This chapter is largely about the water and electrolytes ( salts )in your plasma and how the body manages to keep you from drying up and blowing away even if you are in the hot Texas sun and without liquid drink.
Urinalysis for detection of normal inorganic and organic constituentsrohini sane
An illustrative presentation on urinalysis for detection of normal inorganic and organic constituents for medical, dental , pharmacology and biotechnology students to facilitate easy-learning.
Serum Protein and Albumin-Globulin RatioASHIKH SEETHY
For MBBS Biochemistry Practical. Explains various methods of protein estimation and estimation of AG ratio, conditions leading to alterations in AG ratio etc.
Urinalysis for detection of normal inorganic and organic constituentsrohini sane
An illustrative presentation on urinalysis for detection of normal inorganic and organic constituents for medical, dental , pharmacology and biotechnology students to facilitate easy-learning.
Serum Protein and Albumin-Globulin RatioASHIKH SEETHY
For MBBS Biochemistry Practical. Explains various methods of protein estimation and estimation of AG ratio, conditions leading to alterations in AG ratio etc.
Renal function tests are very useful for effective clinical evaluation of renal failure for effective management. So it is useful for medical and allied professional students and clinical practitioners.
these clearance test plays an very important role in determining the functioning capacity and working status of kidney.
and we estimate how amount of compund is excreted in the urine and absorption too.
and i also attached the mathematical caluculation to identify the metabolic valuve of urea, creatinine, inulin clearance by kidney.
Test for pancreatic and intestinal functions are very important for clinical evaluation gastro intestinal disorders . So it will e useful for medical and allied professional students and practitioners.
Renal function tests are very useful for effective clinical evaluation of renal failure for effective management. So it is useful for medical and allied professional students and clinical practitioners.
these clearance test plays an very important role in determining the functioning capacity and working status of kidney.
and we estimate how amount of compund is excreted in the urine and absorption too.
and i also attached the mathematical caluculation to identify the metabolic valuve of urea, creatinine, inulin clearance by kidney.
Test for pancreatic and intestinal functions are very important for clinical evaluation gastro intestinal disorders . So it will e useful for medical and allied professional students and practitioners.
Fluid and electrolyte balance in oral surgeryPunam Nagargoje
• ELECTROLYTE BALANCE
• Def: - concentration of individual electrolytes in the body fluid compartments is normal and remains relatively constant.
• Electrolytes are dissolved in body fluids
• Sodium predominant extracellular cation, and chloride is predominant extracellular anion. Bicarbonate also in extracellular spaces
• Electrolyte balance
• Na + (Sodium)
– 90 % of total ECF cations
– 136 -145 mEq / L
– Pairs with Cl- , HCO3- to neutralize charge
– Low in ICF
– Most important ion in regulating water balance
– Important in nerve and muscle function
• Electrolyte imbalances: Sodium
• Hypernatremia (high levels of sodium)
– Plasma Na+ > 145 mEq / L
– Due to ↑ Na + or ↓ water
– Water moves from ICF → ECF
– Cells dehydrate
• HYPERATREMIA
• Hypernatremia Due to:
– Hypertonic IV soln.
– Oversecretion of aldosterone
– Loss of pure water
• Long term sweating with chronic fever
• Respiratory infection → water vapor loss
• Diabetes – polyuria
– Insufficient intake of water .
• Clinical manifestations
of Hypernatremia
• Thirst
• Lethargy
• Neurological dysfunction due to dehydration of brain cells
• Decreased vascular volume
• TREATMENT OF HYPERNATREMIA:
• Lower serum Na+
– Isotonic salt-free IV fluid [5% dextrose]
– Oral solutions preferable
• Hyponatremia
• Overall decrease in Na+ in ECF
• Two types: depletional and dilutional
• Depletional Hyponatremia
Na+ loss:
– diuretics, chronic vomiting
– Chronic diarrhea
– Decreased aldosterone
– Decreased Na+ intake
• Clinical manifestations of Hyponatremia
• Neurological symptoms
– Lethargy, headache, confusion, apprehension, depressed reflexes, seizures and coma
• Muscle symptoms
– Cramps, weakness, fatigue
• Gastrointestinal symptoms
– Nausea, vomiting, abdominal cramps, and diarrhea
• Tx – limit water intake or
• discontinue medicines such as diuretics
• TREATMENT OF HYPONATREMIA
• Hyponatremia which develops quickly should be treated quickly & vice-versa
• Patients with severe hypoNa (<115) are at risk of neurological damage
• Too rapid correction causes CENTRAL PONTINE MYELINOLYSIS.
