exam 2: regulation of plasma calcium and phosphate

Question 1

85% of the body’s PHOSPHATE is stored in _______, 14-15% in _____ and less than 1% in the _____

Answer 1

bones
cells
EC fluid

Question 2

only .1% of total body calcium is in the ________. 1% is in _____ and ____ and the rest is store in _________

Answer 2

EC fluid
1% in cells
rest in bones

Question 3

too low of calcium=

Answer 3

neuronal hyper-excitability (tetany)

Question 4

too high of calcium=

Answer 4

neuronal depresion

Question 5

control points for calcium and phosphate:

Answer 5

1. absorption
2. excretion
3. temporary storage

Question 6

control points for calcium and phosphate: (regulation)
1. absorption=
2. excretion=
3. temporary storage=

Answer 6

1. absorption= via intestines
2. excretion= via urine (both ca and phos) (feces ca only)
3. temporary storage= via bones (hydroxyapatite)

Question 7

carpal spasm due to

Answer 7

HYPOcalcemia

Question 8

3 principle hormones that regulate plasma calcium and phosphate:

Answer 8

1. parathyroid hormone (PTH)
2. calcitriol
3. calcitonin

Question 9

PTH:

Answer 9

increases Ca
decreases phosphate

Question 10

calcitriol:

Answer 10

increases ca
increases phosphate

Question 11

calcitonin:

Answer 11

decreases ca
decreases PTH

Question 12

what hormone is the primary hormone that enhances intestinal absorption of calcium and it also causes absorption of phosphate

Answer 12

calcitriol (vitamin D3)

Question 13

releases Ca from bone, enhances renal reabsorption of calcium (kindeys), increases intestinal absorption of calcium (indirectly)= increase vitamin D production

Answer 13

PTH

Question 14

in addition to PTH, bone resoprtion is stimulated by

Answer 14

cortisol and T3

Question 15

how does PTH indirectly increase intestinal absorption of calcium

Answer 15

increasing vitamin D production

Question 16

what two things stimulate bone matrix RESORPTION which INCREASEs plasma calcium

Answer 16

vitamin D3 aka calcitrol and parathyroid hormone PTH

Question 17

excess vitamin D’s main effect is ___ ______ of calcium and phosphate

Answer 17

gut absorption

Question 18

build bone matrix:
break down bone matrix:

Answer 18

build: osteoblasts
break down: osteoclasts

Question 19

what binds to osteoclasts and activates them?

increase of these produced by osteoblasts and it lets them break down the hydroxyatite to increase plasma calcium and phosphate

Answer 19

RANKL

Question 20

occurs when imbalance between bone formation and resoprtion

Answer 20

osteoporosis

Question 21

risk factors for osteoporisis

Answer 21

vitamin D deficiency
inadequate calcium intake
estrogen deficiency
smoking
alcohol
reduced activity

Question 22

lot of other things that activate osteoblasts that break down calcium (bone breakdown) break down hydroxyapatite

Answer 22

corticosteriods (cortisol)
prolactin
vitamin D3

Question 23

calcitonin stimulates bone matrix ________ and inhibits ________= ____ in plasma calcium

Answer 23

deposition
inhibits osteoclasts
decrease in plasma calcium

Question 24

vitamin D3 and PTH stimulate bone matrix____

Answer 24

resorption

Question 25

with calcitonin, there is increased production of: which binds to RANKL so RANKL cannot bind to osteoclasts= apoptotic osteoclast what does this:

Answer 25

increased production of OPG estrogen, calcotonin

Question 26

treatments for osteoprosis

Answer 26

excerise physical therapy estrogen calcium vitamin D bisphosphonates

Question 27

4 pea sized glands on POSTERIOR surface of thyroid gland

Answer 27

parathyroid glands and hormone

Question 28

PTH is secreted by:

Answer 28

chief cells

Question 29

PTH increases ______ by increasing _______, decreasing __________, and increasing _________-

Answer 29

increases: plasma calcium by increasing= intestinal absorption (indirectly by increasing vitamin D levels) decreasing= renal excretion increasing= bone resorption

Question 30

PTH decreases _________ by increasing ________-

Answer 30

PTH decreases phosphate by increasing renal secretion/excretion and decreasing renal reabsorption

