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Case #4 -
A 60 year old with hypercalcemia

DISCUSSION QUESTIONS:
1.) What are the causes of hypercalcemia?  Answer 
2.) To decide on the cause in this patient, what additional history is needed?  Answer 
3.) What are the clinical manifestations of primary hyperparathyroidism?  Answer 
4.) What are the various regulators of calcium metabolism in the body and how do they work?  Answer 
5.) What workup will you do to confirm the diagnosis of primary hyperparathyroidism?  Answer 
6.) What is the underlying pathology in primary hyperparathyroidism?  Answer 
7.) What imaging studies may be done preoperatively to direct the surgeon to the abnormal gland or glands?  Answer 
8.) Is there a way to know intraoperatively if all of the abnormal gland/glands have been removed?  Answer 
9.) What are the risks of parathyroidectomy?  Answer 
10.) What are the symptoms in hypercalcemic crisis?  Answer 
11.) How do you treat hypercalcemic crisis?  Answer 
 
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