MLT Electrolytes and Renal Function

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Which gland has regulatory
areas for thirst, water
Hypothalamus
balance and blood
pressure?
What is the property of a
solution that is influenced
Colligative Properties
by the size and shape of
the molecules ?
What are the 4 Colligative 1. Boiling Point; 2. Freezing Point; 3.
Properties Osmotic Pressure; 4. Vapor Pressure
What is the Average Water 40- 75% Depending on age and body
content of total body fat content ( Obese people and women)
weight?
1. Transport Nutrients to cells; 2.
What are the 4 functions of Determine cell volume; 3. Remove
water? waste products (via urine); 4. Act as
body coolant (via sweating)
1. Intracellular water (inside the cel, 2/3
What is the location of
total body water); 2. Extracellular
water in the body?
(outside the cell, 1/3 total body water)
What are the 2 1. Intravascular (plasma, 93% H2O, 7%
subdivisions of Lipids and proteins); 2. Interstitial Cell
Extracellular Fluid? Fluid (surrounds cells in the tissues)
The use of ATP (Adenosine
Triphosphate) to move SOLUTES from
What is Active Transport?
an area of lower concentration to an
area of higher concentration
 A form of passive movement where
SOLUTES move from an area of higher
concentration to an area of lower
What is Diffusion? concentration; Results in equal
distribution of solutes; Dependent on
size and charge of ion and nature of the
membrane.
the passive movement of FLUIDS from
an area of lower solute concentration
and comparatively more fluid to an area
What is Osmosis? of higher solute concentration and
comparatively less fluid; Stops when
solute concentration is equal on both
sides
What is the Glomerular The nephrons filter about 125 ml of
Filtration Rate? blood per min or about 180 L per day;
How much urine is
1 - 2 Liters
produced per day?
Where is Antidiuretic
It is produced in the Hypothalamus and
Hormone produced and
stored in the Posterior Pituitary Gland
stored?
Itrestores blood volume by reducing
What is the function of
diuresis and increasing water retention.
ADH?

Increased serum osmolality or

What stimulate the release decreased blood volume; Once
of ADH? stimulated it signals the kidney's
reabsorption of water
Which cells in teh kidney
secrets RENIN that leads
Juxtaglomerular Cells
to the production of
Angiotensin II ?
What is produced due to
the stimulation of Aldosterone
Angiotensis II?
What is the function of It regulates the reabsorption of water
Aldosterone? and sodium within the nephrons.
What hormone is released
when the atrial pressure Atrial Natriuretic Peptide
increases?
It counteracts the effects of the renen-
Angiotensin-Aldosterone System by
decreasing blood pressure and
What is the purpose of
reducing the intravascular blood
Atrial Natriuretic Peptide?
volume; Suppresses renin levels;
Decreases ADH relaese; Causes
Vasodilation
What is the normal
To drink
response to thirst?
A physical property of a solution which
What is Osmolality? is based on the concentration of
solutes.
What is the body's
Secertion of ADH and Sensation of
response to an increased
thirst
Osmolality?
What are the effects of
Increases water content in the ECF;
fluid intake, from the
Dilutes eleveted Sodium levels;
sensation of THIRST, on
Decreases osmolality of the plasma
the body?
What is anothe name for
Antidiuretic Hormone Vasopressin
(ADH)?
What area of the kidney
It affects the collecting ducts in teh
does the secretion of ADH
kidneys to increase water absorption
affect?
What disease is caused by
Diabetes Insipidus, Which results in
the deficieny or or failure to
hypernatremia and dehydration
produce ADH?
Sodium and its associated
ions account for what
90%
percentage of osmotic
activity in the plasma?
Osmolality is regulated by change in
How are osmolality and
water balance; Volume is regfulated by
volume related?
changes in sadium balance.
What is are teh effects of Lower plasma osmolality; Suppressed
excess water intake? ADH and sensation of thirst
What is the clinical
significance of excess Hypo-osmolality and Hyponatremia
water intake?
What are the effects water Increased plasma osmolality; ADH and
deficiency? thirst sensation activation
What is the clinical
significance of Water Hyper-osmolality and hypernatremia
deficiency?
When does Hypernatremia Infants, Unconscious patients, or
become an issue (type of anyone unable to drink or ask for water
patients)?
What type of specimens Urine or Serum; Plasma not
are used to test for recommended to possible anticoagulant
Osmolality? coagulation
Solutions cool the expand when they
freeze; By determining the freezing
What is the Freezing Point point you can determine the amount of
Depression? particles based on the freezing curve;
this method used by most Osmometers