• Targeted rate of correction: 0.5-1.0 mEq/L/hour
• Raise plasma Na by <10-12 mEq/L on first day
• Correction @ rate >25mEq/L places at high risk for central pontine myelinolysis
• Hypokalemia
• Normal serum k+ conc is 3.5 to 5.0 mEq/l
• Serum K+ < 3.5 mEq /L
• Beware if diabetic
– Insulin gets K+ into cell
– Ketoacidosis – H+ replaces K+, which is lost in urine
• β – adrenergic drugs or epinephrine
• Causes of Hypokalemia
• Decreased intake of K+
• Increased K+ loss
– Chronic diuretics
– Acid/base imbalance
– Trauma and stress
– Increased aldosterone
– Redistribution between ICF and ECF
• Treatment of hypokalamia
• Metabolic acidosis increases serum K+ levels & vice versa
• Post-op patients on fluid therapy should receive approx 60mEq/day to prevent hypokalemia
• 1mEq/L fall in serum K+= 200-400 mEq total body K+ deficit
• Failure to ↑ Sr. K+ even after sufficient correction should
POWER GENERATION OF THERMAL POWER PLANTsathish sak
. The kinetic energy of the molecules in a solid, liquid or gas
2. The more kinetic energy, the more thermal energy the object possesses
3. Physicists also call this the internal energy of an object
mathematics application fiels of engineeringsathish sak
MATHS IS HARD
MATHS IS BORING
MATHS HAS NOTHING TO DO WITH REAL LIFE
ALL MATHEMATICIANS ARE MAD!
BUT I CAN SHOW YOU THAT MATHS IS IMPORTANT IN
CRIME DETECTION MEDICINE FINDING LANDMINES
Plastic is a material consists of wide range of synthetic or organics that can be moulded into solid object with diverse shapes.
The word PLASTIC is derived from the Greek Word “PLASTIKOS” meaning capable of being shaped or moulded.
Plastics are organic polymers of higher molecular mass.
Radio frequency identification(RFID) technology using at various application by using radio frequency ranges.
It is especially used at tollgates. For automation of gate control.
It can also used at library systems.
Green Chemistry is the utilisation of a set of principles that reduces or eliminates the use or generation of hazardous substances in the design, manufacture and application of chemical products .
Seminar of U.V. Spectroscopy by SAMIR PANDASAMIR PANDA
Spectroscopy is a branch of science dealing the study of interaction of electromagnetic radiation with matter.
Ultraviolet-visible spectroscopy refers to absorption spectroscopy or reflect spectroscopy in the UV-VIS spectral region.
Ultraviolet-visible spectroscopy is an analytical method that can measure the amount of light received by the analyte.
Salas, V. (2024) "John of St. Thomas (Poinsot) on the Science of Sacred Theol...Studia Poinsotiana
I Introduction
II Subalternation and Theology
III Theology and Dogmatic Declarations
IV The Mixed Principles of Theology
V Virtual Revelation: The Unity of Theology
VI Theology as a Natural Science
VII Theology’s Certitude
VIII Conclusion
Notes
Bibliography
All the contents are fully attributable to the author, Doctor Victor Salas. Should you wish to get this text republished, get in touch with the author or the editorial committee of the Studia Poinsotiana. Insofar as possible, we will be happy to broker your contact.
