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ELECTROLYTES Flashcards

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1
Q

Electrolytes for Volume and Osmotic Regulation (3)

A

Potassium
Sodium
Chloride

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2
Q

Cofactors in enzyme Regulation

A

Magnesium
Calcium
Zinc

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3
Q

myocardial rythm and contractility electrolytes are:

A

Potassium
Calcium
Magnesium

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4
Q

most abundant cation in plasma

A

sodium

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5
Q

most abundant anion in plasma

A

chloride

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6
Q

most abundant cation in extraacellular fluid

A

sodium

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7
Q

second most abundant cation in intracellular fluid

A

magnesium

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8
Q

most abundant anion in intracellular fluid

A

phosphate

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9
Q

most abundant anion in extracellular fluid

A

chloride

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10
Q

4% body weight is

A

Plasma

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11
Q

physical property of a solution that is based the
concentration of solutes (expressed as mmol) per kg of solvent (w/w)

A

osmolality

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12
Q

normal plasma osmolality

A

275-295mOsm/kg of
plasma water

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13
Q

1-2% increase in osmolality causes fourfold ____ in ADH/AVP. (increase/decrease)

A

increase

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14
Q

Excess intake of water ____ plasma
osmolality. (increase/lower)

A

lower

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15
Q

Decreased osmolality is seen in:
a. Polydipsia
b. Dehydration
c. Hypercalcemia

A

a. Polydipsia

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16
Q

Responds primarily to a
decreased blood volume

A

RAAS

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17
Q

release from myocardial atria in response to
volume expansion, promotes sodium excretion in
the kidneys

A

Atrial natriuretic peptide

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18
Q

Decrease in URINE osmolality is seen in:
a. Diabetes Mellitus
b. Diabetes Insipidus
c. SIADH
d. Hypovolemia

A

B. Diabetes I.

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19
Q

Principal osmotic particle outside the cell

A

sodium

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20
Q

Treshold critical level for hypernatremia
a. 150 mmol/L
b. 170 mmol/L
c. 160 mmol/L
d. 120 mmol/L

A

a. 150 mmol/L
b. 170 mmol/L
c. 160 mmol/L
d. 120 mmol/L

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21
Q

reference value for sodium (ppt based)
a. 120-160 mmol/L
b. 145-155 mmol/L
c. 136-150 mmol/L
d. 135-145 mmol/L

A

a. 120-160 mmol/L
b. 145-155 mmol/L
c. 136-150 mmol/L
d. 135-145 mmol/L

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22
Q

CSF value for sodium

A

a. 120-160 mmol/L
b. 145-155 mmol/L
c. 136-150 mmol/L
d. 135-145 mmol/L

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23
Q

Sodium-potassium ATPase ion pump moves: _ sodium out of the cell and _ potassium into the cell

a. 3 sodium, 3 potassium
b. 2 sodium, 2 potassium
c. 2 sodium, 3 potassium
d. 3 sodium, 2 potassium

A

d. 3 sodium, 2 potassium

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24
Q

mostly sodium rich foods are:
a. apple
b. kangkong
c. beef

A

a. apple
b. kangkong
c. beef

fruits: avocado, mango

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25
Q

The 2 hormones affecting sodium levels

A

Aldosterone and Atrial Natriuretic factor (ANF)

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26
Q

promotes absorption of sodium in the distal tubules, promotes sodium retention and potassium excretion
a. Aldosterone
b. ANF

A

Aldosterone

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27
Q

ANF is secreted in

A

cardiac atria

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28
Q

blocks aldosterone and renin secretion and inhibits the action of angiotensin II and vasopressin. causes natriuresis.

the process of Na excretion in the urine through the action of kidneys

A

a. Aldosterone
b. ANF

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29
Q

can occur with decrease aldosterone production, less than 135 mmol/L plasma sodium concentration.
a. hypernatremia
b. hyponatremia

A

a. hypernatremia
b. hyponatremia

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30
Q

Increase sodium loss in urine can be attributed with:
a. Ketonuria
b. Cancer
c. Nephrotic syndrome
d. Myxdema

A

a. Ketonuria
b. Cancer
c. Nephrotic syndrome
d. Myxdema

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31
Q

Increase water retention can be attributed with:
a. Vomiting
b. Ketonuria
c. Congestive heart failure
d. Severe burns

A

a. Vomiting
b. Ketonuria
c. Congestive heart failure
d. Severe burns

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32
Q

when urine sodium is less than ____mmol/L water retention maybe result of nephrotic syndrome , hepatic cirrhosis, CHF.
a. 35
b. 40
c. 20
d. 25

A

a. 35
b. 40
c. 20
d. 25

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33
Q

is a group of symptoms that include protein in
the urine, low blood protein levels in the blood, high cholesterol levels, high triglyceride levels, and** swelling**.

