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CCHM 2 > LEC4 - POTASSIUM AND CHLORIDE > Flashcards

LEC4 - POTASSIUM AND CHLORIDE Flashcards

1
Q

is the major intracellular cation in the body

A

Potassium (K+)

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2
Q

the concentration of potassium inside is how many times greater than the outside

A

20 times greater

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3
Q

In laboratory, Only how many percent of the body’s total K+ circulates in the plasma?

A

2% - only two percent is detected in serum

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4
Q

potassium’s regulation includes

A

o Neuromuscular excitability
o Contraction of the heart
o Intracellular fluid volume
o Hydrogen ion concentration

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5
Q

about how many mmol/ L are found in ECF

A

3-5 mmoll/L

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6
Q

how can potassium helps in intracellular fluid volume

A

Correct water distribution inside the cell to prevent bursting or shrinking

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7
Q

a stable electrical charge across a neuron’s membrane when it is not actively sending signal

A

resting membrane potential - RMP

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8
Q

relationship of the values of potassium, RMP, and action

A

inversely

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9
Q

if someone is moving, what is happening to the potassium values

A

increased

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10
Q

if someone is moving, what is happening to the RMP values

A

decrease

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11
Q

an increased in heartbeat will affect the potassium values and the RMP, in what way it can influence the values of potassium and RMP

A

increase potassium and decrease RMP

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12
Q

the elevated potassium, and an increase in heart beat will affect the heart in what way

A

it can cause sudden stoppage of heart or heart attack

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13
Q

this ion is the one responsible in the pH of blood

A

hydrogen ion

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14
Q

once the potassium goes out of the cell, the NA and hydrogen ions will replace the lost potassium.

correct?

A

correct

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15
Q

an increase of hydrogen ion will cause

A

metabolic acidosis

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16
Q

a decrease of hydrogen ion will cause

A

alkalosis

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17
Q

if there’s metabolic acidosis, the hydrogen ions in the blood is elevated. To lessen or correct it, what will be the role of potassium?

A

potassium will go out of the cell so the hydrogen ions can go inside the cell and lower the values of hydrogen ions in the blood that causes acidosis.

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18
Q

if there’s metabolic alkalosis, the hydrogen ions in the blood is decreased. To elevate or correct it, what will be the role of potassium?

A

potassium must go inside the cell so the hydrogen ions can go outside and go to the bloodstream and elevate the number of hydrogen ions.

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19
Q

Na+-K+ ATPase pump mechanism

A

active transport

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20
Q

2 REGULATION OF POTASSIUM

A

the use of Na+-K+ ATPase pump and the
Diffusion of potassium out of the cell into the ECF and plasma

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21
Q

when do potassium uses passive diffusion instead of active transport?

A

when there’s a decrease in pump activity such as

o Depletion of metabolic substrate > e.g.glucose for ATP production
o Competition for ATP between the pump and other energy-consuming activities
o Slowing of cellular metabolism

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22
Q

Three factors that influence the distribution of K+ between cells
and ECF are as follows:

A

(1) K+ loss frequently occurs whenever the Na+, K+ ATPase pump is inhibited
(2) insulin
(3) catecholamines

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23
Q

(1) K+ loss frequently occurs whenever the Na+, K+ ATPase pump is inhibited by conditions such as __, __, and ___

A

hypoxia, hypomagnesemia, or digoxin overdose

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24
Q

(2) insulin promotes acute ____ by increasing Na+, K+-ATPase activity;

A

entry of K+ into skeletal muscle
and liver

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25
Q

insulin promotes the entry of potassium into the cell thus will result in what condition

A

hypokalemia

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26
Q

a catecholamines that is a B stimulator that promotes cellular entry of K

A

epinephrine

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27
Q

a catecholamines that is a B blocker that impairs cellular entry of K

A

propanolol

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28
Q

OTHER FACTORS that might affect distrbution of potassium aside from inhibited atpase pump, insulin, and cathecolamines

A

exercise
hyperosmolality
cellular breakdown

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28
Q

exercise can cause false __ in potassium, please explain why as well

A

false elevations as the K is released from muscle cells during exercise

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28
Q

increase plasma K+ by ___mmol/L with
mild to moderate exercise

A

0.3 to 1.2

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28
Q

increase plasma K+ by ___mmol/L with
exhaustive exercise

A

2-3 mmol/L

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28
Q

can elevations due to exercise be reversed?

A

These changes are usually reversed after several minutes of rest

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28
Q

causes water to diffuse from the cells,
carrying K+ with the water, which leads to gradual
depletion of K+ if kidney function is normal

A

Hyperosmolality

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28
Q

conditions we can observe elevation of potassium that results from cellular breakdown are

A

are severe trauma, tumor lysis syndrome, and massive blood transfusions.

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29
Q

the K in potassium came from the word

A

Kalaium = kalemia

29
Q

It is a serum potassium concentration above the upper limit
of the reference interval.

A

HYPERKALEMIA

30
Q

Hyperkalemia is seen in the following conditions:

A

o Dehydration
o Diabetes insipidus
o Hypoadrenalism
o Acidosis
o Hemolysis
o Thrombocytosis

30
Q

Plasma K+ increases by ______ mmol/L for each 0.1 unit reduction of pH

A

0.2 to 1.7

30
Q

this one is primarily caused by medtech resulting to hyperkalemia

A

artifactual

31
Q

explain why acidosis caused hyperkalemia

A

it’s for the compensation. Since hydrogen ions are elevated in the blood, potassium will gou out of the cell and will cause an increase in K values

32
Q

why chemotherapy is included in hyperkalemia

A

because of the cytotoxicity that causes destruction of cell leaking the potassium to the blood

33
Q

how thrombocytosis can affect potassium

A

platelet releases potassium upon clotting or coagulation process. Since we are using serum, it adds up

34
Q

SYMPTOMS OF HYPERKALEMIA

Hyperkalemia can cause

A

muscle weakness, tingling,
numbness, or mental con fusion by altering neuromuscular
conduction.

