Chloride and Bicarbonate (RVSP)

Question 0

3 functions of chloride

Answer 0

• maintains osmolality
• maintains blood volume
• maintains electric neutrality

Question 1

Major extracellular anion

Answer 1

Chloride (Cl-)

Question 2

Cl- shifts secondarily to a movement of ___ and ___

Answer 2

Na+

HCO3-

Question 3

Organ that absorbs Cl-

Answer 3

Small intestine

Question 4

Passively reabsorbs Cl-

Answer 4

Proximal tubules

Question 5

Excess Cl- is excreted in the _____ and ______

Answer 5

Urine

Sweat

Question 6

Stimulates aldosterone secretion; Cl-

Answer 6

Excessive sweating

Question 7

Effect of aldosterone on serum Cl- levels

Answer 7

Increased Cl- levels

Question 8

Effect of aldosterone on sweat Cl- levels

Answer 8

Decreased Cl- levels

Question 9

Electrolyte that is the partner of Na+

Answer 9

Cl-

Question 10

2 ways in which Cl- maintains electric neutrality

Answer 10

• Cl- acts as a rate-limiting component in Na+ reabsorption

- Chloride shift

Question 11

Buffers H+ inside the red cell

Answer 11

Deoxyhemoglobin

Question 12

Process of maintaining electric neutrality where Cl- diffuses into the red cell as HCO3- didfuses out into the plasma

Answer 12

Chloride shift

Question 13

True/False. Cl- passively follows Na+

Answer 13

True

Question 14

Excessive loss of HCO3-; increased serum Cl-

Answer 14

Hyperchloremia

Question 15

Excessive loss of Cl-

Answer 15

Hypochloremia

Question 16

Causes of hyperchloremia

Answer 16

• GI losses
• RTA
• metabolic acidosis

Question 17

Causes of hypochloremia

Answer 17

• prolnged vomiting
• diabetic ketoacidosis
• aldosterone deficiency
• salt-losing renal diseases (ex: pyelonephritis)
• metabolic alkalosis
• compensatory respiratory acidosis

Question 18

Specimens for Cl-

Answer 18

• serum
• plasma (lithium heparin)
• whole blood
• urine (24 hr)
• sweat

Question 19

Effect of hemolysis on Cl- levels

Answer 19

Decreased (because of dilutional effect)

Question 20

Most commonly used method for Cl-

Answer 20

ISE

Question 21

Mts for Cl-; uses silver wire coated with AgCl as electrode

Answer 21

ISE

Question 22

Reaction for Colorimetric determination of Cl-

Answer 22

Cl- + Hg(SCN)2 —> HgCl2 + SCN-

SCN- + Fe3+ —> Fe(SCN)3

Question 23

Cl- mtd; Ag+ combines with Cl-; excess/free Ag+ indicates endpoint

Answer 23

Cotlove Chloridometer/Whitehorn/Sendroy Stiff/Amperometric-Coulometric

Question 24

Cl- mtd; excess amount of Hg measured by titrating diphenylcarbazone

Answer 24

Schales and Schales / Mercurimetric titration

Question 25

Endpoint of Schales and Schales mtd for Cl-

Answer 25

Blue violet color

Question 26

Reaction for Schales and Schales / Mercurimetric titration for Cl-

Answer 26

Cl- + Hg(NO3)2 ---> HgCl2 + NO3-

Question 27

Titrated in the mercurimetric titration/Schales and Schales method for Cl-

Answer 27

Diphenylcarbazone

Question 28

RR for Cl- (Serum/plasma and urine)

Answer 28

Serum/plasma: 98-107 mmol/L | Urine: 110-250 mmol/day, varies with diet

Question 29

Indicator if Cl- movement

Answer 29

Na+

Question 30

Second most abundant anion in the ECF

Answer 30

Bicarbonate (HCO3-)

Question 31

Composition of Total CO2

Answer 31

- Bicarbonate ion (HCO3-): 90% - carbonic acid (H2CO3) - dissolved CO2

Question 32

Indicative of Total CO2 measurement

Answer 32

HCO3- measurement

Question 33

Major component of the buffering system of blood

Answer 33

HCO3-

Question 34

Reaction in the production of HCO3-

Answer 34

CO2 + H2O H2CO3 H+ + HCO3-

Question 35

Is CO2 acidic or basic?

Answer 35

Acidic

Question 36

Reabsorbs 85% of HCO3-

Answer 36

Proximal tubules

Question 37

Reabsorbs 15% of HCO3-

Answer 37

Distal tubules

Question 38

HCO3- is reabsorbed in the tubules as _______

Answer 38

CO2

Question 39

Problem in alkalosis

Answer 39

Too much HCO3-

Question 40

Remedy for alkalosis

Answer 40

Excrete HCO3-

Question 41

Problem in Acidosis

Answer 41

Too much H+

Question 42

Remedy for Acidosis

Answer 42

- excrete H+ | - reabsorb HCO3-

Question 43

HCO3- level in metabolic acidosis

Answer 43

Decreased

Question 44

Response for metabolic acidosis

Answer 44

Hyperventilation

Question 45

Total CO2 level in metabolic alkalosis

Answer 45

Increased

Question 46

Response for metabolic alkalosis

Answer 46

Hypoventilation

Question 47

3 causes of metabolic alkalosis

Answer 47

- severe vomiting - hypokalemia - excessive alkali intake

Question 48

Specimens for HCO3- determnation

Answer 48

Serum Plasma (lithium heparin) ANAEROBIC (specimens should be capped)

Question 49

Rate of decrease in CO2 if specimen is left uncapped

Answer 49

6 mmol/L/hr

Question 50

HCO3- mtd; uses an acid reagent to convert all forms of CO2 to CO2 gas; uses pCO2 electrode

Answer 50

ISE

Question 51

In the ISE mtd for HCO3-, all forms of CO2 is converted to _______

Answer 51

CO2 gas

Question 52

Electrode used in ISE for HCO3-

Answer 52

pCO2 electrode

Question 53

Reagent used in ISE for HCO3-

Answer 53

Acid reagent

Question 54

HCO3- mtd; Sx is alkalinized to convert all forms of CO2 to HCO3-

Answer 54

Enzymatic mtd

Question 55

In enzymatic mtd for HCO3-, all forms of CO2 is converted to ______

Answer 55

HCO3-

Question 56

Reaction for Enzymatic mtd for HCO3-

Answer 56

1. Phosphoenolpyruvate (PEP) + HCO3- --PEP Carboxylase--> Oxaloacetate + H2PO4- 2. Oxaloacetate + NADH + H+ --MDH--> malate + NAD+ MDH: malate dehydrogenase

Question 57

RR for HCO3- (plasma, serum)

Answer 57

CO2, venous 23-29 mmol/L