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Clinical Chemistry 2 - CEUMLS > Sodium > Flashcards

Sodium Flashcards

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1
Q

major cation outside the cell

A

sodium

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2
Q

most abundant cation in ECF (regardless of being intravascular or interstitial)

A

sodium

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3
Q

principal osmotic particle outside the cell

A

sodium

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4
Q

reference range of sodium in serum

A

135 - 145 mmol/L

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5
Q

reference range of sodium in CSF

A

136 - 150 mmol/L

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6
Q

reference range of sodium in urine

A

40 - 220 mmol/day

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7
Q

condition where the threshold critical value of Na is 160 mmol/L or more

A

hypernatremia

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8
Q

condition where the threshold critical value of Na is 120 mmol/L or less

A

hyponatremia

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9
Q

Na stands for

A

natrium

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10
Q

concentration of substance in the blood wherein it stops reabsorption by the kidneys

A

renal threshold

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11
Q

renal threshold of Na

A

110 - 130 mmol/L

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12
Q

2 factors that maintains sodium conc. in serum/plasma

A
  1. water intake (increased water, decreased Na [diluted by water])
  2. water excretion (more water excreted increases Na conc.)
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13
Q

ATP driven that promotes exit of 3 sodium outside the cell in return with 2 potassium

Prevents osmotic rupture of cells

A

Sodium-Potassium-ATPase ion pump

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14
Q

how does Sodium-Potassium-ATPase ion pump prevents osmotic cell rupture?

A

excretion of 3 sodium also secretes 3 water molecules

(decreases water content inside the cell, thus, no rupture)

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15
Q

2 Functions of Sodium-Potassium-ATPase ion pump

A

maintains increased concentration of intracellular POTASSIUM

maintains increased concentration of extracellular SODIUM

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16
Q

defense to hyperosmolality and hypernatremia

A

thirst

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17
Q

increased water excretion leads to increased or decreased sodium?

A

increased

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18
Q

blood volume status is affected by Na excretion through:

A

aldosterone
angiotensin II
ANP

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19
Q

• blocks aldosterone and renin secretion
• inhibits action of angiotensin II and vasopressin

A

Atrial Natriuretic Peptide

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20
Q

60-75% of filtered sodium are reabsorbed by

A

PCT

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21
Q

how is sodium regulated in kidneys? (2)

A

filtered Na are reabsorbed by PCT
reabsorption of Na in DCT by aldosterone

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22
Q

decreased plasma Na concentration and its value

A

Hyponatremia (<135 mmol/L)

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23
Q

most common electrolyte disorder

A

Hyponatremia

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24
Q

value where hyponatremia symptoms starts

A

125-130 mmol/L

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25
Q

value of sodium that results to severe neuropsychiatric symptoms or momentary memory loss

A

<125 mmol/L

26
Q

glucose condition that causes hyponatremia

A

hyperglycemia

(DM also causes electrolyte imbalance wherein water released in ECF dilutes Na)

27
Q

urine sodium of 20 mmol/day indicates what condition

A

renal sodium and water loss

28
Q

100 mg/dL INCREASE in glucose is equivalent to?

A

1.6 mmol/L DECREASE in sodium

(water is released every glucose uptake by the cell (by insulin), which dilutes Na (hyponatremia)

29
Q

4 general causes of hyponatremia

A

• increased sodium loss
• increased water retention
• water imbalance
• pseudohyponatremia

30
Q

explain the mechanism of hypoadrenalism in increasing sodium loss

A

↓ aldosterone production —> no sodium is reabsorbed in DCT —> sodium is loss in urine

31
Q

mechanism of potassium deficiency (hypokalemia) in increasing sodium loss

A

decreased potassium —> promotes potassium retention in KIDNEYS —> sodium excretion (↓ Na)

retained K = excretes Na

32
Q

mechanism of diuretics (thiazides) in increasing sodium loss

A

promotes urine flow
(by inhibiting renal Na reabsorption in DCT)