A

Nephrotic syndrome

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34
Q

also called underactive thyroid or low thyroid.

a common disorder of the endocrine system in which the thyroid gland does not produce enough thyroid hormone

A

Myxedema

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35
Q

can occur in patient with
hyperproteinemia or hyperlipidemia
a. SIADH
b. Pseudohyponatremia
c. Pseudohypernatremia
d. Polydipsia

A

a. SIADH
b. Pseudohyponatremia
c. Pseudohypernatremia
d. Polydipsia

35
Q

Water imbalance can occur as a result of all of these, except:
a. polydipsia
b. Syndrome of inappropriate ADH secretion ( SIADH)
c Pseudohyponatremia
d. Myxdema

A

a. polydipsia
b. Syndrome of inappropriate ADH secretion ( SIADH)
c Pseudohyponatremia
d. Myxdema

36
Q

Hyponatremia: below ____mmol/L for 48 hrs
considered a medical emergency.
a. 130
b.140
c. 145
d. 120

A

a. 130
b.140
c. 145
d. 120

37
Q

Treatment of hypinaytremia that is an AVP receptor antagonist

A

Conivaptan

38
Q

is associated with SIADH, hypothyroidism and adrenal insufficiency
a. Euvolemic hypernatremia
b. Hypervolemic hyponatremia

A

a. Euvolemic hypernatremia

38
Q

is associated with liver cirrhosis with ascites, CHF and overhydrated postoperative patients
a. Euvolemic hypernatremia
b. Hypervolemic hyponatremia

A

a. Euvolemic hypernatremia
b. Hypervolemic hyponatremia

38
Q

Correcting severe hyponatremia **too rapidly **can cause ________.
a. cerebral myelinolysis
b. cerebral edema

A

a. cerebral myelinolysis
b. cerebral edema

38
Q

Correcting severe hyponatremia **too slowly **can cause ________.
a. cerebral myelinolysis
b. cerebral edema

A

a. cerebral myelinolysis
b. cerebral edema

39
Q

The following are causes of HYPERNATREMIA except:
a. Excess water loss
b. Decreased water intake
c. Increased sodium intake
d. Water imbalance

A

d. Water imbalance

39
Q

Increased sodium intake can be attributed to the following except:
a. Conn’s disease
b. Sodium bicorbonate infusion
c. Vomiting
d. Ingestion of sea water

A

c. Vomiting

39
Q

Most common method for determination of sodium

A

ISE

39
Q

For every 100 mg/dL increase in blood glucose serum sodium decreases by ____ mmol/L.
a. 1.5
b. 1.7
c. 1.4
d. 1.6

A

d. 1.6

39
Q

Sodium level of <____ mmol/L may result to severe
neuropsychiatric symptoms.
a. 155
b. 145
c. 135
d. 125

A

a. 155
b. 145
c. 135
d. 125

39
Q

____ of sodium is used to distinguish between AKI and pre-renal azotemia.

A

Fractional excretion

40
Q

FE of ____ suggest pre-renal azotemia
a. < 0.01
b. > 0.01

A

a. <0.01

41
Q

FE of ____ suggest AKI
a. < 0.01
b. > 0.01

A

b. > 0.01

42
Q

single most important analyte

A

Potassium

43
Q

Regulation of neuromuscular excitability is a function of
a. Sodium
b. Potassium

A

Potassium

44
Q

Reference value of Potassium
a. 1.5 - 7.5 mmol/L
b. 135 - 145 mmol/L
c. 3.5 - 5.1 mmol/L
d. 4.5 - 6.1 mmol/L

A

c. 3.5 - 5.1 mmol/L

45
Q

is the constant membrane potential present in all living cells when they are at rest (i.e when they are not producing any electrical signal).

