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Questions and Answers
In diabetes insipidus, what is a typical characteristic related to fluid balance?
In diabetes insipidus, what is a typical characteristic related to fluid balance?
What is the primary function of Angiotensin II in response to decreased blood volume?
What is the primary function of Angiotensin II in response to decreased blood volume?
During an oxidation reaction within an electrochemical cell, what process occurs at the anode?
During an oxidation reaction within an electrochemical cell, what process occurs at the anode?
Electrolytes have several functions, but which of the following is NOT a key role of electrolytes?
Electrolytes have several functions, but which of the following is NOT a key role of electrolytes?
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What does potentiometry measure in an electrochemical cell?
What does potentiometry measure in an electrochemical cell?
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What is the function of the reference electrode in an ion-selective electrode (ISE) system?
What is the function of the reference electrode in an ion-selective electrode (ISE) system?
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What best describes the relationship between ion activity and ion concentration?
What best describes the relationship between ion activity and ion concentration?
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In the Renin-angiotensin system, what enzyme converts Angiotensin I into Angiotensin II?
In the Renin-angiotensin system, what enzyme converts Angiotensin I into Angiotensin II?
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What is the primary reason for avoiding the use of EDTA tubes when measuring potassium levels?
What is the primary reason for avoiding the use of EDTA tubes when measuring potassium levels?
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Why can falsely high potassium results occur if plasma or serum are not separated from cells in a timely fashion?
Why can falsely high potassium results occur if plasma or serum are not separated from cells in a timely fashion?
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What is the role of valinomycin in the ion-selective electrode used to measure potassium?
What is the role of valinomycin in the ion-selective electrode used to measure potassium?
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What is a critical level of potassium that would require immediate medical intervention?
What is a critical level of potassium that would require immediate medical intervention?
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In which fluid compartment is chloride the most abundant anion?
In which fluid compartment is chloride the most abundant anion?
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How does the body primarily regulate chloride levels, which is unlike sodium or potassium?
How does the body primarily regulate chloride levels, which is unlike sodium or potassium?
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How does the body primarily absorb chloride from the diet?
How does the body primarily absorb chloride from the diet?
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What is the primary reason fist pumping during venipuncture can cause falsely high potassium levels?
What is the primary reason fist pumping during venipuncture can cause falsely high potassium levels?
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Which of the following is the primary function of sodium in the extracellular fluid (ECF)?
Which of the following is the primary function of sodium in the extracellular fluid (ECF)?
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How does the Na+/K+-ATPase pump contribute to maintaining cell volume?
How does the Na+/K+-ATPase pump contribute to maintaining cell volume?
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Which of the following is NOT directly involved in the regulation of sodium levels in the body?
Which of the following is NOT directly involved in the regulation of sodium levels in the body?
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Which type of specimen is NOT suitable for testing sodium levels?
Which type of specimen is NOT suitable for testing sodium levels?
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What is the primary function of a reference electrode in potentiometry?
What is the primary function of a reference electrode in potentiometry?
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Which of the following is the most commonly used method for sodium analysis in clinical laboratories?
Which of the following is the most commonly used method for sodium analysis in clinical laboratories?
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According to the Nernst equation, what is the relationship between the measured potential (E) and the activity (a) of an ion?
According to the Nernst equation, what is the relationship between the measured potential (E) and the activity (a) of an ion?
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What is the principle behind sodium measurement with ion-selective electrodes (ISEs)?
What is the principle behind sodium measurement with ion-selective electrodes (ISEs)?
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What does it mean for an ion-selective electrode to be 'selective but not specific'?
What does it mean for an ion-selective electrode to be 'selective but not specific'?
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What is a key difference between direct and indirect methods of sodium measurement using ISEs?
What is a key difference between direct and indirect methods of sodium measurement using ISEs?
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Which factor is accounted for by using the Nernst equation in ion-selective electrode measurements?
Which factor is accounted for by using the Nernst equation in ion-selective electrode measurements?
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What is the expected outcome on sodium level measurement when using indirect ISE in samples with increased lipids or proteins?
