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My Own Renal Biochem > Calcium Metabolism > Flashcards

Calcium Metabolism Flashcards

1
Q

Serum conc of calcium

A

2.2-2.6

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2
Q

Serum conc of phosphate

A

0.7-1.4

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3
Q

Magnesium serum conc

A

0.8-1.2

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4
Q

Organ systems ca metabolism

A

Skeleton
Kidney
Gi tract

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5
Q

Calcitrophic hormones

A

Parathyroid hormone
Calcitonin
Vitamin D
Parathyroid hormone related protein

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6
Q

Forms of circulating calcium

A

Protein bound-inactive,not excreted
Ionized-active,excreted
Complexed with phosphate,bicarbonate and citrate

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7
Q

Calcium is

A

Essential

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8
Q

Calcium balance

A

Input=output

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9
Q

Negative balance of calcium

A

Osteoporosis

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10
Q

Calcium means of transport into cell

A

Translocation across cell membrane ,Er,mitochondria

Ca atpase

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11
Q

Feedback inhibition of ca

A

Decreased ca->increased pth-> stimulate kidney->vit d->git->release ca.

Also pth-> bone resorption-> ca

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12
Q

Parathyroid hormone structure

A

Prepropth(115aa)->propth->(90aa)->cleaved at position 6/7 ->84 residues(mature peptide)

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13
Q

Factors that regulate pth synthesis

A

Calcium regulates secretion and transcription. Inversely proportional

Transcription Inhibited by high vt D

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14
Q

Pth function

A

Increases calcium

Decreases inorganic phosphate by excretion

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15
Q

Bone components

A

Organic -33%- collagen,structural proteins like proteoglycans,phosphoproteins,osteocalcin

Inorganic-67%-hydroxyapatite with some calcium phosphate

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16
Q

Osteoblast function

A

Bone formation
Bone mineralization
Formation of matrix proteins
Activation of osteoclast by producing RANKL

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17
Q

Function of osteoclast

A

Resorption of bone

RANKL TO RANK which causes differentiation into osteoclasts

18
Q

Osteoblast encased in bone

A

Osteoclast

19
Q

Osteoblasts have receptors for

A

Pth
Vit d
Growth factors
Cytokines

20
Q

Pth

A

Is trying to cause bone resorption

Prevents osteoblast to osteocyte
Promotes osteoblast to osteoclast
Promotes osteoblast activation of osteoclast

21
Q

Pth site of action on kidney

A

Acts on pct (80%)and dct (20%)but primarily on dct bc pct reabsorption is vis osmosis

22
Q

Calcitonin produced by

A

Parafollicar c cells

32aa

23
Q

Calcitonin fxn

A

Inhibits bone resorption

Aids calcium excretion

24
Q

Activationof vit d

A

Skin->liver->kidney

7dehydrocholesterol->cholecalciferol->25hydroxycholecalciferol when acted on by 25 hydroxylase->1,25dihydroxycholecalceferol when acted on by 1 alpha hudroxylase

25
Q

How does activated vit d work

A

Activated vit d->binding to receptor on intestines->transcription of genes ie calbindin->transporter of ca

Nongenomic-allows ca through luminal brush border

26
Q

Vit d deficiency

A

Rickets in children

Osteomalacia-most prominent

27
Q

Deficiency in alpha 1 hydroxylsse

A

Vitamin d resistant rickets

Hypoplastic teeth
Retarded eruption

28
Q

Pthrp isoforms

A

3

138,141,173 due to alternative splicing

29
Q

Pthrp

A

Can activate pth receptor

30
Q

Functions of pthrp

A

Tranfer calcium to milk
Fetal development
Can cause hypercalcemia of malignancy

31
Q

Causes of hypocalcemia

A 
Idiopathic
After exposure to radiation 
Postoperative 
Vit d deficiency 
Malabsorption 
Liver dx
Kidney dx
Vit d resistance
Psiedohyperparsthyroidsm-pth resistance
32
Q

Psuedoparathroidsm symptoms

A 
Hypocalcemia
Hyperphosphatemia
Tetany 
Siezures
Hypoplasia of enamel
Absence of eruption
33
Q

Causes of hypercalcemia

A

Common
Hyperparathyroidsm
Malognancy
Vit d intoxication

Uncommon
Renal failuire
Sarcoidosis
Multiple myeloma

34
Q

Symptoms of hypetcalcemia

A 
Bone ache
Muscle weakness
Arrhythmia
Lethargy
Depression
Confusion
35
Q

Common sumptom of hypercalcemia

A

Pain in bones
Stones
Abdominal pain

36
Q

Treat hypercalcemia of malignancy with

A

Bisphosphatones. Inhibits osteoclastic activity

37
Q

Treatment of serum ca>3

A

Nacl iv

38
Q

Osteoporosis

A

Reduction in bone mineral density for age,srx group

39
Q

Factors affecting peak bone mass

A 
Gender-Males>females
Race-blacks>white 
Genetic
Gonadal steroids-increase pbm
Groth hormone
Calcium intake
Excercise
40
Q

Sequale of osteoporosis

A

Dowagers hump

Loss of 6-9inches in height in upper thoracic vertebra

41
Q

Treatment of osteoporosis

A

Estrogen treatment-inhibit osteoclast activity

Intake of calcium
Excercise daily
Bisphosphatones
Calcitonin
Vit d
Pth (forteo)

My Own Renal Biochem (7 decks)

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