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Chemistry > Mineral Metabolism > Flashcards

Mineral Metabolism Flashcards

1
Q

Function of Calcium

A

Ionized Calcium is the physiological active form
Important co-enzyme in coagulation cascade
Role in heart, muscle, and nerve excitability
Suppresses neuromuscular excitability
Plays a role in transport across membranes

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2
Q

Structure and Concentration of Calcium

A

99% located in bone as CaPo4 complex
- Hydroxyapatite

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3
Q

Location of Calcium in body

A

Bone - 99%
Other sites - 1%

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4
Q

Calcium Analysis

A

Two types of tests
Total serum calcium
Protein bound (albumin and globulins)
Complexed to ions (Citrate, phosphate, bicarbonate, sulfate)
Ionized Ca2+

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5
Q

Phosphorus Function

A

Tied up with calcium in skeleton
Other Functions:
- High intracellular phosphate concentration
- Carbohydrate metabolism: ATP
- Component of nucleic acids, phospholipids, and nucleotides
- Phosphate buffer important in balancing acid in urine

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6
Q

Magnesium Function

A

Found in 50% of bone with calcium and phosphorus
Rest is found with potassium inside cell
Acts as a co-enzyme in enzyme reactions
Regulation not fully understood

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7
Q

Elevated Magnesium

A

Intoxication
Renal Failure - unable to filter appropriately

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8
Q

Low Magnesium

A

Impaired absorption or intake
Excessive renal loss

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9
Q

Organs Involved in regulation of Ca and PO4

A

Parathyroids
Thyroid
Kidneys
Liver
Skeletal system
Intestine

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10
Q

Parathyroid Produces

A

PTH (Parathyroid Hormone)
Regulating Calcium and Phosphorus Concentrations

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11
Q

Thyroid Produces

A

C-cells
Calcitonin

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12
Q

Kidneys Function for Ca and PO4

A

Hydroxylate Vitamin D
Control Ca and PO4 absorption

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13
Q

Liver Creates

A

Hydroxylated Vit D

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14
Q

Parathyroids Info

A

Lobe of the thyroid gland
4 glands are present

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15
Q

Calcitonin

A

Produced by C-cells of Thyroid
Acts antagonistically to PTH
Stimulated by elevated Ca2+
Found in children who also have high Alkaline Phosphatase
Responsible for laying down crystalline bone
Bone and ECF ions are in balance with one another
Osteoclasts
Osteoblasts

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16
Q

Osteoclasts

A

Involve in bone resorption
PTH breaks down CaPO4 component

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17
Q

Osteoblasts

A

Involved in bone formation
Calcitonin creates when too much Ca2+ in serum

18
Q

Vitamin D

A

Steroid hormone made from cholesteroal
Governs absorption of Ca2+ from GI tract
Activated by low serum Ca2+
Activates formation of carrier protein for Ca2+

19
Q

Vitamin D Conversion

A

Active form undergoes two conversions
- First in liver
- Second in kidneys
Kidneys also actively secrete phosphates and reabsorb Ca2+

20
Q

Hypocalcemia caused

A

Hypoparathyroidism
- Serum calcium = Decreased
- Serum Phosphorus = Increased
- Urine Calcium = Decreased
- Urine Phosphorus = Decreased
- PTH = decreased

21
Q

Hypocalcemia Hypoparathyroidism Complications

A

Twitching
Tetany
Convulsions
- Common cause: Thyroid surgery

22
Q

Hypocalcemia Vitamin D Deficiency

A

PTH is working fine, but no Vit D to absorb
- Serum Calium = Decreased
- Serum Phosphorus = Decreased
- Urine Calcium = Decreased
- Urine Phosphorus = Increased
- PTH = Increased

23
Q

Hypocalcemia Vit D Deficiency Complications

A

Rickets (prior to puberty)
Osteomalacia (after puberty) - fractures and bowing of bone
Causes:
- Inadequate sunlight
- Inadequate dietary source
- Kidney disease

24
Q

Hypocalcemia Chronic Renal Failure

A

Serum Calcium = Decreased
Serum Phosphorus = Increased
PTH = Increased
Urine Calcium = Decreased
Urine Phosphorus = Decreased

25
Q

Hypocalcemia Complications

A

Decreased Serum Calcium: Tetany, bone lysis
Secondary Hyperparathyroidism

26
Q

Hypercalcemia Primary Hyperparathyroidism

A

Serum Calcium = Increased
Serum Phosphorus = Normal to Decreased
PTH = Increased
Urine Calcium = Increased
Urine Phosphates = Increased

27
Q

Hypercalcemia Primary Hyperparathyroidism Complications

A

Bone lysis
Kidney stones
Cause: Adenoma of parathyroid gland

28
Q

Hypercalcemia Hypervitaminosis D

A

Serum Calcium = Increased
Serum Phosphorus = Normal to Increased
PTH = Normal to Decreased
Urine Calcium = Increased
Urine Phosphorus = Decreased

29
Q

Hypercalcemia Hypervitaminosis D Complications

A

Kidney Stones
Metastatic Calcification
Renal Failure

30
Q

Hypercalcemia Bone Malignancy

A

Serum Calcium = Increased
Serum Phosphorus = Normal, Increased, or Decreased
PTH = Normal to Decreased PTH
Urine Calcium = Increased
Urine Phosphorus = Increased

31
Q

Hypercalcemia Bone Malignancy Complications

A

Bone Fractures
Cause: Invasive tumors of multiple myeloma and breast carcinoma

32
Q

Metabolic Bone Disease

A

Paget’s Disease (Ostetitis Deformans)

33
Q

Paget’s Disease Frequency

A

3% incidence in those over 40 yrs

34
Q

Paget’s Disease General Info

A

Unknown cause
Bone Resorption = Increased
Osteoclast Activity = Increased
Bone formation = Increased
- Deposition is irregular and haphazard
Alkaline Phosphatase = Increased
Ca = Normal to Rarely Increased
Phosphorus = Normal to Rarely Increased

35
Q

Osteoporosis

A

Loss of bone density with age
General Change in balance mechanism related to hormones and life risk factors

36
Q

Osteoporosis Risk Factors

A

Advanced Age
Women more effected
Perimenopause
Decreased Ca intake
Cigarette smoking
Carbonated Soda

37
Q

Hyperphosphatemia (Increased levels of Phosphate)

A

Hypoparathyroidism (low PTH levels)
Vitamind D Intoxication (increased intestinal absorption)
Renal Insufficiency
Failure to filter phosphates

38
Q

Hypophosphatemia (Decreased levels of Phosphate)

A

Primary or Secondary Hyperparathyroidism
- Primary - tumor keeps producing PTH
- Secondary - renal as PTH is increased but kidneys not responding
Vitamin D deficiency
Malabsorption syndrome
Renal excretion - Primary or Secondary

39
Q

Total Calcium Assay

A

Dye binding or color complex method
Calcium complexes with dye to cause color change
Arsenazo III
o-cresolphathalein complexone
- Magnesium interference eliminated by adding 8-hydroxy quinoline

40
Q

Ionized Calcium Assay

A

Measured with ion-selective electrode

41
Q

Ionized Calcium Calculation

A

((6 x Total Calcium) - (1/3 x Total Protein)) / (Total Protein +6)

42
Q

Phosphorus Assay

A

Phosphate ions complex with molybdate to form phosphomylbdate which gives a color change when reduced to phosphomolybdate

Chemistry (11 decks)

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