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Endocrine - Summer 2019 > Calcium and Parathyroids > Flashcards

Calcium and Parathyroids Flashcards

1
Q

Hyperparathyroidism is a disease of impaired _________

A

calcium

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2
Q

Too much PTH will move into the ______ cause destruction and results in _______ and ________

A

bones / osteoporosis / high serum calcium

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3
Q

What can high serum calcium levels cause?

A

increased BP, heart attack, stroke

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4
Q

Why is caclium important?

A

nerve conduction, bone formation, muscle formation, blood coagulation, cerebral and cardiac function, capillary permeability, cell growth and division, neurotransmitter action

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5
Q

The body contains __ to __ of calcium: __% in skeleton, ____% in plasma, ___% in ECF, __% in cells

A

1-2kg / 98% skeleton / 0.03% plasma / 0.1% ECF / 1% cells

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6
Q

Plasma calcium is present in the following forms

A

50% ionized (active form) / 41% protein bound (primarily to albumin) / 9% combined anions (diffusible)

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7
Q

Plasma calcium equilibrates with ____ calcium, but only 0.5% of _______ calcium is readily exchangeable

A

bone / bone

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8
Q

________ results in nervous system excitement. There is an increased neuronal permeability to _____, which results in easy action potentials

A

hypocalcema / Na

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9
Q

50% ionized or 35% total decrease leads to _____ _____

A

spontaneous discharges

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10
Q

Tetany and seizures from hypocaclemia are most commin in the _____ or ______

A

HAND or FACE

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11
Q

Hand and hypocaclemia

A

carpopedal spasm

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12
Q

Face and hypocaclemia

A

positive Chvosteks sign is from tapping on the facial nerve leads to twitching

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13
Q

In hypocalcemia, the ___ can be prolonged. What can this advance to?

A

QT / You can develop R on T phenomenon and advance to Torsades

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14
Q

The chief manifestation of hypercalcemia is ________

A

skeletal muscle weakness

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15
Q

Hypercalcemia can manifest as nervous system _______. This results in SHORT QT interval, LONG PR interval, constipation, anorexia

A

depression

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16
Q

Treatment for Hypercalcemia

A

maintain UOP, hydrate, administer MITHRAMYCIN in severe cases

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17
Q

The body contains ___ of phosphorous. __% skeletal, __% muscle/tissue, ___% ECF

A

1 kg / 85% skeletal, 15% musle/tissue, 1% ECF

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18
Q

Phsophorous circulates in plasma and about ___% is protein bound

A

12%

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19
Q

Phsophorous levels fluctuate more significantly than ______ because Phos moves between ECF and bone as well as ECF and ICF

A

calcium

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20
Q

T/F There are minimal effects with large fluctuations in phosphorus

A

TRUE

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21
Q

Phos enters the ECF via ___, ____, _____. It is easily absorbed in _____

A

GI, ICF, bone / GI

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22
Q

Phosphorous leaves via ____, ____, ____

A

urine, ICF, bone

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23
Q

Major control site for phos is the _______.

A

kidney

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24
Q

urinary excretion of Phos balances ____ uptake.

A

GI

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25
Q

PTH ______ urinary excretion of phos. So does calcitonin but to a lesser extent

A

increases

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26
Q

GI absorption of phos is increased by what vitamin?

A

1,25 D3

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27
Q

The parathyroid consists of 4 glands behind the ___ and ____ poles of the thyroid gland

A

upper and lower

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28
Q

The parathyroid contain mainly ____ cells and ______ cells

A

chief / oxyphil

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29
Q

**CHIEF cells secrete ________

A

PTH

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30
Q

**Synthesis and secretion of the PTH is related to _____ concentrations in the blood

A

calcium

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31
Q

Parathyroid glands can be enlarged from prolonged stimulation, _________ and _______

A

pregnancy and lactation

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32
Q

Decreases in calcium concentration in the ECF ______ secretion of PTH

A

increases

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33
Q

Increases in calcium concentration in the ECF ________ the activity of the parathyroid gland

A

decreases

34
Q

Vit D, calcitonin, and PTH all help with reabsorption of calcium from the _____ ________ of the kidney

A

proximal tubule

35
Q

PTH increases bone resorption to mobilize ____ and ______

A

calcium and phosphate

36
Q

Bone resorption is the process by which _______ break down bone and release _______ from bone fluid to blood

A

osteoclasts / calcium

37
Q

PTH increases reabsorption of calcium in the kidneys _______ tubules

A

distal

38
Q

PTH decreases reabsorption of _______ in the renal tubule

A

phosphate

39
Q

**PTH increases the production of 1,25 dihydroxycholecalciferol. This is a vit D metabolite which ______ intestinal Calcium absorption

A

enhances

40
Q

**Major stimulus for PTH is what?

A

low serum calcium level

41
Q

Increases in PTH results in what serum changes?

