ELECTROLYTES Flashcards
What are the electrolytes that have a high concentration in RBCs?
- Potassium
- Phosphorus
- Magnesium
What are the electrolytes that have a high concentration in the plasma?
- Sodium
- Chloride
Sodium and chloride have a high concentration in what?
high concentration in the plasma
Potassium, phosphorus, and Magnesium have a high concentration in what?
high concentration in RBCs
These are ions that carry a negative charge
Anions
Anions carry what charge?
negative charge
These ions move toward the anode
Anions
Anions move toward what field?
the anode
The anode is a field with what charge?
positively charged field
This is a positively charged field
anode
Anions move toward the positively charged field
true or false
true
What are examples of anions?
- Choride
- Bicarbonate
- Phosphate
These are ions that carry a positive charge
cations
cations move toward what field?
cathode
This is a negatively charged field
cathode
a cathode has a field of what charge?
a negatively charged field
cations carry what charge?
cations carry a positive charge
What are examples of cations?
- Sodium
- Potassium
- Magnesium
- Calcium
Chloride is an anion
true or false
TRUE
Sodium is an anion
true or false
FALSE
Cation
Sodium is an anion
true or false
FALSE
Cation
Bicarbonate is an anion
true or false
True
Potassium is an anion
true or false
false
cation
Phosphate is an anion
true or false
true
Phosphate is not an anion
true or false
false
anion
Magnesium is an anion
true or false
false
cation
Magnesium is an anion
true or false
false
cation
Calcium is an anion
true or false
False
cation
Calcium is an anion
true or false
False
cation
chloride
Anion or cation
Anion
Bicarbonate
Anion or cation
Anion
Phosphate
Anion or cation
Anion
Sodium
Anion or cation
Cation
Potassium
Anion or cation
Cation
Magnesium
Anion or cation
Cation
Calcium
Anion or cation
Cation
What are 7 functions of electrolytes?
“Important For the Regulation , For the Production, and Maintenance of Volume For Neuromuscular Excitability and Myocardial Rhythm”
- Important cofactors in enzyme activation
- For the regulation of adenosine triphosphatase (ATPase) ion pumps
- For the production and use of ATP from glucose
- Maintenance of acid-base balance
- Volume and osmotic regulation
- For Neuromuscular Excitability
- Myocardial rhythm and contractility
What are the electrolytes for the volume and osmotic regulation?
Na, Cl, K
What are the electrolytes for Myocardial rhythm and contractility?
Mg, K, Ca
What are the electrolytes for important cofactors in enzyme activation?
Mg, Ca, Zn
What are the electrolytes for the regulation of adenosine triphosphatase (ATPase) ion pump?
Mg
What are the electrolytes for the neuromuscular excitability?
Same as Myocardiam Rhthym and contactility
Mg, K, Ca
What are the electrolytes for the production and use of ATP from glucose?
plus ATPase ion pump
Mg and PO4
What are the electrolytes for maintenance of acid-**base **balance?
HCO3, K, Cl
It is the major extracellular anion
Chloride
Chloride promotes the maintenance of what?
promotes maintenance of water balance and osmotic pressure
Chloride promotes maintenance of water balance and osmotic pressure in conjunction with what?
in conjunction with sodium
It promotes maintenance of water balance and osmotic pressure in conjunction with sodium
Chloride
Chloride is the major extracellular anion-chief counter ion of WHAT in WHERE?
the major extracellular anion-chief counter ion of sodium in ECF
It is the only anion to serve as an enzyme activator
Chloride
Chloride is the only anion to serve as a/an what?
to serve as an enzyme activator
This electrolyte has a reference value of 98-107 mmol/L
Chloride
What is the reference value of chloride?
98-107 mmol/L
What is the normal range for chloride in the urine?
110-250 mmol/ day, varies with diet
this electrolyte varies with diet in the urine
chloride
Marked hemolysis may cause decreased levels of chloride due to what?
due to dilutional effect
In chloride specimen consideration, slightly lower values are observed in what kind of specimen?
post prandial specimen
In chloride specimen consideration, low serum values are observed in conditions with what?
high HCO3 levels
In chloride specimen consideration, this may cause decreased levels of chloride due to dilutional effect
Marked hemolysis
In chloride specimen consideration, marked hemolysis may cause what to the levels of chloride due to dilutional effect?
decreased levels
In chloride specimen consideration, what is observed in post prandial specimens?