What is the expected outcome on sodium level measurement when using indirect ISE in samples with increased lipids or proteins?
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How does modifying a solid material (glass) electrode with a gas-permeable membrane expand its applicability?
How does modifying a solid material (glass) electrode with a gas-permeable membrane expand its applicability?
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Which type of electrode relies on the ion-exchange process of insoluble inorganic salts for its potential generation?
Which type of electrode relies on the ion-exchange process of insoluble inorganic salts for its potential generation?
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In the context of ion-selective electrodes, what is a selectivity factor?
In the context of ion-selective electrodes, what is a selectivity factor?
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What is the primary purpose of a solution with a constant composition surrounding a reference electrode?
What is the primary purpose of a solution with a constant composition surrounding a reference electrode?
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In the chloride shift, which ion diffuses out of the red blood cells and into the plasma?
In the chloride shift, which ion diffuses out of the red blood cells and into the plasma?
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What is the primary purpose of the chloride shift?
What is the primary purpose of the chloride shift?
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Which anticoagulant is best for chloride specimen collection in plasma?
Which anticoagulant is best for chloride specimen collection in plasma?
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Which of the following conditions is associated with a decreased level of chloride in cerebrospinal fluid (CSF)?
Which of the following conditions is associated with a decreased level of chloride in cerebrospinal fluid (CSF)?
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In the amperometric-coulometric titration method for chloride analysis, what is the role of silver ions (Ag+)?
In the amperometric-coulometric titration method for chloride analysis, what is the role of silver ions (Ag+)?
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Which method of chloride analysis uses an ion-exchange membrane to selectively bind chloride ions?
Which method of chloride analysis uses an ion-exchange membrane to selectively bind chloride ions?
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A sweat chloride test result of 70 mmol/L is indicative of which condition?
A sweat chloride test result of 70 mmol/L is indicative of which condition?
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What is the relationship between sodium (Na+) and chloride (Cl-) in the body, as described in the content?
What is the relationship between sodium (Na+) and chloride (Cl-) in the body, as described in the content?
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What is the primary mechanism by which the proximal tubules reabsorb bicarbonate?
What is the primary mechanism by which the proximal tubules reabsorb bicarbonate?
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What is the relationship, if any, between total CO2 and bicarbonate (HCO3-) levels in the blood?
What is the relationship, if any, between total CO2 and bicarbonate (HCO3-) levels in the blood?
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In metabolic alkalosis, how do the kidneys contribute to restoring acid-base balance?
In metabolic alkalosis, how do the kidneys contribute to restoring acid-base balance?
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Which condition would likely lead to hypochloremia based on the given information?
Which condition would likely lead to hypochloremia based on the given information?
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What is the effect of aldosterone deficiency on chloride (Cl-) levels in the blood?
What is the effect of aldosterone deficiency on chloride (Cl-) levels in the blood?
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What is the role of the ‘chloride shift’ in maintaining proper physiological function?
What is the role of the ‘chloride shift’ in maintaining proper physiological function?
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How does the body attempt to restore proper pH levels in a state of metabolic acidosis?
How does the body attempt to restore proper pH levels in a state of metabolic acidosis?
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Which of the following conditions is MOST likely to cause hyperchloremia?
Which of the following conditions is MOST likely to cause hyperchloremia?
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Flashcards
Diabetes Insipidus
Diabetes Insipidus
A condition caused by the body's inability to produce or respond to Antidiuretic Hormone (ADH), leading to excessive urination and thirst.
Regulation of Blood Volume
Regulation of Blood Volume
The process by which the body regulates blood volume, typically involving the secretion of renin, the conversion of angiotensinogen, and vasoconstriction.
Electrolytes
Electrolytes
The chemical substances dissolved in a solution, including positively and negatively charged ions like sodium, potassium, and chloride.
