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BS 2 Module 3 > Mineral Homeostasis > Flashcards

Mineral Homeostasis Flashcards

1
Q
  • __% of the Calcium in our bodies is found in our ____
  • ____% of total adult bone mass turnover occurs annually due to bone ______
  • During growth the rate of bone ______ exceeds _____ leading to the skeletal mass to ________
  • _______ growth occurs at the _____ plates
  • Increase in bone width occurs at the ______
  • Rate of _______ & ______ are equal until ~30 where the rate of ________ begins to exceed the rate of _______ and bone mass _______
A
  • 99%; bones
  • 10%; remodeling
  • Formation; resorption; increase
  • Linear; epiphyseal
  • Periosteum
  • Formation; degradation; degradation; formation; decreases
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2
Q
  • 20% of adult bone is _____/_____ bone
  • 80% of adult bone _____/_____ bone. Is ___, ____, and solid bone that forms the _____: the outer shell of most bones. Provides _____ and ______ to the bone
A
  • Trabecular; Spongy
  • Cortical; Compact
  • Dense; stiff;
  • Cortex; strength; protection
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3
Q

-Active _______ synthesize and extrude
collagen
-Collagen fibrils form arrays of an organic matrix
called the ____
-______ ______ is deposited in the osteoid and
becomes mineralized
-Dependent on _______
-______ ______ and ______ play roles in
bone formation and their plasma levels are indicators of _____ activity

A
  • Osteoblasts
  • Osteoid
  • Calcium Phosphate
  • Vitamin D
  • Alkaline Phosphatases; Osteocalcin; Osteoblast
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4
Q

-Interior ________ remain connected to surface
cells via transfer of ________ from enormous
surface area of the interior to extracellular fluid.

A

-Osteocytes; Calcium

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5
Q

Bone Resorption of Calcium by 2 Mechanisms:
1) ______ _____: Is a rapid and transient effect
2) _____ ______: Is slow and sustained
-Bone formation and resorption are mainly
regulated by _____ ____(___) and
Vitamin ____.

A

1) Osteocytic Osteolysis
2) Osteoclasitic resorption
- Parathyroid Hormone (PTH); VitaminD

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6
Q 
Osteocytic Osteolysis
-Transfer of \_\_\_\_\_\_\_\_ from canaliculi to
extracellular fluid via activity of \_\_\_\_\_\_, by removing \_\_\_\_\_\_\_ from most recently formed crystals
-\_\_\_\_\_\_ decrease in bone mass
-Very \_\_\_\_\_\_ process
A
  • Calcium; Osteocytes; Calcium
  • NO
  • Fast
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7
Q

Osteoclastic Resorption
-Does not merely extract ______, it _______
entire matrix of bone and ________ bone mass
-Cell responsible for resorption is the ________

A
  • Calcium; destroys; diminishes

- Osteoclast

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8
Q

Mineral Homeostasis
-______ and ________ ions can combine to form
insoluble ______, the concentrations of these ions in
cells and body fluids is precisely regulated to
prevent inappropriate _______
-Mineral balance is achieved by ______ control
of ______ & ______ transport into and out of ______, ______, & _____

A
  • Calcium and phosphate; salts; precipitations

- Hormonal; Calcium & Phosphate; Intestines; Kidneys; Bone

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9
Q

Importance of Calcium
-In bone provides structural ________ of the skeleton
-Most abundant ______ in the body
-Amount of Calcium is balanced among ______, ____, and _______, which is controlled via Calcium transfer from the 3 organs
Calcium in Extracellular and Cellular Fluids:
-__________ excitability and signal ______
-Blood ______
-________ secretion
-________ regulation
-________ excitation

A
  • Integrity
  • Mineral
  • Intestines, kidney, bone
  • Neurmuscular; transduction
  • Coagulation
  • Hormonal
  • Enzymatic
  • Neuron
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10
Q

Calcium in the Body
-~______ of Ca is ingested per day, and absorption occurs in the ____ _______, and
requires ________
-An adult human contains ~ _________g of Calcium
-Extracellular [Calcium] is ~_____ mg/dL, and [Calcium] in the cytosol is ~ ______M

A
  • 1000mg; small intestines; Vitamin D
  • 1,000g
  • ~10mg/dL
  • ~10-7 M
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11
Q

Regulation of Intracellular Calcium

  • Stored in the ______ and ____
  • ______ transport systems control intracellular [Calcium], where it gets pumped into storage site in _______ to avoid forming _______ pools
A
  • Mitochondria; ER

