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CC LEC 2 > CHLORIDE, MAGNESIUM, POTASSIUM .... > Flashcards

CHLORIDE, MAGNESIUM, POTASSIUM .... Flashcards

1
Q

The major intracellular cation in the body.

● With a concentration 20 times greater inside the cells than
outside.

A

POTASSIUM

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2
Q

As a result, only _____ of the body’s total K+ circulates in the
plasma.

A

2% - POTASSIUM

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3
Q

Functions of K+ in the body include ___________, ___________, _______, __________

A

regulation of neuromuscular excitability, contraction of the heart,
ICF volume, and H+ concentration.
(RCIH)

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4
Q

The internal environment of the cell is negatively charged when at
rest.

A

Resting Membrane Potential

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5
Q

● Has a charge of -70 mv

A

Resting Membrane Potential

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6
Q

Passively and continuously leaks out potassium outside

A

Potassium Channel

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7
Q

When the cells receives a stimuli, and an action has to be
performed, the intracellular space must be positive

A

Excitation

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8
Q

During cell excitation, sodium enters the cell to create a
positive charge, rather than releasing ___________

A

potassium outside

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9
Q

In membrane potential has three (depolarization)

A
  1. Threshold of excitation
  2. Intracellular NA increases
  3. Extracellular K increases
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10
Q

the cell’s electrical charge becomes more positive and less negative

A

Depolarization

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11
Q

the process by which a cell returns to its resting electrical state
after a depolarization (change from negative to positive charge),
typically involving the efflux of potassium ions.

Happens when potassium is move out from the cell
○ Same reason with sodium, it is easier and faster for
potassium to be expelled outside the cell as the
concentration of the cell is less outside.
○ Aside from that the channels of plasma membrane favors
more potassium rather than sodium

A

Repolarization

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12
Q

is when a cell’s electrical charge becomes even more negative
than its usual resting state, making it less likely to fire an
electrical signal.
○ Happens as there is an increase of potassium outflow due
to the fact that potassium channels take time to close.

A

Hyperpolarization

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13
Q

The pump helps establish and maintain the resting membrane
potential of a cell.
○ By pumping three sodium ions out of the cell and two
potassium ions into the cell against their respective
concentration gradients.
○ This process ensures that there are more sodium ions
outside the cell and more potassium ions inside.

A

Sodium-Potassium Pump

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14
Q

The proximal tubules reabsorb nearly all the K+
○ Under the influence of aldosterone, additional K+ is
secreted into the urine in exchange for Na+ in both the
distal tubules and the collecting ducts

A

REGULATION OF POTASSIUM

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15
Q

○ Thus ___________ is the principal determinant of urinary
K+ excretion

A

Distal nephron

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16
Q

3 RENAL PROCESSES

A

Glomerular Filtration
Tubular Reabsorption
Tubular Secretion

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17
Q

Substances are filtered based on size and charge . Ions are
filtered

A

Glomerular Filtration:

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18
Q

Reabsorption of essential nutrients is being done, majority of
which happens at Proximal Convoluted Tubule (PCT)
● Direction: ______________

A

Tubular Reabsorption: Tubules to circulation

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19
Q

Direction: _____________
● Occurs in the Distal Convoluted Tubules (DCT) and Collecting
Ducts

A

Tubular Secretion: circulation to the tubules

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20
Q

It serves to eliminate waste products that were not filtered by the
glomerulus.
● High pressure in the glomerulus prevents all waste products from
being filtered, causing some to be returned to the blood vessels
around the nephron.

A

Tubular Secretion

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21
Q

The secretion of potassium in DCT and Collecting Ducts is under
the influence of _________

A

aldosterone

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22
Q

Aldosterone stimulates both parts of the ________ to
reabsorb sodium at the expense of potassium

A

nephron

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23
Q

The kidney reabsorbs filtered K+ in ____________ and _________

A

hypokalemic states and secretes K+ in hyperkalemic states

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24
Q

Also, only our _________ can eliminate potassium. Thus, it is very
important to know if your kidneys are working

A

kidneys

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25
Q

3 FACTORS THAT INFLUENCE THE DISTRIBUTION OF K+
BETWEEN CELLS AND ECF

A

Potassium, Insulin, Catecholamines

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26
Q

_____________ loss frequently occurs whenever the Na-K ATPase
pump is inhibited by conditions (hypoxia, hypomagnesemia,
*digoxin overdose)

