Electrolyte Imbalance Quiz
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Questions and Answers

What is the typical range of serum potassium for a healthy individual?

  • 22-32 mEq/L
  • 1.8-2.4 mg/dL
  • 8.9-10.2 mg/L
  • 3.7-5.2 mEq/L (correct)

Which of the following electrolytes is primarily found in the intracellular fluid (ICF)?

  • Calcium (Ca2+)
  • Sodium (Na+)
  • Potassium (K+) (correct)
  • Chloride (Cl-)

What is the term used to describe an abnormal increase in the concentration of calcium in the blood?

  • Hypokalemia
  • Hyperkalemia
  • Hypocalcemia
  • Hypercalcemia (correct)

Which of the following is NOT a common route of electrolyte losses from the body?

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

Which analytical technique utilizes a flame to measure electrolyte concentrations?

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

What is the reference range (in serum) for bicarbonate in healthy individuals?

<p>22-32 mEq/L (A)</p> Signup and view all the answers

Which of the following electrolytes is directly involved in the regulation of water balance within the body?

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

How do changes in electrolyte concentration affect the body? (Select all that apply)

<p>Alterations in nerve impulses (A), Changes in blood pressure (B), Disruptions in muscle contractions (C), Impaired bone health (D)</p> Signup and view all the answers

What is the primary function of sodium in the body?

<p>Maintaining fluid balance and nerve impulse transmission (B)</p> Signup and view all the answers

Which of the following conditions is NOT a possible cause of hypernatremia?

<p>Excessive renal loss of salt (C)</p> Signup and view all the answers

Which of the following is a potential symptom of hypokalemia?

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

Which hormone is primarily responsible for regulating calcium homeostasis?

<p>Parathyroid hormone (PTH) (A)</p> Signup and view all the answers

What is the primary function of the selective electrode (ISE) in measuring electrolytes?

<p>To measure the concentration of a specific ion (B)</p> Signup and view all the answers

Which of the following conditions can lead to both hypokalemia and hyperkalemia?

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

Which of the following is NOT a function of potassium in the body?

<p>Maintaining bone density (D)</p> Signup and view all the answers

What is the role of the Na+/K+ ATPase pump in maintaining electrolyte balance?

<p>Transports sodium and potassium across cell membranes against their concentration gradient (B)</p> Signup and view all the answers

Which of the following is a possible cause of hyponatremia?

<p>Excessive water intake (C)</p> Signup and view all the answers

Which of the following conditions can be caused by hypocalcemia?

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

What is a key function of magnesium in the body?

<p>Calcium and bone homeostasis (D)</p> Signup and view all the answers

Which condition is most likely to cause hypermagnesemia?

<p>Increased intake of magnesium (B)</p> Signup and view all the answers

What is the main regulatory organ for bicarbonate in the body?

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

Which of the following is a symptom of renal failure?

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

What is the major cation found in intracellular fluid (ICF)?

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

What causes hypochloremia?

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

Which of the following best describes the distribution of plasma water in body fluids?

<p>20% of extracellular fluid (B)</p> Signup and view all the answers

Which electrolytic disorder is associated with metabolic alkalosis?

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

How much of the body weight in adult males is typically comprised of water?

<p>55 - 60% (C)</p> Signup and view all the answers

What is the primary reason for increased urine volume (polyuria) in renal failure?

<p>Decreased renal filtration (B)</p> Signup and view all the answers

What is the primary role of sodium in the extracellular fluid (ECF)?

<p>Osmotic balance of ECF space (B)</p> Signup and view all the answers

Which diagnostic test would be used to assess kidney function directly?

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

What are pathological losses of water primarily due to?

<p>Vascular bleeding and vomiting (B)</p> Signup and view all the answers

Which of the following compartments contains the majority of body fluid?

<p>Intracellular fluid (C)</p> Signup and view all the answers

What percentage of total body weight does water constitute in adult females?

<p>50 - 55% (D)</p> Signup and view all the answers

How many liters of fluid are estimated for a 70 kg woman?

<p>38 L (B)</p> Signup and view all the answers

What is hydrostatic pressure in the context of body fluids?

<p>The back pressure exerted by water against a membrane (B)</p> Signup and view all the answers

How is osmolality measured in the body?

<p>In osmoles per kilogram of water (D)</p> Signup and view all the answers

What is the normal range of serum osmolality in the body?

<p>280 - 290 mOsm kg-1 (B)</p> Signup and view all the answers

Which formula correctly calculates the anion gap?

<p>[Na+] + [K+] - ([Cl-] + [HCO3-]) (A)</p> Signup and view all the answers

Which of the following can lead to fluid loss in the body?

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

What is the clinical significance of an increased anion gap?

