Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

endoII exam2 > Pales, bone Ca > Flashcards

Pales, bone Ca Flashcards

1
Q

if Ca is too high what is released from thyroid

A

calcitonin to increase Ca deposition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

if Ca is too low what does PTgland release

A

PTH to increase Ca release from bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how does PTH increase Ca release

A

activates the osteoblasts which activates osteoclasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how does low Mg change PTH secretion

A

decreases it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how does PTH change phosphate leves

A

decreases them because increases renal secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

effects of active Vit D3 on Ca and PO4

A

increases Ca and PO4 absorption in gut

decreases PTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What meds can cause hyperCa

A

Vit D
thiazide diuretics
lithium
tamoxifen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what granulomatous disorders can lead to hyper Ca

A

sarcoidosis
TB
wegeners
fungal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what endocrine disorders can lead to hyperCa

A

hyperthyroidism, adrenal insufficiency pheochromocytoma

VIP-oma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the malignancy associated causes hyper Ca

A 
local osteolytic
multiplem myeloma
primary bone turnover
metastatic to bones
PTH-RP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how does primary hyperPTH present

A

asymptomatic hyperCa or with renal stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what type of acid base status will a patient be in primary hyperPTH

A

non anion gap metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what type of bone loss do you have in hyperPTH

A

cortical bone loss leasing to osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

tertiary hyperPTH

A

reduced activation Vit D from chronic renal disease leading to elevated PTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what part of dialysis can cause increase in PTH

A

aluminum containing PO4 binders that increases PTH and leads to osteomalacia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

inheritance of familial benign hypocalciuric hypercalcemia

A

autosomal dominant loss of function mutation in CaSR on PTH cells and renal tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

PTH and Mg levels in familial benign hypocalciuric hypercalcemia

A

mildly elevated PTH and Mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Signs and Sx hypercalcemia

A

fatigue, polyuria, weakness, anorexia, nausea, vomiting, constipation, abdominal pain, lethargy, mental status change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how does hyper Ca affect pancreas

A

can lead to pancreatitis which will eventually produce hypocalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

band keratopathy

A

Ca deposits in cornea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is osteitis fibrosa caystica

A

chronic bone resorption, demineralization, cystic bone lesions
from excessive PTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is an abnormal PTH value if detect hyperCa

A

normal or high because should be low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

hyper Ca and have normal or high PTH

next test?

A

24 hr urinary Ca to rule out the benign familial (low urinary Ca)
if high urinary Ca then probably primary hyperPTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Tx for hyperCa

A 
IV fluids, loop diuretics, IV bisphosphonates
Calcitonin
glcocorticoids
cinacalcet
hemodialysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what msut you do if put patient on loop diuretic for hyperCa
replace fluids
26
why give glucocorticoids in hyperCa
help counter effects of too much vit D in blood from hyperCa
27
when do you use dialysis to Tx hyperCa
hemodialysis
28
what can cause acquired hypoPTH
post surgical autoimmune: PGA APECED, SLE Heavy Metals: copper wilson, iron hemochromatosis Mg deficiency(dec PTH production and Resistance to PTH) other: infection, tumor, granuloma, reidel thyroiditis
29
what can cause MG deficiency
malabsorption | alcoholism
30
PGA type I
autoimmune polyendocrinopathy | presents in childhood: candidiasis, hypoPTH, addison
31
what congenital syndrome can cause congenital hypoPTH
digeorge | CATCH22
32
what causes pseudohypoPTH
end organ R to PTH tubular R to PTH so have hypercalciuria with hypocalcemia hyperPO4
33
pseudopseudohypoPTH
phenotypic abnormalities without hypocalcemia
34
Albright hereditary osteodystrophy
``` short stature obese bradydactyly, round faces dermal ossifications mental retardation ```
35
Mg is cofactor for what
PTH secretion
36
hypo Mg common in what disorders
chronic GI disease nutritional deficiency alcoholism cis-platinum therapy
37
clinical findings of acute hypoCa
``` muscle cramps tetany irritability carpopedal spasm convulsions perioral tingling tingling of hands and feet ```
38
clinical findings chronic hypoCa
``` lethargy personality changes anxiety state blurred vision from cataracts parkinsonism mental retardation ```
39
chvostek sign
facial muscle contraction when tapping facial nerve
40
trousseau phenomenon
carpal spasm after BP cuff from tetany | specific and sensitive for hypoCa
41
if detect low Ca what is next test
albumin levels
42
if hypoCa and low albumin Dx?
hypoproteinemia | confirm with ionized Ca level
43
if hypo Ca and normal albumin next test?
measure PTH, creatinine and phosphorus
44
for every decrease (1) of albumin what do you correct Ca
add .8 to Ca
45
what levels of PTH creatinine and phosphorus lead you to consider PTH resistance
elevated PTH and phosphorus | normal creatinine
46
what levels of PTH creatinine and phosphorus lead you to consider genetic or acquired hypoPTH
low PTH normal creatinine elevated phosphorus
47
what levels of PTH creatinine and phosphorus lead you to consider Vit D problem
elevated PTH normal creatinine normal or reduced phosphorus
48
what levels of PTH creatinine and phosphorus lead you to consider seconary hyperPTH from renal failure
increased PTH increased creatinine increased phosphorus
49
What is Pagets
disorder of bone remodeling that increases rates of bone turnover
50
what are signs of pagets
enlargement of skull, bowing of long bones etiology unknown increased vascularity of bone
51
Sx pagets
``` HA, bone pain warmth of skin over involved bone high output Cardiac failure entrapment neuropathies (hearing loss) kyphosis ```
52
radiogrpahic findings pagets (phases)
osteolytic- wedge shaped resorption of long bones mixed osteoblastic- cotton wool appearance
53
Tx pagets asymptomatic
do not treat
54
Tx Sx pagets
bisphosphonates because dec resorption of bone
55
lab findings pagets
serum alkaline phosphatase elevated high serum C telopeptide high urinary hydroxyproline in active disease serum Ca usually high
56
what medications increase risk for osteoporosis
glucocorticoids, anticonvulsants, heparin
57
when should you measure BMD
women age>65 post menopausal women <65 who have 1+ risk factor osteoporosis postmenopasual woman with fractures women on hormone replacement therapy for long time radiographic findings of osteoporosis someone on corticosteroid therapy for more than 3 mo primary hyperPTH
58
gold standard test for BMD
dexa scan
59
Dexa scan results
T score: standard deviation from mean BMD of young healthy population Z score: standard deviation from BMD of an age and sex of matched group
60
when do you rely on z score for dexa scan
younger men, children and premenopausal women
61
What does a T score of -1 mean
10% bone loss
62
T score for osteoporosis
T score <-2.5 or osteoporotic fracture
63
T score for osteopenia
-1 to -2.5
64
main medication to Tx osteoporosis
bisphosphonates: alendronate and risedronate | bind boney surface and inhibit osteoclastic bone resorption
65
side effects bisphosphonates
esophagitis- can't lay down after taking it cannot eat for an hour because little absorption black box warning: stop if having dental surgery because can cause dental necrosis
66
how do the replacement estrogen hormones affect BMD
decrease vertebral fracture risk | no change on hip fracture risk
67
action teriparatide
stimulate osteoblastic bone formation SQ injection increases BMD
68
action denosumab
monoclonal Ab that inhibits osteoclastic activation | binds RANKL

endoII exam2 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions