Lecture: Electrolytes Flashcards
Equal number of cations and anions
Electroneutrality
Negatively charged & move towards the
anode
Anion
Positively charged & move towards the
cathode
Cations
Electrolytes for volume and osmotic regulation
Sodium
Potassium
Chloride
Electrolytes for myocardial rhythm and contractility
Calcium
Potassium
Magnesium
Electrolytes for acid-base balance
Bicarbonate
Chloride
Sodium
Inorganic Phosphorus / Phosphate
Electrolytes that are enzyme activation cofactors
Calcium
Magnesium
Regulator of ATPase ion pumps
Magnesium
Electrolytes for production and use of ATP from glucose
Magnesium
Inorganic Phosphorus
Electrolytes for neuromuscular excitability
Potassium
Calcium
Magnesium
Electrolytes for blood coagulation
Calcium
Magnesium
Electrolytes for DNA replication and mRNA translation
Magnesium
Average water content in the body
40% to 75%
The fluid inside the cells and accounts for about two thirds of total body water
Intracellular fluid
Accounts for the other one third of total body water
Extracellular fluid
Normal plasma – about _ water
93%
Water retention of 3L
Edema
10-20L water excretion
AVP Deficiency
Ion concentration within cells and in plasma –maintained both by _ and _
Active transport processes
Diffusion
Requires energy (ATP) to move ions across
cellular membranes
Active transport
Passive movement of ions across a membrane
Diffusion
Physical property of a solution based on the concentration of solutes (millimoles) per kg of solvent (w/w)
Osmolality
Concentrated solution = _ osmolality
Increased
Diluted solution = _ osmolality
Decreased
The 92% contributor of osmolality is our _
Sodium
Chloride
Bicarbonate
The remaining 8% of our osmolality is contributed by
Protein
Urea
Glucose
Difference between unmeasured anions and unmeasured cations
Anion Gap
High anion gap indicates _ - increased
acidity of the blood due to metabolic processes
Metabolic Acidosis
Low anion gap is relatively rare; occur from the presence of abnormal positively charged proteins, as in _
Multiple myeloma
Most abundant cation in the ECF; major contributor of plasma osmolality
Sodium
Other name for sodium
Natrium
Specimen for sodium analysis
Serum, heparin plasma, 24-hour urine, sweat
Colorimetric method for sodium
Albanese-Lein Method
Electrode used for ISE of sodium
Glass aluminum silicate
Hormones affecting sodium
Aldosterone
Atrial Natriuretic Factor
Secreted by adrenal cortex; promotes Na
retention and K excretion
Aldosterone
Endogenous antihypertensive agent; secreted from cardiac atria; blocks the aldosterone and renin secretion
Atrial Natriuretic Factor
Serum Na > 145 mmol/L; loss of water, gain of sodium
Hypernatremia
Serum Na < 135 mmol/L; most common electrolyte disorder; Renal failure, Hyperglycemia, SIADH, K+ deficiency
Hyponatremia
Hyponatremia is not corrected with fluid restriction
Barterr’s Syndrome
Systematic error (hemolysis) - dilutional
effect
Hyperproteinemia (Hemoglobin) – plasma
water displacement
Hyperlipidemia
Pseudohyponatremia
Major intracellular cation in the body; mostly affected by hemolysis
Potassium
Other name for potassium
Kalium
Electrode used for ISE of potassium
Valinomycin gel membrane
Colorimetric method for potassium
Lockhead and Purcell
Reduced aldosterone/response; renal failure; mostly due to impaired renal excretion
Hyperkalemia
Most common cause of extrarenal loss
Diarrhea
Promotes urinary K+ loss
Hypomagnesemia
Common cause of pseudohypokalemia
Leukocytosis
Cause of urine osmolality less than 300 mOsm/kg
Diabetes insipidus
Cause of urine osmolality from 300-700 mOsm/kg
Partial defect in AVP
Osmotic diuresis
Cause of urine osmolality greater than 700 mOsm/kg
Loss of thirst
Insensible loss of water
GI loss of hypotonic fluid
Excess intake of sodium
Cause of hyponatremia
Renal failure
Nephrotic syndrome
Hepatic cirrhosis
Congestive heart failure
Increased Water Retention
Causes of hyponatremia
Excess water intake
SIADH
Pseudohyponatremia
Water Imbalance
Range of sodium in serum/plasma
136-145 mmol/L
Range of sodium in 24-hour urine
40-220 mmol/L
Range of sodium in CSF
136-150 mmol/L
Cause of Hyperkalemia
Oral or IV potassium replacement therapy
Increased Intake
Cause of Hyperkalemia
Sample hemolysis
Thrombocytosis
Prolonged tourniquet application
Artifactual
Cause of Hyperkalemia
Acidosis
Leukemia
Hemolysis
Chemotherapy
Muscle/cellular injury
Cellular Shift
Causes of Hyperkalemia
Acute or chronic renal failure
Hypoaldosteronism
Addison’s disease
Diuretics
Decreased Renal Excretion
Cause of Hypokalemia
Malabsorption
GI Loss
Cause of Hypokalemia
Diuretics
Hyperaldosteronism
Barterr’s Syndrome
Gitelman’s Syndrome
Liddle’s Syndrome
Renal Loss
Cause of Hypokalemia
Alkalosis
Insulin Overdose
Intracellular Shift
Range for serum potassium
3.5-5.1 mmol/L
Range for male plasma potassium
3.5-4.5 mmol/L
Range for female plasma potassium
3.4-4.4 mmol/L
Range for urine potassium
25-125 mmol/day
Major extracellular anion; chief counter ion of Na+ in ECF; only enzyme activator anion
Chloride
What enzyme does chloride activates/
Amylase
What is the mercurimetric titration method for chloride?
