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Clinical Chemistry Review > Electrolytes > Flashcards

Electrolytes Flashcards

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1
Q

Equal no. of cations and anions

A

Electroneutrality

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2
Q

Balance of charges

A

Electroneutrality

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3
Q

Average water content of the human body

A

40-75%

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4
Q

1/3 of total body water

A

ECF

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5
Q

2/3 of total body water

A

ICF

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6
Q

Normal plasma
[?] water(Plasma: [?] > Whole blood)
[?] solutes: (Increased in dehydration)

A

93%; 13%

7%

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7
Q

7% solutes:

A

-Proteins
-Glucose
-NPN
-Lipids
-Ions

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8
Q

Excretion of 10-20L H2O everyday

A

Vasopressin deficiency

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9
Q

Volume and Osmotic regulation

A

Sodium Potassium Chloride

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10
Q

Electrolytes
EC =
IC =

A

Na+ > Cl- > HCO3- > Ca2+(5th) > iPO4
K+ > Mg2+(4th)

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11
Q

Myocardial rhythm and contractility

A

Potassium

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12
Q

Neuromuscular excitability

A

Calcium
Magnesium

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13
Q

Cofactors (enzyme)

A

Calcium
Magnesium (CK)
Zinc
Chloride (AMS)
Potassium

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14
Q

ATPase ion pump

A

Magnesium

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15
Q

Production and use of ATP from glucose

A

Magnesium
Phosphate

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16
Q

Production and use of ATP from glucose

A

Magnesium
Phosphate

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17
Q

Acid-base balance

A

Bicarbonate

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18
Q

Replication of DNA and translation of mRNA

A

Magnesium

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19
Q

Major contributor of osmolality (92%, together w/ Chloride and Bicarbonate)

A

Sodium

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20
Q

↑100 mg/dL glucose =

A

↓1.6 mmol/L sodium

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21
Q

Aldosterone
Sodium
Potassium =  Magnesium

A

↑ Sodium
↓ Potassium = ↓ Magnesium

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22
Q

Atrial natriuretic factor
 Sodium

A

↓ Sodium

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23
Q

Excess water loss

A

Hypernatremia

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24
Q

Decreased water intake

A

Hypernatremia

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25
Q

Hyperaldosteronism (Conn’s disease)

A

Hypernatremia

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26
Q

Hypothalamic disease (Chronic hypernatremia)

A

Hypernatremia

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27
Q

Renal failure

A

Hyponatremia

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28
Q

SIADH (increased water retention)

A

Hyponatremia

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29
Q

Marked hemolysis (dilutional effect)

A

Hyponatremia

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30
Q

<125 mmol/L = severe neuropsychiatric symptoms

A

Hyponatremia

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31
Q

Major defense against hyperosmolality and hypernatremia

A

Thirst

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32
Q

= severe thirst
= Moderate deficit of water
= Severe water deficit

A

1-2% water deficit

150-160 mEq/L Na+

> 165 mEq/L Na+

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33
Q

Pseudohyponatremia (artifactual)

A

Hyperlipidemia (turbidity)
Hyperproteinemia

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34
Q

Methods (Na+)

A
  1. FEP
  2. AAS
  3. ISE
  4. Colorimetry =
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35
Q

= Glass aluminum silicate
= Albanese Lein

A
  1. ISE
  2. Colorimetry
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36
Q

Concentration in RBC is 105 mmol/L

A

Potassium

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37
Q

Reciprocal relationship with H+

A

Potassium

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38
Q

0.5% hemolysis =
Gross hemolysis =

A

↑ 0.5 mmol/L

↑ 30%

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39
Q

Serum K+ > Plasma K+ by 0.1-0.7 mmol/L because of

A

platelets (clot)

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40
Q

in muscle activity

A

↑ 10-20%

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41
Q

= mild to moderate exercise

A

↑ 0.3-1.2 mmol/L

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42
Q

= vigorous exercise; fist clenching

A

↑ 2-3 mmol/L

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43
Q

Decreased resting membrane potential → incr. contractility → lack of muscle excitability

