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NE Test #3 > Regulation Of Calcium And Phosphate > Flashcards

Regulation Of Calcium And Phosphate Flashcards

1
Q

Hypocalcemia Symptoms

A

Hyperreflexia, spontaneous twitching, muscle cramps, tingling and numbness

-Chvostek sign and Trousseau sign

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2
Q

Hypercalcemia symptoms

A

Decreased QT interval, constipation, lack of appetite, polyuria, polydipsia, muscle weakness, hyporeflexia

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3
Q

Acidemia vs Alkalemia

A

Acidemia: Free ionized Ca2+ concentration because less Ca bound

Alkalemia: Ca low because more bound

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4
Q

For the most part, calcium and phosphate are..

A

Inversely related

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5
Q

Regulation of PTH gene expression and Secretion

A

Increase in Extracellular Ca2 inhibits PTH synthesis
-Ca and 1,25 Vit D decrease PTH gene, while increasing CaSR gene

Low Calcium causes increase synthesis and storage of PTH, and hyperplasia of parathyroid gland

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6
Q

PTH on Bone, Kidney, Intestine

A

Bone: Increase bone resorption

Kidney: decrease Pi, increase Ca+, increase urinary cAMP

Intestine: activate Vit D to increase Ca2+ absorption

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7
Q

Vitamin D actions on Ca and Pi

A

Increase in both Ca2+ and Pi

-increase bone mineralization

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8
Q

Vitamin D Synthesis

A

Cholecalciferol is main enzyme from diet, but inactive
-made into 25-OH-cholecalciferol but low activity

Kidney makes active form using 1a-hydroylase

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9
Q

PTH receptors are located where?

A

On osteoblasts!

-not osteoclasts

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10
Q

Short Term PTH actions

A

Bone formation
-direct action on osteoblasts

Used to treat osteoporosis

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11
Q

Long Term actions of PTH

A

Bone resorption
-indirect action on osteoclasts
—causes increase in M-CSF cells, which are precursors for osteoclasts

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12
Q

Where is the RANK receptor located and what does it do?

A

On the osteoclasts, and is turned on by the action of RANKL

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13
Q

OPG Action

A

It is a soluble protein that inhibits RANKL/RANK interaction so that there is less bone resorption

Decreased by PTH

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14
Q

What is used during calcium absorption to keep calcium grandient the same?

A

Calbindin

-binds after TRPV6 brings calcium into cell and brings to transporter

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15
Q

What does Vit D do in the Kidney?

A

Promotes Pi reabsorption mainly

-some reabsorption of Ca2+

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16
Q

What does Vit D do in the Parathyroid?

A

Inhibits PTH gene expression and stimulates CaSR gene expression

17
Q

Where are calcitonin receptors located?

A

Osteoclasts!

-decreases the action, thereby decreasing blood Ca and Pi by not allowing bone resorption

18
Q

Estrogen and Estradiol-17-B on Ca and Pi

A

Stimulates reabsorption and bone formation of Ca

19
Q

Cortisol action on Ca

A

Promote bone breakdown by osteoclasts and renal Ca wasting

20
Q

Primary Hyperparathyriodism Markers

A

PTH: increase
Ca: increase
Pi: decrease
VitD: increase

21
Q

Renal Failure (Secondary Hyperparathyroidism) Markers

A

PTH: increased
Ca: decreased
Pi: Increased
VitD: decreased

22
Q

Vitamin D Deficiency Clinical Markers

A

PTH: increased
Ca: decreased
Pi: decreased (can not absorb)
VitD: decreased

23
Q

Hypoparathoidism Clinical Markers

A

PTH: decreased
Ca: decreased
Pi: increased
VitD: decreased

24
Q

Pseudohypothyroidism Cause, Phenotype, and Markers

A

Caused by defective Gs protein, so no AC action leading to no cAMP for T3/T4 production

Short stature and short neck with obesity

PTH: increased
Ca: decreased
Pi: increased
VitD: decreased

25
Q

Humoral hypercalcemia of Malignancy

A

PTH: decreased
Ca: increased
Pi: decreased
VitD: decreased

Caused by a tumor that released PTHrP, which binds to same receptor as PTH
-causes T3/T4 production, leading to negative feedback to PTH

26
Q

Family Hypocalciuric Hypercalcemia (FHH) Clinical Markers

A

Mutations that inactivate CaSR, results in decrease in amount of Ca that is urinated out; more in blood

PTH: increased/N
Ca: increased in blood, decreased in urine
Pi: N
VitD: N

27
Q

Vitamin D Deficiency clinical markers

A 
PTH: increased
Ca: N/decreased
Pi: decreased
VitD: very low
Bone: increased resorption
28
Q

Rickets Type I vs Type II

A

Type I=low 1a-hydroxylase

Type II=low vitamin D receptor

29
Q

When administering exogenous PTH, what happens in patients with pseudohypoparathyroidism?

A

They do not excrete increased Pi (no phosphaturic response) and no increase in urinary cAMP

NE Test #3 (13 decks)

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