Case 5 - Hypercalcaemia Flashcards
1
Q
How does hypercalcaemia present?
A
Stones, goans, bones, psychic moans
- Kidney stones
- Bone pain
- Abdominal pain/constipation
- Nausea and vomitting
- Depression
2
Q
How does hypercalcaemia occur in those with bone mets?
A
Increased osteoclast activity
3
Q
Investigations for hypercalcaemia
A
- Bone profile
- PTH - distinguish between malignancy vs hyperparathyroidism
4
Q
Acute management of hypercalcaemia
A
- Correct dehydration with 0.9% saline
- Bisphosphonates IV - prevent resorption of bone, inhibits osteoclasts
Eg Zoledronic acid or Pamidronate
5
Q
How quickly do bisphosphonates work?
A
take 6-12 months to work
6
Q
Common causes of hypercalcaemia
A
- Malignancy - bone mets, myeloma or PTHrP
- Primary hyperparathyroidism
- Sarcoidosis
- Vitamin D intoxication
- Thyrotoxicosis
- Lithium
- Tertiary hyperparathyroidism
2 main in bold
7
Q
A