Schales and Schales
Indicator for Schales and Schales method of potassium
Diphenylcarbazone
End product of Schales and Schales method of potassium
HgCl2 (blue-violet)
Spectrophotometric methods for chloride
Mercuric Thiocyanate (Whitehorn Titration Mtd.)
Ferric Perchlorate
Colorimetric Amperometric Titration for chloride
Cotlove Chloridometer
Electrode used for ISE of chloride
Tri-n-octylpropylammonium chloride decanol
Exchange of Cl- and HCO3- between plasma
and RBC
Chloride shift
Metabolic alkalosis due to chloride
Hypochloremia
Metabolic acidosis due to chloride
Hyperchloremia
Range of serum/plasma chloride
98-107 mmol/L
Range of urine chloride
110-250 mmol/day
Second most abundant anion in the ECF; major component of the buffering system in blood
Bicarbonate (HCO-3)
Decreased HCO3 – metabolic _ - compensated by _
Metabolic acidosis
Hyperventilation
Increased HCO3 – metabolic _ - compensated by _
Metabolic Alkalosis
CO2 retention
Specimen for bicarbonate
Anaerobically collected plasma/serum
Electrode used for ISE of bicarbonate
pCO2 electrode
Fourth most abundant cation in the body; second most abundant intracellular ion; treatment for arrhythmia
Magnesium (Mg2+)
Percentage of free or ionized magnesium
55%
Percentage of protein-bound magnesium
30%
Percentage of magnesium complexed with ions
15%
Increase renal reabsorption & intestinal absorption of magnesium
PTH
Increase renal excretion of magnesium
Aldosterone and Thyroxine
Hypo or Hyper
Acute Renal Failure
Malnutrition
Sprue
Chronic alcoholism
Severe diarrhea
Hypomagnesemia
Hypo or Hyper
Diabetic coma
Addison’s disease
Chronic renal failure
Hypermagnesemia
What falsely decreases magnesium in sample?
EDTA
Colorimetric methods for magnesium
Calmagite Mtd. – reddish-violet (532 nm)
Formazen – colored complex (660nm)
Magnesium – thymol blue
Reference method for magnesium
Atomic Absorption Spectrophotometry
Dye-Lake method for magnesium uses what color dye?
Titan yellow dye (Clayton yellow or
Thiazole yellow)
Fifth most abundant ECF cation; maximally absorbed in duodenum at acidic pH
Calcium
Percentage of ionized or active calcium
50%
Percentage of protein-bound calcium
40%
Percentage of calcium complexed with anions
10%
Specific marker of calcium disorders
Ionized calcium
Regulators for calcium
1,25-dihydroxycholecalciferol (Activated Vit D3)
PTH
Calcitonin
Hypo or Hyper
Alkalosis
Vitamin D deficiency
Hypoparathyroidism
Hypocalcemia
Hypo or Hyper
Hyperparathyroidism
Increased Vitamin D
Acidosis
Hypercalcemia
Prolonged contact of serum with red cells – _ calcium
Decreased
Precipitation and Redox Titration method for calcium
Clark Collip
Ferro Ham Chloranilic Acid
End color product of precip and redox titration of calcium
Purple
Dye used in colorimetric method of calcium
Arzeno III
Electrode used for ISE of calcium
Liquid membrane
Reference method for calcium
Atomic Absorption Spectrophotometry
EDTA titration methods for calcium
Bachra
Dawer
Sobel
Inversely related to Ca2+; maximally absorbed in jejunum
Inorganic Phosphorus
Form of PO4 that is the principal anion within cells
Organic PO4
Form of PO4 that is a blood buffer
Inorganic PO4
Regulators of PO4
PTH
Calcitonin
Growth hormone
Calcium is _ during AM and _ during PM
High; low
Method of analysis for PO4
Fiske-Subbarow (Ammonium molybdate mtd.)
Hypo or Hyper
Hyperparathyroidism
Avitaminosis D
Hypophosphatemia
Hypo or Hyper
Hypoparathyroidism
Hypervitaminosis D
Hyperphosphatemia