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Clinical Chemistry (ciulla 4th Edition) > Electrolytes > Flashcards

Electrolytes Flashcards

0
Q

What are cations?

A

Positively charged ion

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1
Q

What are electrolytes?

A

Charged ions found in extra/inter cellular and interstitial fluid

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2
Q

Major cations in the body? (4)

A

Sodium, Potassium, Calcium and Magnesium

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3
Q

What are anions?

A

Negatively charged ions

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4
Q

What are the major anions found within the body? (6)

A

Chloride, phosphate, bicarbonate, sulfate, protein and organic acids

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5
Q

clinically, what electrolytes are often measured?

A

Sodium, potassium, chloride and total carbon dioxide or bicarbonate

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6
Q

What method is used to measure electrolytes such as sodium potassium chloride and bicarbonate?

A

Ion selective electrode

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7
Q

Major cation of extra cellular fluid

A

Sodium

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8
Q

Reference range for sodium

A

136-145 mmol/liter

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9
Q

Changes in sodium results in a change in what

A

Plasma volume

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10
Q

Largest contributor for plasma osmolality

A

Sodium

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11
Q

Renal threshold value for sodium

A

110-130mmol/liter

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12
Q

Condition when serum sodium is below 135mmol/liter

A

Hyponatremia

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13
Q

Two types of hyponatremia

A

Delpletional and dilutional

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14
Q

Depletional hyponatremia occurs in

A

Diarrhea, vomiting, severe burns/trauma hypoaldosteronism or Addison’s disease, diuretics

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15
Q

What are the causes of dilutional hyponatremia

A

Over rehydration, syndrome of inappropriate anti diuretic hormone ( SIADH), congestive heart failure, cirrhosis and nephrotic syndrome

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16
Q

Condition when serum sodium is above 150mmol/liter

A

Hypernatremia

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17
Q

When does hypernatremia occur

A

Diarrhea, excessive sweating, diabetes insipidus, hyperaldosteronism, iv infusion, ingestion

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18
Q

Major intracellular cation

A

Potassium

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19
Q

Reference range for potassium

A

3.4-5.0

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20
Q

Level of potassium when specimen is hemolysis

A

Increased

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21
Q

Condition when potassium is below 3.0mmol/liter

A

Hypokalemia

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22
Q

Hypokalemia occurs in

A

Decreased intake, hyperaldosteronism, diuretics, vomiting, diarrhea, laxative abuse, excess insulin

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23
Q

Condition where potassium level is greater than 5.0 mmol/liter

A

Hyperkalemia

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24
Q

What are the causes of hyperkalemia

A

Increased intake, hypoaldosteronism, metabolic acidosis, increased RBI lysis, leukemia, chemotherapy.

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25
Q

Major anion of the extracellular fluid

A

Chloride

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26
Q

Reference range for chloride

A

98-107 mmol/liter

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27
Q

Occurs when serum chloride is below 98

A

Hypochloremia

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28
Q

Occurs when chloride level is above 107mmol/liter

A

Hyperchloremia

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29
Q

Hypochloremia results from what conditions

A

Excessive vomiting, use of diuretics, burns aldosterone

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30
Q

Hyperchloremia results from what conditions

A

Prolonged diarrhea, renal tubular disorder, dehydration, excess loss of bicarbonate

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31
Q

Second largest anion fraction of the extracellular fluid

A

Bicarbonate

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32
Q

Reference range for bicarbonate

A

22-29mmol/liter

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33
Q

ctCO2 is comprised of what

A

HCO3, H2CO3, carbamino. Bound CO2, dissolved CO2

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34
Q

Clinical significance for low bicarbonate

A

Metabolic acidosis, diabetic ketoacidosis, salicylate toxicity

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35
Q

Clinical significance for high bicarbonate

A

Metabolic alkalosis, emphysema, vomiting

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36
Q

Formula used to demonstrate the electro neutrality in body fluids

A

Anion gap

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37
Q

Two formulas for computing anion gap

A

Na - (Cl + HCO3) = anion gap

Na + K - ( Cl + HCO3) = anion gap

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38
Q

Reference range for anion gap if formula used does not contain potassium

A

7-16 mmol/liter

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39
Q

Reference range for anion gap if formula used contains potassium

A

10 - 20mmol/liter

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40
Q

Increased anion gap happens during …

A

Lactic acidosis, ketoacidosis, hypernatremia, ingestion of methanol, salicylates

41
Q

Decreased anion gap happens…

A

Hypoalbuminemia and hypercalcemia

42
Q

What are the three forms of calcium found in plasma

A

Ionized, bound to protein, bound to anions

43
Q

Decreased free calcium levels leads to muscle spasms termed as

A

Tetany

44
Q

Serum calcium is regulated by 3 factors

A

Cholecalciferol or vitamin D
Parathyroid hormone
Calcitonin

45
Q

What effect PTH has on serum calcium

A

Increases calcium

46
Q

Effect of calcitonin towards serum calcium level

A

Decreased

47
Q

What stimulates PTH

A

Low serum calcium levels

48
Q

Another name for vitamin D

A

Cholecalciferol

49
Q

What is the action of PTH in the bone

A

PTH activates osteoclasts to break down bone

50
Q

Action of PTH in the kidneys

A

Enhances tubular reabsorption of calcium and stimulates the hydroxyl action of vitamin D to activ

51
Q

How is cholecalciferol obtained?

