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[Lecture] CC II > Electrolytes: Part 1 > Flashcards

Electrolytes: Part 1 Flashcards

1
Q

Biologic ions

A

Electrolytes

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2
Q

Cation (+/-) migrates to _______ (+/-)

A

+
Cathode
-

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3
Q

Anion (+/-) migrates to _________ (+/-)

A

-
Anode
+

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4
Q

FUNCTIONS OF ELETROLYTES

A

Volume and Osmotic regulations
Myocardial rhythm and contractility
Enzyme cofactors (activators)
Regulation of ATPase-ion pumps
Neuromuscular excitability
Production and Use of ATP from Glucose
Acid-Base Balance Maintenance
DNA replication and mRNA translation

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5
Q

Enzyme/s involved in Volume and Osmotic regulations

A

Na+, K+, Cl-

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6
Q

Enzyme/s involved in Myocardial rhythm and contractility

A

K+, Ca2+, Mg2+

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7
Q

Enzyme/s involved in Enzyme cofactors (activators)

A

Ca2+, Mg2+, Zn2+

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8
Q

Enzyme/s involved in Regulation of ATPase-ion pumps

A

Mg2

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9
Q

active transport that transports electrolyte in and out of the cell

A

ATPase-ion pumps

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10
Q

Enzyme/s involved in Neuromuscular excitability

A

K+, Ca2+, Mg2+

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11
Q

Enzyme/s involved in Production and Use of ATP from Glucose

A

Mg2+, PO4-

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12
Q

Enzyme/s involved in Acid-Base Balance Maintenance

A

HCO3-, K+, Cl-, PO4-

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13
Q

Enzyme/s involved in DNA replication and mRNA translation

A

Mg2+

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14
Q

charged atoms

A

Ions

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15
Q

dissolved in the blood and body fluids such as plasma, urine, CSF, etc.

A

ions

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16
Q

Solvent for all processes in the body.

A

Water

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17
Q

WATER

Human body: _______ water (___L)

A

40-75%
42L

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18
Q

Location of water

A

→ Intracellular fluid (ICF)
→ Extracellular fluid (ECF)

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19
Q

Intracellular fluid

___ or ___% of total body H2O (____L approx)

A

⅔
65%
28

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20
Q

Inside the cell

A

→ Intracellular fluid (ICF)

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21
Q

ECF

___ or __% (__L approx)

A

⅓
35%
14L

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22
Q

Outside the cell

A

→ Extracellular fluid (ECF)

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23
Q

Physiologic functions of Water:

A

→ Transports nutrients to cells
→ Determination of cell volume by its transport into and out of the cell
→ Removal of waste products
→ Body’s natural coolant

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24
Q

Physiologic function of water;

→ Removal of waste products (_____)

A

Urine

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25
Q

Physiologic function of water;

→ Body’s natural coolant (______)

A

Sweat

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26
Q

Sweat - contains __ mmol/L of Na & __ mmol/L of K+

A

15
5

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27
Q

2 Types of Water

A

Intravascular fluid
Interstitial fluid

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28
Q

○ Inside the blood vessel

A

→ Intravascular fluid

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29
Q

○ Plasma (liquid part of unclotted blood) with ___% water

A

Intravascular fluid
93%

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30
Q

○ Gaps in between the cells; fluid that surrounds the cell

A

Interstitial fluid

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31
Q

Retained for 3L of water - will cause _____ (retention of fluids in the tissue)

A

Interstitial fluid
Edema

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32
Q

Maintains concentration of electrolytes within cells and in plasma by actively promoting entry & exit of electrolytes in and out of the cell.

A

ION TRANSPORT MECHANISMS

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33
Q

● 2 Mechanisms of Ion Transport Mechanism

A

Active Transport
Passive Transport (Diffusion)

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34
Q

transport mechanism that requires energy to move ion across cellular membranes.

