HYPERCALCAEMIA

Question 1

WHAT IS HYPERCALCAEMIA?

Answer 1

• high serum calcium > 2.6 mmol/L

Question 2

WHAT ARE THE COMMONEST CAUSE OF HYPERCALCAEMIA?

Answer 2

• primary hyperparathyroidism and malignancy

Question 3

WHAT IS THE HALLMARK OF HYPERCALCAMEIA WITH MALIGNANCY?

Answer 3

• low PTH

Question 4

WHAT IS THE HALLMARK OF PRIMARY HYPERPARATHYROIDISM?

Answer 4

• normal/ high PTH

Question 5

WHAT SHOULD BE CONSIDERED IN HYPERCALCAEMIA WITH SUPPRESSED PTH?

Answer 5

• malignancy until proven otherwise

Question 6

WHAT SHOULD BE CONSIDERED WITH HYPERCALCAEMIA WITH NON SUPPRESSED PTH?

Answer 6

• primary hyperparathyroidism until proven otherwise

Question 7

WHAT IS A CAUSE OF HYPERPARATHYRODISM?

Answer 7

• single parathyroid adenoma

Question 8

WHAT IS THE CLINICAL FEATURES OF HYPERCALCAEMIA?

Answer 8

1) often asymptomatic
2) tiredness
3) generalised aches
4) polyuria
5) polydipsia (nephrogenic diabetes insipidus)
6) kidney stones
7) abdominal pain
8) constipation

Question 9

WHAT IS THE TREATMENT OF HYPERCALCAEMIA?

Answer 9

1) surgery (parathyroidectomy) if serum calcium is >2.85 mmol/L or debilitating symptoms
2) calcimimetics (cinacalcet) - effective at lowering calcium in primary hyperparathyroidism

Question 10

HOW DOES ACUTE SEVERE HYPERCALCAEMIA PRESENT?

Answer 10

• profound dehydration

- renal impairment