| Analyte and flame emission spectrophotometry, color: | Potassium - violet
Sodium - yellow
Magnesium - blue
Calcium -yellow |
| are ions (minerals) capable of carrying an electric charge | Electrolytes |
| Electrolytes are classifies as | anions and cations |
| those electrolytes with a positive charge are, that move toward the
cathode, | cations |
| while those with a negative charge are that move toward the
anode. | anions |
| are an essential component in numerous processes, including | Electrolytes |
| volume and osmotic regulation | sodium [Na+], chloride [Cl−], potassium [K+]); |
| myocardial rhythm and contractility | K+, magnesium [Mg2+], calcium [Ca2+]); |
| cofactors in enzyme activation | e.g., Mg2+, Ca2+, zinc [Zn2+]); |
| regulation of
adenosine triphosphatase (ATPase) ion pumps | (Mg2+) |
| electrolytes responsible for acid–base balance | bicarbonate [HCO3–], K+, Cl−); |
| Electrolytes for blood coagulation | Ca2+, Mg2+); |
| Neuromuscular excitability | K+, Ca2+, Mg2+); |
| Electrolytes for the production and use of ATP from glucose | Mg2+, phosphate PO4 |
| The average water content of the human body varies from | 40% to 75% |
| water values is declining with | age and especially with obesity |
| Women
have lower average water content than do men as a result of a higher fat content | True |
| solvent for all processes in the human body as it is responsible for
transporting nutrients to cells, determining cell volume by its transport into and
out of cells, removal of waste products by way of urine, and acting as the body's
coolant by way of sweating. | Water |
| Water is located in | ICF and ECF |
| accounts for about 2/3 of total body water | ICF |
| accounts for the other 1/3 of total body water and can be
subdivided | ECF |
| Normal plasma is about how many percent with the
remaining volume occupied by lipids and proteins. | 93% |
| is a mechanism that requires energy to move ions across
cellular membranes. | Active transport |
| is the passive movement of ions (no energy consumed) across
a membrane and depends on both the size and charge of the ion being
transported, and on the nature of the membrane through which it is passing. | Diffusion |
| rate of diffusion of various ions also may be altered by | physiologic and hormonal process |
| most biologic membranes are freely permeable | to water
but not to ions or proteins |
| the concentration of ions and proteins on either side
of the membrane will influence the flow of water across a membrane | Osmoregulator |
| Na+,
In addition to the osmotic effects of
other ions, proteins,
and blood pressure influence the flow of water across a membrane. | True |
| is a physical property of a solution that is based on the concentration
of solutes (expressed as millimoles) per kilogram of solvent (w/w). | Osmolality |
| Osmolality is
related to several changes in the properties of a solution relative to pure water,
such as freezing point depression and vapor pressure (blank) | Decrease |
| are the basis for routine measurements of osmolality
in the laboratory. | Colligative property |
| is important in mediating fluid intake | Thirst |
| The other
means of controlling osmolality is by | secretion of AVP |
| This hormone is secreted
by the posterior pituitary gland and acts on the cells of the collecting ducts in the
kidneys to increase water reabsorption | AVP |
| water is conserved, the osmolality decreases is an example of | Negative Feedback loop |
| parameter to which the
hypothalamus responds | Osmolality in plasma |
| causes a fourfold increase in the circulating concentration of AVP, | 1% to 2% increase in osmolality |
| shuts off AVP production. | 1% to 2% decrease in osmolality |
| increasing the reabsorption of water in the
cortical and medullary collecting tubules but has a half-life in the circulation of
only 15 to 20 minutes. | AVP |
| is more important in controlling water
excess | Renal water excretion |
