Exam 2 Renal: CKD-MBD (W)

Secondary Hyperparathyroidism of CKD: Cincalet should not be initiated if serum calcium is ____

Fractures, tendon rupture, bone pain from metabolic bone disease, muscular pain & weakness is what type bone disease?

The development of CKD-MBD starts late in the course of CKD

Why don't we use the phosphate binder, calcium citrate?

Which of the following binders for MBD must you administer two hours prior to other meds

FGF23 is secreted by osteocytes in bone in response to ___ phosphate concentration.

which of the following regarding Calcium carbonate (Tums®, Oystercal®) is incorrect?

Chronic hypermagnesaemia inhibits both PTH synthesis and impairs PTH actions in target tissues.

PTH secretion is regulated via the calcium sensing receptor and the vitamin D receptor by mediating changes in _____

When to treat patients with CKD-MBD?

When looking at bone manifestations the gold standard is an ECHO and for vascular calcifications it is Bone biopsy.

Warning: Cincalet increases phosphate and calcium levels

Which of the following pharmacologic Vitamin D supplementation statements is incorrect?

High Ca, active vitamin D levels,& low phosphate levels fall act as a negative feedback on the PTH gland = homeostasis

____ acts to increase gastrointestinal absorption of calcium and phosphate.

Secondary Hyperparathyroidism of CKD What are the monitoring parameters for Cincalet?

Administration of calcitriol leads to what?

Which of the following is known as a calcium based binder?

What leads to mineral bone disorders?

The main actions of PTH are to increase plasma calcium and decrease plasma phosphate, which is mediated through ____

FGF-Klotho complexes are found in the distal tubule, although phosphate excretion occurs at the proximal tubules.

Bone buffering causes a significant loss of bone calcium, with resulting osteopenia and osteomalacia

Spelling BEE TIME: Which of the following is an Insoluble, polymeric ion binder & is selective for phosphate over Ca

calcium is reabsorbed against an electrochemical gradient via an active process in the ____ and ___

Which of the following is not correct when talking about the nonpharmacologic treatment option for CKD-MBD?

Which of the following is correct when talking about phosphate binders in the treatment of CKD-MBD?

Which of the following pharmacologic options for CKD-MBD would be a chewable option for the patient?

Which of the following options would be the BEST option for a patient with CKD, MBD and Anemia?

Which of the following iron based binders for MBD is also used in iron deficient anemia?

Which of the following statements regarding Cincalet is incorrect?

In CKD, vitamin D receptors (VDR) in parathyroid glands are down regulated as a consequence of ___ levels of calcitriol

Which of the following is a vitamin D2 analogue and is ACTIVE?

Extra Skeletal --> Imbalance of calcium can affect soft tissues, particularly vessels, heart valves and skin.

Hyperphosphatemia is associated with which of the following?

Which of the following is correct regarding the monitoring of Vitamin D supplementation?

The use of PO4 binders is for the management of ?

High doses of calcium-based phosphate binders may contribute to metastatic calcification and bone disease

What is an adverse effect that will happen if chewable tablets are swallowed?

Which of the following is not a stated lab abnormality from Madar's lecture with CKD-MBD?

In the kidney, passive reabsorption of calcium occurs in the ___ and ____ of the loop of Henle.

Which of the following is correct regarding the PTH function in the kidney

What are the changes that occur in CKD-MBD?

FGF-Klotho complexes causes an increase in serum calcium

Which of the following is correct regarding hyperphosphatemia in CKD?

___ and __ has a less risk of hypercalcemia and hyperphosphatemia and should not be d/c if elevation occurs of Ca & Phos

PTH promotes bone formation by direct action on ___ increasing both the number and activity of these cells

PTH promotes recruitment and differentiation of osteoclasts therefore leading to what?

Adrenaline and histamine both stimulate PTH release

Hyperphosphatemia does not become evident until the GFR has decreased to between 25 and 40% of normal (CKD4)

Intestinal absorption of calcium occurs in the ___ and more distally in the colon.

Secondary Hyperparathyroidism of CKD the only oral med approved is Cincalet for patients on dialysis ONLY

Osteoclasts have no PTH receptors and the PTH effect is mediated via cytokines and other factors.

Which of the following labs would NOT be useful in the diagnosis of CKD-MBD?

Calcitriol deficiency indirectly leads to ___ and causes skeletal resistance to the calcemic actions of PTH in CKD

Spelling Bee Time: Which of the following Vit. D supplementations has the shortest half life?

What are the main actions of PTH?