Observation of Io’s Resurfacing via Plume Deposition Using Ground-based Adapt...Sérgio Sacani
Since volcanic activity was first discovered on Io from Voyager images in 1979, changes
on Io’s surface have been monitored from both spacecraft and ground-based telescopes.
Here, we present the highest spatial resolution images of Io ever obtained from a groundbased telescope. These images, acquired by the SHARK-VIS instrument on the Large
Binocular Telescope, show evidence of a major resurfacing event on Io’s trailing hemisphere. When compared to the most recent spacecraft images, the SHARK-VIS images
show that a plume deposit from a powerful eruption at Pillan Patera has covered part
of the long-lived Pele plume deposit. Although this type of resurfacing event may be common on Io, few have been detected due to the rarity of spacecraft visits and the previously low spatial resolution available from Earth-based telescopes. The SHARK-VIS instrument ushers in a new era of high resolution imaging of Io’s surface using adaptive
optics at visible wavelengths.
This presentation explores a brief idea about the structural and functional attributes of nucleotides, the structure and function of genetic materials along with the impact of UV rays and pH upon them.
Richard's aventures in two entangled wonderlandsRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
Toxic effects of heavy metals : Lead and Arsenicsanjana502982
Heavy metals are naturally occuring metallic chemical elements that have relatively high density, and are toxic at even low concentrations. All toxic metals are termed as heavy metals irrespective of their atomic mass and density, eg. arsenic, lead, mercury, cadmium, thallium, chromium, etc.
Slide 1: Title Slide
Extrachromosomal Inheritance
Slide 2: Introduction to Extrachromosomal Inheritance
Definition: Extrachromosomal inheritance refers to the transmission of genetic material that is not found within the nucleus.
Key Components: Involves genes located in mitochondria, chloroplasts, and plasmids.
Slide 3: Mitochondrial Inheritance
Mitochondria: Organelles responsible for energy production.
Mitochondrial DNA (mtDNA): Circular DNA molecule found in mitochondria.
Inheritance Pattern: Maternally inherited, meaning it is passed from mothers to all their offspring.
Diseases: Examples include Leber’s hereditary optic neuropathy (LHON) and mitochondrial myopathy.
Slide 4: Chloroplast Inheritance
Chloroplasts: Organelles responsible for photosynthesis in plants.
Chloroplast DNA (cpDNA): Circular DNA molecule found in chloroplasts.
Inheritance Pattern: Often maternally inherited in most plants, but can vary in some species.
Examples: Variegation in plants, where leaf color patterns are determined by chloroplast DNA.
Slide 5: Plasmid Inheritance
Plasmids: Small, circular DNA molecules found in bacteria and some eukaryotes.
Features: Can carry antibiotic resistance genes and can be transferred between cells through processes like conjugation.
Significance: Important in biotechnology for gene cloning and genetic engineering.
Slide 6: Mechanisms of Extrachromosomal Inheritance
Non-Mendelian Patterns: Do not follow Mendel’s laws of inheritance.
Cytoplasmic Segregation: During cell division, organelles like mitochondria and chloroplasts are randomly distributed to daughter cells.
Heteroplasmy: Presence of more than one type of organellar genome within a cell, leading to variation in expression.
Slide 7: Examples of Extrachromosomal Inheritance
Four O’clock Plant (Mirabilis jalapa): Shows variegated leaves due to different cpDNA in leaf cells.
Petite Mutants in Yeast: Result from mutations in mitochondrial DNA affecting respiration.
Slide 8: Importance of Extrachromosomal Inheritance
Evolution: Provides insight into the evolution of eukaryotic cells.
Medicine: Understanding mitochondrial inheritance helps in diagnosing and treating mitochondrial diseases.
Agriculture: Chloroplast inheritance can be used in plant breeding and genetic modification.
Slide 9: Recent Research and Advances
Gene Editing: Techniques like CRISPR-Cas9 are being used to edit mitochondrial and chloroplast DNA.
Therapies: Development of mitochondrial replacement therapy (MRT) for preventing mitochondrial diseases.
