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Clinical Chem II spring > Parathyroid Function: Calc reg (start for exam 2) > Flashcards

Parathyroid Function: Calc reg (start for exam 2) Flashcards

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1
Q

Describe Calcium jobs
m
o
m
b
n
i

A

maintained in narrow range
optical nerve impulse
muscle contractions
blood coag
normal secretions
initial adhesion

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2
Q

What is calcium regulated by

A

hormonal control

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3
Q

Describe PTH
secreted from…
what receptors
prim targets?

A

secreted from glands adjacent to thyroid
calcium sensing receptors
primary targets bone and kidney

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4
Q

Describe bone and calcium
mobilizes….
increases..
releases…

A

mobilizes calcium from bone which increases bone reabsorbtion and releases minerals into blood stream

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5
Q

Describe Kidney 3 effects
inc reab
inc phos
enhance a

A

increased reabsorb of renal tube calcium
increased phosph excretion
enhanced alpha-hydrox of 25 hydrox Vit D

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6
Q

Describe calcitriol
active met of….induces active re …

A

active met of Vit. D induces active absorption of calcium in small intestine

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7
Q

Describe low blood calcium

A

sensed by parathroid CSR - secretes PTH - activates cascade to restore normal blood ca

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8
Q

Describe Vit D hormone

A

steriod hormone from cholesterol

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9
Q

Describe Vit D3

A

rare in nature, liver/seafood, fortified milk, more potent then D2

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10
Q

Describe Vit D2

A

edible mushrooms

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11
Q

Describe endogenous VIT D
synth of
what is a natural ligand for…
treats 2nd….due to

A

synth of Vit D from sunshine
1,25 (OH) 2D - natural ligand for VIT D steriod receptor
(treats 2nd hyperparathy due to chronic renal failure)

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12
Q

Activated Vit D
causes active…
how much absorbed passively
absence of?

A

causes active adsorbtion of calcium in small intestine
5-10% absorb passively
absence of phosphate (higher passive absorb)

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13
Q

Describe hypocalcemia

A

decreased plasma [] calcium
lack of Vit D

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14
Q

Describe Bones, what stimulates maturation

A

active Vit D stimulates osteoclast maturation

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15
Q

Describe the steps ca+2 falling
stimulates
increases
decreased
increases 1

A

stimulates PTH, increases bone reabs, decreases urinary loss, Increases 1,25(OH)sD production

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16
Q

Describe PTH
maintains…
P/V

3 organs

A

maintains optimal calcium levels: PTH/Vit D work w/ 3 organs

3 organs: GI/Kidney/Bone

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17
Q

Describe GI regulation of PTH
norm..
altered function causes?

A

normal func required/opt absorbtion
altered intestinal funct: gastric bypass
bowel fistula
short bowel syndrome

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18
Q

Role of kidneys in PTH
metabolism
renal failure…
..incr
state?

A

calcium metabolism
renal failure = dist in calcium/phosph metabolism
PTH inc renal tube aborb of calcium reducing renal loss
Hypercalcemia

19
Q

Bone physiology
how much calcium
storge of?

A

1kg of calcium
stoarge of calcium/magn./phosph

20
Q

Describe bone turnover (remodeling)

A

reg/coupled process, breakdown/creation
if “uncoupling” occurs mismatched form/reabs
inc fracture

21
Q

What are bone turn over markers used for?

A

to monitor therapy/predict bone fract risk

22
Q

Bone turnover marker for formation

A

alk phos total and specific bone ALP

23
Q

Describe the two types of bone

A

Cortical bone: shaft of bones, strong,light weight exremities

Trabecular bone: axial skeleton, cross hairs/honeycomb - trabeculae strenght for weight

24
Q

Describe parathyroid disorders
hypercalemia

mod elevation

chronic mild

A

hypercalcemia elev in calcium above expected normal
lethargy/coma

Mod elev: personality changes, kidney stones

chronic mild: sympt free

25
Q

What is the most common cause of hypercalcemia

A

PHPT outpt setting

26
Q

Describe PHPT (primary hyperparathyroidism)
causes?
key feature autonom prod of?
gender association?
inc due to multicha?

