Fluid & Electrolytes Flashcards by Joan Ravalo

Which is false?
A.the older you are, the more water you have
B.the fatter you are, the less water you have
C.BOTA
D.NOTA

Kids have more water

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Differentiate content of extracellular fluid fr intracellular fluid

Extracellular - Na, Cl, HCO3-

Intracellular - K, Ca, Mg, phosphate, sulfate

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Which is false?
A.Hydrostat pressure drives fluid into lymph vessels, from plasma
B.Osmotic pressure causes return of fluid to plasma
C.Osm pressure regulates fluid cell mvmt
D.NOTA

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Which does not pass through pores of fenestrated capillaries / bet adj endothelial cells?
A.electrolytes
B.large water-sol cpd
C.lipid-sol cpd
D.plasma protein

Liver sinusoids sila

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Which passes through pores of fenestrated capillaries?
A.electrolytes
B.large water-sol cpd
C.lipid-sol cpd
D.plasma protein

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Which passes through channels in plasma membrane?
A.electrolytes
B.large water-sol cpd
C.lipid-sol cpd
D.plasma protein

(Pwede more than 1 answer)

A and C

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How is osmolality measured via osmometer? (What concept)

Freezing pt depression

Vapor pressure depression

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Most accurate measurement parameter for osmolality

24hr urine osmolality

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Four parameters maintained in fluid-electrolyte balance

Volume
Osmolality/osmolarity
Conc of indiv ions
pH of body fluid

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Which is false?
A.A decrease in ECF osmotic pressure due to water loss stimulates osmoreceptors @ thirst center
B.Stretch receptors send nerve impulses to inhibit thirst center once there is water gain
C.Hypothalamus - thirst center

Increase ang osmotic pressure ng ECF pag water loss

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Which is false?
A. Renal tubules in charge of water reabsorption
B. Anterior pituitary releases vasopressin
C. 1-2% increase in osmolality –> fourfold increase in ADH
D. Water gain decreases ECF conc

Posterior dapat

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Which does not affect blood volume?
A.atrial natriuretic peptide
B.volume receptor
C.GFR
D.NOTA

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False about tonicity
A. Measure of osmotic pressure gradient of two solutions sep by semiperm membrane
B. Commonly used in describing response of cells immersed in an ext solution
C. Influenced by all solute

Influenced only by solutes that cannot cross the membrane as these only exert osmotic pressure

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Membrane sep ICF vs ECF : (a)

Membrane sep interstitial fluid vs plasma: (b)

(A)cell membrane

(B)capillary wall

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K+ : ICF’s osmotically active solute. Regulated by: __

Na+-K+ ATPase

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Na+: ECF osmotically active solute. Regulated by: __

Kidney sodium handling

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Protein: plasma volume’s osmotically active solute. Regulated by: __

Albumin metabolism

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Major electrolytes na cations: enumerate

Potassium
Sodium
Magnesium
Calcium

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Major electrolytes na anions: enumerate

Bicarbonate
Chloride
Phosphate

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Which is true?
A. Most of metab are dep on electrolyte balance
B. Assays are done on whole blood
C. Electrolytes are distributed equally on intracellular & extracellular spaces
D. NOTA

B-serum, plasma
C-unequally

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Which is false?
A. Intracellular space has high Na & low K, Cl, HCO3-
B. Intracellular space has high Na & K, low Cl, HCO3-
C. Extracellular space has high Cl, HCO3-, Na & low K
D. Extracellular space has low HCO3-, high Na, Cl, K

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Which is false?
A. Sodium - body water distribution
B. Potassium - muscular activity
C. Chloride - blood pH
D. NOTA

Bicarbonate dapat

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enumerate the three processes taking care of electrolyte control

diffusion
Active transport
Osmosis

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Identify

Mathematic calculation of the diff bet cation and anion conc

Anion gap

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``` Which condition does not cause increased anion gap? A. Uremia B. Diabetic ketosis C. Alkalosis D. Starvation ```

C | Acidosis dapat

Processes impt to plasma Na+ regulation. Enumerate

Excretion of water Blood volume regulation Water intake (thirst)

Hormones affecting sodium conc: enumerate

Aldosterone | Atrial natriuretic factor

``` The ff happen & hyponatremia except A.SIADH B.adrenal failure C.diuretics D.dehydration ```

D | Overhydration dapat

``` Urine Na+ >= 20 mmol/day. Water retention will be due to A.congestive heart failure B.liver cirrhosis C.nephrotic syndrome D.chronic renal failure ```

D | The rest are reasons when urine Na

``` Answer L if low, N if normal, H if high osmolality A.increased Na loss B.mannitol infusion C.hyperlipidemia D.multiple myeloma ```

A. L B. H C. N D. N

``` Answer L if low, N if normal, H if high osmolality A.hypercalcemia B.increased water retention C.hyperglycemia D.hypermagnesemia ```

A. N B. L C. H D. N

Conivaptan is used for two kinds of hyponatremia. Enumerate

Euvolemic | Hypervolemic

False about pseudohyponatremia A.usually caused by lack of lipids in serum B. No sodium ions dissolved in lipids, which can take up a considerable volume of serum C. Eliminated by use of ion-selective electrodes D. NOTA

A | Excessive dapat

``` Excess of the ff (except 1) can cause hypernatremia. Pick the odd one out A. Dialysis fluid B. Water C. Aldosterone D. Sodium bicarbonate ```

Why should hypernatremia be corrected gradually?

Rapid correction may cause cerebral edema & death

