Intro: Calcium, Magnesium, Phosphorus ✅

Question 1

Where are they filtered?

Answer 1

glomerulus

Question 2

Where are they reabsorbed?

Answer 2

renal tubules

Question 3

how much calcium is found in bone?

Answer 3

about 99%

Question 4

how much phosphorous is found in bone?

Answer 4

about 85%

Question 5

how much magnesium is found in bone?

Answer 5

about 55%

Question 6

where are they ingested?

Answer 6

through diet

Question 7

where are the absorbed?

Answer 7

intestines

Question 8

where are they excreted?

Answer 8

through urine

Question 9

aside from bone, where is the rest found?

Answer 9

found in the cells → only a small amount in the ECF (in blood volume)

They are intracellular ions

Question 10

they are major cations in the body. what does this mean?

Answer 10

they are positive ions

Question 11

what are they regulated by?

Answer 11

vitamin D, parathyroid hormone & calcitonin

Question 12

how does vitamin D function?

Answer 12

as a hormone

Question 13

what kind of vitamin is vitamin D?

Answer 13

fat soluble

Question 14

what does vitamin D maintain?
how?

Answer 14

normal calcium and phosphorus levels

by increasing absorption from intestines

Question 15

when we need more calcium or phosphorous what does vitamin D do?

Answer 15

works to produce more

Question 16

what is the parathyroid hormone (PTH) a major regulator of?

Answer 16

calcium and phosphorous

Question 17

what secretes PTH?

Answer 17

parathyroid glands

Question 18

what is the main job of PTH?

Answer 18

to maintain ECF and calcium levels

Question 19

what happens to PTH when calcium is high?

Answer 19

PTH is inhibited → PTH levels are low

Question 20

what happens to PTH when calcium is low?

Answer 20

PTH is stimulated → PTH levels are high

Question 21

what does PTH require in order to work?

Answer 21

vitamin D & magnesium

Question 22

when calcium and magnesium are reabsorbed, PTH causes an increased excretion of what?

Answer 22

phosphorous

Question 23

what kind of relationship does phosphorous and calcium have?

Answer 23

an inverse relationship

Question 24

List the steps of PTH in hypocalcemia (6)

Answer 24

1) low concentration of calcium in blood
2) causes release of PTH
3) PTH releases causes efflux (pulls away) of calcium from bone
4) kidneys kick in and there is decreased loss of calcium in urine
5) vitamin D works to enhance absorption of calcium from intestine
6) increased concentration of calcium in blood

Question 25

how much calcium is in the blood?

Answer 25

only a small amount!!

Question 26

how much calcium is protein bound to albumin?

Answer 26

about 40%

Question 27

how much calcium is known as complexed or chelated?

Answer 27

about 10%

Question 28

how much calcium is ionized?

Answer 28

about 50%

Question 29

protein bound calcium cannot pass through what?

Answer 29

the capillary wall

Question 30

what does it mean when calcium is protein bound?

Answer 30

it is inactive and we can never use it (it only hangs out with the protein)

Question 31

what does it mean when calcium is complexed or chelated?

Answer 31

it is combined with citrate, phosphate, etc

Question 32

what is calcium citrate used for?

Answer 32

to prevent blood clotting in transfusions

Question 33

what is ionized calcium able to do?

Answer 33

able to leave the vascular compartments and participate in cellular function

Question 34

how does ionized calcium affect nerve cells?

Answer 34

makes nerve cells less sensitive to stimuli

Question 35

overall how much calcium from our body can we use?

Answer 35

about 50% (ionized)

Question 36

if a patient has LOW albumin, what do we often see? why?

Answer 36

falsely LOW calcium level bc not enough calcium is there or the decreased albumin makes it so not enough calcium can bind

Question 37

when we correct low albumin what do we often see?

Answer 37

that the hypocalcemia was not with the calcium levels but actually albumin levels

Question 38

what can an ionized calcium level be used to do?

Answer 38

another way to check pts calcium and make sure it is normal (bc ionized calcium makes up about half of the calcium in the blood)

Question 39

calcium aids in many ______ reactions

Answer 39

enzyme

Question 40

calcium aids in ____ development

Answer 40

bone

Question 41

how does calcium aid in action potentials?

