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Metabolism > 9 calcium metabolism and HPA > Flashcards

9 calcium metabolism and HPA Flashcards

1
Q

what are two main examples of ca2+ transporters?

A

ca2+ - mg2+ ATPase: high affinity, low capacity

na+ - ca2+ exchanger: low affinity, high capacity

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2
Q

What can increase the risk of calcium deficiency ?

A

lactose free diet
coeliac disease
osteoporosis
breastfeeding
menopausal females

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3
Q

organs involved in calcium deficiency?

A

Gut
bone
kidneys

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4
Q

bone is made of ? bound to a proteoglycan matrix

A

calcium hydroxyapatite

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5
Q

Action of PTH on bone?

A

intermediate action

binds to osteoblasts - inhibits bone formation and release cytokines (chemical messenger)

cytokines stimulate osteoclasts - increase bone resorption/breakdown and release Ca2+ and phosphate.

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6
Q

action of PTH on kidneys?

A

stimulates reabsorption of filtered Ca2+

increased loss of phosphate in urine

activates calcitriol (from Vit D) - uptake of Ca2+ from gut

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7
Q

how does absorption of Ca2+ occur?

A

dependent on Vit D (converted by liver/kidney to active form calcitriol)

D3 - from sunlight (7, dehydroxycholesterol)
D3 - from diet (25-hydroxyvitamin )

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8
Q

cells that secrete PTH?

A

chief cells

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9
Q

PTH initiates what response to low calcium ions?

A

Mobilization of calcium from bone.

Enhancing absorption of calcium from the small intestine.

Suppression of calcium loss in urine.

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10
Q

What is PTHrp?

A

a hormone - PTH-related peptide; that acts at PTH receptors.

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11
Q

hypercalcemia causes and symptoms

A

increase in serum calcium levels

causes- hyperthyroidism, renal failure, drug induced

symptoms - kidney stones, stomach pain, nausea, easy fractures

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12
Q

hypocalcemia causes and symptoms

A

decrease in serum calcium levels

causes - hypothyroidism, GI malabsorption, renal loss

symptoms - impaired cognition, twitching, seizures

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13
Q

Calcitonin opposes the action of which hormones

A

Parathyroid
Calcitriol

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14
Q

How does Calcitonin reduce ECF calcium levels

A

Inhibit osteoclast
Decrease kidney resorption

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15
Q

How is calcium lost from the body

A

Urine
Faeces

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16
Q

How is intracellular calcium controlled

A

Pumped out of cells
Sequestered into organelles(Sarcoplasmic reticulum and mitochondria)

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17
Q

How much calcium in extracellular fluid

A

2.1mmol/l

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18
Q

What are some roles of calcium (4)

A

Lower blood pressure
Regulate heart rhythm
Importance in intracellular signal pathway
Assists in Normal blood clotting

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19
Q

What are the 3 categories of hypercalcaemia causes

A

Hormonal
Non hormonal
Drugs

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20
Q

What are the 3 principle cells in the Parathyroid

A

Chief cells
Oxyphil cells
Adipose cells

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21
Q

What are the causes of hypocalcaemia

A

Hypoparathyroidism
Hypovitaminosis D
GI malabsorption

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22
Q

what are the CNS effects of hypocalcaemia

A

irritability
seizures
personality changes

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23
Q

What are the general effects of hypercalcaemia

A

Stones(kidney stones )
Moans (depression)
Groans(abdominal pain)

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24
Q

What are the hormonal causes of hypercalcaemia

A

Primary hyperparathyroidism
Hypervitaminosis

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25
Q

What are the main hormone regulators of calcium

A

Parathyroid
Vitamin D
Calcitonin

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26
Q

what are the neuromuscular effects of hypocalcaemia

A

tetany
parestesia
twitching
convulsions

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27
Q

What are the non hormonal causes of hypercalcaemia

A

Renal failure

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28
Q

What calcium is physiologically active

A

Free ionised calcium

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29
Q

What can be used in managing a deficiency or excess in pituitary hormone secretion

