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Flashcards in Bone physiology Deck (69)
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31

What symptoms may present with Paget's?

Often asymptomatic but bone pain or deformity and deafness

32

How is Paget's diagnosed?

XR
Increased alk phos

33

How is Paget's treated?

Bisphosphonates

34

Which defect causes osteogenesis imperfecta?

COL1A1/2
Autosomal dominant

35

What is associated with osteogenesis imperfecta?

Blue sclerae
Dentinogenesis imperfecta

36

Which receptor on the parathyroid is for calcium?

Ca sensitive receptor

37

What kind of receptor is CaSR?

G protein coupled

38

How is vitamin D stored in the liver?

Cholecaliferol

39

What does the liver convert it to?

25-hydroxycholecaliferol

40

What does the kidney turn it into?

1,25-hydroxycholecaliferol

41

What are symptoms of acute hypercalcaemia?

Thirst
Dehydration
Polyuria
Confusion

42

What are symptoms of chronic hypercalcaemia?

Myopathy
Fractures
Depression
Abdo pain

43

What are major causes of hypercalcaemia?

Primary hyperparathyroidism
Malignancy

44

What drugs can cause hypercalcaemia?

Vitamin D
thiazides

45

What will blood results be for 1o hyperparathyroidism?

Raised serum Ca
Raised serum PTH
Increased urine Ca excretion

46

What other serum protein is important for diagnosing malignancy?

Alkaline phosphate (raised in malignancy)

47

What is the treatment for acute hypercalcaemia?

Fluids
Loop diuretics once rehydrated
Bisphosphonates will lower Ca

48

How is 1o primary hyperparathyroidism managed?

Surgery or nothing

49

When should surgery for 1o hyperparathyroidism be indicated?

If end organ damage e.g. renal stones, osteoporosis, gastric ulcers or renal disease
Or if calcium is v high (>2.85)

50

What is 2o hyperparathryoidism?

Physiological response to low Ca
PTH raised

51

What is 3o hyperparathyroidism?

Overactive PTH after many years of 2o

52

Which genetic syndromes are closely linked with hyperparathyroidism?

MEN1/2

53

What is FHH?

Familial hypocalciuric hypocalcaemia

54

What signs will be present in FHH?

Low Ca urine
Hypercalcaemia

55

How does PTH work on the gut?

Causes it to absorb Ca and therefore increased serum Ca levels

56

In which fish is vitamin D high in?

Herring

57

What are the symptoms of hypocalcaemia?

Paraesthesia in extremities and perioral
tetany and cramps
Fatigue and myopathy
Long QT on ECG

58

What are the causes of hypocalcaemia?

Hypoparathyroidism
Vitamin D deficiency
renal failure
Pancreatitis

59

What is the treatment for acute hypocalcaemia?

10ml 10% IV calcium gluconate over 10 mins

60

In what congenital condition is the parathyroid gland underachieve?

DiGeorge syndrome