Calcium and Bone disorders Flashcards

1
Q

what is responsible for absorbing calcium and how do we obtain it

A

Vit D - skin and diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what converts Vit D into it’s active form

A

kidneys and liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the active form of Vit D and what effect does it have on calcium

A

calcitrol - increases Ca absorption in gut and prevents Ca loss in kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what receptors detect calcium levels and where are they in the body

A

CaSR receptors in parathyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what does low levels of serum Ca causes the parathyroid to release

A

PTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what effect does PTH have on the body (Vit D, phosphate and Ca)

A

stimulates Vit D, promotes phosphate excretion, increases Ca, absorption from intestines, reduces Ca absorption into bones (can lead to weak bones)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what opposes PTH and where is it produced

A

calcitonin from thyroid causes increases bone Ca absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what can cause hypercalcaemia (6)

A

primary hyperthyroid, primary hyperparathyroidism, kidney failure, cancer (breast and lung), drugs (Vit D and thiazides), granulomatous (TB and sarcoid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what symptoms are seen with Hypercalcaemia

A

bones, stones, abdo groans and psychic moans: kidney stones, thist, dehydration, fractures, depression, myopathy, pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how do you treat Hypercalcaemia (5)

A

fluids, loop diuretics, bisphosphonates, calcitonin, steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are symptoms of hyperparathyroidism

A

fatigue, muscle weakness and aches, polyuria and thirst, bone pain and breaks, kidney stones, cardiac arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what can cause primary hyperparathyroidism

A

adenoma, carcinoma or hyperplasia in parathyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what happens to PTH, Ca and ALP in primary hyperparathyroidism

A

raised serum Ca, PTH and ALP (increased Ca in urine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do you treat primary primary hyperparathyroidism

A

remove surgically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what causes secondary hyperparathyroidism

A

chronic renal failure, vit D deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what happens to PTH and Ca in secondary hyperparathyroidism

A

high PTH, low/ normal calcium

17
Q

how do you treat secondary hyperparathyroidism

A

treat underlying: kidney transplant/ Vit D supplements

18
Q

what causes tertiary hyperparathyroidism

A

overactivity –> hyperplasia

19
Q

what happens to PTH and Ca in tertiary hyperparathyroidism

A

high PTH and high Ca

20
Q

how do you treat tertiary hyperparathyroidism and why in this way

A

parathyroidectomy - end organ damage and very high Ca levels

21
Q

what investigations are done for hyperparathyroidism

A

biochem: Ca, PTH, ALP / imaging: X ray, CT, bone scan, sestamibi scan

22
Q

what medications can be given for hyperparathyroidism

A

Vit D, cincaalcet, Bisphosphates, HRT

23
Q

what can cause hypocalcaemia (5)

A

hypoparathyroidism, vit D deficiency, chronic renal failure, Vit D def, chronic renal failure, hyperabluminaemia, stress/ exercise

24
Q

what are symptoms of hypocalcaemia

A

paraesthesia/ tingling in toes + fingers, muscle spasms, depression, hallucinations, seizures, slow HR, chovstek sign (facial twitch)

25
Q

how do you treat hypocalcaemia

A

acute: IV calcium gluconate, chronic: calcium + Vit D supplements

26
Q

what can cause hypoparathyroidism (5)

A

congenital absence eg DiGeorge, injury to parathyroid, autoimmune, hypomagnaesia, idiopathic

27
Q

how do you diagnose hypoparathyroidism

A

biochem: low Ca and PTH, high phosphate, symptoms similar to hypocalcaemia

28
Q

what is pseudohypoparathyroidism

A

resistance to PTH by receptors leading to hypocalcaemia

29
Q

what gene is associated with pseudohypoparathyroidism

A

GNAS1

30
Q

what hormone deficiency can cause osteoporosis in women

A

oestrogen in post menopause (see MSK)

31
Q

what can lack of Vit D cause

A

osteomalacia and rickets (see MSK)