Calcium Homeostasis Flashcards

1
Q

What are the roles of calcium within the body?

A

Signalling - Ca2+ important signalling molecules e.g. NT’s, muscle fibres

Blood Clotting - Essential component of clotting cascade

Apoptosis

Skeletal Strength - 99% of calcium in body is wrapped up in bone where it gives strength to skeleton

Membrane Excitability - Ca2+ decreases Na+ permeability

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2
Q

What is the effect of hypocalcaemia?

A

Increased neuronal Na+ permeability leading to hyperexcitation of neurons. Can cause tetany and if it spreads to larynx/resp muscles = asphyxiation

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3
Q

What is the effect of Hypercalcaemia?

A

Decreases neuronal Na+ permeability which reduces excitability and depresses the neuromuscular activity. In extreme cases, cardiac arrhythmias

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4
Q

How is calcium distributed within the body?

A

Bones - 99%
Intracellular - 0.9%
ECF- 0.1%

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5
Q

In what form is calcium stored in the bones?

A

Hydroxyapatite

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6
Q

How much calcium is found within the plasma

A

2.2-2.6mM

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7
Q

What does calcium have a high affinity for?

A

proteins

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8
Q

How much calcium is bound to plasma within plasma?

A

~40%

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9
Q

How much calcium can be classed as “free calcium”?

A

1.2mM

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10
Q

What form of calcium is physiologically active?

A

Free calcium

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11
Q

When is binding capacity increased?

A

Under alkalotic conditions e.g. hyperventilation

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12
Q

When is binding capacity of calcium reduced?

A

When acidosis occurs

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13
Q

Define how Total Body Calcium is determined?

A

Ca2+ from diet - Ca2+ excreted in Kidneys and Faeces

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14
Q

What are osteoblasts?

A

Bone Building cells

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15
Q

What is the function of osteoblasts?

A

The lay down a collagen extracellular matrix which they then calcify

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16
Q

What do osteocytes do?

A

They control the activity of osteoblasts and osteoclasts

17
Q

What are osteoclasts?

A

Cells which are responsible for mobilising bone

18
Q

What are the functions of osteoclasts?

A

To secrete H+ ions to dissolve calcium salts and provide proteolytic enzymes to digest the extracellular matrix

19
Q

What are the two hormones which act to increase plasma calcium concentration?

A

Parathyroid Hormone - released by parathyroid gland

Calcitriol (Active form of Vit D3) steroid hormone produced from Vitamin D by the liver and kidneys

20
Q

What are the parathyroid glands?

A

4 glands which lie on the surface of the thyroid

21
Q

What is the action of PTH?

A

Stimulates osetoclasts to increase resorption of Ca2+ and phosphate in bone (Effects seen within 12-24hours)

Inhibiting osteoblasts to reduce Ca2+ deposition in bone

Increasing ReAbsorption of Ca2+

Increasing renal excretion of phosphate. This elevates free calcium concentration by preventing it from being deposited back into bone, a process that requires phosphate

Stimulates the kidney to synthesise calcitrol from Vit D which promotes calcium absorption at the gut and kidney

22
Q

What does Calcitriol do?

A

Complements action of PTH which increases calcium plasma concentration

23
Q

How is calcitriol produced?

A
  1. Liver 2. Kidneys

From vit d or precursors from sunlight in skin. Formation is stimulated by Prolactin in lactating women

24
Q

What hormone acts to decrease [Ca2+] plasma?

A

Calcitonin

25
Where is calcitonin produced?
The thyroid gland
26
What is the action of calcitonin?
To bind osteoclasts and inhibit bone resorption as well as increase renal excretion so preventing a further increase in Ca2+
27
How does cortisol alter Ca2+ balance?
Inhibits osteoblasts by increasing renal excretion of Ca2+ and phosphate. Reduces intestinal absorption of Ca2+ which decreases plasma calcium which increase PTH which increases bone reorption. Produces osteoporosis
28
How does insulin alter calcium balance?
increases bone formation and antagonises the action of cortisol
29
How does oestrogen affect calcium balance?
Promotes bone formation via oestrogen receptors on osteoblasts
30
How does GH affect calcium balance?
Constant stimulus for bone formation
31
How does prolactin affect calcium balance?
Promotes calcium absorption by the gut by stimulating synthesis of calcitriol