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1. Southeast University
Electrolyte, acid base and glucose
disorders
Course Tittle: Clinical Pathology-I
Course Code: BPH- 3014
Submitted to: Ferdowsi Akter
Lecturer, Department of Pharmacy
Submitted by: Sumaiya Sajnin
ID: 2018000300043
Submission date: 08.08.2020

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INDEX
Pathology ...................................................................................................................................2
Electrolyte disorders ..................................................................................................................2
Types of electrolyte disorders................................................................................................3
Calcium ..............................................................................................................................3
Chloride..............................................................................................................................3
Magnesium.........................................................................................................................4
Phosphate ...........................................................................................................................4
Potassium ...........................................................................................................................5
Sodium ...............................................................................................................................5
Symptoms...............................................................................................................................5
Treatment ...............................................................................................................................6
Prevention ..............................................................................................................................6
Acid base disorders ....................................................................................................................7
Respiratory acidosis ...............................................................................................................7
Symptoms...........................................................................................................................7
Cause..................................................................................................................................7
Prevention ..........................................................................................................................7
Metabolic acidosis..................................................................................................................7
Symptoms...........................................................................................................................7
Cause..................................................................................................................................7
Treatment ...........................................................................................................................8
Alkalosis.................................................................................................................................8
Symptoms...........................................................................................................................8
Cause..................................................................................................................................8
Treatment ...........................................................................................................................8
Glucose disorders.......................................................................................................................9
Symptoms...............................................................................................................................9
Cause....................................................................................................................................10
Prevention ............................................................................................................................10
Bibliography.............................................................................................................................10

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Pathology
Pathology is a branch of medical science primarily concerning the cause, origin and nature of
disease. It involves the examination of tissues, organs, bodily fluids and autopsies in order to
study and diagnose disease. Currently, pathology can be divided into eight main areas,
depending on the types of methods used or the types of diseases examined. They are:
 General pathology
 Anatomical pathology
 Clinical pathology
 Chemical Pathology or Biochemistry
 Genetics
 Hematology
 Immunology
 Microbiology (Robertson, 2020)
Electrolyte disorders
Electrolyte imbalance, or water-electrolyte imbalance, is an abnormality in the concentration
of electrolytes in the body. Electrolytes play a vital role in maintaining homeostasis in the
body. They help to regulate heart and neurological function, fluid balance, oxygen delivery,
acid–base balance and much more. Electrolyte imbalances can develop by consuming too
little or too much electrolyte as well as excreting too little or too much electrolyte.
Electrolytes are elements and compounds that occur naturally in the body. They control
important physiologic functions.

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These substances are present in our blood, bodily fluids, and urine. They’re also ingested
with food, drinks, and supplements. An electrolyte disorder occurs when the levels of
electrolytes in your body are either too high or too low. Electrolytes need to be maintained in
an even balance for your body to function properly. Otherwise, vital body systems can be
affected. (Anonymus, 2020)
Types of electrolyte disorders
Elevated levels of an electrolyte are indicated with the prefix “hyper-.” Depleted levels of an
electrolyte are indicated with “hypo-.”
Conditions caused by electrolyte level imbalances include:
1) calcium: hypercalcemia and hypocalcemia
2) chloride: hyperchloremia and hypochloremia
3) magnesium: hypermagnesemia and hypomagnesemia
4) phosphate: hyperphosphatemia or hypophosphatemia
5) potassium: hyperkalemia and hypokalemia
6) sodium: hypernatremia and hyponatremia
Calcium
Calcium is a vital mineral that our body uses to stabilize blood pressure and control skeletal
muscle contraction. It’s also used to build strong bones and teeth.
Hypercalcemia occurs when we have too much calcium in the blood. This is usually caused
by:
a) kidney disease
b) thyroid disorders, including hyperparathyroidism
c) lung diseases, such as tuberculosis or sarcoidosis
d) certain types of cancer, including lung and breast cancers
e) excessive use of antacids and calcium or vitamin D supplements
f) medications such as lithium, theophylline, or certain water pills
Hypocalcemia occurs due to a lack of adequate calcium in the bloodstream. Causes can
include:
a) kidney failure
b) vitamin D deficiency
c) pancreatitis
d) prostate cancer
e) malabsorption
f) certain medications, including heparin, osteoporosis drugs, and antiepileptic drugs
Chloride
Chloride is necessary for maintaining the proper balance of bodily fluids.
Hyperchloremia occurs when there’s too much chloride in the body. It can happen as a result
of:
a) severe dehydration
b) kidney failure

