[24] Hypercalcaemia Flashcards
What is the most common metabolic disorder associated with malignancy?
Hypercalcaemia
What proportion of cancer patients are affected by hypercalcaemia at some point in their disease course?
1/3
What malignancies are most commonly associated with hypercalcaemia?
- Lung
- Breast
- Renal
- Multiple myeloma
- Adult T-cell lymphoma
What is the relevance of hypercalcaemia on prognosis?
It is a poor prognostic indicator in malignant disease, and may indicate uncontrolled tumour progress and metastasis
What is the 30-day mortality rate for cancer patients admitted to hospital with hypercalcaemia?
Almost 50%
What might the symptoms of hypercalcaemia mimic?
The features of terminal malignancy
What is the result of the symptoms of hypercalcaemia mimicing the features of terminal malignancy?
It can be difficult to identify
What is the problem with the symptoms of hypercalcaemia being difficult to identify?
Delayed recognition can worsen morbidity and mortality
What are some presenting features of hypercalcaemia?
- Nausea and vomiting
- Anorexia
- Thirst and polydipsia
- Polyuria
- Lethargy
- Bone pain
- Abdominal pain
- Constipation
- Confusion
- Weakness
At what level does hypercalcaemia become symptomatic?
There is no absolute level of calcium at which patients become symptomatic
What is usually more significant than the absolute level of calcium, with respect to the development of symptoms in hypercalcaemia?
The rate of increase
What investigations are done in hypercalcaemia?
- Ionised calcium
- Alkaline phosphatase
- Renal function and electrolytes
- X-rays
- Bone scan
What is the most reliable laboratory test for hypercalcaemia?
Ionised calcium
What must be done if total calcium is used to measure hypercalcaemia?
Must calculate the corrected calcium level to allow for hypoalbuminaemia
What might x-rays show in hypercalcaemia?
Lytic or sclerotic lesions of bone
