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Chemistry! > Electrolytes > Flashcards

Electrolytes Flashcards

1
Q

what 8 things/processes are electrolytes an essential component of?

A

volume and osmotic regulation
myocardial rhythm
cofactor in enzyme activation
Regulation of ATP ion pumps
acid-base balance
blood coagulation
neuromuscular excitability
production of ATP from glucose

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2
Q

sodium is the major _______ _______. It determines the _______ of plasma, and it’s needed for ______ transport across the cell membrane.

A

sodium is the major extracellular cation. It determines the osmolality of plasma, and it’s needed for active transport across the cell membrane

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3
Q

regulation of sodium depends on what? What percent of sodium is reabsorbed?

A

regulation of sodium depends on intake and excretion of water

60 -75% of sodium reabsorbed. (Maintained by Cl- reabsorption or H+ secretion)

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4
Q

what are symptoms of hyponaturemia?

A

nausea, vomiting, muscle weakness, headache, lethargy, severe symptoms (seizures), coma, respiratory depression

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5
Q

what are three reasons for hyponatremia, and reasons for each of those?

A
  1. increased sodium loss
    - decreased aldosterone
    - diuretics
    - ketonuria
  2. increased water retention
    - renal failure
    - nephrotic syndrome
    - hepatic syndrome
    - CHF
  3. water imbalance
    - excess water intake
    - pseudohyponaturemia
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6
Q

what are symptoms of hypernatremia

A

CNS, altered mental state, lethargy, irritation, restlessness, muscle twitching, fever

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7
Q

what are three causes of hypernatremia

A
  1. excess water loss
    - diabetes insipidus
    - renal tubular disorder
    - prolonged diarrhea
    - severe burns
  2. decreased water intake
    - elderly and infants who cannot ask for water
  3. increased intake or retention
    - hyperaldosteronism
    - sodium bicarb excess
    - dialysis
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8
Q

what is the analysis method for sodium?

A

ion specific electrodes

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9
Q

what is the reference range for sodium?

A

136 - 145 mmol/L

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10
Q

Potassium is the major _______ _______. Why is there only 2% of the body’s K+ circulating in the plasma?

A

it’s the major intracellular cation

there’s only 2% because cellular functions require the body to maintain a low ECF concentration

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11
Q

what are four functions of potassium? How it is potassium regulated?

A

functions to regulate:
- neuromuscular excitability
- contraction of the heart
- intracellular volume
- H+ concentration

regulation:
- K+ absorbed, and then aldosterone causes K+ to be secreted into urine in exchange for Na+

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12
Q

hypokalemia symptoms and four general reasons for hypokalemia

A

symptoms: weakness, fatigue, constipation, (and paralysis)

reasons for hypokalemia
1. gastrointestinal loss
2. renal loss
3. cellular shift
4. dehydration

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13
Q

what are four reasons for gastrointestinal loss causing hypokalemia, and six reasons for renal loss causing hypokalemia?

A

GI loss:
1. vomiting/diarrhea
2. gastric suction
3. intestinal tumor
4. malabsorption’

Renal loss:
1. diuretics
2. nephritis
3. Cushing’s / hypoaldosteronism
4. hypomagnesemia
5. renal tubular acidosis
6. acute leukemia

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14
Q

what are two reasons for cellular shift as they relate to hypokalemia?

A

cellular shift:
- alkalosis
- insulin overdose

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15
Q

what are 4 symptoms of hyperkalemia? What are four general reasons for potassium decreases?

A

muscle weakness, tingling, numbness, and mental confusion

decreased renal excretion, cellular shift, increased intake, or artifact

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16
Q

what are three reasons for decreased renal excretion, cellular shift, and artifact as they relate to hyperkalemia?

A

decreased renal excretion:
1. acute or chronic renal failure
2. hypoaldosteronism
3. Addison’s disease (hypoadrenalcorticalism)

cellular shift:
1. acidosis
2. chemo
3. hemolysis

artifact:
1. sample hemolysis
2. thrombocytosis
3. prolonged tourniquet use during blood draw

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17
Q

what is the reference range for potassium?

A

3.5 - 5.1 mmol/L

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18
Q

Chloride is the major _______ ______. It maintains what three things?

A

it is the major extracellular anion/ It maintains osmolality, blood volume. and electroneutrality

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19
Q

After chloride is ingested and then absorbed in the intestine, anything left is reabsorbed where and with what? Excess chloride is excreted in what two places?

A

it’s reabsorbed in conjunction with sodium in the tubules

excess Cl- is excreted in the urine and sweat

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20
Q

what are five ways to have hypochloremia?

A

excessive loss from:
1. vomiting
2. diarrhea
3. diabetic ketoacidosis
4. aldosterone deficiency
5. pyelonephritis

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21
Q

what are two ways to have hyperchloremia?

A

excess loss of bicarbonate due to GI loss of metabolic acidosis

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22
Q

what is the reference range for chloride?

A

98 - 107 mmol/L

23
Q

bicarbonate is the _____ most common ____ in the ____ fluid

A

bicarbonate is the second most common anion in the extracellular fluid

24
Q

how does bicarb function is the major buffering component system in the blood?