Answer 41

As we see change in the threshold we see sodium & calcium rush into the cell and then comes back out so the potassium can go back in

Question 42

calcium aids in neuron ________

Answer 42

excitability

Question 43

what types of muscle contraction is calcium needed for?

Answer 43

skeletal, cardiac, and smooth muscle

Question 44

calcium affects cardiac _______ and ________

Answer 44

contractility and automaticity

Question 45

calcium is essential for blood clotting, how?

Answer 45

production of clotting factors – all but first 2 steps in coagulation cascade

Question 46

if we start to see problems with calcium, we start to see problems with what else?

Answer 46

bleeding

Question 47

List dietary sources of calcium (12)

Answer 47

1) milk 2) dairy 3) kale 4) broccoli 5) bony fish 6) seeds 7) nuts (almond) 8) beans 9) orange 10) peas 11) meat 12) many foods fortified such as OJ and non-dairy milk products (i.e. oat milk/ almond milk)

Question 48

how much calcium from diet is absorbed?

Answer 48

About 50% is absorbed and the rest is eliminated in stool **about 150 mg/day is absorbed**

Question 49

for which pts is it dangerous to take calcium supplements? what should they do instead?

Answer 49

older adults & perimenopausal/ postmenopausal women recommendation is to replace and fortifying with dietary intake

Question 50

If calcium intake is less than what is secreted into the bowel → the patient will become _________

Answer 50

hypocalcemic

Question 51

what is the normal level of phosphorus?

Answer 51

2.4 to 4.5 mg/dL

Question 52

is phosphorus an intracellular or extracellular ion?

Answer 52

intracellular

Question 53

who has higher levels of phosphorous?

Answer 53

babies and children

Question 54

phosphorus plays a major role in what?

Answer 54

bone formation

Question 55

list foods high in phosphorous (12)

Answer 55

1) hard cheese 2) cream 3) nuts 4) meats 5) whole-grain cereals 6) dried fruits 7) dried vegetables 8) kidney beans 9) kidney meat 10) sardines 11) **sweetbreads (banana/ zucchini bread)** 12) foods made with milk

Question 56

phosphorus is needed to make what?

Answer 56

ATP **this is why we see problems when pts have low phosphorus bc cannot make enough ATP to do its job**

Question 57

what pts do we often see low phosphorus in?

Answer 57

chronic illness (immobile pts)

Question 58

phosphorus is needed for the metabolism of what?

Answer 58

glucose fats proteins

Question 59

how does phosphorus aid in acid-base balance?

Answer 59

helps excrete hydrogen ions

Question 60

what is the difference between organic and inorganic phosphorus?

Answer 60

Inorganic → phosphorus in the blood Organic → phosphorus in the cells

Question 61

when we measure a pts phosphorus levels, what type of phosphorus are we looking at?

Answer 61

inorganic

Question 62

what is the second most abundant ICF cation after potassium?

Answer 62

magnesium

Question 63

what are the normal levels of magnesium?

Answer 63

1.8 to 3.0 mg/dL

Question 64

abnormal magnesium can cause other _______ ______!!!!

Answer 64

electrolyte imbalances

Question 65

magnesium is needed for every step in what?

Answer 65

DNA replication & transcription & transcription RNA

Question 66

magnesium is needed to create what?

Answer 66

ATP (Na/K ATPase pump) action potential

Question 67

without magnesium, what do we start to see?

Answer 67

cardiac arrhythmias & muscular dysfunction

Question 68

magnesium is needed for ______ conduction

Answer 68

nerve

Question 69

magnesium is necessary for ________ & ________ activity, especially in ______ cells

Answer 69

Potassium & calcium activity; cardiac cells

Question 70

magnesium causes peripheral _________ & affects peripheral _______, so it can do what??

Answer 70

vasodilation; resistance it can bring BP down!!

Question 71

magnesium is a ______ ______ relaxant

Answer 71

smooth muscle

Question 72

magnesium can treat ________ because it causes cerebral _________

Answer 72

seizures; vasodilation

Question 73

list dietary sources of magnesium (5)

Answer 73

1) grains 2) nuts 3) meats 4) seafoods 5) green vegetables

Question 74

the ______ hold onto most magnesium

Answer 74

kidneys

Question 75

how much magnesium does the kidneys filter out?

Answer 75

6%