A

Hypercalc
key feature: autonomas overprod of PTH by single gland
woman 3x more

inc due to multichannel analyzers

27
Q

Diagnosis of PHPT
elevation of serum..

biochem findings
inc excretion of
inc al
dec 25
inc 1

A

elev serum calcium/improp norm or elev PTH

biochem findings: hypercalc/hypophosph
inc urine calc excretion
inc alk phosph
dec 25-OH-D
inc 1,25 (OH) 2D

28
Q

Management of PHPT
what surgery?
inoperative….half life
insid
kid
bone loss?

A

parathyroidectomy
intraoperative PTH half life 5 min drops rapidly
insidious onset
kidney stones 20-30%
bone loss cortical > trabular bone

29
Q

Secondary Hyperparathyroid
causes? low
complete rise in?
low c/p
inc al
hypo
deficiency?

A

hypercalcemia - low blood calcium
complete rise in PTH
low calc/phosph
inc alk phos
hypocalc/phoph
VIT D deficiency

30
Q

2nd/3rd HPT in renal failure
what has a central role?
what causes what changes….?
failure to excrete..
proportional to?

A

kidney central roll CKD causes bone/skeletal changes
kidney fails to excrete phosph (impaired Vit D)

bone changes proportional to severity

31
Q

What differentiates 2nd/3rd HPT in renal failure
sustained?
trans…

CKD reduces
increases
PTH?

A

sustained hypercalcemia
some pts delevope transient hypercal

CKD reduced urine phosph excret
inc blood phosph
PTH increased

32
Q

FHH familial hypocalcemia/hypercalcemia
benign mutation to
..production and elevated….are?

results in?

A

benign germline mutation CSR - upsets
PTH production and calcium elevated not prognostic

results in stable/mild hypercalcemia since birth

33
Q

Clinical features: of FHH familial hypocalcemia/hypercalcemia
increased c
inc m
inc pt
whats <100mg
mutant
end orgn…
surgery?

A

Inc serum calcium
inc serum magnesium
inc PTH
urine calc <100mg
mutant CSR
end org dysfunction not common
NO SURGERY

34
Q

Describe Hyperthyrodism
inc b/h
PTH levels?
disease state?
what can cause hyperparathyroidism?
hyper…?

A

inc bone reabsorbtion/hypercalcemia
PTH dec

addisons disease - low PTH steroid replacement

HCTZ/lithium cause hyperthyroidism

hypervitaminosis

35
Q

Describe PTH rp (parathryoid related protein)
secreted by?
similar to?
receptors?

healthy humans?
lactation?

A

substance secreted by cancer
struct similar to PTH/funct features
same receptors

healthy human levels should be low/none

normal lactation can cause PTH rp

36
Q

Hypercalcemia due to PTHrp is not due to what root cause?
secretion not reg by?

PTHrp cant facilitate?

A

cancer
secreation not regulated by very high BP

PTH rp cant facilitate renal hydroxylation of 25 VIT D

37
Q

Hypoparathyroidism
inad…
common causes?

A

inadequate parathyroid gland function

common causes:
neck surgery - thyroidectomy
accidental gland removal
damage to glands in surgert

38
Q

Auto immune destruction in hypothyroidism

A

Type 1 diabetes
hashimotos
addisons
malignant deficiencies

39
Q

Pseudohypoparathyroidism
inherit …lack of
intestinal..

A

inherited disorder lack of PTH response

intenstinal disorders result in malabsorb of calc/VIT D

40
Q

Rickets

A

before epith plate closure in children

41
Q

Osteomalacia

A

minerilization in adults

42
Q

Osteoporosis
what type of bones?
prevelence?
malform/reab ratio?
risk of?
diseases?

A

porous bones in adults
most prevelent bone disease in adults
bone malformation/excessive reab 4:1 F:M
hip fractures
cushings disease

43
Q
A

Clinical Chem II spring (16 decks)

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