Physiology - An introduction to calcium metabolism Flashcards

1
Q

what are the 3 main structures involved in calcium balance

A

bone
kidney
intestine

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2
Q

which of these has a higher conc of calcium normally

a.plasma
b.cell

A

a.plasma

2.5 mmol /L

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3
Q

what is most of the protein bound calcium bound to

a.haemoglobin
b.albumin
c.globulin

A

b.albumin

some bound to globulin

half free

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4
Q

what happens to the amount of free calcium as pH decreases

a.increase
b.decrease

A

a.increase
H+ displaces ca2+ on albumin and so more ca2+ is free and biologically active

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5
Q

which 3 hormones are responsible for regulation of body calcium

A

parathyroid hormone
vitamin d (calcitrol / 1,25 dihydroxycholecalciferol)
calcitonin

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6
Q

when is parathyroid hormone secretion increased

a.low calcium, high phosphate , low mg

b.high calcium, low phosphate, high mg

c.high calcium, high phosphate, high mg

A

a.low calcium, high phosphate , low mg

calcium and phosphate inversely proportional

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7
Q

what are the effects of increased pth on bone

a.rapid exchange from ecf to bone pool, bone production by osteoblasts

b.rapid exchange from bone pool to ecf, bone resorption by osteoclasts

A

b.rapid exchange from bone pool to ecf, bone resorption by osteoclasts

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8
Q

what are the effects of increased pth on bone

a.rapid exchange from ecf to bone pool, bone production by osteoblasts

b.rapid exchange from bone pool to ecf, bone resorption by osteoclasts

A

b.rapid exchange from bone pool to ecf, bone resorption by osteoclasts

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9
Q

what is the effect of pth on the kidney

a.reabsorption of ca2+, excretion of phosphate, formation of vitamin D

b.excretion of calcium, reabsorption of phosphate

A

a.reabsorption of ca2+, excretion of phosphate, formation of vitamin D

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10
Q

what is cholecalcefirol from skin converted to in the liver

a.25 hydroxycholecalciferol
b. 1,25 dehydroxycholecalciferol

A

a.25 hydroxycholecalciferol

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11
Q

what is 25 hydroxycholecalciferol from liver converted to in the kidney when parathyroid hormone is secreted

a.cholecalciferol
b. 1,25 dehydroxycholecalciferol

A

b. 1,25 dehydroxycholecalciferol

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12
Q

what effect does 1,25 dehydroxycholecalciferol have in the intestine

a.enhances ca 2+ absorption

b.decreases ca 2+ absorption

A

a.enhances ca 2+ absorption

pth released in low calcium and stimulates the production of 1,25 d. in the kidney

steroid hormone so binds to nuclear receptor and upregulates transcription of calcium transporters so more calcium into cell

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13
Q

hat effect does 1,25 dehydroxycholecalciferol. have in the bone

a.increase calcification and mineralisation
b. decrease calcification and mineralisation

A

a.increase calcification and mineralisation

for normal osteoblast function

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14
Q

lack of dietary vit D / sunlight , malabsorption of fats and failure to form calcitrol eg chronic renal failure are all causes of what condition]

a.osteopososis
b.osteomalacia
c.osteosarcoma

A

b.osteomalacia

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15
Q

which cells in the thyroid gland produce calcitonin

a.follicle cells
b.c cells
c.kuppfer cells
d.colloid

A

b.c cells

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16
Q

what is the action of calcitonin

a.increase plasma calcium
b.decrease plasma calcium

A

b.decrease plasma calcium

17
Q

what triggers the secretion of calcitonin

a.high calcium in blood
b.low calcium in blood

A

a.high calcium in blood

18
Q

what is the effect of calcitonin on the bones

a.increased resorption
b.inhibited resorption

A

b.inhibited resorption

19
Q

what effect does oestrogen and testosterone have on bone resorption

a. increase
b.decrease

A

b.decrease

so less oestrogen in menopause means increased resorption and osteoporosis

20
Q

what is the principle regulator of calcium

a.calcitonin
b.pth
c.vitamin D

A

b.pth

21
Q

prescense of chvosteks sign ( twitching of ipsilateral facial muscles when tapped on the face anterior to ear) and troessaus sign ( flexion at wrist and pcp when blood supply to arm cut off) indicates….

a.hypocalcaemia
b.hypercalcaemia

A

a.hypocalcaemia

(neuromuscular excitability)- lower threshold for depolarisation

22
Q

bone pain, kidney stones, CNS disturbance and Gi disruption are signs of what state…

a.hyperparathyroidism
b.hyoparathyroidism

A

a.hyperparathyroidism

bones, stones, moans and groans

23
Q

what is the stimulus of 2 hyperparathyroidism

a.tumoyr in parathyroid gland
b.low calcium

A

b.low calcium

increased pth secreted