| more important in preventing water deficit
(dehydration) | Thirst |
| Increase intake of water | in polydipsia |
| How many L of water daily can be excreted | 10 - 20 |
| usually occur only in patients with
impaired renal excretion of water | hypoosmolality and hyponatremia |
| An example of the effectiveness of thirst in
preventing dehydration can be seen in patients | Diabetes insipidus |
| Adequate blood volume is essential to | maintain blood pressure and ensure good
perfusion to all tissues and organs |
| decreased blood volume | renin–angiotensin–aldosterone
hormone system |
| Osmolality may be measured in | Serum / urine |
| Electrolytes provide the largest
contribution to the osmolality value of serum. | sodium, chloride, and bicarbonate |
| • There is almost no metabolic process that are not independent or affected by the Electrolytes | True |
| • It is tested because it can be diagnostically significant when it comes to | identifying the cause of the disease. |
| the ideal anticoagulant for electrolytes, because it can mimic the normal body condition | Heparin |
| best specimen for electrolytes | • Heparinized sample |
| Routinely used top tube in electrolytes | Red |
| The usual routine chemistry | FBS, Lipid profile, SGPT, SGOT, Creatinine, Uric Acid) |
| Electrolytes that are often requested | Sodium Potassium and Chloride |
| • Total body water volume= | 40 L, 60% body weight |
| Percent found in the ICF and in ECF | 66% and 33% |
| • Intracellular fluid volume | 25 L, 40% body weight (Inside the cell) |
| • Extracellular fluid volume | 15 L, 20% body weight |
| (found in the spaces of organ) | Interstitial fluid volume |
| inside the blood vessels | Plasma volume or Intravascular fluid |
| • Na from the latin word | Natrium |
| a silvery soft waxy metallic element of the alkali metal group; occurs abundantly in natural compounds (especially in salt water); burns with a yellow flame and reacts violently in water; occurs in sea water and in the mineral halite (rock salt) | Sodium |
| • Major Cation (positively charged) of the Extracellular fluid | Sodium |
| • Most significant contributor of plasma osmolality | Sodium |
| Responsible for almost ½ of the Osmotic strength of Plasma. Its role is maintaining the normal distribution of water and Osmotic pressure in the Extracellular fluid. | Sodium |
| We intake sodium from the food and our normal diet contains | 8 to 15 grams |
| organ responsible for the regulation of Sodium | Kidneys |
| • Where sodium goes water follows. If water is being retained in the body, Sodium is also retained as well | True or false |
| will also have an effect on Sodium levels | • Blood volume status |
| help in maintaining Sodium levels either retain or excrete the Sodium. | Hormone regulators |
| retains Sodium | Aldosterone
Arginine Vasopressin |
| substance found in the heart that has an effect on the Sodium levels, it will excrete sodium. | Atrial Natriuretic Factor |
| also a hormone regulator that can affect the Sodium but it is INDIRECT | Antidiuretic hormone |
| Increased Sodium Loss
Increased Water Retention
Water Imbalance | Hyponatremia |
| -Excess Water Loss
-Diabetes insipidus
-Renal tubular disorder | Hypernatremia |
| water is excreted sodium is also excreted | Diuretic use |
| because of the dilutional effect | Increase water retention |
| Specimen for Sodium | • Serum, Plasma, Urine, sweat |
| Hemolysis does not greatly affect the specimen but marked hemolysis can cause decrease levels of Sodium due to dilutional effect | Sodium |
| A normal plasma
osmolality is approximately | 295 mmol/L, |
| 60% to 75% of filtered Na+ is reabsorbed in | Proximal tubule |
| one of the
most common electrolyte disorders in hospitalized and nonhospitalized patients | Hyponatremia |
| may also be seen with in vitro
hemolysis, considered the most common cause for a false decrease | Pseudohyponatremia |
