L35. Physiology - Parathyroid
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Questions and Answers

What is the approximate amount of calcium stored in bone?

  • 10,000 g
  • 1,000,000 g
  • 100 g
  • 1000 g (correct)
  • What is the approximate concentration of calcium in plasma?

  • 100 nM
  • 10 nM
  • 10 mM
  • 1 mM (correct)
  • What is the typical dietary intake of calcium?

  • 10 g
  • 1 g (correct)
  • 100 g
  • 0.1 g
  • Which cells produce parathyroid hormone?

    <p>Chief cells (A)</p> Signup and view all the answers

    What effect does parathyroid hormone have on vitamin D?

    <p>Promotes its conversion to the active form (B)</p> Signup and view all the answers

    What is the effect of persistent high levels of parathyroid hormone on bone?

    <p>Increased bone resorption (B)</p> Signup and view all the answers

    Where does parathyroid hormone stimulate calcium reabsorption?

    <p>Kidney (D)</p> Signup and view all the answers

    How does vitamin D help regulate calcium levels?

    <p>It stimulates calcium absorption from the gut (B)</p> Signup and view all the answers

    Which hormone works synergistically with vitamin D to enhance calcium reabsorption in the kidneys?

    <p>Parathyroid hormone (B)</p> Signup and view all the answers

    What physiological mechanism is activated to counter low extracellular calcium levels, ultimately resulting in the release of PTH?

    <p>Low extracellular calcium relieves the inhibitory effect of PKC and intracellular calcium on PTH release (D)</p> Signup and view all the answers

    How does PTH exert its action on the kidneys to regulate calcium levels?

    <p>Directly enhances calcium reabsorption and increases phosphate excretion (C)</p> Signup and view all the answers

    Which of the following statements accurately reflects the role of PTH in bone remodeling?

    <p>Continuous PTH exposure leads to increased osteoclast activity, promoting bone breakdown and elevating blood calcium levels (C)</p> Signup and view all the answers

    Which of the following correctly describes the pathway by which PTH exerts its action?

    <p>PTH interacts with GPCRs linked to adenylate cyclase, resulting in intracellular calcium signaling (D)</p> Signup and view all the answers

    What is the primary function of PTH in regulating blood calcium levels?

    <p>Directly increasing calcium absorption in the kidneys and indirectly acting on bone to increase calcium release (A)</p> Signup and view all the answers

    What is the primary mechanism by which PTH indirectly affects calcium levels?

    <p>Activating Vitamin D synthesis, which enhances calcium absorption in the intestines (C)</p> Signup and view all the answers

    How does the body respond to elevated extracellular calcium levels?

    <p>Inhibition of PTH release to decrease blood calcium levels (B)</p> Signup and view all the answers

    Which of the following accurately describes the relationship between PKC and intracellular calcium regarding PTH release?

    <p>Both PKC and intracellular calcium inhibit PTH release (A)</p> Signup and view all the answers

    What is the primary mechanism by which PTH stimulates bone remodeling?

    <p>Modulating the balance between osteoclast and osteoblast activity (A)</p> Signup and view all the answers

    What is the physiological consequence of chronically elevated PTH levels?

    <p>Increased bone resorption and elevated blood calcium levels (B)</p> Signup and view all the answers

    What is the primary circulating form of Vitamin D in the blood?

    <p>Mono-hydroxylated form (C)</p> Signup and view all the answers

    Where specifically are hydroxylation reactions involved in the conversion of Vitamin D3 taking place?

    <p>Liver and Kidney (D)</p> Signup and view all the answers

    What does the content primarily emphasize about the di-hydroxy form of Vitamin D compared to the mono-hydroxylated form?

    <p>The di-hydroxy form is about 10 times more active. (B)</p> Signup and view all the answers

    What is the primary role of the mono-hydroxylated form of Vitamin D in the body?

    <p>To act as a precursor to the active form of Vitamin D for hormone function. (A)</p> Signup and view all the answers

    Based on the information provided, what is the main source of Vitamin D3?

    <p>Conversion from provitamin D by UV rays. (A)</p> Signup and view all the answers

    What type of molecule is the Vitamin D precursor, 7-dehydrocholesterol, categorized as?

