Calcium 2

Question 1

What are the cancers associated with hypercalcaemia?

Answer 1

Solid tumour secreting parathyroid hormone-related petide - carcinoma of the bronchus

Multiple skeletal metastases - advanced breast cancer

Bone marrow malignancy - secretion of cytokines stimulating bone reabsorption - multiple myeloma.

Question 2

What is osteomalacia and causes?

Answer 2

Failure of the bone to mineralise - characterised by the accumulation of unmineralised osteoid. Usually caused by vitamin D or Ca deficiency.

Calciopenic - low dietry Ca
Malabsorption of Ca
Disordered Vitamin D metabolism
Inadequate sun exposure
Impaired 1 alpha hydroxylase

Phosphopenic - low vitamin D levels
increased renal phosphate loss (phosphotonins increase [PHEX mutation])
Poor phosphate absorption

Osteoblast dysfunction - aluminium

Question 3

What is the treatment for ADHH?

Answer 3

No treatment if asymptomatic
Treatment can cause the urine Ca levels to be toxic causing renal damage
Small dose of vitamin D if recurrent symptoms.