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Y4 Cancer Care > Hypercalcaemia > Flashcards

Hypercalcaemia Flashcards

1
Q

What is Malignant Hypercalcaemia?

A

Serum Ca of 2.6+, secondary to cancer

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2
Q

What are the most common cancers associated with Hypercalcaemia? (4 things)

A
  1. Breast cancer
  2. Lung cancer (squamous cell carcinoma)
  3. Multiple myeloma
  4. Lymphoma
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3
Q

What are the main mechanisms of Hypercalcaemia? (3 things)

A
  1. Osteolytic metastasis
  2. PTH-related prot secretion
  3. Increased 1,25-dihydroxyvitamin D prod
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4
Q

What is the cancer that Osteolytic metastasis is most assoc w?

A

Breast cancer

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5
Q

How does Osteolytic metastasis cause Hypercalcaemia? (4 steps)

A
  1. Tumour cells deposited within bone
  2. Local prod of inflamm cytokines
  3. Stimulates cytokines
  4. Bone resorption
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6
Q

What is PTHrP? (2 points)

A
  1. Protein secreted by tumour cells
  2. Similar to PTH
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7
Q

How does PTHrP cause Hypercalcaemia? (3 things)

A

Similar to PTH, it leads to:
1. Increased bone resorption
1. Distal renal tubular calcium absorption
1. Inhibition of proximal phosphate transport

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8
Q

How is PTHrP different to PTH?

A

Doesn’t lead to vit D activation

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9
Q

What cancers is PTH-related prot secretion commonly assoc with? (2 things)

A
  1. Breast cancer
  2. Non-Hodgkins lymphoma
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10
Q

How does Increased 1,25-dihydroxyvitamin D prod cause Hypercalcaemia?

A

Causes increased absorption of Ca from GI enterocytes

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11
Q

What cancer is Increased 1,25-dihydroxyvitamin D prod commonly assoc with?

A

Hodgkins Lymphoma

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12
Q

What are the CF of MILD hypercalcaemia? (5 things)

A
  1. Asymptomatic (common)
  2. Polyuria
  3. Polydipsia
  4. Mild cog imp
  5. Dyspepsia
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13
Q

What are the CF of MODERATE hypercalcaemia? (5 things)

A
  1. All mild CF
  2. Nausea
  3. Dehydration
  4. Weakness
  5. Constipation
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14
Q

What are the CF of SEVERE hypercalcaemia? (6 things)

A
  1. All mild + moderate CF
  2. Coma
  3. Vomiting
  4. Cardiac dysrhythmias
  5. Pancreatitis
  6. Abd pain
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15
Q

What is the Dx of Malignant hypercalcaemia based on? (2 things)

A
  1. Serum calcium level 2.6+
  2. Identifying underlying cancer
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16
Q

What is the difference in the Hypercalcaemia of Cancer vs Benign causes?

A
  • Cancer = RAPID increase in Ca levels
  • Benign = Slower + more asymptomatic
17
Q

How do you differentiate between Malignant Hypercalcaemia vs Primary Hyperparathyroidism?

A

Malignant hypercalcaemia = PTH suppressed

18
Q

What are the Mx options for Malignant hypercalcaemia? (3 things)

A
  1. IV fluids (most important)
  2. Calcitonin
  3. Bisphosphonates
19
Q

How does Calcitonin work in Mx of Malignant hypercalcaemia? (2 things)

A
  1. Promotes urinary calcium excretion
  2. Inhibits bone resorption
20
Q

How do Bisphosphonates work in Mx of Malignant hypercalcaemia? (2 steps)

A
  1. They are absorbed onto surface of bony network
  2. Inhibit osteoclast activity

Y4 Cancer Care (17 decks)

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