Get this App offline and editable on your phone

iPhone & iPad | Android | PC | Mac

Hypercalcemia

  • Criteria

    • Ca > 10.5 or iCal > 2.7
  • Sx

    • stones, bones, psychic moans, abdominal groans when Ca > 12
  • Labs

    • BMP, PTH, Vit D
  • Tx

    • first line: NS and fuorsemide 40mg
    • second line: calcitonin 0.5-4 MRC U/kg IV over 24h and hydrocortisone 25-100mg IV q6h
  • Ddx

    • hyperparathyroidism (PTH > 81)
      • parathyroid adenoma
      • lithium
      • MEN1 (pituitary, pancreas)
      • MEN2A (medullary thyroid, pheo)
      • FHH (low urine Ca)
      • McCune albright (precocious, unilateral cafe-au-lait)
      • osteitis fibrosa cystica (bone lesions)
    • increased Vit D (PTH < 81, high Vit D)
      • vit D overdose
      • sarcoidosis
      • recovery from rhabdomyolysis
    • bone turnover (PTH < 81, normal Vit D)
      • malignancy (PTHrp)
      • Paget's disease (bone pain, hearing loss)
      • MM
      • prolonged immobilization
      • hyperthyroidism (TSH)
    • other
      • thiazide diuretic
      • milk-alkali syndrome (milk, antacids and poor renal fx, alkalosis)
      • hyperalbuminemia (albumin > 5.2)
      • adrenal insufficiency

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.