Page 40 - Demo

MCQ 2: HypercalcemiaA 70-year-old man with advanced prostate cancer presents with confusion, constipation, and polyuria. His serum calcium is 2.9 mmol/L. What is the most appropriate initial management?A. Oral calcium supplementsB. IV fluids and IV bisphosphonateC. Oral bisphosphonate onlyD. Calcitonin injectionE. Urgent hemodialysisAnswer: IV fluids and IV bisphosphonateExplanation: The patient's symptoms and elevated serum calcium indicate hypercalcemia, a common complication in advanced cancer. The initial management involves IV fluid rehydration to promote calcium excretion, coupled with IV bisphosphonates to inhibit bone resorption. This combination rapidly lowers serum calcium and alleviates symptoms. Oral treatments are less effective in acute, symptomatic hypercalcemia. Calcitonin, while fast-acting, is short-lived and not first-line. Hemodialysis is reserved for severe, refractory cases.