Exam 4 Chemistry Review/Study Questions Part 1 – Flashcards
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List 3 functions of electrolytes |
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Water balance, acid-base balance, muscle contraction |
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Name the major cation of extracellular fluid: |
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Na |
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Name the major cation of intracellular fluid: |
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K |
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Name the major anion of extracellular fluid: |
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Cl |
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Name the major anion of intracellular fluid |
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PO4 |
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When sodium is reabsorbed in the tubules, what 2 electrolytes will be secreted? |
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K & H |
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When sodium is reabsorbed in the tubules, what electrolyte will also be reabsorbed? |
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Cl |
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What hormone regulates the reabsorption of Sodium in the distal tubules? |
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Aldosterone |
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What hormone regulates the reabsorption of Water in the distal tubules |
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ADH (vasopressin) |
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What hormone regulates the reabsorption of Calcium |
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PTH |
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For each of the following conditions, indicate if the serum osmolality will be increased or decreased: Diabetes insipidus |
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Increased |
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For each of the following conditions, indicate if the serum osmolality will be increased or decreased: Water intoxication |
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Decreased |
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For each of the following conditions, indicate if the serum osmolality will be increased or decreased: Dehydration |
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Increased |
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For each of the following conditions, indicate if the serum osmolality will be increased or decreased: Alcohol intoxication |
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Increased |
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State the normal range for serum osmolality |
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275-295 mOsm/kg |
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State the normal range for urine osmolality |
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300-900 mOsm/kg |
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How will an increased osmolality affect the freezing point of a solution? |
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It will decrease it |
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State the formula for a osmolal gap |
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Measured (automated) Osmo minus calculated Osmo |
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Give a likely explanation for a delta Osmo of: -5 |
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Error |
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Give a likely explanation for a delta Osmo of: 5 |
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Normal |
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Give a likely explanation for a delta Osmo of: 50 |
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Increased (Alcohols, Lactate, Increased Protein/Glucose/Lipids) |
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What is the most common cause of hypernatremia? |
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Dehydration |
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Which electrolyte can cause cardiac arrest if either elevated or decreased? |
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K |
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With which electrolyte does chloride "shift" in an attempt to maintain electrical neutrality? |
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HCO3 |
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As sodium levels become elevated in plasma, what 2 electrolytes will be excreted from the urine to maintain electrical neutrality? |
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K & H |
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Of all the electrolytes, which one is most affected by hemolysis? |
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K |
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How will blood pH be affected when bicarbonate levels fall? |
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It will become more acidic |
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List the 3 hormones responsible for regulating calcium levels. |
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PTH, Calcitonin, & Vitamin D |
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How will an elevated albumin level affect the calcium level? |
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As albumin increases, so will calcium |
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Which form of calcium should be tested to best ascertain active levels of calcium in the plasma? |
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Ionized |
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Which two electrolytes can cause tetany if levels fall too dramatically? |
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Ca & Mg |
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In general, what is the relationship between levels of Ca and phosphate? |
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Inverse (in plasma) |
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When is lactate formed? |
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When tissues don’t get enough oxygen, anaerobic glycolysis produces lactic acid. |
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how are lactate levels useful to the physician? |
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Used to predict mortality |
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When is an anion gap usually decreased? |
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Instrument error or when 1 analyte is above the upper limits of normal |
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List conditions causing an elevated AG |
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Alcohols, organic acids, renal failure |
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As Osmolality Increases, what happens to the following: Freezing Point |
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Decreases |
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As Osmolality Increases, what happens to the following: Osmotic Pressure |
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Increases |
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As Osmolality Increases, what happens to the following: Boiling Point |
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Increases |
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As Osmolality Increases, what happens to the following: Vapor Pressure |
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Decreases |
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What is associated with the following: Decreased Serum Osmolality |
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Water Intoxication Excessive ADH Secretion |
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What is associated with the following: Decreased Urine Osmolality |
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Diabetes Insipidus Polydipsia |
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What is associated with the following: Increased Serum Osmolality |
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Dehydration Hyperglycemia Diabetes Insipidus Alcohol Intoxication Renal Failure |
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What is associated with the following: Increased Urine Osmolality |
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Dehydration Glycosuria High protein diets causing inc. urine excretion Proteinuria |
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What is the formula to calculate osmolality? |
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2(Na) + Glucose/20 + BUN/3 |
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What should be the range for Normal Delta Osmo? |
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0-10 |
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If Delta Osmo is a negative number, what should you suspect? |
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Technical Error |
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If Delta Osmo is >10, what should you suspect? |
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Ethanol, Methanol, Ethylene Glycol Lactic Acid Hyperlipidemia or Hyperproteinemia Technical Error |
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What is the name of the method used to analyze the most common electrolytes? |
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ISE |
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What two types of electrodes are used in the ISE method? |
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Reference & Sample (or indicator) |
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What titration method can be used to measure chloride in plasma? |
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Coulometry (outdated) |
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With what trace metal is chloride mixed in this titration method? |
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Ag+ (silver ion) |
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Name the hormone responsible for regulating sodium reabsorption in the renal tubules |
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Aldosterone |
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In regards to sample requirements, what is the difference between direct and indirect ISE? |
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Direct uses undiluted sample Indirect uses pre-diluted sample |
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What can Indirect ISE potentially cause? |
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False decreased sodium if proteins/lipids are too high |