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Pathophysiology > Electrolyte and Acid-Base Imbalances > Flashcards

Electrolyte and Acid-Base Imbalances Flashcards

1
Q

What is the primary cation and where is it located?

A

Na+

extracellular fluid

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2
Q

What is serum level of sodium controlled by?

A

aldosterone action on the kidney

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3
Q

How does sodium move?

A

diffuses between vascular and interstitial fluid
leaks through cell membrane sodium channels
transported from cells by sodium-potassium pump

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4
Q

Sodium potassium pump transports how many sodium ions in and how many potassium ions out?

A

3 sodium ions in

2 potassium ions out

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5
Q

Sodium is important to maintenance of … which affect BP. It also is essential in two other major things.

A

blood volume
maintains membrane potential
nerve impulse conduction

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6
Q

How is Hyponatremia define?

A

serum sodium under 135

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7
Q 
What are some causes of Hyponatremia?
Excessive \_\_\_, \_\_\_, or \_\_\_.
\_\_\_ drugs or low-salt diets. 
\_\_\_ imbalances. Excessive \_\_\_ and insufficient \_\_\_.
Chronic \_\_\_ failure.
Excessive \_\_ intake.
A

sweating, vomiting, or diarrhea

diuretic

hormonal

ADH

aldosterone

kidney

water

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8
Q

What are some effects of Hyponatremia?
Impaired ____ conduction.
Impaired ___ contraction.
Decrease in ___ pressure.

A

nerve

muscle

osmotic

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9
Q

How is Hypernatremia define?

A

when serum sodium is over 145

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10
Q 
Causes of Hypernatremia?
Insufficient \_\_\_\_.
Lost of \_\_\_ mechanism.
Watery \_\_\_.
Ingestion of large amounts of \_\_\_ and not enough water. 
Prolonged periods of rapid \_\_\_\_.
A

ADH

thirst

diarrhea

sodium

respiration

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11
Q 
Effects of Hypernatremia?
Fluid shift \_\_\_ cells.
\_\_\_\_.
Increased \_\_\_.
Increased \_\_\_.
Dry, rough, tongue and mucus membranes.
\_\_\_ and agitation.
A

out

edema

BP

thirst

weakness

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12
Q

What is the major intracellular cation?

A

potassium

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13
Q

Serum levels are …. in regards to potassium.

A

low

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14
Q

What regulates potassium?

A

kidneys

excreted primarily in urine under aldosterone

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15
Q

Levels of potassium are influenced by …. imbalance.

A

acid-base

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16
Q

Acidosis results in ….
alkalosis results in ….
in terms of potassium

A

potassium out of cells=hyperkalemia

potassium into cells=hypokalemia

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17
Q

Potassium regulates …. volume

A

intracellular

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18
Q

Potassium is critical for ___ ___ conduction and ___ contraction.

A

nerve impulse

muscle

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19
Q

Abnormal potassium levels cause what in cardiac function?

A

changes in cardiac conduction, lead to cardiac arrest and are life threatening

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20
Q

When there is a decrease of potassium outside the cell this results in….

A

hyperpolarization; the cell will be less excitable

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21
Q

When there is an increase of potassium outside the cell, this results in…

A

depolarization; the cell is more excitable

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22
Q

Causes of Hypokalemia?
Excessive loss due to ___, ____, ____.
Excessive ____ and ____.

A

diarrhea, diuretics, decreased dietary intake

aldosterone, glucocorticoids (cushings disesase)

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23
Q 
Effects of Hypokalemia?
Cardiac \_\_\_\_ therefore cardiac \_\_\_.
Interference with \_\_\_ function.
Decreased \_\_\_ motility. 
\_\_\_\_.
A

arrhythmias

arrest

neuromuscular

digestive tract

paresthesias

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24
Q

Why are cardiac arrhythmias common with hypokalemia?

A

due to hyperpolarization of resting membrane potential in cardiac myocytes which makes them decreased in excitement

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25
Q

How is the neuromuscular function interfered with as part of Hypokalemia?

A

skeletal muscles are hyperpolarized and they are less responsive to stimuli

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26
Q 
Causes of Hyperkalemia?
Renal \_\_\_
Deficit of \_\_\_
\_\_\_ \_\_\_\_ \_\_\_ 
Leakage of \_\_\_ \_\_\_
Displacement of \_\_\_ by severe or prolonged acidosis.
A

failure

aldosterone

potassium sparing diuretics

intracellular potassium

potassium

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27
Q

Effects of hyperkalemia?
Cardiac ____
Generalized ___ ____
___ and ____

A

arrhythmias

muscle weakness

fatigue and parethesias

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28
Q

Why are cardiac arrhythmias also common in hyperkalemia?

Due to ___ of resting membrane potential of cardiac myocytes.

A

depolarization

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29
Q

Important extracellular cation?

A

calcium

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30
Q

Functions of calcium?

A

structural strength for bones and teeth, muscle contractions, stability of nerve membranes, enzyme reactions, signal transduction

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31
Q

What controls calcium?

A

parathyroid hormone and calcitonin

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32
Q

When there is parathyroid hormone activations what happens to calcium?

A

there is an increase of calcium in blood, resorption from bone, by kidneys and in intestine

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33
Q

What happens when there is calcitonin activations?

A

calcium decreases, is inhibited in bone and kidney resorption

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34
Q

Vitamin …. promotes Ca absorption in intestine.

A

D

35
Q

…. levels influence Ca levels reciprocally.

A

phosphate

36
Q 
Causes of hypocalcemia:
Hypo\_\_\_\_
Malabsorption of \_\_\_ and \_\_\_\_.
Deficiency in \_\_\_\_
Renal \_\_\_\_
Acidosis or alkalosis?
A

hypoparathyroidism

Ca and vitamin D

albumin

renal failure

alkalosis

37
Q

Why would renal failure be a cause of hypocalcemia?

