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Endocrinology Final > Calcitonin/Parathyroid > Flashcards

Calcitonin/Parathyroid Flashcards

1
Q

Where is calcitonin synthesized?

A

Parafollicular cells AKA C-cells of the thyroid gland ***

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2
Q

What is the chemical class of calcitonin?

A

PPP

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3
Q

What are the primary functions of calcitonin?

A

Decrease plasma calcium **
Decrease osteoclast cell synthesis **
Decrease 1 hydroxylase enzyme activity

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4
Q

What are the secondary functions of calcitonin?

A

Decrease digestion, PAIN ***, plasma phosphorus, and plasma sodium

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5
Q

If calcitonin’s ability to decrease pain is a secondary function, what possesses the primary function of decreasing pain?

A

Endorphins

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6
Q

Calcitonin controls the secretion and concentration of what substance?

A

Plasma calcium concentration

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7
Q

Where can some calcitonin be secreted besides the C cells of the thyroid?

A

Thymus and parathyroid

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8
Q

What is the effect of calcitonin on bone reabsorption? ***

A

Inhibition

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9
Q

What does calcitonin do in the body?

A

Lowers calcium and phosphate in plasma ***

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10
Q

Calcitonin can be used as treatment for what conditions?

A

Osteoporosis and Paget’s disease ***

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11
Q

When is calcitonin used as treatment for osteoporosis?

A

If patient has adverse reactions to bisphosphonates

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12
Q

How does calcitonin work as treatment for osteoporosis?

A

Prevents fractures

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13
Q

What happens to bone with osteoporosis?

A

Bone mass and bone strength decreases
Porous bone
Bone breaks easily

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14
Q

What is Paget’s disease (osteitis)?

A

Disorder of the normal bone remodeling ***

Bone formed is abnormal, enlarged, and weak

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15
Q

Does the bone remodeling process occur faster or slower in patients with Paget’s disease?

A

Faster (therefore weak bone is formed)

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16
Q

Paget’s disease is more common among what age group?

A

Over 50

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17
Q

What are the symptoms of Paget’s disease?

A

Pain in bone/spine, fractures, bowed legs, cauda equina syndrome, enlarged skull (possible hearing problems)

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18
Q

What are treatment options for Paget’s disease?

A

Bisphosphonates or calcitonin (if side effects seen with bisphosphonates)

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19
Q

Parathormone (parathyroid hormone) essentially is the opposite of what other hormone?

A

Calcitonin

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20
Q

Where is parathyroid hormone synthesized? *

A

Dark chief cells of the parathyroid gland *

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21
Q

What chemical class is PTH?

A

PPP

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22
Q

What does parathyroid hormone do?

A

Maintains calcium and phosphorus in plasma ***

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23
Q

What condition arises from a deficiency in PTH?

A

Hypocalcaemia (decreased calcium in blood)

24
Q

What are the primary functions of parathyroid hormone? *

A

Stimulate growth *
Increase 100% vitamin D synthesis **
Increase plasma calcium *
Decrease plasma phosphorus

25
Q

What is the means by which parathyroid hormone stimulates growth and increases vitamin D synthesis?

A

Stimulation of 1-hydroxlase enzyme synthesis

26
Q

What is the means by which PTH increases plasma calcium? *

A

Increases renal reabsorption of calcium

27
Q

What is the most powerful hormone to increase plasma calcium? *

A

Parathyroid hormone (PTH) ***

28
Q

Does PTH stimulate osteoblast or osteoclast activity?

A

Osteoclast

29
Q

How does PTH decrease plasma phosphorus?

A

Decreases renal reabsorption of phosphorus

30
Q

What is the most powerful hormone to decrease phosphorus in plasma?

A

PTH

31
Q

PTH controls the secretion of what substance?

A

Plasma calcium

32
Q

What are the secondary functions of PTH? *

A

Big 4: increase metabolism, plasma glucose, BP, and immune response **
Also decreases plasma bicarbonate

33
Q

What can cause hypercalcemia?

A

Increase in hormones that increase plasma calcium
Decrease in hormones that decrease plasma calcium
Excessive sunlight, malignancies, hypervitaminosis
Liver/kidney disorders

34
Q

Where is vitamin D synthesized?

A

Liver * (25-(OH) D3) and kidney (all active forms) *

35
Q

What is the chemical class of vitamin D?

A

Seco-steroid

36
Q

What is the precursor molecule of vitamin D that we obtain from our diet and sunlight?

A

7-dehydrocholesterol aka vitamin D3 aka cholecalciferol

37
Q

What kind of vitamin D do we obtain from supplements?

A

Vitamin D2

38
Q

What does the vitamin D become that is obtained from sunlight and diet when it is hydroxylated in the liver?

A

25-hydroxycholecalciferol ***(aka calcifediol)

39
Q

What is the final form of vitamin D seen after it passes through the kidneys?

A

1,25-dihydroxycholecalciferol (aka calcitriol or 1,25(OH)2D3) ***

40
Q

The activity of what substance leads to tight regulation of vitamin D by the kidneys?

A

1-alpha-hydroxylase

41
Q

What is the major controller of 1-alpha-hydroxylase? **

A

Parathyroid hormone **

42
Q

What are the primary functions of vitamin D? **

A

Increase linear height **

Increase plasma calcium **

43
Q

What are the means by which vitamin D increases linear height?

A

Stimulation of osteoblast cell activity

Increase intestinal absorption of calcium

44
Q

What are the means by which vitamin D increases plasma calcium?

A

Stimulation of osteoclast cell activity
Increase intestinal absorption of calcium
Increase renal reabsorption of calcium

45
Q

What is the secondary function of vitamin D? *

A

Stimulate integumentary system (skin and hair) **
Stimulates immune resonse
Increases oxygen transport and plasma phosphorus

46
Q

What condition results from a deficiency in thyroxine and vitamin D?

A

Alopecia (hair loss)

47
Q

What controls the secretion of vitamin D?

A

Plasma calcium *
Sunlight *
Hormones like PTH, glucagon, cortisol

48
Q

What hormone is most powerful in decreasing the secretion of vitamin D?

A

Glucagon

49
Q

What situations can cause vitamin D deficiency?

A

Sun shunning *

Strict vegetarian diet *

50
Q

What are foods that are good sources of vitamin D?

A

Fish liver oils, egg yolks, some fortified dairy products, fortified grain

51
Q

What is a major symptom of vitamin D deficiency?

A

Cognitive impairment *

52
Q

What conditions can result from vitamin D deficiency?

A

Rickets, severe asthma in children *, some cancers *, increased risk of cardiovascular disease *

53
Q

What is the blood test used to determine vitamin D deficiency? *

A

25-hydroxyvitamin D blood test

54
Q

What is the normal vitamin D range on a blood test?

A

20-50 nanograms/milliliter

55
Q

What level is considered deficient in vitamin D on a blood test?

A

12 ng/ml **

56
Q

What is the treatment for vitamin D deficiency?

A

Short sunlight exposure
Foods rich in vitamin D
Vitamin D supplements if needed (up to 4000 IUs)

Endocrinology Final (7 decks)

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