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c) dialysis
Hypochloremia develops when there’s too little chloride in the body. It’s often caused by
sodium or potassium problems.
Other causes can include:
a) cystic fibrosis
b) eating disorders, such as anorexia nervosa
c) scorpion stings
d) acute kidney failure
Magnesium
Hypermagnesemia means excess amounts of magnesium. This disorder primarily affects
people with Addison’s disease and end-stage kidney disease.
Hypomagnesemia means having too little magnesium in the body. Common causes include:
a) alcohol use disorder
b) malnutrition
c) malabsorption
d) chronic diarrhea
e) excessive sweating
f) heart failure
g) certain medications, including some diuretics and antibiotics
Phosphate
The kidneys, bones, and intestines work to balance phosphate levels in the body. Phosphate is
necessary for a wide variety of functions and interacts closely with calcium.
Hyperphosphatemia can occur due to:
a) low calcium levels
b) chronic kidney disease
c) severe breathing difficulties
d) underactive parathyroid glands
e) severe muscle injury
f) tumor lysis syndrome, a complication of cancer treatment
g) excessive use of phosphate-containing laxatives
Low levels of phosphate, or hypophosphatemia, can be seen in:
a) acute alcohol abuse
b) severe burns
c) starvation
d) vitamin D deficiency
e) overactive parathyroid glands
f) Certain medications, such as intravenous (IV) iron treatment, niacin , and some
antacids.

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Potassium
Potassium is particularly important for regulating heart function. It also helps maintain
healthy nerves and muscles.
Hyperkalemia may develop due to high levels of potassium. This condition can be fatal if left
undiagnosed and untreated. It’s typically triggered by:
a) severe dehydration
b) kidney failure
c) severe acidosis, including diabetic ketoacidosis
d) certain medications, including some blood pressure medications and diuretics
e) adrenal insufficiency, which is when your cortisol levels are too low
Hypokalemia occurs when potassium levels are too low. This often happens as a result of:
a) eating disorders
b) severe vomiting or diarrhea
c) dehydration
d) certain medications, including laxatives, diuretics, and corticosteroids
Sodium
Sodium is necessary for the body to maintain fluid balance and is critical for normal body
function. It also helps to regulate nerve function and muscle contraction.
Hypernatremia occurs when there’s too much sodium in the blood. Abnormally high levels of
sodium may be caused by:
a) inadequate water consumption
b) severe dehydration
c) excessive loss of bodily fluids as a result of prolonged vomiting, diarrhea, sweating,
or respiratory illness
d) certain medications, including corticosteroids
Hyponatremia develops when there’s too little sodium. Common causes of low sodium levels
include:
a) excessive fluid loss through the skin from sweating or burns
b) vomiting or diarrhea
c) poor nutrition
d) alcohol use disorder
e) thyroid, hypothalamic, or adrenal disorders
f) liver, heart, or kidney failure
g) certain medications, including diuretics and seizure medications
h) syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
Symptoms
Mild forms of electrolyte disorders may not cause any symptoms. Such disorders can go
undetected until they’re discovered during a routine blood test. Symptoms usually start to
appear once a particular disorder becomes more severe.
Not all electrolyte imbalances cause the same symptoms, but many share similar symptoms.

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Common symptoms of an electrolyte disorder include:
1) Irregular heartbeat
2) Fast heart rate
3) Nausea
4) Vomiting
5) Diarrhea or constipation
6) Abdominal cramping
7) Muscle cramping
8) Muscle weakness
9) Irritability
10) Confusion
11) Headaches
12) Cause
There are many causes for an electrolyte imbalance. Causes for an electrolyte imbalance may
include:
1) Loss of body fluids from prolonged vomiting, diarrhea, sweating or high fever
2) Inadequate diet and lack of vitamins from food
3) Malabsorption
4) Hormonal or endocrine disorders
5) Kidney disease
6) A complication of chemotherapy is tumor lysis syndrome.
Certain medications may cause an electrolyte imbalance such as:
1) Chemotherapy drugs (cisplatin)
2) Diuretics (furosemide[Lasix] or bumetanide [Bumex])
3) Antibiotics (amphotericin B)
4) Corticosteroids (hydrocortisone)
Treatment
Treatment varies depending on the type of electrolyte disorder and on the underlying
condition that’s causing it.
In general, certain treatments are used to restore the proper balance of minerals in the body.
These include:
 Intravenous (IV) fluids
 Certain IV medications
 Oral medications and supplements
 Hemodialysis
Prevention
Following this advice to help prevent electrolyte disorders:

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 stay hydrated if you’re experiencing prolonged vomiting, diarrhea, or sweating
 visit your doctor if you’re experiencing common symptoms of an electrolyte disorder
(Holland, 2019)
Acid base disorders
Acid-base disorders are pathologic changes in carbon dioxide partial pressure (Pco2) or serum
bicarbonate (HCO3
-) that typically produces abnormal arterial pH values. Acidemia is serum
pH < 7.35. Alkalemia is serum pH > 7.45. Acidosis refers to physiologic processes that cause
acid accumulation or alkali loss. Acid and alkaline levels are measured on a pH scale. An
increase in acidity causes pH levels to fall. An increase in alkaline cause’s pH levels to rise.
When the levels of acid in our blood are too high, it’s called acidosis. When our blood is too
alkaline, it is called alkalosis. Respiratory acidosis and alkalosis are due to a problem with the
lungs. Metabolic acidosis and alkalosis are due to a problem with the kidneys.
Respiratoryacidosis
When we breathe, our lungs remove excess carbon dioxide from our body. When they cannot
do so, our blood and other fluids become too acidic.
Symptoms
Symptoms may include fatigue, shortness of breath, and confusion.
Cause
There are several different causes of respiratory acidosis including:
a) chest deformities or injuries
b) chronic lung and airway diseases
c) overuse of sedatives
d) obesity
Prevention
We can take steps to help prevent some of the conditions that lead to respiratory acidosis.
Maintain a healthy weight. Take sedatives only under strict doctor supervision and never
combine them with alcohol. Do not smoke.
Metabolic acidosis
Metabolic acidosis occurs either when your body produces too much acid, or when your
kidneys are unable to remove it properly.
Symptoms
Symptoms can include rapid breathing, fatigue, and confusion.
Cause
There are three main types of metabolic acidosis. Diabetic acidosis, or diabetic ketoacidosis,
is a buildup of ketone bodies. This is usually due to uncontrolled type 1 diabetes.