A

Active Transport

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35
Q

movement of ions across membrane based on size and charge

A

Passive Transport (Diffusion)

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36
Q

T/F: Passive Transport needs energy

A

FASLSE; Passive transport does NOT need energy

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37
Q

Concentration of solutes per kilogram of solvent (mOsm/Kg)

A

OSMOLALITY

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38
Q

Osmolality is unaffected by:

A

hyperlipidemia
hyperproteinemia
alcohol
mannitol

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39
Q

90% of total osmolality of osmotic activity in plasma

A

Na+ (and its anions)

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40
Q

Normal Plasma Osmolality

A

275-295 mOsm/Kg of plasma water

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41
Q

↑Na2+ and ↓H2O intake

A

Hyperosmolality

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42
Q

Function of Hypothalamus

A

Promote thirst
Promote decrease is vasopressin

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43
Q

major defense of body against hyperosmolality

A

Thirst

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44
Q

T/F: Where Na+ goes, H2O follows:

A

TRUE

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45
Q

↑Na+ = (Inc/dec)H2O

A

inc

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46
Q

Results to hypervolemia = ↑BV = ↑BP = (inc/dec) plasma solute

A

inc

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47
Q

↓Na+

A

Hypoosmolality

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48
Q

Decrease plasma solutes relative to the water

A

Hypoosmolality

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49
Q

What is the meaning of RAAS System

A

RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM

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50
Q

regulates blood volume

A

RAAS System

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51
Q

mainly respond with decreased blood volume
(Hypovolemia)

A

RAAS System

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52
Q

secreted by Renal glomeruli

A

Renin

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53
Q

converts angiotensinogen to angiotensin 1

A

Renin

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54
Q

secreted by the adrenal cortex

A

Aldosterone

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55
Q

secreted by the hypothalamus

A

ADH/Vasopressin/Arginine-Vasopressin
Hormone

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56
Q

OTHER FACTORS AFFECTING BLOOD VOLUME

A
  1. Atrial Natriuretic Peptide and B-type Natriuretic Peptide
  2. Blood Volume Receptors
  3. Glomerular Filtration Rate
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57
Q

Atrial Natriuretic Peptide and B-type Natriuretic Peptide

Promotes Na+ (secretion/excretion) (H2O excretion) -
(low/high) Blood volume & Blood pressure

A

Excretion
low

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58
Q

Vasodilation

A

Atrial Natriuretic Peptide and B-type Natriuretic Peptide

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59
Q

acts against hypervolemia by promoting Na+

A

Atrial Natriuretic Peptide

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60
Q

Stimulates vasopressin secretion (retains
H2O) – (dependent/independent) of Osmolality

A

Blood Volume Receptors
Indepentent

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61
Q

Glomerular Filtration Rate

Hypervolemia - (inc/dec) GFR
Hypovolemia - (inc/dec)GFR

A

Hypervolemia - ↑GFR
Hypovolemia - ↓GFR

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62
Q

What is the old name of Sodium

A

Natrium

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63
Q

The major extracellular cation (most abundant)

A

Sodium

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64
Q

The major contributor to osmolality (____%)

A

Sodium
90

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65
Q

The principal extracellular osmotic particle

A

Sodium

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66
Q

SODIUM

Reference range: Serum

A

135-145 mmol/L

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67
Q

SODIUM

Reference range: CSF

A

136-150 mmol/L

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68
Q

SODIUM

Reference range: Urine

A

40-220 mmol/day

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69
Q

Sodium is maintained by:

A

Water intake
Water excretion

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70
Q

Threshold Critical Values:

→ _____ mmol/L - Hypernatremia
→ ____ mmol/L - Hyponatremia

A

160
120

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71
Q

Renal Threshold:

A

110-130 mmol/L

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72
Q

Concentration where the kidney stops
reabsorption

A

Renal Threshold:

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73
Q

Active Transport - requires energy

A

Na+/K+-ATPase ion Pump

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74
Q

Prevents osmotic rupture of cells

A

Na+/K+-ATPase ion Pump

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75
Q

When there is prevention of osmotic rupture of the cells, the water inside (inc/dec)

A

dec

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76
Q

Requires ATP

A

ATP-Driven

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77
Q

Maintained by promoting exit of __ Na+
outside the cell in-exchange with __ K+

A

3
2

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78
Q

Functions of Na+/K+-ATPase ion Pump

Maintains high concentration of intracellular
___
Maintains high concentration of extracellular
___

A

K+
Na+

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79
Q

What does sodium regulates?

