Electrolytes Ctnd Flashcards

1
Q

Major extracellular anion

A

CHLORIDE

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2
Q

CHLORIDE

FUNCTIONS

A

• Involved in maintaining osmolality, blood volume, and electric neutrality

• Chloride shifts secondarily to a movement of sodium or bicarbonate ions

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3
Q

Chloride Specimen Consideration
• Specimens:

A

Serum
plasma(Li heparin)
whole blood
urine (24-hour)
sweat

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4
Q

Used to measure cystic fibrosis

A

Sweat (sweat patch

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5
Q

CHLORIDE

Hemolysis…
• However, with marked hemolysis, levels may be______ as a result of a dilutional effect

A

does not cause a significant change in serum or plasma values

decreased

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6
Q

Chloride Determination

A

ISE

AMPEROMETRIC COULORIMETRIC METHOD

MERCURIMETRIC TITRATION

MERCURIC THIOCYANATE

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7
Q

Chloride

reference method

A

ISE

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8
Q

Chloride ISE

• lon exchange membrane

A
  • Tri-n-octylpropylammonium chloride decanol

TRI-N-OPA CD

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9
Q

Chloride

• Amperometric-coulometric titration

Measuring device

A

• Cotlove Chloridometer

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10
Q

Chloride

Ag + 2Cl → AgCl
Excess or free Ag → endpoint of titration

What method?

A

Amperometric coulorimetric titration method

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11
Q

(Schales and Schales Method)

A

Mercurimetric Titration

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12
Q

Chloride

Mercurimetric Titration

• Precipitating agent:

A

tungstic acid

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13
Q

Chloride

Mercurimetric titration method

________is titrated with a standard solution of mercuric ions (_____) to form a soluble compound of_____, which does not dissociate to mercuric ions

Excess mercuric ions combine with_________(indicator) to form a______ complex

A

Protein Free Filter

mercuric nitrate

mercuric chloride

s- diphenylcarbazone

blue-violet colored complex

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14
Q

Chloride

• Specimen is mixed with a solution of mercuric thiocyanate

Mercuric chloride - final product

A

Mercuric Thiocyanate (Whitehorn Titration) Method

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15
Q

Chloride

• Free thiocyanate reacts with ferric ions present in ferric nitrate to form a reddish-brown complex

A

Mercuric Thiocyanate (Whitehorn Titration) Method

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16
Q

Method 1.2
Chloride ions react with a mercury(II)-2,4,6-tri-(2-pyridyl)-s-triazine
(TPTZ) complex to form mercury(Il)-chioride. The liberated TPTZ reacts with iron(il) ions yielding ablue coloured complex

The resulting absorbance change at____ is directly proportional to the amount of chloride ions in the sample.

A

590 mm

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17
Q

Chloride package insert

Mix, incubate for____ minutes in the darkand measure the absor-bance of sample (Asample) and STD (Ast)) within____ minutes against the reagent blank. Do not expose to light!

A

5

60

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18
Q

• Composes the largest fraction of the total carbon dioxide

A

Bicarbonate (>90%)

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19
Q

Bicarbonate
• Specimen

A

• Venous serum or heparinized plasma
• Anaerobic collection

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20
Q

If the sample is left uncapped before analysis, CO2 escapes (decrease by….)

A

Bicarbonate

6 mmol/L per hour)

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21
Q

Bicarbonate Determination

• Uses an acid to convert all the forms of CO, to CO, gas and is measured by a pCO, electrode

A

ISE

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22
Q

• Alkalinizes the sample to convert all forms of CO, to CO3-

A

Enzymatic Method

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23
Q

Bicarbonate Reference Range
Reference Ranges

A

CO2-venous 23 to 29 mmol/L (plasma, serum

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24
Q

• Fifth most common element
• Most prevalent cation in the human body

A

Calcium

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25
Q

Calcium FUNCTIONS

A

• skeletal mineralization
• blood coagulation
• neural transmission
• plasma buffering capacity and enzyme activity
• maintenance of normal muscle tone and excitability of skeletal and cardiac muscle

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26
Q

Calcium Distribution
• → bone
• → circulation (blood) + ECF

A

99%

1%

27
Q

Calcium Distribution

• 1% → circulation (blood) + ECF

• → bound to anions (citrate, bicarbonate, lactate)
• → bound to protein (albumin)
• → free/ ionized Ca?+

A

15%

40%

45%

28
Q

Calcium Specimen Consideration
For total calcium determination:

A

• Serum
• Lithium heparin plasma collected without venous stasis
• Do not use EDTA, oxalate, or citrate

29
Q

Calcium Specimen Consideration

For ionized calcium determination:

A

Samples must be collected anaerobically, transported on ice, and stored at 4 degrees Celsius to prevent loss of COz

Heparinized plasma (Do not use heparin in liquid form)

30
Q

Calcium Specimen Consideration
For urine calcium determination:

A

24-hour urine sample acidified with 6mol/L HCl

1mL of acid added for each 100mL urine

31
Q

Calcium Determination

A

• Ortho-cresolphthalein Complexone Method
• Arsenazo Ill Dye Method
• AAS (Reference method)
• ISE (Current Method)

32
Q

Calcium Determination

• Ortho-cresolphthalein Complexone(CPC) Method

• O-CPC reacts with calcium to form _____ in alkaline solution, which is measured at near____

• Uses______ to prevent magnesium interference

A

red color; 580 nm

8-hydroxyquinoline

33
Q

Calcium Determination

• Arsenazo Ill reacts with calcium to form a calcium-indicator complex
usually measured at near___

A

• Arsenazo III Dye Method

650 nm

34
Q

Calcium Determination

• Certain dye solutions like cal-red, calcein, ammonium purate, and Eriochrome Black T have a characteristic color in the presence of ionized calcium.

