Chloride cl extracellular anion functions osmolality

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Chloride (Cl)--- Extracellular anion; Functions: osmolality, volume, electric neutrality, regulation of sweat glands through aldosterone stimulation; RR: 98-107 mmol/L; Serum, plasma, urine, sweat; Method: ISE; Hyperchloremia/Hypochloremia – same as Na+ Bicarbonate (HCO 3 - )--- Measured in form of CO 2 – reabsorbed in kidneys in this form; Extracellular anion; decreased levels--- metabolic acidosis--- occurs as HCO 3 - is retained, often w/ increase in pCO 2 as a result of compensation by hypoventilation----typical causes of metabolic alkalosis include severe vomiting, hypokalemia, and excessive alkali intake--- typical response to this is hyperventilation which lovers CO2; Functions: acid- base balance; Serum, plasma, arterial samples – analyze quickly; Method: ISE, enzymatic; RR: 22-29 mmol/L Magnesium (Mg 2+ )--- Intracellular cation; clinical usefulness---relationship between Mg and cardiovascular, metabolic, and neuromuscular disorders; Hepermagnesemia---- pregnancy (labor and delivery---drugs administered); Hypomagnesemia---cardiovascular, neuromuscular; Functions: cofactor in enzymatic rxns; regulated by kidneys/PTH; Serum, plasma – no oxalate, citrate or EDTA; 24 hour urine – HCL added; RR: serum – 1.8 – 2.4 mg/dl; Method: colorimetric: Mg + calamagite -> reddish violet complex 532 nm-----Mg + formazene dye – color 660 nm----Mg + methyl thymol blue – color formation Calcium (Ca 2+ ) ---Intracellular cation; Intracellular Cation; 99% in bone; Functions: hormone regulation – PTH, vitamin D, calcitonin; Calcium Forms (45% Ionized, 45% bound (albumin), 15% bound (anions)); Reference Ranges: Total: 8.6 – 10.0 mg/dl,
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Ionized: 1.16 – 1.32 mmol/L; Specimens: serum, plasma, urine HCL added; Measurement: (colorimetric) Ortho-cresophthalein, Arsenzo III dye, ISE; Collect on ice- analyze quickly—if suspect problem w/ protein levels like albumin---could affect overall total protein and result in low levels of Ca b/c no protein bound to it; Causes of hypocalcemia---magnesium levels, low albumin levels, vitamin D deficiency; Causes of hepercalcemia---increased vitamin D, hyperthyroidism, hyperparathyroidism; Hypocalcemia---Hypomagnesemia ->inhibits PTH; Symptoms: neuromuscular irritability, cardiac irregularities; Treatment: administer Ca, Vitamin D; Hypercalcemia--- Symptoms: neurologic, GI, renal; Treatment: Estrogen replacement -> cause hyperparathyroidism -> increases Ca excretion Phosphorous (PO 4 - )--- Intracellular anion; Functions: role in PTH regulation, Vitamin D metabolism, Growth Hormone regulation; Reference Range: 2.7 – 4.5 mg/dl; Specimens: serum, plasma – no citrate, oxalate or EDTA, 24 hour urines; Method: Ammonium phophomolybdate complex -> UV absorption 340 nm; Hypophosphatemia: Causes: diabetic ketoacidosis, COPD, asthma, malignancy, alcoholism…; Treatment: rare
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