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Questions and Answers
What is a potential effect of hypercalcemia on the body?
What is a potential effect of hypercalcemia on the body?
- Increased cardiac contractility
- Formation of bone fractures
- Increased muscle strength
- Mineralization of soft tissues (correct)
What percentage of total body calcium is found in bones and teeth?
What percentage of total body calcium is found in bones and teeth?
- 90%
- 70%
- 99% (correct)
- 50%
Which physiological function is NOT regulated by calcium homeostasis?
Which physiological function is NOT regulated by calcium homeostasis?
- Skeletal muscle contraction
- Blood coagulation
- Heart rate regulation
- Protein synthesis (correct)
What condition may result from low calcium levels in the body?
What condition may result from low calcium levels in the body?
Which hormone plays a key role in calcium regulation by acting on bones, the GI tract, and kidneys?
Which hormone plays a key role in calcium regulation by acting on bones, the GI tract, and kidneys?
What condition results in softening of bones in adults due to high PTH levels and vitamin D deficiency?
What condition results in softening of bones in adults due to high PTH levels and vitamin D deficiency?
What physiological effect does high extracellular fluid [Ca2+] have on muscle and nerve excitability?
What physiological effect does high extracellular fluid [Ca2+] have on muscle and nerve excitability?
What is a possible consequence of high concentrations of calcium in renal filtrate?
What is a possible consequence of high concentrations of calcium in renal filtrate?
In hypocalcemia, what is the expected response of calcium regulatory hormones?
In hypocalcemia, what is the expected response of calcium regulatory hormones?
What is the typical calcium level in a lactating dairy cow experiencing hypocalcemia?
What is the typical calcium level in a lactating dairy cow experiencing hypocalcemia?
Which tissues express calcium sensing receptors (CasR)?
Which tissues express calcium sensing receptors (CasR)?
What effect does high serum calcium levels have on PTH secretion?
What effect does high serum calcium levels have on PTH secretion?
Which receptor is classified as the classical PTH receptor?
Which receptor is classified as the classical PTH receptor?
How does PTH act on bone to increase plasma calcium levels?
How does PTH act on bone to increase plasma calcium levels?
Which of the following statements about PTH binding is correct?
Which of the following statements about PTH binding is correct?
What percentage of total calcium in the body is free ionized calcium (Ca2+)?
What percentage of total calcium in the body is free ionized calcium (Ca2+)?
Which tissue is NOT involved in the regulation of total body calcium levels?
Which tissue is NOT involved in the regulation of total body calcium levels?
Which hormone primarily increases blood calcium levels?
Which hormone primarily increases blood calcium levels?
What is the primary function of calcitonin in relation to calcium levels?
What is the primary function of calcitonin in relation to calcium levels?
What triggers the release of parathyroid hormone (PTH) from the parathyroid glands?
What triggers the release of parathyroid hormone (PTH) from the parathyroid glands?
Which of the following processes is NOT a function of PTH?
Which of the following processes is NOT a function of PTH?
How is parathyroid hormone (PTH) stored in the body?
How is parathyroid hormone (PTH) stored in the body?
Which statement best describes the complexed form of calcium in the body?
Which statement best describes the complexed form of calcium in the body?
What is the primary function of parathyroid hormone (PTH) in bone?
What is the primary function of parathyroid hormone (PTH) in bone?
How does PTH increase calcium reabsorption in the kidneys?
How does PTH increase calcium reabsorption in the kidneys?
What is the main effect of vitamin D on calcium levels in the body?
What is the main effect of vitamin D on calcium levels in the body?
Which of the following is NOT a direct stimulator of 1α-hydroxylase activity in the kidney?
Which of the following is NOT a direct stimulator of 1α-hydroxylase activity in the kidney?
What is the role of calcitonin in the regulation of calcium homeostasis?
What is the role of calcitonin in the regulation of calcium homeostasis?
Which of the following factors is MOST likely to increase calcitonin secretion?
Which of the following factors is MOST likely to increase calcitonin secretion?
What is the primary mechanism by which calcitonin lowers blood calcium levels?
What is the primary mechanism by which calcitonin lowers blood calcium levels?
Which of the following conditions is MOST likely to result in hypocalcemia?