| an alert patient is indicative of hypothalamic
disease, usually with a defect in the osmoreceptors rather than from a true
resetting of the osmostat. | Chronic Hypernatremia |
| When plasma is used in Na testing the anticoagulants are | lithium heparin, ammonium heparin, and lithium oxalate are
suitable anticoagulants |
| - from the Neo-Latin | Kalium |
| • Major Cation of the Intracellular fluid | Potassium |
| Potassium are found inside of the cell, around | 20 times greater |
| • Most important analyte because abnormal levels are considered life threatening | Potassium |
| Normal K | 3.5-5.1 mmol/L |
| May alter ECG in K | 6-7 mmol/L |
| Lack muscular excitability | 8 mmol/L |
| Cardiac arrest | 10 mmol/L |
| • If the potassium levels is abnormal, we need to | Rerun results |
| • Can be also included in the Cardiac Markers. | Potassium |
| • Has one of the most important body functions
• Helps our cells uptake nutrients and water
• Helps in muscle contractions and increase levels can reflect in cardiac problems
• Helps our nerves carry messages between the brain and body
• Balances our body fluids and regulates blood pressure
• Helps our bodies digests foods | Potassium |
| • The potassium levels in the blood is decreased | True |
| • The regulation of Potassium has similar mechanisms with | Sodium but opposite effect |
| Hormone regulator that excretes Potassium | Aldosterone and ADH |
| • Aldosterone is produced or stimulated when: | Increase K and decrease Na |
| Specimen for potassium | Serum / Plasma / urine |
| a light soft silver-white metallic element of the alkali metal group; oxidizes rapidly in air and reacts violently with water; is abundant in nature in combined forms occurring in sea water and in carnallite and kainite and sylvite | Potassium |
| Functions include regulation of neuromuscular excitability, contraction of the heart, ICF H+ volume, and concentration | Potassium |
| K+ is released from muscle cells during | Exercise |
| K+ releases into the ECF | Cellular breakdown |
| promotes the entry of K+ into skeletal muscle and liver cells | Insulin |
| causes of artifactual hyperkalemia | Potassium |
| If the patient's platelet count is elevated
(thrombocytosis), serum K+ may be further elevated | True |
| Potassium samples should be stored | Room temp never iced |
| —the most common cause of
artifactual hyperkalemia. | hemolysis occurs after
the blood is drawn, K+ may be falsely elevated |
| In potassium, Hemolysis must be
avoided because of the | high K+ content of erythrocytes |
| serum and plasma generally give similar K+
levels, serum reference intervals tend to be slightly higher | True |
| As with Na+, the current method of choice is | ISE |
| • Represents the majority of the osmotically active constituents of the plasma | Chloride |
| It is similar to Sodium | Chloride |
| Maintenance of water distribution
Osmotic pressure
Anion-cation balance in the Extracellular fluid. | Chloride |
| • Sodium is the representative for the positively charged particles, then Chloride is for the negatively charged. They both maintain water distribution and Osmotic pressure. | True |
| Maintains Electron Neutrality in the blood through: | Reabsorption along with Na+ in the proximal tubules of the kidney and Chloride shift |
| • The bicarbonate will go outside of the cell while Chloride which is an Extracellular anion will go inside of the cell. | Chloride shift |
| Hormone regulator for Chloride | Aldosterone |
| • Chloride possibly follows sodium that is why they are slightly similar. | True |
| Specimen for Chloride | Serum, Plasma, Urine, Sweat |
| • Schales and schales method
• Indicator: diphenylcarbazone | Mercurimetric |
| • End product: HgCl2 (blue violet) | Titration |
| • Whitehorn
• Reagent: mercuric thiocyanate (red) | Spectrophotometric |
| • Cotlove chloridometer | Coulometric-Amperometric |
| The counter ion of Sodium | Chloride |
