Chemistry week 3 Flashcards by Potato Patata

Ions capable of carrying an electric charge

Electrolyes

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Positively charge electrolyte

Cation

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negatively charge electrode

Cathode

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Negatively charge electrolyte

Anion

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Positively charge electrode

Anode

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Electrolyte that functions in volume and osmotic regulations

Sodium, Chloride, Potassium

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Electrolyte that functions in myocardial rhythm and contractility

Potassium, Calcium, Magnesium

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Electrolyte that functions in Regulations of APTase ion pump

Magnesium

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Electrolyte that functions in neuromuscular exciteability

Potassium, Calcium, Magnesium

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Electrolyte that functions in Production and Use of ATP

Magnesium, phosphate

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Electrolyte that functions as an Acid base balance

Potassium, Chloride, Bicarbonate

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Electrolyte that functions in Blood coagulation

Calcium, Magnesium

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Electrolyte that function as Cofactors in enzyme activation

Calcium, Magnesium, Zinc, Chloride, Potassium

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Most abundant cation in the extracellular fluid
Major extracellular cation

Sodium

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Promotes sodium retention and potassium secretion

Aldosterone

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Promotes sodium excretion

Atrial natriuretic factor

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Sodium renal threshold

110 - 130 mmol/L (average of 120mmol/L)

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Sodium normal value

135 - 145 mmol/L

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Can be caused by loss of water, decreased water
intake, and increased sodium intake or retention

Hypernatremia

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Major defense mechanism against hypernatremia

Thirst

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▪ Most common electrolyte disorder.
▪ Can be caused by increased sodium loss,
increased water retention, and water imbalance.

Hyponatremia <135 mmol/L

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1/3 in the body

ECF

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2/3 in the body

ICF

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FORMULA FOR OSMOLALITY

2 Na + (Glucose mg/dL / 20) + (BUN mg/dL / 3)
OR
1.86 Na + (Glucose / 18) + (BUN /2.8) + 9

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____ of osmolality also increases ADH 4 times more

1-2% increase

____ of osmolality can shut off ADH production

1-2% decrease

Increased sodium level which induce the release of more ADH to direct the reabsorption of water in the kidney

Hypernatremia

Decrease in blood volume

Hypovolemia

Increase in blood volume

Hypervolemia

Mechanism that requires energy to move ions across cellular membranes

Active transport

Passive movement of ions across a membrane depending on the charge of concentrations

Diffusion

Refers to the difference between the sums of the concentration of the principal cations and of the principal anions

Anion gap

Anion gap formula

NA - (Cl + HCO3) OR (NA + K) - (Cl + HCO3)

Uremia, Ketoacidosis, Methanol, Aspirin, or ethylene glycol poisoning, Severe dehydration, Lactic acidosis

Increased anion gap

A rare condition wherein sodium chloride gradients cannot form in the loop of Henle causing the retention of chloride ion that is not available for the countercurrent mechanism and sodium loss

Bartter's syndrome

Below ___ mmol/L for 48 hours or less is considered a medical emergency which can lead to coma or death when not treated immediately

120 mmol/L Na

Panic value for hypernatrimia

160 mmol/L

Method of determination of hypernatremia

ISE - potentiometry where measurement is based on the changes in voltage or potential at a constant current. Measure with GLASS AAS - uses fire to consume the analyte which is measured at its GROUND STATE FES/FEP - Uses fire to consume the analyte into atomic particles which is measure at its EXCITED STATE Colorimetric (Albanese Lein) - Combining sodium with zinc uranyl acetate → sodium uranyl acetate precipitate → addition of water produces YELLOW solution

Direct ISE - uses an ____ sample

Undiluted

Indirect ISE - Uses an ___ sample

Diluted

Major intracellular cation of the ICF

Potassium

Low or High potassium level can cause

Arrhytmia

Catecholamines such as epinephrine promotes entry of Potassium into the cell

Beta-2 stimulator

Impairs the entry of potassium into the cell

Beta-blocker

Overdose of ___ promotes acute entry of Potassium into the skeletal muscles and liver

