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Clin Path Quiz 17/18
Lecture 17: Electrolytes
| Question | Answer |
|---|---|
| regulations of minerals in the body | 1, 25 dihydroxy Vitamin D3, parathyroid hormone, fibroblast growth factor-23, calcitonin |
| 1, 25 dihydroxy Vitamin D3 | dietary precursor, activated in both the liver and kidney (activation is promoted by PTH), enhances intestinal absorption of Ca and P |
| parathyroid hormones (PTH) | secreted by parathyroid chief cells in response to decreased ionized Ca or Mg OR in response to increased phosphorous concentrations, affects 3 sites in the body (renal tubules, bone, intestine), net effect is increasing Ca and Mg and decreasing P |
| fibroblast growth factor (FGF)-23 | produced in bone by osteoclasts and osteoblasts, decrease in renal tubular absorption of P, induces phosphorus excretion in urine |
| calcitonin | secreted by thyroid parafollicular cells in response to hypercalcemia, decreases serum calcium and phosphorous by inhibiting bone reabsorption and increasing excretion of both in urine |
| calcium (Ca 2+) and phosphorous (PO4) | both are important for structural integrity of bones and teeth |
| balance for Ca2+ and PO4 is achieved by | calcitonin (produced in thyroid gland, decreases blood calcium), parathyroid hormone (PTH, produced by parathyroid glands, increases blood calcium, decreased blood phosphorous) |
| PTH effects in renal tubules | increase Ca and Mg absorption while decreasing P absorption |
| PTH effects in bone | increase Ca and P release from the bone by increasing bone resorption by osteoclasts (promoted by vitamin D) |
| PTH effects in intestines | increase intestinal absorption of Ca and P (vitamin D is required for intestinal absorption EXCEPT in horses) |
| major function of calcium | provide strength to teeth and bones (> 99% of Ca in the body is found in the bones), intracellular messenger or regulatory ion (muscle contraction, nerve impulse transmission, enzyme activities, blood coagulation, maintenance of inorganic ion transfer) |
| calcium in blood | 10% bound to anions, 40% bound to proteins, 50% ionized (active); all three of these equal total calcium |
| most accurate measure of calcium | active calcium |
| calcium measurement | total calcium or ionized calcium; samples should be serum or heparinized plasma, DO NOT use EDTA of calcium citrate; Ca concentration usually inverse to phosphorous |
| hypercalcemia | inc. calcium; young dogs; caused by hypercalcemia of malignancy (lymphoma, AGASACA, mammary tumors), kidney failure, primary hyperparathyroidism, vit. D toxicity, Addison's, fungal infections |
| AGASACA | apocrine gland of anal sac adenocarcinoma |
| hypocalcemia | dec. calcium; caused: hypoalbuminemia (most common), renal disease, pancreatitis, pregnancy or lactation, ethylene glycol toxicity, primary hypoparathyroidism, hypomagnesemia |
| milk fever | hypocalcemia in cattle, usually around time of parturition, drop in calcium leads to paralysis, life threatening if not treated (oral if standing, IV if laying down) |
| eclampsia | small animals, life-threatening hypocalcemia occurring at peak lactation; present w/ tetany (muscle tremors, twitching, muscle spasms, ataxia) |
| phosphorous functions | 80% found in bones, remaining 20% functions in energy storage, release and transfer, carbohydrate metabolism, composition of physiologically important substances (nucleic acids, phospholipids) |
| phosphorous in the body | not as closely regulated by the body as Ca; absorbed in the intestines, released from bone in response to PTH, excreted by kidneys, insulin shifts phosphorous into cells |
| phosphorous in the blood | majority of phosphorous in whole blood is in erythrocytes, phosphorous in plasma or serum is inorganic phosphorous, chemical assays measure INORGANIC phosphorous |
| hyperphosphatemia | inc in blood phosphorous; causes: artifact (prolonged exposure to RBCs and hemolysis), young animals <1 year of age, decreased glomerular filtration rate |
| return of CKD in cat or dog | P levels increase with decreased GFR (renal disease) |
| hypophosphatemia | dec. blood phosphorous levels; causes: anorexia, hypercalcemia or malignancy, milk fever/eclampsia, hyperparathyroidism, renal failure in horses, diabetes mellitus |
| medical emergency | Ca: > 18 mg/dL, Ca x P > 70-90 soft tissue mineralization and renal failure are more likely, azotemia or dehydration is present |
| Ricketts | disorder of the growing skeleton (only affects YOUNG, GROWING animals); causes: insufficient dietary phosphorous or Ca, inappropriate Ca:P, insufficient availability of vit D; diagnosis on clinical presentation and nutrient deficiencies |
| magnesium | absorbed in intestines, excreted by kidneys, metabolism controlled by aldosterone/insulin/parathyroid hormone; 30% is protein bound in blood, 50% stored in blood |
| magnesium tests | total Mg concentration is usually measured, sample is serum or heparinized plasma, Mg not routinely measured on in-house chemistries, abnormalities will affect MUSCLE FUNCTION in the animal |
| hypermagnesemia | inc blood magnesium, causes muscle paresis/paralysis and cardiac arrythmias, rare in animals but may see secondary to hemolysis |
| hypomagnesemia | decreased blood Mg, causes skeletal and cardiac muscle excitability (rigid paralysis); commonly seen as dietary disease in cattle and sheep called GRASS TETANY |
Created by:
mkroon26
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