A

because of retention of phosphate and Vitamin D not activated.

38
Q

Why would alkalosis be a cause of hypocalcemia?

A

free Ca binding to albumin which causes a negative charge

39
Q

Effects of hypocalcemia:

___ activation of heart muscle and ____ activation of skeletal muscle.

A

decreased

increased

40
Q

Why does hypocalcemia increase activation of skeletal muscle?

A

increases excitability of nerve membranes due to decrease in threshold for nerve excitation. results in hyperactive reflexes

41
Q

Signs of hypocalcemia?

A

Chvosteck’s sign

Trousseau’s sign

42
Q

What is Chvosteck’s sign?

A

spasm of lip or face when the face is tapped in front of the ear.

43
Q

What is Trousseau’s sign?

A

atypical contraction of the fingers when blood pressure cuff blocks circulation to the hand

44
Q 
Causes of hypercalcemia:
\_\_\_\_  \_\_\_\_of  Ca ions from bones. 
\_\_\_\_ from immobility.
Hyper\_\_\_\_
\_\_\_\_ Ca intake.
A

uncontrolled release

demineralization

hyperparathyroidism

increased

45
Q

Effects of hypercalcemia:
____ cardiac contractions.
____neuromuscular activity
____effects.

A

increased strength

depresses

renal

46
Q

Important intracellular cation?

A

magnesium

47
Q

Serum levels of Mg is related to … and …

A

K and Ca

48
Q

Mg is in … reactions including DNA and protein synthesis, … and ….

A

enzyme
glycolysis
oxidative phosphorylantion

49
Q

Mg is important in … and … transport across plasma membrane.

A

K and Ca

50
Q

Mg is important in …. conduction and … contraction.

A

nerve impulse

muscle

51
Q

Causes of hypomagnesemia?

A

GI, kidney

52
Q

Effects of Hypomagnesemia: ____ hyperirritability with tremors.
Heart_____.

A

neuromuscular

heart arrhythmia

53
Q

Causes of hypermagnesemia: ___failure

A

renal

54
Q

Effects of hypermagnesemia: ___neuromuscular function.

___reflexes.

A

depressed

decreased

55
Q 
Phosphate important in \_\_\_ and \_\_\_ mineralization. 
\_\_\_\_
\_\_\_\_system.
Cell\_\_\_\_.
Excreted by \_\_\_\_\_
Reciprocal relationship with \_\_\_\_.
A

bone and tooth

metabolism (ATP)

buffer

integral part of cell membrane

kidneys

calcium

56
Q

Hypophosphatemia is due to ___syndromes.
___
And hyper_____.

A

malabsorption

diarrhea

hyperparathyroidism

57
Q

Hyperphosphatemia is due to ___ failure.
___ damage (intracellular release during chemo).
Manifests like ____.

A

renal
tissue
hypocalcemia

58
Q

A major extracellular anion

A

chloride

59
Q

Chloride levels follow … levels.

A

sodium

60
Q

Chloride ions and …. ions complement each other’s levels. Why?

A

bicarbonate

to maintain electroneutrality in ECF, most abundant anions, RBC as storage

61
Q

Hypochloremia is due to loss of:

A

body fluids- excessive perspiration and early stages of vomiting

62
Q

Hyperchloremia is due to excessive:
Loss of:
Rapid infusion of:

A

sodium chloride intake,

bicarbonate (diarrhea and later stages of vomiting)

isotonic saline which leads to hyperchloremic acidosis

63
Q

Buffer pairs in the blood respond to pH level changes…

A

immediately

64
Q

Respiratory system can alter levels of …

A

carbonic acid through changes in CO2

65
Q

Kidneys can modify the excretion rate of acids through

A

reabsorption or excretion of bicarbonate ions

66
Q

Is respiratory system or kidneys the most effective in control of serum pH? But is is also the…

A

kidneys

slowest

67
Q

A buffer is a combo of …

A

weak acid and its alkaline salt.

68
Q

What is the major ECF buffer? What is it controlled by?

A

sodium bicarbonate-carbonic acid buffer

respiratory system and kidneys

69
Q

Other buffering systems?

A

phosphate, hemoglobin, plasma proteins

70
Q

What is the base to acid ratio in the bicarbonate-carbonic acid buffer system?

A

20:1

71
Q

pH imbalances compensation mechanisms, compensation is … and usually ….

A

limited and short term

72
Q

Goal of pH imbalances?

A

balance the relative proportion of carbonic acid and bicarbonic ions

73
Q

Compensation requires function of …

A

function of the organ not involved in the cause

74
Q

Decompensation occurs when ….

A

causative problem becomes more severe and compensation mechanisms are exceeded or fail

75
Q

Respiratory acidosis results from what diseases?

A

pneumonia, airway obstruction, chest injuries, drugs

76
Q

Chronic respiratory acidosis is common in what disease?

A

COPD

77
Q

Excessive loss of bicarbonate ions in what two fluid loss conditions?

A

diarrhea, vomiting

78
Q

Increased serum bicarbonate is due to…

A

too much lactic acid produced, diabetic ketoacidosis

79
Q

Renal disease or failure decreases… which affects acid/base balance.

A

excretion of acids, and production/retention of bicarbonate ions

80
Q

Effects of Acidosis in regards to K:

A

hyperkalemia

81
Q

Respiratory alkalosis is due to…

A

hyperventilation

82
Q

Metabolic alkalosis is due to retention of:
Excessive ingestion of:
Loss of:

A

retention of bicarbonate, excessive ingestion of antacids, loss of hydrochloric acid from early stage vomiting

83
Q

Effects of alkalosis on K levels:

A

hypokalemia

Pathophysiology (20 decks)

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