Which of the following conditions is MOST likely to result in hypocalcemia?
Which of the following is a potential consequence of hypoparathyroidism?
Which of the following is a potential consequence of hypoparathyroidism?
Which of the following is a primary mechanism by which active vitamin D increases calcium absorption in the intestines?
Which of the following is a primary mechanism by which active vitamin D increases calcium absorption in the intestines?
Which of the following is TRUE about the regulation of 1α-hydroxylase activity by phosphate?
Which of the following is TRUE about the regulation of 1α-hydroxylase activity by phosphate?
What are the primary stimuli for PTH secretion?
What are the primary stimuli for PTH secretion?
Which two of the following hormones directly promote bone resorption?
Which two of the following hormones directly promote bone resorption?
How does Vitamin D regulate calcium homeostasis?
How does Vitamin D regulate calcium homeostasis?
Which of the following is NOT a role of calcitonin in calcium homeostasis?
Which of the following is NOT a role of calcitonin in calcium homeostasis?
What is the primary physiological role of calcitonin in regulating blood calcium?
What is the primary physiological role of calcitonin in regulating blood calcium?
Flashcards
Calcium Sensing Receptor (CaSR)
Calcium Sensing Receptor (CaSR)
A type of receptor that detects changes in blood calcium levels, triggering responses to maintain calcium homeostasis.
Parathyroid Hormone (PTH)
Parathyroid Hormone (PTH)
The main hormone involved in increasing blood calcium levels. It is secreted by the parathyroid glands.
Bone Resorption
Bone Resorption
A process that breaks down bone to release calcium into the bloodstream. This is one of the ways PTH increases blood calcium levels.
Osteoclast cells
Osteoclast cells
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PTH1 Receptor (PTH1R)
PTH1 Receptor (PTH1R)
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Calcium Homeostasis
Calcium Homeostasis
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Vitamin D Activation
Vitamin D Activation
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Calcitonin's Role
Calcitonin's Role
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Calcium Imbalance
Calcium Imbalance
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Calcium forms in the body
Calcium forms in the body
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Why is calcium important?
Why is calcium important?
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What is the parathyroid hormone (PTH) function?
What is the parathyroid hormone (PTH) function?
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How does PTH raise blood calcium?
How does PTH raise blood calcium?
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When is PTH released?
When is PTH released?
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How does PTH affect phosphate levels?
How does PTH affect phosphate levels?
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Where are the parathyroid glands located?
Where are the parathyroid glands located?
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What is the significance of the parathyroid glands?
What is the significance of the parathyroid glands?
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What is parathyroid hormone (PTH) and its function?
What is parathyroid hormone (PTH) and its function?
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What is active vitamin D and its function?
What is active vitamin D and its function?
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How does the body respond to low calcium (hypocalcemia)?
How does the body respond to low calcium (hypocalcemia)?
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How does the body respond to high calcium (hypercalcemia)?
How does the body respond to high calcium (hypercalcemia)?
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What are rickets and osteomalacia, and what causes them?
What are rickets and osteomalacia, and what causes them?
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PTH's Action on Kidneys I
PTH's Action on Kidneys I
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PTH's Action on Kidneys II
PTH's Action on Kidneys II
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PTH's Action on Vitamin D
PTH's Action on Vitamin D
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Vitamin D
Vitamin D
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Vitamin D Activation: Liver
Vitamin D Activation: Liver
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Vitamin D Activation: Kidneys
Vitamin D Activation: Kidneys
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1alpha-hydroxylase
1alpha-hydroxylase
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Vitamin D's Effect on Intestine
Vitamin D's Effect on Intestine
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Vitamin D's Effect on Bones
Vitamin D's Effect on Bones
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Calcitonin
Calcitonin
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Calcitonin's Effect on Bones
Calcitonin's Effect on Bones
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Calcitonin's Effect on Kidneys
Calcitonin's Effect on Kidneys
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Calcitonin's Effect on Intestines
Calcitonin's Effect on Intestines
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Hypoparathyroidism
Hypoparathyroidism
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Hyperparathyroidism
Hyperparathyroidism
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Study Notes
Parathyroid Glands and Calcium Regulation
- Parathyroid glands are small, oval-shaped structures located on the posterior surface of the thyroid gland.