A

Thirst
Water excretion
Blood volume status
Atrial Natriuretic Peptide
Renal Regulation:

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80
Q

WATER EXCRETION

↑H2O excreted = (inc/dec) Na+

A

inc

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81
Q

Blood volume status

affect Na+ excretion through ____________, _____________, and ____.

A

aldosterone
angiotensin II
ANP

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82
Q

Atrial Natriuretic Peptide

blocks ______ and ______ secretion

A

aldosterone
renin

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83
Q

Atrial Natriuretic Peptide

inhibits action of ___________ and ___________.

A

angiotensin II
vasopressin

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84
Q

Responds to hypervolemia

A

Atrial Natriuretic Peptide

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85
Q

Atrial Natriuretic Peptide

Promotes “___________” - sodium excretion

A

Natriuresis

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86
Q

Sodium: Renal Regulation

________ of filtered Na+ are reabsorbed by
____

A

60-75%
PCT

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87
Q

Hormone responsible for Renal Regulation of Sodium

A

Aldosterone

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88
Q

Decreased plasma sodium concentration

A

Hyponatremia

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89
Q

Levels of decreased during Hyponatremia

A

<135 mmol/L

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90
Q

Most common electrolyte disorder

A

Hyponaterima

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91
Q

__________mmol/L hyponatremia symptoms occurs

A

125-130 mmol/L

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92
Q

results to severe neuropsychiatric symptoms (momentary memory loss)

A

<125 mmol/L

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93
Q

_______________ causes hyponatremia

A

Hyperglycemia

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94
Q

ongoing renal sodium and water loss

A

Urine Sodium of 20 mmol/day

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95
Q

For every 100 mg/dL ↑in glucose = _____ mmol/L
↓in Na+

A

1.6

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96
Q

____________ = ↓K+ in blood = Hyponatremia

A

Hypokalemia

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97
Q

Causes of Hyponatremia

A

Increased Na2+ loss
Increased Water Retention
Water Imbalance

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98
Q

Enumerate the diseases/conditions involving increased NA2+ loss

A

Hypoadrenalism
Potassium deficiency
Diuretic
Ketonuria
Salt-losing nephropathy
Prolonged vomiting or diarrhea
Severe burns

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99
Q

↓aldosterone excretion

A

Hypoadrenalism

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100
Q

Examples of Diuretic the Increased NA2+ loss

A

Thiazides

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101
Q

inhibit renal Na+ reabsorption in the DCT

A

Diuretic (Thiazides)

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102
Q

excreted along with blood Na in the
urine

A

Ketonuria

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103
Q

Enumerate the Diseases/Conditions involving the increase of water retention

A
  1. Renal Failure
  2. Nephrotic syndrome
  3. Hepatic cirrhosis
  4. Congestive Heart Failure
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104
Q

Enumerate the Diseases/Conditions involving the increase of water retention

A

Polydipsia
Syndrome of Inappropriate ADH secretion
(SIADH)
Pseudohyponatremia

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105
Q

dilution of plasma causing dilution of
its electrolytes

A

Polydipsia

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106
Q

The dilution of plasma causing dilution of
its electrolytes causes excessive __________

A

Thirst

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107
Q

Syndrome of Inappropriate ADH secretion
(SIADH)

↑ADH = - (inc/dec) Urine Output (Inhibit
Urination)

A

dec

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108
Q

False ↓ in Na+

A

Pseudohyponatremia

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109
Q

Happens only during measurement
(systematic error)

