Lecture 1 Flashcards

1
Q

What do electrolytes help with

A

Homeostasis
* pH Regulation
* Cellular Function

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2
Q

What some conditions that affect electrolytes

and how you make clinical decisions with them

A
  • Dehydration
  • Kidney Disease
  • Diabetes Mellitus
  • Heart Failure
  • Add-on Tests
  • Guided Diagnosis
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3
Q

What does sodium help with

clinical importance

examples of how they help with regulation

A

regulates fluid balance, blood pressure, and nerve function

Hyponatremia and Hypernatremia.

Hormonal Mechanisms: Aldosterone increases sodium reabsorption in the kidneys.

Diseased States: adrenal insufficiency or hyperaldosteronism can
disrupt sodium balance.

136-145 mmol/L

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4
Q

What does potassium help with

clinical importance

examples of how they help with regulation

A

3.5-5.1 mmol/L

-maintains cellular membrane potential, especially in cardiac and skeletal muscles.

Hypokalemia )GI loss -vomiting and diarrhea, Renal loss - increase K excretion, Insulin therapy increase of K update )

and Hyperkalemia (renal failure, diabetes mellitus , trauma from massive hemolysis. Common cause is therapeutic adminstration

Hormonal Mechanisms: Aldosterone promotes potassium excretion in the kidneys.

Diseased States: Renal dysfunction or hyperaldosteronism can cause imbalances.

CALL CRITIALS

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5
Q

What does cholrine
help with

clinical importance

examples of how they help with regulation

A

98-107 mmol/L

maintaining osmotic pressure and acid-base balance

Hypochloremia and Hyperchloremia

Hormonal Mechanisms: Chloride balance is closely linked with sodium and bicarbonate levels.

Diseased States: Conditions like metabolic acidosis or alkalosis can affect chloride levels.

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6
Q

What does bicarb help with

clinical importance

examples of how they help with regulation

A

21-28 mmol/L

maintains blood pH
Ordered at CO2 test

Metabolic Acidosis and Metabolic Alkalosis.

Hormonal Mechanisms: The kidneys regulate bicarbonate reabsorption and excretion.

Diseased States: Renal failure or respiratory disorders can disrupt bicarbonate levels.

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7
Q

Specimen Type - Whole Blood - dis/advantages

A

directly from a sample of whole blood from anticoagulant tube / syringe

Advantages:
No Need for Separation
Faster Turnaround

Disadvantages:
Cellular Influence
Dilution Effect

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8
Q

Specimen Type - Serum

dis/advantages

A

from serum after blood clotting and centrifugation from non-coagulated tube

Advantages:
Reduced Cellular Effect
Consistency

Disadvantages:
Additional Steps
Potential for Gel Interference

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9
Q

Specimen Type - Plasma

dis/advantages

A

Measuring electrolytes from plasma obtained by anticoagulated blood (heparin) and centrifuged to separate plasma from cells

Advantages:
Reduced Cellular Influence
Disadvantages:
Dilution Effect

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10
Q

Ensuring Testing Reliability at each stage of processing

A

Pre-analytical Considerations:
Sample Handling
Sample Preparation

Analytical Considerations:
Calibration
Quality Control

Post-analytical Considerations:
Data Review
Error Management

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11
Q

examples of QC internal and external

A

Internal QC:
Purpose: Monitors daily performance of testing systems.
Methods: Use of control samples with known values to verify accuracy.

External QC:
Participation: proficiency testing programs to compare results with other labs.

Examples:
Proficiency Testing
Inter-Laboratory Comparisons
External Quality Assessment Schemes

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12
Q

What is an anion gap

A

difference between the measured cations (sodium)
and the sum of the measured anions (chloride and bicarbonate).

[Na⁺] - ([Cl⁻] + [HCO₃⁻])

Clinical Importance:
* Diagnosis of Metabolic Acidosis
* Guiding Treatment

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13
Q

Clinical Use of Anion Gap

A

Importance:
o Diagnosis
o Clinical Relevance

Common Conditions
Associated Metabolic Acidosis:
o Diabetic Ketoacidosis (DKA)
o Chronic Kidney Disease (CKD)
o Lactic Acidosis

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14
Q

Delta Checks

A

comparing current test results with old ones from the patients to see if there are significant changes

Importance:
o Quality Assurance
o Patient Safety

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15
Q

Error Management: Pre-Analytical Errors

A

errors before the actual analysis phase
Examples:
o IV Fluid Contamination
o Incorrect Tube Collection
o Hemolysis

Impact on Patient Care:
o Incorrect Diagnosis
o Delayed Results

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16
Q

Error Management: Analytical Errors

A

errors during testing

Examples:
o Instrument Calibration Issues
o Interference

Impact on Patient Care:
o Result Inaccuracy
o Increased Costs

17
Q

Error Management: Post-Analytical Errors

A

errors after the analysis phase.

Examples:
o Data Entry Errors
o Reporting Issues

Impact on Patient Care:
o Delayed Intervention
o Patient Safety Risks

18
Q

What is a Calibration Review

A

Setting and verifying the accuracy of test instruments.

Procedure: Using calibration standards to adjust instrument settings.
Reviewing Calibration Results:
o Assess Performance
o Adjust if Necessary

19
Q

Calibration Frequency when it is preformed

A

regularly based on vendors specs

Unscheduled Situations:
o Analyte Troubleshooting
o Major Maintenance
o Onboard reagent lot expiration

20
Q

Calibration Drifts and Impacts

A

gradual changes in the instrument performance over time

Causes:
* Wear and Tear
* Environmental Changes

Impact on Patient Results:
* Inaccurate Test Results
* Quality Assurance Measures

21
Q

What are critical values and what is the procedure after they arise

A

results way outside the normal range

Procedure:
o Immediate Notification
o Verification
o Patient Management

Protocols:
o Institutional Policies on reporting
o Communication

22
Q

Responsibilities of the MLT when it comes to reporting

A

Accurate Reporting:
* Timeliness
* Critical Results

Patient Care:
* Communication
* Documentation

23
Q

What is used for Na measurement

and its sources of error

A

Ion selective electrodes ISE
-two electrodes one with constant potential = reference
-the other is selective for what you are testing = NA
-the difference in potential from reference and measuring and the concentration of the ion in solution

Sources of error
-in indirect method a diluted sample is used for measurement. In samples with excess lipids and proteins it displaces the plasma water (takes up more volume).- falsely low
-protein buildup on the membrane

Vitros and AU480 used direct methods

24
Q

What is the vitros and au480

A

Vitros Dry slide chemistry -single-use direct ISE potentiometric system

AU480-3 ISE electrodes, one for each of Na, K, Cl and a reference electrode.

25
Q

How do we measure K

A

ISE
ancomycin membrane is used to selectively bind to K+
Change in impedance correlated to K+ concentration
KCl is the inner electrolyte solution