Bone Diseases (3) Flashcards
Red S syndrome- cause and s/s
<300 cals/day can trigger it
s/s- stress fx, shin splints, menstrul loss in F, low test in M
Main marker for bone breakdown
Urine telopeptides
Main marker for bone buildup
Serum alkaline phosphatase (ALP)
Main tests used in bone diseases (4)
Serum Calcium
Serum Albumin
Serum Phosphate
Serum Alkaline phosphatasee
How does parathyroid hormone, kidney function, intestinal function regulate calcium
parathyroid hormone- pulls calc from bone
kidney function- retains calc
intestinal function- final loc of vit d activation
thyroid hormone
hypocalcemia s/s + causes (mc)
tetany, mm weakness
causes- hypoparathyroidism, vit d def, kidney disease( MC)
testing algorithm for hypocalcemia
if calc<2.1
yes= kidney diseas
=no- measure PTH
hypercalcemia- s/s, causes (mc)
s/s- drowsy, gastro pain, cardiac arrhythmias, hypertension
causes- hyperparathyroidism (mc), vit D excess
Hypercalcemia testing
if calc >2.8 check PTH
serum plasma phosphate/phosphorus in relation to calc
Reciprocal relation w calc
enters cell w glucose- will be low w diabetes
Hypophosphatemia- S/s, tests, disease causes
s/s- mm pain+ weakness
tests- serum phosphate
diseases- hyperparathyroidism, vit d def
hyperphosphatemia- s/s, disease causes
s/s- calc phosphate deposition in soft tissues
disease causes- kidney failure (mc)- low calc in kindey failure causes incrrease in phos
what does serum Mg influence
influences secretion of PTH by parathyroid (need it to secrete PTH)
hypomagnesaemia- mc cause + s/s
mc cause- starvation
s/s- tetany, hyperirritabty, tremor
hypermagesaemia- disease causes, S/s
kidney failure/iatrogenic
s/s- centreal nervous system toxicity, mm toxicity
When is deoxypyridinoline released
during bone resorption cross links are released into blood
when i vit D/ calcitriol increased + decreased
increased- hyperparathryoidism, hypervitaminosis D
decreased- liver failure, hypoparathyriodism
Effects of vit d3/ calcitriol on intestine/kidney/bone
bone= calcium/phosphate transport increased
Kidney= prox tubule vit D3 prod dec, distal tubule calcium resporbtion increased
bone= osteoprogentors to osetoclasts
when is calcitonin released and what does it do
released in response to increased plasma calcium
- decreases osteoclastic breakdown
- decreases absorbtion of calcium + phosphate
osteoperosis tests
CBC- look for signs of malnutrition
Serum ALD, calc, phosphate, creatine, TSH
Serum vit D
Pagets disease test
Serum ALP much increased
primary and secondary causes of hyperparathyroidism
primary= usually benign adenoma secondary= Vit D/chronic kidney disease