A

increased calcium and decreased phosphate

42
Q

Increases inPTH results in what urine changes

A

decreased calcium and increased phosphate

43
Q

Increases in PTH increases the ________ of phosphate, potassium, and sodium by increasing the CALCIUM/MAG/HYDROGEN _______. This happens largely where?

A

excretion / reabsorption / distal tubules and collecting ducts

44
Q

**Calcitonin _______ the parathyroid hormone

A

opposes

45
Q

**Calcitonin is produced in the ________ of the thyroid

A

parafollicular (clear or C cells)

46
Q

In general, Calcitonin has the opposite effect of ____

A

PTH

47
Q

Calcitonin inhibits bone _______. It increases ______excretion of calcium

A

resorption / urinary

48
Q

Immediate effect of calcitonin is it _________ osteoclastic activity and osteolysis of osteocytes

A

decreases

49
Q

Delayed effect of CALCITONIN is it _______ osteoclast formation

A

decreases

50
Q

Calcitionin effect on serum

A

decreased calcium and decreased phosphate

51
Q

Calcitonin effect on urine

A

increased calcium excretion and increased phosphate excretion

52
Q

Secretion of Calcitonin is controlled by serum ______ level

A

calcium

53
Q

Increased serum calcium level would lead to ________ calcitonin secretion

A

increased

54
Q

T/F Exact role is unclear but excess or deficient calcitionin does not lead to defects in bone or calcium metabolism

A

TRUE

55
Q

Vitamin D has a potent effect to increase calcium absorption from the _____ _____

A

intestinal tract

56
Q

Vitamin D has important effects both on bone _____ and bone ______

A

depositation / reabsorption

57
Q

** Vitamin D is not iteslf an active substance, but must be converted to its active product _________

A

1,25 dihydroxylcholecalciferol

58
Q

**Vitamin ___ is formed in the skin by exposure to sunlight

A

D3

59
Q

** Vitamin D3 is converted to 1,25 dihydroxylcholecalciferol in by the ______

A

liver

60
Q

GI absorption of calcium is increased by _____

A

Vit D

61
Q

Urinary excretion of calcium is decreased by ______ and increased by ________

A

PTH / Calcitonin

62
Q

Bone resoprtion of calcium is increased by _____ and inhibited by _______

A

PTH / calcitionin

63
Q

Hypoparathyroidism is usually a result of surgical damage to the gland during ______ surgery

A

thyroid

64
Q

After thyroid surgery, calcium levels could fall below normal in 24-72 hrs which results in what?

A

Tetany (calcium ion interferes with membrane transport and interferes with the relaxation of the muscle), muscle cramps, Grand Mal seizures, cardiovascular collapse

65
Q

Treatment for Hypoparathyroidism is what?

A

PTH (expensive and short half life) OR high calcium and Vit D intake

66
Q

**Hypomagnesemia can cause hypocalcemia resistant to _______. So must treat with _______ first.

A

calcium / magensium

67
Q

Magnesium suppresses the release of ____

A

PTH

68
Q

Primary HYPERparahyroidism is from inappropriate hypersecretion of PTH resulting in ________.

A

hypercalcemia

69
Q

Net effect of increased PTH secretion

A

hypercalcemia, hypercalciuria, HYPOphosphatemia, HYPERphosphaturia, bone demineralization

70
Q

Net cardiac effects of increased PTH secretion

A

short QT interval, depresses relaxation

71
Q

Net kidney effects of increased PTH secretion

A

kidney stone formation as calcium is mobilized from bone that is excreted by kidneys

72
Q

Most common cause of hyperparathyroidism is _______ hyperplasia or _______ tumor

A

parathyroid / parathyroid

73
Q

Pregnancy may ______ the parathyroids

A

stimulate

74
Q

Vitamin D deficiency can be from inadequate dietary intake and often due to fat _______ syndrome. Can also be from inadequate sunlight

A

malabsorption

75
Q

In Vitamin D deficiency you have decreased absoprtion of ______ and _______, decreased serum calcium and phosphate, and increased ____ and increased _______ resorption

A

calcium and phosphate / PTH and bone

76
Q

In adults, Vitamin D deficiency can result in _______ or softening of the bones

A

osteomalacia

77
Q

In children, Vitamin D deficiency can result in ______ - bones fail to mineralize, epiphysis fail to fuse, epiphyseal plates widen and bowing and fractures occur

A

Rickets

78
Q

One gram of Calcium Chloride contains the equivalent amount of ionized calcium of what?

A

3 grams of Calcium gluconate

79
Q

Calcium is indicated fro treatment of ______ induced EKG changes because of its cell membrane stabilizing effecs

A

HYPERKALEMIA

80
Q

Calcium is indicated in patients with ________ associated with either CCB or beta-adrenergic blockers

A

hypotension

81
Q

Calcium is contraindicated in patients with _______ toxicity as it may cause _______

A

digoxin / lethal arrhythmias

Endocrine - Summer 2019 (7 decks)

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