Body Fluids and Water Quality Quiz

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Questions and Answers

What is the primary reason for using borosilicate glass or polyethylene bottles for Types II and III water?

They do not absorb gases.

They are cheaper than other materials.

They prevent contamination with airborne microbes. (correct)

They can withstand high temperatures.

What is one common source of water for healthcare facilities that may contain various contaminants?

Bottled water

Rivers (correct)

Rainwater

Filtered water

Which of the following impurities is NOT removed during the distillation process?

Minerals like iron and magnesium

Microbiological organisms

Dissolved gases

Chlorine (correct)

What is the effect of tightly stoppering containers for Types II and III water?

It prevents absorption of gases. Signup and view all the answers

Which process may need to follow distillation to achieve the desired purity level of water?

Deionization Signup and view all the answers

What is the purpose of using double distillation in laboratory settings?

To remove contaminating ammonia. Signup and view all the answers

What kind of contaminants may still be found even in deionized water?

Dissolved gases and nonvolatile substances Signup and view all the answers

What happens to the water during the distillation process?

It transforms into steam and then condenses. Signup and view all the answers

What type of water is produced after deionization and further treatment with membrane filtration and activated charcoal?

Type I water Signup and view all the answers

Which of the following is a characteristic of reverse osmosis?

It removes approximately 90% of dissolved solids. Signup and view all the answers

What is the primary purpose of using activated charcoal in water purification?

To adsorb organic matter. Signup and view all the answers

Osmolality is defined as the number of osmoles of solute per what measurement?

Kilogram of solvent Signup and view all the answers

Which process removes approximately 98% of organic impurities from water?

Reverse osmosis Signup and view all the answers

What does an osmole measure in a chemical solution?

Concentration of compounds affecting osmotic pressure Signup and view all the answers

What additional process is recommended to remove microscopic organisms after deionization?

Ultraviolet oxidation Signup and view all the answers

Which statement about the combination of deionization and distillation is true?

It eliminates the requirement for double distillation. Signup and view all the answers

What is urine osmolality primarily a measure of?

Number of particles dissolved in urine Signup and view all the answers

Which of the following ions contribute significantly to serum osmolality?

Sodium ions Signup and view all the answers

How is the osmolal gap calculated?

Calculated osmolality minus measured osmolality Signup and view all the answers

What is the average osmolal gap range considered normal?

0 to 10 mOsm/kg H2O Signup and view all the answers

What condition is primarily investigated by measuring serum osmolality?

Hyponatremia Signup and view all the answers

Which hormone primarily influences water excretion?

Antidiuretic hormone (ADH) Signup and view all the answers

What primarily affects sodium excretion in the blood?

Fluid intake and thirst Signup and view all the answers

Which of the following best describes electrolytes?

Substances that form ions when dissolved in water Signup and view all the answers

What is the mean fecal Na+ excretion generally considered to be?

Less than 10 mmol/day Signup and view all the answers

In cases of severe diarrhea, what is the maximum fecal loss of K+ that can occur?

60 mmol/day Signup and view all the answers

What is the most significant anion in extracellular fluids?

Chloride (Cl) Signup and view all the answers

What role does chloride (Cl) play in the buffering action during CO2 exchange in red blood cells?

Cl travels from RBCs to plasma to maintain balance Signup and view all the answers

How does the kidney influence electrolyte concentration?

It regulates electrolyte concentration and volume Signup and view all the answers

What condition might lead to high serum levels of chloride (Cl)?

Dehydration and decreased renal blood flow Signup and view all the answers

What is the reciprocal relationship between chloride (Cl) and bicarbonate (HCO3) in the body?

A decrease in Cl results in an increase in HCO3 Signup and view all the answers

Which of the following conditions may result in low serum chloride (Cl) levels?

Chronic pyelonephritis after salt loss Signup and view all the answers

What condition may lead to low chloride (Cl) levels in the body?

Prolonged vomiting Signup and view all the answers

What percentage of bicarbonate (HCO3) is reabsorbed by the proximal tubules of the kidney?

85% Signup and view all the answers

What is the primary method for measuring bicarbonate in the blood?

Total CO2 measurement Signup and view all the answers

An anion gap greater than 16 mmol/L typically indicates what?

