CHLORIDE Flashcards
COUNTERION of sodium
Chloride
average concentrations of Chloride in Skeletal Muscles:
2 to 5 mmol/L
average concentrations of Chloride in Erythrocytes:
90 mmol/L
Average concentrations of Chloride in Plasma:
97 to 107 mmol/L
It has rate limiting component of sodium
Chloride
Functions of Chloride
-Serum electroneutrality
-acid-base balance
-fluid homeostasis
-osmotic pressure
-hydrochloric acid production in the GIT
-renal function
It has a general characteritics of principal extracellular anion and COUNTERION of sodium
Chloride
It is the way in serum when sodium along with chloride in the proximal tubules.
Electroneutrality
2 ways of Electroneutrality in Serum
(1) Sodium is reabsorbed along with Chloride in the Proximal Tubules.
(2) Chloride Shift Phenomenon
Formation is dependent on renal excretion of hydrogen ions.
Bicarbonate
Normal Values of Chloride in Serum and 24-hour urine.
Serum: 98-107mmol/L
24-hour urine: 110-250 mmol/L
Normal value of Bicarbonate in Plasma
22-26 mmol/L
Excess Chloride intake in Hyperchloremia
-Hypertonic saline administration
-Increased Dietary acid load with chronic kidney dysfunction
Excessive water loss in Hyperchloremia
-Fever
-Diaphoresis(excessive sweating)
-Decreased water intake
-Decreased thirst sensation
-Diabetes insipidus
-Osmotic type of diarrhea
-Renal dysfunction
What are the Primary Measured Cations?
-Sodium
-Potassium
What are the Primary Measured Anions?
-Chloride
-Bicarbonate
T/F:
Normally, the total number of cations should be less than to the total number of anions.
False
(T/F)
The total number of cations and total number of Anions has an overall neutral electrical charge.
True
What are the Hypochloremia?
- Gastrointestinal loses from protected emesis(vomiting)
-Secretion type of diarrhea
-Use of Thiazide diuretics ( cardiovascular px)
-Osmotic diuretic therapy (neurologically injured px)
-Chronic Renal Failure - Adrenal sufficiency
When potassium is not included, what would be the expected value?
7 to 16 mmol/L
When potassium is included, What would be the expected value?
10 to 20 mmol/L
Formula of anion gap without potassium
[Na+]-[(Cl^-)+(HCO3)]
Formula of Anion gap with potassium
(Na^+ + K^+) - ( Cl^- + HCO3)
Clinical Significance of Anion gap
Chloride should always substitute bicarbonate (Increased Anion Gap & Decreased Anion Gap)
What are the Increased anion gap?
- Uremia(renal failure)
- Ketoacidosis
- Poisoning due to ingestion of toxic substances
- Lactic acidosis
- severe dehydration
- Instrument error
What are the toxic substances that may be poisoning due to ingestion?
-Methanol
-Ethanol
-Ethylene glycol
-Salicylate
What are the decreased Anion Gap
- Hyperalbuminemia
- Severe hypercalcemia
- Multiple myeloma
- Instrument error
Formation of Bicarbonate:
Carbon Dioxide + Water <—> ^carbonic ahydrase <—> Carbonic acid<—> Bicarbonate + Hydrogen ion
CO2+H20 <—> H2CO3 <—> HCO3^- + H^+
