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Minerals-calcium, phosphorus, iron..pptx
A 32-year-old vegetarian school teacher presented with symptoms of fatigue, breathlessness, and pallor, revealing severe anemia with a hemoglobin level of 7.5 g/dl. The document details the importance of minerals like calcium and phosphorus in the body, their sources, absorption mechanisms, and effects of deficiency or excess, highlighting the role of specific hormones in regulating these minerals. It also discusses the functions and absorption of iron, distinguishing between heme and non-heme iron, and the consequences of iron deficiency and overload.
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Minerals-calcium, phosphorus, iron..pptx
- 1.
- 2. • 32y oldschool teacher presents in out patient dept, with the c/o excess tiredness, breathlessness, loss of appetite, nervousness, and palpitations. • On examination, she was very pale, heart rate was increased. • History revealed that she was hard core vegetarian, and she frequently skipped her meals or breakfast because of her busy schedule. • Blood reports were normal, except for Hb was 7.5 gms/dl
- 4. Dr. ganesh, Dept ofbiochemistry.
- 5. Minerals are inorganiccompounds that are required for the body as one of the nutrients
- 6. A few mineralsare essential for the normal growth, development and maintenance of health. Therefore, they must be included in the diet. When the intake in the diet of these minerals is below the required amount, deficiency symptoms appear.
- 7. Macrominerals Requirement is more than100mg/day Ca++, P, S, Mg, Cl, Na, K. Microminerals Requirement is less than 100mg/day Fe, Cu, Zn, Mo, I, Fl, Cr, CO, Mn
- 8. Calcium Phosphor ous Iron Copper Iodine ZincFluoride Magnesiu m Manganese Selenium
- 9. Certain minerals aretoxic to the body. They are- lead, mercury, arsenic, aluminium and cadmium.
- 11. Calcium is themost abundant mineral in the body Human body contain about 1-1.5 kg of calcium
- 12. Sources and RDA Metabolismof calcium Functions of calcium Regulation of plasma calcium Disorders of calcium metabolism
- 14. milk (cow’s milk –100 mg/100ml) cereals, fish, leafy vegetables , beans etc. Meat is a poor source of Ca.
- 15.
- 16. Formation of bone and teeth Nerve conducti on Muscle contracti on Activatio nof enzymes Blood coagulation Secretion of hormone s As a second messeng er Action on myocardium
- 17. Calcium is neededfor the formation of bones and teeth. Calcium is present in bones along with phosphate as calcium hydroxy apatite . Calcium as compound of phosphate occurs in the bone matrix and, the enamel, dentin and cementum of teeth and renders physical strength to them. Constitue nt of Bones and Teeth
- 18. Ca interacts withtroponin c triggering muscle contraction. It also activates enzyme ATPase and increases the interaction between actin and myosin. Muscle Contrac tion
- 19. Ca (coagulation factorIV) mediates several reactions of blood coagulation cascade. Blood Coagulation
- 20. Ca2+ is neededfor the direct activation of enzymes such as lipase, ATPase, succinate dehydrogenase, etc. Certain other enzymes get activated via a regulatory protein – calmodulin. Activatio n of Enzymes
- 21. Ca is necessaryfor nerve impulse transmission from presynaptic to postsynaptic region. Nerve Impulse Transmiss ion
- 22. Ca2+ reduces membranepermeability and thereby decreases neuromuscular excitability. A fall in serum Ca2+ raises the neuromuscular excitability producing spasms of muscles in hands, feet, face and larynx – hypocalcemic tetany. Neuromusc ular Excitability
- 23. Ca acts assecond messenger( also third messenger) for certain hormones to mediate their action. E.g. Epinephrine. It also acts as third messenger for certain other hormones e.g. ADH. Acts as Second Messenger in Hormone Action
- 24. Ca is alsoneeded for the secretion or release of certain hormones such as insulin, PTH, calcitonin. Secretion of Hormone
- 25. Ca acts onmyocardium and prolongs systole. Action on Heart
- 26. Ca regulates microfilamentand microtubule mediated processes such as endocytosis, exocytosis and cell motility. Endocyto sis, Exocytosi s and Cell Motility
- 27. Ca2+ influences thetransport of water and several ions and thus nfluences membrane structure. Membrane Transport and Structure
- 28.
