Hypercalcemia Lecture Notes

Introduction

Functions:
- Bone and teeth health
- Muscle and nerve function
- Cell function and blood clotting
Absorption and Excretion:
- Absorbed in the GI system
- Stored in bones
- Excreted by kidneys
Vitamin D: Helps in absorption of calcium
Phosphorus Relationship: Inversely related to calcium
- When phosphorus increases, calcium decreases and vice versa

Mnemonic: "HI CAL"
- H: Hyperparathyroidism
- I: Increased intake of calcium/vitamin D
- G: Glucocorticoids suppress calcium absorption
- H: Hyperthyroidism
- C: Calcium excretion decreased (thiazide diuretics, renal failure, bone cancer)
- A: Adrenal insufficiency (Addison's disease)
- L: Lithium usage

Mnemonic: "The body is too WEAK"
- W: Weakness of muscles
- E: EKG changes (shortened QT interval)
- A: Absent reflexes, disorientation, abdominal distension
- K: Kidney stone formation

Hydration: Prevent kidney stones
Safety: Prevent falls and fractures
Monitoring:
- Cardiac, GI, renal, and neuro status
- EKG for shortened QT intervals
- Flank or abdominal pain for kidney stones
Dietary Changes:
- Reduce calcium-rich foods (use mnemonic: "Young Sally's Calcium Serum Continues To Randomly Mess Up")
  - Yogurt, Sardines, Cheese, Spinach, Collard greens, Tofu, Rhubarb, Milk
Medication Adjustments:
- Consider stopping thiazide diuretics, calcium supplements, vitamin D
Moderate Cases:
- Drugs: Calcitonin, bisphosphonates, prostaglandin synthesis inhibitors
Severe Cases:
- Dialysis