Ion-Selective Electrode (ISE)
Ion-Selective Electrode (ISE)
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Potentiometry
Potentiometry
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Oxidation
Oxidation
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Reduction
Reduction
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Anode
Anode
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Indicator (ISE) Electrode
Indicator (ISE) Electrode
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Reference Electrode
Reference Electrode
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Potentiometry Principle
Potentiometry Principle
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Nernst Equation
Nernst Equation
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Selectivity Factor
Selectivity Factor
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Solid Material ISE (e.g., Glass Electrode)
Solid Material ISE (e.g., Glass Electrode)
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Liquid (Ion-exchange) ISE
Liquid (Ion-exchange) ISE
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Solid State ISE
Solid State ISE
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Exercise and Potassium
Exercise and Potassium
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Cellular Breakdown and Potassium
Cellular Breakdown and Potassium
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Potassium Sample Collection
Potassium Sample Collection
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EDTA and Potassium Testing
EDTA and Potassium Testing
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Hemolysis and Potassium Testing
Hemolysis and Potassium Testing
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Clinical Significance of Potassium
Clinical Significance of Potassium
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Critical Potassium Levels
Critical Potassium Levels
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Chloride: Major ECF Anion
Chloride: Major ECF Anion
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Sodium (Na+)
Sodium (Na+)
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Na+/K+-ATPase Pump
Na+/K+-ATPase Pump
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Sodium (Na+) Regulation
Sodium (Na+) Regulation
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Water Intake Regulation
Water Intake Regulation
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Water Excretion Regulation
Water Excretion Regulation
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Sodium (Na+) Excretion Regulation
Sodium (Na+) Excretion Regulation
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Sodium Electrode
Sodium Electrode
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Direct Measurement (ISE)
Direct Measurement (ISE)
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Chloride Shift
Chloride Shift
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What happens during the Chloride Shift in tissues?
What happens during the Chloride Shift in tissues?
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What happens during the Chloride Shift in the lungs?
What happens during the Chloride Shift in the lungs?
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What is a chloride serum/plasma specimen?
What is a chloride serum/plasma specimen?
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What is the best anticoagulant for chloride specimen collection?
What is the best anticoagulant for chloride specimen collection?
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What is the best sample for measuring total chloride excretion?
What is the best sample for measuring total chloride excretion?
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What is the clinical significance of Chloride in CSF?
What is the clinical significance of Chloride in CSF?
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What is the clinical significance of Chloride in sweat?
What is the clinical significance of Chloride in sweat?
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Hypochloremia
Hypochloremia
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Hyperchloremia
Hyperchloremia
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Bicarbonate - ECF
Bicarbonate - ECF
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Total CO2 (TCO2)
Total CO2 (TCO2)
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Bicarbonate as Blood Buffer
Bicarbonate as Blood Buffer
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Bicarbonate and Chloride Shift
Bicarbonate and Chloride Shift
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Kidney Regulation of Bicarbonate
Kidney Regulation of Bicarbonate
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Bicarbonate and Acid-Base Balance
Bicarbonate and Acid-Base Balance
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Study Notes
Electrolytes - Part 1
- CHEM2010 course.
- Covers electrolytes and their role in water balance.
- Textbook chapters 16 (8th ed.) and 11 (9th ed).
Water Balance
- Water intake should equal water output.
- Excess intake leads to edema (fluid in tissues).
- Excess output leads to dehydration.
- Examples of conditions causing dehydration: severe vomiting and diarrhea.
- Kidneys regulate water in the body, adjusting levels as needed.
- High water intake results in dilute urine.
- Low water intake results in concentrated urine.
Daily Water Balance
- Liquid intake: 950 ml
- Oxidation intake: 250 ml
- Food intake: 800 ml
- Total intake: 2000 ml
- Urine output: 1050 ml
- Evaporation output: 850 ml
- Feces output: 100 ml
- Total output: 2000 ml
- These values represent a daily balance.
Kidneys
- Ultimate regulators of water balance.
- Adjust volume and concentration of urine based on factors like water intake.
- High water intake → dilute urine
- Low water intake → concentrated urine
- Key roles: regulating ADH and aldosterone to manage water and sodium balance.
