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MLT Electrolytes
MLT Electrolytes and Renal Function
| Front | Back |
|---|---|
| Which gland has regulatory areas for thirst, water balance and blood pressure? | Hypothalamus |
| What is the property of a solution that is influenced by the size and shape of the molecules ? | Colligative Properties |
| What are the 4 Colligative Properties | 1. Boiling Point; 2. Freezing Point; 3. Osmotic Pressure; 4. Vapor Pressure |
| What is the Average Water content of total body weight? | 40- 75% Depending on age and body fat content ( Obese people and women) |
| What are the 4 functions of water? | 1. Transport Nutrients to cells; 2. Determine cell volume; 3. Remove waste products (via urine); 4. Act as body coolant (via sweating) |
| What is the location of water in the body? | 1. Intracellular water (inside the cel, 2/3 total body water); 2. Extracellular (outside the cell, 1/3 total body water) |
| What are the 2 subdivisions of Extracellular Fluid? | 1. Intravascular (plasma, 93% H2O, 7% Lipids and proteins); 2. Interstitial Cell Fluid (surrounds cells in the tissues) |
| What is Active Transport? | The use of ATP (Adenosine Triphosphate) to move SOLUTES from an area of lower concentration to an area of higher concentration |
| What is Diffusion? | A form of passive movement where SOLUTES move from an area of higher concentration to an area of lower concentration; Results in equal distribution of solutes; Dependent on size and charge of ion and nature of the membrane. |
| What is Osmosis? | the passive movement of FLUIDS from an area of lower solute concentration and comparatively more fluid to an area of higher solute concentration and comparatively less fluid; Stops when solute concentration is equal on both sides |
| What is the Glomerular Filtration Rate? | The nephrons filter about 125 ml of blood per min or about 180 L per day; |
| How much urine is produced per day? | 1 - 2 Liters |
| Where is Antidiuretic Hormone produced and stored? | It is produced in the Hypothalamus and stored in the Posterior Pituitary Gland |
| What is the function of ADH? | Itrestores blood volume by reducing diuresis and increasing water retention. |
| What stimulate the release of ADH? | Increased serum osmolality or decreased blood volume; Once stimulated it signals the kidney's reabsorption of water |
| Which cells in teh kidney secrets RENIN that leads to the production of Angiotensin II ? | Juxtaglomerular Cells |
| What is produced due to the stimulation of Angiotensis II? | Aldosterone |
| What is the function of Aldosterone? | It regulates the reabsorption of water and sodium within the nephrons. |
| What hormone is released when the atrial pressure increases? | Atrial Natriuretic Peptide |
| What is the purpose of Atrial Natriuretic Peptide? | It counteracts the effects of the renen-Angiotensin-Aldosterone System by decreasing blood pressure and reducing the intravascular blood volume; Suppresses renin levels; Decreases ADH relaese; Causes Vasodilation |
| What is the normal response to thirst? | To drink |
| What is Osmolality? | A physical property of a solution which is based on the concentration of solutes. |
| What is the body's response to an increased Osmolality? | Secertion of ADH and Sensation of thirst |
| What are the effects of fluid intake, from the sensation of THIRST, on the body? | Increases water content in the ECF; Dilutes eleveted Sodium levels; Decreases osmolality of the plasma |
| What is anothe name for Antidiuretic Hormone (ADH)? | Vasopressin |
| What area of the kidney does the secretion of ADH affect? | It affects the collecting ducts in teh kidneys to increase water absorption |
| What disease is caused by the deficieny or or failure to produce ADH? | Diabetes Insipidus, Which results in hypernatremia and dehydration |
| Sodium and its associated ions account for what percentage of osmotic activity in the plasma? | 90% |
| How are osmolality and volume related? | Osmolality is regulated by change in water balance; Volume is regfulated by changes in sadium balance. |
| What is are teh effects of excess water intake? | Lower plasma osmolality; Suppressed ADH and sensation of thirst |
| What is the clinical significance of excess water intake? | Hypo-osmolality and Hyponatremia |
| What are the effects water deficiency? | Increased plasma osmolality; ADH and thirst sensation activation |
| What is the clinical significance of Water deficiency? | Hyper-osmolality and hypernatremia |
| When does Hypernatremia become an issue (type of patients)? | Infants, Unconscious patients, or anyone unable to drink or ask for water |
| What type of specimens are used to test for Osmolality? | Urine or Serum; Plasma not recommended to possible anticoagulant coagulation |