A

Pseudohyponatremia

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110
Q

Pseudohyponatremia happens when using __________________________________

A

Indirect Ion Selective Electrode

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111
Q

In patients with hyperlipidemia and
hyperproteinemia

A

Pseudohyponatremia

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112
Q

Increased plasma sodium concentration (_____
mmol/L)

A

Hypernatremia
>145

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113
Q

Water deficit affects plasma concentration (_____
deficit will result to thirst)

A

Hypernatremia
1-2%

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114
Q

Moderate H2O deficiency

A

150-160 mEq/L

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115
Q

Severe H2O deficiency

A

> 165 mEq/L

116
Q

indicative of hypothalamic disease

A

Chronic hypernatremia

117
Q

Causes of Hypernatremia

A

Excess Water Loss
Decreased Water Intake
Increased Na2+ intake or retention

118
Q

Most common cause of Hypernatremia

A

Excess Water Loss

119
Q

Enumerate the diseases/conditions involving excess water loss

A
  1. Diabetes insipidus
  2. Renal tubular disorder
  3. Profuse sweating
  4. Hyperventilation
  5. Diarrhea
  6. Severe burns
  7. Vomiting
  8. Fever
120
Q

polyuria because of deficient vasopressin

A

Diabetes insipidus

121
Q

impairment to retain urine at SG of 1.010

A

Renal tubular disorder

122
Q

1L of water loss/day

A

Profuse sweating

123
Q

1L of water loss/day

A

Hyperventilation

124
Q

Who is affected by Decreased Water Intake

A

Older persons, infants, mental impairment

125
Q

Enumerate the diseases/conditions involving Increased Na2+ intake or retention

A
  1. Hyperaldosteronism
  2. Sodium Bicarbonate Infusion
  3. Increased NaCl administration (Oral/IV)
  4. Ingestion of Sea Water
126
Q

Hyperaldosteronism aka

A

Conn’s Disease

127
Q

in Conn’s Disease, what hormone is increased?

A

Aldosterone

128
Q

Why does ingestion of Sea Water increases Na2+ intake?

A

Sea water has high levels of Na Content

129
Q

Specimens used for the Laboratory Analysis of Sodium

A

Serum
Plasma
24hr Urine
Sweat
Whole Blood

130
Q

What type of Plasma is only used in the laboratory analysis of sodium?

A

lithium heparin
ammonium heparin
lithium oxalates

131
Q

This specimen is used in some analyzers (with
acceptability precautions)

A

Whole blood

132
Q

This specimen is used in Sodium testing

A

Sweat

133
Q

Variables in the Laboratory Analysis of Sodium

A

Marked hemolysis

134
Q

In marked hemolysis, _____________ leading to false
decrease

A

dilutional effect

135
Q

Method used for collection of sweat

A

GIBSON AND COOKE PILOCARPINE
IONTOPHORESIS

136
Q

Sweat sample must be tightly sealed
because it is ____________ (easily evaporates)

A

volatile

137
Q

GIBSON AND COOKE PILOCARPINE
IONTOPHORESIS

Sweat Inducer

A

Pilocarpine + Mild Current
(Iontophoresis)

138
Q

GIBSON AND COOKE PILOCARPINE
IONTOPHORESIS

Output: ____ mg of sweat within __ minutes

A

> 50
30

139
Q

Methods used in Sodium

A

Ion Selective/Specific Electrode
Atomic Absorption Spectrophotometry
Emission Flame Photometry
Chemical Methods (Albanese Lein)

140
Q

Membrane used in Ion Selective/Specific Electrode

A

Glass Aluminum Silicate

141
Q

Atomic Absorption Spectrophotometry
→ measurement of ____________ ions

A

unexcitable

142
Q

Emission Flame Photometry
→ measurement of __________ ions

A

excitable

143
Q

Used in Chemical Methods (Albanese Lein)

A

Cupric sulfate
NaOH

144
Q

Old name of Potassium

A

Kalium

145
Q

The major intracellular cation (_____ mmol/L in
RBC)

