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Gonadal and Parathyroid Homones Objectives

To mobilize bone calium it plays an important role in

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to mobilize bone calium; it plays an important role in mineralization of bone, and abnormal bone results when vitamin D is deficient or its metabolism is defective PTH Parathyroid Hormone – fxn – (bone) increases Ca levels in response to low Ca levels by action on bone and kidneys (rising blood calcium – suppress PTH – decreases bone resorption, increases urinary loss, increased 1,25 dihydroxy vitamin D, decreases GI absorption) (falling blood calcium – stimulates PTH – increases bone resorption, decreases urinary loss, increases 1,25 dihydroxyvitamin D, increased GI absoption); in the bone, it decrease PO 4 - and increases vitamin D hormone; in the kidneys, it increases Ca retention, increases Ca retention, and stimulates the conversion of 25 hydroxy – Vitamin D to 1,25 dihydroxyvitamin D 3. Describe the clinical utility of Calcium and Ionized Calcium and how measurements of one or the other of these is beneficial to diagnosing certain illnesses. Hypercalcemia is the state of blood calcium levels above normal. Ionized (free Ca is the biologically active component of circulating calcium. Only ~ 50% of circulating calcium is present as ionized or free calcium. The remainder is complexed, or bound w/ serum proteins. So when total Ca is measured it needs to be measured in context w/ the other substances w/ which it is bound. Patients w/ low serum abumin would be expected to have a low total calcium and normal ionized calciu; the opposite it true for patients w. high serum albumin. Ionized calcium best correlates w/ the biological activity of calcium, as well as w/ symptoms of hypercalcemia or hypocalcemia, and thus the direct measurement of ionized calcium may often be more valuable clinically. The binding of ionized Ca to proteins is a fxn of pH: more Ca binds @ more alkaline pHs and less a
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Gonadal and Parathyroid Hormones – Objectives more acidic pHs; arterial blood (pH of 7.4) usually has more protein-bound Ca than venous blood which has a pH of 7.2 4. Describe the clinical utility of the Quantitative Beta HCG test and the crucial importance of this test to the physician.
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