Hypercalcaemia of malignancy Flashcards
1
Q
Causes of hypercalcaemia in malignancy
A
PTHrP from the tumour e.g. squamous cell lung cancer
Bone metastases
Myeloma; due primarily to increased osteoclastic bone resorption caused by local cytokines
2
Q
Other causes of hypercalcaemia
A
Primary hyperparathyroidism
Sarcoidosis
Vitamin D intoxication
Acromegaly
Thyrotoxicosis
Milk-alkali syndrome
Thiazides
Dehydration
Addison’s disease
3
Q
Clinical features of hypercalcaemia
A
Bone, stones, groans, psychic moans
Corneal calcification
HTN
4
Q
ECG in hypercalcaemia
A
Shortened QT interval
5
Q
Initial management
A
Rehydration with normal saline (3-4L/day)
Following rehydration bisphosphonates may be used (take 2-3 days to work)
6
Q
Other treatment options
A
Calcitonin (quicker effect than bisphosphonates)
Steroids in sarcoidosis