Slide 10: Conclusion
Summary: Extrachromosomal inheritance involves the transmission of genetic material outside the nucleus and plays a crucial role in genetics, medicine, and biotechnology.
Future Directions: Continued research and technological advancements hold promise for new treatments and applications.
Slide 11: Questions and Discussion
Invite Audience: Open the floor for any questions or further discussion on the topic.
(May 29th, 2024) Advancements in Intravital Microscopy- Insights for Preclini...Scintica Instrumentation
Intravital microscopy (IVM) is a powerful tool utilized to study cellular behavior over time and space in vivo. Much of our understanding of cell biology has been accomplished using various in vitro and ex vivo methods; however, these studies do not necessarily reflect the natural dynamics of biological processes. Unlike traditional cell culture or fixed tissue imaging, IVM allows for the ultra-fast high-resolution imaging of cellular processes over time and space and were studied in its natural environment. Real-time visualization of biological processes in the context of an intact organism helps maintain physiological relevance and provide insights into the progression of disease, response to treatments or developmental processes.
In this webinar we give an overview of advanced applications of the IVM system in preclinical research. IVIM technology is a provider of all-in-one intravital microscopy systems and solutions optimized for in vivo imaging of live animal models at sub-micron resolution. The system’s unique features and user-friendly software enables researchers to probe fast dynamic biological processes such as immune cell tracking, cell-cell interaction as well as vascularization and tumor metastasis with exceptional detail. This webinar will also give an overview of IVM being utilized in drug development, offering a view into the intricate interaction between drugs/nanoparticles and tissues in vivo and allows for the evaluation of therapeutic intervention in a variety of tissues and organs. This interdisciplinary collaboration continues to drive the advancements of novel therapeutic strategies.
THE IMPORTANCE OF MARTIAN ATMOSPHERE SAMPLE RETURN.Sérgio Sacani
The return of a sample of near-surface atmosphere from Mars would facilitate answers to several first-order science questions surrounding the formation and evolution of the planet. One of the important aspects of terrestrial planet formation in general is the role that primary atmospheres played in influencing the chemistry and structure of the planets and their antecedents. Studies of the martian atmosphere can be used to investigate the role of a primary atmosphere in its history. Atmosphere samples would also inform our understanding of the near-surface chemistry of the planet, and ultimately the prospects for life. High-precision isotopic analyses of constituent gases are needed to address these questions, requiring that the analyses are made on returned samples rather than in situ.
2. Introduction
– This chapter is largely about the water
and electrolytes ( salts )in your plasma and
how the body manages to keep you from
drying up and blowing away even if you are
in the hot Texas sun and without liquid
drink.
2
4. General Objectives
• Define the key terms
• Discuss the factors that regulate each of the electrolytes
• Discuss the physiological functions and clinical significance of
each of the electrolytes
• Discuss ISE and Osmometers
4
5. Electrolytes
• Electrolytes
– Substances whose molecules dissociate into ions
when they are placed in water.
– CATIONS (+) ANIONS (-)
• Medically significant / routinely ordered electrolytes
include:
– sodium (Na)
– potassium (K)
– chloride (Cl)
– and CO2 (in its ion form = HCO3- )
5
6. Electrolyte Functions
• Volume and osmotic regulation
• Myocardial rhythm and contractility
• Cofactors in enzyme activation
• Regulation of ATPase ion pumps
• Acid-base balance
• Blood coagulation
• Neuromuscular excitability
• Production of ATP from glucose
6
7. Electrolytes
• General dietary requirements
– Most need to be consumed only in small
amounts as utilized
– Excessive intake leads to increased excretion
via kidneys
– Excessive loss may result in need for
corrective therapy
• loss due to vomiting / diarrhea; therapy required
- IV replacement, Pedilyte, etc.