A

Potassium
105

146
Q

RBC K+ is ____ than of the plasma/serum K+

A

23x

147
Q

The single most important analyte in terms of
abnormality

A

Potassium

148
Q

Functions of Potassium

A

Skeletal and Cardiac Muscle Contraction
Neuromuscular excitability
ICF volume regulation
Hydrogen Ion Concentration

149
Q

slight ↑/↓in K+

A

Skeletal and Cardiac Muscle Contraction

150
Q

affect acid-base balance

A

Hydrogen Ion Concentration

151
Q

Threshold Critical Values:
→ ___ mmol/L (hyperkalemia)
→ ___ mmol/L (hypokalemia)

A

6.5
2.5

152
Q

diseased/conditions in hypokalemia

A

cardiac arrhythmia
Tachycardia

153
Q

T/F: Only one is significant in Hyperkalemia and Hypokalemia therefore, only one must be regulated

A

FALSE; both are significant and should be regulated

154
Q

Potassium

Reference range: Serum

A

3.5-5.1 mmol/L (2%)

155
Q

Potassium

Reference range: Plasma (MALE)

A

MALE: 3.5-4.5 mmol/L

156
Q

Potassium

Reference range: Plasma (FEMALE)

A

3.4-4.4 mmol/L

157
Q

Potassium

Reference range: Urine (24H))

A

25-125 mmol/d

158
Q

Potassium regulation

A

Kidneys
Cellular uptake

159
Q

In which organ:

70-80% of filtered K+ is reabsorb (________________________)

A

Kidneys
proximal tubules

160
Q

Which hormone causes the Kidneys to excrete potassium

A

Aldosterone

161
Q

CELLULAR UPTAKE

Acute K+ elevation will result to rapid (entry/exit) of
K+ in the cell

A

entry

162
Q

What promotes cellular entry of Potassium?

A

→ Insulin
→ Catecholamines
→ Beta-Blockers

163
Q

therapeutic drugs (cardioactive drugs)

A

Beta-Blockers

164
Q

Decreased plasma K+ concentration

A

HYPOKALEMIA

165
Q

Hypokalemia may result in:

A

arrhythmia and paralysis

166
Q

HYPOKALEMIA

If <2.5 mmol/L = _______________

A

induce Cardiac Arrhythmia

167
Q

Causes of Hypokalemia

A

A. Gastrointestinal Loss
B. Renal Loss
C. Cellular Shift
D. Decreased K+ intake

168
Q

Enumerate the diseases/conditions in Gastrointestinal Loss

A
  1. Diarrhea
  2. Vomiting
  3. Gastric Suction
  4. Intestinal Tumor
  5. Malabsorption
  6. Cancer therapy
  7. Large doses of Laxatives
169
Q

most common cause of extrarenal
hypokalemia

A

Diarrhea

170
Q

result to ↑K+ loss through GIT

A
  1. Diarrhea
  2. Vomiting
171
Q

↑K+ loss in stool

A
  1. Intestinal Tumor
  2. Malabsorption
  3. Cancer therapy
  4. Large doses of Laxatives
172
Q

Enumerate the diseases/conditions in Renal Loss

A
  1. Diuretics (thiazide-type)
  2. K+-losing Nephritis
  3. Renal Tubular Acidosis
  4. Hyperaldosteronism
  5. Cushing’s Syndrome
  6. Hypomagnesemia
  7. Acute Leukemia
173
Q

most common cause of renal loss

A

Diuretics (thiazide-type)

174
Q

Lead to ↓hydrogen ion excretion promoting
↑K+ excretion

A

Renal Tubular Acidosis

175
Q

condition in renal loss wherein: Hypernatremia (sodium is absorbed)

A

Hyperaldosteronism

176
Q

What hormone is increased in Crushing’s Syndrome

A

↑cortisol

177
Q

Cortisol is secreted by the _____________

A

adrenal cortex

178
Q

What is the action of cortisol?

