Hypercalcemia of malignancy

Question 1

Which cancers is hypercalcemia more common in

Answer 1

multiple myeloma, breast, lung, kidney, head and neck, lymphoma

Question 2

What to consider in a cancer patient that presents with confusion

Answer 2

Hypercalcemia
Brain metastases
Metabolic disturbance

Question 3

What can hypercalcemia in malignancy be caused by

Answer 3

Tumour production PTH related proetin = true paraneoplastic syndrome
Bony metastases

Question 4

What is PTH-rP

Answer 4

parathyroid hormone related protein
10 x potent than PTH
Produced by tumours -> paraneoplastic syndrome

Question 5

Clinical presentation of hypercalcemia

Answer 5

Rapid onset nausea
Polyuria
Polydipsia
Dehydration
Cardiac arrhyhtmias

Question 6

Biochemical levels in hypercalcemia of malignanyc

Answer 6

Serum Ca2+ >2.7
Serum chloride low
Hypercaluria
High urinary phosphate
Low or undetectable plasma parathyroid hormone

Question 7

Treatment for hypercalcemia of malignancy

Answer 7

IV saline and bisphosphonate