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36 Cards in this Set
- Front
- Back
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Osteoblast |
mesenchymal progenitor Bone matrix excretion |
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Osteoclast |
Hematopoietic progenitor, macrophages RANKL activated |
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Osteocyte |
osteoblasts in matrix |
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FG23 |
decrease reabsorption phosphate, lower Vit D synthesis |
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hypophosphatemia causes |
lower renal absorption, increased renal secretion, rapid redistribution into tissue |
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hypophosphatemia signs |
ATP depletion, muscosceletal complaints, respiratory failure, cardiac dysfunction |
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hyperphosphatemia cause |
decreased renal excretion increased extra cellular fluid phosphate load |
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hyperphosphatemia signs |
tetanus, seizures, increased nephrocalcinosis, pulmonary or cardiac calcifications, acute heart block. |
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hypomagnesemia causes |
decreased renal absorption, increased interstinal losses, ecf expansion, increased bone formation, pancreatitis, pregnancy, lactation, decreased VIT. D formation, decreased PTH secretion |
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hypomagnesemia signs |
altered neuromuscular function (tetanus, tremor, seizures), muscle weakness, delerium, psychocis, cardic arrhythmias |
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hypomagnesemia treatment |
Oral supplementation, IV, monitor serum levels, treat vit. d. deficiency |
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hypermagenesemia causes |
decreased excretion, increased intake, after trauma: rapid mobilization from tissues, adrenal insufficiency, hypothyroidism, hypothermia, renal failure, hypercalcemia |
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hypermagnesemia signs |
vasodilation, neuromuscular damage, hypotension, nausea, paralysis, respiratory failure, coma, GI immobility, heart failure Often combined with renal failure |
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hypermagnesemia treatment |
take away magnesium source and hemodialysis |
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Vitamin D synthesis |
Liver (25), kidney (1) - kidney affected by PTH. Acts on calbindin 9k |
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Vitamin D deficiency causes |
- nutritional deficiency, malabsorption - accelerated loss in GI - liver disease - kidney disease - target organ resistance |
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Vitamin D deficiency signs |
hypocalcemia, secondary hyperparathyroidism, decreased skeletal mineralization, proximal myopathy, rickets and osteomalacia |
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Hypercalcemia causes |
- (PTH increased) Primary hyperparathyroidism: malignancy/adenoma in parathyroid hormone - (PTH normal) Peripheral tumor producing PTHrP - Excess Vitamin D production/levels - Primary problems bone resorption (hyperthyroidism, immobility) - Excessive calcium intake - Endocrine disorders - Drugs |
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Hypercalcemia signs |
mild: asymptomatic severe: lethargy, stupor, coma, nausea, anorexia, pancreatitis, renal failure: polydipsia, polyuria , slow heart rhythm |
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Hypercalcemia diagnostics and treatment |
Measure total calcium levels: serum, albumin Diuretics, biphosphonates, anti vitamin d drugs |
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Hypocalcemia causes: |
- PTH absent (hypoparathyroidism): Parathyroid agenisis: DiGeorge, HDR, kenny,caffey syndrome, AIRE deficiency, ADHH Parathyroid destruction: Acquired: surgical damage Hypomagnesemia impaired secretion and responsiveness to PTH - PTH increased, but ineffective =secondary hyperparathyroidism chronic renal failure, Vitamin D deficiency, drugs (rickets), Receptor PTH impaired (pseudohypothyroidism) - PTH overwhelmed: severe tissue injury, pancreatitis, osteoblastic metasteses |
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hypocalcemia signs |
moderate: tingling, carpalpedal signs severe: seizures, carpopedal-, broncho- and laryngealspasms, slow heart rhtythm, mental changes |
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hypocalcemia diagnostics |
serum calcium, albumin, phosphorus, magnesium, pth levels, serum Vit D. |
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hypocalcemia treatment |
IV, supplementation |
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Hypoerparathyroidism and hypercalcemia surgery |
serum calcium, creatine clearance, bone density and age |
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monitoring calcium |
serum calcium, serum creatine, density bone |
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Calcitonin |
inhibits bone resoption --> lowers CA levels blood. From Parafollicular C cells thyroid gland |
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Osteoporosis |
lower bone strength, high risk of fractures |
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kyphosis |
gebocheld |
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Estrogen action on bone modelling |
Estrogen: increases life span osteoblasts decreases osteoclasts - OPG |
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glucocorticoids and bone remoddeling |
inhibit osteoblasts, increase urinary loss calcium, decrease estrogen levels |
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smoking and bone remodelling |
toxic to osteoblasts modify estrogen metabolism earlier menopause |
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Bone mass measurement |
DXA CT Ultrasound |
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Hypercalciuria: |
Renal Ca leak, too much absorption, hematologic malignancy |
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Biphosphonates |
Block osteoclasts effect |
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Pagets disease |
chaotic bone formation, increased turnover Treatment: biphosphonates, calcitonin |