34
Q

Muscle K+ weakness does not usually develop until plasma
reaches ____ mmol/L

A

8

34
Q

Hyperkalemia disturbs ____, which can lead to cardiac arrhythmias and possible cardiac arrest

A

cardiac conduction

34
Q

Plasma K+ concentrations of ____ mmol/L may alter the
electrocardiogram (ECG),

A

6-7

34
Q

Plasma K+ concentrations of 6-7 mmol/L may alter the
electrocardiogram (ECG), and concentrations_____ mmol/L
may cause fatal cardiac arrest.

A

> 10

34
Q

Hypokalemia is a plasma K+ concentration below the lower
limit of the reference range

A

HYPOKALEMIA

34
Q

HYPOKALEMIA

It is seen in the following condition

A

o Alkalosis
o Vomiting
o Over hydration
o Use of Loop diuretics
o Syndrome of Inappropriate ADH (SIADH) secretion
o Bartter’s syndrome

35
Q

SYMPTOMS OF HYPOKALEMIA

Symptoms (e.g., weakness, fatigue, and constipation) often
become apparent as plasma K+ decreases ____ mmol/L.

A

<3

35
Q

Hypokalemia can lead to muscle weakness or paralysis,
which can interfere with

A

breathing

35
Q

The dangers of hypokalemia concern all patients, but
especially those with ____ because of
an increased risk of arrhythmia, which may cause sudden
death in certain patients.

A

cardiovascular disorders

35
Q

Mild hypokalemia (3.0 to 3.4 mmol/L) is usually

A

asymptomatic

36
Q

acute leukemia is one of the symptoms of hypokalemia, what are the 3 acute leukemia involved?

A

acute myelogenous leukemia
acute myelomonocytic leukemia
acute lymphocytic leukemia

36
Q

COLLECTION OF SAMPLES
* Prevent artifactual hyperkalemia

t/f

A

true

36
Q

a serum used if can’t be tested immediately is stored in

A

refrigerator

36
Q

a whole blood used if can’t be tested immediately is stored in

A

room temp

36
Q

the important anticoagulant for potassium is

A

heparin

37
Q

if we store the whole blood in cold temperature, what will happen to the potassium

A

result in falsely increased vales, promotes release of K in serum

37
Q

Hemolysis → ___% increase in K+ (falsely elevated)

A

3-30

37
Q

grades of Hemolysis → 3-30%

A

o Slight hemolysis (3%)
o Gross hemolysis (30%)

38
Q

the most common cause of artifactual hyperkalemia

A

Hemolysis

38
Q

Flame Emission Spectrophotometry (FES)

PERFORMING TO, EMIT COLORED FALMES
o SODIUM

A

yellow

39
Q

Flame Emission Spectrophotometry (FES)

PERFORMING TO, EMIT COLORED FALMES
o potassium

A

violet

40
Q

is the major extracellular anion

A

CHLORIDE

41
Q

it is involved in maintaining osmolality, blood volume, and electric neutrality

A

CHLORIDE

42
Q

may also occur when there is an excess
loss of HCO3 (bicarbonate)

A

Hyperchloremia

43
Q

Hyperchloremia

It can be seen in the following conditions

A

o Dehydration
o Renal tubular acidosis (RTA)
o Acute renal failure
o Metabolic acidosis associated with prolonged diarrhea

44
Q

why is there HYPERCHLOREMIA in metabolioc acidosis

A

there’s an increase of hydrogen ions. Bicarbonate is the one that is supposed to counter hydrogen ions, however, if there’s a loss of bicarbonate ions, chloride will compensate thus results to elevated values of chloride.

chloride has negative charge thus will neutralize hydrogen ions

45
Q

MEASUREMENT OF CHLORIDE TO SWEAT SAMPLE

A

CYSTIC FIBROSIS

46
Q

in CYSTIC FIBROSIS there’s a defect in

A

cystic fibrosis transmembrane conductance
regulator (CFTR)

47
Q

in laboratory, we induce sweating using

A

pilocarpine iontophoresis

48
Q

pilocarpine iontophoresis

diagnostic level of sweat chloride is

A

> 60 mmol/L

49
Q

Most commonly used for chloride

A

Ion-selective electrode

50
Q

Colorimetric method for chloride determination

A

Schales-Schales method

51
Q

Schales-Schales method uses what reagent

A

mercuric thiocyanate and
ferric nitrat

52
Q

Mercurimetric Titration (Schales-Schales method complex colored formed

A

reddish colored complex

52
Q

Mercurimetric Titration (Schales-Schales is measured as what nm

A

480 nm

52
Q

Cotlove Chloridometer uses how many molecules if silver and chloride

A

2 molecules of silver
2 molecules of chloride

53
Q

Amperometric-coulometric Titration (Cotlove Chloridometer)

what are the components used

A

Silver ion use to react chloride molecule to form silver
chloride

54
Q

methods used for chloride determination

A

Ion-selective electrode
Mercurimetric Titration (Schales-Schales method
Amperometric-coulometric Titration (Cotlove Chloridometer)
Colorimetry

55
Q

REFERENCE INTERVAL for chloride

A

Normal serum concentration:
98-106 mmol/L

55
Q

Daily urinary output of chloride

A

110-250 mmol/L
o Urine (24h) mmol/d, varies with diet

56
Q
A
57
Q
A

CCHM 2 (22 decks)

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