A

bicarb diffuses out of the cell in exchange for chloride to maintain ionic charge neutrality within the cell

25
Q

how is bicarbonate regulated?

A

bicarbonate reabsorbed in tubules as CO2. In alkalosis (relative increase in bicarbonate), the kidneys increase excretion of HCO3- into urine carrying along a cation

during compensation for acidosis, the body will reabsorb more than 90% of bicarbonate to make the blood more alkaline

26
Q

what is the measurement system for measuring bicarbonate?

A

blood gas testing vie co-oximetry measurement of CO2

27
Q

what is the reference range for bicarbonate

A

22 - 29 (22-33??) mmol/L

28
Q

what two ways is calcium found in the blood?

A

it’s in the blood either
- free (active form)
- bound to a protein (albumin) or anion (bicarbonate)

(Ca2+ conc. more in blood than smooth muscle)

29
Q

decreased ionized calcium impairs _____ function, so you have to maintain normal concentration during ____ and critically ill patients

A

impairs myocardial function

maintain normal Ca2+ levels during surgery

30
Q

what three things regulate serum calcium

A

parathyroid hormone (PTH), vitamin D, and calcitonin

31
Q

what three body parts play a role in calcium homeostasis?

A

the intestines, bones, and kidneys

32
Q

what are two symptoms of hypocalcemia?

A

neuromuscular irritability and cardiac irregularities

33
Q

what are five ways to develop hypocalcemia

A
  1. primary hypoparathyroidism
  2. vit D deficiency
  3. hypo/hypermagnesemia
  4. acute pancreatitis
  5. renal disease
34
Q

what are 7 different symptoms of hypercalcemia?

A
  1. drowsiness
  2. weakness
  3. depression
  4. lethargy
  5. coma
  6. anorexia
  7. ulcers
35
Q

what are four ways to develop hypercalcemia?

A
  1. primary hyperparathyroidism
  2. increased vit D
  3. malignancy
  4. multiple myeloma
36
Q

magnesium is mostly found in what four places? 1% of it is found where?

A

mostly found in
1. bone
2. muscle
3. organ tissue
4. soft tissue

1% found in serum where 1/3 of it is bound to albumin

37
Q

magnesium is a cofactor for what 8 enzyme functions?

A
  1. glycolysis
  2. transcellular ion transport
  3. neuromuscular transmission
    4 - 7. carb, proteins, nucleic acids, lipid synthesis
  4. release of/ response to certain hormones
38
Q

Where and how is magnesium regulated?

A

Mg2+ controlled by the kidneys, which either reabsorb magnesium during deficiency (30% by proximal tubule) or excrete it in excess

Henle’s loop is major regulation site

39
Q

What hormone is responsible for magnesium regulation, and how?

A

PTH increases in reabsorption of MG2+ and enhances absorption in the intestine

40
Q

what four bodily states can be affected by hypomagnesemia?

A

cardiovascular, neuromuscular, psychiatric, and metabolic

41
Q

what are 7 symptoms of hypomagnesemia?

A
  1. arrhythmias
  2. cramps
  3. seizures
  4. paralysis
  5. coma
  6. depression
  7. psychosis
42
Q

what are four general ways to be magnesium deficient?

A
  1. increased excretion
  2. decreased absorption
  3. reduced intake (poor diet)
  4. other (chronic alcoholism)
43
Q

what are specific ways increased excretion can result in hypomagnesemia?

A

renal: tubular disorders

endocrine: hyper-
- (para)thyroidism
- aldosteronism
- calcemia
and diabetic ketoacidosis

drug-induced: diuretics, antibiotics, cyclosporine

44
Q

what are decreased absorption causes of hypomagnesemia?

A

surgical resection of small intestine, pancreatitis, vomiting/diarrhea, and laxative abuse

45
Q

what are eight symptoms of hypermagnesemia

A

bradycardia, heart block, skin flushing, increased skin temp, nausea, vomiting lethargy, coma

46
Q

what are three general reasons for hypermagnesemia?

A

decreased excretion, increased intake, and miscellaneous

47
Q

what are four specific reasons for decreased exertion leading to hypermagnesemia

A
  1. acute/chronic renal failure
  2. hypothyroidism
  3. hypoaldosteronism
  4. decreased growth hormone
48
Q

what three things cannot be used for magnesium analysis?

A

oxalate, citrate, and EDTA

49
Q

Phosphate is found everywhere in living cells. Phosphate participates in most important biochemical processes such as ______, _____, and _____

A

DNA/RNA, enzymes, ATP

50
Q

what four things regulate phosphate in the body?

A
  1. absorbed through diet, released from blood, or lost from bone
  2. PTH lowers phosphate blood concentration (by increasing renal excretion)
  3. via D increases phosphate in blood
  4. growth hormone
51
Q

what are seven reasons for hypophosphatemia?

A
  1. diabetic ketoacidosis
  2. chronic obstructive pulmonary disease
  3. asthma
  4. malignancy
  5. inflammatory bowel disease
  6. anorexia nervosa
  7. alcoholism
52
Q

six reasons for hyperphosphatemia

A

renal disease, increased intake, intense exercise, infections, neoplasm disorders, intravascular hemolysis

53
Q

there is a ______ mortality rate associated with hypophosphatemia?

A

high

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