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Chemistry Internship Study Questions Section 2
Electrolytes & Osmolality
79
Chemistry
Undergraduate 4
10/23/2015

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Cards

Term
Why should GRAY top and PURPLE top tubes be AVOIDED when doing electrolyte testing?
Definition
They interfere with Calcium and also Contain Potassium
Term
Which electrolytes are most affected by hemolysis?
Definition
Potassium & Phosphate
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
A
[image]
Definition
Extra
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
B
[image]
Definition
Intra
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
C
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Definition
Extra
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
D
[image]
Definition
Cation
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
E
[image]
Definition
Cation
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
F
[image]
Definition
Anion
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
G
[image]
Definition
Dehydration, Cushing's, Diabetes insipidus
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
H
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Definition
Hemolysis, Tissue trauma, Renal failure, Burns, Diabetes
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
I
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Definition
Dehydration, Metabolic acidosis
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
J
[image]
Definition
Addison's Disease, Diuretics, Diarrhea, Kidney Disease, Heart Failure
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
K
[image]
Definition
Alkalosis, Insulin Excess
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
L
[image]
Definition
Vomiting, Renal Failure
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
M
[image]
Definition
135-145 mEq/L
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
N
[image]
Definition
3.5-5.0 mEq/L
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
O
[image]
Definition
100-109
(Mayo Clinic >/= 18 years:98-107, <18 years: 102-112)
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
P
[image]
Definition
<120
>155
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
Q
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Definition
<3
>6
Term
Fill in the chart. For "highest" and "lowest" levels, list only the most common conditions:
R (UAMS neonates)
[image]
Definition
<90 mmol/L
>120 mmol/L
Term
Define osmolality
Definition
Number of particles present per unit of solution;
Proportional to concentration
Term
What are accepted normal ranges for osmolality for plasma?
Definition
280-300 m Osm/kg
Term
What are accepted normal ranges for osmolality for urine?
Definition
300-900 m Osm/kg
Term
How will an increased osmolality affect each of the following colligative properties:

Freezing Point
Definition
Decreased value
Term
How will an increased osmolality affect each of the following colligative properties:

Vapor Pressure
Definition
Decreased value
Term
How will an increased osmolality affect each of the following colligative properties:

Boiling Point
Definition
Increased value
Term
How will an increased osmolality affect each of the following colligative properties:

