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Questions and Answers
What physiological effect results from Trousseau’s sign?
What physiological effect results from Trousseau’s sign?
Which hormone is released by the parafollicular cells of the thyroid gland?
Which hormone is released by the parafollicular cells of the thyroid gland?
Which of the following best describes the function of calcitonin?
Which of the following best describes the function of calcitonin?
What are the key organs involved in the activation of vitamin D3?
What are the key organs involved in the activation of vitamin D3?
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What is the primary effect of parathyroid hormone (PTH) on calcium levels?
What is the primary effect of parathyroid hormone (PTH) on calcium levels?
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In which conditions does hyperparathyroidism lead to tetany?
In which conditions does hyperparathyroidism lead to tetany?
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What is the source of vitamin D3 in the human body?
What is the source of vitamin D3 in the human body?
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Which statement accurately describes the function of vitamin D3?
Which statement accurately describes the function of vitamin D3?
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What is the primary function of Parathyroid Hormone (PTH)?
What is the primary function of Parathyroid Hormone (PTH)?
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Which of the following actions describes the immediate effect of PTH on the skeleton?
Which of the following actions describes the immediate effect of PTH on the skeleton?
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What is the role of PTH in the kidney?
What is the role of PTH in the kidney?
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How does PTH indirectly influence calcium absorption in the intestine?
How does PTH indirectly influence calcium absorption in the intestine?
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What long-term effect does PTH have on bone structure?
What long-term effect does PTH have on bone structure?
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What effect does PTH have on plasma phosphate levels?
What effect does PTH have on plasma phosphate levels?
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Which cells in the parathyroid glands secrete Parathyroid Hormone (PTH)?
Which cells in the parathyroid glands secrete Parathyroid Hormone (PTH)?
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What is the consequence of increased osteoclast activity due to PTH?
What is the consequence of increased osteoclast activity due to PTH?
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What primarily regulates the secretion of parathyroid hormone (PTH)?
What primarily regulates the secretion of parathyroid hormone (PTH)?
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What occurs when plasma Ca2+ levels are high?
What occurs when plasma Ca2+ levels are high?
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Which statement about hypercalcemia in primary hyperparathyroidism is true?
Which statement about hypercalcemia in primary hyperparathyroidism is true?
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What is the effect of increased PTH secretion on calcium resorption?
What is the effect of increased PTH secretion on calcium resorption?
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Which condition is characterized by osteitis fibrosa cystica?
Which condition is characterized by osteitis fibrosa cystica?
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What is the primary consequence of renal stone formation due to primary hyperparathyroidism?
What is the primary consequence of renal stone formation due to primary hyperparathyroidism?
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What is the relationship between plasma calcium and phosphorus concentrations?
What is the relationship between plasma calcium and phosphorus concentrations?
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What physiological response occurs with low ionized plasma calcium levels?
What physiological response occurs with low ionized plasma calcium levels?
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What physiological effect does hypercalcemia have on neuromuscular excitability?
What physiological effect does hypercalcemia have on neuromuscular excitability?
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Which gastrointestinal disorder is associated with prolonged hypercalcemia?
Which gastrointestinal disorder is associated with prolonged hypercalcemia?
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What is the most common cause of hypoparathyroidism?
What is the most common cause of hypoparathyroidism?
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What triggers manifest tetany in hypoparathyroidism?
What triggers manifest tetany in hypoparathyroidism?
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Which of the following symptoms is NOT a manifestation of hypoparathyroidism?
Which of the following symptoms is NOT a manifestation of hypoparathyroidism?
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What condition is characterized by hypocalcemia and hyperphosphatemia?
What condition is characterized by hypocalcemia and hyperphosphatemia?
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Which of these conditions can lead to the development of hypocalcemia?
Which of these conditions can lead to the development of hypocalcemia?
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Which condition results from accidental removal or damage to parathyroid glands during surgery?
Which condition results from accidental removal or damage to parathyroid glands during surgery?
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Study Notes
Endocrine System Overview
- The endocrine system is a complex network of glands responsible for producing and releasing hormones into the bloodstream.
Parathyroid Gland
- Typically, four small glands located on the posterior aspect of the thyroid gland.
- Contains chief cells that secrete parathyroid hormone (PTH).
