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V - KCU - RN (T2) - OMS1 > Regulation Of Ca/Pi/Mg & DSA > Flashcards

Regulation Of Ca/Pi/Mg & DSA Flashcards

1
Q

What is the total plasma level of calcium

A

5 mEq/L

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2
Q

What is the biologically active form of Vit. D

A

Calcitrol

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3
Q

Calcitrol acts with PTH to do what

A

REBS Bone (stimulate osteoclasts)

This increases Ca and Pi plasma concentrations

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4
Q

What does Calcitrol do

A

Increases serum Ca and Pi

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5
Q

What does Calcitrol do in the intestine

A

Increases Ca absorption and Pi absorption

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6
Q

What does Calcitrol do in the kidney

A

Increases phosphate and Ca REBS

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7
Q

How does Calcitrol act

A

Through the VDR to increase serum C and Pi

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8
Q

What does calcitonin do to bone

A

Lowers serum calcium and Pi levels by inhibiting bone REBS and decreasing osteoclasts

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9
Q

What does calcitonin do to the kidney

A

Promotes renal excretion of Ca and Pi

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10
Q

Clacitonin opposes what

A

PTH

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11
Q

What is calcitonin stimulated by

A

Hypercalemia

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12
Q

What does PTH do overall

A

Increases serum Ca and decreases serum Pi

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13
Q

What does PTH do in the bone

A

Increases osteoclastic REBS

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14
Q

What does PTH do in the intestine

A

Increases Ca/Pi absorption via calcitrol production

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15
Q

What does PTH do in the kidney

A

Promotes REBS of Ca in the DCT

Decreases REBS of Pi in the PCT

Decreases the Na/H antiporter - leading to decreased Pi

Stops HCO3 REBS

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16
Q

Excessive PTH can lead to what

A

Hypercalcemia
Low Pi.
Metabolic acidosis

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17
Q

What is the role of the CaSR

A

Monitors Ca levels in the ThALoH

Inhibits Ca REBS when Plasma Ca levels are high

Blocks the NKCC2 which stops paracellular REBS of Ca.

It also blocks the excretion of recycled K, which can lead to relative hyperkalemia

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18
Q

Most of the Ca is REBS where

A

In the PCT

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19
Q

How is the Ca REBS in the ThALoH

A

Lumen positve voltage drives paracellular REBS

20
Q

Where is the major site or regulation of Ca and how

A

DCT

TRPV5 which is regulated by Vit. D allows Ca to be REBS

21
Q

Volume contraction does what to Ca

What about volume expansion

A

Increases Ca REBS

Decreases Ca REBS

22
Q

How does the ThALoH REBS Ca

A

Paracellularly, which follows Na flow

So increased Na REBS means increased Ca REBS, and this is stimulated by ADH

23
Q

How is Ca REBS in the DCT

A

Via TRPV5 and then into IF via NCE

DCT also has a lumen negative transepithelial voltage which helps pull Ca into the cell

24
Q

Acidemia does what to Ca

What about Alkalemia

A

Acid - increases Ca excretion by inhibiting TRPV5 (inhibits REBS)

Alkalosis - decreases Ca excretion by stimulating TRPV5 (activates more REBS of Ca through TRPV5)

25
Q

Pi REBS is driven by what

26
Q

Pi is REBS primarily with what

27
Q

What does FGF - 23 do

A

Secreted by bone in response to PTH, calcitriol, and high Pi

Blocks Na/HPO3 symporter thus allowing for increased Pi excretion and decreased Pi REBS

28
Q

What is the most important hormone that regulates Pi excretion

A

PTH - inhibits the Na/Pi transporter in the PCT

This inhibition allows for an excretion of Pi and also cAMP in the urine

29
Q

Chronic acidosis does what to Pi excretion

What about chronic alkalosis

A

Acidosis - increases Pi excretion, lowers plasma Pi

Alkalosis - decreases Pi excretion, increases plasma Pi

30
Q

Most Mg is REBS where and how

A

In the ThALoH paracellularly, dependent on the NKCC to make a negative charge for it to be attracted to

31
Q

How does Mg cross the apical membrane of the DCT

32
Q

What is the serum K level

33
Q

What is defined as hyperkalemia and what causes it

A

K>5.2

Causes by rhabdo, burns, hemolysis, ICF to ECF shifts

34
Q

Most K is stored where

A

In the muscle

35
Q

What does hyperkalemia cause in the heart

A

Hyperpolarized membrane

Elongated QRS

Peaked T waves

Vfib

36
Q

What does hypokalemia casue in the heart

A

Hypopolarizes the membrane

Allows for bradycardias, pac’s, pvc’s

37
Q

What are some causes of of hypercalcemia

A

Increased PTH
Polyuria
Increased calcitrol
Sarcardosis

38
Q

What care some causes of hypocalcemia

A

Decreased PTH
Decreased Calcitrol
Increased or decreased Mg

39
Q

What are some causes of hypokalemia

A

Increased insulin
Alkalosis
Decreased Mg

40
Q

What primarily causes hyperkalemia

A

Kidney failure

41
Q

What causes hyperphosphate

A

Decreased PTH
Rhabdo
Laxatives

42
Q

What are some causes of hypophosphate

A

Increased PTH
DKA
Fanconi syndrome

43
Q

Increased Mg means what as far as PTH and Ca

A

Decreased PTH and decreased Ca

44
Q

Low K means what as far as cardiac repol

What about High K

A

Low - prolonged repol

High - enhanced repol

45
Q

What is adequate Ca intake for adults

A

1000 mg/day

46
Q

What peptide does calcitonin act through

A

Calcitonin gene-related peptide (CGPR)

V - KCU - RN (T2) - OMS1 (5 decks)

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