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IEMR > Mineral Homeostasis and Balance > Flashcards

Mineral Homeostasis and Balance Flashcards

1
Q

Calcium is important for what general functions in the body?(4-8 points)

A

membrane excitation, membrane stabilization, muscle contraction, neurotransmitter release, clotting, hormone secretion coupling, neurotransmitter release and constituent of bone and teeth

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1
Q

What is the major intracellular function of phosphate?

A

phosphorylation, formation of high energy bonds, coordinating a myriad of delicate intracellular functions

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1
Q

What is the affect of parathyroid hormones on the kidneys when considering phosphate ?

A

It stimulates the decrease reabsorption of phosphate in the proximal tubule

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1
Q

The facilitative diffusion of calcium in the GIT increases with increase up take of calcium or decreases with increase uptake of calcium?

A

It decrease with increase uptake of calcium

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2
Q

What cell organelle plays a critical role in the capture of calcium and the packaging of calcium phosphate into vesicles?

A

mitochondria

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3
Q

How does the GIT contribute to calcium homeostasis?

A

absorption

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3
Q

Do osteoclast have one nuclei or many nuclei?

A

They have many nuclei, 10-20 or up to 100 if it is a giant nuclei

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5
Q

Why would receiving a large volume of blood have a specific effect on your electrolyte balance?

A

Citrate is an anti-coagulant found in blood which binds to calcium; therefore, decreasing the free calcium levels in the blood

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5
Q

How does PTH affect bone crystal formation?

A

It does not favor bone crystal formation due to the fact that calcium rose while phosphate fell

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6
Q

What is the genearal purpose of hepcidin?

A

It causes degradation of ferroportion, thus blocking iron flow into plasma

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7
Q

How does the bone contribute to calcium homeostasis?(3 points)

A

formation, mineralization and resorption of bone

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7
Q

After osteoblast form the bone matrix, where do they go and what type of cells do they become?

A

they become osteocytes and they become trapped in the bone matrix

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7
Q

Patients with alkalosis are more prone towards what muscular disorder? Why?

A

`tetany. Alkanity promotes precipitation of calcium phosphate while acidity decrease precipitation of calcium phosphate.

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8
Q

What is the mature form of bone mineral?

A

hydroxyapatite

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8
Q

FGF23 is released by what type of cells? This is done in response to what?

A

FGF is release by osteocytes in response to elevated levels of calcitriol

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8
Q

How does dopamine affect the secretion of calcitonin?

A

increases the secretion

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9
Q

How does intermittent PTH affect bone mass? How does activated leptin affect bone mass?

A

intermittent PTH increase bone mass. Activated leptin decreases bone mass

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10
Q

What could be general causes to abnormal mineralization of bone?(3-5 points)

A

calcium deficiency, phosphate deficiency, bone cell dysfunction, mineralization inhibitors and abnormal collagen

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10
Q

For the expression of the full range of effects of PTH, what is required?

A

Vitamin D

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11
Q

What is a common musculoskeletal disease that is caused by vitamin D deficiency?

A

Ricketts and osteomalacia

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12
Q

Activation of 1-25-(OH)2D3 takes place via the levels of what factors in the blood?(6 points)

A

GH, prolactin, PTH, phosphate deficiency, vitamin D deficiency and estrogen

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13
Q

Does calcitonin increase or decrease bone mass?

A

calcitonin increases bone mass

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14
Q

Where is the majority of calcium found in the human body?

A

bone

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15
Q

What type of cells form bone?

A

osteoblast

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16
Q

How does estrogen affect the secretion of calcitonin?

A

increases the secretion?

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17
Q

An increase amount of ECF calcium has what affect on membrane polarization?(2 points)

A

It causes membrane hyper polarization, it decreases neuronal excitability

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19
Q

How does high plasma 1,25-(OH)2-Vitamin D affect PTH secretion?

A

It inhibits PTH secretion

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19
Q

What is the more pronounced but delayed action of PTH?(osteoclast activity and bone resorption)?

A

Activate osteoclasts and increase bone resorption

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20
Q

How does ghrelin effect food intake?

