disorders of calcium metabolism

Question 1

what are the two hormones associated with calcium homeostasis ?

Answer 1

calcitonin
PTH

Question 2

what is the relationship between calcium and PTH and calcitonin ?

Answer 2

if PTH increases so does calcium
if calcitonin increases calcium decreases

Question 3

what is the effect of the PTH on phosphate levels ?

Answer 3

decreases

Question 4

what is the effect of magnesium on the PTH ?

Answer 4

low magnesium = low PTH

Question 5

what is the effect of vitamin D on calcium and phosphate ?

Answer 5

increases both

Question 6

what two signs are associated with hypocalcemia ?

Answer 6

positive chvostek and trousseaus sign

Question 7

what is the diagnosis according to these lab results ?

Answer 7

hypocalcemia with low PTH = hypoparathyroidism

hypocalcemia and elevated PTH = non parathyroid cause

Question 8

where does the activation of vitamin D occur ?

Answer 8

first liver theen the kidney

Question 9

what happens to calcium homeostasis in renal failure ?

Answer 9

low vitamin D so reduced absorption off calcium
and low phosphate

( if vitamin D is low then so is calcium and phosphate )

Question 10

what is the diagnosis regarding PTH in renal disease ?

Answer 10

secondary hyperparathyroidism
which eventually becomes tertiary hyperparathyroidism

Question 11

what are the symptoms of hypercalemia ?

Answer 11

a level of calcium above 2.6 mg/dl
groans
moans
bones
psychiatric moans

Question 12

what is the most common cause of hypercalcemia ?

Answer 12

primary hyperparathyroidism
bony metastasis

Question 13

what type of drug is associated with hypercalcemia ?

Answer 13

thiazide diuretics
so we give loop diuretics instead

Question 14

what are the levels of PTH and calcium in 1rry 2ry and 3ry hyperparathyroidism ?

Answer 14

1ry - high PTH , high calcium
2ry - high PTH , low calcium
3ry - high PTH and high calcium

Question 15

what are the causes of 1ry, 2ry and 3ry hyperparathyroidism ?

Answer 15

1ry- primary parathyroid disorder
2rry - normal response to hypocalcemia
3ry - prolonged secondary PTH

Question 16

what type of syndrome is associated with primary hyperparathyroidism ?

Answer 16

MEN 1

Question 17

what is the treatment of primary hyperparathyroidism ?

Answer 17

surgery

Question 18

what is the pathology behind osteomalacia and rickets ?

Answer 18

defect of bone mineralization secondary to vitamin D deficiency

Question 19

what are the lab findings associated with osteomalacia and rickets ?

Answer 19

1- low serum calcium and phosphate
2- high alkaline phosphate
3- low levels of vitamin D
4- high serum PTH