcium = 40 %
3. Complexed with anions = 10 %
65
It increases intestinal absorption of calcium.
It increases reabsorption in the kidneys.
It increases mobilization of calcium from bones.
1,25 Dihydroxycholecalciferol [1,25-(OH)2-D3]
66
conserves calcium by increasing reabsorption in the kidneys.
increases the level by mobilizing bone calcium.
activates the process of bone resorption.
suppresses urinary loss of calcium.
stimulates the conversion of inactive vitamin D to active vitamin D3 in the kidneys.
PTH
67
thyroid hormone, secreted by the parafollicular C cells of the thyroid gland.
It inhibits PTH and vitamin - hypocalcemic hormone.
It inhibits bone resorption.
It promotes urinary excretion of calcium.
calcitonin
68
Method for detecting calcium
Precipitation and redox titration
Ortho-cresolpthalein Complexone Dyes (colorimetric method)
EDTA titration method (BAchara, Dawer, and Sobel)
Ion selective electrode (liquid-membrane)
Atomic Absorption Specreophotometry - reference method
Emission Flame Photometry
69
Clark colli precipitation end product (Calcium)
Oxcalic acid (purple color)
70
Ferro ham chloranillic acid end product (calcium)
Chloranillic acid (purple color)
71
Ortho-Creolpthalein Complexone dyes
Arzeno III
72
Mg inhibitor of calcium
8- hydroxyquinoline (chelator)
73
Calcium
1. Alkalosis
2. Vitamin D deficiency
3. Primary hypoparathyroidism
4. Acute pancreatitis
5. Hypomagnesemia
6. Malabsorption Syndrome
7. Renal tubular failure
Hypocalcemia
74
Causes of hypercalcemia: CHIMPS
Cancer, Hyperthyroidism, Iatrogenic causes, Multiple myeloma, Hyperparathyroidism, and sarcoidosis)
75
Causes of Hypocalcemia: CHARD
Calcitonin, Hypoparathyroidism, Alkalosis, Renal failure, vit D deficiency
76
Inorganic phosphorus methods
Fiske subbarow method (Ammonium molybdate method)
77
Fiske Subarrow method most common reducing agent
pictol (amino napthol sulfonic acid)
78
Other reducing agent for Fiske subarrow
Elon, ascorbic acid, senidine
methyl amino phenol, n-phenyl-p-phenyline diamine hydrochloride)
79
end product of Fiske and Subarrow
unstable ammonium molybdate complex
80
Most accurate measurement of inorganic phosphorus
unreduced complex at 340 nm
81
Methods for detecting Magnesium
Colorimetric method (calmagite, formazen, magnesium thymol blue)
Atomic absorption Spectrophotometry
Dye Lake Method - titan Yellow dye
82
Color produced from calmagite method (magnesium)
reddish violet
83
Color produced from formazen dye method and magnesium thymol blue method
colored complex
84
Reference method for Mg
AAS
85
Bicarobonate method of detection
Ion selective electrode (pCO2 electrode)
Enzymatic (phophoenolpyruvate carboxylase and dehydrogenase)
86
Reference value of bicarbonate
21-28 mEq/L