- PTH's primary function is regulating calcium (Ca²⁺) concentration in the extracellular fluid (ECF).
- Essential for life due to its role in calcium regulation.
- This hormone increases plasma calcium levels and decreases plasma phosphate levels.
PTH's Action on Target Organs
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1. Skeleton: PTH directly affects bone, increasing bone resorption and releasing ionic calcium and phosphates into the bloodstream.
- Immediate effect: occurs within minutes, PTH stimulates calcium pumps in the bone to release calcium.
- Delayed effect: takes days to weeks, PTH increases osteoclast activity to break down bone and release Ca2+ into the bloodstream.
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2. Kidneys: PTH directly stimulates calcium reabsorption and phosphate excretion in the kidneys.
- It also increases the formation of active vitamin D3 (calcitriol).
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3. Intestine: PTH indirectly increases calcium absorption via vitamin D3 formation.
- Vitamin D3, in turn, increases calcium absorption from the intestine through increasing calbindin production.
Regulation of PTH Levels
- PTH levels are primarily regulated by blood calcium levels, not other glands.
- A calcium sensing receptor on parathyroid cells monitors blood calcium levels.
- High calcium levels inhibit PTH secretion, while low calcium levels increase it.
- This is a negative feedback mechanism.
Relationship between Calcium and Phosphorus
- Plasma phosphorus concentration is inversely related to calcium concentration.
- Their product (Ca²⁺ × PO₄⁻³) remains relatively constant, this is called the solubility product.
Abnormalities of Parathyroid Hormone Secretion
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Hyperparathyroidism
- Causes: Typically a parathyroid gland tumor (adenoma). Compensatory hypertrophy can occur due to vitamin D deficiency or renal failure.
- Manifestations: Bone disease (weak bones, spontaneous fractures), kidney stones, neuromuscular issues (muscle weakness, decreased alertness, poor memory), abdominal pain, nausea, vomiting & constipation, and cardiac arrhythmias.
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Hypoparathyroidism
- Cause: Accidental removal or injury of parathyroid glands during thyroid surgery (thyroidectomy).
- Manifestations: Hypocalcemia, hyperphosphatemia, and tetany (spastic muscle contractions).
Hypocalcemia Causes
- Hypoparathyroidism
- Renal failure
- Alkalemia (decreased ionized Ca²⁺)
- Vitamin D deficiency
Manifestations of Hypocalcemic Tetany (Symptoms)
- Manifest tetany: Occurs when blood calcium levels fall below 7 mg%. Characterized by muscle twitching, tonic and clonic spasms, and generalized convulsions.
- Latent tetany: Blood calcium levels are between 7-8.5 mg%. Tetanic contractions are absent at rest but may occur in stress, hyperventilation, or pregnancy; manifested by provocative tests.
Hypoparathyroidism Treatment
- Manifest tetany: Calcium gluconate via intravenous injection
- Latent tetany: Calcium rich diet and vitamin D3 supplementation.
Calcium Homeostasis
- The interconnected roles of bone, small intestine, and kidneys in calcium regulation.
Role of Calcium in Physiologic Processes
- Bone and teeth formation, neuromuscular excitability, muscle contraction, synaptic transmission, hormone secretion, intracellular communication, blood clotting, and maintenance of tight junctions.
Hormonal Control of Calcium
- Parathyroid hormone (PTH), 1,25-dihydroxycholecalciferol (vitamin D3), and calcitonin play a key role in regulating blood calcium levels.
Vitamin D3
- Obtained from diet (e.g., fatty fish, egg yolks) and formed in the skin from UV light.
- Activated in the liver and kidneys.
- Increases calcium absorption in the intestine, kidneys, and bone.
Calcitonin
- Released by parafollicular cells of the thyroid gland
- Primarily regulates calcium absorption and excretion through it's interaction with the bone and kidneys.
- Antagonistic to PTH (regarding calcium) but similar to PTH (regarding phosphorus).
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Description
This quiz provides an overview of the endocrine system, focusing on the parathyroid gland and its crucial role in calcium regulation. It delves into the functions of parathyroid hormone (PTH) on target organs, including the skeleton and kidneys. Test your understanding of how the endocrine system maintains homeostasis through hormonal regulation.