A

Potassium

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27
Q

promotes acute entry of K ions into skeletal muscle and
liver by increasing Na-K ATPase activity

A

Insulin

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28
Q

_____________ promote cellular entry of K, whereas ___________
impairs cellular entry of K activity

A

Catecholamines; propranolol

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29
Q

_______________(adrenaline) & _____________
(noradrenaline)

A

Epinephrine
norepinephrine

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30
Q

■ Flight and fight

A

Epinephrine

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31
Q

Medication for the heart
■ Beta blocker
■ Possible that our potassium increases in our blood if it
cannot enter the cell

A

○ Propranolol

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32
Q

K is released from cells during _________

A

exercise

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33
Q

In exercise Increases K by __________ mmol/L

A

0.3 – 1.2 mmol/L

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34
Q

Reversed after several minutes of rest

A

exercise

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35
Q

● ____________ during venipuncture can cause erroneous high
plasma K concentrations or _____________

A

Forearm exercise - pseudohyperkalemia

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36
Q

______________ as with uncontrolled diabetes mellitus, causes
water to diffuse from the cells, carrying K+ with the water, which
leads to gradual depletion of K+ if kidney function is norma

A

HYPEROSMOLALITY

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37
Q

_________ into the ECF when cells are broken down
●___________, _______, __________

A

CELLULAR BREAKDOWN
Releases K
Severe trauma, tumor lysis syndrome, and massive blood
transfusions (STM)

38
Q

● Low potassium in the blood

A

HYPOKALEMIA

39
Q

HYPOKALEMIA DUE TO GASTROINTESTINAL LOSS (6)

A

(VDGIMC)
Vomiting
● Diarrhea
● Gastric suction
● Intestinal tumor
● Malabsorption
● Cancer therapy (chemotherapy, radiation therapy)

40
Q

Inhibits Na-Cl co-transporter leading to the secretion of K
via potassium channels in the collecting duct

A

● Diuretics (Thiazides and Loop)

41
Q

___________is the most common cause of
hypokalemia

A

(The use of ) diuretics

42
Q

drugs that are promoting diaphoresis or excretion of water from the body

A

Diuretics

43
Q

Inhibits the reabsorption of sodium

A

Thiazides

44
Q

If you’re drinking these two diuretic, dapat may third
drug na ma add , si ________________

A

potassium sparing diuretics

45
Q

Due to increased accumulation of acid in the body, more
bicarbonate ions will be excreted together with K+

A

● Renal Tubular Acidosis

46
Q

pH of Blood: ______________

A

7.35-7.45

47
Q

A condition in which the adrenal gland produces too much
aldosterone
○ More Na ions will be retained in exchange of K ions
○ You are reabsorbing more sodium

A

● Hyperaldosteronism

48
Q

Low magnesium levels in the blood
○ Potassium channels or Renal Outer Medullary K+ (ROMK)
Channel are inhibited by magnesium

A

● Hypomagnesemia

49
Q

In alkalemia (a condition where the blood becomes
more alkaline), cells take up more potassium (K+)
because alkalemia causes the cells to lose hydrogen
ions (H+) in order to balance and reduce their internal
pH level.

A

● Alkalosis

50
Q

Low potassium in blood
● In healthy persons, an acute oral load of K+ will briefly increase
plasma K+ because most of the absorbed K+ rapidly moves
intracellularly

A

HYPOKALEMIA

51
Q

CAUSES OF HYPERKALEMIA (DCIA)

DECREASED RENAL EXCRETION (4)
CELLULAR SIFT (5)
INCREASED INTAKE (1)
ARTIFICIAL (4)

A

DECREASED RENAL EXCRETION (AHAD)
Acute or chronic renal failure (GFR < 20 mL/min )
● Hypoaldosteronism
● Addison’s disease
● Diuretics

CELLULAR SIFT (AMCLH)
● Acidosis
● Muscle /Cellular injury
● Chemotherapy
● Leukemia
● Hemolysis

INCREASED INTAKE (O)
Oral or intravenous potassium replacement therapy

ARTIFICIAL (STGPR)
● Sample hemolysis
● Thrombocytosis
● Prolonged tourniquet use or excessive fist clenching
● GFR, glomerular filtration rate

