Electrolytes And Iron

Front 1

Electrolytes

Back 1

Ions/charged particles.

Front 2

Anions

Back 2

Negatively charged particle that moves toward the anode in an electrolyte cell.

Front 3

Cations

Back 3

Positively charged particles that moved toward the cathode in an electrolyte cell.

Front 4

Common electrolytes

Back 4

Sodium: Na+ Potassium K+

Chloride: Cl- Bicarbonate HCO-

Calcium: Ca++ Magnesium Mg++

Phosphorous: PO4- Copper Cu++

Zinc: Zn++

Front 5

Where does every metabolic process start? % of male, female, and babies.

Back 5

In water. 60% in males, 50% in females and 77% in babies.

Front 6

How much water do we get from food? How much water do we get from drinking? How much is excreted daily?

Back 6

100 mL in food. 1,000 ML through drinking. 2500 mL through excretion, 1500 in urine. The rest from feces and sweat.

Front 7

Principle extra cellular cation

Back 7

Sodium. Represents 90% of the extra cellular cations.

Front 8

Primary function of sodium

Back 8

Maintaining osmotic pressure and acid-base balance.

Front 9

Reference range of a sodium

Back 9

135-145 milliosmoles/L.

Front 10

Specimens used for sodium

Back 10

Plasma-lithium heparin or ammonium heparin and urine.

Front 11

Hyponatremia can be caused from:

Back 11

Addison's disease, diuretics, vomiting, and diarrhea.

Front 12

Hypernatremia is associated with:

Back 12

Cushing's.

Front 13

Major intracellular cation

Back 13

Potassium.

Front 14

Function of potassium

Back 14

Involvement in muscle contractions and neuromuscular excitability and regulation of hydrogen ion concentration.

Front 15

What are sodium and potassium regulated by?

Back 15

Kidneys.

Front 16

How is potassium absorbed?

Back 16

Absorbed through the intestines and filtered by the glomeruli, most reabsorbed in the tubules.

Front 17

Reference range of potassium.

Back 17

3.5-5 milliosmoles/L.

Front 18

Hypokalemia is associated with:

Back 18

Diuretics, starvation, GI tract issues, and Cushing's disease.

Front 19

Hyperkalemia is associated with:

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Hemolytic diseases and Addison's disease.

Front 20

Sources of potassium

Back 20

Sweet potatoes, tomato paste, regular potatoes, yogurt, canned clams, and prune juice.

Front 21

What can cause a falsely increased potassium results?

Back 21

Hemolysis, prolonged tourniquet time, patient open and closed fist repeatedly prior to venipuncture, and serum/plasma allowed to sit on cells after centrifugation.

Front 22

Measurement of sodium and potassium is usually made by:

Back 22

ISE: ion selective electrodes.

Front 23

Why must care be made to keep the membrane clean?

Back 23

Protein build up can lead to falsely decreased results. An increase of lipids/protein in the sample can cause the "exclusion error."

Front 24

Major extracellular anion

Back 24

Chloride

Front 25

Chloride has a reciprocal relationship with:

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Bicarbonate, therefore playing a vital role in acid-base balance of the blood.

Front 26

Chloride determinations

Back 26

Can be performed on serum or plasma (lithium heparin), urine, CSF, or sweat.

Front 27

Reference range for serum/plasma chloride

Back 27

98-108 milliosmoles/L.

Front 28

Hypochloremia is associated with:

Back 28

GI and kidney loss.

Front 29

Hyperchloridemia

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Acidosis from diarrhea and dehydration.

Front 30

What methods are used to measure chloride?

Back 30

ISE methods, mercuimetric titration, and spectrophotometric methods.

Front 31

CSF chloride reference range and when is it decreased?

Back 31

Higher than serum. 115-130 mmol/L. Decreased in adults with bacterial meningitis.

Front 32

When do chloride levels in CSF fall to approximately that of serum?

Back 32

In cases of bacterial meningitis when the protein levels in CSF increase.

Front 33

When do sweat chloride levels increase?

Back 33

In cases of cystic fibrosis. CF causes a failure of the chloride ion transport system.

Front 34

Total C02

Back 34

Serum or plasma C02 = HCO3- (bicarbonate) + H2CO3 (carbonic acid) + dissolved CO2 + carbamino bound C02.

Front 35

How much does bicarbonate makeup of total C02?

Back 35

More than 90%.

Front 36

Second most abundant anion in the extracellular fluid

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Bicarbonate.

Front 37

Main function of bicarbonate

Back 37

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.

Front 38

Reference range of C02 and measurement methods.

Back 38

20-30 milliosmoles/L. ISE and spectrophotometrically.

Front 39

Most abundant cation

Back 39

Magnesium

Front 40

Second most abundant intracellular cation

Back 40

Magnesium

Front 41

Where is magnesium found?

Back 41

55% skeleton and 45% muscle.

Front 42

What form is most extracellular magnesium in? What does magnesium often function as?

Back 42

Ionized form (the physiologically active form). Often functions as a cofactor.

Front 43

Sources of magnesium in diet. Participates in about how many reactions?

Back 43

Nuts and hard water. 300

Front 44

Increased levels of magnesium are associated with:

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Taking too much antacids, milk of magnesium, dehydration, adrenal insufficiency and ingestion of Epsom salt.

