Hypercalcaemia EMQ

Lindsay Hennah

CID: 00508302

Option List:

A. Primary hyperparathyroidism	G. FHH (familial hypercalciuric hypercalcaemia)
B. Multiple myeloma	H. Sarcoidosis
C. Drug toxicity	I. Bony metastases
D. Chronic kidney disease	J. Paget’s Disease
E. Adenoma	K. Renal stones
F. Vitamin D deficiency	L. Normal

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

1. A 54 year old lady with a new diagnosis of bipolar disorder has some routine bloods done at her GP which show a calcium level of 2.65.

2. A 32 year old lady presents with SOB and a rash on her shins. Her calcium level and active vitamin D levels are above normal.

3. A 23 year old is found to have hypercalcaemia after a routine check-up, but is asymptomatic. On further investigation, the PTH level is normal and the urine calcium level is low.

4. A 12 year old comes with her mother, complaining of increased thirst and going to the loo more than normal. Her calcium level is 2.62, and on further questioning, you find out that she has just had a cast removed after she broke her leg skiing.

5. A 79 year old man presents to A&E with a three week history of pains in his left arm and right thigh. He appears cachectic and confused. Investigations reveal a calcium level of 3.21. FBC reveals a normocytic and normochromic anaemia and a raised ESR.

Answers:

1C (lithium toxicity)

4L (period of immobility due to fracture)