A

It increases food intake

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20
Q

PTH hormone increase what when it comes to bone construction? (2 points)

A

Bone resorption and bone formation

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22
Q

A decreased amount of ECF calcium has what affect membrane polarization?(3 points)

A

It causes membrane depolarization, leads to neutral excitability, i.e., hypocalcemic tetany

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23
Q

What are the four steps of bone remodeling?(4 points)

A

activation, resorption, reversal and formation

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23
Q

How does PTH interact with the intestine?(2 points)

A

It increase calcium and phosphate absorption indirectly via the action of vitamin D

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25
Q

Does increased or decrease ECF calcium lead to muscle paralysis?

A

increased calcium ECF

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27
Q

45% of the calcium bound to something in the blood is bound to what general substance?

A

plasma proteins

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28
Q

How does mechanical load affect bone mass?

A

Mechanical load increases bone mass

29
Q

How does Leptin effect food intake?

A

It decreases food intake

30
Q

Does acidity increase ionize calcium or decrease? Why?

A

Acidity increases ionize calcium because it decreases plasma protein binding of calcium

31
Q

Is Rickets a disease due to a lack of calcium or a lack of phosphate?

A

A lack of phosphate

33
Q

The active transport of calcium in the GIT is dependent upon what?

A

Vitamin D

33
Q

How does increase in plasma phosphate affected PTH secretion?

A

It increases PTH secretion

34
Q

The small amount of calcium outside of bone is bound or free?

A

Both, 55% bound and 45% free

35
Q

How does hypomagnesemia affect PTH secretion?

A

It decreases PTH secretion

36
Q

Is bone resorption via vitamin D independent of PTH?

A

Yes

38
Q

What type of reabsorption of calcium takes place in the kidney?(2 points) Where does each take place?(4 points)

A

Passive paracellular takes place in the proximal tubule and the thick ascending limb. Active transcellular takes place in the thick ascending limb and the distal tubule.

40
Q

What controls the amount of free phosphate in the blood?(3 points)

A

controlled by the kidneys plus effects of PTH and FDF23

41
Q

What is bone considered to be bifunctional?

A

Bone is considered to be bifunctional because it can perform extensive remodeling due to weight bearing effects and it can release calcium into the ECF to maintain electrolyte balance of calcium

42
Q

What are the three major locations in the body where calcium homeostasis is maintained?(3 points)

A

bone, GI tract and kidneys

43
Q

What type of cells derive osteoblast?

A

mesenchymal stem cells

44
Q

Peak bone mass and rate of bone loss are influenced by:(2-4 points)

A

genetics, weight bearing activity, calcium nutritional state, and reproductive endocrine status

46
Q

Where is the majority of phosphate found in the human body?

A

bone

48
Q

If you acutely consume a lot of soda, what does that do your body electrolyte balance?

A

The phosphate will bind to the calcium and decrease the free plasma calcium levels

49
Q

How does Vitamin D affect these values: [Ca2+]plasma, [PO4-]plasma, [Ca2+]urine and [PO4]-urine?

A

Increase, increase, decrease, decrease

51
Q

Is estrogen a pro-resorptive and calciotropic factor or a anti-resorptive and anabolic factor?

A

Estrogen is an anti-resorptive and anabolic factor

51
Q

Parathyroid hormone and vitamin D stimulate osteoblasts to secrete what factors which stimulate osteoclasts to reabsorb bone? 2 points

A

IL6, and Rank-L

52
Q

With regard to calcium homeostasis, the dominant effect of PTH one bone is what?

A

bone resorption

54
Q

What type of absorption of calcium takes place in the GIT?(2 points)

A

facilitate diffusion and active transport

55
Q

The small amount of phosphate outside of the bone is bound or free?

A

Both, 50% for each

56
Q

The total amount of phosphate in the body is 500-800 grams. 85% of this is bound to what?(2 points) The rest if primarily where?

A

85% of phosphate in the body is bound to teeth and bone. The rest is primarily intracellular.

