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RUSVM Clinical Pathology 2016 > Electrolytes > Flashcards

Electrolytes Flashcards

1
Q

What is the major extracellular fluid ion?

A

Sodium

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2
Q

How is sodium eliminated from cells?

A

Sodium pump

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3
Q

What is a major influence on osmolality?

A

Sodium

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4
Q

How is sodium regulated?

A

Through adequate intake
Renal tubular absorption
Intestinal absorption
Osmoreceptors that secrete ADH

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5
Q

What affects plasma volume of sodium?

A

Urine
GI Tract
Sweat

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6
Q

What are the 2 related and interdependent systems of sodium balance?

A

Osmoregulation

Volume regulation

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7
Q

What control osmoregulation of sodium?

A

Osmoreceptors in the hypothalamus sense increased osmolality and secrete ADH

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8
Q

What controls volume regulation of sodium?

A

Stretch receptors sense volume changes

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9
Q

What does ADH respond to?

A

Increases osmolality

Decreased Plasma volume

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10
Q

Where does ADH act?

A

on the collecting ducts to maximize water reabsorption

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11
Q

What system is the main regulator of sodium balance?

A

Renin-Angiotensin - Aldosterone system

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12
Q

What is Aldosterone secreted in response to?

A

Angiotensin
Hyperkalemia
ACTH

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13
Q

What does Aldosterone increase the secretion of?

A

Potassium

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14
Q

What are the four causes of Hyponatremia?

A

Loss of Sodium
Increase in extracellular water
decreased intake of sodium
shifts in plasma osmolality not due to sodium

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15
Q

What is the most common cause of Hyponatremia?

A

Excess sodium loss

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16
Q

What are the 4 causes of Excess sodium loss?

A

through the GI tract: Vomiting, diarrhea, and salive
Renal loss
Cutaneous: sweating and burns
3rd space: sequestration of fluid

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17
Q

What are examples of extracellular fluid sequestration?

A 
Peritonitis
Ascites
Uroabdomen
Chylothorax
GI sequestration
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18
Q

What is a common cause of sodium osmotic shift from Intracellular to extracellular fluid?

A

Hyperglycemia

Mannitol adminstration

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19
Q

What are the three causes of increased extracellular water and hyponatremia?

A

Primary polydipsia
Excessive administration of sodium poor IVF
Edematous conditions

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20
Q

What is the most common cause of Hypernatremia?

A

Dehydration due to lack of intake or pure water loss

21
Q

What is the less common cause of Hypernatremia?

A

Excess intake or retention through ingestion, IV administration, or increased aldosterone

22
Q

What is the major extracellular fluid anion?

A

Chloride

23
Q

What is chloride involved in?

A

transport of electrolytes and water

Acid base metabolism

24
Q

If the changes in sodium and chloride are proportional consider …

A

abnormalities in sodium

25
Q

If changes in chloride concentrations are greater than sodium consider…

A

acid-base abnormalities

26
Q

When evaluating chloride look at….

A

Sodium concentrations

Total CO2

27
Q

What regulates chloride?

A

electrochemical gradients

active transport of sodium

28
Q

What interferes with chloride transport?

A

Furosemide

GI entertoxins

29
Q

What is the most common cause of hypochloremia?

A

Hypochloremic metabolic alkalosis

30
Q

What are the other causes of Hypochloremia?

A 
All causes of hyponatremia
Vomiting in monogastrics
Abomasal disorders
High GI obstructions 
Sweating in horses
31
Q

Paradoxical aciduria requires what 2 things?

A

Volume depletion

Chloride depletion

32
Q

What does the kidney do to compensate for Hypochloremia and Paradoxical aciduria?

A

Reabsorbs sodium to correct dehydration

Resorbs HCO3- instead of chloride (electroneutrality)

33
Q

What is the cause of Hyperchloremia?

A

Parallels sodium increased
Hyperchloremic Metabolic acidosis: GI tract loss of Bicarb or Proximal and distal renal tubular acidoses
Alkalemia/Bicarb excess

34
Q

What are the major functions of Potassium?

A

Major intracellular cation
Resting cell membrane potential
Carbohydrate metabolism
Electron transport

35
Q

What is the major intracellular cation?

A

Potassium

36
Q

How is potassium regulated?

A

Adequate intake
Renal excretion
Sweat
GI loss

37
Q

What hormone promotes renal excretion of potassium?

A

Aldosterone

38
Q

What is the most common cause of Hyperkalemia?

A

Failure of Renal Excretion

39
Q

What are the causes of Hyperkalemia?

A

Failure of renal excretion
Redistribution
Increased intake through parenteral administration

40
Q

What causes of Hyperkalemia pertain to the urinary system?

A

Oliguria/Anuria
Urethral obstruction
Rupture urinary bladder

41
Q

What disease causes Hyperkalemia?

A

Hypoadrenocorticism (Addison’s) - decreased aldosterone

42
Q

What diuretics cause Hyperkalemia?

A

Potassium sparing Diuretics - Spirolactone

43
Q

What is the magic number for Sodium:Potassium ratio??

A

27

44
Q

What is a major mechanism for Hyperkalemia?

A

Redistribution:
Inorganic Acidosis
Insulin deficiency
Severe muscle trauma: Rhabdomyolysis or Seizures

45
Q

What causes Pseudohyperkalemia?

A

Generally in vivo: Marked Thrombocytosis: leakage of intracellular potassium
Hemolysis

46
Q

What is characteristic of EDTA contamination?

A

Low levels of calcium

High levels of potassium

47
Q

What are causes of Hypokalemia?

A

Decreased intake or low Potassium IV fluids
Loss
Horse Sweat
Redistribution: Alkalemia or Insulin injection

48
Q

What are the consequences of Potassium

A

Weakness
Neurologic signs
EKG abnormalities

RUSVM Clinical Pathology 2016 (22 decks)

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