Slightly lower values
In chloride specimen considerations, these are observed in conditions with high HCO3 levels
Low serum values
Lower values are observed in post prandial specimens in chloride specimen considerations
true or false
slightly low values
false
High serum levels are observed in conditions with high HCO3 levels in chloride specimen considerations
true or false
Low serum levels
false
High serum levels are observed in conditions with high HCO3 levels in chloride specimen considerations
true or false
Low serum levels
false
Marked hemolysis may cause increased levels of chloride due to dilutional effect
true or false
decreased levels of chloride
false
Marked hemolysis may cause increased levels of chloride due to dilutional effect
true or false
decreased levels of chloride
false
What is the anticoagulant of choice for chloride?
lithium heparin
Lithium heparin is the anticoagulant of choice for what electrolyte?
chloride
In chloride, marked hemolysis may cause levels to be decreased as a result of what?
as a result of dilutional effect
In the urine specimen for chloride, this is needed because of the large diurnal variation
24-hour collection
In the urine specimen for chloride, why is a 24-hour collection needed?
needed because of the large
diurnal variation
In the urine specimen for chloride, why is a 24-hour collection needed?
needed because of the large
diurnal variation
What are the methods used for chloride?
- Ion Selective Electrode (ISE)
- Mercurimetric Titration
- Colorimetry
This is a solid-state electrode using membranes composed of AgCl
ISE
ISE is a solid-state electrode using membranes composed of what?
AgCl
In this method for chloride, in the presence of Cl¯ anions, an oxidation reduction reaction occurs, silver metal forms Ag+ cation and electrons
ISE
In ISE in Cl, what occurs in the presence of Cl- anions?
an oxidation reduction reaction
In ISE, an oxidation reduction reaction occurs in the presence of what?
in the presence of Cl- anions
When an oxidation reduction reaction occurs, silver metal forms what?
silver metal forms Ag+ cation and electrons
Mercurimetric titration is also called …
Schales and Schales method
Schales and Schales method is also called …
mercurimetric titration
What is the principle in Mercurimetric titration?
- Cl- in the sample combines with the added Hg++ to form the soluble HgCl2 complex.
- Excess unreacted added Hg++ combines with an indicator such as diphenylcarbazone to form a blue violet/purple end point of titration
In Schales and Schales method, the Cl- in the sample combines with added Hg++ to form what?
to form the soluble HgCl2 complex
Excess unreacted added Hg++ combines what an indicator such as what?
such as diphenylcarbazone
Excess unreacted added Hg++ combines with an indicator such as diphenylcarbazone to form a what?
to form a blue-violet/purple end point of titration
Excess unreacted added Hg++ combines with a what?
combines with an indicator
What is the endpoint/end product of mercurimetric titration?
blue-violet/purple
Colorimetry method in chloride is by …
Schoenfeld and Lewellen
Schoenfeld and Lewellen demonstrated what method?
colorimetry
What is the principle of Schoenfeld and Lewellen?
- Cl- ions in serum displaced thiocyanate ions from mercuric thiocyanate forming = mercuric chloride, which is only very slightly ionized
- The liberated thiocyanate ions react with ferric ions to form = the orange-yellow thiocyanate complex, which is measured at 550nm against a water blank
In the colorimtery method, Cl- ions in serum displaces what?
displaces thiocyanate ions
In the colorimtery method, Cl- ions in serum displaces thiocyanate ions from what?
from mercuric thiocyanate
In the colorimtery method, Cl- ions in serum displaces thiocyanate from mercuric thiocyanate forming what?
forming mercuric chloride
the mercuric chloride formed from the displacement of thiocyanate from mercuric thiocyanate is only slightly ionized
true or false
VERY slightly ionized
false
the mercuric chloride formed from the displacement of thiocyanate from mercuric thiocyanate is only slightly ionized
true or false
VERY slightly ionized
false
In Schoenfeld and Lewellen, these react with ferric ions to form the orange-yellow thiocyanate complex?
liberated thiocyanate ions react with ferric ions
In colorimetry method in chloride, the liberated thiocyanate ions react with what?