- 29.
- 30. Calcium absorption isincreased by Calcitriol PTH High protein diet Optimum Ca:P ratio Acidic pH Bile salts Absorption is decreased by Alkaline pH Phytates and oxalates Steatorrhea Vitamin D deficiency Excess phosphate in diet
- 31. Calcium absorption occurs by 1,25(OH)2D3 mediated mechanism. Entersnucleus of int.mucosal cell Stimulates the synthesis of mRNA Synthesis of CALBINDIN(Ca binding protein) Binds with Ca Active form of Vit D Absorption of Ca
- 32.
- 34. Stools Unabsorbed calcium in the diet 60– 70% Urine 50- 200mg/day Sweat 15mg/day
- 35. Human body contain about 1-1.5 kgof calcium 99% present in bone and teeth 1% in soft tissue and extracellular fluid Plasma calcium : 9-11mg/100ml
- 36. 50% 40% 10% % Free or ionized calcium Proteinbound complex with anions
- 37. Ca level inblood is maintained at a narrow range of 9 – 11mg/dL.
- 38.
- 39.
- 40. VIT D Increases bone mineralisatio n by++ osteoblasts Increases the renal reabsorption Increases plasma Ca Increases absorption from intestine by calbindin
- 41. PTH mobilises Ca from bones toblood, bone demineralisa tion by ++ osteoclasts Increases plasma Ca Increases absorption from intestine by Formatn of active Vit D In Kidney Increases the renal reabsorption by Formatn of active Vit D In Kidney
- 42. Calcitonin inhibiting resorption ofbones, by increasing the activity of osteoblasts and decreasing activity of osteoclasts. Decreases plasma Calcium
- 44.
- 45.
- 46. Inadequate intake, rickets Accidentalsurgical removal of parathyroid glands Alkalosis
- 47.
- 48. When Ca levelis less than 7 mg % it results in a life threatening condition, tetany. Symptoms of tetany – spasms of muscles in hands, feet, face, larynx, etc and convulsions – are due to increased neuromuscular irritability.
- 49. Contraction of facialmuscle in response to tapping the facial nerve Chvostek’s sign Carpal spasm occurring after occlusion of the brachial artery with BP cuff for 3 min Trousseau’s sign
- 50. Severe symptomatic cases Intravenous Calcium gluconate Asymptomaticcases Calcium carbonate Vitamin D
- 51.
- 52. When serum Calevel is more than 11 mg % it is known as hypercalcemia. Hyperparathyroidism-increased PTH Hypervitaminosis D Vit D toxicity
- 53. Metastatic calcification Neurological symptoms Renalsymptoms Gastrointestinal symptoms Cardiac arrhythmias
- 54. Treatment of primarydisease Calcitonin
- 56. • About 80%of this occurs in combination with Ca in the bones and teeth • about 10% found in muscles and blood in association with proteins and • remaining 10% seen distributed in various chemical compounds of the body Adult body has about 1kg of phosphorus ( as phosphate ), and is seen in every cell of the body.
- 57. Sources RDA Metabolism FunctionsDisorders
- 59.
- 60.
- 61.
- 62. Phosphorus absorption increased by •Bile salts •Acidity •PTHand vitamin D •Calcium Phosphorus absorption decreased by •High Ca: P ratio •Phytates •Alkalinity •Magnesium and aluminium
- 63. Formation of boneand teeth Production of high energy compounds DNA and RNA synthesis Synthesis of coenzymes Synthesis of phosphoproteins and phospholipids Activation of enzymes by phosphorylation Acid base balance
- 64. Human body contain about 840gm of phosphorus 80%present in bone and teeth 20% in other tissue Plasma phosphorus : 3 – 4mg/100ml
- 65. 3 -4mg/dl ADULT 5 –6mg/dl CHILDREN
- 66.
