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Hypercalcemia

Symptoms: Skeletal: Bone pain Loss of height Bowing of the shoulders Spinal column curvature Pathological fractures Kidney: Flank pain Frequent urination Frequent thirst Abdominal: Pain Nausea and/or vomiting Poor appetite Constipation Psychological: Irritability Memory loss Apathy Depression Dementia Coma Muscular: Weakness Muscle twitches Muscle atrophy Signs and tests: High serum total and/or ionized calcium High serum PTH level (hyperparathyroidism) High urine calcium (hyperparathyroidism, other causes) Low urine calcium (FHH) High vitamin D level (hypervitaminosis D, granulomatous diseases) High serum PTHrP (certain cancers) References: Text Continues Below Taniegra ED. Hyperparathyroidism. Am Fam Physician. 2004; 69(2): 333-9. Carroll MF. A practical approach to hypercalcemia. Am Fam Physician. 2003; 67(9): 959-66. Ariyan CE. Assessment and management of patients with abnormal calcium. Crit Care Med. 2004; 32(4 Suppl): S146-54.

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