Clinical features

Ask about

• known malignancy ^c  
• symptoms of hypercalcaemia e.g. lethargy or polyuria
• endocrine disorders

• which may exacerbate hypercalcaemia (e.g. thiazides, vitamin D)
• which may be more toxic (e.g. digoxin) ^d

• dehydration
• polyuria
• gastrointestinal symptoms (nausea, vomiting, constipation)
• confusion and psychiatric symptoms

Why?

Many cases of hypercalcaemia are asymptomatic

Clinical features of hypercalcaemia c	%
asymptomatic	51%
confusion and dehydration	14%
symptoms of hypercalcaemia (lethargy, polyuria)	8%
renal (stones or decreased function)	7%
hypertension	5%
psychiatric disorder	5%
GI symptoms	4-8%
bone disease	0%