A

mimics the action of aldosterone

179
Q

Condition in renal loss wherein: ↓Mg2+ in blood

A

Hypomagnesemia

180
Q

The decrease of Mg2+ in the blood causes enhanced aldosterone (secretion/excretion)

A

secretion

181
Q

↑immature WBC/blasts

A

Acute Leukemia

182
Q

Enumerate the diseases/conditions in Cellular Shift

A
  1. Alkalosis
  2. Insulin overload
  3. Catecholamines
183
Q

alkaline pH of blood

A

Alkalosis

184
Q

Normal pH concentration of the blood

A

(7.35-7.45)

185
Q

Alkalosis

↓0.4 mmol/L/0.1 pH unit (increase/decrease)

A

increase

186
Q

pH of the blood in alkalosis

A

> 7.45

187
Q

pH of the blood in acidosis

A

7.20

188
Q

hyperglycemic hormone

A

Catecholamines

189
Q

only occurs during analysis

A

Pseudohypokalemia

190
Q

Pseudohypokalemia occurs especially if patient has ____________________

A

leukocytosis

191
Q

↑WBC because WBC takes up K+ if sample is left at room temp.

A

leukocytosis

192
Q

Increased plasma K+ concentration

A

HYPERKALEMIA

193
Q

HYPERKALEMIA

____ mmol/L - can alter ECG trace

A

6-7

194
Q

HYPERKALEMIA

__ mmol/L - can cause lack of muscle
excitability/ muscle weakness

A

8

195
Q

HYPERKALEMIA

___ mmol/L - can cause cardiac arrest

A

10

196
Q

Causes of Hyperkalemia

A

A. Decreased Renal Excretion
B. Cellular Shift
C. Increased K+ intake
D. Artifactual (Pseudohyperkalemia)

197
Q

Most common cause of Hyperkalemia

A

Decreased Renal Excretion

198
Q

Enumerate the diseases/conditions involved in Decreased Renal Excretion

A
  1. Acute or Chronic Renal Failure
  2. Hypoaldosteronism
  3. Addison’s Disease
  4. Diuretics
199
Q

Condition in Decreased Renal Excretion wherein: an adrenal insufficiency

A

Addison’s Disease

200
Q

Example of an adrenal insufficiency

A

hypoaldosteronism

201
Q

Enumerate the diseases/conditions involved in Cellular Shift (Hyperkalemia)

A
  1. Acidosis
  2. Muscle/Cellular Injury
  3. Diabetes mellitus
  4. Chemotherapy
  5. Leukemia
  6. Hemolysis
202
Q

acidic pH of blood (↑H+ )

A

Acidosis

203
Q

ACIDOSIS

↑ 0.2-1.7 mmol/L/0.1 pH unit (increase/decrease)

A

decrease

204
Q

K+ can’t enter the cell due to insulin deficiency

A

Diabetes mellitus

205
Q

Oral or Intravenous Potassium replacement
therapy

A

Increased K+ intake

206
Q

Artifactual causes of Hyperkalemia

A
  1. Sample hemolysis
  2. Thrombocytosis
  3. Prolonged tourniquet use
  4. Excessive fist clenching
207
Q

Sample hemolysis

→ ↑K+ because RBC K+ is ___ (~___ mmol/L)
than serum/plasma

A

23x
110

208
Q

K+ are released from platelets when clotting

A

Thrombocytosis

209
Q

In thrombocytosis, never measure the K+ because it causes false (inc/dec)

A

Increase

210
Q

can promote cellular exit of K+

A

Prolonged tourniquet use
Excessive fist clenching

211
Q

Specimen used in Potassium Laboratory Analysis

A

Heparinized Plasma
Serum
Urine

212
Q

Most preferred sample in Potassium Laboratory Analysis

A

Heparinized Plasma

213
Q

potassium specimen

Serum (______ mmol/L higher than plasma)

A

0.1-0.7

214
Q

Potassium specimen

Do not use EDTA = false (increase/decrease)