7
8. Electrolytes
• Water (the diluent for all
electrolytes) constitutes 40-
70% of total body and is
distributed:
– Intracellular – inside cells
• 2/3 of body water
(ICW)
– Extracellular – outside cells
• 1/3 of body water
– Intravascular – plasma
93% water
» Intrastitial -surrounds the
cells in tissue (ISF)
8
10. Electrolytes
• Ions exist in all of these fluids, but the
concentration varies depending on individual
ion and compartment
• The body uses active and passive transport
principles to keep water and ion concentration
in place
10
11. Electrolytes
• Sodium has a pulling effect on water
– Na affects extracellular fluids (plasma &
interstitial) equally.
– However, because there is considerably more Na
outside cells than inside, the water is pulled out
of cells into the extracellular fluid.
– Na determines osmotic pressure of extracellular
fluid.
11
12. Electrolytes
• Proteins (especially albumin) inside the
capillaries strongly pulls/keeps water inside
the vascular system
– Albumin provides oncotic pressure.
– By keeping Na & albumin in their place, the
body is able to regulate its hydration.
• When there is a disturbance in osmolality,
– the body responds by regulating water intake,
– not by changing electrolyte balance
12
14. Electrolytes
Osmolality -
• Physical property of a solution based
on solute concentration
– Water concentration is regulated by
thirst and urine output
– Thirst and urine production are
regulated by plasma osmolality
14
15. Electrolytes
Osmolality -
∀ ↑ osmolality stimulates two responses
that regulate water
– Hypothalamus stimulates the sensation of
thirst
– Posterior pituitary secrets ADH
• ( ADH increases H2O re-absorption by renal
collection ducts )
• In both cases, plasma water increases
15
17. Electrolytes
• Determination
– 2 methods or principles to determine
osmolality
• Freezing point depression
– (the preferred method)
• Vapor pressure depression
– Also called ‘dewpoint’
17
18. Specimen Collection
• Serum
• Urine
• Plasma not recommended due to
osmotically active substances that can be
introduced into sample
• Samples should be free of particulate
matter..no turbid samples, must centrifuge
18
19. Electrolytes
• Calculated osmolality
– uses glucose, BUN, & Na values
– (Plasma Sodium accounts for 90 % of plasma
osmolality)
• Formula:
– 1.86 (Na) + glucose∕18 + BUN∕2.8 = calculated osmolality
• Osmolal gap = difference between calculated and
determined osmolatity
– Should be less than 10-15 units difference
• (measured – calculated = 10 to 15)
19
20. Electrolytes
• Increase in the difference between
measured and calculated
– would indicate presence of osmo active
substances such as possibly alcohol - ethanol,
methanol, or ethylene glycol or other substance.
∀ ↑ Osmolality are concerns for
– Infants
– Unconscious patients
– Elderly
20
21. Electrolytes
• Decreased osmolality
– Diabetes insipidus
• ADH deficiency
• Because they have little / no water re-
absorption, produce 10 – 20 liters of urine
per day
21
22. Electrolytes
• Osmolality normal values
– Serum – 275-295 mOsm/Kgm
– 24 hour urine – 300-900 mOsm/Kgm
– urine/serum ratio – 1.0-3.0
– Osmolal gap < 10-15 mOsm (depending on
author)
22
23. Electrolytes
• Classifications of ions - by their charge
– Cations – have a positive charge - in an
electrical field, (move toward the cathode)
• Na+ = most abundant extracellular cation
• K+ = most abundant intracellular cation
23
24. Electrolytes
– Anions – have a negative charge - move
toward the anode
• Cl– (1st) most abundant extracellular anion
• HCO–3
– (bicarbonate) second most abundant
extracellular anion
24
25. Electrolytes
• Phosphate is sometimes discussed as
an electrolyte, sometimes as a
mineral.
