Electrolytes Flashcards
1
Q
Equal no. of cations and anions
A
Electroneutrality
2
Q
Balance of charges
A
Electroneutrality
3
Q
Average water content of the human body
A
40-75%
4
Q
1/3 of total body water
A
ECF
5
Q
2/3 of total body water
A
ICF
6
Q
Normal plasma
[?] water(Plasma: [?] > Whole blood)
[?] solutes: (Increased in dehydration)
A
93%; 13%
7%
7
Q
7% solutes:
A
-Proteins
-Glucose
-NPN
-Lipids
-Ions
8
Q
Excretion of 10-20L H2O everyday
A
Vasopressin deficiency
9
Q
Volume and Osmotic regulation
A
Sodium Potassium Chloride
10
Q
Electrolytes
EC =
IC =
A
Na+ > Cl- > HCO3- > Ca2+(5th) > iPO4
K+ > Mg2+(4th)
11
Q
Myocardial rhythm and contractility
A
Potassium
12
Q
Neuromuscular excitability
A
Calcium
Magnesium
13
Q
Cofactors (enzyme)
A
Calcium
Magnesium (CK)
Zinc
Chloride (AMS)
Potassium
14
Q
ATPase ion pump
A
Magnesium
15
Q
Production and use of ATP from glucose
A
Magnesium
Phosphate
16
Q
Production and use of ATP from glucose
A
Magnesium
Phosphate
17
Q
Acid-base balance
A
Bicarbonate
18
Q
Replication of DNA and translation of mRNA
A
Magnesium
19
Q
Major contributor of osmolality (92%, together w/ Chloride and Bicarbonate)
A
Sodium
20
Q
↑100 mg/dL glucose =
A
↓1.6 mmol/L sodium
21
Q
Aldosterone
Sodium
Potassium = Magnesium
A
↑ Sodium
↓ Potassium = ↓ Magnesium
22
Q
Atrial natriuretic factor
Sodium
A
↓ Sodium
23
Q
Excess water loss
A
Hypernatremia
24
Q
Decreased water intake
A
Hypernatremia
25
Hyperaldosteronism (Conn’s disease)
Hypernatremia
26
Hypothalamic disease (Chronic hypernatremia)
Hypernatremia
27
Renal failure
Hyponatremia
28
SIADH (increased water retention)
Hyponatremia
29
Marked hemolysis (dilutional effect)
Hyponatremia
30
<125 mmol/L = severe neuropsychiatric symptoms
Hyponatremia
31
Major defense against hyperosmolality and hypernatremia
Thirst
32
= severe thirst
= Moderate deficit of water
= Severe water deficit
1-2% water deficit
150-160 mEq/L Na+
>165 mEq/L Na+
33
Pseudohyponatremia (artifactual)
Hyperlipidemia (turbidity)
Hyperproteinemia
34
Methods (Na+)
1. FEP
2. AAS
3. ISE
4. Colorimetry =
35
= Glass aluminum silicate
= Albanese Lein
3. ISE
4. Colorimetry
36
Concentration in RBC is 105 mmol/L
Potassium
37
Reciprocal relationship with H+
Potassium
38
0.5% hemolysis =
Gross hemolysis =
↑ 0.5 mmol/L
↑ 30%
39
Serum K+ > Plasma K+ by 0.1-0.7 mmol/L because of
platelets (clot)
40
in muscle activity
↑ 10-20%
41
= mild to moderate exercise
↑ 0.3-1.2 mmol/L
42
= vigorous exercise; fist clenching
↑ 2-3 mmol/L
43
Decreased resting membrane potential → incr. contractility → lack of muscle excitability
Hyperkalemia
44
Decreased renal excretion (Dehydration, renal failure, Addison’s disease)
Hyperkalemia
45
Acidosis (DM)
Hyperkalemia
46
Muscle injury
Hyperkalemia
47
Spironolactone
Hyperkalemia
48
Increased resting membrane potential → arrhythmia
Hypokalemia
49
Leads to hypomagnesemia
Hypokalemia
50
Vomiting
Hypokalemia
51
Diuretics
Hypokalemia
52
Cushing’s syndrome
Hypokalemia
53
Alkalosis
Hypokalemia
54
Insulin overdose
Hypokalemia
55
Renal tubular acidosis
Hyperchloremia
56
Metabolic acidosis
Hyperchloremia
57
Diabetes insipidus (Dehydration)
Hyperchloremia
58
Prolonged diarrhea
Hyperchloremia
59
Prolonged vomiting (↓ HCl)
Hypochloremia
60
Aldosterone deficiency (↓ Na+ = ↓ Cl- = ↑ K+)
Hypochloremia
61
Metabolic alkalosis (↑ HCO3- = ↓ Cl-)
Hypochloremia
62
Marked hemolysis (dilutional effect)
Hypochloremia
63
Acidosis (Ca2+: from Bones → Blood)
Hypercalcemia
64
Cancer
Hypercalcemia
65
Hyperthyroidism
Hypercalcemia
66
Milk-alkali syndrome
Hypercalcemia
67
Tetany
Hypocalcemia
68
Alkalosis (Ca2+: from Blood → Bones)
Hypocalcemia
69
Acute pancreatitis (Ca2+: binds to damage pancreatic tissues)
Hypocalcemia
70
Hypoparathyroidism
