Calcium

Question 1

Interesting point: how much more concentrated is Ca2+ outside the cell then inside the cell?

Answer 1

10,000x!!!

Question 2

How much intake of calcium is recommended daily?

Answer 2

1g (1000mg)

Question 3

What does Vit D do to the apsorption of Ca2+? Phosphorous?

Answer 3

Increases BOTH Ca2+ and PO4-!!!

Question 4

What is the animal precusor for Vit D? Plant precursor?

Answer 4

anmial:cholecalciferol plant:ergocalciferol

Question 5

What is the recommendation of daily Vit D intake for the endocrine society?

Answer 5

30ng/ml

Question 6

What are the two general methods to get Vit D?

Answer 6

Sun exposure and diet

Question 7

Where is Vit D converted to its 25(OH)D storage form?

Answer 7

The liver

Question 8

Where is Vit D converted to its active 1,25(OH)2D form?

Answer 8

the KIDNEY!

Question 9

Can Vit D be made in other tissues beside the kidney?

Answer 9

yep, TB lymphoma leukemia

Question 10

Where is the Vit D receptor? Membrane or intracellular?

Answer 10

Intracellular

Question 11

What happens after Vit D has met with its receptor and started the transcription process?

Answer 11

Calcium binding protein gets expressed in the intestine! and Ca2+ absorption increases

Question 12

What is the relationship between Ca and P absorption once Vit D has done its thing?

Answer 12

they are BOTH absorbed

Question 13

What are considered the four calcium regulating hormones?

Answer 13

PTH, PTHrP(PTH-related peptide), Calcitonin, 1,25 dihydroxyVitamin D

Question 14

What controls the minute to minute level of calcium in the blood?

Answer 14

PTH

Question 15

Where are the PTH receptors?

Answer 15

Bone (get more Ca2+ into blood) and Kidney (reabsorb more Ca2+)

Question 16

Which G protein pathway does PTH use?

Answer 16

Adenylate Cyclase

Question 17

What two events occur with PTH stimulation in the kidney?

Answer 17

1.Synthesis of 1,25-VitD 2. Reabsorption of Ca2+

Question 18

What happens to PO4 when the kidney is stimulated by PTH?

Answer 18

PO4 is EXCRETED while Ca2+ is reabsorbed

Question 19

Other then a possible malignancy, where do we normally see PTHrP? sorry fellas..

Answer 19

Placenta, amniotic fluid, fetus, breast milk

Question 20

What is the main action that is different between PTHrP and PTH?

Answer 20

PTHrP does not stimulate activation of Vit D

Question 21

What do the levels of Ca2+, PO4, and PTH look like after PTHrP is released?

Answer 21

HIGH Ca2+, LOW PO4, LOW PTH

Question 22

What is the most common cause of PRIMARY hyperparathyroidism? What could a second cause be?

Answer 22

high PTH caused by a single Parathyroid tumor…second cause: hyperplasia of all parathyroid glands

Question 23

What two substances are most likely produced by a hypercalcemia malignancy?

Answer 23

PTHrP and 1,25 Vit D

Question 24

What is the disease of “ooones”?

Answer 24

hypercalcemia: stones, groans, moans, overtones, bones

Question 25

What are PTH levels with high PTHrP in urine and high Vit D in urine?

Answer 25

Both conditions will show low PTH (c/o feedback)

Question 26

What blood serum Ca2+ level would you recommend surgery for hypercalcemia?

Answer 26

greater or equal to 11 mg/dl (you even do surgery if no symptoms!!!!)

Question 27

Would you recommend surgery to a hypercalcemia to a younger or older pt?

Answer 27

younger sub 50

Question 28

What are three possible causes of hypocalcemia?

Answer 28

low PTH, Low Vit D, Low Ca2+ intake

Question 29

What condition are we talking bout with muscle spasms , tetany, tingling around mouth/fingertips

Answer 29

hypocalcemia

Question 30

What does hypoparathyroidism do for Ca, Phos, and Vit D levels?

Answer 30

low ca, high phos, low vit d

Question 31

What is the main outcome of childhood Vit D deficiency?

Answer 31

rickets!

Question 32

What does low Vit D do to Ca, phos, and PTH levels?

Answer 32

low Ca, low phos, high PTH

Question 33

What does Vit D deficiency do to bone?

Answer 33

Makes it weak. Sacrifice bone Ca2+ to increase blood Ca2+ (c/o high PTH)

Question 34

What is the main adult Vit D deficiency outcome? What is the main symptom of this deficiency?

Answer 34

oseteomalacia..bone pain!

Question 35

HypoCa levels of phos, 1,25 Vit D, PTH…

Answer 35

phos high, 1,25 Vit d low, PTH Low

Question 36

HypoCa levels of phos, 1,25 Vit D, PTH…

Answer 36

phos low, 1,25Vit D low, PTH high

Question 37

HypoCa levels of phos, 1,25 VitD, PTH…

Answer 37

phos high, 1,25Vit D low, PTH High

Question 38

What is blood Ca with primary hyperparathy?

Answer 38

high Ca

Question 39

What is blood Ca with secondary hyperparathy?

Answer 39

low ca (then causes high PTH)