The addition of a chelating agent binds the calcium, and a change in color results.

A

EDTA Titration (Bachra, Dower, and Sobel)

35
Q

EDTA Titration

A

(Bachra, Dower, and Sobel)

36
Q

Calcium Determination

• calcium is first precipitated as calcium oxalate, converted to oxalic acid with sulfuric acid, and then measured by titration against potassium permanganate

A

Clark-Collip Precipitation method

37
Q

Calcium Determination
• Clark-Collip Precipitation method
• calcium is first precipitated as calcium oxalate, converted to oxalic acid with sulfuric acid, and then measured by titration against…

A

potassium permanganate

38
Q

Calcium Determination

Calcium is precipitated as calcium chloranilate by sodium chloranilate solution
Excess chloranilic acid is removed by washing the precipitate with isopropyl alcohol
Precipitate is treated with EDTA, which chelates calcium and releases chloranilic acid (purple color)

A

• Ferro Ham Chloranilic Acid Precipitation

39
Q

Calcium Determination
• Ferro Ham Chloranilic Acid Precipitation

Calcium is precipitated as calcium chloranilate by _____solution

Excess chloranilic acid is removed by washing the precipitate with isopropyl alcohol

Precipitate is treated with EDTA, which chelates calcium and releases_____

A

sodium chloranilate

chloranilic acid (purple color)

40
Q

Found everywhere in living cells (major intracellular anion)

A

Phosphate

41
Q

• Reservoirs of biochemical energy
ATP, creatine phosphate, and PEP

2,3-BPG in red blood cells

A

Phosphate

42
Q

• Participate in many of the most important biochemical processes

• Inversely related to calcium

A

Phosphate

43
Q

Phosphate
_____%present in the skeletons

• Primarily inorganic phosphate, predominantly as hydroxyapatite and calcium phosphate

A

80 - 85%

44
Q

Phosphate

•____% present in the ECF in the form of inorganic phosphates
intracellularly in the soft tissues in the form of organic phosphates

A

15%

45
Q

Phosphate Specimen Consideration
• Specimen

A

• Serum
• Lithium heparin plasma
• 24-hour urine

46
Q

• Circulating phosphate levels are subject to_____ rhythm

•____ in the late morning and_____ in the evening

A

circadian rhythm

Highest; lowest

47
Q

Phosphate Determination

• Involve the formation of an ammonium phosphomolybdate complex
• Measured by UV at 340 nm or can be reduced to molybdenum blue, which is read between 600 and 700 nm

A

• Fiske-Subbarow Method

48
Q

Phosphate Determination
• Fiske-Subbarow Method

• Involve the formation of an_______
• Measured by UV at____ or can be reduced to______, which is read between_______

A

ammonium phosphomolybdate complex

340 nm

molybdenum blue

600 and 700 nm

49
Q

Fiske Subarrow (Phosphate)

• Reducing agents: PEAS

A

pictol (ammonium napthol sulfonic acid),

elon (methyl amino phenol)

ascorbic acid

senidine (N-phenyl-P-phenylene Diamine
Hydrochloride),

50
Q

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

A

Lactate

51
Q

_____is the normal end product of glucose metabolism (glycolysis)
• Conversion to_____ is activated when a deficiency of oxygen leads to an accumulation of excess NADH

A

Pyruvate

lactate

52
Q

Lactate Specimen Consideration

A

• Tourniquet should not be used

• After sample collection, anaerobic glycolysis will occur

53
Q

LACTATE

Specimens:

A

plasma or whole blood

54
Q

Lactate

• After sample collection, anaerobic glycolysis will occur

• Heparinized plasma but must be______, and the plasma must be separated quickly

A

delivered on ice

55
Q

Lactate

inhibit glycolysis but the specific method directions must be consulted

A

Fluoride and iodoacetate

56
Q

Lactate Determination

• Uses lactate oxidase to produce pyruvate and hydrogen peroxide

Addition of chromogen and catalyzed by peroxidase to form a colored complex

A

• Enzymatic Method

57
Q

Lactate Determination
• Enzymatic Method
• Uses_____ to produce _____ and _____

• Addition of_____ and catalyzed by______ to form a colored complex

A

lactate oxidase

pyruvate and hydrogen peroxide

chromogen

peroxidase

58
Q

• Useful in indicating an increase in one or more of the unmeasured anions in the serum
• As a form of quality control for the analyzer used to measure electrolytes

A

Anion Gap

59
Q

Anion gap

It has a reference range of

A

10 to 20 mmol/L.

60
Q

Anion Gap
• Concentration difference between…

A

commonly measured cations (Na + K) and commonly measured anions (Cl + HCO3)

61
Q

Bawal ang venous stasis sa kay?

A

Total calcium

62
Q

Ionized calcium must be transported

A

With ice

Collected anaerobically

Stored at 4C

Prevents loss of CO2

63
Q

Asa tung bawal ang liquid form sa heparin?

A

Ionized calcium

64
Q

For urine calcium determination… urine must be…

A

Acidified with 6mol/L HCl

1ml of HCl per 100mL of urine