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FLASHCARDS from MEDED lectures COPY > Bones and Calcium Metabolism > Flashcards

Bones and Calcium Metabolism Flashcards

1
Q

Effect of PTH

  • kidneys
  • bones
  • small intestines
A

Effect of PTH

  • Kidneys
  1. Increased calcium reabsorption
  2. Increased phosphate excretion [Phosphate Sparing Hormone]
  3. [Stimulates 1 alpha hydroxylase enzyme in kidney that makes PTH]
  • Bones
    1. Increased bone resorption
  • Small intestines
  • Increased calcium absorption
  • Increased phosphate absorption
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2
Q

Factors increasing calcium metabolism

A

PTH

Calcitriol/Vit D

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3
Q

Factors decreasing calcium metabolism/blood calcium

A

Calcitonin

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4
Q

Effect of calcitriol/vitamin D on:

Kidneys

Bones

Small intestine

A

Effect of calcitriol/vitamin D on:

Kidneys

  1. Increased calcium reabsorption
  2. Decreased phosphate reabsorption

Bones

  1. Increased bone formation

Small intestine

  1. Increased calcium absorption
  2. Increased phosphate absorption
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5
Q

Which has a bigger effect on increasing blood calcium, PTH or calcitriol?

A

Calcitriol

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6
Q

Overall effect of PTH on blood

A

increased calcium

decreased phosphate

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7
Q

Overall effect of calcitriol on blood

A

Greatly increased calcium

Decreased phosphate

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8
Q

Where is PTH produced?

A

Parathyroid glands

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9
Q

Where is calcitriol produced?

A

Skin {with UV light]

Activated by enzymes in liver [25-hydroxylase] and kidney [1-a-hydroxylase]

[PTH stimulates action of 1-a-hydroxylase]

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10
Q

Where is calcitonin produced?

A

Parafollicular cells in thyroid

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11
Q

Why is UK population deficient in calcitriol

A

Less sunlight/UV

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12
Q

SBA 1

63 y o man, generalised bone pain and muscle weakness

What is the most likely underlying diagnosis?

A Osteomalacia

B Primary hyperparathyroidism

C Paget’s disease

D Osteomyelitis

E Osteoporosis

A

A Osteomalacia

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13
Q

sba 2

A 75 year old woman presents with polyuria, constipation. She admits that her mood has been low over the past few weeks. Her blood results reveal the following:

hypercalcaemia

low phosphate

normal pth

normal glucose

What is the most likely underlying diagnosis?

A Osteomalacia

B Primary hyperparathyroidism

C Paget’s disease

D Osteomyelitis

E Osteoporosis

A

B Primary hyperparathyroidism

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14
Q

Explain the parathyroid axis

A

Low calcium

Stimulates production of PTH and Calcitriol/Vit D

Increases blood calcium

Negative feedback decreases production of PTH and Calcitriol/Vit D

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15
Q

primary hyperpth

definition

pathophysiology

risk factors

symptoms and signs

investigations

  • blood
  • other

blood results

treatment

A
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16
Q

secondary hyperpth

definition

patho[hysology

risk factors

symptoms and signs

treatment

A
17
Q

Symptoms of hypocalcaemia

A
18
Q

Symptoms of hypercalcaemia

A
19
Q

Blood biochemistry in different conditions- summary table

A
20
Q

Characteristic radiological finding in primary hyperPTH

A

Pepper Pot Skull

21
Q

Two radiological findings in secondary hyperPTH

A

Looser’s pseudofractures

Rachitic rosary

22
Q

SBA 3

An 82 year old man sees his GP because of a 3 month history of progressive deafness. Using a 512Hz tuning fork, the doctor performed both Weber’s and Rinne’s test. There was lateralisation of vibration to the left ear, and air was louder than bone conduction in both ears. His blood results were normal apart from increased ALP.

What is the most likely underlying diagnosis?

A Osteomalacia

B Primary hyperparathyroidism

C Paget’s disease

D Osteomyelitis

E Osteoporosis

A

C Paget’s disease

23
Q

SBA 4

A
24
Q

Paget’s disease

Definition

Types

Phases of disease

Aetiology

Risk factors

Symptoms

Signs

Investigations

Blood results

A

Paget’s disease

Definition

Aetiology

g

Types

m- %

p- %

25
Q

Osteoporosis

Definition

Aetiology

a- primary causes

b- secondary causes

Symptoms

Signs

Investigations

A

Osteoporosis

26
Q

What is a DEXA scan?

A

Scan to look at bone mineral density

27
Q

What is a T score in a DEXA scan?

A

Patient’s bone mineral density compared to a young healthy adult

28
Q

What is a Z score in a DEXA scan?

A

Patient’s bone mineral density compared to an age matched bone mineral density

29
Q

When calcium is high, PTH should be…?

A

Low [not normal]

30
Q

Biochem q1

A

E Osteoporosis

31
Q

Biochem q2

A

Osteomalacia [due to vitamin D/calcitriol deficiency]

32
Q

Biochem q 3

A

Osteomalacia [due to CKD]

33
Q

Biochem q4

A

B Primary hyperparathyroidism

34
Q

Biochem q5

A

B Primary hyperparathyroidism

[PTH is inappropriately normal]

35
Q

Biochem q 6

A

C Paget’s disease

FLASHCARDS from MEDED lectures COPY (35 decks)

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