- These glands produce parathyroid hormone (PTH).
- Calcium homeostasis is crucial for various physiological functions, including bone and tooth formation, skeletal integrity, intracellular signaling, nerve and muscle function, and blood clotting.
- Calcium levels in the body are tightly regulated within a narrow range (8.5-10.3 mg/dL) using various mechanisms to maintain the proper balance.
- Calcium exists in three forms: 45% ionized calcium (Ca2+), 50% bound to plasma proteins (primarily albumin), and 5% combined with anions like phosphate and sulfate. Only the ionized form (Ca2+) is biologically active.
- Ninety-nine percent of total body calcium is stored in bones and teeth; the remaining portion is found in soft tissues and extracellular fluid.
Calcium Homeostasis
- Calcium levels are tightly regulated by the interplay of several hormones: parathyroid hormone (PTH), vitamin D, and calcitonin.
- These hormones influence calcium absorption, release, and excretion across different tissues, including the gastrointestinal tract, bone, and kidneys.
Regulation of Calcium Levels (The Three 3's)
- The regulation of calcium levels within the body relies on the coordinated actions of three principal components:
- 3 Tissues: Gastrointestinal tract (dietary intake and fecal excretion), Bone (storage and release), and Kidneys (urinary excretion)
- 3 Processes: Calcium absorption (GI tract), Calcium resorption/deposition (bone), and Calcium reabsorption (kidney)
- 3 Principal Hormones: Parathyroid hormone (PTH), 1,25-dihydroxy Vitamin D3/Calcitriol (active vitamin D3), and Calcitonin
Parathyroid Hormone (PTH)
- PTH is a protein hormone (84 amino acids).
- Its primary functions include maintaining calcium homeostasis by increasing blood calcium levels. This is achieved through:
- Increasing bone resorption, releasing calcium from the bone matrix
- Increasing renal calcium reabsorption and reducing renal phosphate reabsorption
- Activating Vitamin D, enhancing calcium absorption in the intestines.
Vitamin D
- Vitamin D is a hormone, not a true vitamin, and is involved in calcium homeostasis.
- Two main sources: Synthesis in the skin from UV light, and dietary sources.
- Vitamin D must be converted to its active form, 1,25-dihydroxyvitamin D3 (calcitriol), through a two-step process occurring primarily in the liver and kidneys.
- 1,25-(OH)2 Vitamin D3 (Calcitriol) binds to specific receptors, influencing target genes for calcium homeostasis within cells.
Calcitonin
- Calcitonin is a peptide hormone (32 amino acids) produced by the parafollicular cells (C cells) of the thyroid gland.
- Calcitonin opposes the effects of PTH, helping regulate blood calcium levels by:
- Inhibiting osteoclast activity preventing the breakdown of bone (bone resorption)
- Decreasing the reabsorption rate of calcium in the kidneys to increase excretion
- Reducing calcium absorption from the intestines. Calcitonin lowers plasma calcium levels.
Disruption of Calcium Homeostasis
- Hypoparathyroidism: Rare condition caused by autoimmune disease, resulting in low PTH secretion, causing hypocalcemia (low blood calcium) and neuromuscular excitability issues (e.g., muscle spasms).
- Hyperparathyroidism: Usually due to a hypersecreting parathyroid tumor and high PTH levels, leading to hypercalcemia (high blood calcium). Chronic renal disease or vitamin D deficiency can sometimes cause hyperparathyroidism as well.
Calcitonin Secretion Regulation
- Plasma calcium level regulates calcitonin secretion. Low serum Ca2+ level inhibits calcitonin release, whereas high levels stimulate it.
Clinical Problems
- High PTH and Vitamin D Deficiency: Leading to bone demineralization. Rickets (in children) and osteomalacia (in adults) are common consequences.
- Low Calcium: Can lead to decreased muscle and nerve excitability, an increased risk of fractures, and kidney stones.
Actions in Response To Conditions
- Low calcium levels (Hypocalcemia): PTH is released to increase calcium levels. Vitamin D activation is also stimulated.
- High calcium levels (Hypercalcemia): Calcitonin is released to decrease calcium levels.
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