chem path
●Calcium metabolism ●Factors affecting calcium intake and loss ●Concept of plasma calcium and albumin correction ●Control of plasma calcium ●Hypercalcaemia ●Hypocalcaemia ●Phosphate metabolism ●Magnesium metabolism ●Uric acid
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Time limit: 50 minutes
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Question 1
What is the main role of calcium in the body?
Explanation
Calcium is primarily known for its role in maintaining bone health, as it is an essential component of bone structure.
Question 2
What does hypocalcaemia refer to?
Explanation
Hypocalcaemia is defined as having abnormally low levels of calcium in the blood.
Question 3
Which factor is NOT associated with calcium metabolism?
Explanation
Body temperature does not play a role in calcium metabolism, whereas vitamin D levels, parathyroid hormone, and dietary intake are critical.
Question 4
What is a common effect of hypercalcaemia?
Explanation
Hypercalcaemia can cause symptoms such as nausea and vomiting due to high calcium levels in the blood.
Question 5
What does plasma calcium correction with albumin involve?
Explanation
Plasma calcium correction with albumin involves adjusting the observed calcium levels based on the amount of albumin present in the blood.
Question 6
A patient presents with symptoms of muscle weakness and confusion. Blood tests reveal low plasma calcium levels, confirming hypocalcaemia. Considering the factors affecting calcium intake and loss, which intervention would most effectively increase the patient's plasma calcium levels?
Explanation
Administering oral calcium supplements directly combats hypocalcaemia by increasing calcium levels in the plasma. Increasing dietary phosphate can lead to further complications, as phosphate can bind calcium and worsen hyocalcaemia. Reducing fluid intake is counterproductive since proper hydration is crucial for kidney function and calcium regulation. A high-protein diet might raise albumin levels but does not address the immediate need for calcium.
Question 7
During a clinical lecture, a resident discusses the treatment options for a patient diagnosed with hypercalcaemia. Which treatment strategy should be prioritized based on the physiological mechanisms controlling plasma calcium?
Explanation
Bisphosphonates are effective in treating hypercalcaemia by inhibiting osteoclast activity, thus reducing bone resorption and lowering plasma calcium. Increasing calcium supplements would only worsen hypercalcaemia. While dietary phosphate may aid in calcium regulation through the kidneys, it is not a primary treatment method. Prescribing magnesium may stabilize cellular processes but does not directly address the elevated calcium levels.
Question 8
[Case Scenario] A 55-year-old male presents to the clinic with symptoms of fatigue, muscle weakness, and increased thirst. His lab results show elevated calcium levels, and a diagnosis of hypercalcemia is made. The physician discusses potential causes of his condition, including excessive calcium intake and other factors that may alter calcium metabolism. Question: Which of the following factors is most likely to exacerbate this patient's hypercalcemia?
Explanation
In this case, the patient's elevated calcium levels are likely due to excessive dietary calcium intake from supplements, which is a known cause of hypercalcemia. Other factors listed do not correlate directly to an increase in serum calcium levels.
Question 9
[Case Scenario] A 30-year-old female presents with muscle cramps and tingling in her fingers. Lab tests reveal low serum calcium levels, diagnosed as hypocalcemia. The physician explains that there are various factors contributing to her condition, including renal function and dietary intake. Question: Which of the following factors could potentially contribute to her hypocalcemia?
Explanation
This scenario illustrates that inadequate dietary vitamin D intake can significantly affect calcium absorption, leading to conditions such as hypocalcemia. Other listed factors are either unrelated or do not have a direct connection to causing low serum calcium levels.
Question 10
[Case Scenario] A 45-year-old man comes to the emergency department with elevated uric acid levels and joint pain consistent with gout. His physician suspects that the patient's hyperuricemia may be related to both his calcium and phosphate metabolism. Question: What would be the best interpretation of the relationship between uric acid and calcium metabolism in this patient?
Explanation
In this case, it is important to understand that uric acid and calcium metabolism are regulated by different pathways in the body, and therefore, an alteration in one does not directly impact the other. This highlights the need for comprehensive metabolic assessments in patients with multiple conditions.