A

increase

215
Q

○ K2EDTA – ____________
○ K3EDTA – _____________

A

versene
sequestrene

216
Q

Variables in the Laboratory Analysis of Potassium

A
  1. Hemolysis
  2. Prolonged tourniquet application
  3. Unseparated whole blood sample stored in
    ice/refrigerator
  4. Lipemia
  5. Exercise and Prolonged Standing
217
Q

Slight hemolysis (50 mg/dL Hgb) –____ ↑ in K+

A

3%

218
Q

Gross hemolysis (>500 mg/dL Hgb) – ___ ↑ in K+

A

30%

219
Q

Unseparated whole blood sample stored in
ice/refrigerator

Promotes exit of K+ from the cell (due to
cold temp) = (inc/dec)in K+

A

inc

220
Q

causes elevated serum potassium

A

Lipemia

221
Q

10-20% increase in potassium

A

Exercise and Prolonged standing

222
Q

Mild-moderate exercise: _______ mmol/L increase

A

0.3 - 1.2

223
Q

Vigorous exercise (fist clenching): ____ mmol/L increase

A

2-3

224
Q

Laboratory Methods in Potassium

A

● Ion Selective Electrode
● Atomic Absorption Spectrophotometry
● Flame Emission Photometry
● Colorimetry (Lockhead and Purcell)

225
Q

K+-specific Membrane:

A

Valinomycin gel

226
Q

The major extracellular anion

A

Chloride

227
Q

Chief counter ion of sodium in plasma

A

Chloride

228
Q

____ and ___ almost always exist as one

A

Na+
Cl-

229
Q

○ Na+ = ______
○ Cl- = _____

A

cation
anion

230
Q

inverse relationship of two electrolytes

A

Counter ion:

231
Q

Chloride is excreted in:

A

Urine and Sweat

232
Q

excess sweating

A

Perspiration

233
Q

Perspiration

(inc/dec) Cl- = (inc/dec) Na+ in the blood

A

dec
dec

234
Q

To retain sodium, __________ secretion/production are stimulated

A

aldosterone

235
Q

Aldosterone promotes reabsorption of sodium in the
___________________

A

DCT

236
Q

Absorption: dietary Cl- are almost completely
(excreted/absorbed) by the intestinal tract

A

absorbed

237
Q

T/F: Chloride’s function is NOT well defined

A

T

238
Q

Enumerate the functions of Chloride

A

→ Maintains plasma osmolality and blood
volume (in conjunction with Na+)
→ Maintains electroneutrality
→ Enzyme activator

239
Q

Cl- is an _______ activator

A

Amylase

240
Q

the only anion that serve as enzyme activator

A

Chloride

241
Q

Chloride

Reference range: Serum/Plasma

A

98-107 mmol/L

242
Q

Chloride

Reference range: Urine (24hr)

A

110-250 mmol/d (or 24 hrs)

243
Q

Where does regulation of chloride occurs?

A

Renal (kidneys)

244
Q

T/F: Chloride is freely filtered by glomerulus

A

T

245
Q

Chloride is reabsorbed by _____________ (with Na+)

A

proximal tubules

246
Q

T/F: reabsorption of Na+ is NOT dependent on the
availability of Cl-

A

FALSE; reabsorption of Na+ is dependent on the
availability of Cl- (excess will be excreted in
the urine)

247
Q

stimulates aldosterone secretion (retains Cl- with Na+)

A

Perspiration

248
Q

balance in the number of electrons in the plasma

A

Electroneutrality

249
Q

Whenever there is aerobic biochemical
process (requires O2) in the body it will
produce _______

A

CO2

250
Q

CO2 will enter the _______

A

red cell

251
Q

Within RBC, CO2 will form _________ by the
enzyme _______________

A

carbonic acid
carbonic anhydrase

252
Q

Carbonic acid will be split into __________
(H+) and __________ (HCO3 -)

A

hydrogen ion
bicarbonate ion

253
Q

one of the principle ion that
contributes to the acidity of the blood or
any substance