A

Hyperkalemia

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44
Q

Decreased renal excretion (Dehydration, renal failure, Addison’s disease)

A

Hyperkalemia

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45
Q

Acidosis (DM)

A

Hyperkalemia

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46
Q

Muscle injury

A

Hyperkalemia

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47
Q

Spironolactone

A

Hyperkalemia

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48
Q

Increased resting membrane potential → arrhythmia

A

Hypokalemia

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49
Q

Leads to hypomagnesemia

A

Hypokalemia

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50
Q

Vomiting

A

Hypokalemia

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51
Q

Diuretics

A

Hypokalemia

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52
Q

Cushing’s syndrome

A

Hypokalemia

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53
Q

Alkalosis

A

Hypokalemia

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54
Q

Insulin overdose

A

Hypokalemia

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55
Q

Renal tubular acidosis

A

Hyperchloremia

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56
Q

Metabolic acidosis

A

Hyperchloremia

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57
Q

Diabetes insipidus (Dehydration)

A

Hyperchloremia

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58
Q

Prolonged diarrhea

A

Hyperchloremia

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59
Q

Prolonged vomiting (↓ HCl)

A

Hypochloremia

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60
Q

Aldosterone deficiency (↓ Na+ = ↓ Cl- = ↑ K+)

A

Hypochloremia

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61
Q

Metabolic alkalosis (↑ HCO3- = ↓ Cl-)

A

Hypochloremia

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62
Q

Marked hemolysis (dilutional effect)

A

Hypochloremia

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63
Q

Acidosis (Ca2+: from Bones → Blood)

A

Hypercalcemia

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64
Q

Cancer

A

Hypercalcemia

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65
Q

Hyperthyroidism

A

Hypercalcemia

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66
Q

Milk-alkali syndrome

A

Hypercalcemia

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67
Q

Tetany

A

Hypocalcemia

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68
Q

Alkalosis (Ca2+: from Blood → Bones)

A

Hypocalcemia

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69
Q

Acute pancreatitis (Ca2+: binds to damage pancreatic tissues)

A

Hypocalcemia

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70
Q

Hypoparathyroidism

A

Hyperphosphatemia

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71
Q

Renal failure

A

Hyperphosphatemia

72
Q

Hypervitaminosis D

A

Hyperphosphatemia

73
Q

Alcohol abuse = most common cause

A

Hypophosphatemia

74
Q

Primary hyperparathyroidism

A

Hypophosphatemia

75
Q

Avitaminosis D (Rickets, Osteomalacia)

A

Hypophosphatemia

76
Q

Addison’s disease

A

Hypermagnesemia

77
Q

Chronic renal failure

A

Hypermagnesemia

78
Q

Acute renal failure

A

Hypomagnesemia

79
Q

Chronic alcoholism

A

Hypomagnesemia

80
Q

Uremia/renal failure

A

Increased AG

81
Q

Ketoacidosis

A

Increased AG

82
Q

Lactic acidosis

A

Increased AG

83
Q

Methanol poisoning

A

Increased AG

84
Q

Ethanol poisoning

A

Increased AG

85
Q

Ethylene glycol poisoning

A

Increased AG

86
Q

Salicylate poisoning

A

Increased AG

87
Q

Hypoalbuminemia

A

Decreased AG

88
Q

Hypercalcemia

A

Decreased AG

89
Q

Hyperlipidemia

A

Decreased AG

90
Q

Multiple myeloma

A

Decreased AG

91
Q

Hemochromatosis

A

Increased iron

92
Q

Viral hepatitis

A

Increased iron

93
Q

Non-IDA

A

Increased iron

94
Q

IDA

A

Decreased iron

95
Q

Malnutrition

A

Decreased iron

96
Q

Chronic infection

A

Decreased iron

97
Q

pH and K+
↓ pH by 0.1 =

A

↑ K+ by 0.2-1.7 mmol/L

98
Q

Methods (K+)
= preferred

A

Lithium heparin plasma

99
Q

Methods (K+)

