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Flashcards in SODIUM AND POTASSIUM Deck (81)
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1
Q

____________is paramount to life for all
organisms.

A

Maintenance of water homeostasis

2
Q

In addition to water homeostasis, these electrolytes play an
important role: (4)

A

(1) In maintenance of pH;
(2) In proper heart and muscle function;
(3) In oxidation-reduction reactions; and
(4) As cofactors for enzymes

3
Q

Laboratory tests for evaluation of disorders of ___________ are the most common
procedures performed in clinical chemistry laboratories

A

renal,
water,
electrolyte,
and acid-base status

4
Q

____________ is one of the major sequelae of common
disorders such as diabetes and hypertension

A

Renal disease

5
Q

four major electrolytes:

A

sodium
potassium
chloride
bicarbonate

6
Q

__________ is classified as anion or cation

A

Electrocytes

7
Q

___________ is negatively charged
ions that move toward an anode

A

anions

8
Q

___________ is positively charged
ions that move toward a cathode

A

cations

9
Q

_____________= denotes the number of ______
Capacity of certain analyte to bind
to another chemical

A

valence

10
Q

Carries one valence
monovalent cation

A

SODIUM

11
Q

Positively charged [under electrophoresis
migration of charges] it will travel towards
the cathode region

A

● CATION ATOM

12
Q

Sodium Comprises ________ of all Extracellular Fluid
(ECF) cations

A

90% of ECF

13
Q

________is found
outside the red blood cell

A

ECF

14
Q

= test to determine the
hydration of patient/ body
■ A test that can help diagnose a
fluid/ electrolyte imbalances
including dehydration

A

Osmolality

15
Q

○ Major determinant of plasma osmolality

A

Sodium

16
Q

NORMAL VALUE OF OSMOLALITY

______ mmol/L
● With _______ mmol/L being the result of Sodium and
associated anion electrolytes

A

295 mmol/L
● With 270 mmol/L being the result of Sodium and
associated anion electrolytes

17
Q

Osmolality INCREASES if _________– and it will
also DECREASES if ___________ [too much fluid in
the blood].

A

dehydrated
overhydrated

18
Q

Sodium has high levels in Extracellular fluids(Blood
plasma and Interstitial fluid),________ for Blood
plasma and ________ for Interstitial fluid
● _______ ions follow, and ________, followed by
__________

A

142 mEq/L
145 mEq/L
Chloride, bicarbonate, calcium

19
Q

INTRACELLULAR FLUID

___________ = highest levels 140 mEq/L
_____________= 100 mEq/L

A

Potassium
Hydrogen phosphate

20
Q

__________is the major cation of extracellular fluid

A

Sodium

21
Q

___________is freely filtered by the glomeruli.

A

sodium

22
Q

The interval for serum Na+ is ____________
Urinary sodium excretion varies with dietary intake, but for
people on an average diet containing ___________ an
interval of __________ is typical

A

135 to 145 mmol/L
8 to 15g /day,
40 to 220 mmol/day

23
Q

SERUM INTERVAL

There is a large diurnal variation in Na
+ excretion,
with the rate of Na+ excretion during then ight
being only _______ of the peak rate during the day.

A

20%

24
Q

6 POSSIBLE SPECIMENS

A

SERUM
PLASMA
URINE
WHOLE BLOOD
SWEAT
CEREBROSPINAL FLUID

25
Q

Certain coagulants should be used

A

PLASMA (Lithium heparin, ammonium heparin, and
lithium oxalate)

26
Q

Increased sodium concentration in the serum[blood]
● Results from excess loss of water relative to Na
+ loss, decreased water intake, or increased Na
+ intake or
retention

A

HYPERNATREMIA

27
Q

It is LESS COMMONLY SEEN in hospitalized patients
than in hyponatremia.

A

HYPERNATREMIA

28
Q

___________ may occur either by
the kidney or through profuse sweating, diarrhea or
severe burns.

A

LOSS OF HYPOTONIC FLUID - HYPERNATREMIA

29
Q

● May result from loss of water in diabetes insipidus

A

HYPERNATREMIA

30
Q

___________ defined as an increased sodium
concentration in plasma water, and is generally diagnosed a
serum sodium levels __________

A

Hypernatremia
>145 mmol/L

31
Q

____________ may not be accompanied by
hypoosmolality, hypernatremia is always associated with an
increased effective plasma osmolality, and hence with a
reduced cell volume.

