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Flashcards in Hypercalcaemia Deck (21)
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1

What is the most common metabolic disorder associated with malignancy?

Hypercalcaemia

2

What proportion of cancer patients are affected by hypercalcaemia at some point in their disease course?

1/3

3

What malignancies are most commonly associated with hypercalcaemia?

- Lung
- Breast
- Renal
- Multiple myeloma
- Adult T-cell lymphoma

4

What is the relevance of hypercalcaemia on prognosis?

It is a poor prognostic indicator in malignant disease, and may indicate uncontrolled tumour progress and metastasis

5

What is the 30-day mortality rate for cancer patients admitted to hospital with hypercalcaemia?

Almost 50%

6

What might the symptoms of hypercalcaemia mimic?

The features of terminal malignancy

7

What is the result of the symptoms of hypercalcaemia mimicing the features of terminal malignancy?

It can be difficult to identify

8

What is the problem with the symptoms of hypercalcaemia being difficult to identify?

Delayed recognition can worsen morbidity and mortality

9

What are some presenting features of hypercalcaemia?

- Nausea and vomiting
- Anorexia
- Thirst and polydipsia
- Polyuria
- Lethargy
- Bone pain
- Abdominal pain
- Constipation
- Confusion
- Weakness

10

At what level does hypercalcaemia become symptomatic?

There is no absolute level of calcium at which patients become symptomatic

11

What is usually more significant than the absolute level of calcium, with respect to the development of symptoms in hypercalcaemia?

The rate of increase

12

What investigations are done in hypercalcaemia?

- Ionised calcium
- Alkaline phosphatase
- Renal function and electrolytes
- X-rays
- Bone scan

13

What is the most reliable laboratory test for hypercalcaemia?

Ionised calcium

14

What must be done if total calcium is used to measure hypercalcaemia?

Must calculate the corrected calcium level to allow for hypoalbuminaemia

15

What might x-rays show in hypercalcaemia?

Lytic or sclerotic lesions of bone

16

What is the purpose of bone scans in hypercalcaemia?

Identify any metastasis

17

What does the management of hypercalcaemia involve?

- Intensive rehydration
- IV bisphosphonates

18

Give an example of a bisphosphonate

Pamidronate

19

What should be considered when managing hypercalcaemia?

If it is appropriate to treat hypercalcaemia

20

When may it not be appropriate to treat hypercalcaemia?

If the patient is receiving care for the last few days of life

21

Is there palliative benefit in treating hypercalcaemia?

There may be palliative benefit from improving the symptoms of hypercalcaemia, even in patients with advanced malignancies