Increased concentrations of unmeasured anions Signup and view all the answers

Which ions are included in the calculation of the anion gap?

Na+, K+, Cl-, and HCO3 Signup and view all the answers

What role does bicarbonate (HCO3) play in evaluating acid-base disorders?

Must be interpreted in the context of other electrolytes Signup and view all the answers

What is one of the products formed during the metabolic dissociation of carbonic acid (H2CO3)?

Hydrogen ions (H+) Signup and view all the answers

Which anion is not directly measured in routine bicarbonate assays?

Phosphate (PO4^3-) Signup and view all the answers

Which action prior to venipuncture can falsely elevate plasma potassium levels?

Opening and closing the fist Signup and view all the answers

What is the main reason for separating cells from plasma or serum within 3 hours after blood collection for potassium testing?

To avoid a shift of K+ from the RBCs to the plasma Signup and view all the answers

Which anticoagulant is most commonly used for chloride testing?

Sodium heparin Signup and view all the answers

What is the best practice for handling specimens intended for total CO2 assays?

Handle them anaerobically to minimize gas loss Signup and view all the answers

What is the effect of moderate hemolysis on chloride concentration in serum?

It does not affect Cl concentration significantly Signup and view all the answers

Which method is incorporated into many automated chemistry analyzers for measuring sodium ions?

Ion-selective electrode potentiometry Signup and view all the answers

What is a characteristic of potassium levels in plasma compared to serum?

They are lower in plasma due to platelet release Signup and view all the answers

What is the recommended action to ensure accurate bicarbonate concentration measurement immediately after collection?

Seal the container immediately with a stopper Signup and view all the answers

Study Notes

Body Fluids

Body fluids are essential for many biological processes.
Water, electrolytes, acid-base balance, anion gap, osmolality, and laboratory considerations are topics covered.

Water

Methods exist to test water purity.
The presence of ionized materials affects water's ability to conduct electricity.
Water's conductance (or resistance) is used in purity testing.
Pure water has a higher resistance than contaminated water.
Purity meters and conductivity lights on water purification systems use measured conductance or electrical resistance to detect contaminants like dissolved ionized matters.
Water used in labs should be tested for quality.
Different preparation methods for highly pure water may be referred to using terms like nitrogen-free, double-distilled, or conductivity water.
Dissolved gases (like CO₂) and organic contaminants affect water quality.
Substances dissolved from container storage can contaminate water.
Water quality must be assessed based on the method of preparation and intended use, for specific laboratory analysis and reagent preparation needs.
Water containing metals notably affects the accuracy of some lab assays.
Reagent water, Type I is to be used immediately post preparation to prevent CO₂ absorption.
Type II and III type water can be stored, but should be used promptly to avoid microbiological contamination.
Water containers must be tightly covered to avoid gas absorption.
Water purification methods vary based on the source.
Common methods are deionization and distillation.
Sometimes distilled water requires further treatment (e.g., deionization).
Distillation involves boiling and cooling, producing condensed steam.
Distillation removes most minerals but not volatile impurities (e.g., CO2, chlorine, ammonia).
Double-distilled water reduces water contamination and is sometimes needed for assays or determinations needing specific contaminant-free water to achieve the desired purity and accuracy.
In deionization, water is passed through resin columns containing charged particles.
Only ionizable substances are removed.
Further treatment (e.g., membrane filtration, activated charcoal) removes non-ionizable impurities or organic matter found in deionized water.
Water purifiers often combine deionization and distillation to eliminate the need for double distillation.
Reverse osmosis uses a membrane under pressure to remove dissolved solids and organic impurities, maintaining some dissolved gases.

Osmolality & Osmolarity

Osmolality and osmolarity measure solute concentration in body fluids (e.g. urine and blood)
An osmole measures the number of solute particles that contribute to osmotic pressure.
Osmolality is expressed as osmoles per kilogram of solvent.
Urine osmolality is a more accurate measure of concentration compared to specific gravity.
The reference range for adult serum osmolality is between 275 and 295 mOsm/kg.
The osmolal gap reflects the difference between calculated and measured osmolality.
Common causes of elevated osmolal gaps include conditions like ketonemia, alcoholism/intoxicants.