A

resting membrane potential (rmp)

46
Q

leads to fatal paralysis or cardiac arrhythmia
a. hypokalemia
b. severe hypokalemia
c. hyperkalemia
d. severe hyperkalemia

A

d. severe hyperkalemia

47
Q

described as large impermeable negatively charged intracellular molecules attracting positively charged ions (e. g.: Na+ and K+) and repelling negative ones (e. g.: Cl−).

a. Donnan effect
b. Membrane selectivity
c. Active Transport

A

a. Donnan effect

48
Q

Active transport that involves electrochemical gradient and **not **involved in maintaining RMP.
a. Primary AT
b. Secondary AT

A

b. Secondary AT

49
Q

is the difference of permeabilities between different ions.
a. Donnan effect
b. Membrane selectivity
c. Active Transport

A

b. Membrane selectivity

49
Q

RMP of skeletal muscles
a. -95 mV
b. -50 mV
c. -80 to -90 mV
d. -70 mV

A

a. -95 mV

50
Q

reabsorbs nearly all potassium

A

Proximal tubules

51
Q

3R’s the major mechanism of diminished renal potassium
excretion except
1. Reduced aldosterone
2. Renal failure
3. Reduced distal delivery of sodium
4. Retained potassium

A
  1. Retained potassium
52
Q

a solute pump that pumps sodium out
of cells while pumping potassium into cells, both against their concentration gradients.

A

ATPase enzyme

53
Q

is the first-line defense against hyperkalemia.

A

Insulin

54
Q

mercumetric titration determination of chloride

a. schales and schales
b. ISE
c. AAS

A

a. schales and schales
b. ISE
c. AAS

55
Q

urinary chloride is ____ mmol/L

a. 110-350
b. 110-300
c.100-200
d.110-250

A

a. 110-350
b. 110-300
c.100-200
d.110-250

56
Q

used to screen cystic fibrosis

a. serum chloride
b. plasma chloride
c. sweat chloride

A

a. serum chloride
b. plasma chloride
c. sweat chloride

57
Q

composes the largest fraction of total CO2

a. chloride
b. bicarbonate
c. sodium

A

a. chloride
b. bicarbonate
c. sodium

58
Q

85% of bicarbonate is reabsorbed in the:

a. PCT
b. DCT
c. CD

A

a. PCT
b. DCT
c. CD

15% in DCT

59
Q

Fourth most abundant cation in the body

a. Calcium
b. Potassium
c. Magnesium

A

Mg

60
Q

Essential cofactor of more than 300 enzymes.
Also regulates movement of potassium across myocardium.

A

Mg

61
Q

is the major renal regulatory site where 50-60% of filtered Mg2+ is reabsorbed in the ascending limb

A

LOH

62
Q

Increase renal excretion of Mg

a. Aldosterone and thyroxin
b. Parathyroid hormone
c. Thyroid hormone

A

a. Aldosterone and thyroxin
b. Parathyroid hormone
c. Thyroid hormone

63
Q

what anticoag should be avoided with Mg
a. citrate
b. edta
c. oxalate
d. heparin

A

a. citrate
b. edta
c. oxalate
d. heparin

64
Q

combines with phosphate to form hydroxy-apatite crystals which provide strength to the bone

a. magnesium
b. calcium
c. chloride

A

a. magnesium
b. calcium
c. chloride

65
Q

Increases the intestinal absorption of calcium as well as the reabsorption in the kidneys

A

1,25 dihydroxycholecalciferol/
Vitamin D

66
Q

activates the process known as bone resorption in which activated osteoclast break down bone and release calcium into the ECF. suppresses urinary loss of calcium.

a. calcitonin
b. PTH
c. vitamin D

A

a. calcitonin
b. PTH
c. vitamin D

Parathyroid hormone (PTH)

67
Q

A thyroid hormone, secreted by the para-follicular C cells of the thyroid gland when the concentration of calcium in the blood increases.

a. calcitonin
b. PTH
c. vitamin D

A

a. calcitonin
b. PTH
c. vitamin D

promotes urinary excretion of calcium, hypocalcemic hormone

68
Q

Fasting is required in Phosphate. True or False.

A

True

69
Q

is a by-product of an emergency mechanism that produces a small amount of ATP when oxygen is severely diminished.

useful for metabolic monitoring in critically ill patients

A

Lactate

70
Q

is the major organ for removing lactate back to glucose by a process called gluconeogenesis

a. kidney
b. liver
c. lungs

A

a. kidney
b. liver
c. lungs

71
Q

Tourniquet should not be used in lactate determination. True or false.

A

True

72
Q

anticoag for lactate
a. oxalate
b. citrate
c. Iodoacetate and fluoride

A

a. oxalate
b. citrate
c. Iodoacetate and fluoride

73
Q

the difference between unmeasured anions and unmeasured cations

A

anion gap

74
Q

anion gap ref range

a. 9-10 mEq/L
b. 8-18 mEq/L
c. 7-17 mEq/L

A

a. 9-10 mEq/L
b. 8-18 mEq/L
c. 7-17 mEq/L

75
Q
A

CLIN CHEM (7 decks)

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