A 70-year-old male presented with severe confusion, shoness of breath and obtundation. Patient was stable. Lab findings revealed, Serum calcium - Moderately raised Serum creatinine- Mildly raised BUN- Mildly raised PTH- normal PTHrP - Elevated Chest x-ray All of the following drugs can be given for the treatment of hypercalcemia except: -
The chest x-ray is suggestive of metastatic deposits, meaning it is a case of HHM (Humoral hypercalcemia of malignancy) Seen in cancers of: - Lung Head and neck Skin Esophagus Breast Most common cause - Overproduction of parathormone related peptide. Management: - Saline rehydration Forced diuresis with furosemide Oral phosphorous Bisphosphonate infusions Calcitonin Indication of steroids in hypercalcemia: - Lymphomas Multiple myeloma Leukemia
Calcitonin
Furosemide
Normal Saline
Prednisolone
Integrated QBank