52
Q

● Major Extracellular Anion

A

CHLORIDE ION

53
Q

Function of Chloride ○ Involved in maintaining _________, _______, _______

A

osmolality, blood volume, and electric neutrality
OBE

54
Q

Physiology & Regulation
○ Main source: __________________
■ We get chloride from our food along with
other electrolytes that are absorbed in the
gastrointestinal system.
○ Kidney: _________ and __________
○ Excess chloride is excreted in ___________ and _______

A

DIET - GI absorption
filtration and reabsorption in PCT
urine and sweat

55
Q

Excessive sweating stimulates aldosterone
secretion - _____________

A

sweat glands

56
Q

○ Act as rate-limiting component

A

● Electrical Neutrality

57
Q

CI- diffuses into the red blood cell to maintain
electroneutrality
○ The movement of chloride from the plasma into our
RBC (replacing the leaving bicarbonate which is also
an anion)

A

● Chloride shift

58
Q

__________ it’s a byproduct of our body and has to be removed through
RBCs.

A

CO2

59
Q

CO2 will bind to water via____________ to form_______________

A

Carbonic anhydrase to form Carbonic
acid (H2CO3)

60
Q

Excess loss of HCO3

A

HYPERCHLOREMIA

61
Q

Excess loss of Cl-

A

HYPOCHLOREMIA

62
Q

HYPERCHLOREMIA as a result
of: (3)

A

● RBC will give off
chloride instead, since
bicarbonate is
insufficient (chloride
levels will increase)
● GI losses
● RTA or Metabolic
Aldosterone acidosis

63
Q

HYPOCHLOREMIA (4)

A

● Prolonged vomiting
(will lead to a poor
absorption of our
electrolytes)
● Diabetic ketoacidosis
● Aldosterone deficiency
(sodium will not be
reabsorbed and
chloride will not also
be reabsorbed)
● Salt-losing
nephropathy
(pyelonephritis)

64
Q

Fifth most common element and is the most prevalent cation in
the human body

A

CALCIUM

65
Q

Sodium is prevalent in the __________ while calcium are
prevalent in our __________

A

plasma - bones

66
Q

Majority of our calcium is stored in our _________, they
are not __________ and are not _________

A

bones
not physiologically active and not circulating

67
Q

FUNCTIONS OF CALCIUM

A

Skeletal mineralization (stored as hydroxyapatite)
● Blood coagulation serves as Clotting Factor IV
● Neural transmission
○ calcium propagate signals down our axons
○ are also involved in dumping neurotransmitters like
acetylcholine, into our synapses (calcium is needed
by the acetylcholine to leave the terminal end of the
axon and enter the synaptic cleft, and bind to its
receptor)
● Pasma buffering capacity and enzyme activity
● Maintenance of normal muscle tone and excitability of skeletal
and cardiac muscle (because it has a connection with our signals
coming from the nerve cells)

68
Q

DISTRIBUTION OF CALCIUM

_______ bone(as hydroxyapatite)
● ______ - circulation (blood) + ECF
● ______ is further divided into 3 different types of calcium:
○ ______ - bound to anions
○ _______- bound to protein (albumin)
○ ________-Free/ ionized Ca*+

A

99% > bone(as hydroxyapatite)
● 1% - circulation (blood) + ECF
● 1% is further divided into 3 different types of calcium:
○ 10% - bound to anions
○ 40% - bound to protein (albumin)
○ 50% -Free/ ionized Ca*+

69
Q

In the laboratory, they are ____________
Calcium results will include calciums that are bound
to proteins and anions

A

hard to measure alone.

70
Q

Some labs have separate tests for total calcium and
free/ionized calcium
○ Total calcium may look normal but free/ionized
calcium may be low, leading to _______ and _______

A

conditions and erroneous results

71
Q

Decreased free calcium levels in the blood can cause muscle
spasms or uncontrolled muscle contractions called __________

A

tetany

72
Q

3 HORMONES THAT REGULATE CALCIUM

A
  1. PTH: secreted in low calcium levels
  2. Vitamin D
  3. Calcitonin: secreted in high calcium levels
73
Q

Trigger or stimulus to increase calcium levels
remember 99% of calcium is stored in bones
(meaning pwedeng kumuha doon sa bone ng excess
calcium) kasi only 1% of our calcium circulates on
plasma
● once you experience low calcium level on your body
it will release PTH, and this PTH will trigger bone
resorption meaning there is a breakdown of parts of
bone in order to release calcium from bone into
circulation thereby normalizing low calcium levels