| What is the Freezing Point Depression? | Solutions cool the expand when they freeze; By determining the freezing point you can determine the amount of particles based on the freezing curve; this method used by most Osmometers |
| In Vapor Pressure, can more or less solvent escape into vapor phase when solutes are added? | Less |
| What is teh formula for calculated Osmolality? | 1.86(Na)+ (Glucose/18) + (BUN/2.8) |
| What is the difference between the measured and calculated osmolality? | Osmolal Gap; It is indicative of dissolved particles in the serum |
| What are Electrolytes? | Ions capable of electrical charge |
| How are Ions classified? | 1. Cations (positively charged; migrates towards cathode); 2. Anions (negatively charged; migrates towards the anode) |
| where are Electrolytes located? | Tissues, Bones, and Fluids |
| What is Electroneutrality? | Ions have different concentrations but totals balance to achieve a neutral charge |
| What are the 4 Extracellular Ions? | Sodium; Chloride; Calcium; Bicarbonate |
| What are the 4 Intracellular Ions? | Potassium; Phosphate; Magnesium; Calcium |
| Which Ions have a general function of body hydration? | Na; K; Cl |
| What Ions have the general function of enzyme activation? | Mg; Ca; Zn |
| Which Ions have the general function of Neuromuscular activity? | Ca; K; Mg |
| What is the principal extracellular cation? | Sodium |
| Which Ion accounts for 90% of all extracellular cations? | Na |
| How many mmol/L is Sodium and it's associated Ions of normal plasma? | Sodium makes up 270 mmol/L of Normal Plasma (290 mmol/L) |
| What is the primary function of Na? | Body hydration |
| What percentage of filtered sodium is reabsorbed in the proximal tubule? | 60 - 75% |
| What is the renal threshold for Na? | 110 - 130 mmol/L |
| How does Aldosterone affect renal absorption? | If aldosterone is increased then renal absorption is increased; If aldosterone is decreased, then renal absorption is decreased. |
| What is Primary Aldosteronism? | A disease characterized by a hypersecretion of aldosterone which increases renal tubular reabsorption of sodium; results in increase in ECF and Increased excretion of K and increase of K in ECF. |
| What 3 ways is sodium regulated? | Intake of water in response to thirst; Excretion of water; Blood volume status |
| What is the serum plasma reference for Na? | 136 - 145 mmol/L |
| What is the reference range in urine (24 hour) for Na? | 20 -220 mmol/day; varies with diet |
| What is the reference range for Na in the CSF? | 136 - 150 mmol/L |
| What is hyponatremia? | A deficiency in Sodium in the blood; Serum/plasma < 135mmol/L |
| What level of Na in the serum /plasma is clinically siginificant for hyponatremia? | < 130 mmol/L |
| What may decreased sodium levels be caused by? | Increased Na loss; Increased water retention; Water imbalance |
| What are some symptoms of hyponatremia (<125 mmol/L)? | Nausea/vomiting; Muscle weakeness; Ataxia (failure of muscle coordination); coma; headache; lethargy; seizures; respiratory depression |
| Whta is Hypovolemic Hyponatremia? | An abnormallydecreased volume of circulationg fluid in the body with a sodium loss in excess of water loss |
| What type of symptoms will a patient have if their Na level is between 125 - 130 mmol/L? | Gastrointestional |
| What are the lab findings for hypovolemic hyponatremia? | Urine Na > 20 mmol/day; renal loss of sodium and water occuring |
| What is hypervolemic hyponatremia? | Increased volume of circulating fluids in teh body with a loss of sodium in excess of water loss |
| What is nearly a problem of water overload? | Edema |
| What are the lab findings of hypervolemic hyponatremia? | Urine Na > 20 mmol/day (acute or chronic renal failure); Urine Na < 20 mmol/day (nephrotic syndrome, Cirrhosis; CHF) |
| What is Hypernatremia? | Increased sodium concentration ( 150 mmol/L) |
| What are some ways that a loss of hypotonic fluid may occur? | by the kidneys; profuse sweating; diarrhea; severe burns |
| What are the lab findings in hypernatremia? | High urine osmolality; Increased hematocrit and protein; BUN increased; Creatinine normal; Specific gravity very high; Serum Na > 160 mmol/L |
| What do most symptoms of hypernatremia commonly involve? | Central Nervous System |
| What is the /principal major intracellular cation? | Potassium |
| What is the renal threshold for Potassium? | it exhibits no renal threshold |
| Where does 2% of the body's potassium circulate? | the Plasma |
| What are the functions of Potassium? | Regulation of neuromuscular excitability; Contraction of the heart; ICF volume; Hydrogen ion concentration |
| What can cause an erroneosly high K during venipuncture? | Forearm exercise |
| Where is nearly all of the K reabsorbed? | Proximal tubules |
| What is the reference range for K? | Plasma, serum- 3.4 - 5.0 mmol/L; Urine (24 hr) 25 - 125 mmol/day |
| What is hypokalemia? | Plasma K concentration below the lower limit of the reference range |
