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Endo Exam 1 > Calcium and Phosphorus Homeostasis > Flashcards

Calcium and Phosphorus Homeostasis Flashcards

1
Q

forms of calcium

A

bound to albumin
complexed to anions
free ionized Ca2+ - bio active**

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2
Q

hypocalcemia

A

hyperreflexia, twitching, cramps, tingling, numbnes

chvostek sign and trousseau sign

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3
Q

chvostek sign

A

tapping facial nerve - twitching facial muscles

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4
Q

trousseau sign

A

carpopedal spasm with inflation of BP cuff

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5
Q

hypercalcemia

A

polyuria, constipation, hyporeflexia, lethargy, polydipsia

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6
Q

changes in plasma protein concentration

A

alter total Ca concentration

-PTH sense change in ionized Ca and can correct

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7
Q

change in anion concentration

A

alter ionized Ca
-change fraction complexed to anions

phosphate increase - ionized Ca decrease

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8
Q

acid base balance

A

acidemia - excess H+ bound to albumin

-increase in ionized Ca2+

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9
Q

alkalemia

A

free ionized Ca2+ decreased - hypocalcemia

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10
Q

Ca homeostasis

A

kidney, bone, intestine

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11
Q

bone resorption

A

(+) PTH, 1,25 Vit D

(-) calcitonin

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12
Q

PTH

A

released from parathyroid gland with decreased plasma ionized Ca2+

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13
Q

chief cells

A

of parathyroid gland - secrete PTH
-activity in N-terminal AAs

sense decrease in extracellular Ca2+ concentration

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14
Q

magnesium

A

low levels stimulate PTH release

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15
Q

PTH on kidney

A

increased Ca reabsorption

decreased P reabsorption

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16
Q

PTH on bone

A

increased bone resorption

  • act on osteoblasts - secrete cytokine
  • osteoclast activity increases
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17
Q

PTH on intestine

A

indirectly on Vit D > 1,25 Vit D

increased Ca absorption

18
Q

primary hyperparathyroidism

A

parathyroid adenomas
-increased PTH secretion

hypercalcemia, hypophasphateima

possible oxlalate stones

stones, bones, groans
-oxalate stones, bone resorption, constipation

19
Q

secondaray hyperparathyroidism

A

vit D deficiency, chronic renal failure
-secondary to hypocalcemia

-elevated PTH, Ca low or normal

20
Q

hypoparathyroidism

A

consequence of surgery
-autoimmune less common

low PTH, hypocalcemia, hyperphosphatemia

Tx: oral Ca supplement and active 1,25 Vit D

21
Q

pseudohypoparathyroidism

A

PTH increased
-Gs protein for PTH in kidney and bone defective

albrights hereditary osteodystrophy

hypocalcemia, hyperphosphatemia, short, obese, subQ calcification, short tarsels/carpals

22
Q

hypercalcemia of malignancy

A

lung or breast tumors secrete PTH-rp

all physiological action of PTH

circulating PTH low**

Tx: furosemide - inhibits renal Ca absorption
and etidronate - inhibits bone resorption

23
Q

familial hypocalciuric hypercalcemia

A

autosomal dominant
decreased urinary Ca, increased serum Ca

mutations in Ca sensing receptor in parathyroid glands

PTH secretion not inhibited

24
Q

calcitonin

A

from parafollicular, or C, cells of thyroid gland

stimulus - increased plasma Ca

inhibits osteoclast

25
Q

Vitamin D

A

promote mineralization of new bone

from diet and in skin (UV light)

kidney - 25 Vit D > 1,25 Vit D

  • stimulus - high Ca in serum
  • alters activity of a-alpha hydroxylase enzyme
26
Q

Vit D in intestine

A

1,25 - increased Ca and P absorption

27
Q

Vit D and kidney

A

increase Ca and P reabsorption

28
Q

Vit D and bone

A

stimulate osteoclast and bone resorption

-breakdown old bone to create new bone

29
Q

rickets

A

Vit D deficiency in children

-growth failure, skeletal deformities

30
Q

osteomalacia

A

vitamin D deficiency in adults

-bending and softening of bones

31
Q

Vit D resistance

A

kidney can’t produce 1,25 Vit D

  • can be caused by chronic renal failure
  • can lead to osteomalacia
32
Q

CaSR

A

Ca sensing receptor

senses extracellular calcium and controls PTH secretion

33
Q

forms of VIt D

A

Vit D3 and Vit D2 - converted to 25 VIt D in liver

kidney - 25 VIt D to 1,25 Vit D
-enzyme - 1 alpha hydroxylase

34
Q

PTH independent hypercalcemia

A

thiazide diuretics
immobilization**
acute renal failure**

35
Q

acute renal failure

A

hypercalcemia

36
Q

chronic renal failure

A

hypocalcemia

37
Q

causes of hypocalcemia

A

Vit D deficiency
liver failure
hypoproteinemia - decreased albumin - decreased total Ca

38
Q

alkaline phosphatase

A

increased with more resorption of Ca from bone

39
Q

high calcium of malignancy

A

high Ca

low PTH

40
Q

primary hyperparathyroidism

A

high Ca

high PTH

41
Q

Vit D deficiency

A

high PTH

low Ca

42
Q

kidney faliure

A

very low Ca

very high PTH

Endo Exam 1 (10 decks)

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