Hypercalcemia

EKG

Tall, possible peaked T-waves, Short QT interval, Possible P-wave disappearance, Heart block, Bradyarrhythmia

Consistent with hypercalcemia

Confirm serum calcium with ionized Ca

Elevated serum Calcium

iPTH

Low iPTH

Measure PTHrP

Elevated

Hypercalcemia of malignancy: Squamous cell carcinomas, Adenocarcinoma of the lung, pancreas, kidney, Breast cancer, Thyroid cancer, Leukemia, Plasma cell myeloma, Hodgkin disease

Normal

Measure 1, 25 (OH)2 vitamin D

Elevated

Likely ddx: lymphoma, granulomatous disease

Low/Normal

Measure 25 (OH) vitamin D

Elevated

Ddx: Vitamin D intoxication

Low/Normal

Ddx: multiple myeloma, medication reaction

Mid-upper Normal iPTH

Ddx: FFH

Elevated iPTH

Ddx: Primary hyperparathryoidism

Normal

No hypercalcemia