Question 31

decrease ECF ca2+ concentration would cause an ______ of PTH secretion hypertrophy of parathyroid gland due to= pregnancy, rickets, lactation

Answer 31

increase rate of PTH secretion

Question 32

increase ECF Ca2+ concentration would lead to _____ activity of parathyroid gland and _____ size of parathyroid gland

Answer 32

decrease activity of parathyroid gland decrease size of it

Question 33

what would be the cause of increase ECF Ca2+ concentrations:

Answer 33

increased vitamin D intake excess quanitities of calcium in the diet bone resorption caused by factors other than PTH

Question 34

what would cause decrease ECF Ca2+ concentrations

Answer 34

pregnancy rickets lactation

Question 35

what indirectly increases intestinal calcium absorption in the intestines

Answer 35

vitamin D

Question 36

increase of PTH with kidney: phosphate:

Answer 36

increase PTH decrease in phosphate reabsorption increase of phosphate renal secretion leads to decrease in plasma phosphate

Question 37

increase of PTH with kidney. calcium:

Answer 37

increase PTH increase in calcium reabsorption decrease in calcium renal secretion leads to increase in plasma calcium (calcium back to normal levels)

Question 38

increase in PTH with bone:

Answer 38

leads to increase bone resorption leads to increase in plasma calcium

Question 39

vitamin D3 can be stored in the ___ for several months

Answer 39

liver

Question 40

what activations the enzyme in the kidney that makes calcitriol

Answer 40

PTH

Question 41

what 3 things are necesary in making active form of vitamin D3

Answer 41

skin liver kidney

Question 42

the active form of vitamin D3 (calcitriol) increases the intestinal absorption of _____ in the intestines epithelium

Answer 42

calcium and phosphate

Question 43

main effect of vitamin D or calcitriol is:

Answer 43

absorption of Ca and Phosphate via intestines

Question 44

however, vitamin d or calcitriol by some effect can reduce excretion of: by what: and it can also lead to:

Answer 44

Calcium or phosphate by the kidneys lead to bone deposition (indirectly by increasing level of calcium in the blood)

Question 45

what is not a major controller of Ca2+ in humans

Answer 45

calcitonin

Question 46

calcitonin is a peptide hormone secreted by

Answer 46

parafollicular cells (C cells) by the thyroid gland

Question 47

this is released in response to elevated levels of free plasma Ca

Answer 47

calcitonin

Question 48

calcitonin lowers plasma Ca by decreasing activity of:

Answer 48

osteoclasts this decreasing bone resorption (so bone deposition)

Question 49

excess PTH secretion due to parathyroid gland tumor

Answer 49

primary hyperparathyroidism

Question 50

Thyroid hormone produced in highest concentrations

Answer 50

T4

Question 51

thyroid hormone produces most of target cells actions of thyroid hormone

Answer 51

T3

Question 52

primary hyperparathyroidism causes extreme osteoclastic activity in bones causes:

Answer 52

cystic bone disease (extreme bone break down)

Question 53

primary hyperparathyroidism. 1. hypercalcemia leads to: 2. low phophate due to: 3. muscle weakness and easy fatigability 4. osteoblastic activity also increased leading to high section of:

Answer 53

1. hypercalcemia leads to: polyuria 2. low phophate due to: increase renal excretion 3. muscle weakness and easy fatigability 4. osteoblastic activity also increased leading to high section of: ALP (alkaline phosphatase)

Question 54

high PTH levels occur as compensation for HYPOCALCEMIA not due to primary abnormality of parathyroid glands

Answer 54

secondary hyperparathyroidism

Question 55

hypercalcemia: hypocalcemia:

Answer 55

hypercalcemia: primary hyperparathyroidism hypocalcemia: secondary hyperparathyroidism

Question 56

causes of hypocalcemia: (secondary hyperparathyroidism-high PTH levels)

Answer 56

vitamin D deficiency and chronic renal disease- cannot synthesize Vitamin D3

Question 57

what leads to rickets in children and osteomalacia in adults and high PTH

Answer 57

vitamin D defiency

Question 58

less common -results from accidental surgical parathyroid gland removal -DECREASES CA levels

Answer 58

primary hypoparathyroidism

Question 59

hypocalcemia increases membrane Na permeability leading to neurmuscular excitability and muscle spasms and:

Answer 59

tetany (carpal spasm)