ELECTROLYTES Flashcards
(85 cards)
1
Q
Electrolytes for Volume and Osmotic Regulation (3)
A
Potassium
Sodium
Chloride
2
Q
Cofactors in enzyme Regulation
A
Magnesium
Calcium
Zinc
3
Q
myocardial rythm and contractility electrolytes are:
A
Potassium
Calcium
Magnesium
4
Q
most abundant cation in plasma
A
sodium
5
Q
most abundant anion in plasma
A
chloride
6
Q
most abundant cation in extraacellular fluid
A
sodium
7
Q
second most abundant cation in intracellular fluid
A
magnesium
8
Q
most abundant anion in intracellular fluid
A
phosphate
9
Q
most abundant anion in extracellular fluid
A
chloride
10
Q
4% body weight is
A
Plasma
11
Q
physical property of a solution that is based the
concentration of solutes (expressed as mmol) per kg of solvent (w/w)
A
osmolality
12
Q
normal plasma osmolality
A
275-295mOsm/kg of
plasma water
13
Q
1-2% increase in osmolality causes fourfold ____ in ADH/AVP. (increase/decrease)
A
increase
14
Q
Excess intake of water ____ plasma
osmolality. (increase/lower)
A
lower
15
Q
Decreased osmolality is seen in:
a. Polydipsia
b. Dehydration
c. Hypercalcemia
A
a. Polydipsia
16
Q
Responds primarily to a
decreased blood volume
A
RAAS
17
Q
release from myocardial atria in response to
volume expansion, promotes sodium excretion in
the kidneys
A
Atrial natriuretic peptide
18
Q
Decrease in URINE osmolality is seen in:
a. Diabetes Mellitus
b. Diabetes Insipidus
c. SIADH
d. Hypovolemia
A
B. Diabetes I.
19
Q
Principal osmotic particle outside the cell
A
sodium
20
Q
Treshold critical level for hypernatremia
a. 150 mmol/L
b. 170 mmol/L
c. 160 mmol/L
d. 120 mmol/L
A
a. 150 mmol/L
b. 170 mmol/L
c. 160 mmol/L
d. 120 mmol/L
21
Q
reference value for sodium (ppt based)
a. 120-160 mmol/L
b. 145-155 mmol/L
c. 136-150 mmol/L
d. 135-145 mmol/L
A
a. 120-160 mmol/L
b. 145-155 mmol/L
c. 136-150 mmol/L
d. 135-145 mmol/L
22
Q
CSF value for sodium
A
a. 120-160 mmol/L
b. 145-155 mmol/L
c. 136-150 mmol/L
d. 135-145 mmol/L
23
Q
Sodium-potassium ATPase ion pump moves: _ sodium out of the cell and _ potassium into the cell
a. 3 sodium, 3 potassium
b. 2 sodium, 2 potassium
c. 2 sodium, 3 potassium
d. 3 sodium, 2 potassium
A
d. 3 sodium, 2 potassium
24
Q
mostly sodium rich foods are:
a. apple
b. kangkong
c. beef
A
a. apple
b. kangkong
c. beef
fruits: avocado, mango
25
The 2 hormones affecting sodium levels
Aldosterone and Atrial Natriuretic factor (ANF)
26
promotes **absorption of sodium** in the **distal tubules**, promotes **sodium retention** and potassium excretion
a. Aldosterone
b. ANF
Aldosterone
27
ANF is secreted in
cardiac atria
28
blocks aldosterone and renin secretion and inhibits the action of angiotensin II and vasopressin. causes **natriuresis**.
| the process of Na excretion in the urine through the action of kidneys
a. Aldosterone
**b. ANF**
29
can occur with decrease aldosterone production, less than 135 mmol/L plasma sodium concentration.
a. hypernatremia
b. hyponatremia
a. hypernatremia
**b. hyponatremia**
30
Increase sodium loss in urine can be attributed with:
a. Ketonuria
b. Cancer
c. Nephrotic syndrome
d. Myxdema
**a. Ketonuria**
b. Cancer
c. Nephrotic syndrome
d. Myxdema
31
Increase water retention can be attributed with:
a. Vomiting
b. Ketonuria
c. Congestive heart failure
d. Severe burns
a. Vomiting
b. Ketonuria
**c. Congestive heart failure**
d. Severe burns
32
when urine sodium is less than ____mmol/L water retention maybe result of nephrotic syndrome , hepatic cirrhosis, CHF.
a. 35
b. 40
c. 20
d. 25
a. 35
b. 40
**c. 20**
d. 25
33
is a group of symptoms that include **protein in
the urine**, **low blood protein levels** in the blood, high cholesterol levels, high triglyceride levels, and** swelling**.