A

hyponatremia

32
Q

Hypernatremia can be due to the following: (3)

A
  1. Excess water loss
  2. Decreased water intake
  3. Increased intake or retention
33
Q

In excess water loss in hypernatremia

A

a. Diabetes insipidus
b. Renal tubular disorder
c. Prolonged diarrhea
d. Profuse sweating
e. Severe burns
f. Vomiting

34
Q

Increased intake or retention in hypernatremia

A

a. Hyperaldosteronism (Conn’s disease)
b. Sodium bicarbonate infusion

35
Q

Characterized by copious production of dilute urine
(3-20 L/day)

A

DIABETES INSIPIDUS

36
Q

People w/ diabetes insipidus drink large volumes of
water, Hypernatremia does not occur usually unless
the ______________

A

thirst mechanism is impaired

37
Q

Excess water loss may also occur in RENAL
TUBULAR DISEASE, such as ____________

A

acute tubular necrosis,

38
Q

____________ with a normal osmolality may be a
result of a high increase in non-sodium cations

A

HYPONATREMIA

39
Q

___________ may also be seen with in vitro
hemolysis, considered the most common cause for a
false decrease. When red blood cells (RBCs) lyse,
Na+, K, and water are released, and since Na+
concentration is lower in RBCs, this results in a false
decrease

A

Pseudohyponatremia

40
Q

Hyponatremia with a high osmolality is associated
with ___________

A

hyperglycemia

41
Q

The elevated levels of glucose increase the
serum osmolality and cause a shift of water
from the cells to the blood, resulting in a ______

A

dilution of Na+ .

42
Q

______________the most common electrolyte disorder, is
defined as reduced plasma sodium less than __________
concentration to a value less than ____________

A

130 mmol/L.
135 mmol/L

43
Q

Hyponatremia can be due to the following:

A
  1. Increase Na+ loss
  2. Increased water retention
44
Q

Increase Na+ loss in hyponatremia

A

a. Thiazide diuretics in the presence of
ADH
b. Saline infusion in the presence of ADH

45
Q

. Increased water retention in hyponatremia

A

a. Renal failure
b. Nephrotic syndrome
c. Aldosterone deficiency
d. Cancer
e. Syndrome of Inappropriate ADH
Secretion (SIADH)
f. Hepatic cirrhosis

46
Q

ranges of serum

A

136-145 mmol/L

47
Q

________, Hypernatremia
_________, Hyponatremia

A

> 145, Hypernatremia
<136, Hyponatremia

48
Q

PACKAGE INSERT in serum

A

● 128-160 mmol/L

49
Q

reference range of sodium in Urine

A

40-220 mmol/day (varies with diet)
24h Urine: 120-240 mmol/day (varies
with diet)
Urine

50
Q

reference range of CSF in sodium

A

136-150 mmol/L

51
Q

linearity of sodium

A

**LINEARITY - 200 mmol/L

52
Q

● REMEMBER THAT WHEN LINEARITY IS REACHED,
THERE IS A RESULT PRODUCED BUT IT IS
_____________

A

EXTREMELY HIGH

53
Q

___________ are all acceptable for Na+
measurements

A

Serum, plasma, and urine

54
Q

When plasma is used ___________ are suitable for anticoagulants

A

When plasma is used, lithium heparin,
ammonium heparin, and lithium oxalate are suitable
anticoagulants

55
Q

_________ does not cause a significant change
in serum or plasma values as a result of decreased levels of
intracellular Na+.

A

hemolysis

56
Q

______________ samples may be used with some analyzers.

A

Whole blood

57
Q

. The specimen
of choice in urine Na+ analyses is a _____________

A

24-hour collection

58
Q

____________ are the most routinely used method in clinical laboratories.

A

Ion-Selective Electrode [ISE] (Glass Ion Exchange
Membrane)

59
Q

1.Serum, heparinized plasma, whole blood, sweat,
urine, feces, or gastrointestinal fluids may be assayed
for Na+
2. When plasma is used, lithium heparin, ammonium
heparin, and lithium oxalate are suitable
anticoagulants.
3. Timed collections of urine, feces, or gastrointestinal
fluids are preferred to allow comparison of values
with reference intervals and to determine rates of
electrolyte loss.
4. Serum, plasma, and urine may be stored at 2°C to 4°C
or frozen.
5. Erythrocytes contain only one tenth of the Na*
present in plasma, so hemolysis does not cause
significant errors in serum or plasma Nat values.
6. Lipemic samples should be ultracentrifuged and the
supernatant analyzed unless a direct ISE is used