– HPO-2
4 / H2PO-
4
– when body pH is normal, HPO-2
4 is the
usual form (@ 80 % of time)
25
27. Routinely measured electrolytes
• Sodium –
– the major cation of extracellular fluid outside
cells
– Most abundant (90 %) extracellular cation
– Functions - recall influence on regulation of
body water
• Osmotic activity - sodium determines osmotic activity
(Main contributor to plasma osmolality)
• Neuromuscular excitability - extremes in concentration
can result in neuromuscular symptoms
27
28. Routinely measured electrolytes
• Diet - sodium is easily absorbed
• Na-K ATP-ase Pump
– pumps Na out and K into cells
• Without this active transport pump, the
cells would fill with Na and subsequent
osmotic pressure would rupture the cells
28
29. Regulation of Sodium
• Concentration depends on:
– intake of water in response to thirst
– excretion of water due to blood volume or osmolality
changes
• Renal regulation of sodium
– Kidneys can conserve or excrete Na+ depending on ECF
and blood volume
• by aldosterone
• and the renin-angiotensin system
– this system will stimulate the adrenal cortex to
secrete aldosterone.
29
30. Sodium (Na)
• Aldosterone
– From the (adrenal cortex)
– Functions
• promote excretion of K
• in exchange for reabsorption of Na
30
32. Sodium (Na)
• Urine testing & calculation:
– 1st. Because levels are often increased, a
dilution of the urine specimen is usually
required.
– Then the result from the instrument (mEq/L or
mmol/L) X # L in 24 hr.
32
33. Clinical Features: Sodium
• Hyponatremia: < 135 mmol/L
– Increased Na+ loss
• Aldosterone deficiency
– Addison’s disease (hypo-adrenalism, result in ➷
aldosterone)
• Diabetes mellitus
– In acidosis of diabetes, Na is excreted with
ketones
• Potassium depletion
– K normally excreted , if none, then Na
• Loss of gastric contents
33
34. Hyponatremia
• Increased water retention
– Dilution of serum/plasma Na+
– excretion of > 20 mmol /mEq urine
sodium)
• Renal failure
• Nephrotic syndrome
• Water imbalance
– Excess water intake
– Chronic condition
34
35. Hypernatremia
• Excess water loss resulting in dehydration
(relative increase)
– Sweating
– Diarrhea
– Burns
– Dehydration from inadequate water intake,
including thirst mechanism problems
– Diabetes insipidus
• (ADH deficiency …↑ H2O loss )
35
36. Hypernatremia
• Excessive IV therapy
• comatose diabetics following
treatment with insulin. Some Na in
the cells is kicked out as it is
replaced with potassium.
– Cushing's syndrome - opposite of
Addison’s
36
37. Specimen Collection:
Sodium (Na)
• serum (sl hemolysis is OK, but not gross)
• heparinized plasma
• timed urine
• sweat
• GI fluids
• liquid feces (would be only time of
excessive loss)
37
38. Sodium (Na)
Note:
• Increased lipids or proteins may
cause false decrease in results.
artifactual/pseudo-hyponatremia
38
39. Sodium (Na)
• Sodium determination
– Ion-selective (specific) electrode
• Membrane composition = lithium aluminum silicate glass
• Semi-permeable membrane allows sodium ions to cross
300X faster than potassium and is insensitive to
hydrogen ions.
• direct measurement
– where specimen is not diluted
– gives the truest results
– systems that dilute the sample give lower
results (called dilutional effect)
39
40. Sodium (Na)
– Flame emission spectrophotometry (flame
photometer)
• Na emits λ 589 nm (yellow)
• Use internal standard of lithium or cesium
• Possible for a dilutional error to occur in some
flame photometer systems, but literature does
not dwell on it.
40
41. Routinely measured
electrolytes
• Potassium (K)
– the major cation of intracellular fluid
• Only 2 % of potassium is in the plasma
• Potassium concentration inside cells is 20 X
greater than it is outside.
• This is maintained by the Na pump,
(exchanges 3 Na for 1 K)
41
1
20
=
OUTSIDE
INSIDE
42. Potassium (K)
• Function – critically important to the
functions of neuromuscular cells
– Critical for the control of heart
muscle contraction!
• ↑ potassium promotes muscular
excitability
• ↓ potassium decreases excitability
(paralysis and arrhythmias)
42
43. Potassium (K)
• Regulation
– Diet
• easily consumed (bananas etc.)
