3.5.1 Calcium Metabolism

Question 1

What is the clinical process of managing hypercalcemia?

Answer 1

Question 2

What is the role of calcium?

Answer 2

Co-factor for enzymatic processes/ ion for cellular function

Question 3

What is the IMAGING study for osteoporosis?

Answer 3

Question 4

What is the activation of Vitamin D pathway?

Answer 4

Question 5

40 year old woman appears in clinic with the following labs. What is the cause?

Answer 5

Question 6

What are the characteristics of citrate?

Answer 6

Question 7

What is the managment of severe hypercalcemia?

Answer 7

Volume expansion with isotonic saline

Administer calcitonin

Administer IV bisphosphonate

Question 8

What is the mechanism of bisphosphonates?

Answer 8

Bisphosphonate therapy targets the osteoclast, the cell that is the initiator of bone resorption. During bone resorption, osteoclasts take up the bisphosphonate. The bisphosphonate inhibits an enzyme within osteoclasts; this inhibition ultimately leads osteoclast inactivation and decreased bone resorption.

Question 9

Fill in this chart

Answer 9

Question 10

What are the characteristics of Denosumab?

Answer 10

Question 11

How would you interpret a BMD?

Answer 11

Question 12

What is the long term management of hypocalcemia?

Answer 12

Question 13

40 year old female who was found to have elevated calcium on lab. Also has normal albumin. What is the cause?

Answer 13

Primary Hyperparathyroidism

Question 14

What is osteoporosis?

Answer 14

Question 15

What are the characteristics of Teriparatide?

Answer 15

Question 16

40 year old woman presents with the following labs. What is the diagnosis?

Answer 16

Possible malignancy

Question 17

What is the etiology of primary hyperparathyroidism?

Answer 17

Question 18

What are the characteristics of PTH?

Answer 18

Question 19

What is the most likely cause of his hypocalcemia?

Answer 19

C

Question 20

What are some of the lifestyle choices to promote good bone health.

Answer 20

Question 21

What is the management of mild hypercalcemia?

Answer 21

No immediate treatment

Question 22

What are the characteristics of post-surgical hypocalcemia?

Answer 22

Question 23

Compare age and bone mass.

Answer 23

Question 24

25 year old has surgery to remove thyroid. 24 hrs post-op she is noting to have perioral numbness and hand cramping. What is the likely cause?

Answer 24

Hypocalcemia from post-surgical hypoparathyroidism.

Question 25

Describe the relationship between PTH and Ca2+?

Answer 25

Question 26

What are the characteristics of Paget's Disease?

Answer 26

Question 27

What is the difference between primary and secondary osteoporosis?

Answer 27

Primary - unrelated to chronic illness; Related to aging and decreased gonadal function. Secondary - Secondary to chronic illness/meds that cause accelerated bone loss; glucocorticoid use, hyperthyroidism

Question 28

What are the characteristics of osteomalacia?

Answer 28

Question 29

What are some of the pharamacologic treatments of low bone mass?

Answer 29

Question 30

Describe the different calcium supplements?

Answer 30

Question 32

Desribe the action of PTH on various organs in the body

Answer 32

Question 33

What are some of the symptoms of hypocalcemia?

Answer 33

In our patients with hypocalcemia, we are going to hear about or elicit symptoms of neuomuscular irritability: Peri-oral paraesthesias Muscle twitching Carpopedal spasms

Question 34

23 year old was in car wreck. She receive massive transfusion of blood products. She was noted to have tetany. What is the cause of her tetany?

Answer 34

Citrate in the blood products binding calcium resulting in a low ionized calcium concentration.

Question 35

Describe the acute management of Hypocalcemia?

Answer 35

Question 36

Compare osteomalacia and Rickets.

Answer 36

Question 37

What are the symptoms of hypercalcemia?

Answer 37

Patients with hypercalcemia may be asymptomatic with the finding picked up on routine lab. However, with significant elevation of calcium levels, we can see renal / skeletal / gastrointestinal / neuropsychiatric complications.

Question 38

What are the characteristics of Vitamin D Action?

Answer 38