A

SAMPLE CONSIDERATIONS

60
Q

What are the four sodium ion determinations

A
  1. Chemical Methods
  2. Flame Emission Spectrophotometry (FES)
  3. Atomic Absorption Spectrophotometry (AAS)
  4. Ion-Selective Electrode [ISE] (Glass Ion Exchange
    Membrane)
61
Q

a. Excitation of atoms

A
  1. Atomic Absorption Spectrophotometry (AAS)
62
Q

a. The sample is mixed up with flame to create
vapor, and whatever color produced by the
flame will be transmitted to the
monochromator
b. Then the prism, next to the photomultiplier
tube and [leave] the device

A
  1. Flame Emission Spectrophotometry (FES)
63
Q

**Outdated methods because of large samples,

A
  1. CHEMICAL METHODS
64
Q

Sodium (Na) [from the blood] is made to react with
zinc uranyl acetate (reagent) to produce a sodium
uranyl acetate precipitate

A

ALBANESE LEIN METHOD

65
Q

ALBANESE LEIN METHOD

___________is mixed with water and a _______
solution is formed which is then measured
_______________

A

Precipitate (SUN)
yellow
spectrophotometrically.

66
Q

ALBANESE LEIN METHOD

Test Tube 1 ➔ Precipitation test
■ Sodium is precipitated in a form of
_____________
■ Precipitates will be transferred to
TT2
○ Test Tube 2 ➔ Precipitate will mix with
water and there is formation of ________ which is measured
spectrophotometrically for Sodium

A

sodium-uranyl acetate
yellow color

67
Q

ALBANESE LEIN METHOD

REAGENT → ______________
PRODUCT → ______________

A

zinc uranyl acetate
sodium uranyl acetate

68
Q

**Followed by AGAPPE

A

MAGNESIUM-URANYL METHOD

69
Q

MAGNESIUM-URANYL METHOD

Sodium is precipitated with ________; the uranyl ions remaining in suspension form
a __________ with thioglycolic acid
● The difference between reagent blank and analysis is
___________ to the sodium concentration

A

magnesium-uranyl
acetate
yellow-brown complex
PROPORTIONAL

70
Q

MAGNESIUM-URANYL METHOD

➔ Protein precipitant: ______________
● Test Tube 1 ➔ ___________
● Test Tube 2 ➔ __________

A

Uranyl acetate and magnesium acetate
Suspension /supernatant
Precipitate

71
Q

UTILIZES GLASS-TYPE MEMBRANE WHICH IS MORE
PREFERRED THAN CHEMICAL METHODS

A

ION SELECTIVE ELECTRODES (GLASS ION EXCHANGE
MEMBRANES)

72
Q

● The _____ method uses a ___________- to
develop an _________produced by having
different ion concentrations on either side of the
membrane

A

ISE
semipermeable membrane
electrical potential

73
Q

ISE

In this type of system, ________- are used.

A

two electrodes

74
Q

_________ are selective for the
ion but are not absolutely specific because other
monovalent cations may react with the electrode but
not in the physiologic range.

A

ION-SELECTIVE ELECTRODES

75
Q

ISE

___________ has a constant potential,
making it the__________,
and the difference in potential between the
reference and measuring electrodes can be
used to CALCULATE THE
“CONCENTRATION” of the ion in teh
solution.
○ However, it isthe ACTIVITY OF THE ION, not
the concentration that is being measured

A

One Electrode
REFERENCE ELECTRODE

76
Q

There are two types of ISE measurement, based on
sample preparation:

A

DIRECT AND INDIRECT

77
Q

measurement provides an
undiluted sample to interact with the ISE
membrane
■ Used in blood gas analyzers

A

DIRECT

78
Q

The INDIRECT measurement uses whole
(diluted) blood samples
Used in most automated
chemistry analyzers

A

INDIRECT

79
Q

● Uses a single-use, direct ISE potentiometric system
● Each disposable slide contains a reference and
measuring electrode.
● A drop of sample fluid and a drop of reference fluid
are simultaneously applied to the slide and the
potential difference between the two is measured,
which is proportional to the Na
+ concentration.

A

VITROS ANALYZERS

80
Q

Protein buildup on the membrane through
continuous use

A

SOURCES OF ERROR

81
Q
A