Nephrotic syndrome
34
also called **underactive thyroid or low thyroid**.
a common disorder of the endocrine system in which the thyroid gland does not produce enough thyroid hormone
Myxedema
35
can occur in patient with
hyperproteinemia or hyperlipidemia
a. SIADH
b. Pseudohyponatremia
c. Pseudohypernatremia
d. Polydipsia
a. SIADH
**b. Pseudohyponatremia**
c. Pseudohypernatremia
d. Polydipsia
35
Water imbalance can occur as a result of all of these, except:
a. polydipsia
b. Syndrome of inappropriate ADH secretion ( SIADH)
c Pseudohyponatremia
d. Myxdema
a. polydipsia
b. Syndrome of inappropriate ADH secretion ( SIADH)
c Pseudohyponatremia
**d. Myxdema**
36
Hyponatremia: below ____mmol/L for 48 hrs
considered a medical emergency.
a. 130
b.140
c. 145
d. 120
a. 130
b.140
c. 145
**d. 120**
37
Treatment of hypinaytremia that is an AVP receptor antagonist
Conivaptan
38
is associated with SIADH, hypothyroidism and adrenal insufficiency
a. Euvolemic hypernatremia
b. Hypervolemic hyponatremia
a. Euvolemic hypernatremia
38
is associated with liver cirrhosis with ascites, CHF and overhydrated postoperative patients
a. Euvolemic hypernatremia
b. Hypervolemic hyponatremia
a. Euvolemic hypernatremia
**b. Hypervolemic hyponatremia**
38
Correcting severe hyponatremia **too rapidly **can cause ________.
a. cerebral myelinolysis
b. cerebral edema
**a. cerebral myelinolysis**
b. cerebral edema
38
Correcting severe hyponatremia **too slowly **can cause ________.
a. cerebral myelinolysis
b. cerebral edema
a. cerebral myelinolysis
**b. cerebral edema**
39
The following are causes of HYPERNATREMIA except:
a. Excess water loss
b. Decreased water intake
c. Increased sodium intake
d. Water imbalance
d. Water imbalance
39
**Increased sodium intake** can be attributed to the following except:
a. Conn's disease
b. Sodium bicorbonate infusion
c. Vomiting
d. Ingestion of sea water
c. Vomiting
39
Most common method for determination of sodium
ISE
39
For every **100 mg/dL increase** in blood glucose serum sodium **decreases** by ____ mmol/L.
a. 1.5
b. 1.7
c. 1.4
d. 1.6
d. 1.6
39
Sodium level of <____ mmol/L may result to severe
neuropsychiatric symptoms.
a. 155
b. 145
c. 135
d. 125
a. 155
b. 145
c. 135
**d. 125**
39
____ of sodium is used to distinguish between AKI and pre-renal azotemia.
Fractional excretion
40
FE of ____ suggest **pre-renal azotemia**
a. < 0.01
b. > 0.01
a. <0.01
41
FE of ____ suggest **AKI**
a. < 0.01
b. > 0.01
b. > 0.01
42
single most important analyte
Potassium
43
*Regulation of neuromuscular excitability* is a function of
a. Sodium
b. Potassium
Potassium
44
Reference value of Potassium
a. 1.5 - 7.5 mmol/L
b. 135 - 145 mmol/L
c. 3.5 - 5.1 mmol/L
d. 4.5 - 6.1 mmol/L
c. **3.5 - 5.1** mmol/L
45
is the **constant membrane potential** present in all living cells when they are **at rest** (i.e when they are not producing any electrical signal).
resting membrane potential (rmp)
46
leads to **fatal paralysis or cardiac arrhythmia**
a. hypokalemia
b. severe hypokalemia
c. hyperkalemia
d. severe hyperkalemia
**d. severe hyperkalemia**
47
described as **large impermeable negatively charged** intracellular molecules **attracting positively charged ions** (e. g.: Na+ and K+) and repelling negative ones (e. g.: Cl−).