Hormones: Antidiuretic Hormone and Aldosterone
- ADH (Arginine Vasopressin Hormone, AKA AVP)
- Increases water reabsorption.
- Secretion stimulated by hypothalamus
- Aldosterone:
- Increases sodium reabsorption.
- Produced by adrenal cortex.
- Important for Na+ (and Cl) reabsorption by kidneys. Associated with the excretion of K+.
Water
- An individual's body weight is 40-75% water.
- Water percentage decreases with age.
- More water in female bodies
- Water is the solvent for processes in the human body.
- Transports nutrients to cells.
- Determines cell volume.
- Removes waste through urine.
- Acts as body coolant (sweating).
- Found both intracellularly and extracellularly.
Body Water Compartments
- Intracellular fluid (ICF): inside cells (~40-50% body weight)
- Extracellular fluid (ECF): outside cells, with:
- Intravascular ECF (plasma): ~5%, the liquid portion of blood.
- Interstitial fluid: ~15%, surrounding cells and tissues.
- Transcellular fluid: insignificant but includes specialized compartments (e.g., cerebrospinal fluid, synovial fluid).
Electrolytes
- Ions that carry an electrical charge.
- Two types: anions (negative charge, toward anode) and cations (positive charge, toward cathode).
- Important in many bodily processes:
- Volume and osmotic regulation (Na+, Cl–, K+).
- Myocardial rhythm and contractility (K+, Mg2+, Ca2+).
- Enzyme activation (Mg2+, Ca2+, Zn2+).
- Blood coagulation (Ca2+, Mg2+).
- Acid-base balance (HCO3–, K+, Cl–).
- Neuromuscular excitability (K+, Ca2+, Mg2+).
Composition of Body Fluids
- ECF: main cation is Na+, main anion is Cl–
- ICF: main cation is K+, main anion is HPO42–
Electrolyte Distribution
- [Na+] in ECF is significantly higher than in ICF.
- [K+] in ICF is significantly higher than in ECF.
- This difference is maintained by the Na+-K+ ATPase pump.
- Hemolysis in samples can lead to falsely elevated K+ levels.
Increase in Anion
- If one anion increases, another anion or multiple cations must change to maintain electroneutrality.
- Total anions always equal total cations.
Osmolality
- Osmolality is the measure of concentration based solely on the number of solute particles (small particles).
- It replaced specific gravity for assessing renal concentration
- 100 mmol Na contributes 100 to osmolality
- 100 mmol NaCl contributes 200 to osmolality
- Increased particles decrease the freezing point of a solution.
Changes in Osmolality
- Hypothalamus responds to osmolality changes.
- Increasing osmolality → body fluids concentrate → thirst sensation → ADH secretion.
- ADH increases water reabsorption by kidneys → diluted urine → decreased plasma osmolality.
- Conversely, low osmolality leads to lack of thirst and suppressed ADH production.
- Reference ranges are available for serum and urine osmolality.
Water Excess
- Excess water intake (polydipsia) lowers plasma osmolality.
- Kidneys lower ADH and thirst.
- Large volume of dilute urine is excreted.
- Usually does not occur without impairment with renal excretion.
Water Deficit
- Thirst prevents water deficit.
- Water deficit increases plasma osmolality.
- AVP and thirst activate to increase water reabsorption.
- Hyper-osmolality and hypernatremia is a concern for infants, unconscious patients, older adults and those with diminished mental status.
Diabetes Insipidus
- No ADH or ability to respond to ADH.
- Excessive thirst.
- High urine output (up to 10 L/day).
- Water intake = output.
- Normal plasma osmolality.
Regulation of Blood Volume
- Renin, angiotensin I, and angiotensin II control blood volume/pressure by triggering vasoconstriction, increased blood pressure and increased Na+ retention by triggering aldosterone excretion.
Ion-Selective Electrodes
- Used in potentiometry.
- Electrochemical cells of two half cells linked by a salt bridge.
- Indicator electrode detects the ion of interest.
- Reference electrode provides constant potential.