In Vapor Pressure, can

more or less solvent
Less
escape into vapor phase
when solutes are added?
What is teh formula for
1.86(Na)+ (Glucose/18) + (BUN/2.8)
calculated Osmolality?
What is the difference
Osmolal Gap; It is indicative of
between the measured and
dissolved particles in the serum
calculated osmolality?
What are Electrolytes? Ions capable of electrical charge
1. Cations (positively charged; migrates
How are Ions classified? towards cathode); 2. Anions (negatively
charged; migrates towards the anode)
where are Electrolytes
Tissues, Bones, and Fluids
located?
Ions have different concentrations but
What is Electroneutrality? totals balance to achieve a neutral
charge
What are the 4 Sodium; Chloride; Calcium; Bicarbonate
Extracellular Ions?
What are the 4 Intracellular Potassium; Phosphate; Magnesium;
Ions? Calcium
Which Ions have a general
function of body hydration? Na; K; Cl

What Ions have the

general function of enzyme Mg; Ca; Zn
activation?
Which Ions have the
general function of Ca; K; Mg
Neuromuscular activity?
What is the principal
Sodium
extracellular cation?
Which Ion accounts for
90% of all extracellular Na
cations?
How many mmol/L is
Sodium makes up 270 mmol/L of
Sodium and it's associated
Normal Plasma (290 mmol/L)
Ions of normal plasma?
What is the primary
Body hydration
function of Na?
What percentage of filtered
sodium is reabsorbed in 60 - 75%
the proximal tubule?
What is the renal threshold
110 - 130 mmol/L
for Na?
If aldosterone is increased then renal
How does Aldosterone absorption is increased; If aldosterone
affect renal absorption? is decreased, then renal absorption is
decreased.
A disease characterized by a
hypersecretion of aldosterone which
What is Primary increases renal tubular reabsorption of
Aldosteronism? sodium; results in increase in ECF and
Increased excretion of K and increase
of K in ECF.
Intake of water in response to thirst;
What 3 ways is sodium
Excretion of water; Blood volume status
regulated?

What is the serum plasma

136 - 145 mmol/L
reference for Na?
What is the reference
range in urine (24 hour) for 20 -220 mmol/day; varies with diet
Na?
What is the reference
136 - 150 mmol/L
range for Na in the CSF?
A deficiency in Sodium in the blood;
What is hyponatremia?
Serum/plasma < 135mmol/L
What level of Na in the
serum /plasma is clinically
< 130 mmol/L
siginificant for
hyponatremia?
What may decreased
Increased Na loss; Increased water
sodium levels be caused
retention; Water imbalance
by?
Nausea/vomiting; Muscle weakeness;
What are some symptoms
Ataxia (failure of muscle coordination);
of hyponatremia (<125
coma; headache; lethargy; seizures;
mmol/L)?
respiratory depression
An abnormallydecreased volume of
Whta is Hypovolemic
circulationg fluid in the body with a
Hyponatremia?
sodium loss in excess of water loss
What type of symptoms will
a patient have if their Na
Gastrointestional
level is between 125 - 130
mmol/L?
What are the lab findings
Urine Na > 20 mmol/day; renal loss of
for hypovolemic
sodium and water occuring
hyponatremia?
Increased volume of circulating fluids in
What is hypervolemic
teh body with a loss of sodium in
hyponatremia?
excess of water loss
What is nearly a problem
Edema
of water overload?
Urine Na > 20 mmol/day (acute or
What are the lab findings
chronic renal failure); Urine Na < 20
of hypervolemic
mmol/day (nephrotic syndrome,
hyponatremia?
Cirrhosis; CHF)
Increased sodium concentration ( 150
What is Hypernatremia?
mmol/L)
What are some ways that a
by the kidneys; profuse sweating;
loss of hypotonic fluid may
diarrhea; severe burns
occur?
High urine osmolality; Increased
What are the lab findings in hematocrit and protein; BUN increased;
hypernatremia? Creatinine normal; Specific gravity very
high; Serum Na > 160 mmol/L
What do most symptoms of
hypernatremia commonly Central Nervous System
involve?
What is the /principal major
Potassium
intracellular cation?
What is the renal threshold
it exhibits no renal threshold
for Potassium?
Where does 2% of the
body's potassium the Plasma
circulate?
Regulation of neuromuscular
What are the functions of excitability; Contraction of the heart;
Potassium? ICF volume; Hydrogen ion
concentration
What can cause an
erroneosly high K during Forearm exercise
venipuncture?
Where is nearly all of the K
Proximal tubules
reabsorbed?
What is the reference Plasma, serum- 3.4 - 5.0 mmol/L; Urine
range for K? (24 hr) 25 - 125 mmol/day
Plasma K concentration below the
What is hypokalemia?
lower limit of the reference range
What can cause GI loss; Renal loss; Increased cellular
hypokalemia? uptake; Decreased intake
What are the symptoms of
muscle weakeness; fatigue;
hypokalemia when it is <
constipation
3mmol/L?
How may mild
With diet rich in K ( dried fruit, Bran
hypokalemia be corrected?
cereal, Orange juice, Nuts, Bananas