– Kidneys
• Kidneys - responsible for regulation.
Potassium is readily excreted, but gets
reabsorbed in the proximal tubule - under
the control of ALDOSTERONE
43
45. Hypokalemia
• Decrease in K concentration
• Effects
• neuromuscular weakness & cardiac
arrhythmia
45
46. Causes of hypokalemia
– Excessive fluid loss ( diarrhea, vomiting,
diuretics )
– ↑ Aldosterone promote Na reabsorption …
K is excreted in its place (Cushing’s
syndrome = hyper aldosterone)
– Insulin IVs promote rapid cellular potassium
uptake
46
47. Causes of hypokalemia
• Increased plasma pH ( decreased Hydrogen ion )
47
K+
moves into RBCs to preserve electrical balance,
causing plasma potassium to decrease.
( Sodium also shows a slight decrease )
H+
K+
RBC
48. Hyperkalemia
• Increased K concentration
• Causes
– IV’S or other increased intake
– Renal disease – impaired excretion
– Acidosis (Diabetes mellitus )
• H+ competes with K+ to get into cells & to be
excreted by kidneys
• Decreased insulin promotes cellular K loss
• Hyperosomolar plasma (from glucose) pulls↑
H2O and potassium into the plasma
48
51. Potassium (K)
• Determination
– Ion-selective electrode (valinomycin
membrane)
• insensitive to H+, & prefers K+ 1000
X over Na+
– Flame photometry
• - K λ 766 nm
51
52. Chloride ( Cl -
)
• Chloride - the major anion of extracellular
fluid
– Chloride moves passively with Na+
or against
HCO3
-
to maintain neutral electrical charge
– Chloride usually follows Na (if one is
abnormal, so is the other)
– Function - not completely known
• body hydration
• osmotic pressure
• electrical neutrality & other functions
52
53. Chloride ( Cl -
)
• Regulation via diet and kidneys
– In the kidney, Cl is reabsorbed in the
renal proximal tubules, along with
sodium.
– Deficiencies of either one limits the
reabsorption of the other.
53
59. Chloride ( Cl -
)
• Mercurimetric titration of Schales and Schales
– Precipitate protein out - 1 st step
– Titrate using solution of mercury
• Hg +2 + 2 Cl- = HgCl2
– When all chloride is removed, next drop of mercury will
complex with diphenylcarbazone indicator to produce violet
color = endpoint
• a calculation required to determine amt of Cl present by
the amt of Hg used
59
60. Chloride ( Cl -
)
• Colorimetric
– Procedure suitable for automation
– Chloride complexes with mercuric
thiocyanate
– forms a reddish color proportional to
amt of Cl in the specimen.
60
61. Chloride ( Cl -
)
• Sweat chloride –
– Remember, need fresh sweat to accurately measure
true Cl concentration.
– Testing purpose - to ID cystic fibrosis patients by
the increased salt concentration in their sweat.
• Pilocarpine iontophoresis
– Pilocarpine = the chemical used to stimulate the
sweat production
– Iontophoresis = mild electrical current that simulates
sweat production
61
62. Chloride ( Cl -
)
• CSF chloride
– NV = 120 - 132 mEq/L (higher than
serum)
– Often CSF Cl is decreased when CSF
protein is increased, as often occurs
in bacterial meningitis.