- ISEs combine these components in a single unit.
- Activity is directly related to concentration
ISE Potentiometry - Key Words
- Activity refers to the concentration of an ion.
- Oxidation is the loss of electrons (at anode)
- Reduction is the gain of electrons (at cathode)
- Anodes are positive electrodes and oxidation occurs there.
- Cathodes are negative electrodes and reduction occurs there.
- Electrochemical cell combines two half-cells connected via a salt bridge.
Electrolyte Functions
- Affect various metabolic processes.
- Maintain osmotic pressure and water balance.
- Control pH.
- Regulate heart and muscle function.
- Involved in oxidation-reduction reactions.
- Act as enzyme cofactors.
Sodium (Na+)
- Major cation in extracellular fluid (ECF).
- Crucial in maintaining water distribution/osmotic pressure.
- Maintains extracellular fluid volume & osmotic pressure.
- Dietary intake (130-260 mmol/day).
- Active transport by Na+/K+-ATPase pump.
- Influences water movement in and out of cells, preventing osmotic rupture.
Regulation of Sodium (Na+)
- Regulated by intake (thirst), excretion (ADH and aldosterone, angiotensin II, atrial natriuretic peptide.)
- Thirst is stimulated by hypothalamus in response to increased osmolality.
- Increased osmolality → hypothalamus stimulates thirst and ADH release.
- ADH increases water reabsorption by kidneys.
- Aldosterone increases Na+ reabsorption.
Specimen Testing - Sodium
- Gold-top/red-top tubes for serum blood samples.
- Special tubes containing heparin for plasma, Random or 24-hour urine collection for testing.
- Hemolysis not significantly affecting testing outcome.
- Storage requirements for delayed analysis.
Methods of Analysis - Sodium
- Chemical methods are outdated.
- Flame emission spectrophotometry (older method).
- Atomic absorption spectrophotometry (older method).
- Ion-selective electrodes (ISEs) are the most routinely used method
Sodium Electrode
- A glass ion-exchange membrane is used for Na+ measurement.
- Na+ interacts with the membrane, which produces a potential related to Na+ activity.
- Reference electrode maintains a constant potential, allowing for measuring the potential difference in relation to concentration.
Measurement Modes for ISEs
- Direct measurement uses undiluted samples with ISE membranes
- Elevated lipids/proteins do not interfere with Direct measurement.
- Indirect measurement uses diluted samples
- Electrolyte exclusion effect where excess lipids/proteins causes falsely decreased Na+ concentrations in blood samples
Sodium Electrode - Sources of Error
- Continuous use buildup of protein on the electrode membranes
- Causes poor selectivity/ poor reducibility of results -Routine/ regular maintenance is required to resolve the problem of protein buildup
Hypo/Hypernatremia
-Conditions related to sodium levels in blood.
- Causes of low/high sodium are listed
Potassium (K+)
- Major cation in intracellular fluid (ICF).
- Daily dietary requirements (50-150 mmol).
- Regulates neuromuscular excitability.
- Regulates heart contraction.
Regulation of Potassium (K+)
- Nearly all K+ is reabsorbed in the proximal tubules of the kidney.
- Additional K+ is secreted into the urine.
- Excess K+ is excreted in the urine.
- Accumulates to toxic levels in renal failure
- Factors impacting K+ distribution: hypoxia, hypomagnesemia, digoxin overdose, insulin, catecholamines, and propranolol.
Factors that influence distribution of K+
- Factors like exercise and hemolysis causing changes in blood K+
- Exercise releases K+ from muscle cells to the ECF.
- Fist-pumping can cause elevated blood K+.
- RBC damage releases K+ into the extracellular fluid (ECF/ plasma)
Specimen Collection - Potassium
- Serum/plasma using Gold-top/red-top tubes.
- Plasma samples use heparin as anticoagulant.
- EDTA (K2EDTA) should not be used for samples, as it may introduce K+ into the sample, leading to inaccurate results. -Urine samples (random or 24 hour).
- Hemolysis should be minimized.
