Gonadal and Parathyroid Homones Objectives

Pregnancy tests test for the prescence or absence of

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Pregnancy tests test for the prescence or absence of HCG (if HCG >25 then test would be +); it is a hormone produced by the placenta; levels can be detected 6 days after conception; rises pretty rapidly throughout 12 wks of development; if suspected of being 8 – 10 wks and there is spotting present – then order HCG to see if they have decreased levels – it they do it could be a miscarriage; a sharp decline in HCG indicates miscarriage; Method: Chemiluminescence; sometimes see HCG ordered on male/female that is past child bearing age to detect tumors 5. Explain the Vitamin D synthesis pathway. Vitamin D received by skin from sun (UV light) converts cholesterol to vitamin D 3 which in the liver is acted on by enzymes and converted to the storage form 25 hydroxy vitamin D which in the kidneys is acted on by enzymes and converted to the active form of vitamin D, 1,25 dihydroxyvitamin D, which in the intestines increased calcium, magnesium, and phosphorus absorption and increases production via parathyroid hormones; and affects the kidneys
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Gonadal and Parathyroid Hormones – Objectives 6. List and explain causes for hypercalcemia and hypocalcemia. HYPERCALCEMIA – causes primary hyperparathyroidism; caused by increased vitamin D, multiple myeloma (malignancy of B-lymohocytes), drugs (thiazide diuretics – hypertension – urinary retention of Ca; lithium – affects PTH secretion; vitamin A – suppresses PTH and 1,25 dihydroxyvitamin D) HYPOCALCEMIA – causes secondary hyperparathyroidism (increases PTH in response to low Ca levels; caused by hypoparathyroidism – parathyroid dysfunction – decreased PTH secretion – accidental removal or autoimmune; decreased vitamin D 7. List risk factors and treatment options for osteoporosis. Osteoporosis: decrease in bone mineralization; 20-25 million affected; 4:1 Female: Male Trx : modify risk factors, increased vitamin D and Ca, fall prevention education Risk Factors : post-meopausal females Men w. hypogonadism Age Family hx Lean body mass Caucasian or Asia Smoking Alcoholism Glucocorticoid Excess Hyperparathyroidism Vitamin D metabolism Hyperthyroidism Bone malignancies
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