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203 > Calcium Homeostatsis > Flashcards

Calcium Homeostatsis Flashcards

1
Q

How does parathyroid gland know when to secrete PTH?

A

Calcium sensing receptor changes shape to different levels of calcium in blood

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2
Q

Low magnesium prevents?

A

PTH release

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3
Q

PTH works on?

A

PTH type 1 receptor

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4
Q

Where are PTH1 receptors?

A

Bone/kidney

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5
Q

How does calcium release work?

A

PTH receptors on osteoblasts, then produces cytokines RANK ligand on rank receptor osteoclasts activation

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6
Q

PTH causes in kidneys?

A

Increased calcium reabsorption

Decreased phosphate reabsorption

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7
Q

What does hypocalcaemia do to neurons?

A

Destabilises

Make sure someone with seizures is checked for hypocalcaemia and hypoglycaemia

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8
Q

Trousseau’s sign

A

Blood cuff above systolic, nerves fire more in hypocalcameia, hand cramps

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9
Q

Chvostek’s sign

A

Tap face, facial nerve present, twitching of mouth

Low plasma calcium increases the permeability of neuronal membranes to sodium

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10
Q

Hypercalcaemia consequences?

A 
Abdominal pain
Thirst 
Polyuria
Musculoskeletal aches
Neurobehavioual symptoms
Renal calculus 
And osteoporosis
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11
Q

40% of calcium is bound to proteins, which ones?

A

Albumin 90%

globulin 10%

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12
Q

When does corrected albumin Ca not work?

A

Albumin conc over 20g/l

In severe acute illness

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13
Q

Calcium level?

A

2.15 and 2.55 mmol/l

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14
Q

Parathyroid glands have which cells?

A

Chief

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15
Q

Osteoclasts releases?

A

H+
CATK
TRAP
And calcium

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16
Q

In kidney PTH converts?

A

25OH vitamin D to 1,25 OH Vitamin D

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17
Q

What does 1, 25 OH vitamin D do in gut?

A

Stimulates calcium transporters and Binding protein (calbindin) in gut cells cause greater absorption of calcium

18
Q

PTH is inhibited by?

A

1,25 OH vitamin D in chief cells

19
Q

Osteocytes cause inhibition?

A

have receptors for 1, 25 OH vitamin D and produce FGF 23 inhibit conversion of 25 to 1,25 vitamin D

20
Q

FGF23 causes?

A

Phosphate excretion

21
Q

Complications of hyperparathyroidism?

A

Osteoporosis and bone cysts

22
Q

Complications of hypercalcaemia?

A

Renal stones

23
Q

Indications of parathyroidectomy?

A

Osteoporosis
Renal calculus
Less than 50 years
Serum calcium over 2.8 mmol/l

24
Q

How to scan for parathyroid adenoma?

A

Ultrasound, sestamibi parathyroid scan (nuclear medicine scan)

25
Q

Hypoparathyroidism causes?

A

Iatrogenic- thyroidectomy, radical neck surgery
Autoimmune
Hypomagnesaemia
Genetic mutations

26
Q

Secondary hyperparathyroidism?

A

Low serum 25 OH vitamin D, lack of sun exposure, GI problems and renal failure

27
Q

Rickets is when you have deficiency of

A

Vitamin D

28
Q

Osteomalacia?

A

Looser zones, small fractures lack of calcium

29
Q

Vitamin d deficiency increases risk of

A

Falls and fractures

30
Q

Hypocalcaemia can cause?

A

Seizures

31
Q

Trousseau sign?

A

Blood pressure cuff above systolic hand cramps

32
Q

Chvostek sign?

A

Tap on face near facial nerve twitching of the mouth

33
Q

What percent of calcium is bound to anions phosphate citrate?

A

10

34
Q

Parathyroid gland detects calcium through?

A

Calcium sensing receptor, change in shape

35
Q

Where does PTH bind?

A

PTH type 1 receptor

36
Q

Rapid ca2+ release in bone happens by?

A

Osteocytes squeezing out calcium

37
Q

If someone has a seizure what should you check?

A

Calcium because it can destabilise neurons

38
Q

Physical signs of hypocalcaemia?

A 
Trousseasu’s sign- carpopedal spasm, cuff inflated over systolic 
Tetany
Seizures
Muscle cramps 
Bronchial spams 
Irritability 
Confusion
Psychosis 
Parkinsonism
39
Q

In 10% of people with hypocalcaemia what is seen?

A

Chvostek’s sign- tap jaw where facial nerve is and the muscle will contract

40
Q

Consequences of hypercalcaemia?

A

Acute: thirst/polyuria
Abdominal pain

Constipation musculoskeletal aches weakness
Neurobehavioural symptoms
Renal calculus
Osteoporosis

41
Q

How do parathyroid chief cells detect calcium?

A

Calcium sensing receptor

42
Q

When osteoclasts break down bone they release?

A

H+
CATK- cathepsin K
TRAP- tartrate resistant acid phosphatase
And calcium

203 (74 decks)

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