Electrolytes: Chloride

Question 1

__________
-Major _____________
-____________ of sodium - an ion that accompanies an ionic specie in order to maintain the electric neutrality
-Promotes maintenance of water balance and osmotic pressure in conjunction with sodium.
-only anion to serve as an _________________
-Secreted in _____ and ______
-Functions:
1. ___________________________________ ( ____________________ in the extracellular fluid)
2. Responsible for _______________ - is an exchange mechanism between chloride and bicarbonate across the membrane of RBCs

Answer 1

Chloride
Major extracellular anion
counterion
enzyme activator
urine and sweat
Maintains water balance and osmotic pressure (anion-cation balance)
chloride shift

Question 2

Salt losing renal disease - ex. ________________
High serum bicarbonate - _________________________ or __________________

Answer 2

pyelonephritis
compensated respiratory acidosis or metabolic alkalosis

Question 3

Specimen Considerations and Patient Preparation
* _________, _________, ____________, _________________ and ________ can be used as a sample
* ________________ - anticoagulant of choice for chloride
* Avoid _____________ - may cause ________ levels of chloride due to _________ effect
* ____________________ - slightly lower values for chloride
* __________ bicarbonate levels - _______ serum chloride

Answer 3

serum, plasma, whole blood, 24-hour urine, sweat
lithium heparin
marked hemolysis - decrease - dilutional effect
post-prandial specimen
high bicarbonate - low serum chloride

Question 4

Methodologies
-Interferences (chemical and colorimetric): (3)

1.______________________
-most commonly used
-uses an______________ membrane selective for chloride ions
-membrane used is in combination with _____________ coated with _____

2. _______________________
   -principle: ___________________
   -uses colorimetric generation of silver ions which combines with chloride to quantitate chloride conc.
   -excess silver ions which were not bound to chloride is used to indicate ____________.
   -sample is diluted in acid with small amounts of gelatin
   * __________ - provides good conductivity
   * __________ - provides sharper endpoint by reducing solubility of silver chloride, decreasing polarity
   * ___________ - makes a smoother titration curve by equalizing the reaction rate over the entire electrode
   -Ag+ + Cl+ –> AgCl
3. __________________________
   -principle: __________________ method
   -based on reaction of chloride ions with mercuric ions to form mercuric chloride
   -blood containing ____________ - leads to positive error
   -2Cl- + Hg2+ –> HgCl2
   -excess Hg + diphenylcarbazone —> __________ color
4. ________________________
   -used in ____________ (__________)
   -uses mercuric thiocyanate and ferric nitrate to form ferric thiocyanate - _________ colored complex
   -measured at _____nm
   -2Cl- + Hg(SCN)2 –> HgCl2 + 2SCN-
   -3SCN- + Fe3+ –> Fe(SCN)3

Answer 4

-Interferences (chemical and colorimetric):
* Bromide
* Cyanide
* Cysteine

1. Ion-selective electrode
   -ion exchange membrane
   -silver wires coated with AgCl
2. Amperometric-Coulometric titration
   -Cotlove Chloridometer
   -end point.
   * nitric acid - good conductivity
   * acetic acid - sharper endpoint
   * Gelatin - makes a smoother titration curve
3. Mercuric (Mercurimetric) titration
   -principle: Schales and Schales method
   - bromide - leads to positive error
   -violet blue color
4. Colorimetric method
   -Autoanalyzer (Technicon)
   -reddish colored complex
   -480nm

Question 5

Values to Remember
Reference values:
* Serum: _________________
* 24-hour urine: ______________
Conversion factor
* mEq/L to mmol/L = ___

Answer 5

98 to 107 mmol/L
110-250 mmol/day
1.0