33
Q

mechanism of ketonuria in increasing sodium loss

A

ketones are loss along with Na in urine

ketone loss = Na loss

34
Q

why does ↑ water retention causes hyponatremia

A

dilutes Na

35
Q

conditions that promotes ↑ water retention leading to hyponatremia

A

• renal failure
• nephrotic syndrome
• hepatic cirrhosis
• CHF

36
Q

conditions that promotes water imbalance leading to hyponatremia

A

• polydipsia (excessive thirst) - dilutes plasma and electrolytes (Na)
• SIADH - ↑ADH; ↓urine output; ↑blood volume; dilutes Na

37
Q

Sodium measurement method that leads to pseudohyponatremia (systematic error)

A

INDIRECT Ion Selective Electrode (dilution requiring)

if patient has:
• hyperlipidemia
• hyperproteinemia

lipids and proteins displaces Na during measurement—> false ↓

38
Q

↑ plasma Na conc. and its value

A

hypernatremia (>145 mmol/L)

39
Q

True or False:
Water deficit (↓ blood vol) of 1-2% causes thirst which affects plasma concentration

A

TRUE

40
Q

indicative of hypothalamic dse due to nonresponsive hypothalamus that can no longer promote THIRST and increases vasopressin

A

chronic hypernatremia

41
Q

moderate water deficit value

A

150-160 mEq/L or mmol/L sodium

42
Q

severe water deficit value

A

> 165 mEq/L or mmol/L sodium

43
Q

most common cause of hypernatremia

A

excess water loss

44
Q

mechanism of diabetes insipidus in causing increased sodium

A

EXCESS WATER LOSS:
polyuria —> vasopressin deficiency —> increase urination —> ↑ Na conc.

45
Q

mechanism of renal tubular disorder in causing increased sodium

A

EXCESS WATER LOSS:
impairment to concentrate urine (in same conc.) SG must be 1.010

46
Q

profuse sweating and hyperventilation causes how many loss of water per day

A

1 liter

47
Q

decreased water intake in population of old people, infants, and mental impairment causes hypernatremia or hyponatremia?

A

hypernatremia

48
Q

conditions that has an ↑ sodium intake or retention

A

• hyperaldosteronism (Conn’s dse)
• sodium bicarbonate infusion
• ↑ NaCl administration
• Sea water ingestion

49
Q

drinking sea water leads to?

A

hypernatremia and excessive thirst

50
Q

accepted specimen for Na analysis

A
  1. serum
  2. plasma
  3. 24 hr urine
  4. sweat
  5. whole blood
51
Q

additives used if plasma specimen is utilized for Na analysis

A

lithium heparin
lithium oxalates
ammonium heparin

52
Q

variable that causes false ↓ Na

A

MARKED hemolysis due to dilutional effect

53
Q

5 Methods used for Na analysis

A
  1. Gibson and Cooke Pilocarpine Iontophoresis
  2. Ion Selective/Specific Electrode
  3. AAS
  4. Emission Flame Photometry
  5. Albanese Lein (chemical method)
54
Q

method of sweat sample collection

A

Gibson and Cooke Pilocarpine Iontophoresis

55
Q

sweat inducers used in Gibson and Cooke Pilocarpine Iontophoresis

A

Pilocarpine
Mild current (iontophoresis)

56
Q

output required in Gibson and Cooke Pilocarpine Iontophoresis

A

> 50 mg sweat within 30 mins

57
Q

what must be done to the sweat sample after collection?

A

tightly sealed (volatile/easily evaporates)

58
Q

Na membrane responsible for selectivity of ISE

A

Glass Aluminum Silicate

59
Q

measurement of non-excitable ion and excitable ion, respectively

A

AAS
EFP

60
Q

reagents used in Albanese Lein

A

Cupric sulfate
NaOh

Clinical Chemistry 2 - CEUMLS (3 decks)

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