| What can cause hypokalemia? | GI loss; Renal loss; Increased cellular uptake; Decreased intake |
| What are the symptoms of hypokalemia when it is < 3mmol/L? | muscle weakeness; fatigue; constipation |
| How may mild hypokalemia be corrected? | With diet rich in K ( dried fruit, Bran cereal, Orange juice, Nuts, Bananas |
| What is Hyperkalemia? | K concentration above the upper limit of the reference range |
| What level does the potassium have to reach before a patient will experience muscle weakness? | 8 mmol/L |
| What is the short term treatment for hyperkalemia? | Administer calcium |
| What substances will shift K back into the cell during hyperkalemia? | sodium Bicarbonate, Glucose, Insulin |
| What is a major extracellular anion that shifts to the movement of Na and HCO3 ions? | Chloride |
| What are the functions of Chloride? | Maintains osmolality, Blood volume, Electric neutrality |
| What is hypochloremia? | An abnormally high level of chloride in the blood |
| Cystic Fibrosis causes an obstruction of What glands? | The exocrine glands (including the sweat glands, mucous glands, and pancreas) |
| What type of disease is Cystic Fibrosis? | An autosomomal, recessively inherited disease of infants anf children |
| What is the single most accepted common diagnostic tool for the clinical ID of cystic fibrosis? | Sweat Chloride Test |
| What is the predominate intracellular anion? | Phosphate |
| Where is 80% of the body's total phosphate contained? | In the bones |
| which electrolyte promotes energy transfer to cells through the formation of ATP? | Phosphate |
| Which electrolyte is the primary ingredient in 2, 3 diphosphoglycerate (2, 3 DPG) ? | Phosphate |
| Loss of regulation by which organ has, has the most profound effect on Phosphate levels? | Kidneys |
| Which are the factors that affect the regulation of Phosphate? | Vitamin-D, Clacitonin, Growht Hormone, Acid-base status, and Parathyroid Hormone (most important factor) |
| What is hyophosphatemia? | Abnormal decrease of phosphate in the blood |
| What dietary deficiencies can cause Rickets? | Vitamin-D or Phosphate |
| What is VDDR (Vit D dependent rickets) caused by? | A deficiency in teh renal reabsorption of phosphate resulting in a low serum calcium and a low phosphate |
| What is hyperphosphatemia? | Abnormal increase of phosphate in teh blood; Most common cause renal failure |
| What can cause an increased breakdown of cells to result in hyperphosphatemia? | Secere infection, Intensive exercise, Neoplastic disorders, and Intravascular hemolysis |
| Circulating phospahte levels are subject to what type of rhythm? | Circadian Rhythm |
| What is the 4th most abundant cation and 2nd most abundant intracellular ion? | Magnesium |
| How much magnesium is contained in the average human body? | 24 g |
| How much magnesium is bound to protein? | 1/3 |
| what is the function of magnesium? | It is the essential cofactor in > 300 Enzymes |
| What are some good sources of Magnesuium in a diet? | Raw nuts, dry cereal, frutis, vegtables, meat, fish, "hard" drinking water |
| What increases the renal reabsorption and wnhances the absorption of Magnesium in the intestine? | PTH |
| Which hormones has the opposite effect of PTH with Mg causing increased excretion? | Aldosterone and Thyroxine |
| What is hypomagnesia? | Abnormally low Mg content of the blood |
| What are symptom of hypomagnesia if the serum level is .59 mmol/L? | Patient will be asymptomatic until serum level falls below .5 mmol/L |
| What may be the symptoms of a patient with a Mg serum level of .48 mmol/L? | Most frequent symptoms involve cardiovascular, neuromuscular, psychiatric, and metabolic abnormalities |
| If a patient with hypomagnesia is severely ill what solution will be given parenterally? | MgSO4 |
| What is hypermagnesemia? | Abnormally high level of Mg in the blood; most common cause renal failure |
| When could MgSO4 cause hypermagnesemia? | Increased intake and therapeutic intake with preeclampsia, cardiac arrythmia, and MI |
| What are some mild to moderate symptoms of hypermagnesemia? | Hypotension, bradycardia, flushed skin, increased temp, nausea, vomiting, and lethargy |
| What are the 3 forms that calcium exist in? | Protein-bound (40% mostly albumin, Ionized (45%), and complexed ( 15% bound to anions |
| What are the irregular muscle spasms called that's caused by a decreased ionized calcium? | Tetany |
| What increases total calciumbut does not affect ionized calcium? | Hyperalbuminemia |
| What are the functions of calcium? | forms teeth and bones (with P), helps maintain cell structure anf formation, Plays role in cell membrane permeability and impulse transmission, affects contraction of muscles, and plays role in blood clotting process and release of hormones |
Created by:
Nsikanete
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