Lecture 14 - Calcium metabolism Flashcards
What is the parathyroid gland formed from embryologically?
Third and fourth brachial artery
Where and how many PTH glands?
- Behind thyroid glands
- x4
What are some importance of calcium?
- Hormone secretion (insulin)
- Muscle contraction
- Nerve conduction
- Exocytosis
How is calcium vital for bone formation?
Ca+K: Hydroxyapatite crystals, a major component of bone
What regulates Ca conc. in blood?
- PTH + calcitriol
How does PTH affect calcium and K homeostasis?
- PTH ⬆️, K ⬇️
- ⬆️Ca reabsorption from kidney
- ⬆️osteoclast resoption –> increase bone turnover
- ⬆️absorption of Ca from food (small intestine)
What types of Vit. D are present in the diet?
- Ergocalciferol (D2): obtain from mushrooms (less potent version of vit D
- Cholecalciferol (D3): Liver of fatty fish
How does Vit D act in Ca & K homeostasis?
- Decrease PTH production
- ⬆️Ca reabsorption from kidney
- ⬆️mineralisation of Ca to bone
- ⬆️absorption of Ca and K from food (small intestine)
What parameters define hypercalcaemia?
- Serum calcium >2.51mmol/L
>3 is severe
What are some symptoms of hypercalcaemia?
- Moans –> Constipation
- Bones –> bone aches
- Stones –> Kidney stones
- Groans –> Confusion
- Thirst and polyuria
What indication does high calcium and low PTH show?
N.B PTH can drive hypercalcaemia
- High Ca due to diff factor (not PTH from parathyroid gland)
- Most likely= cancer –> produce PTH like peptide
What are some examples of cancers with high calcium?
- Myeloma (blood cancer)
- Bone metastases (Bronchus, Thyroid, Breast, Kidney)
Other than cancers what can be a cause of high Ca and low PTH?
- TB
- Sarcoidosis: growth of tiny cancers in lung
- Granulomas that secrete calcitriol
What does high Ca and high PTH suggest?
- Not cancer
- Primary hyperparathyroidism: benign parathyroid adenoma
What are the effects of primary hyperparathyroidism?
- High Ca, Low K
- ⬆️bone turnover