K concentration above the upper limit of

What is Hyperkalemia?
the reference range
What level does the
potassium have to reach
before a patient will 8 mmol/L
experience muscle
weakness?
What is the short term
treatment for Administer calcium
hyperkalemia?
What substances will shift
K back into the cell during sodium Bicarbonate, Glucose, Insulin
hyperkalemia?
What is a major
extracellular anion that
Chloride
shifts to the movement of
Na and HCO3 ions?
What are the functions of Maintains osmolality, Blood volume,
Chloride? Electric neutrality
An abnormally high level of chloride in
What is hypochloremia?
the blood
Cystic Fibrosis causes an The exocrine glands (including the
obstruction of What sweat glands, mucous glands, and
glands? pancreas)
What type of disease is An autosomomal, recessively inherited
Cystic Fibrosis? disease of infants anf children
What is the single most
accepted common
diagnostic tool for the Sweat Chloride Test
clinical ID of cystic
fibrosis?
What is the predominate
Phosphate
intracellular anion?
Where is 80% of the body's
total phosphate contained? In the bones

which electrolyte promotes

energy transfer to cells
Phosphate
through the formation of
ATP?
Which electrolyte is the
primary ingredient in 2, 3
Phosphate
diphosphoglycerate (2, 3
DPG) ?
Loss of regulation by which
organ has, has the most
Kidneys
profound effect on
Phosphate levels?
Which are the factors that Vitamin-D, Clacitonin, Growht Hormone,
affect the regulation of Acid-base status, and Parathyroid
Phosphate? Hormone (most important factor)
What is hyophosphatemia? Abnormal decrease of phosphate in the
blood
What dietary deficiencies
Vitamin-D or Phosphate
can cause Rickets?
What is VDDR (Vit D A deficiency in teh renal reabsorption of
dependent rickets) caused phosphate resulting in a low serum
by? calcium and a low phosphate
 Abnormal increase of phosphate in teh
What is
blood; Most common cause renal failure
hyperphosphatemia?

What can cause an

Secere infection, Intensive exercise,
increased breakdown of
Neoplastic disorders, and Intravascular
cells to result in
hemolysis
hyperphosphatemia?
Circulating phospahte
levels are subject to what Circadian Rhythm
type of rhythm?
What is the 4th most
abundant cation and 2nd
Magnesium
most abundant intracellular
ion?
How much magnesium is
contained in the average 24 g
human body?
How much magnesium is
1/3
bound to protein?
what is the function of It is the essential cofactor in > 300
magnesium? Enzymes
What are some good
Raw nuts, dry cereal, frutis, vegtables,
sources of Magnesuium in
meat, fish, "hard" drinking water
a diet?
What increases the renal
reabsorption and
wnhances the absorption PTH
of Magnesium in the
intestine?
Which hormones has the
opposite effect of PTH with
Aldosterone and Thyroxine
Mg causing increased
excretion?
 Abnormally low Mg content of the blood
What is hypomagnesia?

What are symptom of

Patient will be asymptomatic until
hypomagnesia if the serum
serum level falls below .5 mmol/L
level is .59 mmol/L?
What may be the Most frequent symptoms involve
symptoms of a patient with cardiovascular, neuromuscular,
a Mg serum level of .48 psychiatric, and metabolic abnormalities
mmol/L?
If a patient with
hypomagnesia is severely
MgSO4
ill what solution will be
given parenterally?
Abnormally high level of Mg in the
What is
blood; most common cause renal failure
hypermagnesemia?

Increased intake and therapeutic intake

When could MgSO4 cause
with preeclampsia, cardiac arrythmia,
hypermagnesemia?
and MI
What are some mild to Hypotension, bradycardia, flushed skin,
moderate symptoms of increased temp, nausea, vomiting, and
hypermagnesemia? lethargy
Protein-bound (40% mostly albumin,
What are the 3 forms that
Ionized (45%), and complexed ( 15%
calcium exist in?
bound to anions
What are the irregular
muscle spasms called
that's caused by a Tetany
decreased ionized
calcium?
What increases total
calciumbut does not affect Hyperalbuminemia
ionized calcium?
 forms teeth and bones (with P), helps
maintain cell structure anf formation,
Plays role in cell membrane
What are the functions of
permeability and impulse transmission,
calcium?
affects contraction of muscles, and
plays role in blood clotting process and
release of hormones