Calcium Metabolism Flashcards
Range of calcium
2.2-2.6
What is corrected calcium
Corrected for albumin level
How does PTH alter calcium
Increase bone resorption
Increase renal resorption
Increase 1 alpha hydroxylase
Vitamin D metabolism
D3- mammal (cholecalciferol), D2 plant (ergo)
Liver-25, renal 1
What condition can cause production of 1 alpha outside the kidney
Sarcoidosis- lung
What is needed for PTH synthesis
Mg
What renal disease cases boney problems
Renal osteodystrophy
Cant make 1 alpha
Lack calcium
Biochemistry of Vit D deficiency
High P, low Ca, raised ALP- lack of bone mineralisation
What drugs can induce Ricketts in children
Anticonvulsants
Risk factors of osetoporosis
Age, menopause, bushings, hyperthyroid, steroid treatment
Symptoms of OP
Fractures, in spine- lose height
Diagnosis of OP
DEXA- less than -2.5
Treatment of OP
Bisphosphonates, SERM- tamoxifem (raised chance of endometrial cancer), Vit D
Symptoms of hypercalcaemia
Polyuria, constipation, bone pain, neuro problems
What receptor detects calcium and where
CaSR- PT gland
What condition has a defect in the calcium receptor and what symptoms do they have
Familial hypocalciuric hypercalcaemia (FHH/FBH)- CaSR mutation so doesn’t detect Ca properly- Ca will always be mildly high – don’t have kidney stones
Treatment of hypercalcaemia
Fluids
Bisphosphonates- only if cause is cancer
Hypocalcaemia symptoms and signs
Muscle spasm, tetany , trousseau- arm, Chvosek- face
Causes of Hypocalcaemia
Vit D deficiency, surgery or auto-immune of PT gland, Di Georges and Mg deficiency
Management of Hypocalcaemia
Calcium, 1 alpha Vit D is Chronic renal disease, severe 10% calcium gluconate
Biochemistry of primary, secondary and tertiary hyperPTH
1- high Ca, low P
2- low/normal C, high P, high ALP
3- high Ca, low P
