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Question
Answer
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  
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Where are calcium stored?   stable pool - mature bone labile pool - newly formed bone  
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What is the Ca+ ECF concentraion   8.5-10.5 mg/dl  
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What are 3 fractions of Ca in ECF?   Ionized - biologically activated Protein bound - albumin complexed difussible = ionize + complex non-diffusible - protein bound  
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What are Calcitropic Hormones?   regulate plasma Ca, phophate, magnesium Vitamin D3 Parathyroid hormone (PTH) Calcitonin  
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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  
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stimulant for Vit D3   PTH Insulin growth factor 1 (IGF-1)  
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Inhibitor for Vit D3   fibroblast-derived growth factor 23 (FGF-23) high blood levels of calcium and phosphate  
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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  
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What is the function of PTH?   increase plasma calcium levels  
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What is the function of calcitonin?   opposes action of PTH decrease osteoclast activity  
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What is the stimulus for calcitonin?   >10.5 mg/ml Ca concentration  
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What are C Cells?   parafollicular cells in the thyoid gland - make calcitonin  
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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  
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What are the differential diagnosis w/ hyperparathyroidism?   Diabetes - polyuria, polydipsia Cushings - hypertension, demineralization, tireness irribility Addisons - GI problems Thyrotoxicosis - hypercalcemia grave's Disease - hypercalcemia  
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What are the characteristics of hyperparathyroidism   hypercalcemia and hypophosphatemia genes - MEN1 MEN2a causes - adenomas, hyperplasia, carcinomas patho - severity parallels hypercalcemia= parathyroid gland  
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What is the cause of Hypoparathyroidism?   removal of parathyroid <7 mg/ml Ca  
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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  
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What is the result of Vitamin D Deficiency?   children - rickets adults - osteomalacia  
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What is the cause of Band Keratophaty?   hypercalcemia chronic uveitis long term use of chronic pilocarpine (glaucoma meds)  
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What is the treatment for Band Keratopathy?   chelating agent EDTA anesthetic drops cycloplege with atropine  
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What is Band Keratopathy?   calcium precipitate or cloudy area that covers visual axis starts nasally and temporally occurs in bowman's membrane layer  
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