    <p>A steroid (D)</p> Signup and view all the answers

    Which of these processes is crucial for the synthesis of the active forms of Vitamin D?

    <p>Hydroxylation (B)</p> Signup and view all the answers

    Why is it crucial for the mono-hydroxylated form of Vitamin D to be bound to a globulin carrier protein in the blood?

    <p>To facilitate its transport in the bloodstream. (D)</p> Signup and view all the answers

    In the context of calcium homeostasis, a decrease in plasma calcium levels directly triggers which of the following responses?

    <p>Increased secretion of parathyroid hormone (PTH) from the parathyroid glands (B)</p> Signup and view all the answers

    Which of the following accurately describes the role of parathyroid hormone (PTH) in regulating plasma phosphate levels?

    <p>PTH promotes phosphate excretion by the kidneys (phosphaturia), thereby lowering plasma phosphate levels. (B)</p> Signup and view all the answers

    What is the primary mechanism by which active vitamin D, stimulated by parathyroid hormone (PTH), increases plasma calcium levels?

    <p>Increasing calcium absorption in the gut (C)</p> Signup and view all the answers

    Elevated plasma phosphate levels directly contribute to which of the following in calcium homeostasis?

    <p>Increased deposition of calcium-phosphate in bone and other tissues, leading to decreased plasma calcium. (D)</p> Signup and view all the answers

    Which of the following correctly describes the relationship between parathyroid hormone (PTH) and calcium absorption in the gut?

    <p>PTH indirectly increases calcium absorption in the gut by stimulating the production of active vitamin D in the kidneys. (B)</p> Signup and view all the answers

    How does parathyroid hormone (PTH) directly contribute to the maintenance of bone mineral density?

    <p>Stimulating osteoblasts to secrete factors that promote the differentiation of osteoblasts, leading to increased bone formation. (A)</p> Signup and view all the answers

    Which of the following is a direct effect of parathyroid hormone (PTH) on the kidneys?

    <p>Increased excretion of phosphate, leading to decreased plasma phosphate levels (phosphaturia). (B)</p> Signup and view all the answers

    Which of these statements accurately describes the interplay between parathyroid hormone (PTH) and calcium levels in the body?

    <p>PTH indirectly increases plasma calcium by stimulating calcium reabsorption in the kidneys. (A)</p> Signup and view all the answers

    What stimulates the production of the active form of Vitamin D?

    <p>Insulin (A)</p> Signup and view all the answers

    Which enzyme is responsible for producing the active di-hydroxy form of Vitamin D?

    <p>1α hydroxylase (A)</p> Signup and view all the answers

    What is inhibited by high levels of calcium concerning Vitamin D regulation?

    <p>1α hydroxylase activity (C)</p> Signup and view all the answers

    What does Vitamin D stimulate in the gut to enhance calcium absorption?

    <p>Calcium transporters and binding proteins (B)</p> Signup and view all the answers

    Which of the following hormones also stimulates the active form of Vitamin D production?

    <p>Growth hormone (D)</p> Signup and view all the answers

    What role does Vitamin D play in bone physiology?

    <p>Promotes calcium influx into bone (D)</p> Signup and view all the answers

    What effect does Vitamin D binding to its nuclear receptor have?

    <p>Stimulates gene expression for calcium absorption (D)</p> Signup and view all the answers

    What is an example of feedback inhibition concerning Vitamin D?

    <p>Inhibition of its own production (A)</p> Signup and view all the answers

    What is the principal circulating form of Vitamin D in the blood?

    <p>Monohydroxylated form (D)</p> Signup and view all the answers

    What stimulates the production of the active di-hydroxy form of Vitamin D?

    <p>PTH (Parathyroid hormone) (A)</p> Signup and view all the answers

    Which factor inhibits the production of the active di-hydroxy form of Vitamin D?

    <p>High calcium levels (B)</p> Signup and view all the answers

    The form of Vitamin D that is about 10 times more active than the monohydroxylated form is known as?

    <p>Dihydroxy form (B)</p> Signup and view all the answers

    What process converts provitamin D to vitamin D3?

    <p>Ultraviolet radiation exposure (A)</p> Signup and view all the answers

    What role does feedback inhibition have in Vitamin D production?