- 67. VIT D Increases absorption from intestine Increases the mobilization from bone Increases therenal reabsorption Increases plasma phosphorus
- 68. PTH Decreases the renal reabsorption Decreasesplasma phosphorus
- 69. Calcitonin Inhibits bone resorption Decreases the renalreabsorption Decreases plasma phosphorus
- 70.
- 71.
- 72. Rickets (deficiency ofvit D in children) Hyperparathyrodism Fanconi syndrome – increased urinary excretion of phosphate due to its defective renal reabsorption
- 73.
- 74. Hypervitaminosis D Hypoparathyrodism Renal failure– due to decreased urinary excretion of phosphate Hemolysis
- 77. heme iron • Hemoglobin(Oxygen carrier) Myoglobin (Oxygen storage) • Cytochromes • cytochrome p450 • Catalase • tryptophan pyrrolase Non heme iron •Succinate DH •Xanthine oxidase •Aconitase •Transferrin( transport of iron ) ,Ferritin(iron starage ), Iron suphur protein of mitochondrial ETC
- 78.
- 79. Iron exerts itsfunctions through the compounds in which it is present. 1.Hemoglobin is required for the transport of O2 and CO2. Myoglobin for O2 storage in muscles. 2.Cytochromes and certain non-heme iron proteins are necessary for electron transport chain and oxidative phosphorylation 3.As a component of many enzymes like Peroxidase , Xanthine oxidase, tryptophan pyrrolase etc
- 80.
- 81.
- 82. Absorption Transport StorageExcretion
- 83.
- 84. Phytates and phosphate Gastrointestinal diseases Ferrous form Ascorbic acid Cysteine HCl Factorsincreasing iron absorption Factors decreasing iron absorption Antacid, achlorhydria
- 86. Ferric Iron Fe+++ Ferrous Iron Fe++ Heme iron VitC Hcl Fe++ Fe+++ Ferritin Apoferritin Heme iron Fe++ Fe++ Fe+++ Transferrin Fe+++ Lumen Mucosal cell Blood Ceruloplasmin Apotransferrin Ferroxidase Ferroreductase diet
- 87. Storage Form Ferritin Hemosiderin StorageSite Liver Intestinal mucosal cell Spleen Bone marrow
- 88.
- 89. Excretion of ironis very negligible. Iron is the only element whose level in the body is controlled at absorption level (not by excretion) Hence iron is aptly called as “ONE WAY ELEMENT”
- 90.
- 91. Regulation of body ironis at the level of absorption at INTESTINAL MUCOSAL CELLS As per this theory, iron absorption is mediated by intracellular Fe carrier protein.
- 92. Presence of sufficientamounts of Fe in the body, Keeps this protein in saturated state Consequently, Fe absorption into mucosal cell is blocked.
- 93. When there isFe deficiency state this protein is in unsaturated state Fe absorption into mucosal cell is favoured. Mucosal block is removed
- 94.
- 95.
- 96.
- 98.
- 99. Decreased hemoglobin Microcytic hypochromicanemia Decreased serum iron Increased serum total iron binding capacity Decreased plasma ferritin
- 100. Normal RBCs Small sized RBCscontaining less Hb
- 101. Treatment of underlyingcauses Treating Hookworm Controlling bleeding Administration of iron preparations Orally I.V
- 103. Repeated blood transfusions Genetic-- increased absorptionof iron from intestine Eg: African Bantu tribe hemosiderosis—they cook and brew beer in iron pots Eg: for thalassemia, hemophilia etc.
- 104. Haemosiderosis Increase in iron storesas haemosiderin Without associated with tissue injury Haemochromatosis Excessive deposition of iron in the tissue Associated with tissue injury
- 105. Deposition of hemosiderinin organs leading to organ damage. Liver cirrhosis liver Bronze pigmentation of skin skin Diabetes pancreas Heart failure heart
- 106.
- 107. Desferoxamine- a chelatingagent phlebotomy