Hypercalcaemia Flashcards
1
Q
systems review
A
general - lethargy, anorexia
GI - N/V, constipation
Uro - polydipsia + polyuria
CNS - confusion, fits, coma
cancer - recent weight loss, anorexia
exclude fever + obvious infectious cause - neutropenic sepsis
2
Q
PMH
A
known cancer - type (esp myeloma, breast, lung), date DDx, stage (>20% advanced cancer), treatment (inc SEs)
mood
3
Q
specific meds taken
A
thiazides
lithium
4
Q
investigations
A
corrected serum Ca (<=2.65)
U&Es
PTH, bone scan
5
Q
management
A
aggressive rehydration - 4-6L 0.9% NaCl in 24hrs
IV bisphosphonate = 4mg zoledronic acid over 15 mins
(2nd line: prednisolone, calcitonin)
