HyperCa

Question 0

Acute hypercalcemia with low PTH?

Answer 0

Malignancy – PTHrP

Question 1

Causes of acute hypercalcemia with a high PTH?

Answer 1

Primary hyperparathyroidism, MEN

Question 2

Chronic hypercalcemia with low PTH?

Answer 2

Granulomatous disease, immobilization

genetic: familial hypocalciuric hypercalcemia

OD: milk-alkali syndrome, vitamin D intoxication

Drugs: thiazides, Li

endo: adrenal insufficiency hyperthyroidism

Question 3

Patient with hypercalcemia, hypophosphatemia, elevated PTH? Treatment?

Answer 3

Primary hyperparathyroidism. Medical therapy or surgery

Question 4

Lithium presents like?

Answer 4

Primary hyperparathyroidism

Question 5

Treatment of malignancy related hypercalcemia?

Answer 5

1. Tumor treatment
2. Bisphosphonates
3. Calcitonin

Question 6

Low PTH levels and elevated 1, 25 vitamin D levels? Treatment?

Answer 6

Sarcoidosis. Avoid sunlight, decrease vitamin D and calcium intake, glucocorticoids

Question 7

Mechanism of hypercalcemia in sarcoidosis?

Answer 7

Excess 1, 25 vitamin D synthesized in macrophages and lymphocytes

Question 8

Low PTH levels, elevated 25 vitamin D, normal 1, 25 vitamin D. Tx?

Answer 8

Excessive vitamin D intake. Glucocorticoids

Question 9

Acute treatments of hypercalcemia?

Answer 9

1. Hydration plus diuretic
2. Calcitonin
3. Dialysis

Question 10

Subacute treatment for hypercalcemia?

Answer 10

Bisphosphonate

Question 11

Long-term treatment for hypercalcemia?

Answer 11

Glucocorticoids

Question 12

Symptoms of Hypercalcemia <12

Answer 12

Polyurea and dehydration

Question 13

Symptoms of hypercalcemia >13

Answer 13

1. Neuro: (lethargy, stupor, coma)
2. G.I. (anorexia, nausea, constipation, ulcers)
3. Kidney (polyurea, nephrolithiasis, prerenal azotemia)
4. Musculoskeletal (arthralgias, myalgias, weakness)

Question 14

Indications for parathyroid surgery?

Answer 14

Hypercalcemia >15

Age <-2.5

Question 30

Patient presenting with acute onset of symptomatic hypocalcemia likely has?

Answer 30

Malignancy (multiple myeloma, Lymphoma leukemia, or breast, lung or kidney cancer)