    <p>It limits further production of Vitamin D. (B)</p> Signup and view all the answers

    Which of the following best describes the role of the 1α hydroxylase enzyme?

    <p>It is responsible for the di-hydroxylation of Vitamin D. (A)</p> Signup and view all the answers

    In which organ does the conversion of Vitamin D3 to its active forms primarily occur?

    <p>Liver and kidney (B)</p> Signup and view all the answers

    Flashcards

    PTH

    Parathyroid hormone that regulates calcium levels in the blood.

    Calcium Homeostasis

    The balance of calcium levels in the blood and body.

    Phosphaturia

    The excretion of phosphate in the urine stimulated by PTH.

    Calcium Mobilization

    The process of releasing calcium from bone into the bloodstream.

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    Active Vitamin D

    The form of vitamin D that enhances calcium absorption in the gut.

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    Calcium-Phosphate Deposition

    The process where excess phosphate leads to calcium deposits in tissues and bone.

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    Osteoblasts

    Cells that help form new bone by secreting substances like calcium.

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    Stimulus for PTH Secretion

    Low calcium levels trigger the parathyroid gland to secrete PTH.

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    Intracellular Calcium Concentration

    The amount of calcium within cells, generally around 10 nM, which is very low.

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    Extracellular Calcium Concentration

    The amount of calcium outside cells, especially in plasma, which is much higher at about 1 mM.

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    Major Calcium Storage

    Most calcium in the body, around 1000 g, is stored in bones.

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    Dietary Calcium Intake

    The average daily intake of calcium is about 1 g, necessary for health.

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    Parathyroid Hormone (PTH)

    A hormone produced by parathyroid glands that regulates calcium levels by stimulating reabsorption and vitamin D conversion.

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    Vitamin D and Calcium

    Vitamin D helps regulate calcium levels, enhancing absorption from the gut and synergizing with PTH.

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    Role of Osteoclasts

    Cells activated by high levels of PTH that promote the resorption (breakdown) of bone.

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    Bone Deposition

    The process facilitated by intermittent PTH that leads to the formation of new bone.

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    Calcium Reabsorption in Kidney

    The process stimulated by PTH that increases calcium retention from urine back into blood.

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    Vitamin D3 Production

    The conversion of provitamin D to vitamin D3 via UV rays exposure.

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    7-dehydrocholesterol

    Provitamin D found in the skin, converted to vitamin D3.

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    Mono-hydroxylated form

    The principal circulating form of Vitamin D in the blood.

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    Di-hydroxy form

    The more active form of vitamin D, 10 times more active than the mono form.

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    Hydroxylation reactions

    Biochemical processes in liver and kidney converting vitamin D forms.

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    Globulin carrier protein

    Protein that transports vitamin D in the bloodstream.

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    Active hormone forms of vitamin D

    The biologically active versions of vitamin D produced in the body.

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    Exposure to UV rays

    Initiates the process of vitamin D synthesis in the skin.

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    PKC Activation

    PKC is activated by a Gq GPCR pathway leading to increased intracellular calcium.

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    Extracellular Calcium

    Calcium outside cells that affects the secretion of PTH.

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    PTH Release Inhibition

    PKC and high intracellular calcium inhibit the release of PTH from secretory granules.

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    PTH and Low Calcium

    Low extracellular calcium levels relieve inhibition, resulting in increased PTH release.

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    PTH Actions

    PTH raises blood calcium levels by acting on bone, kidneys, and indirectly through Vitamin D.

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    PTH and Bone

    PTH stimulates bone remodeling by promoting resorption and mineralization.

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    PTH and Kidneys

    In kidneys, PTH increases calcium reabsorption and excretion of phosphate, sodium, and bicarbonate.

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    Vitamin D Activation

    PTH activates the conversion of Vitamin D to its active form.

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    Osteoclast Activity

    Chronic high PTH increases osteoclasts, promoting bone resorption and raising calcium levels.

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    Pulsatile Delivery of PTH

    Short bursts of PTH promote healthy bone growth and remodeling.

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    Provitamin D

    7-dehydrocholesterol, the precursor to vitamin D, found in skin.

