Calcium Homeostasis Flashcards

1
Q

What are the major organs involved in calcium homeostasis?

A

Skeleton

Small Intestine

Kidneys

Parathyroid Glands

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2
Q

What is the distribution of calcium in the plasma?

A

50% is freely ionized Ca, the biologically active form

40% is bound to plasma proteins - pH sensitive

10% in the form of soluble complexes with citrate, phosphate or other compounds

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3
Q

What is the distribution of phosphate in the plasma?

A

Mostly ionized and in the form of phosphoric acid, referred to as inorganic phosphate

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4
Q

What is a negative calcium balance associated with?

A

Immobilization of a limb

Prolonged bed rest

Weightlessness during space flight

Certain forms of cancer

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5
Q

What is positive calcium balance associated with?

A

Skeletal growth

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6
Q

What gives bone its rigidity?

A

Minerals impregnated in the bone matrix, accounts for about 2/3 of bone weight

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7
Q

What are the organic constituents of bone?

A

The principal organic molecule in the bone matrix is type I collagen

Provides tensile strength

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8
Q

How do the bones play a role in calcium homeostasis?

A

Contains a substantial calcium reserve

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9
Q

What is compact bone?

A

Densely packed matrix that forms the shaft of long bones and covers the ends and surfaces of long bones and other bones

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10
Q

What is cancellous bone?

A

Sponge-like bone that makes up the inner portion of flat bones, vertebral bodies and the epiphyses and interior diaphysis of long bones

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11
Q

What is bone remodeling?

A

The resoprtion (breakdown) of discrete packets of old bone by osteoclasts and the subsequent formation of new bone at the resorption sites

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12
Q

What are osteoblasts?

A

Play a major role in both the regulation of bone resorption and in promoting the formation of new bone

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13
Q

What type of bone has the higher annual turnover rate?

A

Cancellous (Trabecular) at about 20% per year

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14
Q

How does the rate of bone modeling change in response to use and disuse?

A

Low levels of loading leads to bone loss (more resorption)

High levels of loading leads to an increase in bone mineral density

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15
Q

What are osteoclast precursor cells and what are they derived from?

A

Derived from monocyte/macrophage lineage cells

Differentiate into osteoclasts

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16
Q

What is the OPG/RANK-L/RANK System?

A

Primary mechanism through which osteoblasts and osteoblast lineage cells regulate osteoclastogenesis and bone resorption

17
Q

What is RANK-L?

A

Cell surface ligand expressed by osteoblast lineage cells

Stimulate osteoclast precursor cells via direct cell-to-cell contact

18
Q

What is RANK?

A

Receptors expressed by osteoclast precursors that bind to RANK-L

19
Q

What occurs when RANK-L stimulates RANK?

A

Activation of signaling pathways in osteoclast precursors that promote their differentiation, fusion into multinucleated cells and activation

Also prolongs the life-span of the osteoclast by inhibiting apoptosis

20
Q

What is osteoprotegerin (OPG)?

A

Soluble protein released by osteoblasts that binds RANK-L and prevents it from activating RANK

21
Q

What stimulates and inhibits RANK-L expression?

A

Stimulates - PTH and 1,25(OH)2D3

Inhibits - estradiol

22
Q

What stimulates and inhibits OPG production?

A

Stimulates - Estradiol

Inhibits - PTH

23
Q

What is M-CSF?

A

Macrophage colony stimulating factor

Promotes the early differentiation of monocyte/macrophage lineage cells and works in concert with RANK-L to promote osteoclastogenesis

24
Q

How is bone resoprtion initiated?

A

By hormones, cytokines or other factors that bind receptors expressed by osteoblasts

This causes the osteoblasts to:

Degrade unmineralized osteoid

Increase their expression of RANK-L

Synthesize and release M-CSF

25
What are osteoclasts and what occurs when they're activated?
Large multinucleated cells formed by the fusion of mononucleated precursors of monocyte/macrophage lineage When activated, attach to bone to form sealing zones which effectively seal off an area of bone surface
26
What is the ruffled border formed by osteoclast plasma membrane?
Secretes H+ onto the bone surface via membrane-associated H+-ATPases The low pH dissolves the hydroxyapatite crystal At the same time proteases secreted by the osteoclast digest the matrix proteins
27
What are Bone turnover markers?
Products of matrix degradation that indicate bone resorption rate CTX and NTX
28
What do osteoblasts express receptors for?
PTH 1,25(OH)2D3 Estorgens Glucocorticoids
29
What two proteins can be used as clinical indicators of bone formation?
Alkaline phosphatase Osteocalcin
30
What occurs to osteoblasts after matrix formation?
50-70% undergo apoptosis Some remaining osteoblasts become lining cells that cover newly formed bone Others become osteocytes
31
What are canaliculi?
Canals that allow the communication of osteocytes with lining cells This network supports bone metabolism and functions to detect changes in mechanical strain
32
How does bone mass change with age?
Modeling of bone continues through early adulthood, afterwhich the skeleton remains in a homeostatic state Starting in the 4th decade of life, more bone is resorbed than produced, causing a gradual decline in bone mass with increasing age