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
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2
Q

How does hypercalcaemia occur in those with bone mets?

A

Increased osteoclast activity

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3
Q

Investigations for hypercalcaemia

A
  • Bone profile
  • PTH - distinguish between malignancy vs hyperparathyroidism
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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
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5
Q

How quickly do bisphosphonates work?

A

take 6-12 months to work

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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

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7
Q
A
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