Insulin

Dehydration, Diabetes Insipidus, Hypoadrenalism, Acidosis, Hemolysis

Hyperkalemia

Muscle weakness, tingling, numbness, or mental confusion

Hyperkalemia

may alter the ECG (K)

6-7 mmol/L

May cause fatal cardiac arrest (K)

>10 mmol/L

Infusion of insulin, Alkalosis, Vomiting, overhydration, Use of loop diuretics, SIADH, Bartter's syndrome

Hypokalemia

Reference method for determination of Sodium

AAS Routinely used - ISE

Potassium method of determination

FES - Violet end color ISE - uses Valinomycin gel AAS - Reference method Colorimetry - Lockhead and Purcell

Chief counterion of sodium

Chloride

Chloride functions

Maintaining osmolality Blood volume Electrical neutrality

Chloride shift

Maintains electroneutrality Bicarbonate diffuses out into the plasma and Chloride diffuses into red cells to maintain electrical balance (BoCi)

Functions in blood coag, enzyme activation, and cardiac and skeletal muscle excitability

Calcium

Ical Protein bound complexed with anions What %?

50% Ical 40% protein bound (albumin) 10% complexed with anions

Hormones that control calcium level

Parathyroid hormone - Parathyroid gland Vitamin D - Skin, Kidney Calcitonin - Thyroid Gland

Hypercalcemic hormone

Parathyroid hormone and Vit D

Hypocalcemic hormone

Calcitonin

Cancer, Hyperthyroidism, Iatrogenic causes, Multiple myeloma, hyperParathyroidism, Sarcoidosis

Hypercalcemia (CHIMPS)

Calcitonin, Hypoparathyroidism, Alkalosis, Renal failure (Ca Bi So), Vitamin D deficiency

Hypocalcemia (CHARD)

Flame test Lithium Potassium Rubidium Magnesium Calcium Sodium

Lithium - red Potassium - violet Rubidium - Red Magnesium - blue Calcium - orange Sodium - yellow

4 electrolytes for anion gap

Sodium, Potassium, Chloride, and Bicarbonate

Methanol poisoning, Uremia, Diabetic ketoacidosis, Paraldehyde ingestion, Hypernatremia, Instrument error, Iron, Inhalants, Isoniazid, Ibuprofen, Lactic acidosis, Ethylene glycol/Ethanol acidosis, Salicylates, Starvation

Increased anion gap (MUDPHILES)

Decreased Anion gap

Increased in unmeasured cation Decrease in unmeasured anion (ADIC) eg. Hypoalbuminemia Hypercalcemia

Major electrolyte concentration that provides the largest contribution to the osmolality value of serum (92%)

Sodium, Chloride, Bicarbonate

Osmolality method of determination

Direct method - Osmometer (colligative property) Indirect method - computation * 2 Na + (Glucose mg/dL / 20) + (BUN mg/dL / 3) OR * 1.86 Na + (Glucose / 18) + (BUN /2.8) + 9

____ particle concentration = _____ freezing point, vapor pressure and ____ boiling point, osmotic pressure

Increase, decrease, increase

Essential for the function of cellular enzymes and energy metabolism

Magnesium

Important role in membrane stabilization, nerve conduction, and ion transport and calcium channel activity

Magnesium

Distribution of magnesium

46% in tissues 53% in bones 1% in serum 1/3 are bound to albumin 2/3 are free or ionized form or bound to citrate

Regulation of magnesium

Henle's loop is the major renal regulatory site (50-60% is reabsorbed in the ascending limb)

Hypermagnesemia in the ff (rare)

Iatrogenic Elderly and patients with bowel disorder and renal insufficiency

Important in constituent in nucleic acid, phospholipid, and phospoproteins

Phosphorus

Regulation of phosphorus

Vitamin D - Increases phosphate levels by absorption in the intestine and reabsorption in the tubules Growth hormone - increases phosphate level by decreasing renal excretion of phosphate Parathyroid hormone - facilitates excretion of phosphate for reabsorption of calcium

