S2D: The Symptom to Diagnosis Podcast Hypercalcemia
Aug 9, 2021
A clinical case about an older patient with constipation leads into a compact guide to causes of high calcium. Listeners get a clear framework: PTH-related vs malignancy vs vitamin D and other causes. Practical points cover when surgery is warranted, pitfalls like milk-alkali and thiazide effects, and acute management steps for dangerous hypercalcemia.
AI Snips
Chapters
Books
Transcript
Episode notes
Check PTH Immediately For Elevated Calcium
- Do check PTH when you find an elevated calcium because primary hyperparathyroidism is the most common outpatient cause.
- Ask about supplements, thiazides, prior stones, osteoporosis, and duration to distinguish secondary causes and medication effects.
Framework For Hypercalcemia Etiologies
- Organize hypercalcemia causes into PTH-related, malignancy, vitamin D–related, and other categories to simplify reasoning.
- In outpatients with normal creatinine and elevated PTH, primary hyperparathyroidism will explain most findings.
Operate Only With Clear Indications
- Do not reflexively operate on every primary hyperparathyroidism patient; weigh symptoms, osteoporosis, nephrocalcinosis, age <50, and calcium >11.2 as indications.
- Use bone density and renal testing to guide decision-making rather than default surgery.