Hyperphosphatemia
71
Renal failure
Hyperphosphatemia
72
Hypervitaminosis D
Hyperphosphatemia
73
Alcohol abuse = most common cause
Hypophosphatemia
74
Primary hyperparathyroidism
Hypophosphatemia
75
Avitaminosis D (Rickets, Osteomalacia)
Hypophosphatemia
76
Addison’s disease
Hypermagnesemia
77
Chronic renal failure
Hypermagnesemia
78
Acute renal failure
Hypomagnesemia
79
Chronic alcoholism
Hypomagnesemia
80
Uremia/renal failure
Increased AG
81
Ketoacidosis
Increased AG
82
Lactic acidosis
Increased AG
83
Methanol poisoning
Increased AG
84
Ethanol poisoning
Increased AG
85
Ethylene glycol poisoning
Increased AG
86
Salicylate poisoning
Increased AG
87
Hypoalbuminemia
Decreased AG
88
Hypercalcemia
Decreased AG
89
Hyperlipidemia
Decreased AG
90
Multiple myeloma
Decreased AG
91
Hemochromatosis
Increased iron
92
Viral hepatitis
Increased iron
93
Non-IDA
Increased iron
94
IDA
Decreased iron
95
Malnutrition
Decreased iron
96
Chronic infection
Decreased iron
97
pH and K+
↓ pH by 0.1 =
↑ K+ by 0.2-1.7 mmol/L
98
Methods (K+)
= preferred
Lithium heparin plasma
99
Methods (K+)
1. FEP
2. AAS
3. ISE = Valinomycin gel
4. Colorimetry = Lockhead and Purcell
100
3. ISE =
4. Colorimetry =
Valinomycin gel
Lockhead and Purcell
101
Chief counter ion of sodium in ECF
Chloride
102
Chloride methods measure
bromide and iodide
103
↓ Cl- =
↓ HCO3-
104
Methods (Cl-)
1. Schales and Schales
2. Whiterhorn Titration method
3. Ferric perchlorate
4. Cotlove chloridometer
5. ISE -Ion exchange membrane
105
1. Schales and Schales
-Mercurimetric titration
106
-Diphenylcarbazone
1. Schales and Schales
107
-Excess Hg++
1. Schales and Schales
108
-(+) Blue violet
1. Schales and Schales
109
-Mercuric thiocyanate
2. Whiterhorn Titration method
110
-Reddish complex
2. Whiterhorn Titration method
111
-Coulometric amperometric titration
4. Cotlove chloridometer
112
-Excess Ag++
4. Cotlove chloridometer
113
-Ion exchange membrane
5. ISE
114
-Tri-n-octylpropylammonium chloride decanol
5. ISE
115
Calcium
99% =
1% =
Bones
ECF
116
Absorbed in the duodenum
Calcium
117
Absorption is favored at an acidic pH
Calcium
118
3 Forms of Calcium
= Free/Ionized/Unbound/Active Calcium
= Protein-bound (Albumin)
= Complexed with anions
50%
40%
10%
119
↑ Ca2+ = ↑ absorption (intestine) and reabsorption (kidney)
Vitamin D3
120
↑ Ca2+ = ↑ resorption (bone) and reabsorption (kidney)
PTH
121
↓ Ca2+ = ↑ urinary excretion (major net loss of calcium)
Calcitonin
122
Practical considerations (Ca2+)
= specimen of choice
Serum
123
↓ Albumin (1g/dL) =
↓ Ca2+ (0.8 mg/dL)
124
Low PTH
Primary hypocalcemia
125
Parathyroid gland disease
Primary hypocalcemia
126
High PTH
Secondary hypocalcemia
127
Renal failure (↑ excretion)
Secondary hypocalcemia
128
Methods (Ca2+)
1. Clark Collip precipitation method
2. Ferro Ham Chloranilic acid precipitation method
3. Colorimetric
4. EDTA titration method (Bachra, Dawer and Sobel)
5. AAS
6. ISE
7. FEP
129
-(+) Oxalic acid -Renal calculi
1. Clark Collip precipitation method
130
-(+)Chloranilic acid
2. Ferro Ham Chloranilic acid precipitation method
131
= Ortho-Cresolphthalein complexone dyes
-Dye: Arzeno III -8-hydroxyquinoline
3. Colorimetric
132
= chelates (inhibits) Mg2+
Arzeno III -8-hydroxyquinoline
133
5. AAS =
6. ISE =
Reference method
Liquid membrane
134
Inorganic Phosphorus
85% =
15% =
Bones
ECF (iPO4)
135
Maximally absorbed in the jejunum (Ca2+: duodenum)
Inorganic Phosphorus
136
Trancellular shift: Once absorbed inside cells, it no longer comes out = used for energy production
Inorganic Phosphorus
137
Dirunal variation: ↑ late morning, ↓ evening
Inorganic Phosphorus
138
= principal anion within cells
Organic phosphate
139
= part of the blood buffer (Measured in the clin.lab.)