Osmotic Pressure
Definition
Increased value
Term
What is the formula from class that is used to calculate osmolality?
Definition
2(Na) + Glucose/20 + BUN/3
Term
Calculate an osmolality from the following data (use the formula from class):
BUN 20 mg/dL
Glucose 100 mg/dL
Sodium 140 mEq/L
Definition
292 mOsm/kg
Term
What are the most common conditions responsible for hyperosmolality of serum?
Definition
Diabetes mellitus, Dehydration, Renal Failure, and Hyperproteinemia
Term
What is the formula for delta osmolality?
Definition
Measured-Calculated
Term
What is the normal range for delta osmolality?
Definition
0-10
Term
What 3 major substances are most commonly associated with an elevated delta osmolality?
Definition
Methanol, isopropanol, ethylene glycol. Increased lipids, protein, or glucose
Term
What is the most common cause of a delta osmolality <0?
Definition
Error
Term
What is meant by "anion gap"?
Definition
Estimate of unmeasured electrolyte
Term
Why is an "anion gap" measured?
Definition
Used to assess acid-base disorders and lab QC
Term
Give the formula for the anion gap
Definition
(Na + K) - (Cl + HCO3)
Term
What is the normal range for the "anion gap"?
Definition
12-20 mmol/L
Term
How will the "anion gap" be affected in the following conditions? (increased, decreased, or unaffected)
Salicylate Poisoning
Definition
Increased
Term
How will the "anion gap" be affected in the following conditions? (increased, decreased, or unaffected)
Ketosis
Definition
Increased
Term
How will the "anion gap" be affected in the following conditions? (increased, decreased, or unaffected)
Dehydration
Definition
Increased
Term
How will the "anion gap" be affected in the following conditions? (increased, decreased, or unaffected)
Ethylene Glycol Poisoning
Definition
Increased
Term
What is the most likely cause of an AG<5?
Definition
Lab Error OR Significant Increase in Na, K, Cl, or HCO3
Term
What is the difference between a direct and indirect ISE analysis?
Definition
Direct - NO Sample Dilution required
Indirect - Requires Sample Dilution
Term
What are the main sources of interference in the indirect ISE test?
Definition
Increased Lipids & Proteins
Term
What is the clinical significance of an elevated sweat chloride test?
Definition
Cystic Fibrosis
Term
What is the name of the procedure/technique used to collect sweat for analysis?
Definition
Pilocarpine iontophoresis
Term
Which 2 analytes, when markedly decreased in serum, can cause tetany?
Definition
Calcium & Magnesium
Term
Why are oxalate & EDTA unacceptable anticoagulants for calcium analysis?
Definition
Both chelate Calcium, causing falsely Decreased results
Term
Why is the determination of ionized Calcium important?
Definition
This form is NOT bound to protein and is a better reflection of Calcium levels in patients that may have protein abnormalities or liver disease
Term
What effect does each of the following have on serum Calcium levels:
PTH
Definition
Increased
Term
What effect does each of the following have on serum Calcium levels:
Calcitonin
Definition
Decreased
Term
What effect does each of the following have on serum Calcium levels:
Vitamin D
Definition
Increased
Term
What is the most common cause of elevated plasma Calcium?
Definition
Hyperparathyroidism
Term
What common plasma cell disease is also associated with elevated Calcium?
Definition
Multiple Myeloma (MM)
Term
How does the Albumin concentration influence the level of Calcium?
Definition
Most Calcium is Albumin bound so when there are Increased levels of Albumin there will likely be Increased levels of Calcium
Term
Where is most body Iron found?
Definition
Blood / RBCs (Hemoglobin)
Term
What is the carrier protein for Iron?
Definition
Transferrin
Term
What is the storage form of Iron?
Definition
Ferritin
Term
Where is the storage form of Iron stored?
Definition
Liver & Bone Marrow
Term
What are the most common causes of Iron Deficiency Anemia (IDA)?
Definition
Chronic Blood Loss, Pregnancy, Childhood, & Dietary Insufficiency
Term
Describe the typical RBC morphology in Iron Deficiency Anemia (IDA)
Definition
Microcytic, Hypochromic
Term
What is the purpose of the TIBC test?
Definition
Indirect measure of Transferrin. Used to differentiate causes of Iron deficiency.
Term
How is TIBC calculated / What is the formula for TIBC?
Definition
TIBC = Transferrin * 1.4
Term
What is %Tf Saturation?
Definition
Measures the degree to which the binding sites are saturated with Iron
Term
What is the formula for %Tf Saturation?
Definition
(Fe/TIBC)x100
Term
Under what conditions (test results) can the TIBC & %Tf Saturation NOT be calculated?
Definition
Fe <5 OR Transferrin <70
Term
Complete the chart below. Indicate whether the following conditions are typically associated with Increased, Normal, or Decreased test results:
A
[image]
Definition
Decreased
Term
Complete the chart below. Indicate whether the following conditions are typically associated with Increased, Normal, or Decreased test results:
B
[image]
Definition
Increased
Term
Complete the chart below. Indicate whether the following conditions are typically associated with Increased, Normal, or Decreased test results:
C
[image]
Definition
Decreased
Term
Complete the chart below. Indicate whether the following conditions are typically associated with Increased, Normal, or Decreased test results:
D
[image]
Definition
Decreased
Term
Complete the chart below. Indicate whether the following conditions are typically associated with Increased, Normal, or Decreased test results:
E
[image]
Definition
Decreased
Term
Complete the chart below. Indicate whether the following conditions are typically associated with Increased, Normal, or Decreased test results:
F
[image]
Definition
Decreased
Term
Complete the chart below. Indicate whether the following conditions are typically associated with Increased, Normal, or Decreased test results:
G
[image]
Definition
Decreased
Term
Complete the chart below. Indicate whether the following conditions are typically associated with Increased, Normal, or Decreased test results:
H
[image]
Definition
Normal / Increased
Term
Complete the chart below. Indicate whether the following conditions are typically associated with Increased, Normal, or Decreased test results:
I
[image]
Definition
Increased
Term
Complete the chart below. Indicate whether the following conditions are typically associated with Increased, Normal, or Decreased test results:
J
[image]
Definition
Normal / Decreased
Term
Complete the chart below. Indicate whether the following conditions are typically associated with Increased, Normal, or Decreased test results:
K
[image]
Definition
Increased
Term
Complete the chart below. Indicate whether the following conditions are typically associated with Increased, Normal, or Decreased test results:
L
[image]
Definition
Increased
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