Blake Exam C flashcards
How many miligrams per deciliter are contained in 145mEq/L of Na+
1.) convert miliqulivalence per liter to equivalence per liter = (145mEq/1.00L)( 1Eq/110^3L)= .145Eq/1L
2.) .145Eq/L= X g of NA/ (22.99AW of NA/ 1 Val)/ 1L of sol
3.) .145= (X g of Na/ 22.99)
4.) .14522.99= 3.33g/L or X
5.) convert g/L to miligrams/dl
3.33g/L( 1L/10dl)( 1000mg/g)= 333mg/dl
How do you to convert from mg/dl to meq/L. if sodium MW is 23 and the concentration of NA is 350mg/dl
1.) convert Mg/dl to g/dl=350mg/dl( 1g/1000mg)(10dl/1L)=3.5g/l
2.) Plug-in g/L into your equation ( g/L of Na/ AW of Na/1VA)= 3.5/ (22.99/1Val)= .1522eq/L
3.) .1522Eq/L( 1000mEq/1Eq)= 152.2mEq/L
Pseudohyponatremia and pseudohypocalcemia occur with what methodology to detect lithium( Red color), K+ ( violet color), and Na( yellow color) occur with
Flame emmision spectroscopy
Is calcium low with hypoalbuminemia and Ionized calcium is not affected
True
What is slightly higher in Heperinzed plasma then in serum
K+
The normal range for K+
3.5-5.0mEq/L
Sodium normal range
135-145 mEq/L
Calcium normal range is
9.2-11.0 mEq/L
Magnesium normal range is
1.3-2.1mEq/L
Bicarb normal range is
21-28mEq/L
Chloride normal range is
95-103mEq/L
phosphorous normal range is
2.3-4.7 mg/dL
Iron normal range is
60-150ug/dl
therapeutic lithium normal range is
0.5-1.4 mEq/L
1.0-1.6mEq/L
what is the main regulator of ADH
is Osmolality, neurons within the hypothalamus respond to change in blood osmolality
what are the intracellular electrolytes and what will falsely elevate theses
K+, Mg2+, Phosphorous, Fe. so hemolysis will falsely elevate these
what are the extracellular electrolytes
Cl-, bicarb, Na, and Ca2+
Hyponatremia- A low sodium concentration
conditions
vomiting and diarrhea
excessive sweating and burns
Renal reabsorption disease ( PCT, ALOT, and DCT)
hypoaldosteronism
Polyuria and osmotic diuresis
results in GI leakage and neural problems
Hypernatremia causes a high sodium concentration
caused by
CHF
liver disease–> low protien–> low oncotic pressure–> excrete more water–> high NA
renal disease
Hyperaldosteronism
severe dehydration
nasogastric feeding of high protein concentration w/o sufficient fluid intake
high protein
Hypothalamic injury to thirst mechanism (Ex. adipsia)
excessive intake of NA with therapy aka Na Herparin is used when patient has a bleeding problem
Pregnancy
Hypokalemia
Vomiting, diarrhea
Cushing’s Syndrome - hyperaldosteronism
Renal reabsorptive disease - renal tubular necrosis (PCT, ALOH, DCT)
Metabolic alkalosis
H+ shift
Insulin excess
Diuretic therapy - high urine → K follows water
Low intake over a long period of time
results in
K depletion
Hyperkalemia- There is a high potassium concentration.
Hypoaldosterone - Addison’s Disease
Renal failure
Acidosis
High H+ (low pH) → H+ exchange with intracellular K
Insulin deficiency
High glu plasma → high filtration → high water in tubule → dehydration → high K
Translocation of K
Excess intake
Cellular breakdown
Exercise - physical stress stimulate muscle cells to release K
Hospital administration of infusion solutions containing K if patient cannot excrete
Anoxia, shock
Very low oxygen → low ATP → no Na/K ATPase activity → K permeability → K leakage
Continued metabolism → high CO2 → acidosis → damage membrane → release K
Artificial False Elevation
Elevated platelet, WBC counts - high clot → cells squished → K leak
Tourniquet left on too long - hypoxia due to low blood → sicked shape RBC → squished → K leak
Results in:
Interference with heart electrical impulses
Dehydration will cause elevated levels of
Na+
Urinary blockage causes elevated levels of
Na+
High potassium is associated with Cushings or Addisons
Addisons disease( hypoaldosteronism)
H+ will enter the cell in _______ will leave the cell causing hyperkalemia and vice versa
K+
Chloride will enter the cell and Bicarb will exit in states of
Acidosis
A high amount of insulin will cause a low ____
Potassium
High bicarb is associated with
metabolic alkalosis
High CO2 is associated with
Respiratory acidosis
Hypochloremic metabolic alkalosis occurs when
There is a loss of chloride ions and occurs due to a loss of gastric fluid.
When does hyperchloremia occur
in chronic metabolic acidosis; aka chloride ions need to take up H ions.
Anion gap calculations
(Na + K) - (Cl + HCO3) = 15 mmol/L (10-20)
Na - (Cl + HCO3) = 12 mmol/L (7-16)
two methods to determine Na and K
FEP and ion selective electrode potentiometry
Total CO2 exists as
dissolved CO2( 3%), Carbamino ( 33%) and bicarb ( 64%)
what is the major form of CO2 transported in blood
most of the CO2 in blood exists as Bicarb and is formed from the reaction of CO2 + H20–> HCO3 by carbonic anhydrase.
administration of insulin on K+ levels
Lowers the amount of serum K because glucose and K are both taken up into the cell.
Acidosis cause elevated or decreased K + levels in the serum
Elevated because of K+ and H+ shift in the cell
Alkalosis will cause an increase or decrease in K+ in the serum
Decrease in the serum potassium as K+ into the cell H+ moved out. As K+ is moved in it stimulates the distal cells of the nephron to secrete more K+.
as pH is decreased, Ca2+ _________
H+ disrupts Ca2+ from binding to binding sites and causes an increase in ICa2+.
high free calcium, high divalent pH.
As the pH is Increased Albumin becomes more
negatively charged and binds with calcium therefore decreasing the amount of ICa2+.
low free calcium and high monovalent pH
What is a cause of low Calcium, low PTH, and high phosphate
Pseudohypoparathyrosm
what is a cause of a of low Ca, low PTH, and high pH
PseudohypoPh because you will have a low calcium, low PTH, and high phosphate, which will cause phosphate to bind with H+ to become Phosphorous.
how is alkaline phosphatase inhibited
By serum calcium levels, if alkaline phosphatase comes into contact with serum calcium, then it will crystalized.
Where is alkaline phosphatase secreted?
in bone formation from osteoblast which is regulated by PTH and PTH stimulates the release of ALP from bone It also stimulates phosphorous excretion into the urine and calcium reabsorption from the gut
when there is low Mg2+, there is low what
Calcium and PTH, Mg2+ is required for enzymes that cause PTH to be released and if there is a decrease in Mg2+ then there will be a decrease in Calcium.
what condition will cause a low absorption and high excretion of Mg2+
Alcoholism and intestinal sprue.
Magnesium blocks ______ entry into the cell
Calcium