Hypercalcemia

Question 1

What effects does hypercalcemia have on the kidneys?

Answer 1

(Induces nephrogenic diabetes insipidus by impairing ADH binding, increases medullary blood flow (subsequently decreasing the medullary concentration gradient), induces renal arteriolar vasoconstriction (decreased kidney perfusion), and can lead to renal mineralization)

Question 2

What clinical signs can be associated with hypercalcemia?

Answer 2

(PU/PD, anorexia/hyporexia, lethargy, weakness, cardiac arrhythmias, and seizures/muscle twitching; but typically the clinical signs of the underlying disease causing the hypercalcemia are more apparent)

Question 3

(T/F) PTHrp is always abnormal if there is cancer present in the body.

Answer 3

(F, can be normal and still have cancer somewhere)

Question 4

Why can hyperparathyroidism be removed from the differential list for a hypercalcemic patient if their PTH is low?

Answer 4

(Bc if there is a shit ton of calcium in the blood, that should have negative feedback on the parathyroid gland = low PTH, if the parathyroid gland weren’t working appropriately, then you wouldn’t have a low PTH)

Question 5

What type of diuretics should be avoided in cases of hypercalcemia because they cause absorption of calcium?

Answer 5

(Thiazides)