<p>It suggests elevated levels of unmeasured anions (B)</p> Signup and view all the answers

Which electrolyte is crucial for conduction of nerve impulses?

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

What does a normal anion gap range indicate?

<p>A balance of measured anions and cations (A)</p> Signup and view all the answers

Flashcards

Water Steady State

The amount of fluid consumed is equal to the amount of fluid eliminated from the body.

Pathological Losses

A loss of fluids and electrolytes due to various conditions like vomiting, diarrhea, or bleeding.

Body Fluids and Fluid Compartments

Water is present within and outside the cells. The fluid inside cells is called intracellular fluid (ICF), and the fluid outside cells is called extracellular fluid (ECF).

Intracellular Fluid (ICF)

The fluid inside the cells, mainly composed of potassium as the primary cation and phosphate as the primary anion.

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Extracellular Fluid (ECF)

The fluid surrounding the cells, further divided into interstitial fluid (between cells), plasma (in blood), and transcellular fluid. The primary cation in ECF is sodium, and the primary anion is chloride.

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Sodium in ECF

The primary cation in the extracellular fluid, responsible for maintaining the osmotic balance of the ECF space.

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Potassium in ICF

The major cation in the intracellular fluid, playing a crucial role in essential processes such as muscle contraction and nerve impulse transmission.

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Phosphate in ICF

The primary anion in the intracellular fluid, playing a crucial role in various metabolic processes.

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Magnesium

A vital electrolyte involved in numerous bodily functions, including acting as a cofactor for enzymes, maintaining calcium and bone homeostasis, and contributing to nerve and muscle function.

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Hypermagnesemia

A condition where magnesium levels in the blood are abnormally high.

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Hypomagnesemia

A condition characterized by abnormally low magnesium levels in the blood.

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Chloride

A major electrolyte crucial for maintaining osmolality, blood volume, and electrical neutrality.

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Hypochloremia

A condition where chloride levels in the blood are lower than normal.

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Hyperchloremia

A condition where chloride levels in the blood are higher than normal.

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Bicarbonate

A crucial electrolyte that plays a critical role in maintaining acid-base balance and pH in the blood, acting as a buffer system.

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Renal Failure

The term used to describe a range of conditions affecting the kidneys’ ability to filter waste from the blood.

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Osmosis

Movement of water from an area of low solute concentration to an area of high solute concentration, aiming to equalize the concentration on both sides of a semi-permeable membrane.

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Osmotic Pressure

The pressure exerted by the flow of water through a semi-permeable membrane separating two solutions with different concentrations.

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Osmolality

The number of dissolved particles in the body water, measured in osmoles. It reflects the concentration of solutes in a solution.

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Anion Gap

The difference between the sum of measured cations (like sodium and potassium) and the sum of measured anions (like chloride and bicarbonate) in blood.

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Increased Anion Gap

An increased anion gap indicates a higher concentration of unmeasured anions, which can be caused by various disease states.

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Fluid Balance

The maintenance of the body's fluid balance is essential for various physiological processes, including the regulation of blood volume, blood pressure, and electrolyte balance.

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Electrolytes

Electrolytes are minerals that carry an electric charge and play crucial roles in many bodily functions.

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Electrolytes and Acid-Base Balance

Electrolytes are essential for maintaining acid-base balance by helping to regulate the pH of body fluids.

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What are electrolytes?

Electrolytes are chemical compounds that dissolve in water and produce electrically charged particles called ions. They play a crucial role in numerous bodily functions, including maintaining fluid balance, muscle contraction, nerve impulse transmission, and regulating pH.

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How are electrolytes classified?

Electrolytes are categorized into two groups based on their charge: anions, which carry a negative charge, and cations, which carry a positive charge.

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Where are electrolytes found in the body?

Electrolytes are distributed throughout the body in two main compartments: intracellular fluid (ICF) and extracellular fluid (ECF). ICF refers to the fluid found inside cells, while ECF encompasses the fluid outside of cells, such as blood plasma.

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How do electrolyte changes affect health?

Changes in electrolyte concentrations can significantly affect human health. These changes can arise from fluctuations in the amount of electrolytes present or from alterations in the amount of water in the body.

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What is the role of potassium in the body?

Potassium (K+) is a crucial electrolyte that plays a vital role in muscle contractions, nerve impulses, and maintaining heartbeat rhythm. Low potassium (hypokalemia) can lead to muscle weakness, heart arrhythmias, and fatigue. High potassium (hyperkalemia) can also cause heart problems.

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What is the role of sodium in the body?

Sodium (Na+) is the primary electrolyte in ECF. It plays a crucial role in maintaining fluid balance, nerve impulse transmission, and regulating blood pressure. Low sodium (hyponatremia) can lead to confusion, seizures, and coma. High sodium (hypernatremia) can cause dehydration and neurological problems.

