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Clinical Pathology > 52 - Disorders of Calcium, phosphate & magnesium > Flashcards

52 - Disorders of Calcium, phosphate & magnesium Flashcards

1
Q

Ca is what component in bone

A

Hydroxyapatite

so it phosphate

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2
Q

Physiological important of Mg

A

Cofactor for ATP
Neuromuscular excitability
Enzymatic function
Regulates ion channels

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3
Q

Calcium controlled by

A

PTH

Vit D and metabolites

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4
Q

Calcium relations

A

GI uptake
Renal clearance
Bone

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5
Q

Plasma calcium is in what forms

A

Ionised (physiologically active)

Bound - inactive, albumin

Complexed - salts, Ca phosphate, calcium citrate

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6
Q

What is adjusted calcium

A

Adj Ca = total Ca + (40-alb) x 0.025

Takes into account bound Ca
Same reference range

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7
Q

Acidosis affect of Ca-albumin

A

Reduces [bound Ca]

Increased [ionised]

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8
Q

Alkalosis of Ca-albumin

A

Increases [bound Ca]

Reduces [ionised Ca]

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9
Q

Alkalosis (e.g. hyperventilation) can precipitate … w/ Ca

A

tetany

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10
Q

Hypocalcaemic patients with acidosis - symptoms?

A

Don’t develop symptoms

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11
Q

Ca-PTH loop

A

Parathyroid uses Mg as cofactor to make PTH which is positive feedback for bone, GI and kidneys to release Ca. Ca then gives -ve feedback to PT glands.

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12
Q

PTH does what

A

Increases Ca turnover with net resorption

Decreases Ca clearance, but, increase phosphate excretion. Vitamin D then increases Ca absorption. Making more plasma Ca

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13
Q

Causes of hypocalcaemia

A 
Hypoproteinaemia
Vit D deficiency
HypoPThyroidism
Inadequate intake
Pseudohypoparathyroidism
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14
Q

Causes of hypercalaemia

A 
Hyperparathyroidism
Malignancy
Drugs
Vit D excess
Bone disease and immobilisation
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15
Q

Distinguishing differential diagnoses using graph - whats on axis

A

[plasma PTH] vs [serum ionised calcium]

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16
Q

Phosphate used

A

Intracellularly

High energy rxns

17
Q

Phosphate deficiency causes

A

Hyperparathyroidism
Excess losses
Poor intake

18
Q

Phosphate deficiency - symptoms

A

Haemolysis, thrombocytopenia + poor granulocyte function

Severe muscle weakness, resp. failure, rhabdomyolysis

Confusion, irritability and coma due to metabolic encephalopathy

Renal dysfunction

19
Q

Phosphate deficiency - treatment

A

Necessitates changes to IV fluids inc. TPN formulations

20
Q

Hypomagnesaemia associated with

A

Hypokalaemia
Hyponatraemia
Hypophosataemia
Hypocalcaemia

21
Q

Magnesium depletion - causes

A

Renal - drugs, hypercalcaemic

GI tract - malnutrition,IV nutrition, diarrhoea, malabsorption

22
Q

Magnesium depletion - effects

A 
Cellular
Biochemical
Endocrine
CVS
CNS
Muscle
23
Q

Tissue Mg status - best predictor is what

A

Leucocyte Mg - good correlation + predictive value

Muscle Mg - 20% body Mg, important physiologically and requires biopsy

Clinical Pathology (65 decks)

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