Electrolytes

Electrolytes are charged particles (ions) when dissolved in fluid.
Electrolytes are either anions or cations.
Electrolytes like sodium, potassium, calcium, magnesium, chloride, and bicarbonate are crucial.
Electrolyte concentrations vary among body compartments (e.g., plasma, serum, urine)
Electrolyte imbalances result from issues with excretion or conservation.
Imbalances can be harmful or fatal as many vital metabolic processes depend on them.

Sodium (Na+)

Sodium is the major extracellular cation.
Sodium balances osmotic pressure and electrolyte balance.
Low serum sodium (hyponatremia) is seen in several conditions, including severe polyuria, metabolic acidosis, Addison's disease, diarrhea, and some renal tubular diseases.
Excess sodium (hypernatremia) often results from congestive heart failure, liver disease, renal disease.
Excessive water loss, diabetic coma, Cushing syndrome all feature increased sodium.
The kidneys play a role in regulating sodium levels by conserving or excreting it, depending on body hydration.

Potassium (K+)

Potassium is the major intracellular cation.
Potassium maintains crucial muscle actions, particularly in the heart.
Inadequate potassium intake can lead to hypokalemia.
Hypokalemia results from prolonged diarrhea, vomiting, or poor nutritional intake.
Hypokalemia is critical but the body is still able to excrete significant levels of K+.
Excess potassium (hyperkalemia) potentially results from kidney dysfunction or urinary obstruction.
Adrenocortical hormones and acid-base balance affect potassium.
Kidney failure leads to elevated potassium.

Chloride (Cl-)

Chloride is the major extracellular anion.
Maintaining osmotic pressure and electrical neutrality are key functions.
The amount of chloride (Cl-) typically fluctuates in tandem with HCO3-.
High serum/plasma chloride (Cl-) can be due to excess Cl- intake or severe dehydration conditions.
Low serum/plasma chloride can be due to prolonged vomiting, acidosis, or certain kidney diseases like chronic pyelonephritis.

Bicarbonate (HCO3-)

Bicarbonate is another essential extracellular anion.
Bicarbonate is a major component in acid-base balance.
Filtered through the kidneys, but minor amounts are in urine.
A key part of metabolic reactions involving CO₂ and H₂O, converting into carbonic acid (H₂CO₃).
The rate of CO₂ released is assessed for total CO₂ levels.

Anion Gap

The anion gap is a calculation to check acid-base balance and electrolyte disorders.
Measuring the difference between anions (e.g., Chloride, Bicarbonate) minus cations (e.g., Sodium, Potassium) in the blood.
A healthy person's anion gap is typically between 8 and 16 mmol/L.
An increased gap usually points to high unmeasured anions (like phosphates or proteins).
Possible causes include ketoacidosis or lactic acidosis.
Decreased gap can imply low unmeasured anions or high cations (like calcium or magnesium).
Increased anion gap is notably seen in certain medical conditions, like ketoacidosis, lactic acidosis, and some intoxications.
The anion gap acts as a secondary diagnostic indicator (quality check) for electrolyte results. In the presence of an anion gap elevated in a supposedly healthy person, this indicates that more tests on the sample may be required to confirm that the test results are error-free.

Important factors and considerations for body fluid specimen testing

Plasma/serum, urine, and other body fluids are suitable for electrolyte testing.
Lithium heparinized specimens are useful for testing except for sodium.
Capillary tubes collect body fluid specimens, and require analysis as soon as possible.
Appropriate methodology/technique is critical in analysis to prevent errors or contamination,
Specific handling and technical requirements for a variety of specimen tests must be considered per electrolyte type.

Methods for quantitative electrolyte measurement

Electrolytes are often measured together using ion-selective electrodes (ISEs).
ISEs use selective membranes for specific electrolytes (Na+, K+,Cl-,HCO3-)
Measurements are made on undiluted (direct) or diluted (indirect) samples,
Factors that can affect measurements ( e.g., protein, lipids, etc. ) must be considered.

Reference values

Serum levels of specific electrolytes vary and are expressed in mmol/L.

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Description

Test your knowledge on the essential role of body fluids in biological processes and the methods used to assess water quality. This quiz covers topics like water purity testing, the impact of dissolved materials, and laboratory considerations for maintaining optimal water standards. Dive in to understand the nuances of water conductance and the importance of purity.