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90 Cards in this Set
- Front
- Back
Electrolytes |
Ions/charged particles. |
|
Anions |
Negatively charged particle that moves toward the anode in an electrolyte cell. |
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Cations |
Positively charged particles that moved toward the cathode in an electrolyte cell. |
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Common electrolytes |
Sodium: Na+ Potassium K+ Chloride: Cl- Bicarbonate HCO- Calcium: Ca++ Magnesium Mg++ Phosphorous: PO4- Copper Cu++ Zinc: Zn++
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Where does every metabolic process start? % of male, female, and babies. |
In water. 60% in males, 50% in females and 77% in babies. |
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How much water do we get from food? How much water do we get from drinking? How much is excreted daily? |
100 mL in food. 1,000 ML through drinking. 2500 mL through excretion, 1500 in urine. The rest from feces and sweat. |
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Principle extra cellular cation |
Sodium. Represents 90% of the extra cellular cations. |
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Primary function of sodium |
Maintaining osmotic pressure and acid-base balance. |
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Reference range of a sodium |
135-145 milliosmoles/L. |
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Specimens used for sodium |
Plasma-lithium heparin or ammonium heparin and urine. |
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Hyponatremia can be caused from: |
Addison's disease, diuretics, vomiting, and diarrhea. |
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Hypernatremia is associated with: |
Cushing's. |
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Major intracellular cation |
Potassium. |
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Function of potassium |
Involvement in muscle contractions and neuromuscular excitability and regulation of hydrogen ion concentration. |
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What are sodium and potassium regulated by? |
Kidneys. |
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How is potassium absorbed? |
Absorbed through the intestines and filtered by the glomeruli, most reabsorbed in the tubules. |
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Reference range of potassium. |
3.5-5 milliosmoles/L. |
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Hypokalemia is associated with: |
Diuretics, starvation, GI tract issues, and Cushing's disease. |
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Hyperkalemia is associated with: |
Hemolytic diseases and Addison's disease. |
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Sources of potassium |
Sweet potatoes, tomato paste, regular potatoes, yogurt, canned clams, and prune juice. |
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What can cause a falsely increased potassium results? |
Hemolysis, prolonged tourniquet time, patient open and closed fist repeatedly prior to venipuncture, and serum/plasma allowed to sit on cells after centrifugation. |
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Measurement of sodium and potassium is usually made by: |
ISE: ion selective electrodes. |
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Why must care be made to keep the membrane clean? |
Protein build up can lead to falsely decreased results. An increase of lipids/protein in the sample can cause the "exclusion error." |
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Major extracellular anion |
Chloride |
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Chloride has a reciprocal relationship with: |
Bicarbonate, therefore playing a vital role in acid-base balance of the blood. |
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Chloride determinations |
Can be performed on serum or plasma (lithium heparin), urine, CSF, or sweat. |
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Reference range for serum/plasma chloride |
98-108 milliosmoles/L. |
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Hypochloremia is associated with: |
GI and kidney loss. |
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Hyperchloridemia |
Acidosis from diarrhea and dehydration. |
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What methods are used to measure chloride? |
ISE methods, mercuimetric titration, and spectrophotometric methods. |
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CSF chloride reference range and when is it decreased? |
Higher than serum. 115-130 mmol/L. Decreased in adults with bacterial meningitis. |
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When do chloride levels in CSF fall to approximately that of serum? |
In cases of bacterial meningitis when the protein levels in CSF increase. |
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When do sweat chloride levels increase? |
In cases of cystic fibrosis. CF causes a failure of the chloride ion transport system. |
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Total C02 |
Serum or plasma C02 = HCO3- (bicarbonate) + H2CO3 (carbonic acid) + dissolved CO2 + carbamino bound C02. |
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How much does bicarbonate makeup of total C02? |
More than 90%. |
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Second most abundant anion in the extracellular fluid |
Bicarbonate. |
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Main function of bicarbonate |
Buffering of blood. Most specimens have lost most of the dissolved gaseous C02 during specimen processing. Therefore, a routine C02 is basically a measure of bicarbonate. |
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Reference range of C02 and measurement methods. |
20-30 milliosmoles/L. ISE and spectrophotometrically. |
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Most abundant cation |
Magnesium |
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Second most abundant intracellular cation |
Magnesium |
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Where is magnesium found? |
55% skeleton and 45% muscle. |
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What form is most extracellular magnesium in? What does magnesium often function as? |
Ionized form (the physiologically active form). Often functions as a cofactor. |
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Sources of magnesium in diet. Participates in about how many reactions? |
Nuts and hard water. 300 |
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Increased levels of magnesium are associated with: |
Taking too much antacids, milk of magnesium, dehydration, adrenal insufficiency and ingestion of Epsom salt. |
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Specimen used for magnesium |
Serum or lithium heparin plasma, do not use oxalate, citrate or EDTA since these anticoagulants all bind magnesium. |
