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Calcitropic Hormones

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What activities in the body needs calcium? hemostasis membrane excitation stabilization of membranes intercellular adhesion muscle contraction excitation/secretion process neurotransmitter release production and maintenance of bone
Where are calcium stored? stable pool - mature bone labile pool - newly formed bone
What is the Ca+ ECF concentraion 8.5-10.5 mg/dl
What are 3 fractions of Ca in ECF? Ionized - biologically activated Protein bound - albumin complexed difussible = ionize + complex non-diffusible - protein bound
What are Calcitropic Hormones? regulate plasma Ca, phophate, magnesium Vitamin D3 Parathyroid hormone (PTH) Calcitonin
Mechanism of Vitamin D3 first hydroxylation (liver) -> 25-OH vit D (calcidiol) - second hydroxylation (kidney) -parathormone ->>Vit D3 (calcitrol, cholecalciferol) 1,25-dihydroxy vit D
stimulant for Vit D3 PTH Insulin growth factor 1 (IGF-1)
Inhibitor for Vit D3 fibroblast-derived growth factor 23 (FGF-23) high blood levels of calcium and phosphate
What are PTHrP? minerilization of chondrocytes and citical development of mammary glands, skin and hair follicles high PTHrP = malignant tumor squamous cell carcinomas, breast carcinomas
What is the function of PTH? increase plasma calcium levels
What is the function of calcitonin? opposes action of PTH decrease osteoclast activity
What is the stimulus for calcitonin? >10.5 mg/ml Ca concentration
What are C Cells? parafollicular cells in the thyoid gland - make calcitonin
What are the clinical manifestations of Hyperparathyroidism? nephrolithiasis w/ pyelonephritis polyuria and polydipsia salt and pepper bone - osteoporosis tired, irribility, lability GI problems hypertension - pheochromocytoma band/limbus keratopathy hypercalcemia
What are the differential diagnosis w/ hyperparathyroidism? Diabetes - polyuria, polydipsia Cushings - hypertension, demineralization, tireness irribility Addisons - GI problems Thyrotoxicosis - hypercalcemia grave's Disease - hypercalcemia
What are the characteristics of hyperparathyroidism hypercalcemia and hypophosphatemia genes - MEN1 MEN2a causes - adenomas, hyperplasia, carcinomas patho - severity parallels hypercalcemia= parathyroid gland
What is the cause of Hypoparathyroidism? removal of parathyroid <7 mg/ml Ca
What are the Clinical manifestations of Hypoparathyroidism? Tetany Trousseau Sign - carpopedal spasm of blood pressure photophobia, diplopia, pseudomotor cerebri, spicules and PSC, eye twitching, vit D defiency Chovstek Sign - unilateral spam of facial muscle Convulsion in children hyperreflexia
What is the result of Vitamin D Deficiency? children - rickets adults - osteomalacia
What is the cause of Band Keratophaty? hypercalcemia chronic uveitis long term use of chronic pilocarpine (glaucoma meds)
What is the treatment for Band Keratopathy? chelating agent EDTA anesthetic drops cycloplege with atropine
What is Band Keratopathy? calcium precipitate or cloudy area that covers visual axis starts nasally and temporally occurs in bowman's membrane layer
Created by: prinny916



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