Hypercalcemia of Malignancy

Question 1

Hypercalcemia of malignancy is most common in what tumor types? (2)

Answer 1

lung; breast

Question 2

What are some non-malignancy related causes of HCM?

Answer 2

hyperparathyroidism; medications; renal failure

Question 3

What is the most common way HCM presents in terms of pathophysiology?

Answer 3

increased parathyroid hormone related protein (PTHrP)

Question 4

What is the most common type of HCM?

Answer 4

humoral

Question 5

What is the equation for corrected calcium?

Answer 5

serum calcium + 0.8 (4 - serum albumin)

Question 6

What is the cutoff for mild hypercalcemia?

Answer 6

< 12 mg/dL

Question 7

What is the cutoff for moderate hypercalcemia?

Answer 7

12-14 mg/dL

Question 8

What is the cutoff for severe hypercalcemia?

Answer 8

> 12 mg/dL

Question 9

What is the mainstay of treatment in hypercalcemia?

Answer 9

hydration

Question 10

Why do you not need to make renal dose adjustments in patients with HCM?

Answer 10

most patients will have renal dysfunction due to the elevated calcium so you need to get the calcium under control before worrying about renal function

Question 11

What bisphonates are used in treatment of HCM? (2)

Answer 11

pamidronate; zolendronic acid

Question 12

What treatment is used in mild asymptomatic HCM?

Answer 12

hydration

Question 13

What treatment is used in mild symptomatic HCM? (2)

Answer 13

hydration; bisphosphonates

Question 14

What treatment is used in moderate HCM?

Answer 14

hydration; bisphosphonates

Question 15

What treatment is used in severe HCM?

Answer 15

hydration; bisphosphonates; calcitonin

Question 16

What treatment options are there for refractory HCM? (3)

Answer 16

phosphates; gallium nitrate; denosumab

Question 17

What treatment options are available for chronic HCM management? (2)

Answer 17

zolendronic acid; pamidronate