A
  1. FEP
  2. AAS
  3. ISE = Valinomycin gel
  4. Colorimetry = Lockhead and Purcell
100
Q
  1. ISE =
  2. Colorimetry =
A

Valinomycin gel

Lockhead and Purcell

101
Q

Chief counter ion of sodium in ECF

A

Chloride

102
Q

Chloride methods measure

A

bromide and iodide

103
Q

↓ Cl- =

A

↓ HCO3-

104
Q

Methods (Cl-)

A
  1. Schales and Schales
  2. Whiterhorn Titration method
  3. Ferric perchlorate
  4. Cotlove chloridometer
  5. ISE -Ion exchange membrane
105
Q
  1. Schales and Schales
A

-Mercurimetric titration

106
Q

-Diphenylcarbazone

A
  1. Schales and Schales
107
Q

-Excess Hg++

A
  1. Schales and Schales
108
Q

-(+) Blue violet

A
  1. Schales and Schales
109
Q

-Mercuric thiocyanate

A
  1. Whiterhorn Titration method
110
Q

-Reddish complex

A
  1. Whiterhorn Titration method
111
Q

-Coulometric amperometric titration

A
  1. Cotlove chloridometer
112
Q

-Excess Ag++

A
  1. Cotlove chloridometer
113
Q

-Ion exchange membrane

A
  1. ISE
114
Q

-Tri-n-octylpropylammonium chloride decanol

A
  1. ISE
115
Q

Calcium
99% =
1% =

A

Bones

ECF

116
Q

Absorbed in the duodenum

A

Calcium

117
Q

Absorption is favored at an acidic pH

A

Calcium

118
Q

3 Forms of Calcium
= Free/Ionized/Unbound/Active Calcium
= Protein-bound (Albumin)
= Complexed with anions

A

50%

40%

10%

119
Q

↑ Ca2+ = ↑ absorption (intestine) and reabsorption (kidney)

A

Vitamin D3

120
Q

↑ Ca2+ = ↑ resorption (bone) and reabsorption (kidney)

A

PTH

121
Q

↓ Ca2+ = ↑ urinary excretion (major net loss of calcium)

A

Calcitonin

122
Q

Practical considerations (Ca2+)
= specimen of choice

A

Serum

123
Q

↓ Albumin (1g/dL) =

A

↓ Ca2+ (0.8 mg/dL)

124
Q

Low PTH

A

Primary hypocalcemia

125
Q

Parathyroid gland disease

A

Primary hypocalcemia

126
Q

High PTH

A

Secondary hypocalcemia

127
Q

Renal failure (↑ excretion)

A

Secondary hypocalcemia

128
Q

Methods (Ca2+)

A
  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
Q

-(+) Oxalic acid -Renal calculi

A
  1. Clark Collip precipitation method
130
Q

-(+)Chloranilic acid

A
  1. Ferro Ham Chloranilic acid precipitation method
131
Q

= Ortho-Cresolphthalein complexone dyes
-Dye: Arzeno III -8-hydroxyquinoline

A
  1. Colorimetric
132
Q

= chelates (inhibits) Mg2+

A

Arzeno III -8-hydroxyquinoline

133
Q
  1. AAS =
  2. ISE =
A

Reference method

Liquid membrane

134
Q

Inorganic Phosphorus
85% =
15% =

A

Bones

ECF (iPO4)

135
Q

Maximally absorbed in the jejunum (Ca2+: duodenum)

A

Inorganic Phosphorus

136
Q

Trancellular shift: Once absorbed inside cells, it no longer comes out = used for energy production

A

Inorganic Phosphorus

137
Q

Dirunal variation: ↑ late morning, ↓ evening

A

Inorganic Phosphorus

138
Q

= principal anion within cells

A

Organic phosphate

139
Q

= part of the blood buffer (Measured in the clin.lab.)