a. Donnan effect
b. Membrane selectivity
c. Active Transport
a. Donnan effect
48
Active transport that involves **electrochemical gradient** and **not **involved in maintaining RMP.
a. Primary AT
b. Secondary AT
b. Secondary AT
49
is the difference of permeabilities between different ions.
a. Donnan effect
b. Membrane selectivity
c. Active Transport
b. Membrane selectivity
49
RMP of **skeletal muscles**
a. -95 mV
b. -50 mV
c. -80 to -90 mV
d. -70 mV
a. -95 mV
50
reabsorbs nearly all potassium
Proximal tubules
51
3R’s the **major mechanism of diminished renal potassium**
**excretion** except
1. Reduced aldosterone
2. Renal failure
3. Reduced distal delivery of sodium
4. Retained potassium
4. Retained potassium
52
a solute pump that pumps sodium out
of cells while pumping potassium into cells, both against their concentration gradients.
ATPase enzyme
53
is the first-line defense against hyperkalemia.
Insulin
54
mercumetric titration determination of chloride
a. schales and schales
b. ISE
c. AAS
**a. schales and schales**
b. ISE
c. AAS
55
urinary chloride is ____ mmol/L
a. 110-350
b. 110-300
c.100-200
d.110-250
a. 110-350
b. 110-300
c.100-200
**d.110-250**
56
used to screen cystic fibrosis
a. serum chloride
b. plasma chloride
c. sweat chloride
a. serum chloride
b. plasma chloride
**c. sweat chloride**
57
composes the **largest fraction of total CO2**
a. chloride
b. bicarbonate
c. sodium
**a. chloride**
b. bicarbonate
c. sodium
58
85% of bicarbonate is reabsorbed in the:
a. PCT
b. DCT
c. CD
**a. PCT**
b. DCT
c. CD
| 15% in DCT
59
Fourth most abundant cation in the body
a. Calcium
b. Potassium
c. Magnesium
Mg
60
Essential cofactor of more than 300 enzymes.
Also regulates movement of potassium across myocardium.
Mg
61
is the major renal regulatory site where 50-60% of filtered Mg2+ is reabsorbed in the ascending limb
LOH
62
Increase renal excretion of Mg
a. Aldosterone and thyroxin
b. Parathyroid hormone
c. Thyroid hormone
**a. Aldosterone and thyroxin**
b. Parathyroid hormone
c. Thyroid hormone
63
what anticoag should be avoided with Mg
a. citrate
b. edta
c. oxalate
d. heparin
a. citrate
b. edta
**c. oxalate**
d. heparin
64
combines with phosphate to form hydroxy-apatite crystals which provide strength to the bone
a. magnesium
b. calcium
c. chloride
a. magnesium
**b. calcium**
c. chloride
65
Increases the intestinal absorption of calcium as well as the reabsorption in the kidneys
1,25 dihydroxycholecalciferol/
Vitamin D
66
activates the process known as **bone resorption** in which activated osteoclast break down bone and release calcium into the ECF. **suppresses urinary loss of calcium.**
a. calcitonin
b. PTH
c. vitamin D
a. calcitonin
**b. PTH**
c. vitamin D
| Parathyroid hormone (PTH)
67
A thyroid hormone, secreted by the para-follicular C cells of the thyroid gland when the concentration of calcium in the blood increases.
a. calcitonin
b. PTH
c. vitamin D
**a. calcitonin**
b. PTH
c. vitamin D
| promotes urinary excretion of calcium, hypocalcemic hormone
68
Fasting is required in Phosphate. True or False.
True
69
is a by-product of an emergency mechanism that produces a small amount of ATP when oxygen is severely diminished.
useful for metabolic monitoring in **critically ill patients**
Lactate
70
is the major organ for removing lactate back to glucose by a process called gluconeogenesis
a. kidney
b. liver
c. lungs
a. kidney
**b. liver**
c. lungs
71
Tourniquet should not be used in lactate determination. True or false.
True
72
anticoag for lactate
a. oxalate
b. citrate
c. Iodoacetate and fluoride
a. oxalate
b. citrate
**c. Iodoacetate and fluoride**
73
the difference between unmeasured anions and unmeasured cations
anion gap
74
anion gap ref range
a. 9-10 mEq/L
b. 8-18 mEq/L
c. 7-17 mEq/L
a. 9-10 mEq/L
**b. 8-18 mEq/L**
c. 7-17 mEq/L
75
