Electrolytes (what plants crave)

Question 1

Define terminology associated with electrolytes
Electrolyte
Anion
Cation
Intracellular/extracellular
Anion Gap
Trace element

Answer 1

Electrolyte: ions that can carry a charge
Anion: negative charge, move towards anode
cation: positive charge, move towards the cathode
Intracellular: Within a cell
extracellular: outside a cell
Anion gap: Difference between unmeasured anions and unmeasured cations
Trace element: Very small amounts of essential elements. iron, zinc, fluoride, selenium, copper, chromium, iodine, manganese, and molybdenum

Question 2

Discuss electrolyte metabolism for each electrolyte

Answer 2

Na: 90% of of cations in ECF. determines osmolality of plasma
CL: Major extracellular anion. Osmolality, blood volume, electric neutrality.
K: 20x greater inside cell than outside. Heart contraction, neuromuscular excitability, ICF volume, Hydrogen Ion concentration. regulated by kidneys
Mg: 2nd most abundant intracellular cation, 4th extracellular. important co-factor in enzymatic actions
Ca: 99% part of the bone. Important for myocardial contraction
Zn: correct function of glucose and lipid metabolism.

Question 3

Discuss water metabolism, movement, regulation

Answer 3

40-75% of body weight
Universal solvent for body processes
xports nutrients to cells (Active, Diffusion. Maintained through controlling electrolytes and proteins)
regulates cell volume
removes waste
coolant

Question 4

Discuss methodologies for electrolyte measurement

Answer 4

Typically measured in Serum, plasma, whole blood, urine, or sweat in some cases. Using electrodes to selectively separate and measure ions.

Question 5

Discuss disease states and disorders associated with electrolyte metabolism

Answer 5

Diabetes insipidus: Insufficient ADH, causing kidneys to overproduce urine and requiring increased water intake.

Question 6

State reference intervals and critical values
Sodium
Potassium
Chloride
Bicarbonate
Calcium
Magnesium
Phosphate

Answer 6

Na: 135-145 mmol/L. <120 clinically significant
K: serum: 3.5-5.1 mmol/L; Urine 33-86. >10 = death.
Cl: Plasma, serum 98-107 mmol/L; urine 110-250 mmol/d
HCO3: CO2 venous 22-29mmol/L
Ca: 2.24-2.53 mmol/L
Mg: .66-1.07 mmol/L
PO4: .81-1.45 mmol/L

Question 7

Given the following conditions, list and explain causes, symptoms and diagnostic levels associated with each condition

Hyponatremia/pseudohyponatremia
Hypernatremia

Answer 7

Hypo: increased sodium loss/water retention.
Hyper: Higher than normal concentration of sodium in serum

Question 8

Define and explain the usefulness of the Anion Gap

Answer 8

Difference between unmeasured anions and cations. Useful for finding increased levels in unmeasured anions in serum/QC for analyzers.

Question 9

Given electrolyte data, calculate the anion gap

Answer 9

[Na+K] - [Cl +HCO3]

Question 10

Correlate an increased or decreased anion gap with specific disorders or conditions

Answer 10

Increased: uremia/renal failure, ketoacidosis, glycol poisoning, lactic acidosis, hypernatremia, machine malfunction

Question 11

Given the following conditions, list and explain causes, symptoms and diagnostic levels associated with each condition

Hypokalemia
Hyperkalemia

Answer 11

Hypokalemia: Lower plasma potassium. Gastrointestinal loss, renal loss.
Hyperkalemia: Higher plasma potassium. decreased renal excretion, cellular shift, increased intake.

Question 12

Given the following conditions, list and explain causes, symptoms and diagnostic levels associated with each condition

Hypochloremia
Hyperchloremia

Answer 12

Hypo: Loss of Bicarb
Hyper: prolonged vomiting.

Question 13

Given the following conditions, list and explain causes, symptoms and diagnostic levels associated with each condition

Increased levels of bicarbonate
Decreased levels of bicarbonate

Answer 13

increased: Metabolic alkelosis.
decreased: Metabolic acidosis

Question 14

Given the following conditions, list and explain causes, symptoms and diagnostic levels associated with each condition

Hypocalcemia
Hypercalcemia

Answer 14

Hypo: Not enough calcium. Vit D deficiency, Acute pancreatitis, renal disease.
Hyper: Increased vit D, malignancy, multiple myeloma.

Question 15

Given the following conditions, list and explain causes, symptoms and diagnostic levels associated with each condition

Hypomagnesemia
Hypermagnesemia

Answer 15

Hypo: renal excretion, endocrine excretion, decreased absorption, reduced intake
Hyper: Hypothyroidism, enemas, dehydration

Question 16

Osmolality calculation

Answer 16

2(Na)+(glucose/20)+(bun/3)