57
Q

How does calcitonin affect these values: [Ca2+]plasma, [PO4-]plasma, [Ca2+]urine and [PO4]-urine?

A

decrease, decrease, increase, increase

58
Q

What type of cells synthesize calcitonin?

A

parafolicullar cells in the thyroid gland

59
Q

How do gonadal steroids affect these factors: osteoclast activity, bone resorption, osteoclast apoptosis, osteoblast apoptosis?

A

decrease, decrease, increase, decrease

60
Q

how does gastrin, CCK, glucagon and secretin affect the secretion of calcitonin?

A

increases the secretion of calcitonin

61
Q

How does glucocorticoids affect these values: [Ca2+]plasma and [Ca2+]urine ?

A

decrease, increase

62
Q

Does estrogen increase or decrees bone mass?

A

estrogen increases bone mass

63
Q

What are the three special properties of parathyroid chief cells?(3 points)

A

thye replicate when chronically activated, they can synthesize & store large amounts of PTH, they can rapidly secrete stored hormone in response to changes in blood calcium

64
Q

How does the body regulate the solubility of calcium and phosphate?

A

The calcium and phosphate product are regulated quite heavily

65
Q

How does CT affect the action of 1-alpha-hydroxylase?

A

inhibits the action of that enzyme

66
Q

Osteoporosis usually has an excess of what hormonal group?

A

Glucocorticoids

68
Q

A large amount of what mineral is found in colas and sodas?

A

phosphate

69
Q

Paresthesia is caused by hypocalcemia or hypercalcemia?

A

Hypocalcemia

71
Q

During the postmenopausal phase, what happens when comparing the relative activity of osteoclasts and osteoblasts?

A

There is a relative increase in the osteoclastic activity and a relative decrease in the osteoblastic activity

72
Q

How does the thyroid hormone affect the listed factors: bone resorption, bone formation?

A

There is a relative increase in bone resorption and a relative decrease in bone formation

73
Q

How does FGF23 affect the kidneys?

A

It decreases the expression of the sodium phosphate cotransporter in the proximal tubule which in turn decreases the reabsorption of phosphate in the kidneys.

74
Q

What factors leads to the inactivation of the active form of Vitamin D?(3-4)

A

high plasma calcium high plasma phosphate, high 1-25-(OH)2D3 and CT

75
Q

How do glucocorticoids affect these factors: osteoblast activity, osteoblast apoptosis?

A

decrease, increase

76
Q

What is the short term action of PTH on bone?(4 points)

A

acts on plasma membrane of osteocytes to take up more calcium and phosphate form lacunal fluid and adjacent bone crystals

77
Q

Vitamin D is needed for the active uptake of what minerals/nutrients?(3 points)

A

phosphate, calcium and magnesium

78
Q

How do the kidneys maintain calcium homeostasis?

A

It increases calcium reabsorption when needed

78
Q

How does Hypercalcemia affect the kidney, GI tract, and the nervous system generally speaking?

A

associated with peptic ulcer disease, neurological deiseases, and kidney stone.

79
Q

Is bone resorption via vitamin D dependent on PTH?

A

Yes

80
Q

What vitamins/hormones play a major role in calcium homeostasis?(3 points)

A

calcitonin, vitamin D and parathyroid hormone

81
Q

Is prolatctin an anti-resorptive and anabolic factor or an pro-resorptive and calciotropic factor?

A

pro-resorptive and calciotropic factor

82
Q

How do glucocorticoids affect bone mass?

A

Glucocorticoids increase bone mass

84
Q

What is the affect of parathyroid hormone on the bones?

A

It stimulates the loss of calcium and phosphate in the bone

86
Q

What is the relative solubility of calcium phosphate in water?

A

It is very low

87
Q

How does PTH affect these values: [Ca2+]plasma, [PO4-]plasma, [Ca2+]urine and [PO4]-urine?

A

Increase, decrease, decrease, increase

88
Q

What controls the amount of free calcium in plasma?(2 points)

A

Vitamin D and PTH

89
Q

Is tetany caused by hypercalcemia or hypocalcemia?

A

Hypocalcemia

IEMR (19 decks)

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