T2: Water and Electrolyte Balance Part 3

Question 0

Bicarb is the 2nd most important extracellular _____

Answer 0

anion

Question 1

Reference Range of bicarbonate

Answer 1

22-28 mEq/L

Question 2

Functions of bicarbonate

Answer 2

1 Levels regulated by the kidney
2 decrease in metabolic acidosis
3 increase in metabolic alkalosis

Question 3

Not all ions measured when electrolytes are performed so a gap exists because of contribution of unmeasured anions: protein, sulfate, phosphate, and organic acids

Answer 3

Anion gap

Question 4

Clincal purpose of anion gap calculation

Answer 4

to estimate unmeasured anions

Question 5

laboratory purpose of anion gap calculation

Answer 5

instrument error determines acceptability of results

Question 6

Expected range of anion gap using (Na+K)-(Cl+HCO3)

Answer 6

12-20 nEq/L

Question 7

Expected range of anion gap using (Na)-(Cl+HCO3)

Answer 7

8-16 mEq/L

Question 8

Three general causes of an increased anion gap and two conditions associated with each

Answer 8

1 increased unmeasured anions-lactic acidosis, ketoacidosis, toxic ingestion
2 decreased unmeasured cations- decreased Ca and Mg
3 Lab error-overestimation of Na, or underestimation of Cl or HCO3

Question 9

Three general causes of a decreased anion gap and one condition associated with each

Answer 9

1 decreased unmeasured anions-hypoalbuminemia
2 increased unmeasured cations-K, Ca, Mg, paraproteins
3 Lab error-underestimation of Na, overestimation of Cl or HCO3

Question 10

Reference Range fo Calcium

Answer 10

8.5-10.5 mg/dL

Question 11

Four functions of calcium

Answer 11

1 decreases in neuromuscular excitability
2 blood coagulation
3 activator in enzymatic reactions
4 transfer inorganic ions across cell membranes

Question 12

Three forms of Ca in the blood

Answer 12

1 bound
2 filterable: ionized
3 filterable: complexed

Question 13

Physiologically active form of Ca in the blood

Answer 13

Filterable Ionized

Question 14

Five factors that control serum Ca levels

Answer 14

1 absorbled in GI tract
2 parathyroid hormone (PTH)
3 calcitonin 
4 vitamin D
5 protein (ALB) levels

Question 15

seven causes of hypocalcemia

Answer 15

1 decreased serum protein (most common)
2 hypoparathroidsim
3 steatorrhea
4 nephrosis
5 pancreatitis
6 Vit D deficiency
7 Heparin during surgery

Question 16

Three causes of hypercalcemia

Answer 16

1 metastatic bone disease (most common)
2 multiple myeloma
3 hyperparathyroidism

Question 17

List the most common cause of hypercalcemia

Answer 17

Metastatic bone disease (secondary to cancer of breast, lung, and kidney)

Question 18

Two reasons why profoundly decreased ionized Ca levels may be fatal

Answer 18

1 causes tetany, seizures, hypotension, decreased cardiac function
2 enhances hyperkalemia=fibrillation and cardiac standstill

Question 19

Reference Range of Magnesium

Answer 19

1.9-2.5 mg/dL

Question 20

Three functions of magnesium

Answer 20

1 activator in enzymatic reactions (transfer/storage)
2 crucial in cellular physiology
3 CHO, lipid, protein, and nucleic acid metabolism

Question 21

Two general causes of hypomagnesemia and two specific conditions associated with each

Answer 21

1 impaired intake-malabsorption, malnutrition, diarrhea, alcoholism
2 excessive renal loss-diruetics, hyperaldosteronism, and primary hyperparathyroidism

Question 22

Three general causes of hypermagnesemia

Answer 22

1 renal failure
2 magnesium intoxication
3 treatment of toxemia of pregnancy (MgSO4 excess)

Question 23

Reference Range of phosphorus

Answer 23

2.5-4.5 mg/dL

Question 24

Five functions of phosphorus

Answer 24

1 major intracellular anion
2 metabolism closely related to Ca
3 intermediary metabolism
4 component of phospholipids, nucleic acids, and ATP
5 bone minearlization
6 minor plasma buffer

Question 25

Five general causes of hypophosphatemia

Answer 25

1 Ricket's 
2 hyperparathyroidism
3 Fanconi's syndrome
4 hemolytic anemia
5 diabetes mellitus

Question 26

Four general causes of hyperphosphatemia

Answer 26

1 glomerular renal failure
2 hypervitaminosis D
3 hypoparathyroidism
4 bone repair

Question 27

of moles of solute particles dissolved per kg H2O (w/w soln)

Answer 27

osmolality

Question 28

reporting units for osmolality

Answer 28

mOsmol per kg H2O (w/w)

Question 29

reporting units for osmolarity

Answer 29

mOsmol per L H2O (w/v)

Question 30

three substances that have the greatest effect on serum osmo

Answer 30

Na, Glucose, urea

Question 31

clinical use of serum osmo measurement

Answer 31

determine the presence of “unmeasured substances” in blood

Question 32

Reference Range for serum osmo

Answer 32

280-300 mOsm/kg

Question 33

Seven conditions in which serum osmo may be increased

Answer 33

1 severe dehydration
2 renal failure
3 alcohols
4 ethylene glycol
5 ketone bodies
6 lactic acid
7 mannitol administration