| the counter balance ion of Sodium | Potassium |
| its precise function in the
body is not well understood; however, it is involved in maintaining osmolality,
blood volume, and electric neutrality. | Chloride |
| Excess Cl− is excreted in the | Urine and Sweat |
| Excessive sweating stimulates | Aldosterone |
| The specimen Cl- of choice in urine analyses is | 24-hour collection |
| Extracellular cation, Almost exclusively found in the Plasma | Calcium |
| • It is the most abundant Mineral in the body and Least affected by hemolysis | Calcium |
| Calcium in Blood | 1% |
| Calcium in Bone | 99% |
| Free/Ionized Calcium | 45% |
| Protein Bound Calcium | 40% |
| • Bone structure
• Has an effect on muscle contraction
• Nerve impulse transmission
• Wound healing (Calcium is part of the coagulation cascade that can help in wound healing)
• Has an effect in cellular metabolism | Calcium |
| Hormone regulators of Calcium | PTH, Vit D, Calcitonin |
| MAJOR hypercalcemic agent (increasing the calcium levels in blood) | • Parathyroid hormone |
| considered as a hormone because of its physiologic function. (Hypercalcemic also). Does not come from the Sun, but present in the skin that when it comes contact with sunlight (UV rays), | Vitamin D |
| Hypocalcemic agent (decrease) | Calcitonin |
| a disease that can reflect on total calcium but not in ionized calcium. | • Hypoalbuminemia |
| Specimen for Calcium | • Serum/plasma |
| • Anticoagulants that are calcium chelators should not use can cause false results (Ex. EDTA, Oxalate) | True |
| • Clark-Collip ppt
• Endpoint: oxalic acid (purple) | Precipitation Test |
| • Ferro-Ham ppt
• Endpoint: chloranilic acid (purple) | Precipitation Test |
| • Orthocresolphthalein complexone (CPC)
• Dye: Arsenazo III | Colorimetric |
| • Also found in Bones, approximately 53% of magnesium in the body is found in the bone and the rest is found in the muscles, soft tissues and other organs. Only small portions are present in the serum and red cell | Magnesium |
| Functions:
• Bone structure
• Energy production
• DNA / RNA synthesis
• Glutathione synthesis
• Blood sugar control
• Blood pressure regulation
• Muscle contraction
• Nerve Function
• Essential for regular heartbeat | Magnesium |
| Hormone regulators for Magnesium | PTH, Aldosterone, Thyroxine |
| • Appears to be related to Calcium and Sodium in some ways. | Magnesium |
| Free/Ionized in Magnesium | 61% |
| Protein-bound in Magnesium | 34% |
| • Hypomagnesemia is the most frequently observed electrolyte disorder among hospitalized patients in the ICU, because the main source of magnesium is from food. | True |
| Specimen for Magnesium | • Serum/plasma |
| • Second most abundant anion in the Extracellular fluid | Bicarbonate |
| • Involved in the buffering system (maintains pH) of the blood | Bicarbonate |
| • Normal blood ph – 7.35 – 7.45 | Bicarbonate |
| • The kidneys (primarily) and the lungs greatly influence the | Acid Base Balance |
| Increase Carbon dioxide (Co2) | Acidosis |
| Decrease Carbon dioxide (Co2) | Alkalosis |
| Increase Bicarbonate (HCO3) | Alkalosis |
| Decrease Bicarbonate (HCO3) | Acidosis |
| Specimen for Bicarbonate | Specimen
• Serum/plasma
• Arterial blood |
| Anticoagulant for Bicarbonate | Serum or lithium heparin plasma |
| In Bicarbonate specimens should be | Anaerobic |
| fourth most abundant cation in the body and second
most abundant intracellular ion. | Magnesium |
| a light silver-white ductile bivalent metallic element; in pure form it burns with brilliant white flame; occurs naturally only in combination (as in magnesite and dolomite and carnallite and spinel and olivine) | Magnesium |
| The overall regulation of body Mg2+ is controlled largely by the | Kidney |
| Evacuated tube that can be used for electrolyte testing | GREEN, GOLD, PLAIN RED |
| Analyte and flame emission spectrophotometry, color: | Potassium - violet
Sodium - yellow
Magnesium - blue
Calcium -yellow |
