Calcium Metabolism

Question 1

Range of calcium

Answer 1

2.2-2.6

Question 2

What is corrected calcium

Answer 2

Corrected for albumin level

Question 3

How does PTH alter calcium

Answer 3

Increase bone resorption
Increase renal resorption
Increase 1 alpha hydroxylase

Question 4

Vitamin D metabolism

Answer 4

D3- mammal (cholecalciferol), D2 plant (ergo)

Liver-25, renal 1

Question 5

What condition can cause production of 1 alpha outside the kidney

Answer 5

Sarcoidosis- lung

Question 6

What is needed for PTH synthesis

Answer 6

Mg

Question 7

What renal disease cases boney problems

Answer 7

Renal osteodystrophy
Cant make 1 alpha
Lack calcium

Question 8

Biochemistry of Vit D deficiency

Answer 8

High P, low Ca, raised ALP- lack of bone mineralisation

Question 9

What drugs can induce Ricketts in children

Answer 9

Anticonvulsants

Question 10

Risk factors of osetoporosis

Answer 10

Age, menopause, bushings, hyperthyroid, steroid treatment

Question 11

Symptoms of OP

Answer 11

Fractures, in spine- lose height

Question 12

Diagnosis of OP

Answer 12

DEXA- less than -2.5

Question 13

Treatment of OP

Answer 13

Bisphosphonates, SERM- tamoxifem (raised chance of endometrial cancer), Vit D

Question 14

Symptoms of hypercalcaemia

Answer 14

Polyuria, constipation, bone pain, neuro problems

Question 15

What receptor detects calcium and where

Answer 15

CaSR- PT gland

Question 16

What condition has a defect in the calcium receptor and what symptoms do they have

Answer 16

Familial hypocalciuric hypercalcaemia (FHH/FBH)- CaSR mutation so doesn’t detect Ca properly- Ca will always be mildly high – don’t have kidney stones

Question 17

Treatment of hypercalcaemia

Answer 17

Fluids

Bisphosphonates- only if cause is cancer

Question 18

Hypocalcaemia symptoms and signs

Answer 18

Muscle spasm, tetany , trousseau- arm, Chvosek- face

Question 19

Causes of Hypocalcaemia

Answer 19

Vit D deficiency, surgery or auto-immune of PT gland, Di Georges and Mg deficiency

Question 20

Management of Hypocalcaemia

Answer 20

Calcium, 1 alpha Vit D is Chronic renal disease, severe 10% calcium gluconate

Question 21

Biochemistry of primary, secondary and tertiary hyperPTH

Answer 21

1- high Ca, low P
2- low/normal C, high P, high ALP
3- high Ca, low P