USMLE/COMLEX - Step 2 - Hypercalcemia

USMLE/COMLEX - Step 2 - Hypercalcemia The pathophysiology of hypercalcemia involves a complex interplay between the parathyroid glands, bones, kidneys, and gut. PTH is the primary regulator of calcium homeostasis, and it acts on these organs to maintain normal serum calcium levels. Therefore, when serum calcium levels rise, PTH secretion decreases, leading to a reduction in bone resorption and an increase in calcium excretion in the urine. Conversely, when serum calcium levels fall, PTH secretion increases, leading to an increase in bone resorption and a decrease in calcium excretion in the urine. In hypercalcemia, the underlying cause disrupts this delicate balance, leading to excess calcium in the blood. Fatigue Abdominal pain Bone pain Kidney stones Excessive thirst and urination Confusion, memory loss, depression, irritability Bone pain and tenderness Abdominal pain Kidney stones Excessive thirst and urination Confusion and altered mental status Cardiac arrhythmias Serum calcium test Parathyroid hormone test 25-hydroxyvitamin D test Urine calcium test X-rays, bone scans, CT scans, or MRI scans Kidney function tests Liver function tests Electrolyte tests Complete blood count test Treating hypercalcemia involves a range of strategies tailored to the underlying cause and severity of the condition. General treatment strategies may include rehydration with intravenous fluids, medications to reduce bone resorption and lower calcium levels, surgery in some cases, treating underlying conditions, dietary changes, and regular monitoring.