react with ferric ions
In colorimetry method in chloride, the liberated thiocyanate ions react with ferric ions to form what?
to form the orange-yellow thiocyanate complex
how is the orange-yellow thiocyanate complex formed from the reaction of liberated thiocyanate ions and the ferric ions measured?
measured at 550nm against a water blank
how is the orange-yellow thiocyanate complex formed from the reaction of liberated thiocyanate ions and the ferric ions measured?
measured at 550nm against a water blank
the orange-yellow thiocyanate complex in Schoenfeld and Lewellen is measured against a what?
against a water blank
Under colorimetry, what is another test done?
sweat test
It is the single most accepted common diagnostic tool for clinical identification of cystic fibrosis
sweat test
The sweat test is the single most accepted common diagnostic tool for the clinical identification of what?
for the clinical identification of cystic fibrosis
Cystic fibrosis is also called …
MUCOVISCIDOSIS
It is the single most accepted common diagnostic tool
Sweat test
It is essential for the insulin-mediated entry of glucose into cells
Phosphate
Phosphate is essential for the insulin-mediated entry of glucose into cells by a process involving what?
a process involving phosphyorylation of the glucose and the co-entry of K+
It is inversely related to calcium.
Phosphate
This electrolyte has a reference value of 2.7-4.5 mg/dL (adults) 4.5-5.5 mg/dL (child)
Phosphate
What is the reference value of phosphate in adults?
2.7-4.5 mg/dL
What is the reference value of phosphate in children?
4.5-5.5 mg/dL
What do you call it when phosphorus exists as a principle anion within cell?
organic phosphate
When phosphorus exists as part of the blood buffer
Inorganic phosphate
Organic phosphate is part of the blood buffer
true or false
Inorganic phosphate
false
Organic phosphate is the principal anion within cell
true or false
true
Phosphorus exists as what? (2)
- Organic
- Inorganic
What are the forms of phosphorus?
- Free or unbound form
- Complexed with ions
- Protein-bound
What form of phosphorus has the highest percent?
Free or unbound form
What percent of phosphorus is protein bound?
10%
What percent of phosphorus is free or unbound?
55%
What percent of phosphorus is complexed with ions?
35%
10% of phosphorus is what form?
protein bound
55% of phosphorus is what form?
Free or unbound
What are the factors affecting phosphate concentration?
- PTH
- Calcitonin
- Growth hormone
This is a factor affecting phosphate concentration that decreases the phosphate by renal excretion
PTH
This is a factor affecting phosphate concentration that inhibits bone reabsorption
Calcitonin
This is a factor affecting phosphate concentration that increases phosphate renal reabsorption
Growth hormone
How does the PTH affect phosphate concentration?
It DECREASES phosphate by renal excretion
How does the PTH affect phosphate concentration?
It DECREASES phosphate by renal excretion
How does the Calcitonin affect phosphate concentration?
It INHIBITS bone reabsorption
How does the Growth Hormone affect phosphate concentration?
It INCREASES phosphate renal reabsorption
The PTH decreases phosphate by what?
by renal excretion
Calcitonin inhibits what?
renal reabsorption
Growth hormone increases what?
increases phosphate renal reabsorption
A high CHO diet in phosphorus can result to what?
DECREASED LEVELS of phosphate
What is required in specimen consideration in phosphorus?
fasting is required
Why is fasting required as a practical consideration in phosphorus?
because a high CHO diet can result in decreased levels of phosphorus
In specimen consideration of phosphorus, what must be done to the specimen?
Separate the serum from the red cell immediately after clotting is completed
In the specimen consideration of phosphorus, what are the anticoagulants that interfere with the analytical method?
- Oxalate
- Citrate
- EDTA
Phosphate (PO4) deficiency can lead to what?
ATP depletion
ATP depletion is due to what?
Phosphate (PO4) deficiency
It is the second most abundant anion in the ECF
Bicarbonate
This electrolyte has a reference value of : 21-28 mEq/L (venous blood, plasma or serum)
Bicarbonate
What is the reference value of Bicarbonate?
21-28 mEq/L
How does the pH imbalance of bicarbonate happen?