Methods of Measurement - Potassium
- Flame photometry (an older method).
- Ion-selective electrodes (ISEs) are the most common approach.
Potassium Electrode
- Ion-exchange electrode.
- Membrane contains valinomycin, which selectively binds with K+.
- KCl is used for the inner electrolyte solution.
- Can function in direct or indirect measurement modes
- Similar outcome between the direct/indirect methods, unlike Na+
Chloride (Cl–):
- Major anion in the extracellular fluid (ECF).
- Major contributor to osmolality.
- Importance in maintaining proper hydration, blood volume, and electrical neutrality.
Regulation of Chloride
- Absorbed by intestinal tract → filtered by glomerulus → passively reabsorbed into the blood by proximal tubules -excess chloride excreted in urine and sweat.
How Chloride Maintains Electroneutrality
- Chloride assists in maintaining electroneutrality involving Na+ reabsorption.
- Processes like bicarbonate shift are crucial to maintaining this balance.
Chloride Specimen Collection
- Serum/plasma (separate from cells) using Lithium heparin as an anticoagulant.
- Urine samples (24hr),
- CSF samples
- Sweat as a screening test for Cystic Fibrosis
Chloride Methods of Analysis
- Amperometric-coulometric titration.
- Mercurimetric titration.
- Colorimetry.
- Ion-selective electrodes (ISEs)
Chloride Methods of Analysis
- Silver ions quantitatively generated for titrating the sample
- free silver ions indicate the end point of titration which is used to calculate amount of chloride in the sample
- Example of the method is Cotlove Chloridometer.
Chloride Methods of Analysis
- Ion-selective electrodes (ISEs)
- Use ion-exchange membranes bind to Cl–.
- Common in clinical chemistry analyzers.
Chloride - Clinical Significance
- Chloride disorders often share similar causes as sodium disorders.
Bicarbonate (HCO3) :
- Second most abundant anion in ECF.
- Major component in blood buffer systems
- Critical to maintaining acid-base balance
Regulation of Bicarbonate
- Reabsorbed by proximal tubules in kidneys; and 15% reabsorbed by distal tubules
- Bicarbonate combines with H+ → H2CO3
- H2CO3 dissociates into water and CO2
- CO2 diffuses back into extracellular fluid (ECF)
- Excess HCO3 excreted in urine in alkalosis
- HCO3 reabsorbed in acidosis
Bicarbonate Specimen Collection
- Serum and lithium heparin plasma. (arterial or whole blood samples)
- Anaerobic techniques required - Exposure to air will decrease CO2 levels
- Samples need to be analyzed within a timely manner
TCO2 Methods of Analysis
- ISE method (pCO2) (uses a combination pH electrode with gas-permeable membrane and pH-sensitive electrode):
- Enzyme method to measure TCO2.
Anion Gap
- Represents concentration of unmeasured anions (proteins, phosphates, sulfates, organic acids).
- Calculated by subtracting the sum of commonly measured anions from the sum of commonly measured cations.
- Useful for identifying metabolic disorders
- Useful for quality control in electrolyte measurements.
Anion Gap Calculation
- Measured cations – measured anions
- (Na) + (K) - (Cl) - (HCO3)
- Normal gap is 7–16mmol/L (or 10–20 mmol/L if K+ included, depending on testing protocol).
Abnormal Anion Gap
- Low anion gap (rare): multiple myeloma, instrument error
- High anion gap (MUD PILES): methanol, uremia, diabetic ketoacidosis, paraldehyde, inhalants, ibuprofen, lactic acidosis, ethylene glycol acidosis, salicylates, starvation ketoacidosis
Summary of Serum/Plasma Reference Ranges
- Provides a quick overview of normal and critical values for serum/plasma electrolytes.
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Description
Test your understanding of key concepts in electrochemistry and the hormonal regulation of fluid balance. This quiz covers topics such as diabetes insipidus, the Renin-angiotensin system, and the functioning of ion-selective electrodes. Perfect for students studying advanced biology or biochemistry.