Acidosis, over medication with vitamin D, infant's drinking cow's milk or adult drinking laxatives, lymphoblastic leukemia, Dec. PTH

Hyperphosphatemia

Alcohol abuse, vitamin D deficiency, steatorrhea, Ketoacidosis, COPD, Asthma, and malignancy

Hypophosphatemia

Specimen of choice for phophate

Serum sample Plasma - lithium heparin as anticoagulant

By product of an emergency mechanism that produces a small amount of ATP when oxygen is severely diminished

Lactate

Can be an early indicator of hypoxia

Lactate

Specimen of choice for lactate

Anticoagulant iodacetate and fluoride or heparin can be used. Must be placed in ice and quickly separated

Specimen handling for lactate

Avoid using tourniquet, if used blood should be collected immediately w/ no hand clenching

Normal value of pH

7.35 - 7.45

Normal value of pCO2

35-45 mmHg

Normal value of HCO3

22-29 mEq/L

pCO2 <35 mmHg

Respiratory alkalosis

pCO2 >45 mmHG

Respiratory acidosis

HCO3 <22 mEq/L

Metabolic acidosis

HCO3 >29 mEq/L

Metabolic alkalosis

Electrode for pH and it's principle

Glass electrode

Electrode for pCO2 and it's principle

Clarke electrode Amperometry/polagraphy

Electrode for HCO3 and it's principle

Severinghaus electrode / Potentiometry

Hormones produced: Thyrotrophin-releasing hormone Corticotrophin-releasing factor Other releasing or inhibiting horomens

Hypothalamus

Hormones produced: TSH ACTH LH Prolactin GH

Anterior pituitary gland

Hormones produced: (store and secrete) Vasopressin Oxytocin

Posterior pituitary gland

Hormones produced: Epinephrine (Adrenaline) Norepinephrine (Noradrenaline) (Catecholamines)

Adrenal Medulla

Hormones produced: Cortisol Aldosterone 11-deoxycortisol

Adrenal cortex

Hormones produced: T3 T4 Calcitonin

Thyroid gland

Hormones produced: PTH

Parathyroid gland

Hormones produced: Insulin Glucagon

Pancreas

Hormones produced: Gastrin

Gastrointestinal tract

Hormones produced: Estrogen Progesterone

Ovaries

Hormones produced: Progesterone hCG Human placental lactogen

Placenta

Hormones produced: Testosterones Other androgens

Testes

Hormones produced: EPO 1,25-dihydroxy Vitamin D Prostaglandin

Kidneys

What type of hormones? Cortisol Aldosterone Progesterone Estrogens Testoterones

Steroid hormones

What type of hormones? Insulin PTH LH FSH TSH Thyrotropin-releasing hormone ACTH Prolactin GH Calcitonin Glucagon

Peptide or protein hormones

What type of hormones? Epinephrine Norepinephrine T4 T3

Amines or amino acid derivatives

What type of hormones? Prostaglandins

Fatty acids

Stimulates the release of TSH and PROLACTIN

TRH

Stimulates the release of LH and FSH

Gonadotropin-releasing hormone (GnRH)

Stimulates ACTH release

Corticotrophin-releasing hormone (CRH)

Stimulates GH release

Growth hormone releasing hormone (GHRH)

Inhibits GH and TSH

Somatostatin

Inhibits prolactin release

Dopamine

Also known as the master gland

Anterior Pituitary gland

Most abundant of all pituitary hormone

Decreased GH or GHD

Dwarfism

Confirmatory test for dwarfism

Insulin tolerance test

Due to overproduction of GH in adulthood

Acromegaly

Screening and confirmatory test for adulthood

Screening = IGH-1 / Serum somatomedin C Confirmatory - OGTT

Hypersecretion of GH during childhood

Gigantism

Turns off secretion of ACTH and CRH

Increased cortisol

Stimulates secretion of ACTH

Decreased cortisol

ACTH is highest at what time of the day

Morning

ACTH function

Stimulates the synthesis of cortisol (adrenal cortex)

