Pathophysiology > Electrolytes > Flashcards

Electrolytes Flashcards

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1
Q

What is the importance of electrolytes?

A

crucial role in homeostasis
found in blood, urine, fluids

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2
Q

What are the major cations? What are the major anions?

A

C–Na, K, Ca, Mg, H
A–Cl, HCO3, PO4

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3
Q

What is the primary regulator of electrolyte balance?

A

kidneys

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4
Q

What are the main roles of calcium?

A

muscle contraction
nerve signaling
blood clotting
cell division
bone and teeth formation

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5
Q

What are the main roles of potassium?

A

blood pressure level stability
heart contractions
muscle function

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6
Q

What are the main roles of magnesium?

A

muscle contraction
heart rhythm
nerve function
digestion
protein fluid balance

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7
Q

What are the main roles of sodium?

A

principal cation in ECF
maintain fluid balance
muscle contraction
nerve signaling

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8
Q

What is the main role of chloride?

A

maintain fluid balance

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9
Q

What is the octet rule?

A

tendency for atoms to prefer eight electrons in valence shell

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10
Q

What are the FOUR rules of fluid regulation?

A

all homeostatic mechanisms for fluid composition respond to changes in ECF
no receptors directly monitor fluid balance
water follows salt
water content rises and falls with gain and loss

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11
Q

What is the normal range of sodium?

A

135-145 mEq/L

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12
Q

What regulates sodium levels?

A

aldosterone
ADH
atrial natriuretic peptide
estrogen, progesterone, glucocorticoids

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13
Q

What is hyponatremia?

A

sodium < 135 mEq/L
most common electrolyte disorder

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14
Q

What is the etiology of hyponatremia?

A

sodium deficiency
excessive water intake

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15
Q

What is hypernatremia?

A

sodium > 145 mEq/L
cellular dehydration

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16
Q

What is the etiology of hypernatremia?

A

excess sodium intake
water deficient

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17
Q

What is Cushing Syndrome?

A

excess cortisol from sodium retention
hump on back of neck

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18
Q

What are normal levels of potassium?

A

3.5-5 mEq/L
primary ICF cation
most dangerous electrolyte imbalance

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19
Q

What regulates potassium levels?

A

aldosterone
sodium to collecting ducts
serum K levels

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20
Q

What are the shifts of potassium?

A

acidosis–hyperkalemia, K out of cells
alkalosis–hypokalemia, K into cells

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21
Q

What is hyperkalemia?

A

Serum K > 5 mEq/L
nerve and muscle abnormally excitable

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22
Q

What is the etiology of hyperkalemia?

A

deficient excretion–renal failure
excess intake
intercompartmental shifts of K ions–acidosis, low insulin

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23
Q

What is hypokalemia?

A

Serum K < 3.5 mEq/L
nerve and muscle less excitable
weakness

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24
Q

What is the etiology of hypokalemia?

A

deficient intake
excess loss–vomit, diarrhea
intercompartmental shifts–alkalosis, excess insulin