A

Inorganic phosphate

140
Q

3 Forms of Inorganic Phosphorus
= Free
= Complexed with ions
= Protein-bound

A

55%

35%

10%

141
Q

↓ PO4 = ↑ Ca2+

A

PTH

142
Q

↑ PO4 = ↓ Ca2+

A

Calcitonin

143
Q

↑ PO4 (renal reabsorption)

A

Growth hormone

144
Q

Fasting is required (Nonfasting: ↓)

A

PO4

145
Q

Methods (iPO4) Most accurate:

A

unreduced phosphomolybdate formation (340nm)

146
Q

Methods (iPO4)

A
  1. Fiske Subbarow Method (Ammonium molybdate method)
147
Q

-Reducing agents: Pictol, Elon, Senidine, Ascorbic acid

A
  1. Fiske Subbarow Method (Ammonium molybdate method)
148
Q

-(+) Phosphomolybdenum blue

A

Fiske Subbarow Method (Ammonium molybdate method)

149
Q

Magnesium
53% =
46% =
1% =

A

Bones

Muscles and soft tissues

Serum and RBC

150
Q

Vasodilator

A

Magnesium

151
Q

3 Forms of Magnesium
55% =
30% =
10% =

A

Free/Ionized/Physiologically active

Protein-bound

Complexed with ions

152
Q

↑ Mg2+ = ↑ Ca2+ = ↓ PO4

A

PTH

153
Q

↓ Mg2+ = ↓ K+ = ↑ Na+

A

Aldosterone (& Thyroxine)

154
Q

Methods (Mg2+)

A
  1. Calmagite
  2. Formazen dye method
  3. Magnesium Thymol blue method
  4. AAS = reference method
  5. Dye-lake Method
155
Q

-(+) Reddish-violet complex
-(+) Colored complex
-(+) Colored complex
-Titan Yellow dye (Clayton Yellow or Thiazole yellow)

A
  1. Calmagite
  2. Formazen dye method
  3. Magnesium Thymol blue method
  4. Dye-lake Method
156
Q

90% of the total CO2

A

Bicarbonate

157
Q

HCO3- diffuses out of the cell in exchange for Cl- to maintain ionic charge neutrality w/in the cell

A

Chloride shift

158
Q

Difference between unmeasured anions and unmeasured cations

A

Anion Gap

159
Q

QC for ISE

A

Anion Gap

160
Q

Cystic Fibrosis (Mucoviscidosis) Defective gene:

A

Cystic fibrosis transmembranous conductance regulator (Chromosome 7)

161
Q

Miconeum ileus (Infants) ; Foul-smelling stool ; URT infection

A

Cystic Fibrosis (Mucoviscidosis)

162
Q

↑ Na+ and Cl-

A

Cystic Fibrosis (Mucoviscidosis)

163
Q

Sweat inducer

A

Pilocarpine

164
Q

Reference method (Sweat sodium and chloride)

A

Gibson & Cooke pilocarpine iontophoresis

165
Q

Prooxidant

A

Iron

166
Q

Iron
= Total body iron
= Hgb
= Transferrin and Ferritin

A

3-5g

Ferrous

Ferric

167
Q

Methods (Iron)

A
  1. Colorimetric = HCl and Ferrozine
    -(+) Blue color
  2. Anodic stripping voltammetry
168
Q

UIBC + Serum Iron

A

TIBC

169
Q

Increased: IDA, hepatitis, iron-supplemented pregnancy

A

TIBC

170
Q

Decreased: Non-IDA, nephrosis

A

TIBC

171
Q

Measure of reserve iron binding capacity of transferrin

A

UIBC

172
Q

Index of iron storage

A

% Transferrin Saturation

173
Q

Increased: Iron overdose, hemochromatosis, sideroblastic anemia

A

% Transferrin Saturation

174
Q

Decreased: IDA (lowest), malignancy, chronic infection

A

% Transferrin Saturation

175
Q

TIBC (μg/dL) x 0.70 = mg/dL

A

Transferrin

176
Q

Sodium 1/α Potassium
Potassium 1/α Hydrogen ion
Potassium α Magnesium
Magnesium α Calcium
Calcium 1/α Inorganic phosphate
Chloride 1/α Bicarbonate

A

Clinical Chemistry Review (15 decks)

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