Gondaotropins

FSH and LH

what does FSH do in male

Aids in spermatogenesis

What does FSH do in female

aids in ovulation and final follicular growth

What does LH do in male

Helps leydig cells produce testosterone

What does LH do in female

Helps corpus luteum produce estrogen

Also known as thyrotropin

TSH

Also known as pituitary lactogen hormone

Prolactin

Does not have the capacity to produce hormones, only releases hormones.

Posterior pituitary gland

Vasopressin and Oxytocin are produced in?

Hypothalamus

Main stimulus for the creation of thyroid hormone

Iodine

Lobes of thyroid glands are connected by

Isthmus

Produced by follicular cells

T3 and T4

Produced by parafollicular cells

Calcitonin

Two major cells of thyroid gland

Follicular cells and Parafollicular cells

Most active thyroid hormonal activity

Better indicator of recovery from hyperthyroidism as the recognition of recurrence of hyperthyroidism

Most abundant thyroid hormone

T3 - INC T4 - INC TSH - DEC

Primary hyperthyroidism

T3 - INC T4 - INC TSH - INC

Secondary Hyperthyroidism

T3 - N T4 - N TSH - DEC

Subclinical Hyperthyroidism

T3 - Dec T4 - Dec TSH - INC

Primary hypothyroidism

T3 - Dec T4 - Dec TSH - Dec

Secondary hypothyroidism

T3 - N T4 - N TSH - INC

Subclinical Hypothyroidism

Primary hormone that responds to stress

Catecholamines

Outer region of adrenal gland

Adrenal cortex

Major site of steroid hormone

Adrenal cortex

Principal source of meralocorticoid (aldosterone)

Zona glomerulosa

Site of glucocorticoid synthesis (cortisol)

Zona Fasciculata

Produces androstenedione and dehydroepiandrosterone

Zona reticularis

Principal glucocorticoid

Cortisol

Cushing's syndrome

Excessive production of cortisol

Screening test for cushing's syndrome

24 hour urinary free cortisol Overnight dexamethasone Midnight salivary cortisol

Confirmatory test for cushing's syndrome

Low-dose dexamethasone suppression Midnight plasma control Corticotrophin-releasing hormone stimulation test

Cortisol: INC ACTH: INC

Cushing's disease (Primary)

Cortisol: INC ACTH: DEC

Cushing's syndrome (secondary)

Addison's disease

Decrease cortisol production

Screening test and confirmatory test for addison's disease

Screening: ACTH stimulation test Confirmatory test: Insulin tolerance test

Most potent mineralocorticoid

Aldosterone

Conn's disease

Primary Hyperaldosteronism

Function is for sodium retention

Aldosterone

Screening and confirmatory test for conn's disease

Screening - Plasma aldo concentration/ Plasma renin activity ration Confirmatory test - Saline suppression test Oral sodium loading test Fludrocortisone suppresion Captopril challenge

Testosterone - DEC LH and FSH - DEC

Pre-testicular (secondary hypogonadism)

Testosterone - DEC LH and FSH - INC

Testicular (Primary hypogonadism)

Testosterone - N LH and FSH - N

Post-testicular

Rise in FSH stimulates estrogen production

Follicular phase

After the LH surge, subsequent luteinization of the graafian follicle to form the corpus luteum

Luteal phase

Most abundant estrogen in post-menopausal women

Estrone (E1)

Most potent estrogen secreted by the ovary and the most abundant estrogen in premenopausal women

Estradiol (E2)

Estrogen found in maternal urine Major estrogen secreted by the placenta during pregnancy

Estriol (E3)

Used to assess fetoplacental viability and as a marker for Down syndrome

Estriol (E3)