- It diffuses out of the cell in exchange for chloride to maintain ionic charge neutrality within the cell
- the buffering capacity of blood is maintained by a reversible exchange process between bicarbonate and chloride
The pH imbalance of bicarbonate diffuses out of the cell in exchange for what?
in exchange for chloride
The pH imbalance of bicarbonate diffuses out of the cell in exchange for chloride to maintain what?
to maintain ionic charge neutrality within the cell
The diffusion of phosphate out of the cell in exchange for chloride to maintain ionic charge neutrality is called what?
chloride shift
this is maintained by a reversible exchange process between bicarbonate and chloride
the buffering capacity of blood
How is the buffering capacity of blood in the pH imbalance of phosphorus maintained?
maintained by a REVERSIBLE process
The buffering capacity of blood in the pH imbalance of phosphorus is maintained by a REVERSIBLE process between what?
between bicarbonate and chloride
What is the function of Bicarbonate?
it is the major component of the buffering system in the blood
How is the specimen for bicabonate collected?
blood is ANAEROBICALLY collected
What is the specimen suitable for the analysis of bicarbonate?
Serum or lithium heparin plasma
Serum or lithium heparin is suitable for the analysis of what?
bicarbonate
Serum or lithium heparin is suitable for the analysis of what?
bicarbonate
lithium heparin is the anticoagulant of choice for what electrolyte?
chloride
What are the 2 methods used for the analysis of bicarbonate?
- ISE
- Enzymatic
The Ion Selective Electrode for the analysis of bicarbonate uses what electrode in particular?
pCO2 electrode
The enzymatic method for the analysis of bicarbonate uses what enzyme in particular?
phosphoenolpyruvate carboxylase and dehydrogenase
This is used to carboxylate phosphoenolpyruvate (PEP) in the presence of PEP carboxylase
HCO3-
HCO3- is used to carboxylate what?
used to carboxylate phosphoenolpyruvate (PEP)
HCO3- is used to carboxylate PEP in the presence of what?
in the presence of PEP carboxylase
this catalyzes the formation of oxaloacetate
PEP carboxylase
PEP carboxylase catalyzes the formation of what?
oxaloacetate
Known as Major extracellular cation
Sodium
It is the most abundant cation in the ECF
Sodium
Sodium represents what percent of ALL EXTRACELLULAR CATIONS?
90%
Slight hemolysis does not affect the testing process for this electrolyte
Sodium
significant hemolysis can dilute the sample for the testing of this electrolyte
Sodium
What are the samples than can be used for analysis bicarbonate?
Serum, plasma, or urine
What must be avoided in the analysis of sodium?
Avoid any additive with SODIUM
What additives can be used for the analysis of sodium?
Lithium heparin, potassium EDTA
What is the reference method for the analysis of sodium?
Atomic Absorption Mass Spectrometry (AAS)
What are the methods for the analysis of sodium?
- AAS
- ISE
- Chemical Method
In the analysis of sodium, what is the ISE electrode used in particular?
Glass membrane electrode
It is the most routinely used method in clinical laboratories for the analysis of sodium
ISE electrode: Glass membrane electrode
What are the 2 types of ISE measurements in the analysis of sodium?
- Direct method
- Indirect method
this ISE measurement is the undiluted sample
direct method
This type of ISE measurement is the diluted sample
Indirect method
This type of ISE measurement can be affected by protein and lipid that can displace sodium
Indirect method
The indirect method can be affected by what?
by protein and lipids
In the indirect method, these can displace sodium
proteins and lipids
what is the effect of proteins and lipids to sodium can lead to what?
can lead to falsely decreased measurement
In the chemical method for the analysis of sodium, what is the chemical method called?
albanese lien
Albanese lien is composed of what?
cupric sulfate and NaOH
It is the major intracellular cation in the body
Potassium
This electrolyte has a concentration 20 times greater inside the cells than outside.
Potassium
Potassium has a concentration 20 times greater outside the cells than inside
True or false
20 times greater inside the cells than outside
false
In the preanalytical analysis of potassium, what must be avoided?
- Hemolysis
- Prolonged tourniquet application
- excessive opening and closing of fists during phlebotomy
For the analysis of potassium, blood should be stored where?
stored at room temperature
In the analaysis of potassium, if the sample is a whole blood, how must the sample be handled?
