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Clinical Chemistry 2 > Chloride and Bicarbonate (RVSP) > Flashcards

Chloride and Bicarbonate (RVSP) Flashcards

0
Q

3 functions of chloride

A
  • maintains osmolality
  • maintains blood volume
  • maintains electric neutrality
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1
Q

Major extracellular anion

A

Chloride (Cl-)

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2
Q

Cl- shifts secondarily to a movement of ___ and ___

A

Na+

HCO3-

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3
Q

Organ that absorbs Cl-

A

Small intestine

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4
Q

Passively reabsorbs Cl-

A

Proximal tubules

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5
Q

Excess Cl- is excreted in the _____ and ______

A

Urine

Sweat

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6
Q

Stimulates aldosterone secretion; Cl-

A

Excessive sweating

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7
Q

Effect of aldosterone on serum Cl- levels

A

Increased Cl- levels

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8
Q

Effect of aldosterone on sweat Cl- levels

A

Decreased Cl- levels

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9
Q

Electrolyte that is the partner of Na+

A

Cl-

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10
Q

2 ways in which Cl- maintains electric neutrality

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

- Chloride shift

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11
Q

Buffers H+ inside the red cell

A

Deoxyhemoglobin

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12
Q

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

A

Chloride shift

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13
Q

True/False. Cl- passively follows Na+

A

True

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14
Q

Excessive loss of HCO3-; increased serum Cl-

A

Hyperchloremia

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15
Q

Excessive loss of Cl-

A

Hypochloremia

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16
Q

Causes of hyperchloremia

A
  • GI losses
  • RTA
  • metabolic acidosis
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17
Q

Causes of hypochloremia

A
  • prolnged vomiting
  • diabetic ketoacidosis
  • aldosterone deficiency
  • salt-losing renal diseases (ex: pyelonephritis)
  • metabolic alkalosis
  • compensatory respiratory acidosis
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18
Q

Specimens for Cl-

A
  • serum
  • plasma (lithium heparin)
  • whole blood
  • urine (24 hr)
  • sweat
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19
Q

Effect of hemolysis on Cl- levels

A

Decreased (because of dilutional effect)

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20
Q

Most commonly used method for Cl-

A

ISE

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21
Q

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

A

ISE

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22
Q

Reaction for Colorimetric determination of Cl-

A

Cl- + Hg(SCN)2 —> HgCl2 + SCN-

SCN- + Fe3+ —> Fe(SCN)3

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23
Q

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

A

Cotlove Chloridometer/Whitehorn/Sendroy Stiff/Amperometric-Coulometric

24
Q

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

A

Schales and Schales / Mercurimetric titration

25
Q

Endpoint of Schales and Schales mtd for Cl-

A

Blue violet color

26
Q

Reaction for Schales and Schales / Mercurimetric titration for Cl-

A

Cl- + Hg(NO3)2 —> HgCl2 + NO3-

27
Q

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

A

Diphenylcarbazone

28
Q

RR for Cl- (Serum/plasma and urine)

A

Serum/plasma: 98-107 mmol/L

Urine: 110-250 mmol/day, varies with diet

29
Q

Indicator if Cl- movement

A

Na+

30
Q

Second most abundant anion in the ECF

A

Bicarbonate (HCO3-)

31
Q

Composition of Total CO2

A
  • Bicarbonate ion (HCO3-): 90%
  • carbonic acid (H2CO3)
  • dissolved CO2
32
Q

Indicative of Total CO2 measurement

A

HCO3- measurement

33
Q

Major component of the buffering system of blood

A

HCO3-

34
Q

Reaction in the production of HCO3-

A

CO2 + H2O H2CO3 H+ + HCO3-

35
Q

Is CO2 acidic or basic?

A

Acidic

36
Q

Reabsorbs 85% of HCO3-

A

Proximal tubules

37
Q

Reabsorbs 15% of HCO3-

A

Distal tubules

38
Q

HCO3- is reabsorbed in the tubules as _______

A

CO2

39
Q

Problem in alkalosis

A

Too much HCO3-

40
Q

Remedy for alkalosis

A

Excrete HCO3-

41
Q

Problem in Acidosis

A

Too much H+

42
Q

Remedy for Acidosis

A
  • excrete H+

- reabsorb HCO3-

43
Q

HCO3- level in metabolic acidosis

A

Decreased

44
Q

Response for metabolic acidosis

A

Hyperventilation

45
Q

Total CO2 level in metabolic alkalosis

A

Increased

46
Q

Response for metabolic alkalosis

A

Hypoventilation

47
Q

3 causes of metabolic alkalosis

A
  • severe vomiting
  • hypokalemia
  • excessive alkali intake
48
Q

Specimens for HCO3- determnation

A

Serum
Plasma (lithium heparin)

ANAEROBIC (specimens should be capped)

49
Q

Rate of decrease in CO2 if specimen is left uncapped

A

6 mmol/L/hr

50
Q

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

A

ISE

51
Q

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

A

CO2 gas

52
Q

Electrode used in ISE for HCO3-

A

pCO2 electrode

53
Q

Reagent used in ISE for HCO3-

A

Acid reagent

54
Q

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

A

Enzymatic mtd

55
Q

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

A

HCO3-

56
Q

Reaction for Enzymatic mtd for HCO3-

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

MDH: malate dehydrogenase

57
Q

RR for HCO3- (plasma, serum)

A

CO2, venous 23-29 mmol/L

Clinical Chemistry 2 (11 decks)

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