Natural steroid produced by the human fetal liver May be used as an oral contraceptive

Estetrol (E4)

FSH and LH - HIGH E2 - LOW

Menopause (primary hypogonadism)

FSH and LH - LOW E2 - LOW

Sheehan's syndrome (Secondary hypogonadism)

Diagnostic marker for Zollinger Ellison syndrome

Gastrin

Produced by trophoblast cells of the placenta

hCG

A dimeric molecule consisting of one alpha and one beta subunit that confers antigenic individuality

hCG

Diagnostic marker for carcinoid tumor

5-HIAA

Secreted in one location and release into blood circulation, binds to specific receptor to elicit physiological response

Endocrine

Secreted in endocrine cells and released into interstitial space; binds to specific receptor in adjacent cells and affects its function

Paracrine

Secreted in endocrine cells and sometimes released into interstitial space; binds to specific receptor on cell of ORIGIN resulting SELF-regulation of its function

Autocrine

Secreted in endocrine cells and remains in relation to plasma membrane; acts on immediately adjacent cell by direct cell-cell contact

Juxtacrine

Secreted in endocrine cells and released into lumen of gut

Exocrine

Secreted in neurons and release into extracellular space; binds to receptor nearby cells and affects its function

Neurocrine

Secreted in neurons and released from nerve endings; interacts with receptors of cells at distant site

Neuroendocrine

Secreted in the cells and REMAINED as well as function inside the synthesis of origin

Intracrine

The hypothalamus is above the pituitary gland and is connected to the ____

Infundibulum

Responsible for secreting compounds towards the pituitary gland in order for the hypothalamus to be able to regulate the compounds released by the pituitary gland

Neurons

Carry the trophic hormones directly to the anterior pituitary

Portal vessel

Release their hormones into the second set of capillaries for distribution to the rest of the body

Endocrine cells of the pituitary gland

Inhibitory neutrotansmitter

Gamma-aminobutyric acid (GABA)

Affected by serotonin, endorphins, acetylcholine

ACTH release

Stress, inflammation, hypoglycemia

Physiologic stimulus

Looks like a pinecone

Conarium/Epiphysis cerebri (pineal gland)

Inappropriate production of breast milk

Galactorrhea - Hypersecretion of PRL

Inhibits the release of ADH

Ethanol

Cortisol is bound to a glycoprotein which is known as

Transcortin

Most potet meralcorticoid

Aldosterone

Resembles primary aldosteronism clinically, but aldosterone level is low and absence of hypertension

Liddle's syndrome

Aldosterone: Inc Renin : dec BP: High K: Low

Primary hyperaldosteronism

Aldosterone: Inc Renin: Inc BP: high except in edematous disorder K: Low / normal

Secondary hyperaldosteronism

Aldosterone: Dec Renin: Inc BP: Low K: High

Primary hypoaldosteronism

Hyperthyroidism with peculiar edema behind the eyes called exolphthalmos

Grave's disease

The thyroid turns into a woody or stone-hard mass

Riedel's

Most common cause of primary hypothyroidism

Hashimoto's disease

Aluminum is measured using

ICP-MS or GFAAS

Blackfoot disease

Arsenic exposure

Normal amount of copper in the body

50-120mg

Menke's disease

extreme copper deficiency

Interferes with absorption of iron and zinc

Copper

Wilson's disease

Copper toxicity

* Iron deficiency * Late pregnancy * Oral contraceptives * Viral Hepatitis

Increase in TIBC

* Chronic infections * Malignancy * Iron poisoning * Nephrosis * Kwashiorkor * Thalassemia

Decrease in TIBC

Typical threshold for acute lead toxicity

45ug/dL

Upper threshold for lead toxicity, shows signs and symptoms

60ug/dL

Acute manganese aerosol intoxication

Locura manganica (manganese madness)

Keshan's disease and Kashin-beck disease

Selenium deficiency

Chemistry week 3 Flashcards

Elec, blood gases, Toxicology, Endocrinology