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25
What are normal calcium levels?
9-11 mg/dL affected by pH
26
What regulates calcium levels?
parathyroid hormone calcitonin calcitriol (vit D)
27
What is hypocalcemia?
total serum < 8.8 mg/dL ionized levels < 4 mEq/L
28
What is the etiology of hypocalcemia?
excess loss decreased intake
29
What are the clinical manifestations of hypocalcemia?
muscle spasms Chvostek sign--facial nerve Trousseaus sign--carpal spasm
30
What is hypercalcemia?
serum > 14 mg/dL ionized levels > 5 mEq/L
31
What is the etiology of hypercalcemia?
increased intake or release--tumors, immobility deficient excretion
32
What are the clinical manifestations of hypercalcemia?
stones bones groans overtones
33
What are the ions in ICF and ECF?
ICF--K, Mg, HPO4, SO4 ECF--Na, Cl, HCO3, Ca
34
What is hydrostatic pressure?
force generated by fluid pressure on capillary walls by blood plasma
35
What is oncotic pressure?
osmotic pressure exerted by proteins in blood plasma
36
What is osmotic pressure?
minimum pressure needed for solution to prevent inward flow of solvent across membrane
37
What is the primary determinant of plasma osmolality?
plasma sodium glucose and urea
38
What is tonicity?
ability of extracellular solution to make water move in or out of cell by osmosis
39
What are the TWO types of thirst?
osmotic thirst hypovolemic thirst
40
What signals stimulate the thirst center?
hypothalamus volume receptors in atria angiotensin II mouth neurons
41
What is osmotic thirst?
osmoreceptors in hypothalamus sense increased serum osmolarity levels release ADH and sense of thirst
42
What is Diabetes Insipidus?
endocrine disorder affecting water and electrolyte balance excess excretion of dilute urine and extreme thirst
43
What is SIADH?
syndrome of inappropriate ADH hypotonic hydration
44
What is hypovolemic thirst?
drop in blood volume from loss of extracellular water RAAs activated, angiotensin II and aldosterone
45
What factors increase susceptibility to fluid imbalances?
obesity 30% elderly 45% newborn and infants 73%
46
What is fluid sequestration?
excess fluid accumulation in particular locations edema hemorrhage pleural effusion
47
What causes edema?
imbalance between forces that keep fluid in vessel and those that promote exit into interstitial space
48
What are the FOUR forms of edema?
inflammatory hydrostatic oncotic obstructive
49
What are the types of edema?
generalized organ specific pitting nonpitting
50
What are the clinical manifestations of edema?
impaired arterial circulation susceptibility to tissue breakdown impaired organ function pain
51
What ion is most precisely regulated in ECF?
hydrogen
52
What is acid base balance crucial for life?
enzymes function within narrow range of pH affects on electrolytes neuron sensitivity blood pH (too high can cause death)
53
Where do acids in the body come from?
by products of protein, nucleic acids, carb, and fat metabolism
54
What are the TWO groups of acids?
Volatile--leaves body by lungs Nonvolatile--leaves body by kidneys
55
What are the mechanisms for pH maintenance?
respiratory regulation--CO2 chemical buffer systems renal regulation--HCO
56
What are the FOUR major buffer systems?
protein phosphate ammonia bicarbonate-carbonic acid
57
How do protein buffers react to changes in pH?
pH rises--carboxyl group releases H pH falls--amine group binds H
58
What is an important protein buffer?
hemoglobin
59
What are the actions of phosphate buffer systems?
buffers ICF and urine low plasma concentration holding H in urine to expel from body
60
Where are ammonia buffers found? What do they do?
not in blood, renal tubule buffers ammonia secreted to bind to H and Cl to excrete in urine
61
What is the most important buffer system in plasma?
bicarbonate-carbonic acid
62
What organs are involved in bicarbonate-carbonic acid systems?
lungs--decrease CA by blowing off CO2 kidneys--reabsorb HCO3
63
What are respiratory mechanisms for?
eliminates CO2 only works on volatile acids
64
What results from respiratory system impairment?
acid base imbalances hypoventilation--acidosis hyperventilation--alkalosis
65
What are renal mechanisms for?
alters excretion/retention of H or HCO3 excretes nonvolatile acids
66
What is compensation?
body's response to acid base imbalance to maintain homeostasis
67
What are the types of compensation?
fully--back to normal partial--range outside norm uncompensated--no response respiratory metabolic
68
What is the acid base mnemonic?
ROME Respiratory Opposite Metabolic Equal
69
What are the FOUR patterns of acid base imbalances?
respiratory acidosis respiratory alkalosis metabolic acidosis metabolic alkalosis
70
What is respiratory acidosis?
lung disorder affects ability to breathe out CO2 leading to excess acid in body pH decrease--pCO2 increase
71
What is respiratory alkalosis?
too little CO2 in blood from lungs expelling too much pH increases--pCO2 decreases
72
What is metabolic acidosis?
too much acid produced by body or too much HCO3 is lost pH decreases--HCO3 decreases
73
What is metabolic alkalosis?
too much acid loss from body or too much HCO3 pH increase--HCO3 increase
74
What is the compensation for respiratory acidosis?
kidneys excrete more H and reabsorb more HCO3
75
What is the compensation for respiratory alkalosis?
kidneys excrete less H and reabsorb less HCO3
76
What is the compensation for metabolic acidosis?
rapid, deep respirations kidneys excrete more acid and increase HCO3 abdorption
77
What is the compensation for metabolic alkalosis?
slow, shallow respirations kidneys excrete less acid and decrease HCO3 reabsorption
78
Low pH--high CO2--high HCO3
respiratory acidosis
79
Low pH--low CO2--low HCO3
metabolic acidosis
80
High pH--low CO2--low HCO3
respiratory alkalosis
81
High pH--high CO2--high HCO3
metabolic alkalosis
Pathophysiology
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