Study Guide for Exam 4: Water, Iron, Chloride, Sodium, & Potassium

1. Water

a. Functions

i. Chemical reactions

ii. Body temperature regulation

iii. Lubrication and protection

iv. Solvent and transport medium

v. Maintenance of blood volume

vi. Acid-base balance

b. Content and Distribution in the Body

i. Over 50% body weight is water

1. Depends on age, gender,

body size, and

composition

2. Decreases with age and

body size

ii. Extracellular fluid functions

1. Interstitial fluid bathes the cells

iii. Plasma

iv. Lymph

c. Excretion

i. Most lost through the urine

ii. Small amount in the feces

 iii. Some lost through the respiratory and skin

d. Sources

i. Beverages and foods

ii. 25% from foods

1. particularly plant foods

iii. minor from metabolism

e. RDA

i. Women – 2.7 L

ii. Men – 3.7 L

iii. Depends on activity level and energy intake

iv. Recommendation on body weight

f. Water and Sodium Balance

i. Osmosis: movement of water from low to high concentration in solute

concentration across semipermeable membrane

1. Hyponatremia – diluted plasma due to overconsumption of water

2. Hypernatremia – loss of water without solutes

g. Kidney

i. Made of nephrons

1. Parts of the nephron:

Bowman’s capsule, loop of

henle, distal tubule,

collecting duct
 a. Solutes travel in the nephron

2. Vascular component

h. Renin-Angiotensin-Aldosterone System and Sodium Balance

i. RAAS = increases sodium

and chloride reabsorption

ii. Aldosterone = increases

sodium reabsorption and

potassium excretion

iii. Low BP and plasma volume

causes -> release renin

2. Sodium

a. Overview

i. Most abundant ETC cation

ii. On bone surface (30-40%)

b. Source

i. Salt in processed foods

c. DV on food labels

i. 2400mg

1. 2/3 of people consume more than the recommended amount

d. Absorption

i. Most is absorbed in the SI and proximal colon

ii. Mechanisms of absorption

1. Sodium/glucose cotransporter
 2. Electroneutral sodium and chloride cotransport exchange

transporter

e. Transport

i. Free in blood

ii. Range 135-145 mEg/L

f. Functions

i. Maintenance of osmotic pressure

ii. Nerve transmission/impulse conduction

iii. Muscle contraction

g. Interaction

i. Increase sodium intake = increases urinary calcium excretion

h. Excretion

i. Kidneys and sweat

1. Controlled by aldosterone

i. Deficiencies

i. Rare, but can occur due to excessive sweating

j. RDA

i. 1500 mg/day

k. Toxicity

i. Tolerable Upper Intake Level = 2300 mg/day

l. Assessment

i. 24-hour urinary sodium excretion level

3. Potassium
a. Overview

i. Major ITC cation

b. Sources

i. Widespread

1. Fruit, vegetables, legumes, nuts, nut butters, seeds, milk, yogurt,

and can be added to processed foods

ii. Usually consumed below recommended amounts

c. Absorption

i. Over 85% is aborbed

1. Mostly SI

2. Some in the colon

ii. Mechanisms

1. Passive diffusion

2. Potassium/hydrogen ATPase

d. Function

i. Need an accurate ITC and ETC ratio is necessary to maintain a cell’s

resting membrane potential

ii. Water and acid-base balance

iii. Helps with cellular metabolism

e. Interaction

i. Decrease the excretion of calcium

f. Excretion

i. Kidney
 ii. Small amount in feces and sweat

g. RDA

i. 4700 mg/day

h. Deficiencies

i. Loss of fluid and electrolytes

ii. Cause – hypokalemia

i. Assessment

i. Plasma/serum potassium concentrations

4. Chloride

a. Overview

i. Most abundant ECF anion

b. Source

i. Sodium chloride

c. Absorbed

i. Intestine

ii. Absorption of chloride follows that of sodium

1. Sodium-glucose cotransport system

2. Electroneutral

sodium-chloride

cotransport

absorption

3. Electrogenic sodium absorption

d. Functions
 i. Formation of gastric HCl acid

ii. Released from WBCs to destroy pathogens

iii. Exchange anion to bicarbonate in RBCs

iv. Excrete through GI, skin, kidneys

e. RDA

i. 2300 mg/day

f. Assessment

i. Serum concentration

5. Iron

a. Overview

i. Found in ferrous state or ferric state

ii. 2 forms

1. heme iron – 25-35% absorption

a. more readily absorbed

b. food: meat, fish, poultry

2. non heme iron – 2-20%

absorption

a. plant food

iii. 2-4g iron found in the body

b. Food sources

i. Red meats, seafood, legumes, dark green leafy vegetables, whole grains,

nuts, tofu, some fruits and vegetable

ii. Grains fortified with iron

 iii. Oral supplements of ferrous iron

c. Digestion and Absorption

i. Heme

1. Hydrolyzed by hemoglobin

and myoglobin in stomach

and SI by enzyme

2. Absorbed by heme carrier

protein (hcp1)

ii. Non heme

1. Hydrolyzed in the GI tract

2. Fe+3 reduced to Fe+2

3. Transported by divalent cation transporter DMT1

d. Overview of Iron Digestion and Absorption

 i. HCl helps release iron from foods in the stomach.

