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ENDOCRINO > Calcium and phosphorus metabolism > Flashcards

Calcium and phosphorus metabolism Flashcards

1
Q

Only difference between Pi and Ca++

A

Pi is a component of the phopholipid membrane

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2
Q

% of Ca++ that is free

A

50%

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3
Q

Respiratory alkalosis causes

A

Hypocalcemia

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4
Q

Respiratory acidosis causes

A

Hypercalcemia

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5
Q

Why does respiratory acidosis cause hypercalcemia

A

Because H+ binds to albumin so Ca++ is now free

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6
Q

Ca++ free depends on

A

[H+]

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7
Q

Calciotrophic hormones

A

Vitamin D

PTH

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8
Q

Vitamin D effect on Ca++

A

Increases intestinal Ca++ absorption

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9
Q

Anabolic hormones

A

GH and sex hormones

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10
Q

PTH function

A

Parathyroid hormone controls Ca++ in blood

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11
Q

Half life of PTH

A

2 minutes

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12
Q

Increased PTH pathologies

A

Hypocalcemia
Hyperphosphatemia
Catecholamines

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13
Q

What causes PTH inhibition

A

Hypercalcemia
Vitamin D administration
Hypomagnesemia

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14
Q

Enzyme activating Vitamin D

A

1-a-Hydroxylase

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15
Q

Functions of PTH

A

Activate 1-a-hydroxylase
Decrease phosphate
Increase Ca++

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16
Q

How many times does Vitamin D get hydroxylased

A

2 times, in liver and kidney

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17
Q

Active form of Vitamin D

A

1.25 Vitamin D

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18
Q

Which Vitamin D do we measure

A

25 Vitamin D

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19
Q

Osteoblast and osteoclast function

A

Osteoblast –> bone formation

Osteoclast –> bone destruction

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20
Q

What do osteoblasts bind to in osteoclasts

A

Osteoblasts have RANKL that bind to RANK in osteoclasts

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21
Q

PTH secretion impact on RANK/RANKL process

A

PTH stimulates an increase in Ca++
Therefore when PTH is increased, there is an increase in RANKL from osteoblasts binding to RANK in osteoclasts for bone resorption

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22
Q

Inhibitor of RANK/RANKL

A

Osteoprotegerin (OPG)

23
Q

How is OPG an inhibitor

A

It inhibits osteoclasts differentiation and function

24
Q

Osteoclasts differentiation and bone resorption depends on

A

RANKL of osteoblasts and OPG

25
Q

Effect of PTH on kidney on distal convoulted tubule

A

Increase Ca++ reabsorption

26
Q

Consequence of increased reabsorption of Ca++ in distal convoluted tubule

A

Hypercalcemia

27
Q

Effect of PTH on proximal tubule

A

Decreased Pi reabsorption

28
Q

Consequence of decreased Pi reabsorption

A

Phosphaturia –> increased Pi excretion

29
Q

What does UV light activate in the process of Vit. D synthesis

A

Activated proVit D to cholecalciferol

30
Q

Cholecalciferol undergoes

A

Double hydroxylation

31
Q

Effects of Vit. D

A

Increased bone resorption and formation
Increased Ca++ reabsorption in kidney
Increased Ca++ absorption in intestine
Decreased PTH synthesis

32
Q

In intestine, Ca++ enters enterocytes through

A

TRPV6

33
Q

Inside cell, Ca++ captured by

A

Calbindin

34
Q

Ca++-Calbindin reaches bloodstream through

A

PMCA

35
Q

Regulation of Vit. D synthesis through

A

FGF23

36
Q

FGF23 produced by

A

Mature osteoblasts

37
Q

FGF23 binds to

A

Klotho receptor in kdney

38
Q

Binding of FGF23 to Klotho receptor in kidney causes

A

Phosphaturia –> decreased Pi reabsorption –> increased Pi excretion

39
Q

How does FGF23 impact Vit. D synthesis

A

FGF decreases calcitriol (1.25 Vitamin D) synthesis by supressing 1-a-hydroxylase

40
Q

Most rapid response to a hypocalcemia

A

Increase in PTH

41
Q

What does PTH activate in hypocalcemia

A

C1a activation

42
Q

C1a activation in hypocalcemia causes

A

Vitamin D activation (slower response than PTH)

43
Q

Result of hypocalcemia, Ca++, PTH, FGF23

A

Increased Ca++
Decreased PTH
Decreased FGF23

44
Q

Main role of PTHrp

A

In hypercalcemia and malginant tumors

45
Q

Function of PTHrp

A

Bone resorption and Ca++ reabsorption causing hypercalcemia

46
Q

If during hypercalcemia we have normal PTH levels, then we measure

A

PTHrp

47
Q

Function of calcitonin

A

Antiresorptive at bone level

48
Q

What secretes calcitonin

A

Parafollicular cells

49
Q

Calcitonin used in treating

A

Hypercalcemia

50
Q

Increased levels of ?? during medulary thryoid cancer

A

Calcitonin

51
Q

SUMMARY: PTH impact on Ca++

A

Increased Ca++

52
Q

SUMMARY: Vit. D impact on Ca++ and Pi

A

Increased Ca++ and Pi

53
Q

SUMMARY: Calcitonin impact on Ca++ and Pi

A

Decreased Ca++ and Pi

54
Q

SUMMARY: FGF23 impact on Pi, PTH and Vit. D

A

Promotes Pi excretion –> phosphaturia
Inhibits PTH
Inhibits Vit. D synthesis

ENDOCRINO (4 decks)

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