- “Pump-leak”; organelles; cytosolic

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12
Q

Extracellular Calcium
- Normally ranges from _____ mg/dL in the
_____
3 forms of Calcium in serum:
1) _______ calcium makes up ____% of the total and is biologically ______
2) _______ calcium makes up ___%, where 90% is bound to _____ and the rest is bound to globulins
3) Calcium complexed to serum ________ (_____ & phosphate) make up 10%

A
  • 8.5-10 mg/dL; blood
    1) Ionized; 50%
    2) Protein-bound; 40%; albumin
    3) Constituents; Citrate
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13
Q

Daily Calcium Turnover

  • Intake of ~____mg of ____ Calcium
  • ~___mg of unabsorbed dietary Calcium and ~____mg of fecal Calcium are excreted
  • The _____ filters ~______ mg/day and ~200mg get excreted in the _____, 98% of the _____ Calcium is exchanged back into the _____
  • ~350mg gets absorbed into the ____ from the intestine, ~_____ mg goes back into the intestines, and bone _____ results in ~____mg being absorbed back into and from the bone with the _____.
  • Bone contains ~______ mg of Calcium
A
  • 1,000mg; dietary
  • 650mg; 150mg
  • Kidney; 10,000 mg/day; urine; filtered; blood
  • blood; 150mg; remodeling; 500mg; blood
  • 1 million mg
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14
Q
  • ~_____ mg of phosphate is ingested per day
    -Phosphate is absorbed in the _____ ____,
    stored in the ______ and excreted by the ______
A
  • 1,000

- Small Intestines; Skeleton; Kidneys

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15
Q

Storage of Phosphate
-An adult human contains approximately _____g of
phosphorus
-~ ____% of this is present in crystalline form in the
______
- ~___% is present in the _________ fluids, and the concentration in cells is ~___mM
-Phosphate concentrations are ____ rigidly maintained than that of ______

A
  • 700mg
  • 85%; skeleton
  • 15%; extracellular; 5mM
  • Less; Calcium
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16
Q

Phosphorous in Blood and Bone
-PO4 normal plasma concentration is _____ mg/dL.
87% is ______, with 35% complexed to
different ____ and 52% ionized.
-13% is in a non-diffusible _____ ____ state. 85-90% is found in ___
- The rest is in ____, ____, & ______

A
  • 3.0-4.5 mg/dL; diffusable; ions
  • protein bound; bone
  • ATP; cAMP; & proteins
17
Q

Regulation of Pi homeostasis

  • Cells require adequate Pi for ____ metabolism and ____ ___ synthesis
  • Cells take up Pi from the ____ using _______, a form of active transport
  • Absorption and reabsorption of Pi occurs primarily in the ______ and the _____
  • Pi is regulated by ____, _____, and _____
A
  • Energy; nucleic acid
  • blood; Na+/Pi co-transporters
  • Intestines; kidneys
  • PTH; Vitamin D; FGF23
18
Q

Hormonal Control of Calcium
Major Hormones:
-__________: Acts on the intestines, kidneys, and bones
-______ ______(___): Acts on the kidneys and bones
-__________: Acts on the kidneys and bones
-Both ______ & _____ increase blood calcium, while _____ decreases it

A
  • 1,25(OH)2 Vitamin D3
  • Parathyroid Hormone (PTH)
  • Calcitonin
  • Vitamin D & PTH; Calcitonin
19
Q

Vitamin D
-Is the precursor of the hormone __________, which increases absorption in the ______ and reabsorption in the _______
2 Natural Forms of Vitamin D:
1)______/______: Derived from the plant steroid ergosterol
2)______/______: Derived from cholesterol
-Both must be _______ to be in the active form, this occurs in the ______, and the rate is determined by ____
-Dietary Vitamin D is usually ____

A
  • 1,25 (OH)2 Vitamin D3; small intestine; kidney
  • Vitamin D2/Ergocalciferol
  • Vitamin D3/Cholecalciferol
  • Hydroxylated; kidney; PTH
  • Vitamin D2
20
Q

Health Problems Associated with Vitamin D Deficiency
Causes:
-Lack of ____ exposure
-__________ & supplements
-_________ related diseases like Crohn’s, Whipple’s, Cystic fibrosis, Coeliac, or liver disease
-______ & _______ failure
-_________
Consequences:
-Mental problems like ________ & _______
-Higher rate of _______
-______ disease
-__________ diseases like Type 1 diabetes & Rheumatoid arthritis
-Many different ________
-Bone diseases: ______, ________, & _______ (children only)

A 
Causes:
-Sun
-Medications
-Malabsortption
-Renal & hepatic
-Obesity
Consequences:
-Schizophrenia & depression
-Autoimmune
-Cancers
-Osteoporosis; Osteomalacia; Ricketts
21
Q

