VI-Calcium and Bone

Question 1

acidemia =

Answer 1

hypercalcemia so inc ionized Ca

Question 2

alkalemia =

Answer 2

hypocalcemia so dec ionized Ca

Question 3

inc plasma anions =

Answer 3

more Ca forms complexes so dec ionized Ca
-i.e. phosphate

Question 4

hypercalcemia presentation

Answer 4

1. muscle weakness
2. lethargy
3. depression
4. constipation
5. reduced appetite
6. heartburn, nausea
7. polyurea
8. nephrolithiasis aka kidney stones
9. cardiac dysrhythmia

Question 5

hypocalcemia presentaiton

Answer 5

1. muscle spasms from inc neuromuscluar excitabilty
2. tingling and numbness
3. hypocalcemic tetany
4. seizures
5. cardic dysrhythmias
6. trousseau sign of claw hand
7. chovostek sign of twitching with facial N

Question 6

dec plasma Ca = ? PTH

Answer 6

inc PTH to inc plasma Ca
-inc bone resoprtion/break down
-dec phosphate reabsorption
-inc Ca absorption

Question 7

effects of PTH

Answer 7

1. dec plasma phosphate
2. inc plasma Ca
3. inc calcitriol/active vit D

Question 8

stimulants of PTH

Answer 8

1. low plasma Ca
2. high plasma phosphate

Question 9

inhibits PTH

Answer 9

1. high plasma Ca
2. high calcitriol
3. low plasma P

Question 10

effects of calcitriol

Answer 10

1. inc P and Ca reabsorption from kidney and intestine
2. promote PTH action from bone

aka want to inc Ca and P

Question 11

stimulate calcitirol

Answer 11

1. PTH
2. low plasma P

Question 12

inhibit calcitriol

Answer 12

1. high plasma Ca
2. high plasma P
3. high calcitriol

Question 13

1alpha-hydroxylase function

Answer 13

convert vitamin D precursor to active calcitriol
-inhibited by FGF23 from osteoblasts

Question 14

hypoparathyroidism

Answer 14

insufficient secretion of PTH from PT glands
-from surgery, autoimmune, familial, idiopathic

Question 15

primary hyperparathyroidism

Answer 15

xs PTH from dysfunction of PT gland
-usually adenoma

Question 16

secondary hyperparathyroidism

Answer 16

disease outside of PT glands cause enlargement and hyperactive
-chronic renal failure, chronic Ca deficiency

Question 17

presentation of hypoparathyroid

Answer 17

1. tetany from inc neuromuscular aka hypocalcemia signs
2. hyperphosphatemia
3. low vit D and Ca

Question 18

presentation of primary hyperparathyroid

Answer 18

1. hypercalcemia
2. hypophosphatemia bc PTH dominates calcitriol
3. constipation, indigestion, nausea
4. peptic ulcers
5. pancreatitis
6. bone pain, loss bone density
7. muscle weakness
8. depression, lethargy
9. kidney stones

Question 19

secondary hyperparathyroidism presentation

Answer 19

rickets- from vit D def, bowed legs, -Ca either normal or dec
-P either inc or dec depending on cause