Parathyroid and Calcium Flashcards

1
Q

what do calcium salts (with phosphate) do ?

A

provide structural integrity of bone

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2
Q

What are calcium ions necessary for ?

A

Both intracellular and extracellular ions are essential for

> neuromuscular excitation

> blood coagulation

> hormone secretion

> enzyme activity

> fertilization

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3
Q

how much calcium is in the body ?

A

70 kg and 1200g of Ca2+

> 99% of Ca2+ is in your bones (stably stored as Hydroxyapatite)

> Also found in your soft tissues; intracellular (11g) and extracellular (1g)

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4
Q

Calcium Background

(regulation of Ca2+)

A

Extracellular Ca2+ is very tightly regulated:

>ionized calcium (“free”; 50%)

> protein-bound calcium (40%)

> calcium complexed with phosphate and citrate (10%)

Cellular Ca2+ is also highly regulated:

> largely associated with membranes in mitochondira, endoplasmic reticulum and plasma membrane

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5
Q

how is total body calcium maintained ?

A

**Total body calcium = intake - output**

Intake: Diet

> approx. 1/3 absorbed in small intestine. absorption is hormone regulated

  • body can’t make it so it has to be replaced (RECOMMENDED: approx 1000 mg/day)

Output: Kidneys

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6
Q

Total body Calcium

A

**Total body calcium = intracellular + extracellular (ECF/plasma + bone)**

small intestine brings in calcium into extracellular fluid (0.1%) and 99% of calcium is found in the bone

there’s 0.9% free Ca2+ in the blood

and your kidneys filters and reabsorbs Ca2+, some leaving in your urine

**READ TEXTBOOK**

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7
Q

How does the endocrine system control [Ca2+] ?

A

3 hormones regulate movement of calcium between BONE, KIDNEY & INTESTINE

  1. Parathyroid hormone (PTH)
  2. Calcitriol (Vit D3)
  3. Calcitonin

** first two are the most important in adults **

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8
Q

Outline the relationship between calcium and the parathyroid hormone

A

Parathyroids are seen in terrestrial amphibians and onwards

There are 2 cell types: Chief cells (produce PTH) and Oxyphils (function unknown)

When plasma Ca2+ begins to fall, PTH acts to raise blood Ca2+ back to normal levels

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9
Q

what are the 3 mechanisms that PTH raises blood Ca2+

A
  1. stimulates osteoClasts to resorb bone (Primary Mechanism)
  2. Stimulates kidneys to resorb Ca2+
  3. Stimulates kidneys to produce enzyme needed to activate Vitamin D, which in turn promotes better absorption of Ca2+ from food and drink across the intestinal epithelium
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10
Q

Calcium & PTH : Hypo vs Hyper

A

secreted continuously, not stored..

Hypocalcaemia (too low):

> PTH secretion increases (stimulates resorption to get more Ca2+ back into blood)

Hypercalcaemia (too high):

>PTH secretion decreases

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11
Q

How does PTH stimulate osteoclasts to resorb bone

A

Bone is constantly formed and resorbed. Calcium in bone is mainly crystals (Hydroxyapatite)

> a small fraction is ionized and readily exchangeable

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12
Q

Describe bone deposition and resorption

A

Bone deposition:

OsteoBLASTs secrete a matrix of collagen protein, which becomes hardened by deposits of hydroxyapatite

Bone resorption:

osteoCLASTs dissolve the hydroxyapatite and return the bone calcium (and phosphate) to the blood

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13
Q
A

PTH stimulates kidneys to resorb Ca2+

>resorption of Ca2+ results in increased blood Ca2+ which negatively feedbacks to decrease blood Ca2+ maintaining ideal conditions

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14
Q

Calcium and Vitamine D3:

stimulates kidneys to produce enzyme needed to activate Vit D3

A

Overall : Vit D3 acts on the intestines to absorb more Ca2+ from food and drink

  1. Vit D3 is produced from its precurcor molecule 7-dehydrocholesterol under the influence of ultraviolet B sunlight
  2. Vit D3 is secreted into the blood (from skin or intestine) and functions as a PREhormone (not active). Goes to the liver, chemically changed, hydroxyl group added to carbon #25
  3. Still not active, needs a hydroxyl added to carbon #1, This is done by enzyme in the kidneys that is stimulated by PTH

> result is 1,25-dihydroxyvitamin D3 (maintains calcium balance in the body)

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15
Q

Calcium and Calcitonin

A

Calcitonin is made in C cells of thyroid in response to high Ca2+, plays only a minor role in adult humans.

Calcitonin works on the kidneys to stimulate

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16
Q

difference between hypo and hyperthyroidism ?

A

Hypothyroidism:

hypocalcaemia (not enough Ca2+ in blood)

muscular weakness, ataxia

caridac arrythmia

Hyperthyroidism:

hypercalcaemia (too much Ca2+ in blood)

increased bone resorption (fractures)

mineralization of soft tissue

increased thirst & urination

17
Q

disorders of VIt D3

A

Deficiency = poor bone mineralization

rickets : bone pain, stunted growth, deformities IN CHILDREN

osetomalacia : bone pain, fractures IN ADULTS

osteoporosis : most common disorder of the bone

18
Q

osteoporosis

A

reduction of quality of bone due to excess absorption

risk of bone fractures

known RISK factors :

  • female gender
  • lack of exercise
  • calcium deficient diet

effects 1 in 3 women; 1 in 5 men

19
Q

treatment for osteoporosis

A

adequate calcim & vitamin D3 intake (loss begins at 30 yrs)

hormone therapy (PTH & calcitonin)

>associated with cancer/stroke/disease

PREVENTION (diet, exercise)