ii. The free heme is absorbed by hcp1

iii. It is then hydrolyzed by heme oxygenase in the enterocyte

iv. If nonheme is inhibited in the small intestine, it will be excreted

v. Fe+3 is reduced to Fe+2

vi. DMT1 carries the iron across the brush border membrane into the cytosol

of the enterocyte

vii. Fe+2 is oxidized and stored as ferritin

viii. Ferroportin transports the iron across the basolateral membrane and out

into the blood

e. Iron inhibitors

i. Polyphenols

ii. Oxalic acid

iii. Phytic acid

iv. Divalent cation

f. Cell’s Use of Iron

i. Used by intestinal cell

ii. Stored as ferritin

iii. Transported through cell

to body tissues

g. Regulation of Iron Absorption

i. Hepcidin
 1. Controls iron release into blood

h. Iron Transport

i. Ferric iron attaches to transferrin in the blood

1. Transferrin = glycoprotein with 2 binding

sites

ii. Unbound iron can form free radicals as they react with hydrogen peroxide

i. Storage

i. Liver, bone marrow, spleen

ii. Storage proteins

1. Ferritin

2. Hemosiderin

j. Functions

i. Oxygen delivery via

hemoglobin and myoglobin

ii. Helps with ETC by cytochromes

and other enzymes

iii. Amino acid metabolism

iv. Carnitine synthesis

v. Antioxidant roles

vi. Thyroid hormone synthesis

k. Interactions with other nutrients

i. Vitamin c

ii. Copper
 iii. Zinc

iv. Vitamin A

v. Lead

l. Iron Excretion

i. Fecal = major route

ii. Skin

iii. Urine

iv. Menstrual

m. RDA

i. Men = 8mg

ii. Women

1. Premenopausal = 18mg

2. Postmenopausal = 8mg

3. Pregnancy = 27mg

4. Lactation = 9mg

n. Iron deficiency

i. Decrease in blood hemoglobin to 7g/100mL of blood

ii. Treatment = intake of iron

iii. Common

o. Iron Toxicity

i. Tolerable Upper Intake Level = 45mg

ii. Hemochromatosis

1. Iron overload
 p. Assessment

i. First stage – iron diminishes

1. Test plasma ferritin

ii. Second stage – transport iron decreases

1. Plasma ferritin decreases

iii. Continued progression

1. Free protoporphyrin rises

iv. Final stages – anemia occurs

1. Hemoglobin and hematocrit is altered

6. Overview of Iron Paper

a. Iron deficiency was found in kids pre/postnatal, 6-24 months, and especially in

young adolescent women who started their menstrual cycle

b. This was found to lead to neurobehavioral deficits

c. The paper concluded that an iron supplement was beneficial in helping prevent

such deficits in children

Flashcards:

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11.
12.
How much of our body weight is made up of
Name 4 Functions of water
water?

13. 14.
RDA for water How is water excreted?

15.
16.
How much of our water intake do we get from
DV for sodium on food labels
food?

17. 18.
Where is sodium absorbed RDA for sodium

19. 20.
Sources of potassium Functions of potassium

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12.
i. Chemical reactions ii. Body temperature
11.
regulation iii. Lubrication and protection iv.
50%
Solvent and transport medium v. Maintenance of
blood volume vi. Acid­base balance

14.
13.
Mostly out the urine, but some through the
i. Women – 2.7 L ii. Men – 3.7 L
feces, respiratory, and skin

16. 15.
2400 mg 25% (which is usually plant food sources)

18. 17.
1500mg/day in the SI and proximal end of the colon

20.
19.
i. Need an accurate ITC and ETC ratio is
Fruit, vegetables, legumes, nuts, nut butters,
necessary to maintain a cell’s resting membrane
seeds, milk, yogurt, and can be added to
potential ii. Water and acid­base balance iii.
processed foods
Helps with cellular metabolism

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21. 22.
Excretion of potassium RDA for potassium

23. 24.
Source of chloride Functions of chloride

25. 26.
RDA for chloride Is heme or non­heme more readily absorbed?

27. 28.
Food sources of iron Iron inhibitors

29. 30.
What regulates iron? Storage sites for iron

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22. 21.
4700mg/day kidney, sweat, feces

24.
i. Formation of gastric HCl acid ii. Released from
23.
WBCs to destroy pathogens iii. Exchange anion
sodium chloride(salt)
to bicarbonate in RBCs iv. Excrete through GI,
skin, kidneys

26.
25.
Heme and its found in meats, seafood, and
2300mg/day
poultry

28. 27.
Red meats, seafood, legumes, dark green leafy
i. Polyphenols ii. Oxalic acid iii. Phytic acid iv.
vegetables, whole grains, nuts, tofu, some fruits
Divalent cation
and vegetable, grains fortified, oral supplements

30. 29.
Liver, bone marrow, spleen Hepcidin

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32. 31.
feces, urine, menstrual, skin copper, vitamin C, zinc, vitamin A, lead

33.
i. Men = 8mg ii. Women 1. Premenopausal =
18mg 2. Postmenopausal = 8mg 3. Pregnancy =
27mg 4. Lactation = 9mg

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31. 32.
What does iron interact with? iron excretion

33.
RDA for iron

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