MRCP Q 356

Which of the following is not typically a cause of hypercalcaemia?

1. Hyperparathyroidism
2. Hypothyroidism
3. Milk-alkali syndrome
4. Sarcoid
5. Squamous-cell carcinoma

Correct Answer 2

Hypothyroidism Two of commonest causes of hypercalcaemia in the western world are primary hyperparathyroidism and malignancy. In primary hyperparathyroidism there is excess production of parathyroid hormone (PTH); although usually from a benign adenoma, this sometimes results from hyperplasia of the parathyroid glands and, in rare cases, a carcinoma. Thyrotoxicosis can cause hypercalcaemia as well as osteoporosis. The milk-alkali syndrome can occur in patients who suffer from dyspepsia and drink milk and alkalicontaining antacids, which reduce the renal excretion of calcium. Around one-fifth of those with sarcoid have increased calcium levels. Various mechanisms cause raised hypercalcaemia of malignancy.

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