Mechanism of Vitamin D Action
-______ _______(___): Belongs to the steroid/thyroid hormone receptor superfamily. Binds cooperatively to ____ ____ ____(___) as a heterodimer with the Retinoid X Receptor (RXR)

A

-Vitamin D Receptor (VDR); Vitamin D response elements (VDREs)

22
Q
  • Calcium is dependent on ___________ for absorption by inducing the production of _____ _____ _____ that sequesters Calcium allowing it to be absorbed ______ the gradient
  • In the small intestines is greatest in the _____>____>____
  • _______ is better at low pH, with peak absorption at the beginning of the ______
A
  • Vitamin D; Calcium Binding Proteins; Against
  • Duodenum; Jejunum; Ileum
  • Absorption; duodenum
23
Q

Vitamin D Actions on Bones

  • _______ have Vitamin D receptors and ______ do not
  • Absence of _____ results in excess ______ accumulation, repressing Osteoblastic _____ synthesis
  • ________ stimulates Osteoblast to produce a ______ signal to activate ______ to resorb Calcium from the matrix
  • ________ also stimulates the process _______ _______
A
  • Osteoblasts; Osteoclasts
  • 1,25 (OH)2 Vitamin D3; Osteoid; Collagen
  • 1,25 (OH)2 Vitamin D3; paracrine; Osteoclasts
  • 1,25 (OH)2 Vitamin D3; Osteocytic Osteolysis
24
Q

Regulation of Vitamin D

  • _____ increases 1-hydroxylase activity, increasing production of active form. This ______ absorption in the intestines; _____ release from the bone; and _______ loss in the kidneys
  • ____ is regulated via negative feedback inhibition
  • Low [_____] increases 1-hydroxylase activity increasing production of the active form and ________ reabsorption from the urine
A
  • PTH; increases; increases; decreases
  • PTH
  • [Phosphate], phosphate
25
Q

Vitamin D Deficiency caused Skeletal Diseases

  • ______ _____ ______: In children, where a softening of bones potentially leading to fractures and deformity, due to defective _______ or _______ of bones
  • ________: Adult form of Rickets
  • _______ _____: Mutation in the Vitamin D Receptor
  • _________ _____: Hereditary disease of phosphate metabolism (PHEX mutation)
  • ________ ______: Genetic defects in Vitamin D metabolism (CYP27B1 loss of function)
A
  • Vitamin D-dependent Rickets Type II; mineralization; calcification
  • Osteomalacia
  • Vitamin D-resistant Rickets
  • Hypophosphatemic Rickets
  • Pseudo-deficiency Rickets
26
Q

PTH

  • An 84 amino acid _______ polypeptide hormone, where only the first _____ amino acids are essential for ______
  • Synthesized and secreted by the _______ ______ (just posterior to the ____ ____, and receives its blood from the ____ _____), primarily synthesized by _____ _____
  • Major player in Calcium _________ in humans
A
  • Monomeric; 34; function
  • Parathyroid gland; thyroid gland; thyroid arteries; Chief Cells
  • Homeostasis
27
Q

Actions of PTH
-In the blood it ______ [Ca] and _______ [Pi]
-Acts directly on ____ to simulate the slow ______ and _____ of Calcium into the extracellular space. _____ in Osteoblasts increases [cAMP] to activate PKA that _____ function when PTH is secreted continuously
2 Effects in Kidneys:
1) Acts directly on kidneys to _____ increase calcium ______ and phosphate ______ by acting on the distal tubule. Inhibited by _________, another hormone.
2) Stimulates transcription of ________ for Vitamin D activation, this _______ both calcium and phosphate absorption

A
  • Increases; decreases
  • Bone; resorption; release; GPCRs; inhibits
    1) Quickly; reabsorption; excretion; Calcitonin
    2) 1-hydroxylase; increases
28
Q

Parathyroid Hormone Receptor PTH1R
-Highly expressed in the _____ and ______, as well as in growth plate _______ by mediating paracrine/autocrine actions of _______ when in tissue other than the ______ and ______

A

-Kidney; bone; chondrocytes; PTHrP; kidneys; bone

29
Q
  • PTH can have both catabolic and ______ effects on bone depending on the ________ of its application
  • ___________ administration of PTH can be useful in treating ____________ & __________ disease
A
  • Anabolic; kinetics

