SAQ 118 – Metabolic – hypercalcaemia with renal impairment

A 65 year old woman with a history of osteoporosis and depression presents with two weeks of increasing confusion and malaise.

Her observations are BP 130/85 mmHg, HR 100/min, temperature 36 C, and GCS 13.

Initial blood results are shown below.

Initial blood results

Test	Result	Units	Reference range
Na+	144	mmol/L	134-146
K+	4.2	mmol/L	3.4-5
Cl-	98	mmol/L	98-106
HCO3-	38	mmol/L	22-32
Urea	17.2	mmol/L	3-8
Creatinine	258	micromol/L	45-90
Glucose	5.4	mmol/L	3.5-5.5
Calcium	4.47	mmol/L	2.1-2.5
Phosphate	0.92	mmol/L	0.75-1.4
Albumin	40	g/L	35-50

Provide one calculation to help you interpret these results.

(Marked out of 1.0)

/ 1

List three significant abnormal findings in these results.

(Marked out of 3.0)

/ 3

List four likely differential diagnoses for this presentation.

(Marked out of 4.0)

/ 4

Complete the following table demonstrating two key treatment tasks. How would you achieve each of these tasks?

(Marked out of 4.0)

Key treatment task	How will you achieve it?
1.
2.

/ 4

Total Score: 0 / 12

Percentage: 0%