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What is the role of chloride in the body?

Chloride (Cl-) is the most abundant anion in ECF and is crucial for maintaining fluid balance, stomach acid production, and nerve impulse transmissions. Chloride imbalances can lead to various health issues.

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How are electrolytes measured?

Electrolytes are often measured in blood samples or urine using various laboratory techniques, such as flame spectrophotometry or ion-selective electrodes, to assess their concentrations and identify any potential imbalances.

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Sodium (Na+)

Sodium (Na+) is a major electrolyte found primarily in the extracellular fluid (ECF). It plays a crucial role in maintaining fluid balance, nerve impulse transmission, and muscle contraction.

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Hyponatremia

Low blood sodium levels. It can be caused by excessive loss of sodium, excessive water intake, or impaired excretion of water by the kidneys.

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Hypernatremia

High blood sodium levels. It can happen due to excessive sodium intake, water loss, or a problem with the body's ability to respond to antidiuretic hormone (ADH).

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Potassium (K+)

Potassium (K+) is another essential electrolyte, primarily residing inside cells (intracellular fluid). It's crucial for maintaining heart rhythm, muscle function, and nerve impulses.

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Hypokalemia

Low potassium levels in the blood. Can result from a shift of potassium into cells, loss through the kidneys, or loss from the gut.

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Hyperkalemia

High potassium levels in the blood. It can occur due to a shift of potassium out of cells, kidney failure, or inadequate potassium secretion.

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Calcium (Ca2+)

Calcium (Ca2+) is a mineral, primarily found in bones. It has many roles, including muscle contraction, nerve signaling, blood clotting, and enzyme function.

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Parathyroid hormone (PTH)

Parathyroid hormone (PTH) is produced by the parathyroid glands and plays a critical role in calcium regulation. It increases blood calcium levels by stimulating bone resorption, calcium reabsorption in the kidneys, and vitamin D activation.

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Vitamin D

Vitamin D is a fat-soluble vitamin that helps regulate calcium levels. The active form of vitamin D promotes calcium absorption from the gut and contributes to bone health.

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Calcitonin

Calcitonin is a hormone released by the thyroid gland that, primarily, helps lower blood calcium levels. Its precise mechanism is not fully understood, but it may involve inhibiting bone resorption.

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Study Notes

Electrolyte Overview

  • Electrolytes are reviewed, an introduction provided, and the kidneys' role in water and electrolyte balance is discussed.
  • Water intake and loss are equal in a steady state.
  • Daily water intake = 2.2 L, with metabolic production adding 0.3 L
  • Daily water loss = 0.9 L (skin), 1.5 L (urine), 0.1 L (feces), and 0.9 L (lungs).
  • Pathological losses include vascular bleeding (H₂O, Na+), vomiting (H₂O, H+), and diarrhoea (H₂O, HCO₃⁻).

Body Fluids and Fluid Compartments

  • Body fluid percentages vary : 55-60% of body weight for adult males, and 50-55% for females (with 5% extra adipose tissue)
  • A 70 kg male has approximately 42 L of body fluid, and a 70 kg female has approximately 38 L.
  • Body fluids are divided into:
    • Intracellular fluid (ICF): inside cells, with potassium (K+) as the major cation and phosphate (PO₄⁻) as the major anion.
    • Extracellular fluid (ECF): outside cells, includes interstitial fluid (between cells), plasma (in circulatory system), and transcellular fluid (epithelial spaces). ECF primarily utilizes sodium (Na+) as the major cation and chloride (Cl⁻) as the major anion.
  • ICF averages approximately 28 L in a 70kg man.
  • ECF averages approximately 14 L in a 70kg man.
  • Exchange between compartments happens via hydrostatic pressure (pressure exerted against the membrane) and osmotic pressure (pressure exerted when water moves through a semi-permeable membrane due to different concentration on either side).

Osmolality

  • Osmolality measures dissolved particles in body water (osmoles).
  • Dissolved particles exert osmotic pressure.
  • Water moves from low to high osmolality.
  • Osmolarity is the number of osmoles per kilogram of water.
  • Normal body fluid osmolality is approximately 280 - 290 mOsm/kg.

Osmolality Calculation

  • Osmolality is calculated as: [sodium x 2] + urea + glucose.

Anion Gap

  • Anion gap = ([Na+] + [K+]) - ([Cl⁻] + [HCO₃⁻]).
  • Normal range = 6-18 mmol/L.
  • Increased anion gap indicates increased unmeasured anions (e.g., lactate, acetoacetate, β-hydroxybutyrate).