A

Dietary intake and exposure to sunlight

52
Q

What is the active form of cholecalciferol

A

1,25- dihydroxycholecalciferol

53
Q

Effect of vitamin D in calcium

A

Increased absorption of calcium in the intestines

54
Q

Which part produces calcitonin hormone

A

Parafollicular cells of the thyroid gland

55
Q

Effect of calcitonin to vitamin D and parathyroid hormone

A

Inhibits PTH and vit D

56
Q

3 methods for measuring calcium

A

ISE
AAS
Spectrophotometer in method ( ortho-cresolpthalein complex one, arsenazo III dye)

57
Q

Method uses metallochromatic indicators that bind to calcium producing a color change

A

Spectrophotometric

58
Q

In ISE analysis of calcium, why must the specimen be acidified first

A

To convert all the protein and anion bound calcium to ionized calcium

59
Q

Interferences of spectrophotometric method of calcium include…

A

Hemolysis and icterus and lipemia

60
Q

Can anticoagulants such as EDTA, oxtail ate and citrate be used for specimens that have calcium request

A

No

61
Q

Interferences for ISE calcium analysis

A

Protein build up in electrode and in viro change in blood pH

62
Q

Reference range for calcium

A
  1. 6-10.3 mg/dl total calcium

4. 6-5.3 mg/dl free calcium

63
Q

3 factors that regulate phosphate levels

A

Kidneys excrete or reabsorb
PTH increases renal excretion of phosphate
Vitamin D intestinal absorption and renal reabsorption

64
Q

Effect of PTH on phosphate level

A

Decrease

65
Q

Effect cholecalciferol to phosphate level

A

Increase

66
Q

Hyperphosphatemia is caused by what conditions?

A

Renal failure, hypoparathyroidism, neoplasticism diseases, lymphoblastic leukemia and intense exercise

67
Q

Hypophophatemia is either caused by what conditions

A

Diabetic ketoacidosis, hyperparathyroidism, asthma, alcoholism, malabsorption syndrome

68
Q

2 methods of measuring phosphate

A

Ammonium molydate + phosphate ions -> phosphomolybdate colorless complex read at 340 nm

Aminonaphtholsulfonic acid to reduce the complex to form colored product at 600-700nm

69
Q

Sources of error for phosphate measurement

A

Hemolysis, lipemia, icterus, anticoagulants

70
Q

ReferencE range for phosphate

A

2.5 - 4.5

71
Q

3 forms of magnesium in plasma

A

Free, bound to protein, complexed

72
Q

Biologically active form of magnesium

A

Free

73
Q

Percentage of. The 3 forms of magnesium found in plasma

A

55% free, 30% bound, 15% complexed

74
Q

Percentage of 3 forms of calcium found in plasma

A

50% free, 30% bound 10% complexed

75
Q

Effect of PTH to magnesium level

A

Increases reabsorption

76
Q

Hyper magnesium is caused by what conditions

A

Renal failure and excess antacids

77
Q

Hypomagnesium is caused by what conditions

A

GI disorder, renal disease, hyperparathyroidism others

78
Q

Methods used to measure magnesium

A

Calmagite, methyl thymol blue, AAS

79
Q

Measure free or ionized magnesium

A

ISE

80
Q

Sources of error

A

Anticoagulants such as EDTA oxalate and citrate

81
Q

Reference range for magnesium

A

1.7 - 2.4

82
Q

Stored form of iron

A

Ferritin and hemosiderin

83
Q

Transports iron

A

Transferrin

84
Q

Serum iron exhibits diurnal variation, which part of the day is the value highest ( morning, noon, afternoon, nighttime)

A

Morning

85
Q

Transferrin is increased in IDA, give a condition where it is decreased

A

Iron overload, hemochromatosis, severe infections

86
Q

Reference range for transferrin

A

200-360

87
Q

Ferritin reflects what part of iron supply and metab

A

Iron storage

88
Q

True or false

Ferritin is a sensitive and early indicator for iron deficiency disease

A

True

89
Q

True or false

Iron is increased in severe infections, iron overload, hemochromatosis

A

Itrue

90
Q

Reference range for ferritin

A

20-250ng/ml for males

10-120ng/ml for females

91
Q

Decreased serum iron indicates what conditions

A

IDA, malnutrition, blood loss and infection ( severe)

92
Q

Increased iron is associated with what conditions

A

Iron overdose, sideroblastic anemia, viral hepatitis, hemochromatosis

93
Q

Total iron content measures

A

Measure the serum iron bound to transferrin

94
Q

TIBC measures what

A

Measure the iron bound to transferrin if all the binding sites on transferrin were occupied

95
Q

Chromogen agent for total iron content

A

Bathophenanthroline or ferrosilicon

96
Q

What is added to remove unbound Ferric in TIBC

A

MgCO3

97
Q

Calculated value that represents the amount of iron that transferrin is capable of binding

A

Percent Transferrin saturation

98
Q

Formula for percent transferrin saturation

A

% transferrin saturation = serum iron (ug/gl)/ TIBC(ug/dl) *100

99
Q

Reference range for serum iron

A

45-160(ug/dl)

100
Q

Reference range for TIBC

A

250-450 ug/dl

101
Q

% saturation

A

15-55%

Clinical Chemistry (ciulla 4th Edition) (3 decks)

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