Clin Chem Exam 3- Water And Electrolyte Balance

Front 1

Functions of body water

Back 1

Transports nutrients to cells
Determines cell volume
Removes waste by urine
Acts as body coolant

Front 2

Intracellular ion of body water

Back 2

K+

Front 3

Extracellular ion of body water

Back 3

Na+ and Cl-

Front 4

Ratio of Na:K for pump

Back 4

3 Na out: 2 K in

Front 5

Most common cation in plasma

Back 5

Na

Front 6

Most common Anion in plasma

Back 6

Cl

Front 7

Na reference range for plasma

Back 7

136-145 mmol/L

Front 8

K ref. range for plasma

Back 8

3.5-5.1

Front 9

Cl ref. range for plasma

Back 9

98-107

Front 10

CO2 ref range for plasma

Back 10

23-29

Front 11

Electrolyte:
maintains osmotic pressure, membrane potential, muscle contraction and nerve conduction

Back 11

Na

Front 12

Electrolyte:
major counter ion available when acids become neutralized to their conj bases

Back 12

Na

Front 13

Na levels in body fluids maintained by

Back 13

renal reabs in the proximal convoluted tubules
controlled by Na-K-ATPase pump

Front 14

Na maintained by hormone ____________ as a consequence of changes in blood vol and blood pressure

Back 14

aldosterone

Front 15

extremely high or low Na levels can cause

Back 15

swelling on the brain and spinal cord

Front 16

Abnormal ____ levels are due to dilutional effects of body water

Back 16

Na

Front 17

may be due to hyperglycemia

Back 17

Hyponatremia
low Na

Front 18

may be due to diabetes insipidus

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Hypernatremia
high Na

Front 19

Electrolyte:
maintains cardiac rhythm and contributes to neuormuscular conduction

Back 19

K

Front 20

also controlled by the Na-K-ATPase pump

Back 20

K

Front 21

due to decreased renal function (renal failure)
responds to electrolyte imbalance (acidosis)
Hemolysis> Falsely elevated

Back 21

Hyperkalemia

Front 22

due to GI loss and Renal loss (vomiting/diarrhea)
Responds to electrolyte imbalance (alkalosis)

Back 22

Hypokalemia

Front 23

Electrolyte:
helps maintain electrical neutrality with Na
almost completely absorbed by intestine
contributes to maint. of acid-base balance by participating in isohydric shift

Back 23

Cl-

Front 24

may be caused diabetes insipidus or when loss of bicarbonate

Back 24

Hyperchloremia

Front 25

may follow hyponatremia or cause by loss due to vomiting

Back 25

Hypochloremia

Front 26

Electrolyte:
major buffer for metabolically produced acids
Reabs. by PCT and DCT in kidneys

Back 26

HCO3-

Front 27

may be associated with conditions such as metabolic acidosis

Back 27

Decreased HCO3-

Front 28

may be associated with metabolic acidosis

Back 28

Increased alkalosis

Front 29

Anion Gap equation
and ref. arange

Back 29

(Na + K) - (Cl + HCO3-)
10-20 mmol/L

Front 30

incr. prod. of acids > decr. amount of HCO3- in plasma> increase Anion Gap
ex: DKA, hypoxia, and renal failure

Back 30

Metabolic acidosis

Front 31

can be due to not being reabsorbed from PCT or abnormal secretion of aldosterone

Back 31

Incr. Anion Gap due to abn conc. of Na

Front 32

the measure of the number of dissolved particles in a solution

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Osmolality
range= 275-300 mOsm/kg

Front 33

Calculated Osmolality formula
(estimated by measuring its principle soultes)

Back 33

2(Na) + (glucose)/20 + (BUN)/3

Front 34

by measuring freezing point depression or decrease in vapor pressure
each 1000 mOsm/kg depresses freezing pint of H2O by 1.86 C

Back 34

Measured Osmolality

Front 35

measured osmo- calc osmo =
normal = 9 mOsm/kg

Back 35

osmolal gap

Front 36

effect of incr. Osmolality

Back 36

Sensation of thirst> Secretion of ADH or vasopressin (from post pituitary) > acts on kidneys to incr. water reabs.

Front 37

the 2 major hormones that control blood vol

Back 37

ADH/ vasopressin- post. pituitary gland
Aldosterone- cortex of adrenal gland

Front 38

2 major hormones the regulate blood pressure

Back 38

Epinephrine and Norepinephrine from adrenal medulla

Front 39

determinant of renal water excretion
synt. by hypothalmus and stored in post. pituitary
stimulated by hypertonic plasma circulating PP and increased plasma osmolality
travels to collecting ducts of kidney > more water reabs.

Back 39

ADH

Front 40

regulated by rein-angiotensin system
stimulated by cells in the juxtaglomerulus-apparatus in nephron arteriole sensing low blood flow to the kidneys

Back 40

Aldosterone

Front 41

Mechanism of Aldosterone

Back 41

JGA secrets protease enzyme renin which acts on angiotensin and converts is to Angiotensin I
Carried to lungs where ACE converts it to Angiotensin II
> Vasoconstriction> incr. blood pressure
> Stim of aldosterone
Aldosterone stims. DCT to reabsorb Na+ back into plasma> increased blood volume (also stims. K+ excretion)

Front 42

Hyperosmolality and Hypernatremia >

Back 42

ADH release
> Na retention and K excretion and water retention

Front 43

Hypovolemia >

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Thirst
decrease of renal pressure> renin prod> angiotensin.... etc.

Front 44

Hypervolemia >

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ANP prod
>Renal Na and H2O excretion and vasodilation

Front 45

stim. by nerve impulse from nervous syst. due to physiologic threat
> Enhances irritability of heart muscle> incr heart rate and incr strength od heart beat> incr blood pressure

Back 45

Epinephrine and Norepinephrine

Front 46

treatment symptomatic (diuretics) and shows no abn. lab tests

Back 46

Primary(essential/idiopathic) hypertension

Front 47

rare tumor in adrenal medulla
causes incr secretion of epinephrine and norepinephrine > incr blood pressure
causes incr prod of metabolites metanphrine and normetanephrine> incr VMA
measue levels in urine to diagnose

Back 47

Pheochromacytoma

Front 48

excessive prod. due to tumor
incr blood volume> increase blood pressure
measure urinary excretio of aldosterone, Na, and K to diagnose

Back 48

Aldosterone induced hypertension

Front 49

syndrome of inappropriate ADH due to tumor prod. excess ADH
incr blood vol> incr blood pressure
measure serum and urine osmolality, excess ADh > dilute serum and conc. urine

Back 49

SIADH

Front 50

lack of ADH secretion or lack of kidney resp to ADH
huge vol of urine excreted> dehydration> thirst> fluid intake> more urine prod and hyponatremia
but no abd. blood pressure

Back 50

Diabetes insipidus

Front 51

hormone prod by intestinal tumors resulting in episodic hypertension

Back 51

Serotonin

Front 52

breaks down into 5-HIAA by monoamine oxidase
measure 5-HIAA for intestinal tumors

Back 52

Serotonin