Mineral Balance Lectures Flashcards

1
Q

Calcium Reference Range

A

8.6-10.0 mg/dl

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2
Q

Calcium Functions

A
  • Skeletal mineralization
  • Nerve impulse transmission
  • muscle contraction
  • blood coagulation
  • enzyme cofactor
  • cell membrane integrity and permeability
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3
Q

Organs associated with Calcium balance

A
  • Small intestine
  • Bones
  • Kidneys
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4
Q

Hydroxyapatite

components

A

Calcium+Phosphorus+hydroxide

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5
Q

Hydroxyapatite importance

A

99% of calcium in bones and teeth is in this form

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6
Q

Calcium bound to proteins (%)

A

-40%

most bound to albumin

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7
Q

Free “ionized” calcium and pH (acidosis/alkalosis)

A

Acidosis: more free Ca2+ (less binding)
Alkalosis: less free Ca2+ (more binding)

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8
Q

Free calcium (%)

A

50%

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9
Q

Calcium in salts (%)

A

10%

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10
Q

Ionized Calcium function

A
  • Physiologically active calcium

- monitored in heart surgery

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11
Q

Ionized calcium reference range

A

4.6-5.3 mg/dl

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12
Q

PTH and calcium

A
  • Secretion increases calcium levels

- glands have calcium receptors that respond to Ca levels

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13
Q

How PTH increases calcium

A
  • Bone resorption and release of Ca to blood.
  • Increase renal reabsorption of Ca (excretion of phosphorous)
  • Intestinal reabsorption
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14
Q

Calcium and Phosphorous relationship

A
  • Inverse relationship
  • Reabsorption of Ca = secretion of Phosphorous
  • Influenced by PTH
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15
Q

Vitamin D/Calcium

A

Increases calcium and phosphate by increasing absorption from GI tract

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16
Q

Vitamin D/Calcium

A

Increases calcium and phosphate by increasing absorption from GI tract

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17
Q

Vitamin D/PTH

A

Increases bone resorption and enhances PTH

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18
Q

Calcitonin

A

Inhibits bone resorption, promotes bone formation

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19
Q

primary Hyperparathyroidism

A

Increased calcium, PTH

Decreased phosphorous

20
Q

Hypoparathyroidism

A

Decreased PTH
Decreased calcium
Increased phosphorous
(injury)

21
Q

Hypercalcemia conditions

A
.Hyperparathyroidism
.Malignancy
.Renal failure
.Multiple myeloma
.Increased Vit. D
.Milk Alkali syndrome
.Diuretics, Lithium, Vit. A
22
Q

Hypercalcemia Symptoms

A
Kidney stones
Fractures
Hypertension
Arrhythmia
Constipation
Disorientation
23
Q

Hypocalcemia

A
Hypoalbuminemima
Hypoparathyroidism
Renal failure
Decreased magesium
Citrate toxicity
24
Q

Hypocalcemia/Hypoalbuminemia

A

Liver disease
nephrotic syndrome
malnutrition

25
Q

Hypocalcemia symptoms

A
Neuromuscular irritability
Tetany
Trosseau and Chvostek's
Depression
Cardiac irregularity
26
Q

Total Calcium Specimen

A
Serum
Li heparin plasma
No EDTA
Hemolysis (decrease)
HCI urine
27
Q

Ionized calcium requirements

A

Anaerobic
Heparin whole blood
Serum/plasma
ph and Ca2+ reported

28
Q

Rickets

A

Vitamin D deficient
Bone deformity
Abnormal mineralization
Children

29
Q

Osteomalacia

A

Adults
Vitamin D deficient
Abnormal mineralization

30
Q

Osteoporosis

A

Low bone mass

Assess bone density and PTH/Vitamin D

31
Q

Paget’s disease

A

Excessive bone resorption
Increased ALP
Treat w Calcitonin

32
Q

Phosphorous reference range

A

2.5-4.5 mg/dl

33
Q

Phosphorous distribution

A

80% bone
20% soft tissue
<1% in bloodstream

34
Q

Phosphorous regulation

A
Kidneys
PTH (decrease)
Vitamin D (increase) 
GH 
Calcitonin
35
Q

Hyperphosphatemia

A

Decreased excretion
Cellular shift (acidosis)
PTH (low)

36
Q

Hypophosphatemia conditions

A
Increased excretion
Diuretics
DKA
increased PTH
Cell shift (alkalosis)
Malabsorption
37
Q

hypophosphatemia symptoms

A
Weakness
double vision
slurred speech
dizziness
respiratory failure
impairment of cardiac contractility
38
Q

Phosphorous specimen

A

serum
Li hep plasma
Hemolysis (increase)
Diurnal variation

39
Q

Magnesium ref range

A

1.6-2.6 mg/dl

40
Q

Magnesium distribution

A

50% bone
40% muscle
1% RBC

41
Q

Magnesium forms

A

Ionized: 55%
Protein bound: 30%
Ionic: 15%

42
Q

Hypomagenesiemia symptoms

A
Hypertension
Arrhythmia
Weakness
tetany
Depression
psychosis
43
Q

Hypermagnesemia symptoms

A
Hypotension
Bradycardia
warm skin
nausea
vomiting
hypocalcemia
44
Q

Magnesium specimen

A

Serum
Heparin plasma
24 h urine (HCl)

45
Q

Magnesium specimen

A

Serum
Heparin plasma
24 h urine (HCl)

46
Q

Metabolically active Vitamin D

A

1,25 dihydroxy vitamin D3

47
Q

Secondary hyperparathyroidism

A

Increased PTH
Increased phosphorous
Decreased calcium