Hypophosphatemia

Question 1

What happens with marked hypophosphatemia

Answer 1

Intravascular hemolysis

Question 2

Major mechanisms

Answer 2

-Decreased intake or absorption
-Transcellular shifting ECF-> ICF
-Increased urinary excretion
-Multifactorial

Question 3

Decreased intake or absorption

Answer 3

-Prolonged anorexia or Pi deficient diet
-Phosphate binding agents (used in renal disease)
-GI disease
-Hypovitaminosis D

Question 4

Transcellular shifting

Answer 4

-Respiratory alkalosis-> stimulate glycolysis and Pi shifts to ICF
-Increased insulin and glucose concentration-> for ATP production causes shift to ICF

Question 5

Increased urinary excretion

Answer 5

-Increased PTH or PTHrp
-Prolonged and or osmotic diuresis

Question 6

Parturient hypocaclemia

Answer 6

-Excess phosphate output relative to intake
-Defect response to PTH and vitamin D
-Increased calcium output-> PTH-> increased renal Pi excretion