A
  1. PTH: secreted in low calcium levels
74
Q

Triggers to increase the absorption of calcium in our
diet and also help our PTH in bone resorption.
● Target: to increase calcium level in blood

A
  1. Vitamin D
75
Q

Secreted by thyroid gland
● Secreted in high calcium level (opposite of both PTH
and Vit. D)
● If mataas ang calcium level sa blood, calcitonin will
be released by thyroid gland to excrete excess
calcium and will become normal level in blood)
● Meaning ginapababa niya ang calcium level

A
  1. Calcitonin: secreted in high calcium levels
76
Q

an inactive substance in the skin

A

7-dehydrocholesterol

77
Q

● still an inactive form of vitamin D
● Produced when 7-dehydrocholesterol is exposed to UV Light

A
  1. Cholecalciferol or vitamin D3
78
Q

● Both of them, will enter liver and be converted to calcidiol
(25-hydroxyvitamin D)
● Still an inactive form of vit. D
● Will enter kidney and will form an active form of vitamin D

A
  1. Ergocalciferol or Vitamin D2
79
Q

l (1, 25-dihydroxyvitamin D or 1,25-dihydroxycholecalciferol
(1,25-[OH]2 -D3 ) - has power to induce certain changes in our body to
increase calcium levels in plasma

The active form of Vitamin D
● To increase intestinal absorption of calcium in our diet
○ Induce to increase bone resorption, hence prompting
breakdown of the bone, causing the release of
calcium into circulation
○ Lastly, it decreases the excretion of calcium as well
as phosphate.

A
  1. Calcitriol
80
Q

a reserve and will be activated by thyroid hormone

A

Inactive metabolite (24, 25-dihydroxyvitamin D

81
Q

In summary

A

7-dehydrocholesterol → UV light exposure →
Cholecalciferol + Ergocalciferol (from diet) → Enter
together in the liver and undergo hydroxylation →
Calcidiol → Hydroxylated in the Kidney → Calcitriol
(Active form of Vitamin D)
○ Hence to make an active form of vitamin D
Cholecalciferol must undergo two hydroxylation
processes first from the liver second in the kidneys.

82
Q

Increase the level of calcium in our blood and trigger or
stimulus is low in calcium levels
● To increase or to normalize low calcium level

A

PARATHYROID HORMONE

83
Q

PARATHYROID HORMONE
● 3 MAJOR EFFECTS: (BCS)

A

○ Bone resorption
○ Conserves Ca2+ by increasing tubular reabsorption
○ Stimulates renal production of active vitamin D

84
Q

____________ is not good because calcium tends to deposit in
our body

A

Hypercalcemia

85
Q

Fourth most abundant cation
● Second most abundant intracellular ion

A

MAGNESIUM

86
Q

MAGNESIUM
○ ______ - bone
○_______ - muscle and other organs and soft tissue
○ Less than ______ serum and erythrocytes
■ Protein-bound (primarily albumin)
■ Free or ionized form : major
■ Complexed with other ions

A

53%
46%
1%

87
Q

Function of magnesium (5)

A

Functions:ETNSR
● Essential cofactor - example are ALP & ACP
● Transcellular ion transport- transports of ion from
apical surface to basolateral surface
● Neuromuscular transmission
● Synthesis of carbohydrates, proteins. Lipids, and
nucleic acid
● Release of and responds to certain hormones

88
Q

MAGNESIUM

Controlled largely by the __________
● Non-protein-bound are filtered by the glomerulus
○ __________ is reabsorbed by the PCT
○ _______ is reabsorbed in ascending loop of
Henle
● Renal threshold: _________

A

Kidney
25-30%
50-60%
0.60-0.85 mmol/L

89
Q

○ Increases renal reabsorption and intestinal
absorption
○ Main target is calcium and not magnesium, but it will initiate reabsorption and intestinal absorption of
calcium and madadamay ang si magnesium( so it is
moe in calcium than in magnesium)

A

PTH

90
Q

○ Increases the renal excretion of magnesium
○ To eliminate magnesium in our bod

A

● Aldosterone and thyroxine

91
Q
A

CC LEC 2 (4 decks)

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