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?

    <p>It prevents absorption of gases. (B)</p> Signup and view all the answers

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

    <p>Deionization (D)</p> Signup and view all the answers

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

    <p>To remove contaminating ammonia. (C)</p> Signup and view all the answers

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

    <p>Dissolved gases and nonvolatile substances (A)</p> Signup and view all the answers

    What happens to the water during the distillation process?

    <p>It transforms into steam and then condenses. (D)</p> Signup and view all the answers

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

    <p>Type I water (B)</p> Signup and view all the answers

    Which of the following is a characteristic of reverse osmosis?

    <p>It removes approximately 90% of dissolved solids. (A)</p> Signup and view all the answers

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

    <p>To adsorb organic matter. (A)</p> Signup and view all the answers

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

    <p>Kilogram of solvent (B)</p> Signup and view all the answers

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

    <p>Reverse osmosis (B)</p> Signup and view all the answers

    What does an osmole measure in a chemical solution?

    <p>Concentration of compounds affecting osmotic pressure (C)</p> Signup and view all the answers

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

    <p>Ultraviolet oxidation (A)</p> Signup and view all the answers

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

    <p>It eliminates the requirement for double distillation. (B)</p> Signup and view all the answers

    What is urine osmolality primarily a measure of?

    <p>Number of particles dissolved in urine (A)</p> Signup and view all the answers

    Which of the following ions contribute significantly to serum osmolality?

    <p>Sodium ions (B)</p> Signup and view all the answers

    How is the osmolal gap calculated?

    <p>Calculated osmolality minus measured osmolality (B)</p> Signup and view all the answers

    What is the average osmolal gap range considered normal?

    <p>0 to 10 mOsm/kg H2O (D)</p> Signup and view all the answers

    What condition is primarily investigated by measuring serum osmolality?

    <p>Hyponatremia (A)</p> Signup and view all the answers

    Which hormone primarily influences water excretion?

    <p>Antidiuretic hormone (ADH) (B)</p> Signup and view all the answers

    What primarily affects sodium excretion in the blood?

    <p>Fluid intake and thirst (A)</p> Signup and view all the answers

    Which of the following best describes electrolytes?

    <p>Substances that form ions when dissolved in water (C)</p> Signup and view all the answers

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

    <p>Less than 10 mmol/day (D)</p> Signup and view all the answers

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

    <p>60 mmol/day (C)</p> Signup and view all the answers

    What is the most significant anion in extracellular fluids?

    <p>Chloride (Cl) (C)</p> Signup and view all the answers

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

    <p>Cl travels from RBCs to plasma to maintain balance (D)</p> Signup and view all the answers

    How does the kidney influence electrolyte concentration?

    <p>It regulates electrolyte concentration and volume (D)</p> Signup and view all the answers

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

    <p>Dehydration and decreased renal blood flow (A)</p> Signup and view all the answers

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

    <p>A decrease in Cl results in an increase in HCO3 (B)</p> Signup and view all the answers

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

    <p>Chronic pyelonephritis after salt loss (B)</p> Signup and view all the answers

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

    <p>Prolonged vomiting (A)</p> Signup and view all the answers

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

    <p>85% (D)</p> Signup and view all the answers

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

    <p>Total CO2 measurement (C)</p> Signup and view all the answers

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

    <p>Increased concentrations of unmeasured anions (C)</p> Signup and view all the answers

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

    <p>Na+, K+, Cl-, and HCO3 (D)</p> Signup and view all the answers

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

    <p>Must be interpreted in the context of other electrolytes (A)</p> Signup and view all the answers

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

    <p>Hydrogen ions (H+) (D)</p> Signup and view all the answers

    Which anion is not directly measured in routine bicarbonate assays?

    <p>Phosphate (PO4^3-) (B)</p> Signup and view all the answers

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

    <p>Opening and closing the fist (A)</p> 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?

    <p>To avoid a shift of K+ from the RBCs to the plasma (A)</p> Signup and view all the answers

    Which anticoagulant is most commonly used for chloride testing?