NEVER REFRIGERATE
Why must whole blood sample in the analysis of potassium never be refrigerated?
because of the tendency of potassium to LEAK OUT from serum upon refrigeration
What can the results be if whole blood for the analysis of potassium if specimen was refrigerated?
FALSELY ELEVATED
What is the reference method for potassium?
Atomic Absorption Mass Spectrometry (AAS)
What is the ISE used for the analysis of potassium?
Valinomycin membrane electrode
The flame emission photometry in the analysis of potassium produced what color?
purple
What is the chemical method used for the analysis of potassium?
Lockhead and Purcell method
What are the methods used for the analysis of Potassium?
- AAS
- ISE: Valinomycin membrane electrode
- Flame emission photometry
- Chemical method: Lockhead and Purcell method
Most abundant cation in the body
Calcium
Where is calcium distributed in the body?
- Bones
- Blood
- Cytosol
What percent is calcium present in the bones?
99%
What percent is calcium present in the blood?
1%
What percent is calcium present in the cytosol?
<1%
What are the forms of Calcium in the blood?
- Ionized
- Protein bound
- Complexed
This form of calcium in the blood is measurable
Ionized
These are examples of complex forms of calcium
- lactate
- citrate
- bicarbonate
What form of calcium in the blood is the most abundant?
Ionized
How many percent of calcium in the blood is ionized?
45%
How many percent of calcium in the blood is protein bound?
40%
How many percent of calcium in the blood is complexed?
15%
This electrolye is capable of binding magnesium
calcium
Because calcium is capable of binding magnesium, what must be done prior to analysis?
USE A MAGNESIUM SHELTER
A magnesium shelter is composed of what?
8-hydroxyquinoline/quinolol
Why should a magnesium shelter be used prior to calcium analysis?
to avoid interference by magnesium for O-cresolphthalein complexone method
Prior to calcium analysis, a magnesium shelter is used to avoid the interference by magnesium for what method?
O-cresolphthalein complexone method
What are the methods that can be used for the analysis of calcium?
AAS and Dye Binding methods
What is the reference method for the analysis of calcium?
Atomic Absorption Mass Spectrometry
What is the wavelength used to measure chloride colorimetrically?
550nm
What is the wavelength for O-cresolphthalein complexone?
570nm
what is the wavelength of Arsenazo III dye?
530nm
What are the Dye binding methods used in the analysis of calcium?
- O-cresolphthalein complexone (570nm)
- Arsenazo III dye (530nm)
- Clark and collip method
- Sulkowitch
this dye binding method does not need for a shelter
Arsenazo III dye
Why does the Arsenazo III dye does not need a shelter?
because it is specific to calcium
This dye binding method is an old method
Clark and Collip method
This dye binding method is a redox titration
Clark and Collip method
This dye binding method is for urine calcium analysis
Sulkowitch
Sulkowitch is used specifically for the analysis of what?
Urine calcium analysis
It is the fourth most abundant cation in the body
Magnesium (Mg2+)
It is second most abundant intracellular ion.
Magnesium
What are the methods that can be used for the analysis of Magnesium?
- AAS
- Dye binding methods
What is the reference method for the analysis of Magnesium?
Atomic Absorption Mass Spectrometry (AAS)
What are the dye binding methods for the analysis of Magnesium?
- Titan yellow
- Calmagite with magnesium
- Formazan
- Methylthymol blue
- O-cresolphthalein complexone
What is the wavelength for Titan Yellow?
570-590nm
What is the wavelength for Calmagite with Magnesium?
532 nm
What is the wavelength for Formazan?
660 nm
What is the wavelength for Methylthymol blue?
600 nm
What is the wavelength for O-cresolphthalein complexone?
570 nm
What is the color produced by Calmagite with magnesium?
reddish violet complex
What is the color produced by Formazan?
blue complex
Using O-cresolphthalein complexone, if we are to measure magnesium, what should be done?
we should inhibit the calcium
In O-cresolphthalein, if we are to measure magnesium why should inhibit the calcium?
in order to avoid interference by calcium
In O-cresolphthalein, if we are to measure magnesium calcium is inhibited in order to avoid interference by calcium. What is used?
“glycosilated glyco EDTA” in magnesium analysis used
It is the chief counter ion of sodium in ECF
chloride