Inorganic phosphate
140
3 Forms of Inorganic Phosphorus
= Free
= Complexed with ions
= Protein-bound
55%
35%
10%
141
↓ PO4 = ↑ Ca2+
PTH
142
↑ PO4 = ↓ Ca2+
Calcitonin
143
↑ PO4 (renal reabsorption)
Growth hormone
144
Fasting is required (Nonfasting: ↓)
PO4
145
Methods (iPO4) Most accurate:
unreduced phosphomolybdate formation (340nm)
146
Methods (iPO4)
1. Fiske Subbarow Method (Ammonium molybdate method)
147
-Reducing agents: Pictol, Elon, Senidine, Ascorbic acid
1. Fiske Subbarow Method (Ammonium molybdate method)
148
-(+) Phosphomolybdenum blue
Fiske Subbarow Method (Ammonium molybdate method)
149
Magnesium
53% =
46% =
1% =
Bones
Muscles and soft tissues
Serum and RBC
150
Vasodilator
Magnesium
151
3 Forms of Magnesium
55% =
30% =
10% =
Free/Ionized/Physiologically active
Protein-bound
Complexed with ions
152
↑ Mg2+ = ↑ Ca2+ = ↓ PO4
PTH
153
↓ Mg2+ = ↓ K+ = ↑ Na+
Aldosterone (& Thyroxine)
154
Methods (Mg2+)
1. Calmagite
2. Formazen dye method
3. Magnesium Thymol blue method
4. AAS = reference method
5. Dye-lake Method
155
-(+) Reddish-violet complex
-(+) Colored complex
-(+) Colored complex
-Titan Yellow dye (Clayton Yellow or Thiazole yellow)
1. Calmagite
2. Formazen dye method
3. Magnesium Thymol blue method
5. Dye-lake Method
156
90% of the total CO2
Bicarbonate
157
HCO3- diffuses out of the cell in exchange for Cl- to maintain ionic charge neutrality w/in the cell
Chloride shift
158
Difference between unmeasured anions and unmeasured cations
Anion Gap
159
QC for ISE
Anion Gap
160
Cystic Fibrosis (Mucoviscidosis) Defective gene:
Cystic fibrosis transmembranous conductance regulator (Chromosome 7)
161
Miconeum ileus (Infants) ; Foul-smelling stool ; URT infection
Cystic Fibrosis (Mucoviscidosis)
162
↑ Na+ and Cl-
Cystic Fibrosis (Mucoviscidosis)
163
Sweat inducer
Pilocarpine
164
Reference method (Sweat sodium and chloride)
Gibson & Cooke pilocarpine iontophoresis
165
Prooxidant
Iron
166
Iron
= Total body iron
= Hgb
= Transferrin and Ferritin
3-5g
Ferrous
Ferric
167
Methods (Iron)
1. Colorimetric = HCl and Ferrozine
-(+) Blue color
2. Anodic stripping voltammetry
168
UIBC + Serum Iron
TIBC
169
Increased: IDA, hepatitis, iron-supplemented pregnancy
TIBC
170
Decreased: Non-IDA, nephrosis
TIBC
171
Measure of reserve iron binding capacity of transferrin
UIBC
172
Index of iron storage
% Transferrin Saturation
173
Increased: Iron overdose, hemochromatosis, sideroblastic anemia
% Transferrin Saturation
174
Decreased: IDA (lowest), malignancy, chronic infection
% Transferrin Saturation
175
TIBC (μg/dL) x 0.70 = mg/dL
Transferrin
176
Sodium 1/α Potassium
Potassium 1/α Hydrogen ion
Potassium α Magnesium
Magnesium α Calcium
Calcium 1/α Inorganic phosphate
Chloride 1/α Bicarbonate
