CLINICAL APPLICATIONS/DETERMINATION/METHODS OF SODIUM

Question 1

CAUSES OF HYPONATREMIA

Answer 1

Increased Sodium Loss
Increased Water Retention
Water Imbalance

Question 2

Causes of Increased Sodium Loss

Answer 2

Hypoadrenalism (↓aldosterone)
Potassium deficiency
Diuretic use (thiazide)
Ketonuria (Na loss w/ketones)
Salt-losing nephropathy
Prolonged vomiting or diarrhea

Question 3

Causes of Increased Water Retention

Answer 3

Renal failure (dilution of Na)
Nephrotic syn. (↓COP-PV, ↑AVP)
CHF, Hepatic cirrhosis

Question 4

Causes of Water Imbalance

Answer 4

SIADH (↑AVP, ↑water retention)
Pseudohyponatremia

Question 5

SIADH means

Answer 5

Syndrome of Inappropriate Anti-Diuretic Hormone

Question 6

During Potassium deficiency:
aldosterone will promote Na+ reabsorption, which in return, promote K+ excretion in urine

Answer 6

K+ is increased in plasma

Question 7

During Potassium deficiency:
K+ must be conserved by the kidneys, in return, Na+ will be excreted in urine

Answer 7

K+ is decreased in plasma

Question 8

What are the CLASSIFICATION OF HYPONATREMIA BY OSMOLALITY?

Answer 8

WITH LOW OSMOLALITY
WITH NORMAL OSMOLALITY
WITH HIGH OSMOLALITY

Question 9

↑ Sodium loss
Increased water retention – all solutes including sodium are diluted

Answer 9

WITH LOW OSMOLALITY

Question 10

Sodium is decreased but the plasma osmolality is not affected.

Answer 10

WITH NORMAL OSMOLALITY

Question 11

Causes of NORMAL OSMOLALITY

Answer 11

Increased non-sodium cations
Lithium excess (drug medication)
Increased gamma globulins
Severe hyperkalemia
Severe hypermagnesemia
Increased non-sodium cations
Lithium excess (drug medication)
Increased gamma globulins
Severe hyperkalemia
Severe hypermagnesemia

Question 12

Other solute concentration is too high
Examples: Hyperglycemia, Mannitol Infusion

Answer 12

WITH HIGH OSMOLALITY

Question 13

CAUSES OF HYPERNATREMIA

Answer 13

Excess Water Loss
Decreased Water Intake
Increased Intake or Retention of Sodium

Question 14

Causes of Excess Water Loss

Answer 14

Diabetes insipidus (↓AVP)
Renal tubular dis. (↓urine conc.)
Prolonged diarrhea
Profuse sweating
Severe burns

Question 15

Causes of Decreased Water Intake

Answer 15

Old/infants/mental impairment

Question 16

Causes of Increased Intake or Retention of Sodium

Answer 16

Cushing syn. (↑Na reabsorption)
Hyperaldosteronism (↓AVP)
Hypertonic salt solution

Question 17

What are the tube and specimen needed for Specimen Collection of Sodium?

Answer 17

Serum (red); Plasma (green: Lithium heparin, Ammonium heparin, Lithium oxalate)

Question 18

T/F. False ↑ with MARKED HEMOLYSIS because sodium is also seen inside the cell

Answer 18

True

Question 19

What are the interfering agents that might encounter in Sodium?

Answer 19

Hgb, Lipids, and Bilirubin

Question 20

T/F. In Flame Emission Spectroscopy, the color of sodium after excitation is RED

Answer 20

False, YELLOW

Question 21

NOT COMMONLY USED for sodium
It is used for ions that are not easily excited.

Answer 21

Atomic Absorption Spectroscopy

Question 22

The REFERENCE METHOD as it is rapid (STAT)

Answer 22

Ion Selective Electrode

Question 23

T/F. In Ion Selective Electrode, uses Glass ion-exchange membrane for sodium

Answer 23

True

Question 24

COLORIMETRIC METHOD for sodium determination

Answer 24

Albanese-Lein