HELP w/ electrolytes in FA pg 471

[NoWayOut]

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I am STUCK on this page in FA (471 in the 2010 ed.)
They have the electrolytes listed and then 2 columns. I am not even sure how to read it for Cl-. Are these supposed to be the clinical features or causes? For the other electrolytes, they seem like Clinical features, but for Cl-.. I am a little confused.

Cl- : Under low serum conc:
*secondary to met. alk (ok ..I am assuming this Met Alk associated with vomitting ?!?)
* hypokalemia... have no clue what the link between hypokalemia and hypochloremia is.. is it a consequence of low Cl-? or is it a cause? explain please.
* hypovolemia... huh? does this have something to do with incr. RAA?!?
* inrease aldosterone... how will this get rid of chloride? The only thing I found is that Cl - is secreted when HCO3 is reabsored.

Need your input badly

 

[aashkab]

try to think of it that with every positive cation, a Cl- anion has to be present. so if you are losing H+ (met alk), K+ (hypokalemia), or Na+ (hypovolemia) you are also losing chloride. an example of this is how the CF transporters pump chloride which is actually the reason for Na, and water to eventually follow as well.

i believe aldosterone increases bicarb reabsorption and hydrogen secretion in the collecting duct, and would therefore increase Cl- secretion (the sodium ion comes with the bicarb here i think)

 

[kryptik]

if you have uw q# 0956 can help with the Chloride and metabolic alkalosis stuff

 

[NoWayOut]

Thanks.
There was something I read about a HCO3/ Cl- cotranspoter on the basal membrane that works in response to synthesis of "new" HCO3, so I figure that everytime the cell has to generate new HCO3 (effect of Aldost.), then it must release Cl-...thus Hypochloremia.

kryptik:
I wish there was a way we can put the number of the question in search.. I would like to see that q's but it will be like looking for a needle in a haystack ..lol...hope I find it thru my second round of UW. Thanks.

 

[kryptik]

kryptik:
I wish there was a way we can put the number of the question in search.. I would like to see that q's but it will be like looking for a needle in a haystack ..lol...hope I find it thru my second round of UW. Thanks.

yes you can search by question #; go to Utilities and click on Search

 

[aashkab]

Thanks.
There was something I read about a HCO3/ Cl- cotranspoter on the basal membrane that works in response to synthesis of "new" HCO3, so I figure that everytime the cell has to generate new HCO3 (effect of Aldost.), then it must release Cl-...thus Hypochloremia.

kryptik:
I wish there was a way we can put the number of the question in search.. I would like to see that q's but it will be like looking for a needle in a haystack ..lol...hope I find it thru my second round of UW. Thanks.

Are you referring to the HCO3/Cl transporter in RBC's? That could be an explanation also I guess

 

[aashkab]

Thanks.
There was something I read about a HCO3/ Cl- cotranspoter on the basal membrane that works in response to synthesis of "new" HCO3, so I figure that everytime the cell has to generate new HCO3 (effect of Aldost.), then it must release Cl-...thus Hypochloremia.

kryptik:
I wish there was a way we can put the number of the question in search.. I would like to see that q's but it will be like looking for a needle in a haystack ..lol...hope I find it thru my second round of UW. Thanks.

Are you referring to the HCO3/Cl transporter in RBC's? That could be an explanation also I guess

 

[NoWayOut]

yes you can search by question #; go to Utilities and click on Search

Very Cool..I did not know that..Thanks.

 

[NoWayOut]

Are you referring to the HCO3/Cl transporter in RBC's? That could be an explanation also I guess

No actually, I was referring to the DCT/colecting duct..where aldosterone works. I am not 100% positive, but I do sort of remember reading that when I was searching for an explanation to the Cl- loss. Could it be that the tubule is impermeable to the Cl- ion in that area (DCT/ Collecting)? Could that explain the Cl- loss whenever Aldosterone is in action (loss of K+, H+, Cl-)?