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Questions and Answers
What is the primary function of electrolytes in the body?
What is the primary function of electrolytes in the body?
Which of the following is NOT considered a major cation in plasma?
Which of the following is NOT considered a major cation in plasma?
What could cause elevated potassium levels in plasma (hyperkalemia)?
What could cause elevated potassium levels in plasma (hyperkalemia)?
Which electrolyte is considered the major intracellular cation?
Which electrolyte is considered the major intracellular cation?
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What happens to hydrogen ions (H+) and potassium ions (K+) during a decrease in plasma potassium levels?
What happens to hydrogen ions (H+) and potassium ions (K+) during a decrease in plasma potassium levels?
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What is the ideal sample type for analyzing electrolytes and blood gases?
What is the ideal sample type for analyzing electrolytes and blood gases?
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Which condition is associated with a decrease in plasma potassium levels (hypokalemia)?
Which condition is associated with a decrease in plasma potassium levels (hypokalemia)?
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What is a common artifact that can result in falsely elevated sodium levels during testing?
What is a common artifact that can result in falsely elevated sodium levels during testing?
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Study Notes
Electrolytes
- Electrolytes are minerals that carry an electrical charge
- They are found in all body fluids
- Negative ions are called anions
- Positive ions are called cations
Functions
- Maintain water balance and fluid osmotic pressure
- Important for normal muscular and nervous functions
- Maintain and activate enzymes
- Regulate acid-base balance
Major Electrolytes in Plasma
- Cations: Calcium (Ca++), Magnesium (Mg++), Sodium (Na+), Potassium (K+)
- Anions: Chloride (CI-), Bicarbonate (HCO3-), Inorganic phosphorus (PO4-), and Protein
Electrolyte Assays
- Changes in electrolyte concentration result from intake, shifts between ECF and ICF, and renal retention
- Arterial samples are ideal for electrolyte and blood gas analysis
- Analyze immediately
Sodium (Na+)
- Major cation of plasma and extracellular fluid (ECF)
- Critical for water distribution and osmotic pressure maintenance
- Sodium heparin tubes may falsely elevate sodium levels
Conditions Associated with Altered Sodium Levels
- Hypernatremia: Water deprivation, hyperventilation, osmotic diuresis
- Hyponatremia: Gastrointestinal disorders, ketonuria, hypoadrenocorticism, congestive heart failure
Potassium (K+)
- Major intracellular cation
- Crucial for normal muscular function, respiratory, cardiac, and nerve impulse transmission, and carbohydrate metabolism
- Plasma preferred for potassium analysis, avoiding hemolysis
- Hyperkalemia: Increase in plasma potassium levels, due to cellular necrosis, urinary obstruction, and hypoadrenocorticism
- Hypokalemia: Decreased potassium levels, due to inadequate intake, alkalosis, and fluid loss
Potassium (K+) as an Intracellular Buffer
- Plasma and ECF potassium levels affect plasma hydrogen ion (H+) concentration
- Potassium and hydrogen ions move freely between intracellular fluid (ICF) and ECF
- Changes in plasma potassium levels affect the movement of potassium and hydrogen ions between ICF and ECF
Conditions Associated with Altered Potassium Levels
- Hyperkalemia: Metabolic acidosis, urinary tract obstruction, and renal insufficiency
- Hypokalemia: Often related to inappropriate or inadequate potassium intake, or conditions causing fluid loss
Magnesium (Mg2+)
- Second most common intracellular cation
- Found in high concentrations in bones
- Activates enzyme systems
- Imbalance of Mg/Ca ratio can cause muscular tetany
- Cattle and sheep are most affected by magnesium deficiencies
- Anticoagulants other than heparin can decrease magnesium results
Calcium (Ca2+)
- More than 99% of the body's calcium is stored in bone
- The remaining 1% is critical for neuromuscular excitability, enzyme activity, blood coagulation, and ion transfer
- Hypercalcemia: Inhibits neurons and muscle cells, potentially leading to heart arrhythmias
- Hypocalcemia: Increases excitability, causing muscle tetany
Calcium Regulation
- Parathyroid Hormone (PTH): Released by parathyroid glands in response to low blood calcium levels
- Calcitonin: Released by thyroid glands in response to high blood calcium levels
- These hormones regulate calcium levels in the blood through bone, kidney, and intestinal interactions
Calcium (Ca2+) Concentrations
- Calcium and inorganic phosphorus concentrations are inversely related
- Filtering and reabsorbing phosphate is influenced by PTH
- High or normal extracellular fluid calcium inhibits PTH secretion
- Calcium release from bone is inhibited, and more phosphate is retained.
Chloride (Cl-)
- Predominant extracellular anion, crucial for water distribution, osmotic pressure, and electrolyte balance
- Hyperchloremia: Elevated chloride levels
- Hypochloremia: Decreased chloride levels
- Sample hemolysis or prolonged storage can interfere with chloride results
Bicarbonate (HCO3-)
- Second most common plasma anion
- Kidneys regulate bicarbonate levels
- Estimated from blood CO2 levels (approx 95%)
- Arterial blood samples are preferred for bicarbonate measurements
Inorganic Phosphorus
- More than 80% of phosphorus is stored in bones
- Important in energy storage and transfer, carbohydrate metabolism, and composition
- Hyperphosphatemia/Hypophosphatemia: Abnormal phosphorus levels (elevated/low), affecting other electrolytes. Hemolyzed samples can falsely raise phosphorus levels
Anion Gap
- Normally, cations equal anions in the body
- Anion gap is calculated by subtracting anions from cations
- Normal values vary slightly between species (dogs and cats)
- Increased anion gap can be associated with lactic acidosis, renal failure, and diabetic ketoacidosis.
- A decreased anion gap is commonly linked to hypoalbuminemia.
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Description
This quiz covers the essential role of electrolytes in the body, including their functions, major cations and anions, and the importance of maintaining their balance. It also discusses methods for analyzing electrolyte concentrations and the implications of their fluctuations. Test your knowledge on this critical aspect of human physiology.