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    Mono-hydroxylated Vitamin D

    The principal circulating form of vitamin D in the blood, bound to globulin.

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    Di-hydroxy Vitamin D

    The active form of vitamin D, about 10 times more active than mono-hydroxylated form.

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    1α Hydroxylase Enzyme

    An enzyme stimulated by PTH to convert inactive vitamin D to its active di-hydroxy form.

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    Regulation of Vitamin D

    PTH stimulates vitamin D production; inhibited by high calcium levels and feedback mechanisms.

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    Feedback Inhibition

    Vitamin D inhibits its own production when levels are sufficient to maintain balance.

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    Role of Phosphate in Vitamin D Regulation

    Low plasma phosphate stimulates the 1α hydroxylase enzyme for active vitamin D production.

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    Vitamin D Stimulators

    Insulin, sex steroids, and growth hormone trigger the production of active vitamin D.

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    Calcium Transporters

    Proteins that facilitate the absorption of calcium from the gut, activated by vitamin D.

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    Vitamin D Action in Gut

    Vitamin D enhances calcium and phosphate absorption in the gut via the VDR.

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    Nuclear Receptor (VDR)

    A receptor that vitamin D binds to in order to exert its effects on gene expression.

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    Bone Flux of Calcium

    Vitamin D promotes calcium flow into bones by increasing gut absorption.

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    Phosphate Absorption

    Vitamin D also stimulates phosphate absorption in the intestines, aiding in bone health.

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    Study Notes

    Calcium Homeostasis

    • Calcium concentrations are generally low intracellularly (10 nM) and high extracellularly (1 mM), for example in plasma.
    • The majority of calcium in the body is stored in bone (~1000 g).
    • Dietary calcium intake is approximately 1 g.

    Parathyroid Hormone

    • Produced by Chief cells in the parathyroid glands.
    • Stimulates calcium reabsorption in the kidneys.
    • Converts vitamin D to its active form (1,25 (OH)2 Vit D).
    • In bone, persistent high PTH levels activate osteoclasts, promoting bone resorption, whereas intermittent high levels cause bone deposition.

    Vitamin D

    • Derived from diet or UV exposure.
    • Regulates calcium levels.
    • Stimulates calcium absorption in the gut.
    • Acts synergistically with PTH to enhance calcium reabsorption in the kidneys.
    • Direct effects on bone cause calcium release (but indirect effects promote mineralization).

    Regulation of Calcium and Phosphate

    • Calcium and phosphate levels are linked, maintaining a specific ratio in blood.
    • Fluctuations in these levels induce effects in bone, kidneys and gut, mediated by PTH and Vitamin D.
    • Elevated plasma phosphate induces calcium-phosphate deposition in bone and other tissues, resulting in decreased plasma calcium.
    • Decreased calcium levels stimulate PTH secretion.

    Calcitonin

    • Primarily produced by the thyroid but also by the thymus, pituitary, adrenal glands, and brain.
    • Not involved in minute-to-minute serum calcium regulation.
    • Plays a role in maintaining bone density during pregnancy and lactation (and in suckling infants).
    • Stimulated by elevated plasma calcium levels.
    • Suppressed by hypocalcemia.
    • Stimulated by GI hormones (gastrin, cholecystokinin, or glucagon).
    • Acts to decrease plasma calcium and phosphate levels, inhibiting osteoclast activity.

    Calcium Pathologies

    • Vitamin D deficiency causes rickets (reduced bone mineralization in children) and osteomalacia (demineralized bone and reduced bone strength in adults).
    • Major risk factor for osteoporosis is declining estrogen in aging women.
    • Other endocrine disorders (hyperthyroidism, hyperparathyroidism, Cushing disease, etc.) can also be responsible.
    • Inadequate calcium intake, alcoholism, smoking, and sedentary lifestyle also increase risk.
    • Familial hypocalciuric hypercalcemia (FHH): A genetic mutation in the calcium-sensing receptor on PTH-producing Chief cells alters calcium setpoint.

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    Calcium Homeostasis PDF

    Description

    This quiz focuses on the role of calcium in the body, including storage, dietary intake, and the mechanisms by which parathyroid hormone regulates calcium levels. Test your knowledge on how these processes interact and the effects of hormone regulation on bone health.

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