calcium for mbbs students
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not for ur health:/ its a study based ppt. good luck doctorssTRANSCRIPT
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CalciumNormal calcium level9 – 11 mg/dl9.4 mg/dl or 2.4 mmol /L
Calcium importantContraction of skeletal musclesContraction of smooth musclesCardiac muscle contractionTransmission of nervous impulsesClotting of bloodSecretory activity of the glands
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CalciumExcitable tissues are very sensitive to changed calcium levelHypercalcemia→ depression and sluggishness of
nervous tissueHypocalcemia → increased excitability of nervous
tissue99 % calcium in the bones
Reservoir and store (buffer calcium level in ECF)0.1 % in the extra cellular fluid1 % in the intracellular fluid
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Phosphate85 % stored in bones14-15 % in the ICFLess than 1 % in ECF
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Three forms of calciumBound to plasma proteins41 %Nondiffusible Non ionizable
Bound to citrates, oxalates, phosphates etc9 %Diffusible Nonionizable
50 % ionic calcium IonicDiffusibleFunctionally the most important calcium
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PhosphateHPO4
-- 1.05mmol/L
H2PO4- 0.26 mmol/L
↓ pH → ↑ H2PO4-
↑ pH → ↑ HPO4—
Phosphate level expressed as total quantity of phosphorus in mg/dl
Normal levels Children 4-5 mg/dlAdults 3-4 mg/dl
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Hypocalcemia and tetanyHypocalcemia → ↑ excitability of nervous tissue↑ neuronal cell membrane permeability to Na+ Easy initiation of depolarization and action
potential50 % reduction in Calcium level → spontaneous
nervous impulses → propagation to skeletal muscles → spontaneous tetanic contraction of the skeletal muscles Tetany
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TetanyInitially spontaneous tetanic contraction of
the muscles of hand and forearm i.e. carpopedal spasm develops
Tetany develops at calcium level of about 6 mg/dl
Lethal at 4 mg/dl levelLatent tetany at level between 6 and 8Minor stimulus causes nervous discharge
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HypercalcemiaLevel 12 mg/dl
Depression of nervous systemSluggish reflexesDecreased QT interval of heartLack of appetiteConstipation
Level 17 mg/dlPrecipitation of calcium in all the tissues
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Calcium absorption and excretionDaily intake 1000 mgSecretion in GIT secretions 250 mgAbsorption 350 mgExcretion in the feces 900 mgNet absorption 100 mgExcretion in urine 100 mgCa ++ like all other bivalent cations are
very poly absorbedIts absorption requires activated vitamin
D
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Renal excretion of CalciumDaily excretion 100 mg99 % of filtered calcium absorbed
PCT. LH, DCT and CDDaily filtration 9980 mg Daily absorption 9880 mgHypocalcemia No excretionHypercalcemia proportionate excretion
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Renal excretion of PhosphateThreshold substanceNo excretion if level is below 1 mmol/LHigher level proportionate excretion
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