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MLT Electrolytes

MLT Electrolytes and Renal Function

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