A

hormonal therapy
medical therapy

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30
Q

What can lead to a calcium imbalance

A

Poor absorption
Poor calcium intake
Excessive loss-lactation

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31
Q

What does hypervitaminosis D cause

A

Excessive production of 1,25 dihydroxy vitamin D3
Suppression of PTH

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32
Q

What drugs can cause hypercalcaemia

A

Thiazides
Lithium

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33
Q

What feedback system in parathyroid hormone

A

negative

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34
Q

What gland is parathyroid hormone released from

A

parathyroid gland

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35
Q

What inhibits parathyroid release

A

High extracellular calcium

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36
Q

What is 25 hydroxy vitamin D3 converted to in the liver

A

1,25-dihydroxy vitamin D3

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37
Q

What is 7-dehydrocholesterol converted to in the skin

A

Cholecalciferol

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38
Q

What is calcitonin secreted from

A

Parafollicular cells of the thyroid gland

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39
Q

What is cholecalciferol converted to in liver

A

25-hydroxy vitamin D3

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40
Q

what is humoral hypercalcaemia of malignancy

A

tumour secretion of parathyroid hormone-related peptide [PTHrP]

41
Q

What is hypercalcaemia

A

Calcium levels rises

42
Q

What is hypocalcaemia

A

Calcium levels fall

43
Q

What is the action of calcitriol on the bone

A

Stimulate bone re-modelling

44
Q

What is the action of Parathyroid on the bone

A

Bind to osteoblasts
Inhibit bone formation
Release cytokines which stimulate osteoclasts
Increased bone breakdown
Release of calcium and phosphate

45
Q

What is the action of parathyroid on the kidneys

A

Stimulate increased reabsorption of calcium
Increased loss of phosphate in urine
Activation of calcitriol

46
Q

What is the action of parathyroid on the kidneys

A

Stimulate increased reabsorption of calcium
Increased loss of phosphate in urine
Activation of calcitriol

47
Q

What is the normal response to hypercalcaemia

A

Decreased Parathyroid
Decreased calcitriol -less calcium taken up from gut
Less calcium absorption from kidney
Decreased breakdown of bone
Increase bone formation

48
Q

What is the normal response to hypocalcaemia

A

Increased parathyroid production
Increased calcitriol
Increased calcium absorption from gut and kidney
Increased breakdown of bone
Decreased bone formation

49
Q

What is the process for negative feedback control for parathyroid

A

Decreased calcium stimulate parathyroid
Parathyroid acts on bone and released calcium and raises calcium concentration
Increased calcium inhibits parathyroid release

50
Q

What is the role of calcitriol in the gut

A

Increased expression of proteins that import Ca2+

Promote absorption of calcium from diet

51
Q

What is the role of PTHrP

A

Cartilage development
Calcium transport in placenta

52
Q

What is the role of the chief cells

A

Produce and degrade parathyroid

53
Q

What occurs as a result of Parathyroid suppression

A

Decreased bone resorption
Increased urinary loss of calcium
Decreased 1,25-dihydroxy Vitamin D3 production

54
Q

what organ systems affected by hypocalcaemia

A

Neuromuscular
CNS
Cardiovascular

55
Q

What organ systems are effected by hypercalcaemia(5)

A

CNS
GI
Renal
Skeletal
Cardiovascular

56
Q

What stimulate the synthesis and secretion of parathyroid

A

Low extracellular calcium

57
Q

By what method is PTHrP released

A

Paracrine

58
Q

How are lactotropes controlled

A

Hypothalamus secrete dopamine

dopamine inhibit prolactin secretion

lactotropes release increased due to prolactin reduction

59
Q

How are neurones that secrete hypothalamic releasing hormones affected

A

nervous inputs - enviroment influences endocrine system
chemical signals-feedback