``` Specimens used for sodium include all except A.serum B.stool C.heparinized plasma D.urine ```

``` Methods for Na & K det include all except: A.emission flame photometry B.gas-liquid chromatography C.ion-selective electrode D.colorimetry ```

B Dapat atomic absorption spectrophotometry

Enumerate 3 factors that affect potassium level

Exercise Hyperosmolality Cellular breakdown

``` Not a possible factor or cause of hypokalemia A. Renal loss B. Acidosis C. Malabsorption D. Acute leukemia ```

``` Not a possible factor or cause of hyperkalemia A. Diuretics B. Hemolysis C. Insulin overdose D. Excessive fist clench ```

Identify method Solutions containing alkali ions diluted with standard are aspirated into the flame, and the atoms emit light at one/more wavelengths

Emission flame photometry

Identify method | Measures the amount of energy absorbed by Na, K rather than emitted

Atomic absorption flame spectrophotometry

Which is false? A.the amount of monochromatic light absorbed by sample in spectrophotometry is dir prop to conc B.chloride conc varies directly with bicarbonate C.chloride - anion with highest extracellular conc D.chloride maintains electrical neutrality

B | Inverse dapat

``` Chloride conc is decreased in all except A.Prolonged vomiting B.Salicylate intoxication C.Aldosterone deficiency D.Salt-losing nephritis ```

``` Chloride conc is increased in all except A.Renal tubular acidosis B.Salicylate intoxication C.Aldosterone deficiency D.Diabetes insipidus ```

Most commonly used method in determining chloride conc

Ion selective elctrode

``` Specimen used to det chloride A.serum B.plasma C.urine D.both A and B E.both B and C ```

Enumerate methods of determination | For chloride

Schales & Schales Titration Method Coulometric method Colorimetric method

Enumerate the 2 colorimetric methods of determination For chloride. What is the similarity?

Autoanalyzer Manual Uses both mercuric thiocyanate since Cl has high affinity for Hg

``` Increased bicarbonate happens in which scene? A. Metab acidosis, respi alkalosis B. Metab alkalosis, respi acidosis C. Metab acidosis, respi acidosis D. Metab alkalosis, respi alkalosis ```

``` Decreased bicarbonate happens in which scene? A. Metab acidosis, respi alkalosis B. Metab alkalosis, respi acidosis C. Metab acidosis, respi acidosis D. Metab alkalosis, respi alkalosis ```

Also called chloridometer principle A.Schales & Schales Titration Method B.Coulometric method C.Colorimetric method

Sample titrated with standardized mercuric nitrate solution A.Schales & Schales Titration Method B.Coulometric method C.Colorimetric method

Equation used to calculate bicarbonate @ blood

Henderson-Hasselbach equation

Enumerate 2 methods of det for carbon dioxide

Ion-selective electrode | Enzymatic method

Which is false? A.to determine CO2, use EDTA as anticoagulant for blood sample B.hypocalcemia can be a consequence of reduced plasma albumin C.rate of charge in absorbance of NADH is proportional to concentration of bicarbonate D.vitamin D may be administered to treat hypocalcemia

A | Dapat lithium heparin

``` Hypercalcemia causes include all except: A.multiple myeloma B.thiazide diuretics C.alkalosis D.cancer ```

``` Hypocalcemia causes include all except: A.vitamin D deficit B.thiazide diuretics C.alkalosis D.acute pancreatitjs ```

``` Which has low PTH, high Ca? A.hypercalcemia of malignancy B.secondary hyperparathyroidism C.hypoparathyroidism D.primary hyperparathyroidism ```

``` Which has low PTH, low Ca? A.hypercalcemia of malignancy B.secondary hyperparathyroidism C.hypoparathyroidism D.primary hyperparathyroidism ```

``` Which has high PTH, high Ca? A.hypercalcemia of malignancy B.secondary hyperparathyroidism C.hypoparathyroidism D.primary hyperparathyroidism ```

``` Which has high PTH, low Ca? A.hypercalcemia of malignancy B.secondary hyperparathyroidism C.hypoparathyroidism D.primary hyperparathyroidism ```

``` Not preferred specimen for Ca A.CSF B.lithium heparinized plasma C.whole blood D.24h urine ```

Enumerate 3 diff methods for measuring calcium

Ortho-cresolphthaleib complexone dyes Arsenazo III dye Ion-selective electrode (liquid membrane)

Which is false? A.regulation is controlled by Henle's loop B.PTH increases renal absorption of Mg C.Aldosterone decreases renal excretion of Mg2+ D.Thyroxine increases renal excretion of Mg2+

C | Increase din dapat

``` Not preferred specimen for Mg A.Serum B.lithium heparinized plasma C.whole blood D.24h urine ```

Enum Mg det methods (general)

Colorimetric | Atomic absorption spectrophotometry

Enum Mg det colorimetric methods

Calmagite Formazan Methylene blue

Which is false? A.phosphate deficiency affects affinity of Hb for oxygen B.parathyroid hormone affects renal regulation of phosphate by lowering phosphate blood conc C.excess Growth hormone causes increase in phosphate D.vitamin D increases phosphate through absorption @ kidneys

Which is false? A.hemolysis of sample for phosphate must be avoided because of higher conc inside RBC B.serum can be used for phosphate det C.lithium heparin plasma may not be used for phosphate det D.Phosphate is not affected by diurnal variation

D | highest level in late morning & lowest at Evening

Complex formed in determining phosphate

Ammonium phosphomolybdate

``` Which electrolyte analyzer is used bedside A. iSTAT B. GEM C. Osmotech D. IRMA ```

``` Which electrolyte analyzer also measures blood gas A. iSTAT B. GEM C. Osmotech D. IRMA ```

B, D

``` Which electrolyte analyzer is @POCT setting & handheld A. iSTAT B. GEM C. Osmotech D. IRMA ```