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MINERAL METABOLISM BONE (CLINICAL CORRELATIONS (Achondroplasia (short…

- - - - 6P + -OH + 10Ca2+ crystals
    - - osteocalcin
      - sialoprotein
  - - - support & protection
    - - hematopoiesis
    - - mineral storage, acid-base balance
- - - - growth plate appearance
      - ossification of carpals
      - confirm diagnosis
        
        hormone imbalance
        
        early fusion of growth plates
        
        nutrition deficiency
        
        chronic illness (autoimmune)
  - - - osteoporosis
      - low radiation
      - bone density & area
      - reproducible
    - - cheap
      - not accurate enough
- - - - shoe size :small_red_triangle: noticed 1st
  - - - soft bones
      - poor mineralization
      - GI issues (no absorption)
    - - bowed legs
      - :heavy_minus_sign: Ca2+
      - osteomalacia in growing bones
      - wider epiphyses
        
        wrist
        
        knee
        
        ribs
        
        rachitic rosary
    - - low bone mineral density
      - pathological fractures
      - stooped/hunched over
      - menopause/age associated
- - - - osteoblasts
      - markers
        
        serum alkaline phosphatase
        
        serum osteocalcin
    - - osteoclasts
      - markers
        
        urinary collagen telopeptides
        
        urinary hydroxyproline (collagen AA)
    - - intestines
        
        absorption of Ca2+ & P
        
        99% Ca2+ & 85% P in bones
        
        50% free Ca++
        
        Ca bound with :arrow_up: pH
        
        40% bound to albumin
        
        10% paired w/anions
      - kidneys
        
        reabsorption
  - - - :arrow_up: PTH = :arrow_up: [Ca2+]ext, :arrow_up: resorption
      - :arrow_down: PTH : :arrow_down: [Ca2+]ext., :arrow_down: resorption
    - - growth
      - growth plate maturation
      - menopause: :arrow_up: resorption/breakdown
    - - growth
    - - :check: Ca2+ absorption
    - - :arrow_down: Ca2++
      - :forbidden: resorption/osteoclasts