Fluid Imbalance

  • Fluid loss can occur through gastrointestinal (GI) tract (diarrhea, vomiting), kidneys (diuresis), blood vessels (hemorrhage), and the skin (burns, sweating).
  • Fluid gain can occur with heart, liver, or kidney failure.

Electrolyte Functions

  • Electrolytes regulate volume, osmotic pressure, acid-base balance, enzyme function, nerve impulse transmission, and cardiac function.

Electrolytes Measured in Clinical Labs

  • Common electrolytes include sodium (Na+), potassium (K+), chloride (Cl-), bicarbonate (HCO₃⁻), magnesium (Mg²⁺), and calcium (Ca²⁺).

Electrolyte Losses

  • Renal excretion, stool losses, sweating, abnormal routes (e.g., vomit, diarrhea).

Measuring Electrolytes

  • Flame spectrophotometry (measures characteristic colors produced by metal ions)
  • Ion-selective electrodes (ISE) allow for specific ion measurement and external reference electrode.
  • Colorimetric methods can also be used.

Sodium Function and Regulation

  • Sodium (Na+) regulates plasma osmolality, water balance, nerve impulses, and muscle contraction.
  • Sodium's regulation features include thirst, kidney function (Na+/K+ and Na+/H+ pumps), antidiuretic hormone (ADH), renin-angiotensin-aldosterone system (regulates blood volume), and aldosterone.

Sodium Deficiency (Hyponatremia)

  • Symptoms: nausea, vomiting, weakness, mental confusion, headache, lethargy, possible coma, and hypotension.
  • Causes: excessive water intake, renal loss of salt, excessive ADH secretion, water overload, congestive heart failure, cirrhosis, and renal disease.

Sodium Excess (Hypernatremia)

  • Symptoms: dehydration, increased thirst, fever, tremors, altered mental status, lethargy, seizures, coma, and hypertension.
  • Causes: extrarenal loss, renal losses, impaired ADH response, excessive water loss, and hyperaldosteronism.

Potassium Function and Regulation

  • Potassium (K+) regulates cardiac contraction, nerve impulses, muscle contractions, and acid-base balance.
  • Potassium's regulation includes kidney function (Na+/K+ pumps and Acid/Base), aldosterone.

Potassium Deficiency (Hypokalemia)

  • Symptoms: weakness, fatigue, anorexia, nausea, arrhythmias, and possible cardiac arrest.
  • Causes: extrarenal shifts and renal losses.

Potassium Excess (Hyperkalemia)

  • Symptoms: muscular weakness, tingling, numbness, confusion, cardiac arrhythmias, and possible cardiac arrest.
  • Causes: intra to extracellular shifts and renal failure.

Calcium Function and Regulation

  • Calcium (Ca²⁺) regulates bone health, muscle contraction, nerve transmission, membrane transport, and blood coagulation.
  • Calcium's regulation involves the kidneys (reabsorption), parathyroid hormone (PTH), and vitamin D.
  • Disorders include hypocalcemia (hypoparathyroidism, malabsorption, renal failure) and hypercalcemia (hyperparathyroidism, excess vitamin D, tumors).

Magnesium Function and Regulation

  • Magnesium (Mg²⁺) is an enzyme cofactor, and helps with Calcium and bone homeostasis.
  • Regulation involves the kidney, PTH, serum Mg²⁺, and aldosterone.
  • Disorders include hypomagnesemia (decreased intake, malabsorption, increased loss, renal disease etc.) and hypermagnesemia (usually increased intake, or renal disease).

Chloride Function and Regulation

  • Chloride (Cl⁻) maintains osmolality, blood volume, and electric neutrality.
  • Regulation involves kidneys (reabsorption with Na+ ) and aldosterone.
  • Disorders include hypochloremia (similar to hyponatremia, prolonged vomiting, high [bicarbonate] associated with metabolic alkalosis) and hyperchloremia (similar to hypernatremia, dehydration, and prolonged diarrhea or metabolic acidosis).

Bicarbonate Function and Regulation

  • Bicarbonate (HCO₃⁻) determines pH (along with H⁺), buffers the blood, and maintains acid-base equilibrium.
  • Bicarbonate's regulation involves the kidneys (reabsorption) and lungs.
  • Disorders include acid-base imbalances.

Renal Failure Signs and Symptoms

  • Symptoms include uraemia (nausea, vomiting, lethargy), urinary disorders (frequency, nocturia, retention), urine volume disorders (polyuria, oliguria, anuria), and urine composition disorders (hematuria, proteinuria), and edema (salt and water retention).

Diagnostic Tests

  • Urinalysis, urine osmolality, spot urine for Na+ and K+, serum osmolality, creatinine, creatinine clearance, and serum electrolytes are used for diagnosis.

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