Q: 54 year old female is transferred to ICU from oncology floor with coma which requires intubation. Labs send 2 hours ago showed calcium of 18.4 mg/dL. What should be the next step (Best answer)
A) Intravenous fluid (IVF)
B) intravenous fluid with Furosemide
C) Hemodialysis
D) Intravenous Bisphosphonate
E) Zoledronic acid
Answer: C
Hemodialysis(HD) rarely gets mentioned as treatment for life threatening hypercalcemia but once calcium level cross 18 mg/dL with obvious clinical signs, HD becomes an absolute indication. IVF, IV Bisphosphonates or Zoledronic acid are all valid treatments of hypercalcemia but in extreme situation, HD is indicated.
A) Intravenous fluid (IVF)
B) intravenous fluid with Furosemide
C) Hemodialysis
D) Intravenous Bisphosphonate
E) Zoledronic acid
Answer: C
Hemodialysis(HD) rarely gets mentioned as treatment for life threatening hypercalcemia but once calcium level cross 18 mg/dL with obvious clinical signs, HD becomes an absolute indication. IVF, IV Bisphosphonates or Zoledronic acid are all valid treatments of hypercalcemia but in extreme situation, HD is indicated.
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