Chloride

Major extracellular anion which is the counterpart of Sodium

Chloride

Chloride functions as:

Controls _________ and ________ w/ sodium

regulates ______________ balance

Contributes to the acidity of ______________

Water balance and Osmotic Pressure

Regulates Acid-Base Balance

Gastric Juice

Excretion of Chloride is through the (3):

Kidneys

GI tract

Sweat

Process which occurs in cardiovascular system and refers to the exchange of bicarbonate and chloride across membrane of RBCs.

Also known as Chloride Shift

HAMBURGER PHENOMENON

It is the decreased concentration of chloride ions in the blood

Hypochloremia

Hypochloremia is caused by:

Prolonged ___________

Diabetic ___________

_____________ deficiency

Salt-losing renal diseases like _____________

Metabolic _______________

Profuse ___________

______________ Disease (low cortisol and aldosterone)

- Prolonged vomiting

- Diabetic ketoacidosis

- Aldosterone deficiency

- Salt losing renal diseases such as pyelonephritis

- Metabolic alkalosis

- Profuse sweating

- Addison’s disease (low cortisol and aldosterone)

Increased concentration of chloride ions in the blood

Hyperchloremia

Causes of Hypercloremia

_____________

___ Losses

RTA

Metabolic ________

CHF

_________ syndrome

Dehydration

Gi losses

Renal Tubular Acidosis

Metabolic Acidosis

Congestive Heart Failure

Cushing’s Syndrome

Specimen collection for Chloride (4)

Serum

Plasma

24hr Urine

Sweat

Interferences for Specimen Collection of Chloride:

Slightly lower in ______________ specimen and serum with high conc. of __________

Hemolysis causes falsely __________

Postprandial specimen and specimen w/ bicarbonate

Falsely Decreased

Methods of Measurement for Chloride (4)

Ion Selective Electrode

Amperometric / Coulometric

Schales and Schales

Zall Color

Method of Measurement for Chloride that is the most common method, it uses silver sulfide and silver chloride membrane

Ion-Selective Electrode

Most accurate method of measurement for Chloride, it gives a direct read-out chloride concentration. It has adaptations using the Cotlove titrator or chloridometer

Amperometric - Coulometric Method

Method of Measurement for Chloride that uses Chloride ions and Mercuric nitrate to form soluble mercuric chloride, which indicates a faint pink of violet

Schales and Schales

Method of Measurement that uses a reagent that contains Mercuric thiocyanate and ferric nitrate

Zall color reaction

Method of Measurement where Chloride ions in serum displaces thiocyanate ions from the mercuric thiocyanate forming mercuric chloride which is only very slightly ionized.

Schoenfeld and Lewellen

Schoenfield and Lewellen form a _______________ color

Orange-Yellow thiocyanate complex

Chloride Measurement is measured at ____ nm

492 nm

Normal range of Chloride:

Serum:

CSF:

Urine:

96-110

125-135

170-255

Chloride Computation

Conventional Unit:

SI unit:

Abs of sample or control / Abs of standard x 355

mg/dL x 0.2822