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Hyperchloremic acidosis is when our body loses too much sodium bicarbonate, often after
severe diarrhea.
Lactic acidosis is when too much lactic acid builds up. This can be due to:
a) prolonged exercise
b) lack of oxygen
c) certain medications, including salicylates
d) low blood sugar, or hypoglycemia
e) alcohol
f) liver failure
g) cancer
h) kidney disease
i) severe dehydration
Treatment
The underlying condition behind the acidosis must be treated. In some cases, sodium
bicarbonate is prescribed to return the blood to a normal pH.
Alkalosis
Alkalosis is when alkaline levels are too high due to decreased carbon dioxide or increased
bicarbonate. There are five kinds of alkalosis.
Symptoms
Symptoms of alkalosis may include:
a) muscle twitching, hand tremor, muscle spasms
b) numbness and tingling
c) nausea
d) vomiting
e) lightheadedness
f) confusion
Cause
Respiratory alkalosis is when your blood has low levels of carbon dioxide. This can be
caused by a number of factors, including:
a) lack of oxygen
b) high altitude
c) fever
d) lung disease
e) liver disease
f) salicylate poisoning
Treatment
Some medications (such as chloride and potassium) can help correct chemical losses. Further
treatment will depend on the cause. (Pietrangelo, 2017)

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Glucose disorders
Pathological conditions in which the blood glucose cannot be maintained within the normal
range, such as in hypoglycemia and hyperglycemia. Etiology of these disorders varies.
Plasma glucose concentration is critical to survival for it is the predominant fuel for the
central nervous system. There are some glucose metabolism disorders:
1) Diabetes Mellitus: Diabetes mellitus (DM), commonly known as diabetes, is a group
of metabolic disorders characterized by a high blood sugar level over a prolonged
period of time. Symptoms often include frequent urination, increased thirst, and
increased appetite. diabetes melitus cannot diagnosed untill the blood glucose level
get too high and this type of diabetes seen in 10% people of the world population
2) Glycosuria: Glycosuria is the excretion of glucose into the urine. Ordinarily, urine
contains no glucose because the kidneys are able to reabsorb all of the filtered glucose
from the tubular fluid back into the bloodstream.
3) Hyperglycemia: Hyperglycemia refers to high levels of sugar, or glucose, in the
blood. It occurs when the body does not produce or use enough insulin, which is a
hormone that absorbs glucose into cells for use as energy. High blood sugar is a
leading indicator of diabetes.
4) Hyperinsulinism: Hyperinsulinism refers to an above normal level of insulin in the
blood of a person or animal. Normal insulin secretion and blood levels are closely
related to the level of glucose in the blood, so that a given level of insulin can be
normal for one blood glucose level but low or high for another.
5) Hypoglycemia: Hypoglycemia, also known as low blood sugar, is a fall in blood
sugar to levels below normal. This may result in a variety of symptoms including
clumsiness, trouble talking, and confusion, loss of consciousness, seizures or death. A
feeling of hunger, sweating, shakiness and weakness may also be present.
Symptoms
If blood sugar levels become too low, signs and symptoms can include:
a) An irregular or fast heartbeat.
b) Fatigue.
c) Pale skin.
d) Shakiness.

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e) Anxiety.
f) Sweating.
g) Hunger.
h) Irritability.
Cause
Immune-mediated causes of impaired glucose tolerance include stiff person syndrome and
anti-insulin receptor abnormalities. Other causes of glucose intolerance are liver disease (as
in cirrhosis) and renal failure.
Prevention
a) Lose weight.
b) Lower our blood sugar.
c) Boost your sensitivity to insulin — which helps keep your blood sugar within a
normal range. (Anonymus, hypoglycemia, 2020)
Bibliography
Anonymus. (2020, July 13). Electrolyte imbalance. Retrieved from wikipidia:
https://en.wikipedia.org/wiki/Electrolyte_imbalance
Anonymus. (2020). hypoglycemia. Retrieved from mayoclinic:
https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-
20373685
Holland, K. (2019, April 29). Electrolyte Disorder. Retrieved from Healthline:
https://www.healthline.com/health/electrolyte-disorders#prevention
Pietrangelo, A. (2017, June 6). acid base balance. Retrieved from healthline:
https://www.healthline.com/health/acid-base-balance
Robertson, S. (2020). What is pathology . Retrieved from news-medical: https://www.news-
medical.net/health/What-is-Pathology.aspx