62
63. bicarbonate ion (HCO3
-
)
• Carbon dioxide/bicarbonate –
– * the major anion of intracellular fluid
– 2nd
most important anion (2nd
to Cl)
• Note: most abundant intra-cellular
anion
• 2nd
most abundant extra-cellular
anion
63
64. bicarbonate ion (HCO3
-
)
• Total plasma CO2 =
HCO3
-
+ H2CO3
-
+ CO2
– HCO3
-
(carbonate ion) accounts for
90% of total plasma CO2
– H2CO3
-
carbonic acid (bicarbonate)
64
65. bicarbonate ion (HCO3
-
)
• Regulation:
– Bicarbonate is regulated by
secretion / reabsorption of the
renal tubules
– Acidosis : renal excretion↓
– Alkalosis : renal excretion↑
65
66. bicarbonate ion (HCO3
-
)
• Kidney regulation requires the enzyme
carbonic anhydrase - which is present in
renal tubular cells & RBCs
carbonic anhydrase carbonic anhydrase
Reaction: CO2 + H2O H2CO3 H+ + HCO–3⇋ →
66
67. bicarbonate ion (HCO3
-
)
CO2 Transport forms
– 8% dissolved in plasma
• dissolved CO2
– 27% carbamino compounds
• C02 bound to hemoglobin
– 65% bicarbonate ion
• HCO3- - carbonate ion
67
68. bicarbonate ion (HCO3
-
)
• Normal values
– Total Carbon dioxide (venous) – @ 22-
30 mmol/L
• includes bicarb, dissolved & undissociated
H2CO3 - carbonic acid (bicarbonate)
– Bicarbonate ion (HCO3–) – 22-26 mEq/L
68
69. bicarbonate ion (HCO3
-
)
• Function –
– CO2 is a waste product
– continuously produced as a result of cell
metabolism,
– the ability of the bicarbonate ion to accept a
hydrogen ion makes it an efficient and effective
means of buffering body pH
– dominant buffering system of plasma
– makes up @ 95% of the buffering capacity of
plasma
69
70. bicarbonate ion (HCO3
-
)
• Significance
– The bicarbonate ion (HCO–3) is the
body's major base substance
– Determining its concentration provides
information concerning metabolic
acid/base
70
71. bicarbonate ion (HCO3
-
)
• CO2 /bicarb Determination
– Specimen can be heparinized plasma,
arterial whole blood or fresh serum.
Anaerobic collection preferred.
• methods
• Ion selective electrodes
• Colorimetric
• Calculated from pH and PCO2 values
• Measurement of liberated gas
71
72. Electrolyte balance
• Anion gap – an estimate of the unmeasured
anion concentrations such as sulfate,
phosphate, and various organic acids.
72
73. Electrolyte balance
• Calculations
– 1. Na - (Cl + CO2 or HCO3-) =
– NV 8-12 mEq/L
– Or
– 2. (Na + K) - (Cl + CO2 or HCO3-)
NV 7-14 mEq/L
• which one to use may depend on whether K
value is available. Some authors feel that K
value is so small and usually varies little, that
it is not worth including into the formula.
73
74. Electrolyte balance
• Causes in normal patients
– what causes the anion gap?
– 2/3 plasma proteins & 1/3 phosphate& sulfate ions, along with
organic acids
• Increased AG –
– uncontrolled diabetes (due to lactic & keto acids)
– severe renal disorders
• Decreased AG -
– a decrease AG is rare, more often it occurs when one
test/instrument error
74
76. ELECTROYTE TOP 10
∀ ↑ Osmolality is detected by the Hypothalamus Gland Thirst
sensation and secretion of ADH by Posterior Pituitary Gland. ADH
increases renal reabsorption of water
∀ ↓ Blood Volume stimulates Renin - Angiotensin - Aldosterone system.
Aldosterone secretion by the Adrenal Cortex stimulates increased renal
absorption of sodium
• Sodium is the main extracellular cation and contributor to plasma
osmolality
• Potassium is the main intracellular cation
• Plasma “COPlasma “CO22” = Dissolved CO” = Dissolved CO22 + H+ H22 COCO33 + HCO+ HCO33
--
• Chloride is usually a passive follower of Sodium to maintain electricalChloride is usually a passive follower of Sodium to maintain electrical
chargecharge
• Sodium and Potassium usually move opposite each otherSodium and Potassium usually move opposite each other
• Parathyroid Hormone ( PTH ) secretionsecretion increases plasma calcium ,,
increases plasma magnesium andand decreases phosphatedecreases phosphate
• Acidosis is associated with ↑ Potassium ( Alkalosis with ↓ Potassium ) 76