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Clin Path Quiz 15/16
Lecture 16: Electrolytes
| Question | Answer |
|---|---|
| electrolytes | a substance with a positive or negative charge in an aqueous (fluid) solution; cations -> positive charge, anions -> negative charge |
| electrolytes used in clinical pathology | sodium (Na+), chloride (Cl-), potassium (K+), bicarbonate (HCO3-) |
| functions of electrolytes | nerve conduction and muscle function (membrane potential for muscle contractions/nerve impulses), regulate water balance in blood and osmotic fluid balance, molecule transport (across membranes), enzyme reactions, regulate body pH |
| causes of electrolyte alterations | increased or decreased intake, increased loss (kidneys, GI tract, skin), decreased excretion through kidneys, shifting into or out of cells |
| electrolyte testing | heparinized plasma or arterial blood (avoid hemolysis), routine test that can be added to in-house chemistry analysis |
| arterial blood sampling sites | dorsal metatarsal (pedal) arteries, femoral arteries, lingual arteries (only under anesthesia) |
| sodium (Na+) | major cation of the body, helps maintain normal osmolariy of blood and tissue fluid, maintains water distribution across cell membranes, regulation involves the renin-angiotensin-aldosterone system (kidneys) |
| renin-angiotensin-aldosterone system | decreased blood volume (hypovolemia) leads to increased reabsorption of Na+, CL- and H2O by the kidneys,; increased blood volume (hypervolemia) leads to inhibition of sodium of sodium reabsorption by the kidneys |
| hypernatremia | elevated sodium; result of decreased total water content (inadequate access to water, insensible loos: panting, hyperventilation, fever/sweating), excess sodium (salt toxicosis) |
| hyponatremia | decreased sodium, loss of more sodium than water in the body (GI losses: diarrhea, vomiting, renal disease, hypoadrenocorticism), excess of water in the body (congestive heart failure, diabetes mellitus |
| chloride (Cl-) | major anion of the body, often moves with sodium 'travel together', should be interpreted with sodium, measured as paart of in-house electrolyte panel of chemistry analyzer |
| hyperchloremia | elevated chloride; DEHYDRATION |
| hypochloremia | decreased chloride; GI loss, sequestration, renal disease, diuretic administration, hyperadrenocorticism |
| potassium (K+) | required for normal muscle and nerve function, serum potassium is good indicatory of total body potassium, measured as part of in-house electrolyte panel, cannot use EDTA to measure potassium |
| hyperkalemia | increased potassium; decreased renal excretion (renal insufficiency or failure, urinary tract obstruction/urine leakage into the body, hypoadrenocorticism; can lead to cardiac arrest and death |
| hypokalemia | decreased blood potassium; decreased intake of K+ (anorexia most common cause), loss (vomiting, diarrhea, diuresis), shifting K+ into cells (increased insulin) |
| sodium to potassium ratio | Na/K; measured on electrolyte panel of chemistry; low Na/K (<27) associated with hypoadrenocorticism -> hyponatremia with hyperkalemia |
| hypoadrenocorticism (Addison's disease) | inadequate secretion of corticosteroids by the adrenal cortex due to destruction of the adrenal cortices or insufficient ACTH secretion; uncommon in dogs and rare in cats), can be difficult to diagnose |
| Addison's disease commonly seen in... | young to middle aged female dogs (poodles/doodles) |
| clinical signs of Addison's disease | vomiting, weight loss, hind limb weakness, anorexia, lethargy, vomiting, weakness |
| Addisonian Crisis | signs/presentations associated with shock (profound weakness, pale mucous membranes, prolonged CRT, weak femoral pulses, dehydration, collapse), bradycardia due to hyperkalemia, vague or inconsistent signs |
| potassium in practice (cats) | CKD; expect hyperkalemia due to renal failure, cats are ussually anorexic, with severe disease we will see a hypokalemia that can be treated with diet and supplementation |
| potassium in practice (cats -> urethral obstruction) | decreased outflow of urine, post-renal azotemia, hyperkalemia |
| bicarbonate (HCO3) | buffer in the body to help maintain a normal pH, not routinely measured on electrolyte panel of in-house chemistry analyzer (blood gas analysis), total CO2 (tCO2) |
| increased bicarbonate concentration | metabolic alkalosis |
| decreased bicarbonate concentration | metabolic acidosis |
Created by:
mkroon26
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