This is the podcast surgery ice rounds.

My name is Dr. Jeffrey Guy.

I'm an associate professor of surgery and director of the Byrne Center at Vanderbilt University School of Medicine.

The topic that I'd like to talk about today is that of hypercalcemia.

We had this, came up in a discussion recently, and it is something that you typically will see

on board exams, in-service exams

and so even though it's high

or potentially malignant levels of hypercalcemia

is not something we see commonly

it's something that you need to be aware of

what it is and how it manifests and what is the appropriate

treatment for it.

Just as a general rundown, hypercalcemia is really defined as an ionized calcium of greater

than 10.5 milligrams per decilator.

It will often manifest itself with an altered metal status with confusion, lethargy,

psychosis, and even coma. Patients will often be hyporeflexic and will have muscle weakness.

Other symptoms would include constipation, shortening of the QT interval. That's not something we're

often talking about. We're often talking about prolongation of the QT interval, as well as pancreatitis.

Now, patients who have chronic hypercalcemia, they could also have things like bone changes

and something called ban keratopathy, not something that we typically would see in an

intensive care unit, and patients may have underlying disease such as hyperparathoridism, but probably more commonly

something like malignancy, particularly in a surgical ICU, other conditions that can cause

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