Calcium metabolism

Question 1

Normal Ca range

Answer 1

2.2-2.6

Question 2

symptoms of hypercal

Answer 2

bone pain, kidney stones, abdo groans (N&V, constip), psychiatric moans (lethargy, memory loss, psychosis)

nephro DI

Question 3

sympto of hypocal

Answer 3

CATS go numb

convulsions, arrhythmias, tetany, spasms, finger numbness

Question 4

how is a corrected ca calculated

Answer 4

= serum Ca + 0.02 x (40-serum albumin)

Question 5

what is the effect of PTH on Ca

Answer 5

PTH -> 1 alpha hydroxylase activity -> conv of 25 hydroxylase vit D3 to calcitriol

• > inc Ca release from bone, inc Ca renal absorb,
• > in blood Ca

Question 6

what is the effect of PTH on PO4

Answer 6

inc renal PO4 wasting

Question 7

where is 1 A hydroxylase normally found

Answer 7

kidney

sarcoidosis -> found in lung (-> summer hypercal)

Question 8

blood findings in primary hyperpara

Answer 8

inc Ca, dec PO4, inc PTH

Question 9

what are the findings in osteomalacia

Answer 9

dec bone mineralization and looser zones
dec Ca
dec K
inc alp

Question 10

findings in osetoporosis

Answer 10

normal blood results and biochem

Question 11

what is the treatment for osteoporosis

Answer 11

bisphosphonates (alendronate) -> dec bone resorop

Question 12

what is a significant associating of bisphosphonate use

Answer 12

osteonecrosis of the jaw

Question 13

patho of Familial hypocalciuric hypercalcemia (FHH)

Answer 13

CaSR mut -> dec sensitivity to Ca -> mild hypercal

Question 14

what malignancies are associated with hypercal

Answer 14

sq cell LC, bone mets/breast Ca, myeloma

Question 15

causes of hypocol with raised PTH

Answer 15

(secondary hyperpara)

vit D def, CKD, PTH res

Question 16

causes of hypoecal with lowered PTH

Answer 16

surgical, AI hypopara, congenital

Question 17

how will pagets disease present

Answer 17

bone pain + warmth over area

Ca/PO4 normal, raised ALP