Front 45

Specimen used for magnesium

Back 45

Serum or lithium heparin plasma, do not use oxalate, citrate or EDTA since these anticoagulants all bind magnesium.

Front 46

Methods used to measure magnesium

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Colorimetric methods: calgamite, formazen dye, or methylthymol blue.

Front 47

Reference range of magnesium

Back 47

0.6-1 milliosmoles/L.

Front 48

Function of calcium (5th most prevalent cation)

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Regulates cellular functions, blood coagulation, and nerve response.

Front 49

3 forms that serum calcium exist in

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Bound to protein, complex, and ionized.

Front 50

% of serum calcium that's bound to protein. % found in skeleton as extracellular crystals.

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50%, therefore protein levels affect calcium levels. 99%

Front 51

Hypercalcemia is associated with:

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Multiple myeloma, disease of plasma cells, Prolonged immobilization, and primary parahyperthyroidism.

Front 52

Hypocalcemia

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Primary hypoparathyroidism , and vitamin D deficiency.

Front 53

Reference range of calcium and specimen used

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8.5-10. Serum or lithium heparin, don't use EDTA.

Front 54

What form does phosphate exist in the body?

Back 54

Organic phosphate esters or inorganic phosphate.

Front 55

% of phosphate found in bone

Back 55

80.

Front 56

Decrease of magnesium is seen with:

Back 56

During pregnancy, can cause hyper excitable labor, causing early delivery, reduced intake and increased renal secretion.

Front 57

The organic phosphate esters are primarily:

Back 57

Intracellular and help make ATP.

Front 58

Where are inorganic phosphate ions primarily found?

Back 58

Extracellular fluid, where they serve as part of our buffer system.

Front 59

Regulation of phosphate levels are closely related to:

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The calcium levels.

Front 60

Hypophosphatemia is seen with:

Back 60

Common with people in hospital, nutritional recovery syndrome, and alcohol withdrawal.

Front 61

Hyperphosphatemia is associated with:

Back 61

Lymphoblastic leukemia, and renal failure. Lymphoblasts have more phosphate.

Front 62

Reference range of phosphate

Back 62

2.5 to 4.5 mg/dL

Front 63

Reagent uses for measurement of phosphate

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Myobdenum blue.

Front 64

Anion gap

Back 64

Calculation. Non specific, but can help determine acid-base disorders. Sort of QC.

Front 65

What does the anion gap detect?

Back 65

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.

Front 66

Calculation of anion gap and formula

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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)

Front 67

Reference range of anion gap

Back 67

10-18 mEq/L

Front 68

How much iron is in body? How much in hemoglobin (RBCs)?

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3-5 grams in body, 2-2 1/2 in hemoglobin.

Front 69

Where is most iron found?

Back 69

Within mature RBCs or their precursors in the bone marrow.

Front 70

What % of iron is stored in hemoglobin and how much in other tissues?

Back 70

65% of in hgb and 30% in other tissues.

Front 71

How do we get iron?

Back 71

Through diet.

Front 72

How is iron lost?

Back 72

Through the breakdown of epithelial cells in the intestine and skin. Most lose about 1 mg/day. During menstruation, another mg may be lost.

Front 73

What is absorption of iron into the bloodstream from the intestines partially regulated by? Other factors that affect absorption or iron.

Back 73

Intestinal mucosal cells. Amount of iron already stored and the rate of RBC synthesis.

Front 74

How is most iron normally lost each day?

Back 74

Through epithelial cells and red cells lost through urine and feces.

Front 75

Which form of iron binds with oxygen? Which doesn't?

Back 75

Ferrous. Ferric.

Front 76

What form of iron do we eat?

Back 76

Ferric state.

Front 77

Ferritin

Back 77

Major storage protein.

Front 78

Transferrin

Back 78

Major transport protein.

Front 79

Haptoglobin

Back 79

Binds with free hemoglobin and helps with its disposal.

Front 80

Hemopexin

Back 80

Also binds free hemoglobin.

Front 81

Other sources in the body of iron.

Back 81

Myoglobin, enzymes (when iron functions as a cofactor), and circulating in blood.

Front 82

Hemosiderin

Back 82

An iron storage molecule. It takes in ferritin molecules. It's the overflow when ferritin molecules are full.

Front 83

Increases/decreases of serum iron, transferrin, iron saturation, and serum ferritin of IDA

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Serum iron: deceased

Transferrin: increased

Iron saturation: decreased

Serum ferritin: decreased

Front 84

Main reason for iron deficiency in adults and children.

Back 84

Chronic bleeding disorders and decreased intake.

Front 85

Hemosiderosis

Back 85

Implies iron overload w/o associated tissue damage.

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Hemochromatosis

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Iron overload with injury to involved organs. Generally cell degeneration and fibrosis.

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Classical disorder iron overload

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Hereditary hemochromatosis. Early diagnosis is critical.

Front 88

Increase/decrease of serum iron, transferrin, iron saturation, and serum ferritin for hereditary hemochromatosis

Back 88

Serum iron: increased

Transferrin: decreased

Iron saturation: increased

Serum ferritin: increased

Front 89

Bronze diabetes

Back 89

Iron loading in the tissues. Iron deposits in the pancreas causing it to be non functional. Also causes autosplenectomy.

Front 90

Treatment of hemochromatosis

Back 90

Therapeutic phlebotemies and chelating drugs.