A

Hydrogen ion

254
Q

↑H+ = ↓ph = (inc/dec) acidity

A

inc

255
Q

hemoglobin that doesn’t have oxygen bound to it

A

Deoxyhemoglobin

256
Q

It will buffer the H+ to maintain pH

A

Deoxyhemoglobin

257
Q

____________ (anion) will diffuse out of the
cell

A

Bicarbonate ion

258
Q

↑ Cl- + ↑ bicarbonate = electroneutrality is
_______________ = result in (inc/dec) in number of
negatively charged substance in the
plasma

A

disturbed
inc

259
Q

To maintain the electroneutrality, ____(abundant
in plasma) will enter the cell along with _____

A

Cl-
Na+

260
Q

When bicarbonate exit the cell, it will exit
along with ____

A

Na+

261
Q

T/F: Cl- passively follows Na+

A

T

262
Q

T/F: Disorders related to Cl- is NOT same as Na+

A

FALSE; Disorders related to Cl- is the same as Na+

263
Q

Other causes of Chloride Shift

A
  1. Hyperchloremia (↑Cl-)
  2. Hypochloremia (↓Cl-)
264
Q

Excessive loss of HCO3-

A

Hyperchloremia (↑Cl-)

265
Q

Excessive loss of HCO3- is due to:

A

GIT loss
metabolic alkalosis
renal tubular acidosis

266
Q

Excessive Cl- loss

A

Hypochloremia (↓Cl-)

267
Q

Excessive Cl- loss is due to

A

Vomiting
Diabetic Ketoacidosis
Aldosterone deficiency
Salt-losing nephropathies

268
Q

Elevated blood HCO3- (disturbs electroneutrality)

A

Hypochloremia (↓Cl-)

269
Q

Elevated blood HCO3- is due to:

A

compensated respiratory acidosis
metabolic alkalosis

270
Q

Specimen used in Laboratory Analysis of Chloride

A

Serum
Heparinized Plasma
24hr Urine

271
Q

Type of Heparinized Plasma used in Chloride

A

Lithium heparin

272
Q

Method of Collection of Sweat in Chloride Laboratory Analysis

A

Gibson and Cooke Pilocarpine Iontophoresis

273
Q

Variables in Chloride Laboratory Analysis

A

Marked Hemolysis:
Interfering Substances:

274
Q

Marked Hemolysis causes ________________ (false decrease)

A

DIlutional effect

275
Q

Enumerate the interfering substances

A

Bromide
cyanide,
cysteine

276
Q

The interfering substances causes false (inc/dec) as these are measured as Cl- in chemical/coulometry
method)

A

inc

277
Q

Laboratory methods in chloride

A
  1. Schales and Schales (Mercurimetric Titration)
  2. Spectrophotometric Methods
  3. Coulometric Amperometric Titration (Cotlove
    Chloridemeter)
  4. Ion Selective Electrode (ISE)
278
Q

Indicator used in Schales and Schales (Mercurimetric Titration)

A

Diphenylcarbazone

279
Q

End product in Schales and Schales (Mercurimetric Titration)

A

Mercuric chloride (HgCl2)

280
Q

Mercuric chloride (HgCl2) shows what color?

A

blue violet color

281
Q

Spectrophotometric Methods

Forms reddish complex

A

Mercuric thiocyanate (Whitehorn Titration
Method)

282
Q

Spectrophotometric Methods

Forms colored complex

A

Ferric perchlorate

283
Q

Reagent used in Coulometric Amperometric Titration (Cotlove Chloridemeter)

A

Silver

284
Q

End product of Coulometric Amperometric Titration (Cotlove Chloridemeter)

A

Silver Chloride

285
Q

T/F: The number of silver used to form silver chloride
is equivalent to the Cl- ions present in the sample

A

T

286
Q

Membrane used in Ion Selective Electrode (ISE)

A

tri-n-octylpropylammonium chloride
decanol

[Lecture] CC II (3 decks)

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