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Methods used to measure magnesium |
Colorimetric methods: calgamite, formazen dye, or methylthymol blue. |
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Reference range of magnesium |
0.6-1 milliosmoles/L. |
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Function of calcium (5th most prevalent cation) |
Regulates cellular functions, blood coagulation, and nerve response. |
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3 forms that serum calcium exist in |
Bound to protein, complex, and ionized. |
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% of serum calcium that's bound to protein. % found in skeleton as extracellular crystals. |
50%, therefore protein levels affect calcium levels. 99% |
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Hypercalcemia is associated with: |
Multiple myeloma, disease of plasma cells, Prolonged immobilization, and primary parahyperthyroidism. |
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Hypocalcemia |
Primary hypoparathyroidism , and vitamin D deficiency. |
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Reference range of calcium and specimen used |
8.5-10. Serum or lithium heparin, don't use EDTA. |
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What form does phosphate exist in the body? |
Organic phosphate esters or inorganic phosphate. |
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% of phosphate found in bone |
80. |
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Decrease of magnesium is seen with: |
During pregnancy, can cause hyper excitable labor, causing early delivery, reduced intake and increased renal secretion. |
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The organic phosphate esters are primarily: |
Intracellular and help make ATP. |
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Where are inorganic phosphate ions primarily found? |
Extracellular fluid, where they serve as part of our buffer system. |
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Regulation of phosphate levels are closely related to: |
The calcium levels. |
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Hypophosphatemia is seen with: |
Common with people in hospital, nutritional recovery syndrome, and alcohol withdrawal. |
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Hyperphosphatemia is associated with: |
Lymphoblastic leukemia, and renal failure. Lymphoblasts have more phosphate. |
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Reference range of phosphate |
2.5 to 4.5 mg/dL |
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Reagent uses for measurement of phosphate |
Myobdenum blue. |
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Anion gap |
Calculation. Non specific, but can help determine acid-base disorders. Sort of QC. |
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What does the anion gap detect? |
Number of positive ions in plasma must balance the number of negative ions. Detects imbalances in concentrations of ions other than sodium, chloride, and bicarbonate. |
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Calculation of anion gap and formula |
Subtraction of the sum of the two major play anions from the sum of the two major cations. Formula: A-Gap = (Na + K) - (Cl + C02) |
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Reference range of anion gap |
10-18 mEq/L |
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How much iron is in body? How much in hemoglobin (RBCs)? |
3-5 grams in body, 2-2 1/2 in hemoglobin. |
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Where is most iron found? |
Within mature RBCs or their precursors in the bone marrow. |
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What % of iron is stored in hemoglobin and how much in other tissues? |
65% of in hgb and 30% in other tissues. |
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How do we get iron? |
Through diet. |
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How is iron lost? |
Through the breakdown of epithelial cells in the intestine and skin. Most lose about 1 mg/day. During menstruation, another mg may be lost. |
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What is absorption of iron into the bloodstream from the intestines partially regulated by? Other factors that affect absorption or iron. |
Intestinal mucosal cells. Amount of iron already stored and the rate of RBC synthesis. |
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How is most iron normally lost each day? |
Through epithelial cells and red cells lost through urine and feces. |
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Which form of iron binds with oxygen? Which doesn't? |
Ferrous. Ferric. |
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What form of iron do we eat? |
Ferric state. |
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Ferritin |
Major storage protein. |
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Transferrin |
Major transport protein. |
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Haptoglobin |
Binds with free hemoglobin and helps with its disposal. |
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Hemopexin |
Also binds free hemoglobin. |
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Other sources in the body of iron. |
Myoglobin, enzymes (when iron functions as a cofactor), and circulating in blood. |
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Hemosiderin |
An iron storage molecule. It takes in ferritin molecules. It's the overflow when ferritin molecules are full. |
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Increases/decreases of serum iron, transferrin, iron saturation, and serum ferritin of IDA |
Serum iron: deceased Transferrin: increased Iron saturation: decreased Serum ferritin: decreased |
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Main reason for iron deficiency in adults and children. |
Chronic bleeding disorders and decreased intake. |
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Hemosiderosis |
Implies iron overload w/o associated tissue damage. |
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Hemochromatosis |
Iron overload with injury to involved organs. Generally cell degeneration and fibrosis. |
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Classical disorder iron overload |
Hereditary hemochromatosis. Early diagnosis is critical. |
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Increase/decrease of serum iron, transferrin, iron saturation, and serum ferritin for hereditary hemochromatosis |
Serum iron: increased Transferrin: decreased Iron saturation: increased Serum ferritin: increased |
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Bronze diabetes |
Iron loading in the tissues. Iron deposits in the pancreas causing it to be non functional. Also causes autosplenectomy. |
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Treatment of hemochromatosis |
Therapeutic phlebotemies and chelating drugs. |