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ICC2 > disorders of calcium metabolism > Flashcards

disorders of calcium metabolism Flashcards

1
Q

in what form does most calcium exist in our body ?

A

mineral deposits in the skeleton and teeth

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2
Q

what are the different forms in which calcium circulates in the body ?

A

ionized : biologically active
bound to protein: mainly albumin , inactive
complexed to citrate and phosphate: biologically active

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3
Q

what is the role of calcium ?

A 
skeletal strength 
neuromuscular condition 
stimulus secretion coupling 
second messenger within cells 
blood coagulation
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4
Q

of the circulating calcium in what form does calcium mostly exist in ?

A

ionized calcium

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5
Q

what is the role of calcitonin in calcium metabolism ?

A

calcitonin released from the parafollicular cells decrease the osteoclast activity

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6
Q

what is the effect of the parathyroid hormone ?

A

it allows for hypercalcaemia to occur through :
renal tubular reabsorption
increased in gut reabsorption
increased bone resorption

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7
Q

what is the effect of parathyroid hormone on phosphates?

A

reduces phosphate levels through reduced tubular reabsorption

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8
Q

what is the effect of vitamin D on calcium homeostasis ?

A

causes hypercalcaemia and hyperphosphataemia

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9
Q

how does vitamin D increase the levels of calcium and phosphate ?

A

through :
increased bone resorption
increased gut reabsorption
increased renal tubular reabsorption

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10
Q

what effect does calcitonin have on calcium homeostasis ?

A

decreases calcium levels

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11
Q

what are the clinical features of hypocalcemia ?

A

numbness, paraesthesia, muscle cramps, convulsions
cataracts
myopathy and bone pain
behavioural disturbances
positive trousseau’s sign and chovestek’s

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12
Q

what changes on the ECG would indicate hypocalcaemia ?

A

prolonged QT

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13
Q

what are the causes of hypocalcaemia ?

A 
vitamin d deficiency 
renal failure 
hypoparathyroidism 
pseudohypoparathyroidism 
magnnesium depeltion 
acute pancreatitis 
massive blood transfusion
artefactual
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14
Q

how does a patient with hypoparathyroidism present ?

A

hypocalcaemia and low or undetectable PTH

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15
Q

what would a non parathyroid cause of hypocalcaemia ?

A

hypocalcaemia and elevated PTH

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16
Q

what does renal failure lead to in relation to calcium homeostasis ?

A

low levels of vitamin D
high serum phosphate
reduced GI absorption
which eventually leads to elevated PTH

17
Q

what does low vitamin D in the blood cause ?

A

osteomalacia

18
Q

what is the diagnosis in a patient that has high PTH due to renal disease ?

A

secondary hyperparathyroidism

19
Q

what do the lab investigations of a patient with tertiary hyperparathyroidism patient look like ?

A

elevated calcium levels

elevated parathyroid hormone levels

20
Q

what are the clinical features of hypercalcaemia ?

A 
usually asymptomatic 
polyuria , dehydration n
anorexia, nausea, vomiting 
renal calculi 
peptic ulceration 
acute pancreatitis
weakness
21
Q

what are the commonn causes of hypercalcaemia ?

A

primary hyperparathyroidism
malignant disease
bony metastasis

22
Q

what type of drug could cause hypercalcaemia ?

A

thiazide diuretics

23
Q

what would the labs of a non parathyroid cause of hypercalcaemia look like?

A

hypercalcaemia

suppressed PTH

24
Q

what would the labs of a PTH mediated cause of hypercalcaemia look like ?

A

hypercalcaemia

raise or detectable PTH

25
Q

what are the three types of hyperparathyroidism ?

A

primary
secondary
tertiary

26
Q

what does 1ry hyperparathyroidism look like ?

A

increased PTH , Increased calcium

27
Q

what does secondary hyperparathyroidism look like ?

A

increased PTH , decreased calcium

28
Q

what does tertiary hyperparathyroidism ?

A

increased PTH, increased calcium

29
Q

what are the causes of 1ry hyperparathyroidism ?

A

PT hyperplasia
adenoma
cancer
part of MEN type 1

30
Q

causes of 2ry hyperparathyroidism ?

A

diet
malabsorption
vit d deficiency

31
Q

what are the causes of tertiary hyperparathyroidism ?

A

ESRF with chronic secondary PTH

post transplant

32
Q

what is the treatment for 1ry hyperparathyroidism ?

A

surgery

33
Q

what is osteomalacia and rickets a result of ?

A

a defect in bone mineralization secondary to vit D deficiency

34
Q

what is the treatment for vit d deficiency ?

A

give cholecalciferol 20,000 IU once weekly for 6 weeks
then
800-1000 IU daily

35
Q

what are the lab findings in osteomalacia and rickets ?

A

low serum calcium and phosphate
low vitamin D
high alklaline phosphate
high serum PTH ( secondary hyperparathyroidism)

ICC2 (42 decks)

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