stcc Electrolytes
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| anion | negative charge; move toward positive anode
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| cation | postive charge; move toward negative cathode
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| active transport | mechanism that requires energy to move ions across cellular membranes
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| diffusion | passive movement of ions across a membrane; depends on size/charge of ion, nature of membrane
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| antidiuretic hormone (ADH) | vasopressin; controls osmolality; natual response to thirst
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| osmolality | physical property of a solution based on the concentration of solute per kilogram of solvent
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| decreased blood vol response | vol receptors/thirst sensation; secration of epinephrine/norepinephrine; production of angiotensin II; decreased GFR
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| increased blood vol response | release of atrial natriuretic peptide (ANP); vol receptors; increase GFR; increased plasma sodium
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| osmolality determination | as freezing point increases, vapor pressure decreases
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| osmolality ranges | serum 275-295mOsm/kg; urine(24hr) 300-900mOsm/kg; urine/serurm ratio 3.0-1.0
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| sodium | major extracellular cation; major function is determining osmolality of plasma
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| sodium regulation | controlled by intake of water, water excretion, blood volume status
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| sodium balance | extra/intracellular balance through active transport
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| hyponatremia | sodium levels less than 135mmol/L; vomiting, diahrrea, severe burns
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| hypernatremia | sodium levels greater than 145mmol/L; excessive water loss, decrease water intake, increased intake/retention
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| specimens for testing sodium levels | serum, plasma, urine, CSF
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| testing methods for sodium | ISE (semipermiable membrane) or chemical
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| potassium | major intracellular cation; major function-regulate neuromuscular excitability (heart contractions) and control of hydrogen ion concentration for acid base balance
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| potassium regulation | through the cells and kidneys
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| hypokalemia | potassium levels lower than 3mmol/L; GI loss, renal loss
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| hyperkalemia | potassium levels greater than 5mmol/L; cellular shifts, increased intake, decreased renal excretion
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| specimens for testing potassium | serum, plasma, urine
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| testing methods for potassium | ISE using a valinomycin membrance
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| hemolysis will effect results for these electrolytes | potassium, phosphate, chloride
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| potassium ranges | plasma, serum 3.4-5.0mmol/L; urine(24hr) 25-125mmol/day
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| sodium ranges | serum, plasma 136-145mmol/L; urine(24hr) 40-220mmol/day; CSF 136-150mmol/day
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| chloride | major extracellular anion; functions- body hydration, ionic neutrality, blood volume, maintain osmotic pressure
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| chloride shift | chloride maintains neutrality in RBCs where bicarbonate diffuses out of the cell while chloride diffuses into RBC
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| specimens for testing chloride | serum, plasma, sweat
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| testing method for chloride | ISE or colormetric
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| sweat test | diagnoses cystic fibrosis
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| chloride ranges | plasma/serum 98-107mmol/L; urine(24hr) 110-250mmol/day
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| bicarbonate ranges | serum/plasma 22-29mmol/L
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| bicarbonate | 2nd most abundant extracellular anion; function-buffer blood formed from CO2 within cells
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| bicarbonate regulation | electrical neutralility
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| metabolic acidosis | bicarbonate combines with H+ producing CO2--> exhaled in lungs
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| metabolic alkalosis | retention of bicarbonate
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| hyperchloremia | excessive loss of bicarbonate ions; caused by GI losses, RTA, metabolic acidosis
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| hypochloremia | excessive loss of chloride; caused by vomiting, diabetiv ketoacidosis, increase levels of HCO3
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| specimens for bicarbonate testing | serum, plasma; must remained capped
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| method for testing bicarbonate | ISE or enzymatic (NADH measured)
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| magnesium | 2nd most abundant intracellular ion, 4th most abundant cation; function- essential cofactor for enzymatic reactions
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| magnesium found in these body sites | bone, intracellular, extracellular
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| magnesium found in these forms extracellulary | free ionized, bound to protein, complexed to anions
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| regulation of magnesium | diet, through kidney reabsorption/excretion
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| specimens for testing magnesium | serum, plasma
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| magnesium ranges | serum, plasma 0.63-1.0mmol/L
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| testing methods for magnesium | colormetric using formazen, methythymol dyes
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| calcium | divalent cation (2pos charges)
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| calcium found | bone, heart muscle, clotting factors
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| forms of calcium in plasma | bound to protein, complexed to anions, free/ionized
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| hormaones that control calcium | parathyroid (increases); vitamin D (increases); calcitonin (decreases)
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| specimens for testing calcium | serum, plasma
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| testing method for calcium | ISE; colormetric, using ortho-cresolphthalein complexone(CPC) or arsenzo III
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| phosphate | major intracellular anion; functions- component of DNA/RNA, coenzyme for enzymatic reactions, enery source, buffer for the release of O2 from hemoglobin
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| phosphate regulation | by renal excretion/reabsorption and by hormones - PTH, vitamin D, growth
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| specimens for phosphate | serum, plasma
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| highest levels of phosphate | in the morning
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| testing method for phosphate and wavelength | colormetric- using ammonium phosphomolybdate complex (340nm) or molybdenum blue (600-700nm)
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| phosphate ranges | serum/plasma - child 1.45-1.78mmol/L, adult 0.87-1.45mmol/L; urine(24hr) 13-42mmol/day
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| lactate | end product of anaerobic glycolysis; function-early indicator of oxygen deprivation
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| gluconeogenisis | process occuring in liver that converts lactate back to glucose
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| tesing method for lactate | enzymatic--> coupled with peroxidase to form a color
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| collection requirements for lactate | no tourniquet used and no prior exercise; specimen delivered on ice and separated quickly
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| lactate ranges | venous- 0.5-2.2mmol/L; arterial 0.5-1.6mmol/L; CSF 1.1-2.4mmol/L
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| anion gap | approximation of the difference between unmeasured anions and unmeasured cations
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