- Intermittent; Osteoporosis; Periodontal

30
Q

PTH Regulation

  • Regulated by plasma [____] via an ______ relationship
  • Maximum secretion with plasma [_____] below 3.5 mg/dL, this is below the average amount indicating the body needs more [_____]
  • Plasma [____] above 5.5mg/dL _____ PTH secretion, this is above the average amount indicating the body needs less [_____]
A
  • [Calcium]; inverse
  • [Calcium]; [Calcium]
  • [Calcium]; inhibits; [Calcium]
31
Q

-_____: Cell surface GPCR capable of detecting small changes in serum [Calcium], that is expressed in the _____ _____, ______, and _______

A

-CaSR; Kidney tubules; Chondrocytes; Osteoblasts

32
Q
  • _______: 32 amino acid long product of Parafollicular/C Cells in the Thyroid that inhibits Osteoclast bone _____ and promotes renal ______ of Calcium
  • Secreted to a rise in plasma [______] that targets ______ by increasing [cAMP] to inhibit their motility and cell shape which _______ them. Results in a ______ fall of [Calcium] by halting bone _______
A
  • Calcitonin; resorption; excretion

- [Calcium]; Osteoclasts; inhibits; rapid; resorption

33
Q

Growth Hormones

  • Normal levels are need for _______ growth
  • _______ intestinal Calcium absorption and renal phosphate resorption
  • Low levels prevent normal bone _______, while excessive levels result in bone _________
A
  • Skeletal
  • Increased
  • Production; abnormalities
34
Q

Glucocorticoids (__________)

  • Normal levels are necessary for ______ growth
  • _________ levels decrease renal calcium reabsorption, interfere with intestinal calcium ________, and stimulate ____ secretion. Additionally interfere with ______ _____ production and action; and Gonadal Steroid production
  • Too high levels cause rapid ______
A
  • Cortisol
  • Skeletal
  • Excessive; absorption; PTH; Growth Hormone
  • Osteoporosis
35
Q

Thyroid Hormones

  • Important for skeletal growth during ______ and _______ by directly effecting Osteoblasts
  • ________ leads to decreased bone growth
  • ________ can lead to increased bone ____, suppression of ____, decreased _______ metabolism, and decreased Calcium _______; all lead to _______
A
  • Infancy; childhood
  • Hypothyroidism
  • Hyperthyroidism; loss; PTH; Vitamin D; absorption; Osteoporosis
36
Q

Effects of Diets

  • ________: Essential minerals that cannot be made and must be ingested
  • Increasing dietary intake of _______ may prevent ______ in postmenopausal women
  • Excessive _____ intake can impair renal Calcium reabsorption, _____ blood Calcium thus increasing ___ synthesis & release. Due to a decreased ______ production in aging women, Calcium does NOT get absorbed so PTH causes increase bone ______.
  • High ______ diet can cause Calcium bone loss due to the resulting ______ environment
  • ________ beverages is associated with increased ______ and loss of Calcium
A
  • Biominerals
  • Calcium; Osteoporosis
  • Sodium; decreasing; PTH; Vitamin D; loss
  • Protein; acidic
  • Carbonated; excretion
37
Q

Effects of Exercise
-Bone cells respond to ______ gradients in
laying down bone
-Lack of weight-bearing exercise _______ bone formation, while _______ exercise helps form bone
-Increased bone resorption during _______ may result in hypercalcemia

A
  • Pressure
  • Decreases; increased
  • Immobilization
38
Q

Osteoporosis
-Osteoporosis is characterized by a significant _______ in bone mineral _____ compared with age- and sex matched norms
- Decrease in both bone _____ and bone ____
-Most common ______ bone disease
-Women lose 50% of their ________ bone and 30% of their ______ bone
-30% of all ___________ women will sustain an
osteoporotic fracture as will ____ of all men

A
  • Reduction; density
  • Mineral; matrix
  • Metabolic
  • Trabecular; Compact
  • Post-menopausal; 1/6th
39
Q

Vitamin D Deficiency: Rickets
-Inadequate intake and absence of _______
-The most prominent clinical effect of Vitamin
D deficiency is _______, defective mineralization of the bone matrix
-Vitamin D deficiency in children produces _______
-Deficiency in the _________ enzyme produces Vitamin D-resistant Rickets. This is a ___ _____ gene on the X chromosome, resulting in renal tubular defects of phosphate _____.
Phenotypes:
-Teeth can be ______ (thinning) or the __________ (decreased mineralization) of enamel
-Delayed ______ of teeth
-Minimal caries can result in _______, resulting in ______ abscesses being common

A

-Sunlight
-Osteomalacia
-Rickets
-1-hydroxylase; sex linked; reabsorption
Phenotypes:
-Hypoplastic; Hypocalcification
-Eruption
-Pulpitits; Periapical

BS 2 Module 3 (12 decks)

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