    <p>Sodium heparin (A)</p> Signup and view all the answers

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

    <p>Handle them anaerobically to minimize gas loss (D)</p> Signup and view all the answers

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

    <p>It does not affect Cl concentration significantly (D)</p> Signup and view all the answers

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

    <p>Ion-selective electrode potentiometry (A)</p> Signup and view all the answers

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

    <p>They are lower in plasma due to platelet release (D)</p> Signup and view all the answers

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

    <p>Seal the container immediately with a stopper (B)</p> Signup and view all the answers

    Flashcards

    What is distilled water?

    Water that's been boiled and the steam is cooled and collected. This removal process eliminates many minerals but not volatile impurities like CO2, chlorine, or ammonia.

    What is distilled water used for?

    A type of water purified through the process of distillation. This water usually meets the specifications for Type II and Type III water.

    What is double-distilled water?

    A special type of distilled water that undergoes another distillation step to remove contaminating ammonia. This is important for tests where ammonia can interfere with results.

    How is deionized water produced?

    This method of water purification passes water through a resin column containing positively and negatively charged particles. These particles remove ions from the water, leading to deionized water.

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    What is deionized water?

    Water that is free from most ions. This can be achieved through distillation or deionization. It's essential for many laboratory and industrial applications.

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    How do I store Type II and Type III water?

    Type II and Type III water should be stored in borosilicate glass or polyethylene bottles as they are less likely to contaminate the water.

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    Why should Type II and Type III water be used quickly?

    Type II and Type III water need to be used quickly to prevent contamination from air.

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    What are some contaminants found in water?

    Water sources vary greatly, with rivers, lakes, springs, and wells containing numerous contaminants.

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    Deionized Water

    Water treated to remove most ions, typically using ion-exchange resins.

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    Reverse Osmosis

    A process where water is passed through a semipermeable membrane, removing most dissolved solids, organic impurities, microbes, leaving water relatively pure.

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    Osmole

    A unit of measurement that describes the number of moles of a compound contributing to a solution's osmotic pressure.

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    Osmolality

    The concentration of a solute in a solution, expressed as osmoles per kilogram of solvent.

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    Distillation

    The process of heating water to vapor, then condensing the vapor to collect pure water, leaving impurities behind.

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    Ultrafiltration

    A purification technique using a porous membrane to physically trap large molecules, particles, and microbes.

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    Adsorption

    A purification method where a substance's surface attracts and holds specific impurities, removing them from the water.

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    Ultraviolet Oxidation

    A method using a high-energy ultraviolet light to break down organic contaminants in water.

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    Urine Osmolality

    A measure of urine concentration based on the number of dissolved particles. It is measured in milliosmols per kilogram (mOsm/kg).

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    Osmolal Gap

    The difference between the measured osmolality and the calculated osmolality. It's used to identify the presence of substances like ketones or alcohol in the blood that aren't accounted for in the standard osmolality calculation.

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    Plasma Osmolality

    The condition to which the hypothalamus responds by regulating water intake and excretion to maintain a stable level of dissolved particles in the blood. It is primarily controlled by the balance of electrolytes, especially sodium.

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    Hyponatremia

    The amount of sodium in the blood is too low. It can be caused by excessive water intake, water retention due to medical conditions, or decreased ability of the kidneys to produce urine.

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    Regulation of Plasma Sodium (Na+)

    The process of maintaining a stable concentration of sodium in the blood. It involves regulating water intake, water excretion, and blood volume through hormones like ADH, aldosterone, and angiotensin II.

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    Electrolytes

    Substances that form ions or charged particles when dissolved in water. They are either negatively charged anions or positively charged cations.

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    Antidiuretic Hormone (ADH)

    A hormone released by the pituitary gland that helps to regulate water excretion by the kidneys. It plays a role in maintaining water balance and blood volume.

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    Aldosterone

    A hormone secreted by the adrenal glands that helps to regulate sodium and potassium balance in the body. It plays a key role in maintaining blood pressure.

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    What is the normal amount of sodium (Na+) in feces?

    The amount of sodium (Na+) in feces usually stays under 10mmol per day. This is a normal level.

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    How much potassium can be lost in severe diarrhea?

    Severe diarrhea can lead to a significant loss of potassium (K+), up to 60 mmol per day, which needs addressing.

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    What is the relationship between potassium levels in CSF and plasma?