60
Q

how does hypothalamus control anterior pituitary secretion

A

release neurohormones from median eminence which travels in hypophyseal portal circulation to anterior pituitary gland

61
Q

How is Gonadotropin Releasing Hormone (GnRH) released

A

small pulses

62
Q

how is the hypothalamus and anterior lobe of pituitary gland connected

A

vascular connection

63
Q

how is the hypothalamus and posterior lobe of pituitary gland connected

A

neurological connection

64
Q

how is the pituitary gland developed

A

anterior lobe formed from ectodermal cells from roof of pharynx

fusion of anterior lobe with down growth neural tissue from hypothalamus

65
Q

what are gonadotropes controlled by

A

Gonadotropin Releasing Hormone (GnRH)

66
Q

what are somatotropes controlled by

A

Growth Hormone Releasing Hormone (GHRH)

67
Q

what are the effects of Adrenocorticotropic hormone deficiency

A

mild hypotension
hyponatraemia (low level of sodium in blood)

68
Q

What are the effects of gonadal deficiencies

A

loss of libido
loss of secondary sexual hairs
erectile dysfunction

69
Q

What are the effects of Growth hormone deficiency

A

growth failure in children
impaired wellbeing in adults

70
Q

What are the effects of hyperparathyroidism

A

Hypercalcuria
Increased risk of fracture
Increase risk of kidney stones

71
Q

what are the effects of Thyroid stimulating hormone deficiency

A

weight gain
dry skin
cold intolerance

72
Q

What can cause hypoparathyroidism

A

Post surgery
Autoimmune
Pseudohypoparathyroidism( PTH resistance)

73
Q

what cell produces adrenocorticotropic hormone

A

corticotropes

74
Q

what cells are most abundant in the anterior pituitary

A

somatotropes

75
Q

what cells produce thyroid stimulating hormone

A

thyrotropes

76
Q

what condition associated with excess Adrenocorticotropic hormone

A

cushing’s disease

77
Q

what conditions are associated with excess growth hormone

A

Acromegaly
gigantism

78
Q

what controls thyrotropes

A

Thyrotropin Releasing Hormone (TRH)

79
Q

what do Follice stimulating hormone and luteinising hormone act on

A

gonads to control reproduction

80
Q

what does anterior pituitary arise from

A

Rathke’s pouch

81
Q

what does anterior pituitary secreate

A

tropic hormones

82
Q

What does Gonadotropin Releasing Hormone (GnRH) stimulate

A

Luteinising and follice stimulating hormone secretion

83
Q

what does posterior pituitary arise from

A

neuroectoderm

84
Q

what does prolactin do

A

controls milk production and reproductive processes

85
Q

what is follice stimulating hormone produced by

A

gonadotropes

86
Q

what is growth hormone produced by

A

somatotropes

87
Q

What is hypopituitarism

A

decreased secretion of one or more pituitary hormones

88
Q

what is luteinising hormone produced by

A

gonadotropes

89
Q

what is prolactin produced by

A

lactotropes

90
Q

What is pseudohypoparathyroidism

A

Parathyroid resistance

91
Q

what is pituitary adenomas

A

growth or tumor on the pituitary

excess hormonal secretion

92
Q

what is the management for pituitary tumours

A

Surgery
radiotherapy
medical therapy

93
Q

what is the most common cause of pituitary disease

A

pituitary adenomas

94
Q

what is the role of the infundibulum

A

connection between the hypothalamus and the posterior pituitary.

95
Q

What type of gland is anterior pituitary

A

endocrine

96
Q

what type of gland is posterior pituitary

A

neurosecretory gland

97
Q

Where is the parathyroid gland located

A

4 glands around the thyroid gland

98
Q

4 glands around the thyroid gland

A

base of brain in sella turcica

99
Q

Why does parathyroid increase loss of phosphate in urine

A

Since calcium is being absorbed phosphate needs to be removed or it will react with calcium and form calcium hydroxyapatite

Metabolism (9 decks)

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