Hypercalcemia Clinical Overview

A set of vocabulary flashcards detailing the etiologies, clinical manifestations, regulatory mechanisms, and therapeutic interventions for hypercalcemia as presented in the lecture notes.

Primary hyperparathyroidism

A principal cause of hypercalcemia involving overactivity of the parathyroid glands.

Carcinoma causes of Hypercalcemia

Includes lung cancer, breast cancer, multiple myeloma, renal cell carcinoma, leukemia, lymphoma, and rhabdomyosarcoma.

Thiazide diuretics

A class of medications, such as hydrochlorothiazide, that can lead to hypercalcemia.

Lithium

A medication identified as a potential cause for elevated blood calcium levels.

Hypophosphatemia

A condition of low phosphate levels in the blood that serves as a cause for hypercalcemia.

Paget's disease

A bone disorder listed as a potential cause for hypercalcemia.

Hypercalcemia Symptom Mnemonic

Painful bones, Renal stones, Abdominal groans, Sitting on the throne (polyuria, constipation), and Psychiatric overtones (depression).

Polydipsia and Polyuria

Significant signs of hypercalcemia characterized by the need to drink more fluids and frequent urination (‘sitting on the throne’).

Calcitonin

A hormone released by the Thyroid Gland when blood calcium levels rise above a set point to lower those levels.

Parathyroid Hormone (PTH)

A hormone released by the Parathyroid Glands when blood calcium levels fall below a set point to raise those levels.

Inverse Relationship of Calcium and Phosphate

The physiological principle that as blood calcium levels rise, phosphate levels fall.

Investigations for Hypercalcemia

Diagnostic steps including blood tests for $Ca$, $Mg$, $P$, PTH, ECU, and PTH-related protein, as well as chest X-rays and bone scans.

Complications of Hypercalcemia

Clinical risks such as osteoporosis, kidney stones, kidney failure, nervous system problems (confusion, dementia, coma), and abnormal heart rhythm (arrhythmia).

calcitonin

one of medication for hypercalcemia that helps lower calcium levels by inhibiting osteoclast activity and promoting renal excretion of calcium.

Calcimimetics

A treatment used to control overactive parathyroid glands.

Bisphosphonates

Medications used to increase bone density; they have strong gastrointestinal irritation when taken orally and cannot be used if renal function is insufficient.

Denosumab (Prolia, Xgeva)

A treatment for cancer-caused hypercalcemia used when patients do not respond well to bisphosphonates.

Prednisone

A treatment used for hypercalcemia when the underlying cause is an excessive intake of Vitamin D.

iv fluid and diuretics

Common treatments for managing acute hypercalcemia by promoting urinary excretion of calcium and restoring fluid balance.

treatment for hypercalciumia

情况	首选治疗
Mild / Moderate hypercalcaemia（稳定）	✅ IV 0.9% NaCl
补液后仍持续高钙	➜ IV bisphosphonate
Hypercalcaemic crisis（重症）	➜ IV saline + Calcitonin ± Bisphosphonate
Severe renal failure / 无法补液	➜ Haemodialysis
Vitamin D intoxication / Sarcoidosis	➜ Glucocorticoids