    The concentration of potassium (K+) in Cerebrospinal Fluid (CSF) is about 70% of the amount in blood plasma.

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    How does dietary potassium affect its excretion?

    The amount of potassium (K+) released in urine changes based on how much potassium is consumed. Typically, it ranges from 25 to 125 mmol per day.

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    Where is chloride found in the body?

    Chloride (Cl-) is found in many bodily fluids, including serum, plasma, CSF, tissue fluid, and urine.

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    What is the relationship between Chloride and Bicarbonate?

    The balance between chloride (Cl-) and bicarbonate (HCO3-) in the extracellular fluid is important. They have a reciprocal relationship, meaning an increase in one leads to a decrease in the other.

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    What is the role of Chloride in electrical neutrality?

    Chloride (Cl-) plays a crucial role in maintaining the electrical neutrality of fluids in the body. It's like the balancing element for sodium (Na+).

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    What is the chloride shift?

    Chloride (Cl-) is involved in the chloride shift, which is the movement of chloride and bicarbonate between red blood cells and plasma during oxygenation and deoxygenation of blood.

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    What is Anion Gap?

    A calculation that reflects the difference between positively charged electrolytes (cations) and negatively charged electrolytes (anions) in your blood. It helps assess acid-base balance and detect electrolyte imbalances.

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    What is Chloride (Cl-)?

    Chloride (Cl-) is a major extracellular anion, playing a role in fluid balance and maintaining electrical neutrality. It's often measured alongside bicarbonate (HCO3-), another key anion, in blood tests.

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    What is Bicarbonate (HCO3-)?

    Bicarbonate (HCO3-) is a crucial buffer in the body, helping to regulate blood pH by absorbing excess hydrogen ions. It's essential for maintaining acid-base balance.

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    What is Metabolic Acidosis?

    This condition results from either excessive production or insufficient excretion of acids within the body. It can be caused by diabetic acidosis (high blood sugar) or renal failure (kidney malfunction).

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    What can cause decreased Chloride levels in the blood?

    This can be caused by prolonged vomiting, leading to loss of stomach acid and a decrease in serum chloride levels.

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    Why is total CO2 measurement important?

    This measurement, along with blood pH and CO2 pressure (PCO2), is crucial for evaluating acid-base disorders. By measuring total CO2, we can get a snapshot of how well the body is managing acid levels.

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    What does an elevated Anion Gap indicate?

    When the anion gap exceeds 16mmol/L, it suggests an increased concentration of unmeasured anions like phosphate (PO4-) and sulfate (SO42-) in the blood. This may indicate underlying medical conditions like kidney disease.

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    How do the kidneys manage Bicarbonate (HCO3-)?

    The kidneys reabsorb bicarbonate (HCO3-), a crucial buffer for blood pH, in two main regions: the proximal tubules reabsorb about 85%, while the distal tubules reabsorb the remaining 15%. This reabsorption ensures that the body maintains proper acid-base balance.

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    Potassium (K+) accuracy

    Potassium levels measured in blood can be inaccurate if the blood isn't separated from the cells within 3 hours because potassium can shift from red blood cells to the plasma.

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    Fist clenching impact on K+

    Opening and closing the fist too many times before a blood draw for potassium testing can significantly increase potassium levels (10-20%) due to muscle activity.

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    Serum vs. Plasma K+

    Serum potassium levels are slightly higher than plasma potassium levels due to the release of potassium from platelets during clotting.

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    Chloride test specimen

    Chloride (Cl-) tests are often performed using serum separator gel tubes, allowing separation and stability.

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    Chloride and hemolysis

    Hemolysis (red blood cell breakdown) doesn't significantly impact chloride levels in serum.

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    Bicarbonate (HCO3-) specimen

    Arterial blood is the preferred sample for bicarbonate (HCO3-) analysis. Bicarbonate is measured in plasma or serum.

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    Bicarbonate (HCO3-) handling

    HCO3- levels are most accurate when measured quickly after blood collection and centrifugation. The specimen should be handled anaerobically to prevent CO2 loss.

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    Electrolyte profile

    Sodium (Na+), potassium (K+), chloride (Cl-) and bicarbonate (HCO3-) are commonly grouped together for laboratory analysis. These are called electrolytes.

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    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.

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